Dr. Chapa’s OBGYN Clinical Pearls
Episodes
White Classification: Still Relevant?
20 Aug 2022
Contributed by Lukas
In 1949, Priscilla White published her landmark study on diabetes in pregnancy, launching the “White Classification”. This has been a staple of pr...
Epilepsy and Women’s Care
17 Aug 2022
Contributed by Lukas
Epilepsy/seizure disorders disproportionately affects women of reproductive age over men. The influence of sex hormones on seizure prevalence is well ...
OB Listeriosis
14 Aug 2022
Contributed by Lukas
There are so many things to go over with our pregnant patients especially at their initial intake visit. However, one thing that should not be left of...
InTOXiCaTED?
11 Aug 2022
Contributed by Lukas
I’ll let this episode title speak for itself… LOL. Hope this makes you smile.
New Med for ENDO! (With Guest Co-Host)
08 Aug 2022
Contributed by Lukas
Endometriosis is a devastating condition. Once thought to have its impact only during reproductive age, endometriosis has been linked to an increased ...
Mag Neuroprotection at 22 Weeks?
02 Aug 2022
Contributed by Lukas
Yesterday, 08/01/2022, we released a podcast on “The 22 Week Birth”. As a follow-up to this, and in response to 5 separate questions (all related ...
The 22 Week Birth
02 Aug 2022
Contributed by Lukas
Over the last several years, the “limit of viability” for neonates has decreased dramatically. The new “lower limit” of neonatal viability can...
Polyhydramnios
28 Jul 2022
Contributed by Lukas
Polyhydramnios affects from 0.2 to 2% of all pregnancies. Which is preferred for diagnosis, MVP or AFI? Is amnioreduction an effective intervention? W...
Misuse of Fetal Scalp Stimulation
23 Jul 2022
Contributed by Lukas
One of the most common techniques to assess fetal status intrapartum is the fetal scalp stimulation test. First proposed in 1936, its incorporation in...
HT in BRCA Patients?
19 Jul 2022
Contributed by Lukas
In this session, we will continue our brief summary of the NAMS 2022 clinical update on hormone therapy. Is hormone therapy allowed in patients with k...
Can HT continue past 65? NAMS 2022 UPDATE
16 Jul 2022
Contributed by Lukas
Medical information moves fast. We know a lot more about risks and benefits of hormone therapy since the impactful WHI study was first released. In th...
New Data on Water Births (July 2022)
12 Jul 2022
Contributed by Lukas
For several years, data has validated the value of water immersion during labor (1st stage). However, when it comes to the 2nd stage of labor, the AAP...
Melatonin Use in Pregnancy?
08 Jul 2022
Contributed by Lukas
Sleep disruption and poor sleep quality are not unusual during pregnancy. That’s obvious! What’s not so obvious is whether a common over-the-count...
“Reverse Sequence” Syphilis Tests
03 Jul 2022
Contributed by Lukas
Lots of practical clinical pearls in this episode! “Reverse sequence testing” for syphilis has largely taken over the traditional testing algorith...
Does Ella Cause Abortion?
27 Jun 2022
Contributed by Lukas
Over the last several days I have received numerous Facebook messages, podcast voice memos, and personal texts regarding the potential for misapplicat...
New ACOG (June 16, 2022) Advisory: “PreP Talk”
25 Jun 2022
Contributed by Lukas
On June 16, 2022, the ACOG released a new practice advisory regarding PreP in the ObGyn patient population. This has important implications on how we ...
PCOS and ACUTE PeriPartum Risks
23 Jun 2022
Contributed by Lukas
We have come a long way from the first report from Stein and Leventhal describing “polycystic ovaries“ on ultrasound in infertile women back in th...
UPDATE
20 Jun 2022
Contributed by Lukas
Well…so there’s this. 😳😳😳
Monkeypox 101: Effect in Pregnancy and Beyond.
13 Jun 2022
Contributed by Lukas
This is your crash course into all things “Monkeypox”. Data for this podcast comes from the CDC, WHO, and the Royal College of Obstetricians and G...
Hydration for Oligo?
09 Jun 2022
Contributed by Lukas
Which is better for determining amniotic fluid volume: the AFI or MVP? There’s data to support one or the other. In cases of isolated oligohydramnio...
Is Myfembree Birth Control?
06 Jun 2022
Contributed by Lukas
According to the ACOG, by natural menopause it is estimated that up to 70% of women will have developed a uterine leiomyoma. 70%! Most of course are a...
Ganas!
03 Jun 2022
Contributed by Lukas
Meet Hilda! In this quick episode, I’ll share a very unique story of one of our coworkers (our featured guest on the podcast). I know this will enco...
