Dr. Chapa’s OBGYN Clinical Pearls
Episodes
The REFEREE: MORE SSRI and PTB Info (Sept 2024)
05 Sep 2024
Contributed by Lukas
on 09/02/2024, we released an episode called, "Do SSRIs Raise PTB Risk?". In that episode, we highlighted a new publication from the AJOG (A...
Failure Rates S/P Tubal Sterilization: NOT What we Thought.
04 Sep 2024
Contributed by Lukas
Tubal sterilization goes back to the 1880s. The first collaborative review of sterilization effectiveness was the CREST study published in 1996 in the...
Do SSRIs Raise PTB Risk?
02 Sep 2024
Contributed by Lukas
Depressive disorders during pregnancy are common, with estimated prevalence ranging from 11% to 16%. Accordingly, antidepressant drugs, most commonly ...
OROPOUCHE!
30 Aug 2024
Contributed by Lukas
Just when we thought we had put coronavirus in our rearview mirror for the most part, here comes mPOX again. We covered that in a previous episode. Un...
“New” Info on PCOS: Name Change? OB Implications?
29 Aug 2024
Contributed by Lukas
Polycystic ovary syndrome (PCOS) was first described in 1935 by Irving Freiler Stein and Michael Leo Leventhal at the Central Association of Obstetric...
BRAND NEW Lexicon for 1st Trimester US (08/27/24)!
28 Aug 2024
Contributed by Lukas
Our immediate past episode focused on the “C-section scar pregnancy”. In that episode we discussed the ultrasound markers of early pregnancy (firs...
CS Scar Pregnancy
26 Aug 2024
Contributed by Lukas
Cesarean scar pregnancy (CSP) occurs when an early pregnancy implants on the cesarean scar defect (CSD), myometrial tissue previously disrupted by ces...
Make it TIGHT! 😳
24 Aug 2024
Contributed by Lukas
(DISCLOSURE: Sexual Content) Back in April 2023, we released an episode on the “Jade Vaginal Egg” and vaginal weights for vaginal tightening. Whil...
The “Broken” IUD: Detection and Clinical Management
22 Aug 2024
Contributed by Lukas
The IUD is a very safe and supremely effective contraceptive method. Given its increasing rate of use, practitioners are bound to see its relatively i...
Umbilical Cord Gases: What, Why, When?
21 Aug 2024
Contributed by Lukas
In 1958, James et al. first described umbilical cord blood gas analysis to evaluate the fetus's metabolic condition at the time of delivery. It...
FDA HPV Self-Swab Ready Aug 15, '24: NOT FOR HOME (Listen for Details)
18 Aug 2024
Contributed by Lukas
According to the National Institutes of Health, almost 13,000 women in the United States are diagnosed with cervical cancer each year, resulting in ar...
NEW Syphilis At-Home Test: Promises and Problems
18 Aug 2024
Contributed by Lukas
The rise of home testing for STIs/HIV started long before the recent pandemic (the FDA approved its first HIV home test collection kit way back in 199...
2024 UPDATE: Mpox in Pregnancy
16 Aug 2024
Contributed by Lukas
The World Health Organization declared on 8/14/24 that the increasing spread of Mpox in Africa is a global health emergency, warning the virus might u...
Boar’s Head, Listeria, and Pregnancy
13 Aug 2024
Contributed by Lukas
On July 26, 2024, Boar’s Head issued its recall of 7 million pounds of ready-to-eat meat and poultry products that might be contaminated with the po...
New Way to Reduce HDFN?: Enter, Nipocalimab
12 Aug 2024
Contributed by Lukas
Our tagline, “Medicine moves fast“, is the absolute truth! Historically, identification of fetuses at risk of hemolytic disease of the fetus/newbo...
The Return to LT-O-Whole Blood (LTOWB) for OB Transfusion
09 Aug 2024
Contributed by Lukas
Prior to the 1970s, when component therapy became the preferred method of resuscitation, whole blood (WB) was the resuscitative medium of choice for h...
