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Dr. Chapa’s OBGYN Clinical Pearls

Science

Episodes

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HRT and WHI: Fear vs Reality! (Part 1)

21 Jan 2019

Contributed by Lukas

(Part 1) The media attention surrounding the publication of the initial results of WHI in 2002 led to fear and confusion regarding the use of hormonal...

Nuchal Cords: Innocent or Guilty?

20 Jan 2019

Contributed by Lukas

Nuchal cord (NC) is common, and the vast majority of term deliveries with nuchal cord have normal outcomes. However, nuchal cord associated fetal morb...

Umbilical Artery Dopplers

16 Jan 2019

Contributed by Lukas

Umbilical Artery Doppler studies are a valuable tool to assess vital well-being in the growth restricted fetus. What are the indices that are evaluate...

Sickle Cell in Pregnancy: Part 2

12 Jan 2019

Contributed by Lukas

In this episode, which is part 2, we will cover the role of “prophylactic” red blood cell transfusion during pregnancy. We will also cover the med...

Sickle Cell in Pregnancy: Part 1

10 Jan 2019

Contributed by Lukas

Sickle cell disease is the most common inherited condition worldwide. Sickle cell disease carries unique maternal and fetal risks during pregnancy. In...

ACOG Emphasizes Interpregnancy Care: OB Care Consensus #8

08 Jan 2019

Contributed by Lukas

The interpregnancy interval provides an ideal opportunity to discuss interventions which can maximize maternal as well as neonatal outcomes. Do you kn...

Pitocin! From Discovery to Modern Day Use.

06 Jan 2019

Contributed by Lukas

At what gestational age does the uterus become responsive to oxytocin? Can Pitocin result in hypertension or HYPOtension?...And who was Sir Henry Dale...

Peripartum Cardiomyopathy (Part 2)

03 Jan 2019

Contributed by Lukas

Is Digoxin routinely used for peripartum cardiomyopathy? Can women who had peripartum cardiomyopathy take oral contraceptive pills? In this episode, w...

Peripartum Cardiomyopathy (Part 1)

02 Jan 2019

Contributed by Lukas

(Part 1): Peripartum cardiomyopathy occurs in about 1 in 2,000 births in the United States. Although relatively rare, it can be devastating to the mot...

How “Blowing Smoke Up Someone’s A$$” went from medical treatment to a modern colloquial phrase.

30 Dec 2018

Contributed by Lukas

Did you know the common, modern-day, colloquial expression about “blowing smoke up someone’s A$$” actually has a medical origin? Yep... it was a...

Gestational HTN and PreEclampsia UPDATE: ACOG PB 202

28 Dec 2018

Contributed by Lukas

In 2013, the ACOG released a comprehensive review on hypertensive disorders in pregnancy. In January 2019, the College re-visits gestational hypertens...

Beer 🍻 and Breastfeeding? What’s the data on alcohol use during lactation?

25 Dec 2018

Contributed by Lukas

Alcohol use during pregnancy is well studied with well stated warnings. But what about alcohol use during breastfeeding? What’s the data on that? In...

Our Holiday Message to you!

24 Dec 2018

Contributed by Lukas

Our BEST Holiday wishes to you!

ACOG UPDATE (Part 2): Chronic Hypertension in Pregnancy.

24 Dec 2018

Contributed by Lukas

This is part 2 of our review of the ACOG practice bulletin #203. In this session, we will review low-dose aspirin for preeclampsia prevention, as well...

ACOG UPDATE! AHA and Chronic Hypertension in Pregnancy.

23 Dec 2018

Contributed by Lukas

Recent recommendations from the American College of Cardiology (ACC) and the American Heart Association (AHA) have changed the criteria for diagnosing...

SCABIES!....In Pregnancy.

22 Dec 2018

Contributed by Lukas

OK, so your pregnant patient comes to you with persistent itching between the fingers and toes and you suspect scabies. Which medication is safe to us...

Is vaginal estrogen safe? New data from the Nurses’ Health Study!

21 Dec 2018

Contributed by Lukas

Genitourinary syndrome of menopause causes a significant disruption in quality of life for many menopausal women. The ACOG and NAMS endorse vaginal es...

“Weed”, Sperm, and Epigenetics: A Cautionary Note!

20 Dec 2018

Contributed by Lukas

As legal access to marijuana continues expanding across the US, more researchers are studying the effects of tetrahydrocannabinol, (THC), in teens, ad...

Hello! From our 3rd Year ObGyn Med Students!

19 Dec 2018

Contributed by Lukas

Just something fun to break up the monotony.