Does the Progestin Matter?
02 Jun 2022
Contributed by Lukas
There are currently (in the USA) 4 generations of available progestins in combination birth control pills. Are these differences clinically relevant, ...
Fetal Microcephaly
28 May 2022
Contributed by Lukas
Fetal microcephaly is a devastating diagnosis. Prognosis is dependent on whether fetal microcephaly is isolated or part of other congenital anomalies....
Update
26 May 2022
Contributed by Lukas
Here’s what’s going on… As of May 26, 2022.
The Mask of Pregnancy
21 May 2022
Contributed by Lukas
Pregnancy can definitely work some changes on the body. Melasma is a common pregnancy reaction, and can be a cosmetic concern to many affected. Are tr...
The Non-Palpable Implant
17 May 2022
Contributed by Lukas
The etonogestrel implant is the most effective LARC available. Well, how many years AFTER the FDA approval of 3 years does the implant remain effectiv...
Is Too Much FM Bad?
12 May 2022
Contributed by Lukas
Historically, obstetrical providers cautioned patients about decreased fetal movement. But what about maternal perception of INCREASED fetal movement?...
The Metronidazole Myth!
08 May 2022
Contributed by Lukas
Since the 1960s, metronidazole has carried a label warning stating that alcohol use while taking the medication can lead to significant side-effects. ...
BUMP1 and BUMP2! (May 2022)
05 May 2022
Contributed by Lukas
On May 3, 2022, JAMA published 2 separate randomized clinical trials (RCTs) regarding patient’s self-monitoring of blood pressures at home. Historic...
Headaches in Pregnancy: New ACOG Guidance (May 2022)
29 Apr 2022
Contributed by Lukas
In May 2022, the ACOG Will release a new Clinical Practice Guidance (#3). This will cover “Headaches in Pregnancy and Postpartum”. Do you know whi...
Epidural’s Secret Benefit!
26 Apr 2022
Contributed by Lukas
Addressing severe maternal morbidity is a public health priority in the US. Postpartum hemorrhage is one of the driving contributors to severe materna...
NIPTS Takes a HIT (May 2022 New Publication from Obstetrics & Gynecology)
22 Apr 2022
Contributed by Lukas
It could not have been timed any better: Coming off the heels of the recent FDA warning on the use of noninvasive prenatal test (NIPTS), a new study s...
ACOG’s 4/20/22 Response to FDA Warning!
21 Apr 2022
Contributed by Lukas
On April 19, 2022 the FDA released a warning regarding the inappropriate use of cell free DNA genetic screening tests. Within 24 hours, the ACOG (Apri...
IUS Use and Acne: It’s Real!
19 Apr 2022
Contributed by Lukas
Without doubt, the most common reason for requested progestin-intrauterine system (IUS) removal is abnormal bleeding patterns. But do you know what th...
Matthew’s Question: ROM Plus and EGA
16 Apr 2022
Contributed by Lukas
On Friday, April 15, 2022, I received a Facebook question regarding a recent episode on ROM test. We stated that ROM Plus, as a test, has accuracy bet...
🚨ACOG Practice Advisory🚨: CHAP Trial Response (April 2022).
11 Apr 2022
Contributed by Lukas
Today, April 11, 2022, the ACOG updated its practice advisory regarding chronic hypertension in pregnancy. This follows the statement from the Society...
Ovaries OUT! (New Data On Age of BSO at Benign Hyst)
10 Apr 2022
Contributed by Lukas
Since 2005, experts have advocated for ovarian conservation, until the age of 65, at time of hysterectomy for benign indication. However, a soon to be...
🚨ACOG ALERT🚨 (April 6, 2022): CHAP Trial
07 Apr 2022
Contributed by Lukas
A study published on April 2, 2022 in The New England Journal of Medicine, "Treatment for Mild Chronic Hypertension during Pregnancy” (CHAP Trial) h...
ROM Tests: Not All Are The Same.
02 Apr 2022
Contributed by Lukas
This is Part 2 where we will wrap up our review of commercially available screening tests for ROM. Do you know what each test specifically checks for?...
Understanding ROM Tests: Pitfall Prevention Pearls (Part 1)
30 Mar 2022
Contributed by Lukas
PROM is a common diagnosis in Labor and Delivery. However, making a false positive diagnosis OR a false negative one may place the pregnancy at risk o...
Send The Placenta? Hmm…likely NO.
26 Mar 2022
Contributed by Lukas
Some things in medical practice stem more out of tradition than true clinical evidence. Such is the case for histological examination of the placenta....
