Dr. Chapa’s OBGYN Clinical Pearls

Mini Q&A: 1. TOLAC Ut Rupture, & 2.Measles!

02 May 2025

Contributed by Lukas

I know this sounds braggadocious, but I'm going to say it anyway: I work with some incredible people! We recently released a podcast on updated TO...

Dating a TWIN Gestation: Smaller or Larger Fetal Estimate?

30 Apr 2025

Contributed by Lukas

Spontaneous twin pregnancies occur in about 1 out of every 250 pregnancies. A real world clinical question has to do with dating a spontaneous twin ge...

"TOLAC SEEMS SAFE": Ya Don't Say. (NEW DATA)

27 Apr 2025

Contributed by Lukas

In the ACOG Practice Bulletin 205 (Reaffirmed August 2025), the stated risk of uterine rupture with TOLAC is stated as 0.7% (after 1 prior LTCS). Howe...

The MYTH of Multitasking

25 Apr 2025

Contributed by Lukas

As healthcare professions we are often pulled in different directions ALL AT ONCE. It happens. We "multitask" every day. Or do we? Neuroscience actual...

The OBGYN EXODUS that wasn't (April 21, 2025 Data)

23 Apr 2025

Contributed by Lukas

I love my home state of TEXAS. I am definitely full of Texas pride. We have Texas barbecue, Texas, hospitality, and of course, the Texas music scene! ...

Rectus at CS: Close or Not?

22 Apr 2025

Contributed by Lukas

There have been various publications and commentaries published on “evidence-based” cesarean section techniques. Still, one of the persistent cont...

New ACOG Guidance on PATH Prenatal Care (May 2025)

19 Apr 2025

Contributed by Lukas

On December 13, 2022, we released an episode describing a new concept in prenatal care, called the PATH model. This was to “redesign” prenatal car...

Pelvic Congestion Syndrome (PCS): Fact or Fiction?

17 Apr 2025

Contributed by Lukas

Pelvic congestion syndrome is a controversial entity that does not currently have validated diagnostic criteria. In the ACOG PB 218 (2020), it states,...

Baby After Uterine Transplant Q&A: Fantastical Facts

14 Apr 2025

Contributed by Lukas

On Monday April 7, 2025, the UK’s publication The Guardian wrote, “Surgeons are hailing an ‘astonishing’ medical breakthrough as a woman becam...

2025 Update (ACCP): ABX Safety in Pregnancy

11 Apr 2025

Contributed by Lukas

On March 19. 2025, The American College of Clinical Pharmacy published, "A review of antibiotic safety in pregnancy- 2025 Update". In this e...

EASY BREEZY IUS Patient Tale

10 Apr 2025

Contributed by Lukas

Well Podcast Family, in this VERY BRIEF episode, we will highlight a patient's perspective on IUS insertion with lidocaine jelly pre-insertion pre...

CAT BITTEN in Pregnancy

09 Apr 2025

Contributed by Lukas

Animal bites in humans are a common problem in the United States, with two to five million occurring each year. The vast majority of animal bites are ...

Single or Multiple Dose Diflucan for VVC? Oral or Topical?

04 Apr 2025

Contributed by Lukas

VVC is second to BV in vaginitis type, here in the USA. data indicate that 75% of women have experienced at least one episode of genital candida throu...

POTS in Pregnancy

02 Apr 2025

Contributed by Lukas

Postural Orthostatic Tachycardia Syndrome (POTS), first described in the 1940s, is a heterogeneous and often debilitating condition affecting the auto...

Microhematuria: 2025 AUA/SUFU Guideline

31 Mar 2025

Contributed by Lukas

Hematuria remains one of the most common urologic diagnoses, estimated to account for over 20% of urology evaluations. Women with hematuria have been ...

BREAKING NEWS: Self-Collection STI Kit Approved

28 Mar 2025

Contributed by Lukas

HOT HOT HOT Off the News CycleL The FDA has just approved (1 hour ago) a new at-home STI test kit. Does this work? What is the data on accuracy? What ...

PCOS, Mood, and Metformin: New Data on MetSyn.