Vulvar Lichen Planus

19 Dec 2018

Contributed by Lukas

Lichen Planus is a chronic inflammatory mucocutaneous disorder that can affect the mouth, vulva, vagina, and anus. Wickham’s Striae are characterist...

Vulvar Lichen Simplex Chronicus (2018 Update)

19 Dec 2018

Contributed by Lukas

Vulvar Lichen Simplex Chronicus is a non-scarring, chronic inflammatory disease of the skin characterized by intense itching. 65% to 75% of patients h...

Vulvar Lichen Sclerosus (2018 Update)

18 Dec 2018

Contributed by Lukas

Vulvar Lichen Sclerosus is a chronic inflammatory vulvar dermatosis. There is an association between this condition and various systemic autoimmune co...

Ulipristal for NEXPLANON Bleeding?

18 Dec 2018

Contributed by Lukas

The etonogestrel contraceptive implant is a type of LARC with proven high efficacy. Yet, similar to all progestin only contraception, abnormal bleedin...

ACOG Practice UPDATE! 17OHP IM vs 17OHP SQ

16 Dec 2018

Contributed by Lukas

On December 15, 2018, the ACOG released a Practice Update regarding subcutaneous use of 17OHP rather than IM 17OHP for preterm birth prevention. Weekl...

Nipple Discharge

16 Dec 2018

Contributed by Lukas

Nipple discharge is a common breast symptom. Keys and clues to stratify patients as either low risk or high-risk include: the patient’s age, unilate...

Let us hear from YOU!

15 Dec 2018

Contributed by Lukas

Let us hear from you! Thanks for being a part of our podcast family! Did you know, you can send us feedback and recommendations/suggestions for future...

Sex During Pregnancy

15 Dec 2018

Contributed by Lukas

Pregnant women and their partners often ask whether or not sex is allowed in pregnancy and what possible consequences may occur. Does sex cause preter...

“POI” in Young Women

14 Dec 2018

Contributed by Lukas

Premature Ovarian Insufficiency (POI) has replaced the previous term of “premature ovarian failure” or “premature menopause”. POI is a stressf...

Does Progestin Birth Control Cause Depression?

13 Dec 2018

Contributed by Lukas

Progestin only contraceptive options include the subdermal implant, Injection, IUS, and pills. Progestin based LARCs provide HIGHLY effective contrace...

“Your name is Mudd!” How “Duty to Treat” ruined a physician’s life.

11 Dec 2018

Contributed by Lukas

Dr. Samuel A. Mudd. Although few in modern times are aware of this physician, many have heard of the unwelcoming statement, “Your name is Mudd!“. ...

Talc Before Panties? A look at the curious & controversial data on talc and female cancer.

11 Dec 2018

Contributed by Lukas

Talc Before Panties? A look at the curious & controversial data on talc and female cancer... The controversy between the use of talc in the female gen...

Risk Reduction Salpingectomy

09 Dec 2018

Contributed by Lukas

An evolving burden of evidence supports the theory that a large majority of high-risk ovarian epithelial cancers have a tubal origin. RRS is growing i...

The “Big O”: Female Orgasm- The How, Why, and What of the BIG O!

08 Dec 2018

Contributed by Lukas

The “BIG O”!! This podcast will cover the biology of, purpose of, and surprising health benefits of... female orgasm. (Yep...Oh, the topics we cov...

PRES: Posterior Reversible Encephalopathy Syndrome

07 Dec 2018

Contributed by Lukas

PRES may be associated with Preeclampsia and Eclampsia. The condition is theorized to result from dys-autoregulation of posterior cerebral perfusion. ...

Ovarian Torsion

05 Dec 2018

Contributed by Lukas

Ovarian torsion is considered a gynecological emergency. Ovarian torsion can also occur in pregnancy. Recent data has confirmed the feasibility of ova...

The PALM-COEIN System for AUB

04 Dec 2018

Contributed by Lukas

In 2011, the FIGO adopted a new nomenclature to characterize abnormal uterine bleeding in the reproductive age patient. ACOG subsequently adopted the ...

Diagnosis and management of palpable breast masses

03 Dec 2018

Contributed by Lukas

Fibroadenomas are the most common cause of breast masses in adolescent girls and young women. Nonetheless, it is important to remember that the palpab...

Dysmenorrhea and Endometriosis in the Adolescent Patient

02 Dec 2018

Contributed by Lukas

This podcast is a review of the ACOG Committee Opinion 760 from December 2018. Dysmenorrhea, or menstrual pain, is the most common menstrual symptom a...