Prevention of HBV Vertical Transmission: New Data
22 Mar 2022
Contributed by Lukas
There is a recommendation for universal screening of Hepatitis B surface antigen in pregnancy. Which antiviral medication is recommended for preventio...
Duration of PP MagSulfate: New Data
14 Mar 2022
Contributed by Lukas
Why is Magnesium Sulfate the first-line medication for preeclampsia/eclampsia? How did that arise into the current, international, standard-of-care re...
OB Care After ART (SMFM Series #60; 2022)
07 Mar 2022
Contributed by Lukas
Pregnancies that arise after assisted reproductive technologies (ART) are at higher risk of maternal, fetal, and even placental complications. In this...
Statins and Preeclampsia Prevention: Yes or No.
03 Mar 2022
Contributed by Lukas
Preeclampsia occurs in 3 to 5% of the general OB population. It has even higher prevalence among those with high-risk conditions. Currently, aspirin s...
Optimizing Natural Fertility (ASRM)
26 Feb 2022
Contributed by Lukas
Couples trying to conceive often ask questions like these: When is the best time to have sex to get pregnant? Is there a better sexual position to hav...
Water Immersion in Labor: AAP/ACOG vs ACNM
22 Feb 2022
Contributed by Lukas
Hydrotherapy (water immersion) has a proven safety record and proven benefits in the first stage of labor. But what about actually delivering with wat...
23AndMe and OCPs
17 Feb 2022
Contributed by Lukas
The old adage, “Too much of anything is a bad thing”, is traditionally credited to Mark Twain. Was he right? Does the same apply to medical inform...
Allergic to Semen!
08 Feb 2022
Contributed by Lukas
Semen allergy is a real (although rare) immune reaction. Do you know what the presenting signs/symptoms are?The ISSM has established diagnostic criter...
Did WHO Ban Bakri?
05 Feb 2022
Contributed by Lukas
Postpartum hemorrhage continues to be a worldwide leaning cause of maternal morbidity and mortality. In May 2021, the WHO updated it’s global recomm...
Birth During Covid and Child Development: NEW DATA
20 Jan 2022
Contributed by Lukas
Globally, more than 200 million infants have been born since the onset of the COVID-19 pandemic. It has been unclear whether fetal exposure to materna...
NEW ACOG ADVISORY: JAN 2022
15 Jan 2022
Contributed by Lukas
In the ACOG Practice Bulletin #106, which was released in 2009, the use of maternal supplemental oxygen for fetal heart rate tracing correction is men...
OB HTN UPDATES (BIG CMQCC Recommendations).
13 Jan 2022
Contributed by Lukas
Hypertensive disorders in pregnancy are a large contributor to maternal mortality. Maternal mortality rates for chronic hypertension in pregnancy have...
New Data on Periods After Covid Vaccination
07 Jan 2022
Contributed by Lukas
Concerns about a possible association between COVID-19 vaccination and abnormal menstrual cycles may lead to vaccine hesitancy. Social media sites hav...
Repeat CS timing with 2+ CSs
06 Jan 2022
Contributed by Lukas
Women with multiple prior low-transverse CSs show a trend toward increased risk of rupture compared with a single prior CS. While some have advocated ...
Zmax Beats E-Mycin for PPROM Care
04 Jan 2022
Contributed by Lukas
In 1997, Mercer et al first published their data on antibiotic use for PPROM latency. With IV Erythromycin shortages, Zmax is a known substitute. New ...
Not All LARCS Are Equal!
29 Dec 2021
Contributed by Lukas
Traditionally, physicians have informed patients that long acting reversible contraceptives are “just as effective“ as female sterilization. While...
Tale of 2 Anti-Covid ORAL MEDS: Ok for Pregnancy?
23 Dec 2021
Contributed by Lukas
As of December 23, 2021 the FDA has granted Emergency Use Authorization to 2 different oral medications (Pfizer; Merck) in the fight against Covid-19....
Nonvigorous Newborn & Delayed Cord Clamping
22 Dec 2021
Contributed by Lukas
In our previous podcast, we stated that – due to lack of data – early cord clamping may be considered with nonvigorous neonates. However, the babi...
Placental Transfusion of the Neonate (Jan 2022 ACOG CME Summary)
19 Dec 2021
Contributed by Lukas
There are 3 umbilical cord management strategies at time of delivery: (1) Early cord clamping, (2) Delayed clamping, and (3) Cord milking. How long sh...
SSE: To Lube or Not to Lube.