28 Mar 2025

Contributed by Lukas

Metabolic syndrome (MetSyn) is a cluster of conditions, such as increase in waist circumference, dyslipidemia (elevated triglyceride levels and reduce...

Introducing Blujepa!

25 Mar 2025

Contributed by Lukas

Throughout their lifetime, over 50% of women experience uUTIs, with recurrent infection reported in approximately 30%. Today, on March 25, 2025, the F...

Internists, IUDs, and Inspiration.

24 Mar 2025

Contributed by Lukas

Medicine has traditionally been practiced “in silos”. But compartmentalization of medical practice/interventions can leave gaps in patient care. P...

“Devil in the Details”: UPDATE on Stopping PIT in Active Labor (AJOG)

21 Mar 2025

Contributed by Lukas

TWICE BEFORE, we have covered Pitocin use intrapartum: 1. On Oct 24, 2022 we covered, “Save the Pitcoin! Safe to Stop Pit Once in Active Phase?”, ...

Perspectives From the Trenches: “The Rise of Autism”.

20 Mar 2025

Contributed by Lukas

Fresh off the heels of our immediate last episode, we bring you a perspective from the trenches! Sarah, a Clinical Pearls podcast family member, is a ...

Does OB N/V = Autism?

19 Mar 2025

Contributed by Lukas

Autism Spectrum Disorder (ASD) has an alarming trend of rise in the US. Currently, 1 in 36 (or 1 in 40 in some reports) have an ASD diagnosis. For thi...

Ramadan Fasting & Pregnancy

14 Mar 2025

Contributed by Lukas

Fasting during the lunar month of Ramadan (Feb 28 to March 30, 2025) is a core practice for Muslims across the world. During Ramadan, Muslims abstain ...

Vaginal Seeding…AGAIN?

13 Mar 2025

Contributed by Lukas

Infants born by vaginal birth are exposed to maternal vaginal bacteria, which are one of the contributing influences on the subsequent development of ...

Introducing: MIUDELLA®

10 Mar 2025

Contributed by Lukas

On Feb 24, 2025, the FDA granted approval for MIUDELLA®, a hormone-free, low-dose copper IUD developed by US manufacturer Sebela Women's Health I...

Treat MEN for BV Protection in Women?

07 Mar 2025

Contributed by Lukas

BV is a vaginal dysbiosis resulting from replacement of normal hydrogen peroxide and lactic-acid producing Lactobacillus species in the vagina with ...

Danny vs Dave Thomas!! (Editorial Correction to SMA Episode)

06 Mar 2025

Contributed by Lukas

Thank you to our GREAT podcast family members who fixed by history regarding "Hollyweird" ! And thank you DANNY Thomas for your legacy at SJ...

Breakthrough in Prenatal SMA Therapy

06 Mar 2025

Contributed by Lukas

Screening for spinal muscular atrophy (SMA) should be offered to all women who are considering pregnancy or are currently pregnant. SMA is an autosoma...

Vit D and PTB (“New” Feb 2025 Data?)

03 Mar 2025

Contributed by Lukas

Vitamin D gets a lot of attention, and it should, mainly for its known role in bone stability. However, vitamin D has significant additional roles in ...

ASA Desensitization in Pregnancy

28 Feb 2025

Contributed by Lukas

According to published estimates, the prevalence of an NSAID allergy (hypersensitivity) in the general population is estimated to be between 0.5% and ...

MEASLES 101! What to Know.

24 Feb 2025

Contributed by Lukas

Its BACK. While the current outbreak is in western Texas and Eastern NM, it is expected to spread to other States. Measles is an acute viral respirato...

TOLAC: IOL or Wait? (March 2025 Data)

22 Feb 2025

Contributed by Lukas

The ACOG's PB 205 (2019; reaffirmed Aug 2024) states that "when compared with spontaneous labor, induced labor is associated with a lower likelihood o...

Funic Presentations at Term: CS or Not? Timing?

20 Feb 2025

Contributed by Lukas

Funic presentation, the umbilical cord presenting as the leading feal component seen on ultrasound, may be a transient phenomenon and is usually consi...

