Dr. Chapa’s OBGYN Clinical Pearls

Fetal AC> 90%: Diagnosis?

11 Apr 2026

Contributed by Lukas

The diagnosis of fetal growth restriction can be made with an isolated abdominal circumference less than the 90th percentile. So is the opposite true?...

Livi Post-Sex Vaginal Device: Hmmmm

09 Apr 2026

Contributed by Lukas

Livi by LiviWell is an FDA-cleared, single-use, soft polyurethane foam device designed to immediately absorb post-intercourse fluids (semen) to suppor...

CGMs in GDM: Evolving Support

06 Apr 2026

Contributed by Lukas

Modern medicine has come a long way in its fight against diabetes. We now have continuous glucose monitors (CGM) and automated insulin delivery (AIDs)...

Exploring Encompass RNA PreE (At-Home) Test

04 Apr 2026

Contributed by Lukas

Podcast family, we have to be careful what we ask for…Because we might just get it! We have been asking for new ways to predict preeclampsia for clo...

OPS vs RRS: April 2026 AJOG

01 Apr 2026

Contributed by Lukas

Words matter, and equally as important, our actions matter. Sometimes the words opportunistic salpingectomy (OPS or OS) are used interchangeably with ...

Vaginal GSpot Injection: Again?

29 Mar 2026

Contributed by Lukas

Platelet-rich plasma (PRP) injections do not have formal FDA approval for specific clinical indications. PRP is regulated as an autologous blood produ...

TWOFER! (Quickie #4): A. Placental Grading, B. GBS discordant Results

25 Mar 2026

Contributed by Lukas

Podcast family, welcome to Quickie #4. This one will be fun: A. Medicine changes, and changes fast. I trained with and learned the Grannum grading pla...

The Problem of Proving Pregnancy too Promptly

22 Mar 2026

Contributed by Lukas

Well, it's no doubt we live in a culture of immediate gratification. When we need to know something, we must know it immediately! This even applie...

AMAZING! Lauren's Lesson: You Go Girl!

21 Mar 2026

Contributed by Lukas

What an AMAZING lesson, Podcast Family, in this impromptu episode, we will hear from one of my former medical students, now BOARD-CERTIFIED OBGYN...an...

Quickie #3: The iPhone AI Fetal Movement Detector?

19 Mar 2026

Contributed by Lukas

Podcast family we've all heard the rumors that oursmartphones are “LISTENING TO US”. Well, some of that is actually true, and trust me I'm...

What’s Best Analgesia for ECV?

16 Mar 2026

Contributed by Lukas

Neuraxial analgesia (epidural or spinal) combined withtocolytic therapy is the pain control method that best increases the success rate of external ce...

Does BMI Affect Vag Miso Cervical Ripening? (IMPROVE Subanalysis)

12 Mar 2026

Contributed by Lukas

The ACOG 2025 guideline specifically recommends either oral or vaginal misoprostol for cervical ripening; it does not include buccal administration am...

Quickie #2: Can a Virgin Get BV?

11 Mar 2026

Contributed by Lukas

In this quickie episode, we will answer a question from one of our podcast family members: “Can a virgin get BV?”. It’s a complicated question, ...

Best ZMax Regimen for PPROM?

08 Mar 2026

Contributed by Lukas

For preterm prelabor rupture of membranes, the standard protocol for latency augmentation has remained IV amoxicillin and erythromycin for 2 days, fol...

QUICKIE: AC v EFW for EFW Care

07 Mar 2026

Contributed by Lukas

Well podcast family welcome to the first installment of what will be a periodic recurrence, of our episode called, “QUICKIE”. These are meant to b...

Can Oral Probiotics Reduce recurrent sPTB?

05 Mar 2026

Contributed by Lukas

Probiotics. They are often marketed as the end of all and be all for all our health issues. And they CAN do some real good. There is NO DOUBT a connec...

