Discover and read the best of Twitter Threads about #obgyn

Most recents (24)

Do you have an undiagnosed patient despite exome sequencing? 🤔

It could be a repeat expansion disorder.

Here are 5 scenarios that should make you think of a repeat expansion disorder in adults. 🧵

#GeneChat #MedTwitter
A 21 y man with slurred speech who is experiencing difficulty with coordination and balance over the last several years. He fatigues easily.

Diagnosis: Friedreich's ataxia
Genetics: GAA repeat expansion in the 1st intron of FXN
Inheritance: Autosomal recessive

A 25 y woman with hot flashes and irregular menses over the last several months (early menopause).

Diagnosis: Fragile X-associated primary ovarian insufficiency (FXPOI)
Genetics: CGG repeat expansion in the 5' UTR of FMR1
Inheritance: X-linked

Read 7 tweets
Guideline summary for #ED docs on early pregnancy loss/miscarriage:…
10% of all #pregnancies end in #miscarriage, though the rate approaches 80% by maternal age 45yrs.
Half of early pregnancy loss (AKA miscarriages) are due to chromosomal abnormalities. 🧵
Crown-rump length (CRL) 7mm or greater and no heartbeat. Mean sac diameter (MSD) 25mm and no embryo.
Each one is an #ultrasound feature diagnostic of early pregnancy loss.
80% of patients with early pregnancy loss can be safely managed with an expectant management (watch and wait) approach.
Relatively few miscarriages will require ED care; most of these will involve significant and symptomatic haemorrhage or infection.
Read 15 tweets
So I spoke with the Health Care Authority of West Virginia who approves certificates of need in our state. A 🧵 by #folkreporter @folkreporters 1/
I spoke with Timothy Adkins, the interim director of the Certificate of Need program. He clarified the CON program for me, as it pertains to #obgyntwitter in West Virginia. 2/
If an ambulatory care center aka hospital or hospital affiliated clinic exists in your community, that entity DOES NOT need to apply for a CON to add #obgyntwitter care to it's existing facility. 3/
Read 8 tweets
#OBGYN #pregnancy #COVID19 The obstetrician Kimberely Biss out of Florida is quite misguided on her statements in the hallway. One of the simplest rules of research is that you cannot necessarily generalize your personal experience to the whole population.
The actual situation on cervical cancer screening is more complicated than what she discusses - there was a lapse in screening/ diagnosis, which needed to catch up. She implies that COVID vaccines cause cervical cancer - NO, HPV does (in most cases).…
COVID vaccines do not raise the miscarriage rate -…
Miscarriage can be one of the most traumatic experiences ever but even then, systematic analysis is necessary.
Read 6 tweets
SEMINAL ARTICLE re: #ICD11 Chapter 08 - Diseases of the #NervousSystem 🧠

Study Title: The #leptomeninges as a critical organ for normal #CNS development and function: first patient and public involved systematic review of #arachnoiditis (chronic #meningitis). @PLOSONE

#CES- #CaudaEquina Syndrome
#DLM – Diseases of the #Leptomeninges
#ESI- #Epidural Steroid Injection
LM - #Leptomeninges
#LMF- #Leptomeningeal #Fibrosis
#NAA- #neuraxialanesthesia
PSR- PRISMA Systematic Review
#SAH- #Subarachnoid Hemorrhage
#SAS- #Subarachnoid Space

Key Findings:

1. A varyingly described, and poorly characterized #CNS disease called #arachnoiditis (aka #adhesivearachnoiditis) was exhaustively systematically-reviewed for the first time.
Read 27 tweets
#COVID19 is affecting fresh newborns. Delivered a healthy 3 kg full term baby uneventfully. Short labor, no PROM, no distress, clear liquor. Baby had persistent grunting. Shifted to nicu. Xray reveals totally white lungs bilaterally. Echo normal…
Covid antibodies level is 1600 ( normal <1) and IgG is >200 ( normal <17).
Baby is on ventilator and prognosis is grim. Mother has absolutely no symptoms.
Please please, all pregnant ladies, mask up, especially in last trimester. ..
I have already lost 4 babies precisely because of this #COVID19 in newborn. Only one survivor. I am praying for this baby.
#Omicron is dangerous for newborns.
#MedTwitter #Pediatrics #OBGYN
Read 18 tweets
It is with sadness that I share with you all today that I will be closing my specialized family medicine practice in November.

