Dr. Chapa’s OBGYN Clinical Pearls
Episodes
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...
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...