2024 CDC MEC UPDATE! HOT OFF THE PRESS!
08 Aug 2024
Contributed by Lukas
MEC CHANGES ARE HERE! During January 2022, the CDC held virtual scoping meetings that included 27 participants with expertise in contraception, adoles...
New Non-Estrogen Medication for Hot Flashes? Veozah's Competitor
03 Aug 2024
Contributed by Lukas
In May 2023, the FDA approved fezolinetant (Veozah), an oral medication that's the first neurokinin 3 (NK3) receptor antagonist to treat moderate ...
Antepartum AI for Stillbirth Prevention
02 Aug 2024
Contributed by Lukas
Artificial Intelligence (AI) has arrived. Machine Learning is a form of AI which is being investigated/used for improving maternal outcomes. The UK ha...
Maternal Obesity and SUID: New Data
30 Jul 2024
Contributed by Lukas
We all are aware that multiple adverse obstetrical outcomes have been linked to maternal obesity, such as stillbirth, preterm birth, NICUs admission, ...
NEW Clinical Practice Update (Aug 2024)
29 Jul 2024
Contributed by Lukas
Our immediate past episode summarized a validation study of cell-free DNA (cfDNA) isolated from maternal plasma for fetal RBC genotyping in alloimmuni...
cfDNA Fetal RBC Genotyping in Alloimmunized Pregnancies: July 2024 NEW DATA
27 Jul 2024
Contributed by Lukas
In September 2022, a cell-free DNA assay using next-generation sequencing and quantitative counting tech for fetal antigen status determination became...
Skyrocketing Sex Strangulation Rates: The Alert
26 Jul 2024
Contributed by Lukas
First off, let’s all agree that everyone has a different STYLE of sexual intimacy, and that’s OK. Yep, we all understand that there's always b...
Candida as IAI & Perinatal Sepsis? YES.
24 Jul 2024
Contributed by Lukas
Candida in women is being right? Afterall, vulvovaginal candidiasis during pregnancy is common. Candida species may be isolated from the vagina of 15 ...
The New PreTRM Biomarker Test
22 Jul 2024
Contributed by Lukas
Biomarker testing has arrived in Obstetrics. Of course, we have been using some biomarkers for years, like PAMG1 (Amnisure) and AFP+ILGFBP1 (ROM Plus)...
Sequential CX Ripening: Which Should Be First?
21 Jul 2024
Contributed by Lukas
Published studies, including 2 large network meta-analyses, support the safety and efficacy of misoprostol (PG E1) when used for cervical ripening and...
Latent TB Treatment in OB
19 Jul 2024
Contributed by Lukas
Tuberculosis (TB) was historically called "consumption" due to the dramatic weight loss and wasting away experienced by patients. The modern...
Previable and Periviable PPROM (NEW SMFM CS #71)
17 Jul 2024
Contributed by Lukas
Approximately 0.5% of all births occur before the 3rd trimester of pregnancy, and very early deliveries result in the majority of neonatal deaths and ...
Toxic Tampons?!
15 Jul 2024
Contributed by Lukas
Researchers estimate that more than 100 million women in over 120 countries use tampons during their menstrual cycle. Tampons are generally considered...
Does Summer Heat Imprint Childhood Cancer In-Utero?
13 Jul 2024
Contributed by Lukas
It's Summer…and its getting HOT in here! Although the effect of heatwaves in pregnancy has been studied various times, the data remains limited ...
New Fast Track Designation for ENDO DX tool
11 Jul 2024
Contributed by Lukas
Up to 1 in 10 reproductive-aged women are impacted by endometriosis. Dysmenorrhea is the most common pelvic complaint of adolescents. While most cases...
Well, That's Interesting...Say Whaaaat?
10 Jul 2024
Contributed by Lukas
Well, sometimes the "traditional", evidence-based recommendations don't have the desired result they are supposed to. When the "usu...
New Data (July 8, 2024) for Maternal RSV Vaccine
09 Jul 2024
Contributed by Lukas
RSV season is just around the corner (Fall and Winter months). Newborns are 16x more likely to be hospitalized with serious RSV lung infection than th...