15 Dec 2021
Contributed by Lukas
The clinical gold standard for the diagnosis of ruptured membranes is the sterile speculum examination (SSE). Tests like Amnisure or ROM+ are consider...
Postpartum Foot Drop
06 Dec 2021
Contributed by Lukas
Postpartum neuropathies are an infrequent occurrence but can significantly impact a patient’s quality of life. Are you familiar with “strawberry p...
Delayed Postpartum Preeclampsia/Eclampsia (CMQCC 2021 Update)
03 Dec 2021
Contributed by Lukas
New onset hypertension in the postpartum period should be assumed to be preeclampsia until proven otherwise. Up to 26% of eclamptic seizures occur bey...
The Science of Gratitude.
24 Nov 2021
Contributed by Lukas
Thanksgiving 2021 is upon us! However, did you know that mental health experts make the very important distinction between gratefulness, thankfulness,...
HIV in Pregnancy: Quick Facts.
19 Nov 2021
Contributed by Lukas
(Introducing Dr. Garrett Dunn as guest resident on today’s episode!) The CDC estimates that more than 1.1 million people in the US are living with H...
Vaginitis: Wet Prep vs DNA Based Tests.
18 Nov 2021
Contributed by Lukas
How do you diagnose vaginitis? Do you treat BV/yeast/trichomoniasis found on Pap smear? Do you use the Wet Prep, or molecular/DNA test? An ePub recent...
Real Alternatives to 50 g GTT?
12 Nov 2021
Contributed by Lukas
This session is a follow-up to our immediate pest episode. Are there any evidence-based true alternatives to the 50 g screening test for GDM? What abo...
JellyBeans for GDM Screen?
11 Nov 2021
Contributed by Lukas
It’s true, patients do NOT enjoy the 50 gram oral glucola test for gestational diabetes screening. And, the 100 gram test is even worse! Online sour...
The RISE of Hepatitis C in Pregnancy.
05 Nov 2021
Contributed by Lukas
The prevalence of Hepatitis C viral infection in pregnancy has doubled over the past 10 years. Active hepatitis C viral infection in pregnancy increas...
OB Antiphospholipid Antibody Syndrome (Part 2)
01 Nov 2021
Contributed by Lukas
In this episode, a simple to follow algorithm for management of APS in pregnancy will be presented. We will cover both antepartum and postpartum care....
OB Antiphospholipid Antibody Syndrome (Part 1)
29 Oct 2021
Contributed by Lukas
Antiphospholipid syndrome has well established diagnostic criteria. Nonetheless, healthcare providers still find the condition- and it’s management-...
Fetal Renal Pelvic Dilation (SMFM Consult Series 4)
21 Oct 2021
Contributed by Lukas
Fetal renal pelvic dilation occurs in 1% to 5% of all pregnancies. Although most are benign, it can be associated with genetic and structural disorder...
Thank you Liane!
16 Oct 2021
Contributed by Lukas
Just a quick message response for one of our listeners, Liane. Great points Liane… I take your message to heart! Here’s is our response. Thank you...
Domestic Violence Awareness (Featuring Dr. Katie Light)
13 Oct 2021
Contributed by Lukas
October is Domestic Violence Awareness month. This is such an important issue to discuss, and we will give into it here! Making her podcast debut is o...
The Anti-Covid PILL
11 Oct 2021
Contributed by Lukas
Molnupiravir is now on the scene as a potential new therapy for mild to moderate COVID-19. As an oral administered medication, this could revolutioniz...
Testosterone Use in Women
09 Oct 2021
Contributed by Lukas
There continues to be a lot of faulty assumptions regarding testosterone therapy in women. In 2014 the Endocrine Society joined an international panel...
Edging “Le Petite Mort”: An Orgasmic Experience
07 Oct 2021
Contributed by Lukas
Sexual climax has been defined not only as a bodily/physiological reaction but as a mental process as well. First termed “the little death” histor...
Antepartum Fetal Surveillance: Part 2 (Leslie Clark, DO)
02 Oct 2021
Contributed by Lukas
Thank you to Dr. Leslie Clark (Senior Resident) for your great work in wrapping up our discussion on antepartum fetal surveillance. In this session, w...
Antepartum Fetal Surveillance (Guest Resident Spotlight): Part 1
29 Sep 2021
Contributed by Lukas
In this session I am joined by one of our upper level (Senior) wonderful residents, Dr. Catherine Jimenez. Dr. Jimenez and I recorded this as an impro...
The Motives of Motivation: Why Inspiration is Better.
26 Sep 2021
Contributed by Lukas
Here’s a question for you: would you rather have motivation, or inspiration? Used interchangeably in common dialogue, the two can actually be polar ...