Septic Pelvic Thrombophlebitis

02 Dec 2018

Contributed by Lukas

Septic pelvic thrombophlebitis can occur in the deep pelvic vessels alone or may involve the ovarian vein. Ovarian vein thrombosis is most frequent on...

Thank you!! Danke! Gracias!

27 Nov 2018

Contributed by Lukas

Our mission is to educate, train, and develop healthcare professionals in women’s healthcare. Our podcast has hit a milestone!! This podcast, which ...

Immediate Postpartum LARCs

27 Nov 2018

Contributed by Lukas

Immediate postpartum LARCs are endorsed by the ACOG. This podcast will summarize the ACOG committee opinion 670, and review the new data (October 2018...

Pregestational Diabetes Mellitus

22 Nov 2018

Contributed by Lukas

This podcast will quickly summarize the ACOG practice bulletin number 201 on pre-gestational diabetes mellitus. This ACOG practice bulletin is set to ...

Are “routine“ pelvic examination going extinct? Let’s take a look at the data.

17 Nov 2018

Contributed by Lukas

Traditionally, a well-woman visit has included a pelvic examination defined as external genitalia inspection, speculum examination, and bimanual exam....

Elagolix: Indications, Data, and Dosing.

11 Nov 2018

Contributed by Lukas

Endometriosis related pelvic pain affects approximately 8% of reproductive age women. Recently, the FDA approved a new oral GnRH antagonist for treatm...

Migraine with Aura and Estrogen Containing Birth Control: What’s the Data on Risk?

09 Nov 2018

Contributed by Lukas

Traditionally, migraines with aura were considered contraindicated for estrogen containing birth control. However, that recommendation was made in the...

Opthalmia Neonatorum

03 Nov 2018

Contributed by Lukas

Neonatal opthalmia refers to conjunctivitis of any cause occurring within the first 4 weeks of newborn life. Gonorrhea now accounts for less than 1% o...

Asymptomatic microscopic hematuria in women

29 Oct 2018

Contributed by Lukas

In this podcast, we will cover the combined committee opinion from the ACOG and AUGS regarding asymptomatic microscopic hematuria in women. The ACOG d...

“The Savior of Women”: Ignaz Semmelweis

26 Oct 2018

Contributed by Lukas

In this brief historical profile, we will cover the inspiring tale of Dr. Ignaz Semmelweis. The story begins in the year 1846. Dr. Semmelweis was the ...

Marijuana use in pregnancy and while breast-feeding

23 Oct 2018

Contributed by Lukas

In this podcast, we will review the new clinical expert series from the ACOG on marijuana use in pregnancy and while breast-feeding. This clinical exp...

Framed, or Famed? LoL. It’s OK to laugh at yourself at times.

20 Oct 2018

Contributed by Lukas

A personal message regarding our last podcast to our listeners. 😁

How a famed surgeon changed the field of obstetrics: William Hallstead, postpartum hemorrhage, and brave genius.

20 Oct 2018

Contributed by Lukas

This is a quick historical perspective of an ingenious approach to a deadly obstetrical problem in history. Dr. William Halstead, the father of modern...

Thrombocytopenia in pregnancy

18 Oct 2018

Contributed by Lukas

Thrombocytopenia in pregnancy is defined as a maternal platelet count less than 150,000. In this podcast, we will review the ACOG practice bulletin nu...

Intrapartum Care of the HIV Positive Patient

08 Oct 2018

Contributed by Lukas

There have been significant changes – and advancement – in the interparty management of the HIV infected patient. In this session, we will quickly...

Acute Fatty Liver of Pregnancy

26 Sep 2018

Contributed by Lukas

Acute fatty liver of pregnancy is a rare but potentially life-threatening condition which usually presents in the 36th week of pregnancy. In this podc...

GBS in Pregnancy

20 Sep 2018

Contributed by Lukas

In this session, we will review the ACOG committee opinion on prevention of early onset GBS neonatal infection. This comes from the committee opinion ...

Does BMI affect emergency birth-control effectiveness?

15 Sep 2018

Contributed by Lukas

Levonorgestrel and ulipristal are 2 oral emergency contraceptive options. Since 2010, pharmacokinetic studies have suggested a lower effectiveness of ...

PMS and PMDD: Clinical Review

06 Sep 2018

Contributed by Lukas

In this session, we will review the diagnostic criteria for premenstrual syndrome and premenstrual dysphoric disorder. Options for therapy will also b...

Umbilical Cord Prolapse

30 Aug 2018

Contributed by Lukas

In this session, we will review and obstetrical emergency that has the potential to result in severe Ville and morbidity or even mortality… Umbilica...