Believe in Bed Rest for PTB? The AWARE Study

02 Mar 2026

Contributed by Lukas

Neither the ACOG nor SMFM recommend strict bed rest for preterm birth prevention, or nor preeclampsia. Yet tradition often conflicts with evidence. A ...

Pregnancy and the Brain

27 Feb 2026

Contributed by Lukas

A study published in Nature Communications, published Feb 19, 2026, found that “pregnancy physically alters a woman’s brain, with a second pregnan...

Hyst + BSO for BRCA Risk Reduction?

24 Feb 2026

Contributed by Lukas

Approximately 5–10% of all breast cancers are hereditary, and among those, BRCA1 and BRCA2 mutations are responsible for about 60% of cases. Yet, ov...

New Data: Screen Maternal Ferritin with Prenatal Care?

21 Feb 2026

Contributed by Lukas

The ACOG states that, “Iron deficiency anemia during pregnancy has been associated with an increased risk of low birth weight, preterm delivery, and...

Alex’s Input: Aspirin’s Awkward Acumen

18 Feb 2026

Contributed by Lukas

We recently covered an SMFM abstract that was presented at the annual Pregnancy Meeting held in early February 2026. The authors were from my Alma Mat...

More Support for 162mg LDA Universal Use in OB

16 Feb 2026

Contributed by Lukas

Well, even though low dose aspirin has been recommended for the reduction of preeclampsia risk for many years, 2 controversies persist: 1. who should ...

GDM vs “Early” GDM vs PrePreg DM: A Proposal

13 Feb 2026

Contributed by Lukas

As BMIs and weights increase across the US population, there have been increased calls for universal screening for existing DM at entrance to prenatal...

HPV? Check Your Pad.

10 Feb 2026

Contributed by Lukas

There has been a shift in cervical cancer screening from primary cytology based to HPV based. Even HPV screening has had its evolution from physician ...

You Ask, We Answer!

08 Feb 2026

Contributed by Lukas

Well podcast family, we are back with another installment of our “You ask, We answer” edition. We've got 2 fascinating and real-world clinical...

Understanding Fetal Microcephaly

05 Feb 2026

Contributed by Lukas

Fetal Microcephaly has an incidence of 2 to 12 in10,000 births in the USA and can be diagnosed prenatally via ultrasound (in second or early third t...

OB Cough Induced Rib Fracture? YEP. It’s a Thing.

02 Feb 2026

Contributed by Lukas

Stress fractures are common injuries in athletes and military recruits, that’s’ understandable- based on the physical forces placed on the long bo...

When ZMAX if OUT for CS: Alternative?

31 Jan 2026

Contributed by Lukas

We have learned a lot about extended spectrum coverage of prophylactic antibiotics for cesarean section. The landmark C/SOAP trial randomized 2,013 wo...

Another Pub on Hysterotomy Closure

29 Jan 2026

Contributed by Lukas

We have covered the subject of whether to include the decidual (innermost) layer when closing the uterine incision during cesarean section (CS) on at ...

New Data on MVP or AFI For Poly

26 Jan 2026

Contributed by Lukas

As OB healthcare providers, we have several pieces of guidance regarding determination of amniotic fluid volume antepartum. The SMFM has Consult Serie...

“Expression of Concern” Over a Green Journal Article

24 Jan 2026

Contributed by Lukas

Back in March of 2025, the green journal (obstetrics andgynecology) published A systematic review and meta-analysis on 2 medications (non-hormonal) an...

FDA’s ENG Label Change: What To Know

23 Jan 2026

Contributed by Lukas

Implanon (etonogestrel implant) first received FDA approval in 2006, followed by the improved, radiopaque version, Nexplanon, approved by the FDA in 2...

Does Ursodiol Reduce Adverse Outcomes in ICP?

21 Jan 2026

Contributed by Lukas

Ursodiol (ursodeoxycholic acid) is a prescription bile acid medication used to dissolve cholesterol gallstones, prevent gallstones during rapid weight...