I have been offered a #surgicalabortion role in BC!
Surgical abortion opportunities like this are limited (sometimes more so for family docs) and I knew that I had to take the leap. The Ottawa #OBGYN team was so dedicated to my surgical abortion learning and I want to maintain those skills.

I have training I want to use.
My clinic will continue to accept some referrals as outlined by faxes sent to clinics in the surrounding area. Patients can still self-refer for #contraception, #pap smears, and #abortion care.
Read 11 tweets
1) Pregnancy is a significant sociocultural event in human society.

It marks the sacred connection between one generation and its offspring.

This is what most people think.

Let me tell you why its not --> through the lens of evolutionary medicine.
2) Pregnancy is actually a vicious battle between two partially related genetic entities --> the mother and its fetus.

Neither side shows mercy or takes prisoners.

We will focus on the battle for fuel at the fetomaternal interface in this Tweetorial.
3) First of all --> the physiology.

The pregnant female usually experiences reset homeostasis --> with fasting blood sugar (FBS) gradually falling till the week 12 --> then it stabilizes till term.

But PPBS shows sharper, more sustained rise, along with rising insulin levels!
Read 33 tweets
This just out: Physicians do not logically/correctly estimate the probability of outcomes resulting from sequences of events - a thread. #conjunctionfallacy #probability #medicaldecisionmaking #clinicalreasoning #innumeracy #numeracy… @JAMANetworkOpen
In this article, we showed that physicians estimated the probability of two events both occurring as *more* likely than one or both of the individual events. This is logically impossible and consistent with the #conjunctionfallacy. This #bias can lead to catastrophic outcomes
The impetus for the study was an #OBGYN catastrophe that resulted, in part, from this bias. A woman presented in labor w brow presentation. For successful vaginal delivery, 2 events must happen: reversion to deliverable position, and vaginal delivery w/o #caesareansection
Read 20 tweets

I am a 31 year old trans man. My periods have never been normal. They last way too long, are always way too heavy, and it seems there's a physical barrier keeping the lining from shedding effectively because it is always oxidized and clotted. 1/
I first asked for a hysterectomy when I was 14. Obviously, this was denied. That makes perfect sense. I was put on birth control and they didn't look any further. That birth control caused me to have my period for over a year straight before I gave up. 2/
I asked for a hysterectomy or at least testing again at 21, when I still thought I was a cis woman. I was told that I might change my mind, and what if I found a partner someday that wanted me to have kids? I said "then they aren't going to be my partner." I was denied tests 3/
Read 12 tweets
New publication 🚨 Our RCT + isotope tracing detailing a significant nutrient-nutrient interaction during pregnancy between choline and docosahexaenoic acid (DHA; omega 3) is now online @AJCNutrition. A thread ⬇️… #RDchat #Metabolism #Obgyn #obstetrics
Nice write up of our trial from @NutraUSA!…
Read 3 tweets
Congratulations to all the M4s that #Match2022-ed a couple days ago, including our own @allison_milen!

Did know #ObGyn is leading change in the way the Match is done? Here’s a 🧵 on how! 1/10
Early 1900s: hospitals 🏥 were competing with each other to get the best medical students 🧑‍⚕️, and medical students were competing with each other to get the best internships offers 🤩, which were made via telegram! 2/10
By the 1940s, hospitals would make very early offers to M3 or even M2s! Students had 10 days, sometimes only 12 hours ⏳ , to respond to an offer via phone or telegram without knowing what other offers might come in! 😰 3/10
Read 10 tweets
On the 49th Anniversary of #RoevWade, here are 49 thoughts, facts, and feelings about #abortion. A 🧵

