Dr. Chapa’s OBGYN Clinical Pearls
Episodes
“Backdoor” Activity? Ask,Screen,Treat: Nongenital STIs.
16 Sep 2019
Contributed by Lukas
Once taboo, anal sex has slowly been slipping into the mainstream. A recent study found that 37% of women reported having anal sex with the opposite s...
IC/Painful Bladder Syndrome (Part2): Treatment options
15 Sep 2019
Contributed by Lukas
Treatment strategies for IC should proceed using more conservative therapies first with less conservative therapies employed if symptom control is ina...
IC/Painful Bladder Syndrome: New AUA Guidelines
14 Sep 2019
Contributed by Lukas
The effects of IC/BPS on psychosocial functioning and QoL are pervasive, damaging work life, psychological well-being, personal relationships and gene...
Funisitis
12 Sep 2019
Contributed by Lukas
In 2017, the ACOG defined 3 classes of intraamniotic infection. Although most research/data has been on inflammation/infection of the placenta/membran...
OB Forceps’ Strange History
11 Sep 2019
Contributed by Lukas
Obstetrical forceps have a strange history: considered by historians to have been created by William Chamberlain, a French surgeon, the tool was kept ...
9.1.1.
11 Sep 2019
Contributed by Lukas
Never. Forget.
Female Athlete Triad
11 Sep 2019
Contributed by Lukas
Exercise in the young female adolescent is wonderful! But like everything else, too much can be dangerous. The Female Athlete Triad is marked by: 1. l...
Beyond Gardnerella: BV Biofilm New Data.
08 Sep 2019
Contributed by Lukas
Garderella Vaginalis may not be the only pathogen causing BV like symptoms. New data has linked BV with a vaginal BIOFILM ecosystem. It also increases...
Desquamative Inflammatory Vaginitis: An Old/New Awareness
07 Sep 2019
Contributed by Lukas
The human vaginal ecosystem is highly dynamic. The vaginal microbiome can affect host physiology, and vice versa. In 1965, Desquamative Inflammatory V...
BARE DOWN There? New data on STIs and going bare.
05 Sep 2019
Contributed by Lukas
Pubic hair grooming is a highly prevalent practice with self-reported rates between 75 to 99% of women. Does this increase STI risk? In this podcast, ...
Best Vaginal Prep PreCS? A new systematic review & meta-analysis.
05 Sep 2019
Contributed by Lukas
Post CS endometritis is thought to be linked to ascending vaginal bacteria. In 2016, the CSOAP trial concluded that adding ZMAX to standard antibiotic...
Mycoplasma genitalium: An Overlooked STI.
03 Sep 2019
Contributed by Lukas
Mycoplasma genitalium is a facultative anaerobic organism which has been associated with cervicitis, endometritis, PID, infertility, susceptibility to...
Adolescent BC leads to Depression? Let’s see.
02 Sep 2019
Contributed by Lukas
Previous evidence suggests that use of oral contraceptives, especially during adolescence, may increase women’s vulnerability to depression in the s...
⚠️ Labor 2nd Stage: Too Long?
01 Sep 2019
Contributed by Lukas
In 2014, the ACOG released a consensus statement, “Safe Prevention of the Primary Cesarean”. This extended the 2nd stage of labor by 1 hour. Was t...
Wound Healing Principles: A clinical review.
31 Aug 2019
Contributed by Lukas
Wound healing is a complex and dynamic process! In this episode, we will review the 4 stages of wound healing using the analogy of “the broken house...
The V is NOT a TRUMPET! Air embolism after cunnilingus. 😳
29 Aug 2019
Contributed by Lukas
Air embolism during pregnancy has been reported… usually linked to blowing air into the vagina during orogenital sex. In this session, we will revie...
Testosterone Use in Women: Wonder-Drug or Waste?
27 Aug 2019
Contributed by Lukas
There is currently no FDA approved testosterone products for women. Internet sources, and some pharmacies, offer a variety of testosterone products fo...