New CC #11: Positive HCG in the Non-OB/Non-Gyn CA Patient

18 Jan 2026

Contributed by Lukas

HCG is a heterodimeric glycoprotein typically produced by trophoblastic tissue. However, there are occasions where a serum HCG is obtained that remain...

TXA for ENG Implant Bleeding?

16 Jan 2026

Contributed by Lukas

The ENG implant has data placing it as the most reversible, hormonal contraceptive agent available with a typical use failure rate of 0.05%. Unfavorab...

Does Uterine Incision-to-Delivery Interval Matter?

13 Jan 2026

Contributed by Lukas

It’s a controversial topic: the impact of uterine incision (hysterectomy) on the neonate delivery interval (also called the U-D interval). Does it m...

cfDNA: Jan 2026 Practice Advisory

10 Jan 2026

Contributed by Lukas

In January 2026, the ACOG released its Practice Advisory on Screening for fetal Chromosomal Abnormalities. This comes after its Nov 2025 endorsement o...

TOLAC, PIT, and Internals: The Latest

08 Jan 2026

Contributed by Lukas

Uterine rupture or dehiscence associated with TOLAC results in the most significant increase in the likelihood of additional maternal and neonatal mor...

The 2025 Big Baby Trial

05 Jan 2026

Contributed by Lukas

Currently, as of today’s date, neither the ACOG nor SMFM currently support routine early induction of labor for suspected fetal macrosomia, instead ...

Brain Zapping at Home Now Approved!

02 Jan 2026

Contributed by Lukas

In mid-December 2025, the FDA approved an at home devicethat aims to treat depression by sending electric current into a part of the brain (the prefro...

New Data on VO-CPP (PeVD) Therapy

30 Dec 2025

Contributed by Lukas

While endometriosis is highly associated with Chronic Pelvic Pian (CPP), some women may suffer from a different primary or coexistent secondary etiolo...

Emily's Thanks to You

28 Dec 2025

Contributed by Lukas

A brief THANK YOU prior to 2025 end.

FHT Baseline Change (110-160) in Labor: Danger, or Disregard?

27 Dec 2025

Contributed by Lukas

In 2002, the National Institute of Child Health and Human Development (NICHD) proposed the 3-Tier fetal heart rate (FHR) classification system that wa...

PFM Question: IAI WITHOUT Fever?

24 Dec 2025

Contributed by Lukas

Podcast Family, in our immediate past episode we tackled the discrepancy that is often found between a clinical diagnosis of intra-amniotic infection/...

Chorio Paradox: When Clinical & Path DX Don’t Agree

21 Dec 2025

Contributed by Lukas

Welcome to "Labor & Delivery Debrief," the podcast where we tackle your toughest questions about childbirth and maternal health. Today, we're diving d...

WARNING: DepoP and Meningiomas

18 Dec 2025

Contributed by Lukas

Depo-Provera was approved in 1992 by U.S. regulators. About 1 in 4 sexually active women in the United States have used the shot at some point, accord...

Lube It Up For Baby Delivery?

17 Dec 2025

Contributed by Lukas

The second stage of labor, characterized by active pushing and the descent of the fetal head, can be a challenging and prolonged phase for both mother...

The 2 New FDA Approved GC Meds

15 Dec 2025

Contributed by Lukas

Within the last few days, there has been breaking news regarding the war on gonorrhea. Nuzolvence (zoliflodacin) was FDA approved on December 13, 2025...

Delayed Cord Clamping UPDATE (With Med Student Guest Host)

13 Dec 2025

Contributed by Lukas

It’s so interesting to see how medical evidence evolves, and changes, over time. The result of course is that clinical practice evolves and changes ...

Continue Metformin in 1st T for PCOS?

11 Dec 2025

Contributed by Lukas

Podcast Family, we have covered PCOS on this show many times in the past; and yet- again, there is new information! A new publication from AJOG (Gray ...