1)Abortion is health care
2)1 in 4 women* will have an abortion in their lifetime…
3)so everyone loves someone who had an abortion
4)60% of people who have an abortion are already parents
5)Banning abortion will not make it go away, it will just make it unsafe
6)More than two-thirds of abortions happen before 8 weeks
7)The phrase “late-term abortion” is not a medical term and does not exist.
8)Abortions save lives. Period. End of story.
9)“Abortion is freedom. It may not be for you, but it may be for someone in your community” @sistersong_WOC
10)The majority of people obtaining abortions identify as Catholic
Read 14 tweets
Thanks to years of #obgyn advocacy and decades of safe use of medication abortion, as of today, many patients will no longer need to risk unnecessary exposure to #COVID19 as a condition of using #mifepristone for abortion care. 1/
From our statement: "Requiring the medicine to be dispensed in person, then taken elsewhere at the patients’ discretion, is arbitrary and does nothing to bolster the safety of an already-safe medicine." 2/
"We are pleased to see mifepristone regulated on... the scientific evidence during the pandemic, rather than political bias against comprehensive reproductive health care, & we look forward to working with policy makers to ensure this principle governs post-pandemic care.” 3/
Read 5 tweets
I don't know who needs to hear this (@joycefr), but AAPLOG is a hate group that violates all 4 core principles of medical ethics and promotes experimentation on humans without consent. Your recent piece is irresponsible journalism *at best*. A 🧵
First, let's start with autonomy: the decision making process of the people we care for must be free from coercion. AAPLOG leverages their "status" as physicians to promote scientifically inaccurate information about #abortion and #contraception to promote an extremist ideology.
No matter your opinion on #abortion, the science is clear: Abortion is safe. Decades of research demonstrates the overwhelming safety of abortion. AAPLOG uses false information as coercion in medical care…
Read 13 tweets
Very important and high-yield #AIBD2020 session with @UmaMahadevanIBD on #IBD in #pregnancy! 🤰🔥💩👶

@IBDConference #GITwitter #GI #OBGYNtwitter #OBGYN
Management of a healthy pregnancy begins... before pregnancy!

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD
Start planning early!

Want 3 months of steroid-free remission before conception.

#AIBD2020 @IBDConference @UmaMahadevanIBD #IBD
Read 23 tweets
#WetreadCoW Case 15

Hx: Vaginal bleeding

What is the first question to ask? What are the possible diagnoses? (more images to come of course 😀)

Professionally appropriate gif responses only please. No spoilers! #FOAMrad #FOAMed #radres #errad #bodyrad
@ER_Rad_Hanna @GayatriJoshiMD @RadioGyan #WetreadCoW Case 15 (cont)

+Urine pregnancy test

Diagnosis(es)? Gifs only please! 😀 FOAMrad #FOAMed #radres #errad #bodyrad
#WetreadCoW Answer: Cervical Ectopic Pregnancy

Imaging is easy!

-⭐️NO IUP(endometrium opposed, no fluid or sac)
-gestation sac w/ fetal pole in cervix

1) cervical ectopic
2) spont abortion

Here: Closed os, no endometrial fluid➡️ectopic
#FOAMrad #bodyrad #errad #obgyn
Read 9 tweets
Med Schools offer almost no instruction in the world's #1 cause of working-age disability. It'd be like Dental Schools not covering cavities.

7 words diagnose most #migraine: Recurrent #pain w/ hypersensitivity &/or nausea. 60% of patients go undiagnosed. #MedicalTwitter #PCP
#Migraine is PROGRESSIVE. A 40% diagnostic rate condemns some to lifelong #disability: Late diagnosis & ineffective treatment of acute #migraine are leading risks for continuous migraine. #PCP #MedicalTwitter…
🔴HOW DOES THIS CHILD GO 8 YEARS WITHOUT A DIAGNOSIS? She has textbook ICHD-3 #migraine! 1>sudden hypersensitivity (smell) 2>throbbing #pain 3>nausea 4>need for bedrest