Excessive Maternal Wt Gain (gwg) = Stillbirth?

17 Feb 2025

Contributed by Lukas

One in five women in the U.S. have a BMI of 30 or more at the START of pregnancy. Around 1 in 5 women gain more than 40 pounds during pregnancy, which...

PUR and Peppermint Oil?

15 Feb 2025

Contributed by Lukas

Estimates of Postpartum Urinary Retention (PUR) incidence vary widely from 1.5% to 17.9%, with undiagnosed cases making the true incidence difficult t...

PP Ibuprofen with HDP? “NEW info”.

12 Feb 2025

Contributed by Lukas

In 2013, The ACOG’s Hypertension Task Force suggested that NSAIDS not be used in postpartum patients with hypertensive disorders of pregnancy due to...

The Survey Says....! (FULL EPISODE)

11 Feb 2025

Contributed by Lukas

(We were made aware that this original posting had the last section DROPPED accidentally)...here is the full episode! Ahhh...TECHNOLOGY! *This is why ...

The Survey Says...! (PLEASE SEE UPDATED VERSION 2/11/25)

10 Feb 2025

Contributed by Lukas

Well, we typically focus on ONE or maybe TWO publications to highlight and review. However, in this episode, which we have decided to call, “Survey ...

Severe CHTN or Superimposed PreE w/Severe Features?

06 Feb 2025

Contributed by Lukas

Yep, its an area of debate and confusion. Controversy surrounds the diagnosis of CHTN with severe BPs vs superimposed preeclampsia with severe feature...

Eclampsia = Brain Scan?

04 Feb 2025

Contributed by Lukas

According to the ACOG, eclampsia is a low frequency, high acuity emergent condition. The rate of an eclamptic seizure is 1/200 in those with preeclamp...

“Sounds Reasonable”! 3 Things to Consider.

01 Feb 2025

Contributed by Lukas

Well, in this episode we have a “3-in-1” subject review. Often in medicine, we find ourselves with some data to guide us, but definitely not a “...

No Need for PP LMWH VTE Prophylaxis?

28 Jan 2025

Contributed by Lukas

Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is responsible for 9–30% of pregnancy-related mortality in...

"CNN" Update (Chapa News Network): 1. ACOG RSV-GBS Response, 2. TRD

24 Jan 2025

Contributed by Lukas

This- is-CNN. No, that THAT CNN...This is Chapa News Network! WE have late-breaking news developments on 2 fronts: 1. The ACOG has released a clinical...

Is Sleep Position REALLY Linked to Stillbirth?

23 Jan 2025

Contributed by Lukas

Around a third of a person’s life is spent asleep. Previous studies have reported an association between sleep disordered breathing, like OSA, and p...

External Aortic Compression: Buying Time in Pelvic Hemorrhage

21 Jan 2025

Contributed by Lukas

Internal manual aortic compression is a procedure that may be used intraoperatively in the management of massive pelvic bleeding. But what about EXTER...

The Miracle Med in Menses? MenSCs.

20 Jan 2025

Contributed by Lukas

Mesenchymal stem cells (MSCs) are multipotent adult stem cells which can differentiate into multiple cell types. MSCs can be isolated from the bone ma...

Maternal Tachycardia: When to Eval.

17 Jan 2025

Contributed by Lukas

Tachycardia in pregnancy is common and distinguishing between physiological and pathological causes can be a challenge. Plus, until recently, there ha...

Time for Stillbirth Prevention Bundle: NOW.

13 Jan 2025

Contributed by Lukas

The stillbirth rate in the US is considerably higher than in many countries with similar resources. In 2021, the United States stillbirth (loss before...

*FDA Warning*: RSV Vacc and GBS (Breaking it Down)

10 Jan 2025

Contributed by Lukas

Guillain-Barré syndrome (GBS) is a rare disorder that causes muscle weakness and sometimes paralysis. It's caused by the body's immune system damagin...

Response to 2 New Pubs: “Ya Don’t Say?!” (Sarcasm Added)

08 Jan 2025

Contributed by Lukas

Sometimes you read a new study and you just have to say, "You Don't Say?!" In this episode, we will highlight 2 publications which were released Dec 2...