No OB Hep C RX: Time For Change

08 Dec 2025

Contributed by Lukas

Major health organizations, including the CDC and ACOG, recommend universal Hepatitis C Virus (HCV) screening for all pregnant women during each pregn...

Freebirth, Wildbirth, and the Price of Autonomy

07 Dec 2025

Contributed by Lukas

Welcome to the no spin podcast. In today's episode, we're tackling a subject that's gaining traction but carries significant risks: the fr...

ACS Update on Self-Collected VAGINAL HPV Tests

05 Dec 2025

Contributed by Lukas

In 2024, the ASCCP updated their guidance to include DualStain technology as part of primary HPV cervical cancer screening. Now, on December 4, 2025, ...

The Reverse Løvset Maneuver For SD

03 Dec 2025

Contributed by Lukas

In the original Løvset maneuver (described for breech presentations), the fetus is rotated in one direction to facilitate arm delivery. For shoulder ...

Titrated Oral MISO Solution For Labor Augmentation?

01 Dec 2025

Contributed by Lukas

Misoprostol, as an E1 prostaglandin, is primarily used in obstetrics for cervical ripening (when the Bishop Score is under 6) and/or for labor INDUCTI...

IUD, Cytology, and Actinomyces: Management.

30 Nov 2025

Contributed by Lukas

Actinomyces species are considered part of the normal vaginal and urogenital tract flora. The percentage of Pap smears containing Actinomyces-like org...

LDA for Unexplained Recurrent SABs?

26 Nov 2025

Contributed by Lukas

Recurrent pregnancy loss (RPL) affects approximately 5% of couples and is an emotional burden on those affected. There is some evidence that vaginal p...

Change Gloves After Placenta at CS? Yes, and No.

24 Nov 2025

Contributed by Lukas

Having data is sometimes different than having clinically applicable data. This is exactly the issue with the proposed plan to reduce surgical site in...

Refresher of Genetic MD

21 Nov 2025

Contributed by Lukas

Muscular dystrophy (MD) is a group of genetic diseases that affect about 16 to 25 per 100,000 people in the US, with the most common childhood form be...

Use GA at CS Electively? Maybe, Maybe.

19 Nov 2025

Contributed by Lukas

Regional anesthesia, typically with a spinal or epidural, haslong been favored for cesarean births due in part to concerns about the effects that gene...

Lido Patches After CS? Maybe.

18 Nov 2025

Contributed by Lukas

The US has no shortage of lidocaine patch television commercials. Topical lidocaine has a role for local, topical, minor aches and pains. What about l...

More Measles Material

17 Nov 2025

Contributed by Lukas

Podcast Family, we have covered the subject of Measles previously on this show (links below). Those episodes were a preview of what has now been relea...

Self-Hypnosis For Hot Flash Relief.

12 Nov 2025

Contributed by Lukas

The term "hypnosis" was first described in 1843 byScottish surgeon James Braid, who published the book Neurypnology. He coined the term &quo...

That's So Random!

12 Nov 2025

Contributed by Lukas

Well, from time to time we cover RANDOM tidbits of information which cover RANDOM questions and/or RANDOM patient care issues that we encounter. In th...

HISTORY MADE: New HRT News TODAY (11/10/25)

10 Nov 2025

Contributed by Lukas

On August 15, 2025, we reviewed the data from an FDA expert panel calling on the FDA to remove the exiting Black Box warning on commercial HRT options...

A BMI-Based Labor Curve?

09 Nov 2025

Contributed by Lukas

The ACOG acknowledges that maternal obesity affects labor curves and recommends allowing more time for cervical dilation before diagnosing labor arres...

Use Antibiotics at 2nd Degree OB Lac Repair?

06 Nov 2025

Contributed by Lukas

Do you routinely order prophylactic antibiotics at time ofsecond-degree laceration repair? Is there data for that? While the use of prophylacticantibi...