Is Risk-Reducing OS for Ov Ca Overrated?
08 Jul 2024
Contributed by Lukas
A substantial collection of evidence indicates that the fallopian tube serves as the primary site of origin for a large portion of high-grade serous o...
SAB: Which Genetic Test is Which, and When?
05 Jul 2024
Contributed by Lukas
Approximately 20% to 25% of pregnancies end in miscarriage, and there are many medical reasons why it may occur. About half are caused by chromosome a...
Do Fireworks Harm a Pregnancy?
04 Jul 2024
Contributed by Lukas
Happy Independence Day, America! We hope you are enjoying this wonderful, national holiday. Yep...Its a PARTY in the USA! In light of the festivities,...
Adolescents in the ED Need BC!
02 Jul 2024
Contributed by Lukas
(Here’s a WONDERFUL QI Project for this New Residency Academic Year) With 70.8% of pregnancies among adolescents being unintended, there is a clear ...
Fear the 37.5-37.9 °C Temp with PROM?
30 Jun 2024
Contributed by Lukas
PROM occurs in approximately 10% of pregnancies and leads to a risk of IAI in women that is 3 times higher than that in non-PROM women. The risk of ea...
THANK YOU (for Daniel and Isaac)
29 Jun 2024
Contributed by Lukas
Podcast Family, I hope this episode gives you pause and brightens your day 🌞. Just a quick work and acknowledgement to likley our YOUNGEST podcast ...
Do OCPS Cause Hypothyroidism?
28 Jun 2024
Contributed by Lukas
Oral Hormonal contraception gets the blame for a lot of things, including the development of hypothyroidism. Hypothyroidism is one of the most common ...
PROM: Pit or Cytotec?
26 Jun 2024
Contributed by Lukas
Podcast Fam, on March 27, 2024 our episode was called "Balloon for PROM: Yea or Nay". Although mechanical cervical balloons for induction were the foc...
Maternal Stress & The Fetal Brain
23 Jun 2024
Contributed by Lukas
Anxiety disorders are the most common mental health issue in the United States, affecting nearly 1 in 5 adults, or 40 million people. Another 19 milli...
OB EPO Use & Blood Salvage at CS (IOCS)
21 Jun 2024
Contributed by Lukas
Respect for patient autonomy is a fundamental part of the clinician-patient relationship and discussion of healthcare interventions. Some patients dec...
Sildenafil Cream for Women? “New” Data (June 18, 2024)
19 Jun 2024
Contributed by Lukas
"HSDD" as a diagnosis has been gone for some time. According to the ACOG, the DSM-V defines the combined entity of female sexual interest/arousal diso...
More PP HTN NEWS (June 12, 2024 Data)
17 Jun 2024
Contributed by Lukas
Hypertensive disorders of pregnancy (HDP), including chronic hypertension, gestational hypertension, and pre-eclampsia, are increasingly common in the...
IOPP For Post CS Opioids “New Data”
14 Jun 2024
Contributed by Lukas
At time of post cesarean discharge, most providers prescribe a fixed number of opioid tablets. However, past data has shown that most patients don't u...
(You ASKED) TOLAC IOL or Expectant Care: PART 2!
11 Jun 2024
Contributed by Lukas
Podcast Family, this episode has 2 parts: 1. First, a "non-medical" little life lesson that I heard recently which I will share with you...I...
TOLAC: IOL at 39 Wks or Wait?
10 Jun 2024
Contributed by Lukas
After a primary CS, the decision to undergo trial of labor after cesarean (TOLAC) or schedule a repeat cesarean birth is one in which a patient’s va...
IM Vit K Avoidance at Birth: Alternatives?
09 Jun 2024
Contributed by Lukas
Hemorrhagic disease of the newborn (HDNB) was first identified over a century ago, and presents as unexpected bleeding, often with gastrointestinal he...
