Episode 10.1 VBAC Updates, Estrogen Packs, Co-Sleeping, and More!

Howard and Antonia dive into their tenth season with a critical look at several new studies. Topics include:• Estrogen-soaked vaginal packing after surgery lacks evidence for benefits while carrying unnecessary costs• Recent studies on vaginal birth after cesarean deserve careful interpretation beyond aggregate outcomes• Hospital uterine rupture rate is 0.2-0.4%, with only 8% resulting in catastrophic outcomes when properly managed• Warnings against infant co-sleeping date back to ancient times, predating modern pediatric recommendations• Vaginal hysterectomy continues to decline despite shorter OR times, lower costs, and similar complication rates• Swedish study shows only 25% of ideal candidates receive vaginal hysterectomies, with projections showing disastrous decline in rates of appropriate surgeriesStay tuned for our next episode featuring Scott Guthrie discussing neonatal resuscitation and other neonatal concepts important for OB-GYNs to understand.00:00:00 Season 10 Introduction00:01:13 No Evidence for Estrogen Packs After Surgery00:10:35 VBAC Studies: Interpreting Maternal Risks00:19:12 Catastrophic Uterine Rupture: Hospital vs Home00:28:53 King Solomon and Infant Co-Sleeping Dangers00:39:50 Vaginal Hysterectomy: Declining Despite Evidence00:54:09 Cost and Time Analysis of Hysterectomy Routes01:06:24 Closing Thoughts on Season 10Follow us on Instagram @thinkingaboutobgyn.