Fertility Meds Cause Breast CA? Let’s look at the data.
26 Aug 2019
Contributed by Lukas
Many studies have evaluated the relationship between fertility drugs and breast cancer. Are you aware of what the data shows? How would you cancel you...
Fertility Meds Cause Ovarian CA? Let’s look at the data.
25 Aug 2019
Contributed by Lukas
The use of fertility drugs that may cause alterations in endogenous hormones and multiple ovulations has raised concerns about the long-term safety of...
Amniotic Fluid Embolus
24 Aug 2019
Contributed by Lukas
Amniotic fluid embolism is a rare but potentially lethal condition. Because of the rarity of this condition, most physicians and institutions have lim...
Uric Acid for Preeclampsia Eval? No.
23 Aug 2019
Contributed by Lukas
Serum uric acid levels are often ordered for the evaluation of hypertensive disorders of pregnancy. But why is this done? Is this test able to guide c...
😳SEX Headaches😳: Yes...it’s a thing!
22 Aug 2019
Contributed by Lukas
Yes...it’s a real diagnosis. Sexual headaches may be PRIMARY (without other etiology) or secondary (due to a more serious issue). Primary sexual hea...
How Committed are YOU? A life lesson from Julie Moss.
19 Aug 2019
Contributed by Lukas
If you have never heard the story of Julie Moss (1982), start listening to this episode! This is an example of not just being interested in a project/...
ERCP in Pregnancy
18 Aug 2019
Contributed by Lukas
Surgery for biliary tract disease is among the top 3 reasons for non-obstetrical surgery during pregnancy (1:1500 to 1:10,000 pregnancies). What is th...
Do Hurricanes Cause Labor?
17 Aug 2019
Contributed by Lukas
💥Hurricanes💥! No… Not the traditional and historic drink from New Orleans! 🍹🍹We’re talking about the intense, devastating, natural wea...
Fetal Kick Counts: Tradition VS Truths; The AFFIRM Trial Data.
14 Aug 2019
Contributed by Lukas
Stillbirth is a pervasive problem worldwide. Maternal perception of reduced fetal movement has been identified as a potential strategy for stillbirth ...
Don’t Steam the V! The V is not a teapot. Here are the potential risks of vaginal steaming.
12 Aug 2019
Contributed by Lukas
Vaginal steaming has become a cult phenomenon since 2010. But this “alternative“ practice has some real potential risks. Where did this even come ...
OCPs/HRT in BRCA Carriers: What’s the Evidence?
11 Aug 2019
Contributed by Lukas
Because of the increased risk for breast cancer, BRCA mutation carriers may have concerns about taking oral contraceptives or using hormone replacemen...
Endometriosis and adverse OB outcomes.
09 Aug 2019
Contributed by Lukas
Women with endometriosis may represent a unique population of women at greater risk for adverse outcomes across pregnancy and birth. In this session, ...
OB Outcomes per Advancing Weeks of Term Gestation.
08 Aug 2019
Contributed by Lukas
Is 39 weeks the “sweet spot” for delivery? Neonatal and maternal adverse outcomes have been studied through increasing gestational ages from 37 we...
ALERT: Methylene Blue- A Potential Cause of Serotonin Toxicity
07 Aug 2019
Contributed by Lukas
Healthcare professionals and patients may not realize that methylene blue has monoamine oxidase inhibitor (MAOI) properties. Methylene blue should gen...
Opioid Use in Pregnancy: Methadone and Buprenorphine Medical Therapy.
06 Aug 2019
Contributed by Lukas
Opioid use in pregnancy is a real issue! This podcast will review 2 pharmacotherapies for opioid dependency in pregnancy. We will end the session with...
Chronic Kidney Disease in Pregnancy.
04 Aug 2019
Contributed by Lukas
Chronic kidney disease can affect anywhere from 0.1 to 4% of all pregnancies. Pre-existing renal disease can have severe consequences for a pregnancy....