Prophylactic Antibiotics in Labor & Delivery

28 Aug 2018

Contributed by Lukas

In this session, we will review the ACOG practice bulletin (199) from September 2018 on the use of prophylactic antibiotics in labor and delivery. Thi...

Ovarian Vein Thrombosis

20 Aug 2018

Contributed by Lukas

Ovarian vein thrombosis was recently the subject of a clinical review by the American College of OBGYN in November 2017. Ovarian vein thrombosis occur...

Clarification- Klumpke's palsy: "Neuropathy at gyn surg".

18 Aug 2018

Contributed by Lukas

Alright, as occasionally happens… There was an error in the editing of our prior podcast regarding nerve injury at gynecological surgery. This very ...

Nerve Injury at Gyn Surgery

17 Aug 2018

Contributed by Lukas

Gyn surgery can be associated with iatrogenic nerve injury. Neuropathy can be classified into three types: neuropraxia, axonotmesis, and neurotmesis. ...

Management of Intra-Amniotic Infection

12 Aug 2018

Contributed by Lukas

In this podcast, we will review the ACOG updated guidelines regarding intra-amniotic infections. Three classifications have been given by the ACOG: 1....

Delayed umbilical cord clamping after birth (ACOG CO 684)

06 Aug 2018

Contributed by Lukas

The ACOG, as well as the AAP, recommends delayed umbilical cord clamping in stable term as well as preterm neonates. While once considered necessary t...

Epithelial Ovarian Cancer

02 Aug 2018

Contributed by Lukas

Ovarian cancer is the most deadly of all gynecological malignancies. Most cases present an advanced stage. Epithelial ovarian cancer is the most commo...

Follow us on Facebook

01 Aug 2018

Contributed by Lukas

Howdy! Thanks for following our podcast. Be sure to find us, and follow us, on our Facebook page by the same name. Typically, additional information a...

Cervical Cancer

31 Jul 2018

Contributed by Lukas

Persistence of high-grade oncogenic HPV is the key risk factor for the development of cervical carcinoma. In this session, we will review the pathophy...

Endometrial Cancer

28 Jul 2018

Contributed by Lukas

Endometrial carcinoma is the most commonly diagnosed gynecologic malignancy. The SGO and the ACOG released a practice bulletin in 2015 which is the mo...

Endometrial Intraepithelial Neoplasia

28 Jul 2018

Contributed by Lukas

EIN Represents a true antecedent lesion in the endometrial cavity with the potential to develop into endometrial adenocarcinoma. This podcast will rev...

Emergency Contraception

24 Jul 2018

Contributed by Lukas

In this session, we will cover emergency contraception: levonorgestrel, Ullipristal, and the copper IUD. Data for this podcast comes from the ACOG pra...

MRI use in Pregnancy: Is Gadolinium a Concern?

23 Jul 2018

Contributed by Lukas

MRI offers some advantages over ultrasound as a diagnostic tool in pregnancy. In this session, we were review the ACOG committee opinion on MRI use in...

Ultrasound in Pregnancy PART2

22 Jul 2018

Contributed by Lukas

In Part 1, we covered the basics of OB ultrasound. In this session, a short additional piece, we answer a few additional questions regarding ultrasoun...

Ultrasound in Pregnancy

22 Jul 2018

Contributed by Lukas

Ultrasound is the most common procedure performed during pregnancy. The ACOG recognizes three types of ultrasound: standard, limited, and specialized....

Pelvic Inflammatory Disease (PID)

20 Jul 2018

Contributed by Lukas

Unrecognized or misdiagnosed PID may result in infertility, tubal pregnancy, and chronic pelvic pain. In this session, we will review the CDC guidelin...

Thromboembolism in Pregnancy

17 Jul 2018

Contributed by Lukas

In this session, we will review thromboembolism in pregnancy based on the July 2018 ACOG Practice Bulletin. We will cover DVT and PE presentation, wor...

Chancroid

16 Jul 2018

Contributed by Lukas

In this session, we will review chancroid, a genital STI caused by H. Ducreyi. This bacterium causes ulcers presenting as painful sores (soft chancre)...

Syphilis

14 Jul 2018

Contributed by Lukas

In this session, we will discuss the clinical stages of syphilis, diagnosis, treatments, and pregnancy considerations.

Gonococcal Infection

13 Jul 2018

Contributed by Lukas

In this session, we will cover the microbiology and the pathophysiological processes of gonococcal infections. Screening, treatment, and prevention of...