“New” PCOS Info: 4 Types (AGAIN)

05 Nov 2025

Contributed by Lukas

On March 29, 2023, we released an episode titled, “The 4 PCOS Phenotypes”. That was in 2023! Now, on 29 October 2025, in the journal Nature Medici...

Folic Acid Update: Women on Epilepsy Meds Do NOT Need More

02 Nov 2025

Contributed by Lukas

Taking folic acid prior to conception and during pregnancy can help protect the unborn baby from developing abnormalities. Supplements are particularl...

Whole Blood for PPH!

31 Oct 2025

Contributed by Lukas

Back on August 9, 2024, we released an episode (link in the show notes) reviewing the renewed interest in transfusing whole blood for PPH rather than ...

New Med For Hot Flashes

29 Oct 2025

Contributed by Lukas

Elinzanetant, sold under the brand name Lynkuet, receivedapproval from the U.S. Food and Drug Administration (FDA) on October 24, 2025, for the treatm...

Vaginal Vit C For BV? AGAIN!

27 Oct 2025

Contributed by Lukas

On January 18, 2020, we released an episode called “Vaginal Vit C for BV? Yep, it’s DATA”. That was 5 years ago! Now, in the Green Journal, a ne...

AFLP vs Preeclampsia with Severe/HELLP

24 Oct 2025

Contributed by Lukas

Here is a real-world clinical case with a tricky differential: Our team recently readmitted a patient 6 days postpartum/post C-section (which was done...

Does IV Pitocin Increase Abruption Risk?

21 Oct 2025

Contributed by Lukas

I was recently asked to OPINE on the labor management for a patient who was receiving IV Pitocin for augmentation, who experienced a placental abrupti...

Does Oral PCN Affect OB GBS Culture Result?

19 Oct 2025

Contributed by Lukas

Current guidelines recommend universal collection of a vaginal-rectal swab for GBS colonization at 36-37 weeks and 6 days for the identification of pa...

New CPU: Male RX for BV (10/16/25)

17 Oct 2025

Contributed by Lukas

On March 7, 2025, we released an episode summarizing key aspects of a NEJM publication regarding male partner therapy for women with recurrent BV. Alt...

Perform PFMT Antepartum?

15 Oct 2025

Contributed by Lukas

Podcast family, as we have said on many previous occasions, we get episode suggestions from either real-world patient encounters, from things that are...

Extended Release Nifedipine Intrapartum For Severe HTN

14 Oct 2025

Contributed by Lukas

In the 09/1/2018 Society for Academic Specialists in General Obstetrics and Gynecology’s (SASGOG’s) Pearls of Exxcellence publication, “Manageme...

Fetal Gastroschisis

12 Oct 2025

Contributed by Lukas

Fetal gastroschisis is a congenital defect of the abdominal wall, typically located to the right of a normally inserted umbilical cord, through which ...

“New” CPU on Zuranolone? “NOTHING” .

11 Oct 2025

Contributed by Lukas

On October 9, 2025, the ACOG released a clinical practice update (CPU) regarding Zouranolone and brexanolone. As postpartum depression is an area of c...

What Did You say?!

07 Oct 2025

Contributed by Lukas

Sometimes you hear something that makes you just stop and say, “What did you say?!”. Yep, in this episode we will give evidence-based answers to t...

SCIENCE CHANGES: New Data on HPV Vaccination Peri-Leep/Cone

05 Oct 2025

Contributed by Lukas

In July 2023, the ACOG released a Practice Advisory stating, “Based on data on the benefit of adjunct HPV vaccination, ACOG recommends adherence to ...

AUDIO?!! FIXED!

04 Oct 2025

Contributed by Lukas

FYI

Elevated msAFP but Normal Fetal Anatomy: What Now?

03 Oct 2025

Contributed by Lukas

A breakthrough discovery in the 1970s was the determination of alpha-fetoprotein levels in the serum of pregnant women to detect fetuses with neural t...