Depression/Anxiety Meds in Pregnancy.
02 Aug 2019
Contributed by Lukas
Depression/anxiety can affect up to 20% of women during pregnancy. These 2 psychological conditions have adverse pregnancy outcomes in and of themselv...
Can SEX induce Labor?
31 Jul 2019
Contributed by Lukas
For decades, women have been told that having intercourse/orgasms late in pregnancy can hasten the onset of labor. But is this a myth, or is this true...
Adnexal Torsion in Adolescents: New ACOG Opinion (Aug 2019)
27 Jul 2019
Contributed by Lukas
Thirty percent of all cases of adnexal torsion occur in females younger than 20 years. In this episode, we will review the latest committee opinion fr...
NEW ERAS Post CS Guidelines
23 Jul 2019
Contributed by Lukas
This Enhanced Recovery After Surgery Society guideline was created to support the most common surgical procedure in the industrialized healthca...
Interpregnancy Intervals and OB Outcomes.
20 Jul 2019
Contributed by Lukas
Short interpregnancy intervals, as well as long intervals between pregnancies, are associated with some potential adverse obstetrical outcomes. What d...
SLYND! The new, novel drospirenone oral BC pill.
17 Jul 2019
Contributed by Lukas
How much do you know about the recently approved novel BC pill, SLYND? Do you know it’s efficacy? What are the contraindications? In this session, w...
How bad do you want it?
16 Jul 2019
Contributed by Lukas
DISCLOSURE: Not for the PC! Not for those who lack determination, or GRIT. This is the antidote for mediocrity. Just a little motivation to KEEP YOU F...
Recurrent Preg Loss (Part 2).
14 Jul 2019
Contributed by Lukas
Part 2: In this session, we will wrap up our discussion on recurrent pregnancy loss by focusing on 3 controversial areas: 1. Immunological therapy, 2....
Recurrent Preg Loss (Part 1).
13 Jul 2019
Contributed by Lukas
Recurrent pregnancy loss is devastating for the affected couple. In part 1, we will review the diagnosis of this condition. We will also cover parenta...
OB Rapid-Fire Q&A! Common questions and concerns raised during pregnancy.
11 Jul 2019
Contributed by Lukas
Howdy, all! Rather than discussing one topic, this session will review “quick facts“ on common OB concerns/questions. Should we screen for HSV dur...
Revised GBS Guidelines: ACOG CO 782 (July 2019)
08 Jul 2019
Contributed by Lukas
On July 1, 2019 ACOG updated/revised the GBS algorithm for intrapartum prophylaxis. In this session, we will cover GBS prophylactic indications, NAAT ...
Does H. Pylori lead to Hyperemesis?
04 Jul 2019
Contributed by Lukas
Persistent nausea and vomiting in pregnancy is a terrible condition! It affects quality-of-life, and impacts the mother’s overall psychological well...
Less Fetal Movement?..Drink Sugary Drinks...Right?!! NO!
30 Jun 2019
Contributed by Lukas
It has long been held that maternal perception of fetal movement may protect against stillbirth. However, the 2018 AFFIRM trial called the tradition i...
Boot Camp! 3 Life Lessons Learned!
27 Jun 2019
Contributed by Lukas
Left...Right...Left...Right...Left! I just recently completed my military boot camp experience! That was an adventure. In this session, we will cover ...
New Female SEX Med? Is Vylessi the DESIRE wonder drug?
24 Jun 2019
Contributed by Lukas
Sexual intimacy is an important part of a couples’ relationship. On June 21, 2019, the FDA approved a new novel medication for hypoactive sexual des...
Sunscreen Use in Pregnancy: Safe or Worrisome?
18 Jun 2019
Contributed by Lukas
🌞🌞IT IS SUMMER!! 👏👏 Are sunscreens safe to use during pregnancy? What does ACOG say? In this session, we will review the ACOG practice sta...