2 Topics: 1.New, and 2.Weird!

07 Jan 2025

Contributed by Lukas

In this episode, we will cover 2 topics: the first is brand new in print (01/06/2025 ), and the second is just weird. In the “new” portion we'll s...

Mode of Delivery for Periviable PTB: Does it Matter?

05 Jan 2025

Contributed by Lukas

Preterm infants, especially those born at periviability, are at inherent risk of a variety of short-term neonatal complications- depending on their ge...

MATISSE Trial: Maternal RSV Vaccine Outcomes

03 Jan 2025

Contributed by Lukas

In most regions of the United States, RSV season starts in the fall and peaks in the winter. In September 2023, the ACOG released a Practice Advisory ...

FDA Lit Review on Tampon Safety Released

28 Dec 2024

Contributed by Lukas

In August 2024, researchers at Columbia University published a study that found measurable concentrations of 16 metals in multiple brands of tampons. ...

Take Aspirin to Prevent PP HTN?

26 Dec 2024

Contributed by Lukas

Low-dose aspirin (LDA), typically prescribed at a dosage of 81 mg daily, is primarily used during pregnancy to prevent or delay the onset of preeclamp...

The Controversy of Cerclage and PPROM

23 Dec 2024

Contributed by Lukas

Somethings in medicine are pretty cut and dry. Others...not so much. Such is the case with obstetrical management of PPROM with a cervical cerclage in...

2025 SFP Statement on BC and Body Weight

19 Dec 2024

Contributed by Lukas

In late 2024, the CDC updated their MEC on contraception in those with medical co-morbidities. Obesity (BMI >/= 30) was also referenced in that rev...

Fetal RHD Positive, Yet RH Blood Type Negative at Birth? YEP.

16 Dec 2024

Contributed by Lukas

We have made SIGNIFICANT progress in our ability to screen for fetal RH factor using cell free DNA from maternal blood. Cell-free DNA to determine the...

Best ASA Admin Time? YEP, there IS one.

13 Dec 2024

Contributed by Lukas

The saying says, “The Devil is in the details”. This idiomatic phrase that means even the grandest project depends on the success of the smallest ...

BRAND NEW USPSTF Recs (12/10/24) on HPV Screening

11 Dec 2024

Contributed by Lukas

EVERYTHING CHANGES! So true. And now, the USPSTF has changed (UPDATED) their recommendations for cervical cancer screening in regards to HPV primary s...

Episode: OB Sono “Issues”: 2 for 2.

09 Dec 2024

Contributed by Lukas

Well, in this episode we have 2 very interesting and challenging clinical situations. These come from real world clinical encounters so we thought we ...

NEW DATA: Acetaminophen in OB=ADHD & ASD! (Not So Much.)

06 Dec 2024

Contributed by Lukas

Acetaminophen (Paracetamol) is a common over-the-counter medication that has gained substantial media attention regarding its use by pregnant women. A...

Another Nail in the 81mg ASA Coffin? Move to 162mg?

02 Dec 2024

Contributed by Lukas

In November 2013, ACOG issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin (81mg) beginning in the late 1st tri...

The Fertility Anxiety Panic: Freeze Eggs in 20s?

28 Nov 2024

Contributed by Lukas

The first successful births from frozen eggs were twins, born in Australia in 1986. IVF serves a valuable role for those with persistent infertility i...

Avoiding Sex While Pregnant, To Avoid Pregnancy? And MORE!

26 Nov 2024

Contributed by Lukas

Introducing one of our Senior Residents, Dr. Mauldin: Dr. Mauldin just told me of a real patient encounter she had just today, that I felt we HAD to s...

Chewing Gum to Prevent Preterm Birth! Maybe.

23 Nov 2024

Contributed by Lukas

In the United States, more than 400,000 babies are born prematurely each year, which is about 1 in 10 babies. Over the last several decades, multipl...

