Source / episode info

• **Episode:**239
• **Title:**Divine Intervention Episode 239 – The NBME and OBGYN Risk Factors (+ Upcoming Step 2CK Course).
• **Published:**2020-06-01
• Source:Episode page

One-liner

This episode reviews high-yield OB/GYN risk factors, including those for postpartum depression (personal history), infertility (ovulatory dysfunction), various cancers (HPV, DS exposure), and obstetric emergencies like placental abruption, uterine rupture, and the protocols for Group B Streptococcus prophylaxis.

High-yield summary

• Postpartum Depression: The single biggest risk factor is a personal history of Major Depressive Disorder (MDD).
• Infertility: On board exams, ovulatory dysfunction remains the most common cause, with Polycystic Ovary Syndrome (PCOS) being the chief culprit.
• Cervical Cancer/Vulva Cancer: The primary risk factor for both is persistent Human Papillomavirus (HPV) infection, particularly types 16, 18, and 30.
• Endometrial Cancer: The strongest risk factor is exposure to "on-off-post-estrogen" (estrogen given without adequate progestin).
• Obstetric Emergencies: Prior C-section history increases the risk of both postpartum endometritis and uterine rupture; prior placental abruption increases the risk of subsequent abruption.
• Group B Strep Prophylaxis: Must be administered at 35–37 weeks gestation, but also indicated if ROM >18 hours or if maternal temperature 100.4^F.

Learning objectives

• Identify the primary risk factors for common OB/GYN malignancies (cervical, endometrial, vulvar).
• Differentiate between various obstetric complications (e.g., placental abruption vs. previa; endometritis vs. chorioamnionitis) and their associated risk factors.
• Understand the indications and timing of prophylactic antibiotics in obstetrics (Group B Strep, RhoGAM).
• Recognize the key predictors of prognosis for common cancers (breast, vulvar, endometrial).
• List the major complications and risk factors associated with labor management procedures (e.g., LEEP, C-section).