🔥NEW PRACTICE UPDATE: Paternal & Fetal Genotyping (cfDNA) in Alloimmunized Pregnancy
05 Jun 2024
Contributed by Lukas
Proving that our podcast tagline, “Medicine Moves Fast” is true… this episode highlights something that is, once again, 🔥🔥🔥 Off the Pre...
cCMV (Part 2): Prevention, and Care.
05 Jun 2024
Contributed by Lukas
June is CMV awareness month. And that’s the keyword there… Awareness! The way we prevent CMV transmission is by awareness. It would be great to ha...
cCMV (Part 1): Presentation, Transmission, & Workup
03 Jun 2024
Contributed by Lukas
In 2011, Congress passed a resolution naming June "National CMV Awareness Month," to raise awareness about the most common congenital infection in the...
Does BDP Cause Adverse Preg Outcomes?
29 May 2024
Contributed by Lukas
(VACAY EDITION) Recently in our high-risk OB clinic, I saw a patient who was disappointed that she “had to stop breastfeeding” as she entered her ...
The Remedy for Painful IUD Insertion?
28 May 2024
Contributed by Lukas
In our podcast archive, we have an episode titled, “TikToc’s #IUD is Killing a Good LARC”. In that episode, I discussed our protocol of using vi...
UPDATE: Universal CX Length Screening and More Progesterone Stuff!
23 May 2024
Contributed by Lukas
It definitely is interesting how published data tends to have sporadic “groupings” in print. For example, last week 2 publications were released w...
New GDM Guidance!
22 May 2024
Contributed by Lukas
It’s exciting to know that we are practicing a type of medicine that is alive and ever-evolving! Such is the case regarding our clinical practice/ma...
Fluoride in Drinking Water Harmful in Pregnancy? Fake News or Real Foe?
21 May 2024
Contributed by Lukas
The United States began adding fluoride to community water supplies in 1945. At that time, Grand Rapids, Michigan became the first community in the wo...
Fun Stories From ACOG… & MORE!
19 May 2024
Contributed by Lukas
Podcast family, this episode is recorded on the last day of the ACOG ACSM. Wanted to share with you some encouragement that I received from our podcas...
Lioness Device: New Hope for PTB?
16 May 2024
Contributed by Lukas
We all can agree that we need a new ally against the foe of pre-term birth. With the disappointing results regarding the (lack of) efficacy of progest...
🔥OFF THE PRESS: Best Dose of UFH for Antepartum Inpatients? (May 14, 2024 Data)
14 May 2024
Contributed by Lukas
Unbelievable timing! In our immediate past episode, we discussed the controversy surrounding pharmacoprophylaxis for antepartum inpatients. Just 3 day...
Lovenox for Antepartum Inpatients?
11 May 2024
Contributed by Lukas
All of us can agree that the rates of obesity are progressively climbing, not just in the US, but globally. Obesity is a known independent risk factor...
DQC: New Hope for Vaginosis
09 May 2024
Contributed by Lukas
Bacterial vaginosis (BV) is known as a normal vaginal microbiota resulting in low lactobacilli; it affects one-quarter to one-third of reproductive-ag...
Tocolysis Confusion!
07 May 2024
Contributed by Lukas
Preterm birth is the leading cause of death in newborns and children. Tocolytic drugs aim to delay preterm birth by suppressing uterine contractions t...
Puerperal Group A Streptococcus Infection
05 May 2024
Contributed by Lukas
Haemorrhage, hypertensive disorders, and sepsis are responsible for more than half of maternal deaths worldwide. Further, it is estimated that for eve...
The HRT Makeover
03 May 2024
Contributed by Lukas
Menopausal HRT is getting a big, big facelift! Get ready for new research trials, physician education programs, and patient awareness campaigns on men...
What the What?!
01 May 2024
Contributed by Lukas
Just the other day in my University clinic, in one single morning, I had 3 separate patients with three very interesting histories; these became the b...
NEW TODAY! USPSTF MMG Update
30 Apr 2024
Contributed by Lukas
Well, once again… Late breaking news! Today, April 30, 2024, the USPSTF released its updated recommendations for breast cancer screening (mammograph...