Understanding Dual Stain in HPV Triage (ASCCP 2024 Update)

20 Nov 2024

Contributed by Lukas

The U.S. Preventive Services Task Force and the World Health Organization recommend primary HPV screening, starting at age 25, as an option (some as p...

New Data: Vaginal Estrogen Use in Breast CA Survivors

18 Nov 2024

Contributed by Lukas

With an estimated 3.8 million breast cancer survivors in the United States, OBGYNs and other women's healthcare providers often are on the front lines...

Steroids & Studies & "Shared-Decisions": Oh My!

15 Nov 2024

Contributed by Lukas

Yep! We have definitely covered the evolving saga and controversy regarding antenatal corticosteroids in the late preterm/early term interval. It's li...

A Mini-Plethora of ObGyn News

13 Nov 2024

Contributed by Lukas

Well, in the last 4 weeks there have some interesting developments in the sphere of OBGYN medical news. In October 2024, out of the American Society o...

Was the ARRIVE Trial an IOL Mandate? (New ACOG CPU)

09 Nov 2024

Contributed by Lukas

The ARRIVE was published in the New England Journal of Medicine on August 8, 2018 1. This study was a large unmasked multicenter trial conducted from ...

New Data for UTI in Women

07 Nov 2024

Contributed by Lukas

Urinary tract infections (UTIs) are a leading cause of health care visits in the USA and around the world. In the US, they have a cost burden of $3.5 ...

Does OB Superficial Thrombophlebitis (SVT) Need LMWH? YES, and NO.

05 Nov 2024

Contributed by Lukas

Everyone understands that VTE (DVT and/or VTE) requires life-saving anticoagulation. That's simple. No controversy there. But what about pregnancy-ass...

24-28 Hour Post-CS Discharge: New Data

31 Oct 2024

Contributed by Lukas

According to the UK’s National Institute for Health and Care Excellence (NICE; 2024), women who are S/P scheduled CS and recovering well, who are af...

Q&A: ABRYSVO® Every Pregnancy? Clitoxin™?

28 Oct 2024

Contributed by Lukas

Welcome Back to another episode of "You ask, We Answer"! As Abrysvo (RSV vaccine) now has some time on the market, some women may find themselves with...

Can Placental Volume on Sono Predict IUFD?

26 Oct 2024

Contributed by Lukas

Ultrasound assessment of placental volume has been proposed as an important aspect of prenatal care. It involves measuring the size and volume of the ...

New AHA/ASA 2024 Guidance: WH Focus

24 Oct 2024

Contributed by Lukas

Stroke is also a leading cause of adult-onset disability; among individuals who survive 6 months, almost half are dependent in at least 1 activity of ...

The Enigma of Endo and Early Birth

23 Oct 2024

Contributed by Lukas

Several observational studies have suggested that women with endometriosis have a slightly increased risk for preterm birth. The cause seems to be rel...

Insulin Initiation Made Easy

20 Oct 2024

Contributed by Lukas

In November's Green Journal, Drs Amy Valent and Linda Barbour will publish their Clinical Expert Series (CES) on insulin management in GDM and Type 2 ...

The OCP Makes You Gay?

19 Oct 2024

Contributed by Lukas

The relationship between hormonal birth control and sexual orientation has been a topic on social media channels and threads; it is a discussion of co...

Miso for EPF With Prior CSs?

16 Oct 2024

Contributed by Lukas

Early pregnancy failure (EPF), pregnancy loss in the first trimester, is a common pregnancy complication, with 15 to 20% of clinically recognized preg...

RPL with APS: When to Start RX

15 Oct 2024

Contributed by Lukas

The SMFM, ACOG and RCOG all recommend screening for Antiphospholipid Antibody Syndrome (APS) in women with Recurrent Pregnancy Loss (RPL). However, on...

CHS in pregnancy (Updated Data)

12 Oct 2024

Contributed by Lukas

Cannabinoid Hyperemesis Syndrome (CHS): Yep, this is definitely an issue and has been in recent print. This was just covered in an expert commentary i...

Dehydration Causes OB Contractions? YES, and NO.