Fetal Dextrogastria

01 Oct 2025

Contributed by Lukas

The only structure of fetal gastrointestinal tract (GIT) which is seen on routine second trimester anomaly scan is the fetal stomach. Under normal con...

Surprising C-Section Data

28 Sep 2025

Contributed by Lukas

Did you know that C-Section birth is referenced in Shakespeare’s Macbeth? Cesarean Section is the most common laparotomy in the world, and yest we a...

Bell’s Palsy in Pregnancy

26 Sep 2025

Contributed by Lukas

Just today in clinic, we had a patient, who was well into her third trimester, come to her regular scheduled appointment with new onset left-sided fac...

“CPR” For Decreased Fetal Movement? The CEPRA Trial

23 Sep 2025

Contributed by Lukas

Maternal perception of decreased fetal movement at term occurs in up to 15% of pregnancies and is a cause for maternal and provider concern. All mater...

New Intrapartum FHT Guidance: Oct 2025 CPG 10

21 Sep 2025

Contributed by Lukas

In the 1960s, continuous electronic fetal monitoring was introduced as a way to better capture and document the fetal response to labor and uterine co...

OB? Get Your ZZZZs: Insomnia’s Effects on Pregnancy

18 Sep 2025

Contributed by Lukas

In 2023, we released 2 episodes on obstructive sleep apnea (OSA) and adverse pregnancy. Now, on September 16, 2025, a new publication from JAMA Networ...

BNP and proBNP in PreE

17 Sep 2025

Contributed by Lukas

Brain-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels originate from the cardiac cells in response to cardiac strain. This may...

Vag E2 in Women With CVA HX?

13 Sep 2025

Contributed by Lukas

Stroke (CVA) is very common in women, who have a higher risk than men over their lifetime; one in five women between the ages of 55 and 75 will experi...

Does Vit B6 Reduce Mastalgia? New Meta-analysis 09/2025

11 Sep 2025

Contributed by Lukas

Mastalgia is a common breast complaint in reproductive aged women. Mastalgia can be separated into three categories: 1) cyclical, 2) noncyclical, and ...

09.10.2025

10 Sep 2025

Contributed by Lukas

We are delaying today's program, as stated in this message. We will resume our program as soon as possible. Remembering Charlie Kirk.

Eric's Encounters: Suppl. to Our Prior Episode

06 Sep 2025

Contributed by Lukas

We have a wonderful podacst community! Within 24 hours of our immediate past episode release, one close friend- and fellow OBGYN, Dr. Eric Colton (OB ...

Decidua or No Decidua at CS Closure: "New" Sept 2025 Data

06 Sep 2025

Contributed by Lukas

On Sept 10, 2023, er released an episode titled, “CS Ut Closure: Decidua or No Decidua?”. We highlighted the importance of AVOIDING the decidua at...

Can SVD Occur After Pelvic Fracture?

03 Sep 2025

Contributed by Lukas

According to the J Am Acad Orthop Surg Glob Res Rev. (2024), the incidence of pelvic ring injuries is 34.3 per 100,000 with trauma being the most obvi...

Add MORE Progestin for Progestin BTB? (New Data)

31 Aug 2025

Contributed by Lukas

Traditionally, we have learned that any imbalance in the estrogen: progesterone relationship can trigger irregular uterine bleeding. That makes sense,...

Labor Cervical Exams: 2 hrs, 4 hrs, 8 hrs?

29 Aug 2025

Contributed by Lukas

Routine vaginal examinations (VEs) are a standard component of intrapartum care, traditionally performed at regular intervals to monitor cervical dila...

Treating Breast Ca During Pregnancy? (New Guidance)

27 Aug 2025

Contributed by Lukas

Breast cancer is an hormone responsive malignancy, meaning it may use estrogen and progesterone, reduced in high quantities during a pregnancy, for gr...