This episode features our favorite podcast ninja, Dr. Maddie White. She and Howard discuss how medical dramatizations misrepresent obstetric emergencies (yes, we are watching The Pitt). Then, we dissect evidence-based approaches to common triage scenarios including labor evaluation, rupture of membranes, and preterm labor assessment.
• Television shows like "The Pitt" and "ER" portray shoulder dystocia and postpartum hemorrhage inaccurately, lacking proper urgency and technique
• Hospital-based labor triage often costs approximately 10 times more than office-based evaluation, often without clinical benefit
• Understanding pretest probability fundamentally changes how test results should be interpreted for suspected rupture of membranes
• Most expensive tests like Amnisure (>$500) provide minimal additional value over traditional approaches when interpreted properly
• Evidence doesn't support routine use of fetal fibronectin testing in preterm labor evaluation
• We discuss universal cervical length screening for prevention of preterm labor in the midtrimester and later in pregnancy for evaluation of threatened preterm labor
00:00:53 Critiquing Obstetric Emergencies in TV Shows
00:10:13 Proper Management of Shoulder Dystocia
00:14:52 Postpartum Hemorrhage Management Approaches
00:19:59 Evaluating Term Labor Complaints
00:25:35 Rupture of Membranes Testing Strategies
00:34:12 Understanding Test Probability and Performance
00:42:26 Cervical Length Screening Evidence
00:51:23 Preterm Labor Triage Tools
01:00:23 Concluding Thoughts on Evidence-Based Practice
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