She might've avoided #disability w/ early diagnosis & treatment. #PCP…
Read 10 tweets
1. I have a couple of thoughts about this. The classification of "culturally appropriateness" in terms of attire, holding alcohol, and #MedBikini shows a single world-view can skew results and demonstrates the importance of diversity.
2. My main issue is the classification of physicians commenting on political and social issues as unprofessional. I disagree. It is exactly because physicians have remained silent for so long on topics such as abortion and gun control, that we are in this political battle
3. Our silence has created the space for non-science to occupy and drive the conversation. Our silence is the reason why a legislator in Ohio could bring forth a bill where an #obgyn would be liable for not re-implanting an ectopic gestation and could be prosecuted for murder.
Read 9 tweets
Wetread Summer Series Case 6

Hx: pelvic pain (pregnancy test pending 🙄)

Please answer with professionally appropriate gif responses only. No spoilers! #WetreadCow #FOAMrad #FOAMed #radres #errad #bodyrad #obgyn Image
Here are some coned down views that may be helpful. ImageImage
Wetread SS Case 6 Answer: Ruptured Heterotopic Pregnancy (IUP + ruptured ectopic pregnancy)

Too easy?🤔 No one likes OB?☹️🤣

+IUP generally excludes ectopic pregnancy. Here's the rare exception proving the rule. Labeled gif below for #radres. #WetreadCow #FOAMed #errad #bodyrad
Read 4 tweets
اسعد الله اوقاتكم بكل خير اصدقاء فريق أرشدني🌹🌹

خلوكم قريب للحالة الثانية 2nd case.
A 32-year-old G 3 P 2+0 with 32 weeks pregnancy reported to an obstetric casualty with a history of vaginal bleeding for 2 hours. On examination, a cesarean scar is present and the uterus is relaxed
In this case, first a normal vaginal delivery at term 5 years ago, second a CS for transverse lie at 36 weeks in labor, 3 years ago. There is a history of spotting 2 weeks ago and now she has soaked her undergarment, and there is no history of abdominal pain.
Read 21 tweets
For the #OBGYN community please watch the free AAGL #COVIDー19 webinar w/ global gyn surgeons from Seattle to Italy & S.Korea. Sobering glimpse for what’s to come nationwide. I have summarized international takeaways below:
S.Korea has implemented many strategies that’s helping to effectively #FlattenTheCurve:

1. National coordinated/organized response:
-“United we stand, divided we fall”
2. Testing:
-Relatively cheap (<$200)
-Results available in 4-6 hours, -Convenience-drive thru testing launched quickly
-Fast Isolation and Treatment

3. Tracking (controversial)
-All confirmed cases using surveillance cameras, car license plates & credit cards
Read 19 tweets
Isn’t it hard to make room in our brains for ANYTHING that isn’t #COVID19 related right now?

Well. For wellness’ sake, I say we must.

And so. I bring you a thread of random, very happy photos snapped from #MatchDay celebrations’ past.*

*All courtesy of my smart phone. 👊🏽 Image
These three happy M4s are now board certified in Anesthesiology, Otolaryngology, and Cardiology.

They were in my very first small group. This photo makes me happy to this day. ☺️

@CQ__MD Image
This M4 was also a module leader for the M1 Cardiology Module. What a happy surprise it was for this future pediatrician to walk in to decorations from the M1s!

Kindness rocks. Image
Read 13 tweets
With the #abortion bills in the US effectively banning abortion in all circumstances, it is time we remember Henry #Morgentaler, a Canadian physician who challenged the #criminalization of abortion in Canada and went to prison for it.


#law #medicine #obgyn
Dr. Morgentaler was born in Poland in 1923. He was imprisoned in Nazi concentration camps during World War II. After the war, he immigrated to Canada to study and practice medicine. 2/25
From the beginning he had an interest in reproductive health, becoming one of the first physicians to perform vasectomies, place intrauterine devices (IUD, a form of birth control), and provide birth control pills to unmarried women. 3/25
Read 25 tweets

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