10 Oct 2024

Contributed by Lukas

Proper hydration is important for physiology whether male or female, and if female… hydration in pregnancy is important for proper uterine blood flo...

Dupixent Use in Pregnancy: Sept 2024 Data

09 Oct 2024

Contributed by Lukas

Eczema is also known as a form of Atopic Dermatitis (AD). Males and females are not equally affected by AD, and studies have shown that AD is more com...

Pump the Brakes on "ROUTINE" IV Fluids in Labor (SMFM ALERT)

08 Oct 2024

Contributed by Lukas

Hurricane Helene has caused massive devastation for a part of the US, and now we are bracing again for Milton, set to affect Florida within the next 2...

The Pregnancy “One-Stop Shop”: Screen for BRCA1? HPV Vacc PP?

06 Oct 2024

Contributed by Lukas

BRCA1 mutations dramatically increase the lifetime risk of breast, ovarian, pancreatic, and other cancers, yet most BRCA1-positive patients are not id...

Bed Rest for FGR? Surprising 2024 Data

02 Oct 2024

Contributed by Lukas

The ACOG defines Fetal Growth Restriction (FGR) as fetuses with an estimated fetal weight or abdominal circumference that is less than the 10th percen...

Use 130/80 Cut-off in OB? Depends! (CHIP, CHAP, & CLIP).

01 Oct 2024

Contributed by Lukas

In the ACOG practice bulletin 203, the ACOG states that, “Traditionally, the diagnosis of hypertension (HTN) in pregnancy has been 140/90, on 2 occa...

D-MER: Breastfeeding's Ugly Side

28 Sep 2024

Contributed by Lukas

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional "drop" that occurs in some women just before milk release and continues for not more tha...

It's a Small World

26 Sep 2024

Contributed by Lukas

Podcast Family, every once in a while we need a little reminder that we are all wired for community. Despite differences in geographic locations, cult...

Does LNG-IUS Increase Breast CA?

24 Sep 2024

Contributed by Lukas

The LNG-IUS has been on the U.S. market since 2001. Since 2005, there have been several studies examining the association (if any) of LNG-IUS users an...

Labor Hacks? Pit Breaks, Propranolol, & Calcium

22 Sep 2024

Contributed by Lukas

We all what to win in life, right? That’s why we have life hacks…to beat the system. Sometimes those tricks are tremendously successful while some...

New Meta-Analysis on Immediate PP GTT (Sept 19, 2024)

20 Sep 2024

Contributed by Lukas

On May 22, 2024, we summarized a then soon-to-be-released ACOG CPU on Screening for GDM in Pregnancy and Postpartum. That CPU was officially released ...

The "Tradition" of 24-Hrs PP MagSo4

17 Sep 2024

Contributed by Lukas

Magnesium Sulfate for preeclampisa can be traced back to the work of Horn in 1906! Yet, despite such a long history of use, there are still questions ...

Alpha-Gal Syndrome in Pregnancy

13 Sep 2024

Contributed by Lukas

Filet Mignon, Pork Loin, Rib-Eye….all delicious (unless you are vegetarian)! If you are a meat- eater, be aware of AGS. Alpha-gal syndrome (AGS), al...

NEW SPECIAL REPORT: FDA SAFETY NOTICE for Veozah

13 Sep 2024

Contributed by Lukas

Today, 9/12/24, the FDA released a SAFETY COMMUNICATION regarding Veozah. As you may recall, we have been following this novel medication since March ...

New CPU from ACOG (9/10/24): RH IG Under 12 weeks

11 Sep 2024

Contributed by Lukas

Back in January 2024, we summarized the SFP's position statement on RH IG use (or rather non-use) under 12 weeks IUP gestations. Then, in February...

ONE MORE Random Question/Specific Answer: ABX with Bakri?

10 Sep 2024

Contributed by Lukas

In our last episode we tackled random questions with specific answers. After that episode went live, one of our nurses asked about the value of antibi...

Random Questions: Specific Answers!

08 Sep 2024

Contributed by Lukas

Welcome to this episode of "Random Questions: Specific Answers"! In this episode we will (surprise) answer random questions- with specific a...