Chlamydial Infection in Women

12 Jul 2018

Contributed by Lukas

Chlamydia Trachomatis is the most common bacterial STI. In this session, we will review screening recommendations, treatment, pregnancy considerations...

PART 2: Chronic Hypertension in Pregnancy

11 Jul 2018

Contributed by Lukas

In this short session, we will cover recommended delivery times for women with chronic hypertension as well as breast-feeding on antihypertensive medi...

Chronic Hypertension in Pregnancy

10 Jul 2018

Contributed by Lukas

Chronic hypertension affects 3 to 5% of all pregnancies. In this session, we will cover the SMFM and ACOG bulletins on the subject. Which patients nee...

Pre-labor rupture of membranes (PROM)

05 Jul 2018

Contributed by Lukas

In January 2018, the ACOG changed the terminology for PROM, now referred to as pre-labor rupture of membranes. In this session, we will review practic...

Lactation

05 Jul 2018

Contributed by Lukas

In this session, we will review the process of mammogenesis and lactogenesis as well as the process of lactation. Mastitis and breast abscess manageme...

Managing fetal macrosomia

02 Jul 2018

Contributed by Lukas

Fetal macrosomia predisposes both the mother and child to increased risks. In this review, a summary of the ACOG practice bulletin #173, we will revie...

Update on Maternal Alloimmunization (Part 2)

25 Jun 2018

Contributed by Lukas

This is part 2 of our series on maternal alloimmunization. In this session, we will review prevention of RH isoimmunization with a brief review on Rho...

Update on Maternal Alloimminization (Part 1).

25 Jun 2018

Contributed by Lukas

In March 2018, the ACOG released an updated practice bulletin on the management of alloimmunization during pregnancy. The ability to determine genotyp...

Multifetal Gestations

23 Jun 2018

Contributed by Lukas

Multifetal gestations are either dizygotic or monozygotic. The rate of monozygotic twins tends to be constant worldwide. Twin and triplet pregnancies ...

Non-obstetrical surgical conditions in pregnancy

21 Jun 2018

Contributed by Lukas

In this session we will cover general surgery comditiond in pregnancy. The three most common non-obstetrical surgical conditions in pregnancy are: app...

Cell free DNA for fetal aneuploidy screening

20 Jun 2018

Contributed by Lukas

Cell free DNA screening evaluates short segments of DNA in a maternal serum and can be used to screen for fetal aneuploidy, fetal RH type, and sex chr...

Spontaneous abortion (Early Preg Loss)

10 Jun 2018

Contributed by Lukas

In this session, we will cover data from the ACOG practice bulletin number 150, on early pregnancy loss. We will cover etiology, diagnosis, and the th...

Prenatal (Antepartum) Care: Part 3

09 Jun 2018

Contributed by Lukas

In this final session, we will review RhoGAM use, GBS screening, and the ACOG update on vaccinations in pregnancy (Tdap).

Prenatal (Antepartum) Care: Part 2

09 Jun 2018

Contributed by Lukas

This is part 2 of our 3 part series on antepartum care. In this session, we will cover ultrasound use, screens for aneuploidy, screening for inherited...

Antepartum (Prenatal) Care: Part 1

08 Jun 2018

Contributed by Lukas

In this session, we will review the ACOG guidelines regarding specific screening tests, monitoring, and interventions during routine prenatal/antepart...

Preconception Care

08 Jun 2018

Contributed by Lukas

In this session, we will review guidelines for pre-conception care based on the ACOG current commentary.

The Obsolete Friedman Curve

05 Jun 2018

Contributed by Lukas

1955, Emmanuel Friedman described the labor progress of 500 nulliparous wowen. That curve became the standard for labor management for 60 years. Howev...

Mechanism of normal labor: the passenger and the pelvis

03 Jun 2018

Contributed by Lukas

In this session, we will cover specifics of the mechanisms of labor. We will cover details on the fetus (lie, attitude, presentation, and position) an...

Intimate partner violence

02 Jun 2018

Contributed by Lukas

In this session, we will review intimate partner violence which was presented in the American College of OB/GYN committee opinion #518.

Maternal physiologic respiratory changes in pregnancy

02 Jun 2018

Contributed by Lukas

In this session we will cover the maternal physiological changes which occurr during pregnancy.

HPV!

26 May 2018

Contributed by Lukas

In this session, we will review the pathophysiology of human papillomavirus infections. We will also cover HPV immunization, and contrast primary scre...

Sexual Assault

25 May 2018

Contributed by Lukas

In this session, we will review the ACOG committee opinion (592) on sexual assault as well as the CDC algorithm for post exposure prophylaxis followin...

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