Can Turmeric (Curcumin) help PostPartum Depression?
17 Jun 2019
Contributed by Lukas
Turmeric is an edible root used in cooking. It’s powdered into a bright yellow spice popular in Asian cuisine. Turmeric also has a history of medici...
I’ll Be Baaack!
11 Jun 2019
Contributed by Lukas
Just a brief hiatus!
HbA1C and Birth Defects
09 Jun 2019
Contributed by Lukas
What is the mechanism by which elevated hemoglobin A-1C causes birth defects? Is there a “cut off“ level for this affect? Let’s look at the data...
Cardiac Arrest in Pregnancy
07 Jun 2019
Contributed by Lukas
Maternal cardiac arrest… a devastating condition! Techniques for maternal resuscitation have changed, even from when I was a resident. 30° left lat...
The Pill Made Me Fat! What?? Do OCPs cause weight gain?
05 Jun 2019
Contributed by Lukas
Weight gain is commonly cited as a side effect of combination oral contraception, and is amount the top reasons for pill discontinuation. Do birth con...
THRIVE (Part 3)! The FIRE of Your PASSION.
04 Jun 2019
Contributed by Lukas
(Part 3): The Finale of our 3-Part series! Remember when you would have done anything to get into medical school, and cried/struggled to get that perf...
THRIVE (Part 2)! The Challenge!
04 Jun 2019
Contributed by Lukas
(Part 2): Take the challenge! This is Principle #2 in our “mini-series”. It is easy to fall into a trap of “the routine“, and the mundane. Doi...
THRIVE! You have been warned....
03 Jun 2019
Contributed by Lukas
WARNING: This is my most personal, and passionate podcast yet. In light of the recent CNBC news article regarding physician well-being, this podcast w...
Maternal O2 use in Labor: Benefit or Harm?
31 May 2019
Contributed by Lukas
For decades, common practice in Labor And Delivery has been to use supplemental maternal oxygen by facemask as a remedy for fetal heart rate decelerat...
AMAZING: The 1st Self- Appendectomy; The True Account of Dr. Evan O'Neill Kane.
30 May 2019
Contributed by Lukas
This is TRUE, and a testament to what having a VISION, a strong will, and a desire to change the status-quo can accomplish! This is the remarkable tru...
cfDNA and Maternal Cancer: A Cause For Concern?
29 May 2019
Contributed by Lukas
In 2011, cf DNA from the maternal serum became commercially available to screen for fetal aneuploidy. Overall, about 3% of test results will detect an...
Pitocin For Early D&C? No!
26 May 2019
Contributed by Lukas
Somethings in medicine are done by tradition. The use of Oxytocin during first trimester uterine evacuation is one such thing. Evidence seems to be la...
Brexanolone for PP Depression: Facts and Precautions.
22 May 2019
Contributed by Lukas
In March 2019, the FDA approved the first medication specifically targeted for postpartum depression, brexanolone (Zulresso). However, this medication...
SMFM Dont’s! (Part 2)
21 May 2019
Contributed by Lukas
Does finding an isolated echogenic cardiac focus or choroid plexus cyst require amnio? What about MTHFR testing for thrombophilia? AFI or deepest vert...
SMFM Don’ts!! (Part 1)
21 May 2019
Contributed by Lukas
(Part 1) Cerclage for twins? What about progesterone? Do gestational diabetics controlled with diet (A1) alone require antepartum fetal surveillance? ...
Send a Voice Message!
17 May 2019
Contributed by Lukas
Now, regardless of which venue/platform you are listening to the podcast through, you can leave us a voice message! Simply go to “episode notes“ a...
CALL TO ACTION: US Maternal Mortality and CVD
14 May 2019
Contributed by Lukas
The CDC confirmed in a report recently released that about 700 women die each year in the United States from cardiovascular conditions, infections, he...
