Episode 11.6 Ovarian Torsion & The Pitt

We use a plotline from The Pit to separate ovarian torsion facts from TV fiction and explain why Doppler findings can’t replace clinical judgment. Then we answer a listener question on trial of labor after myomectomy and how we counsel when the data are thin and the details matter. • why “competency porn” and “certainty porn” can distort real expectations of care • how color Doppler actually works and why red and blue do not always mean artery and vein • PCOS misconceptions and what really increases torsion risk • ovarian torsion as a clinical diagnosis and why preserved Doppler flow cannot rule it out • ultrasound clues that help beyond flow alone, including the whirlpool sign and peripheral follicles • when oophoropexy might be considered and why it remains controversial • why detorsion usually beats oophorectomy even with a black or blue ovary • limits of lab tests and the need to think in probabilities, not binaries • false positives and false negatives in pregnancy testing, including the hook effect and real-world mix-ups • counseling on vaginal delivery after myomectomy, focusing on depth, cavity entry, number and location of incisions, and shared decision-making Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram 0:01 Welcome And What We Cover0:32 The Pit Torsion Plot Setup3:06 Competency Porn And Public Expectations8:39 Color Doppler Basics BART Rule10:09 PCOS Myths And Torsion Risk13:27 Endometriosis Guidance And Clinical Diagnosis18:29 Torsion Diagnosis Beyond Doppler Flow24:30 Oophoropexy When It Helps And Harms29:22 Scoring Tools For Torsion Triage32:48 Detorsion Versus Oophorectomy And Recovery37:09 Certainty Porn And Limits Of Tests41:09 Pregnancy Tests False Positives And Negatives47:10 Listener Question TOL After Myomectomy50:01 Counseling Factors And Limited Rupture Data55:31 Closing And Next Guest TeaseFollow us on Instagram @thinkingaboutobgyn.