Source / episode info
- **Episode:**22
- **Title:**Divine Intervention Episode 22 – Comprehensive OBGYN 3rd Year Shelf Review.
- **Published:**2018-04-25
- Source:Episode page
One-liner
This episode reviews critical OBGYN concepts including postpartum mental health management (PPD vs psychosis), risk factors and treatment for endometritis, key physiological changes during pregnancy, and optimal timing for routine prenatal screening tests.
High-yield summary
- Endometritis: Risk factors include cesarean delivery, multiple cervical exams, prolonged labor, and ruptured membranes. Treatment is typically a combination of clindamycin and gentamicin.
- Postpartum Contraception: If the patient desires birth control, use only progestin-only contraceptives (e.g., Depo) to avoid inhibiting breastfeeding.
- Mental Health Distinction: Postpartum blues involves mild mood swings; Postpartum depression requires SSRIs; Postpartum psychosis is a medical emergency requiring immediate hospitalization and antipsychotics due to hallucinations/delusions.
- Prenatal Screening Timing: GBS swab should be obtained between 35–37 weeks gestation. GDM screening is performed between 24–28 weeks using an OGTT.
- Pregnancy Physiology: Pregnancy causes a hypercoagulable state (increased clotting factors), decreased systemic vascular resistance, and increased cardiac output due to massive plasma volume expansion.
Learning objectives
- Differentiate the clinical presentations, severity, and management of postpartum blues, depression, and psychosis.
- Identify major risk factors and appropriate antibiotic regimens for puerperal endometritis.
- Apply knowledge of normal physiological changes in pregnancy (cardiac output, blood volume, coagulation).
- Determine the correct timing for routine prenatal screening tests (GBS, GDM, NIPT/Amnio).
- Calculate recommended weight gain during gestation based on maternal BMI.
Board exam buzzwords