Am. Soc. Breast Surgeons: Updated Breast CA Screening Recs
11 May 2019
Contributed by Lukas
Controversy surrounding screening mammography guidelines has resulted in conflicting recommendations from physicians and uncertainty for women. The Am...
Skin to Skin at CSection: Part 2
09 May 2019
Contributed by Lukas
In this session (Part 2), we will cover skin to skin neonatal contact at time of Cesarean birth. Is this possible? What does the data show? This will ...
Skin to Skin Neonatal Contact: What’s the Big Deal?
08 May 2019
Contributed by Lukas
Skin to Skin neonatal contact is endorsed/recommended by the AAP, AWHONN, the CDCP, and the WHO. What’s the data behind his practice? Are there any ...
Osteoporosis
06 May 2019
Contributed by Lukas
Researchers estimate that approximately 10.2 million Americans have osteoporosis, and an additional 43 million have low bone density. Equally stark ar...
The “HYSTerical” Origins of Vibrators!
05 May 2019
Contributed by Lukas
“Hysteria” referred to a constellation of psychological and physical ailments occurring only in women. It was thought to have its origin in the ut...
The Non-Fundal IUD. What’s to do?!
02 May 2019
Contributed by Lukas
Hey, we have all been there at one time or another: The ultrasound report shows an IUD/IUS in the endometrial cavity but it is NOT in the fundal locat...
Why PLACEBO pills in Birth Control Pills? The Surprising History.
01 May 2019
Contributed by Lukas
What do Mexican Yams, menses, and the Pope have in common? The answer: the Birth Control Pill! In this session, we will review the interesting and sli...
46XY Females: AIS vs Swyer Syndrome
30 Apr 2019
Contributed by Lukas
Both Androgen Insensitivity Syndrome (AIS) and Swyer Syndrone (Pure Gonadal Dysgenesis) are characterized by phenotypical females who are genetic male...
MEASLES!! ACOG Practice Advisory.
27 Apr 2019
Contributed by Lukas
The US is currently experiencing the greatest number of reported cases of measles, also known as rubeola, since the disease was eliminated in 2000. Ou...
Female Ejaculation and “Squirting”: HEY...YOU ASKED!!
23 Apr 2019
Contributed by Lukas
In the late 1950s, two researchers (Masters and Johnson) began breakthrough research on human sexuality. Since then, “sexologists” have expanded o...
LIKE...What NOT to say!
18 Apr 2019
Contributed by Lukas
I’m sorry… I had to release this pent-up frustration regarding a common occurrence! LoL. “Like... I really hope you, like, enjoy this session”...
Fetal Echogenic Bowel
18 Apr 2019
Contributed by Lukas
Fetal Echogenic bowel is a non-specific finding observed during 0.2 to 1.8% of routine second trimester ultrasound. Possible causes include primary ga...
Does Progestin Only BC Cause Depression?
12 Apr 2019
Contributed by Lukas
Birth control, especially progestin only methods, seem to take a lot of heat regarding their potential role in CAUSING depression. Although past indiv...
PreCS Vaginal Prep
07 Apr 2019
Contributed by Lukas
In 2016, the CSOAP trial confirmed that adding Azithromycin 500 mg IV to standard cephalosporin antibiotic prophylaxis pre-Cesarian helps reduce post ...
IV vs Oral Iron Therapy in Pregnancy
04 Apr 2019
Contributed by Lukas
Iron deficiency anemia during pregnancy has been linked to several obstetrical adverse events including preterm birth, low birth weight, Cesarian Sect...
Prolactinomas in Pregnancy
01 Apr 2019
Contributed by Lukas
Prolactinomas are categorized as micro- or macroadenomas based on their size. These tumors are considered the most frequently diagnosed functioning, a...
Pavovirus B19 in Pregnancy
31 Mar 2019
Contributed by Lukas
Parvovirus B 19 is a single-stranded DNA virus that causes the childhood exanthem known as fifth disease. The risk of maternal Parvo B19 infection var...
