Updates on Vaginal Hysterectomy

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Here are some recent studies about the route of hysterectomy and their implications for vaginal hysterectomy. Cuff dehiscence rates A new study this month from Finland looked at cuff dehiscence rates from 13,645 hysterectomies. They found the following rates of vaginal cuff dehiscence: Vaginal hysterectomy (VH): 0.05% (n=4150) Abdominal hysterectomy (AH): 0.02% (n=5538) Laparoscopic hysterectomy […]

No, you shouldn’t eat your placenta…

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A small pilot study of the effects of eating the placenta after birth (usually through encapsulation) was published this week. Not surprisingly, the study, published in Women and Birth, an Australian midwifery journal, found that consuming one’s placenta had no effect on maternal mood, maternal fatigue, or maternal-infant bonding, despite the bias of the authors towards […]

Stop Making Me Look Bad, Guys

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It, unfortunately, happens that a physician who works hard to practice evidence-based medicine sometimes appear as an outlier compared to other physicians. In Obstetrics, this is most palpable when patients present who have had care with others doctors in the current or a previous pregnancy. They, naturally, compare what I do to what the other guys did. So, I’m […]

Subchorionic Hematomas, Lakes, and all that Jazz…

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Two things drive me crazy, and a third vexes my soul: Over-diagnosis of subchorionic hematoma; Inappropriate counseling and recommendations regarding subchorionic hematoma; And inappropriate management of placental lakes. Not a week goes by that I don’t see a patient who has presented to an emergency department somewhere, diagnosed with a (questionable) subchorionic hematoma or placental […]

Ten Things I’ve Learned About Maternal Mortality

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I’ve attended two conferences in the last 3 weeks that largely revolved around maternal mortality in the United States. About 700 women each year die in the United States during or around the time they give birth. For those of who practice Obstetrics, we believe that even one is too many. I’ve been reading and […]

Four Tips for Removing a Nexplanon

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Nexplanon removal should be a relatively straightforward and easy procedure. However, there are a few things you can do to make the job even easier. Number four is my favorite. Here are four tips for removing a Nexplanon. 1. Pick the right spot. Move the device by pushing on the distal end to see where […]

The Serena Syndrome

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(Note: I have no personal knowledge of Serena Williams’ pregnancy or the care she received. This article is based on publicly available information only and many details are surmised.) Serena Williams recently had a baby. Apparently, she almost died. Here’s how Serena herself described what happened: I almost died after giving birth to my daughter, […]

Four Tips for Using A Quantitative HCG Test

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Pregnancy tests come in three varieties: a urine qualitative test (it’s either positive or negative), a serum qualitative test (again, either positive or negative), and a serum quantitative test (with a specific numeric result). I see far too many serum quantitative hCGs ordered in clinical practice (by OBs, ER docs, etc.) and this implies that […]