🔥 Clinical Practice UPDATE: IAI and FEVER (April 29, 2024) 🔥
30 Apr 2024
Contributed by Lukas
Traditionally, clinical guidance has incorporated maternal fever as a required criterion for suspected intraamniotic infection. That is exactly what i...
Regenerative Medicine in GYN
28 Apr 2024
Contributed by Lukas
Regenerative Medicine is definitively a HOT and marketable offering across a variety of medical disciplines. But it is equally as controversial. The m...
⭐️OBGYN NEWS UPDATE (ALERT): 🔥🔥Off The PRESS
26 Apr 2024
Contributed by Lukas
WOW. There has been a lot of new developments in the ObGyn world within the last 48 hours. In this episode, we will highlight 3 big developments/alert...
FACT or FICTION: Menstrual Synching; and Use of the “Q” Word!
25 Apr 2024
Contributed by Lukas
(With Resident Co-Host Dr Taylor Apley) Menstrual synchrony is often reported by all-female living groups and by mothers, daughters and sisters who ar...
Good News for ALPS Follow up?
24 Apr 2024
Contributed by Lukas
Our regular podcast family members know that we have been following the antenatal corticosteroid story (especially in the late pre-term/early term int...
Gestational Breast Cancer (PABC)
22 Apr 2024
Contributed by Lukas
Breast cancer is the second most common cancer among women in the United States (with skin cancer are the most common). About 9% of all new cases of b...
Colostrum Harvesting? Do No or Not To Do…That’s The Question.
19 Apr 2024
Contributed by Lukas
Historically, colostrum was expressed by women mid- to late-pregnancy with the intent to avoid engorgement and breast trauma in the postnatal period, ...
New Practice Advisory for Syphilis in Pregnancy (April 2024)
18 Apr 2024
Contributed by Lukas
From 2012 to 2021, congenital syphilis cases in the United States increased by 755%. According to the CDC, 88% of congenital syphilis cases in 2022 co...
Female Low T?
17 Apr 2024
Contributed by Lukas
There is a STRONG debate within the medical community as to whether testosterone should be prescribed to women during menopause and the time before an...
IV Fe PP, and More
15 Apr 2024
Contributed by Lukas
While the importance of optimizing a woman's hemoglobin level during the peripartum period has been emphasized in recent guidelines by the Society for...
Amnioinfusion with IAI? Yay or Nay?
12 Apr 2024
Contributed by Lukas
Amnioinfusion was first described in 1976 using a rhesus monkey model. In that landmark study, the authors reported that variable decelerations occurr...
Acetaminophen (Paracetamol) in Pregnancy and Autism: Latest Data (April 9, 2024)
10 Apr 2024
Contributed by Lukas
In 2014, a publication out of JAMA Pediatrics raised questions regarding the safety of acetaminophen in pregnancy describing a possible “association...
When Things Go South: Perinatal PTSD
08 Apr 2024
Contributed by Lukas
It has been stated that “Trauma is in the eye of the beholder”. Healthcare providers must be aware that a woman makes experience a birth as trauma...
New HDP Med Data: The PYTT Study
07 Apr 2024
Contributed by Lukas
In July 2023 and again in November 2023, we discussed the “Rule of 55“ and its role in the management of hypertensive disorders of pregnancy. The ...
The Eclipse’s Effect on Pregnancy ☀️🌞🕶️🕶️🌖🌗🌘🌑
05 Apr 2024
Contributed by Lukas
On April 8, 2024, parts of the United States will be within the Path of Totality for the total solar eclipse. The state of Texas has already declared ...
⭐️NEW⭐️Clinical Practice Update: ACOG Updates PB 222 (Biomarkers for PreE).
04 Apr 2024
Contributed by Lukas
Today, April 3, 2024, the ACOG released a clinical practice update to practice bulletin# 222 (gestational hypertension eclampsia). This is in direct r...
New Data Re: Obesity in Pregnancy- Weight Gain Recs, and NPWT at CS
02 Apr 2024
Contributed by Lukas
According to the CDC, as well as worldwide data, the percentage of individuals categorized as overweight or obese is rising. First released in 1990 by...