Toxoplasmosis in Pregnancy
29 Mar 2019
Contributed by Lukas
In the United States, 1 out of 1,000-8,000 babies are born with toxoplasmosis. Vertical transmission increases per trimester but severity of fetal dis...
CMV in Pregnancy
29 Mar 2019
Contributed by Lukas
CMV is the most common congenital infection, occurring in 0.2 to 2.2% of all neonates. Vertical transmission of this herpesvirus is possible throughou...
Do OCPS help ovarian cysts resolve?
28 Mar 2019
Contributed by Lukas
Historically, oral contraceptive pills were prescribed in attempt to help quicken resolution of ovarian cysts. Is this practice evidence-based? In thi...
Universal Low-Dose ASA Use In Pregnancy?
25 Mar 2019
Contributed by Lukas
In 2018, The ACOG expanded the possibility of low-dose aspirin use in pregnancy for preeclampsia prevention. Women deemed at moderate risk (1 or more ...
The PROLONG trial: Does 17-OH really prevent preterm birth?
20 Mar 2019
Contributed by Lukas
Recently, the PROLONG Trial, investigating 17-OHP’s role in preventing recurrent preterm birth, called into question the effectiveness of this treat...
VTE and Gyn Surgery
16 Mar 2019
Contributed by Lukas
In 1858, Virchow reported on the triad of hypercoagulability, venous stasis, and vessel wall injury as the factors pertinent to venous thromboembolism...
Do BC Pills have to be stopped before GYN surgery?
10 Mar 2019
Contributed by Lukas
Postop DVT and PE are potentially devastating to a postop patient. What does the ACOG and the American College of Chest Physicians say about stopping ...
One abnormal value on 3 Hr GTT: Implications?
07 Mar 2019
Contributed by Lukas
In the United States, GDM is diagnosed by a 3 hour GTT when 2 or more values are above a designated cut off. But what happens when only one value is e...
ACOG: Umbilical Cord Blood Banking
26 Feb 2019
Contributed by Lukas
Umbilical cord blood banking still carries significant misperceptions regarding its potential use. Did you know, that umbilical cord blood is not mean...
NS or LR: The IV Fluid Battle May Have Ended.
23 Feb 2019
Contributed by Lukas
IV fluids?! Does it really make a difference if the patient receives normal saline (NS) or Lactated Ringers (LR)? Well, for short bouts of rehydration...
FOAMed!!
20 Feb 2019
Contributed by Lukas
FOAMed!!! A shout out to “free open access medical education”. Thanks for the information, Scott C.-one of our clinical medical students!
Vanishing Twin Syndrome
20 Feb 2019
Contributed by Lukas
Incredibly, Although the frequency of multiple gestation is 3 to 5% at 8 weeks, vanishing twin syndrome occurs in 20-30% of all multifetal gesstations...
HIV PrEP
14 Feb 2019
Contributed by Lukas
According to the CDC, 1 in 8 of the 1.2 million people living with HIV in the United States are unaware of their HIV status and only half of those kno...
Screening for Perinatal Depression
11 Feb 2019
Contributed by Lukas
Perinatal depression, which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery, is one ...
Polyhydramnios
08 Feb 2019
Contributed by Lukas
Polyhydramnios is an abnormal increase in amniotic fluid volume typically diagnosed in the second or third trimester. Either the single deepest vertic...
DKA in Pregnancy
06 Feb 2019
Contributed by Lukas
Diabetic ketoacidosis in pregnancy is an obstetric and medical emergency and therefore requires prompt and aggressive treatment in a specialized care ...
Glycemic Effects After Steroids for FLM
04 Feb 2019
Contributed by Lukas
Corticosteroid therapy for fetal lung maturity was first endorsed back in 1994. But what do we know about its affect on glycemic levels? Pregnant wome...