Childbirth-PTSD
22 Sep 2021
Contributed by Lukas
PTSD has come a long way from its original designation as “shellshock”relating to veterans of war. PTSD is also possible following childbirth, eve...
🚨🚨Emergency BC🚨🚨: Part 2
14 Sep 2021
Contributed by Lukas
In this session we wrap up our discussion of emergency contraception. Is there a preferred option for those with larger BMIs? What if the patient has ...
🚨🚨Emergency BC🚨🚨: Part 1
10 Sep 2021
Contributed by Lukas
Despite its use for decades, misinformation and misperceptions about emergency contraception still persist. Are all options the same? What is their ef...
ACOG’s MLoC Program (Jan 2022)
05 Sep 2021
Contributed by Lukas
The US is ranked 65th among industrialized nations for maternal morbidity and mortality outcomes. That is unacceptable! Maternal levels of care initia...
OB Monoclonal Antibody Use
01 Sep 2021
Contributed by Lukas
Available mAbs are directed against a large number of antigens and used for the treatment of immunologic diseases, reversal of drug effects, and cance...
Prophylactic TXA for Prevention of PPH.
29 Aug 2021
Contributed by Lukas
Tranexamic Acid’s use in obstetrics skyrocketed in 2017 after the release of the WOMEN trial. At that time, the ACOG endorsed TXA for use with diagn...
ACOG PostPartum MultiModal Pain Control (Sept 2021 Clinical Consensus): Part 2
25 Aug 2021
Contributed by Lukas
(Part 2) In this session, we will wrap up our summary review of the ACOG September 2021 Clinical Consensus bulletin on postpartum pain management. Wha...
ACOG PostPartum MultiModal Pain Control (Sept 2021 Clinical Consensus): Part 1
22 Aug 2021
Contributed by Lukas
Uncontrolled postpartum pain can lead to postpartum depression, impaired maternal-child bonding, and even chronic pain syndromes. Uncontrolled postpar...
Primary Amenorrhea
18 Aug 2021
Contributed by Lukas
The diagnostic algorithm for primary amenorrhea is extremely logical once one understands this pathophysiology. While some patients presenting with pr...
CDC STI RX UPDATES 2021
15 Aug 2021
Contributed by Lukas
At the end of July 2021, the CDC updated its treatment guidelines for sexually transmitted infections. Changes were made to recommended treatments for...
New PTB Prevention Bulletin: ACOG Aug 2021 (PB 234). Part 2
04 Aug 2021
Contributed by Lukas
In 2003, the ACOG/SMFM endorsed IM progesterone for PTB prevention. But new data has called this into question (PROLONG trial). In this session, we wi...
New PTB Prevention Bulletin: ACOG Aug 2021 (PB 234). Part 1
01 Aug 2021
Contributed by Lukas
The last time ACOG released a practice bulletin on the prevention of preterm birth was in 2012. In August 2021, the ACOG will release a new practice b...
NSGU (Lipschütz ulcers): Painful sores in virginal patients.
27 Jul 2021
Contributed by Lukas
Non-sexually acquired genital ulceration (NSGU) is painful ulceration of the external genitalia, usually in adolescents, unrelated to sexual activity....
Stop BF After Covid Vaccine? Yes or No?
23 Jul 2021
Contributed by Lukas
There is a whirlwind of false/misleading information on social media regarding the COVID-19 vaccines. Some social media posts state that breast-feedin...
Cholestasis of Pregnancy: SMFM Consult #53 (2021)
19 Jul 2021
Contributed by Lukas
Our understanding of Intrahepatic Cholestasis of Pregnancy has changed just over the last 5 years. What is the best laboratory test to help diagnose t...
Why we do this!
12 Jul 2021
Contributed by Lukas
Thank you for sharing your message! And, most importantly, congratulations on your board certification! Hope this makes someone else smile, as it did ...
Atypical Breast Hyperplasia
09 Jul 2021
Contributed by Lukas
Atypical Breast Hyperplasia may present either as Atypical Ductal Hyperplasia or Atypical Lobular Hyperplasia. Which of these two is considered the mo...
Perinatal Fe Deficiency Facts
05 Jul 2021
Contributed by Lukas
Correction of iron deficiency anemia in pregnancy is not just about fixing a low “H & H”. Iron deficiency during pregnancy is associated with real...
Nifedipine tocolysis? No (July 2021 Green Journal)
01 Jul 2021
Contributed by Lukas
Nifedipine is one of the most common medications used for tocolysis. However, does it actually improve neonatal outcomes? What about tocolysis in gene...