The Steroids Saga: New Data, New Debate, New News.
01 Apr 2024
Contributed by Lukas
The current dose and schedule for antenatal corticosteroids (ACS) follows the original publication by Liggins and Howie in 1972. That dose and schedul...
Depo-Provera Causes Brain Tumors?! 😬🧠😬
29 Mar 2024
Contributed by Lukas
Meningiomas are common intracranial tumors with a female predominance. The vast majority of these tumors are benign (World Health Organization [WHO] g...
Balloon For PROM? Yea or Nay
27 Mar 2024
Contributed by Lukas
According to the ACOG, pre-labor rupture of membranes (PROM) complicates 10% of all births in the United States and is a major contributor to perinata...
Neonatal Subgaleal Hemorrhage: Pearls of Wisdom
25 Mar 2024
Contributed by Lukas
Obstetrical vacuum and forceps are incredible tools, when used correctly, to assist vaginal delivery. Appropriately selected and used, they can be piv...
New Menopause CURE? The Ovarian Autotransplantation Debate
22 Mar 2024
Contributed by Lukas
Ovarian preservation by autologous transplantation has given hope to patients desiring future fertility after certain gonadotoxic therapies for malign...
PreMeal or PostPrandial Glucose Checks PP with Type I DM
21 Mar 2024
Contributed by Lukas
Since the late 1990s, the standard practice for GDM care has been to measure postprandial glucose values. For patients with pre-gestational diabetes, ...
Hep C and BF Confusion (and Updated HIV BF Guidance)
18 Mar 2024
Contributed by Lukas
Is breastfeeding with Hepatitis C safe? The answer: Yes! But confusion persists today mainly surrounding the serum hepatitis C viral load. That’s th...
Are ADHD Meds Safe In Pregnancy?
15 Mar 2024
Contributed by Lukas
It has been estimated that up to 4.4% of the US adult population has been diagnosed with ADHD. Use of ADHD medication is increasing among pregnant wom...
Check the Box: REASSURING NEWs regarding US Maternal Mortality
13 Mar 2024
Contributed by Lukas
Four years, the US National Vital Statistics System has reported an abnormally high maternal mortality rate in the United States, showing it to be nea...
Should We Screen For Thrombophilia Pre-OCP? March 2024 Data
10 Mar 2024
Contributed by Lukas
The ACOG, CDC, and WHO currently do not recommend universal screening for thrombophilia in the general population before starting oral contraceptive p...
Metformin in OB and Child's Neurodevelopmental Outcomes (March 2024 Data)
08 Mar 2024
Contributed by Lukas
Gestational Diabetes (GDM) is vastly more prevalent in pregnancy compared to pre-existing diabetes. In 2009, the ACOG states that 7% of all pregnancie...
OPill…Now HERE! (ACOG PA March 2024)
07 Mar 2024
Contributed by Lukas
On this podcast, we have been following this story of the OPill for several months. Previous episodes on the subject can be found in our podcast libra...
GLP1 Agonist Exposure in Pregnancy
05 Mar 2024
Contributed by Lukas
Use of second-line noninsulin diabetic medications, like Glucagon-like peptide 1 (GLP-1) agonists and sodium-glucose co-transporter-2 (SGLT2) inhibito...
Foley For CX: Tension or No Tension? And More (March 2024 Data)
01 Mar 2024
Contributed by Lukas
Using mechanical options as a way to prime/ripen the cervix for labor is nothing new. Balloon catheters have been used for labor induction as far back...
Things That Make You Go Hmmmm
29 Feb 2024
Contributed by Lukas
It’s very important to stay up-to-date and current with new data. But sometimes you read something that is hot-off-the press and it makes you just s...
GDM Dx with Abnormal Fasting Value: Start Meds?
28 Feb 2024
Contributed by Lukas
The “traditional“ Parkland management protocol for GDM included the immediate initiation of medical therapy for those with abnormal fasting blood ...