Dr. Chapa’s OBGYN Clinical Pearls
Episodes
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...
Ad-Hoc Med Translators: Take Caution.
27 Jun 2021
Contributed by Lukas
According to the latest US Census Bureau report analyzing the use of languages in the United States, over 20% of Americans speak a language other than...
GO MOMs! A New NIH Study for GDM
23 Jun 2021
Contributed by Lukas
Our understanding of gestational diabetes has changed over the last two decades, and more changes are sure to come! The traditional screen between 24 ...
LEEP or CKC? Part 2
20 Jun 2021
Contributed by Lukas
Welcome back! In this session, we will review the contraindications for LEEP and the specific indications for CKC.
LEEP or CKC? A Review of ASCCP Guidelines for HG Dysplasia (Part 1)
16 Jun 2021
Contributed by Lukas
In 2019, the ASCCP made some impactful changes to the management algorithm for cervical dysplasia. Why was the treatment algorithm divided between tho...
Evidence Based Hysterotomy Closure
14 Jun 2021
Contributed by Lukas
Cesarean section is the most common laparotomy performed worldwide. So, you would think we would have a standardized way of closing the uterine incisi...
Mag for RLS? Allison’s Inquiry.
10 Jun 2021
Contributed by Lukas
I love how our medical community can come together to discuss and brainstorm on better ways to care for our patients. Last night I received a message ...
RLS in Pregnancy (Part 2)
10 Jun 2021
Contributed by Lukas
Welcome to Part 2! In this session we will complete our discussion of RLS in Pregnancy and review its workup and management strategies.
RLS in Pregnancy (Part 1)
07 Jun 2021
Contributed by Lukas
Restless Leg Syndrome (RLS), now often referred to as Willis–Ekbom Disease (WED), is a common sensorimotor disturbance much more prevalent in women ...
Brexafemme: Helpful, or Not?
03 Jun 2021
Contributed by Lukas
The FDA has approved Brexafemme, an antifungal drug, for treating vaginal yeast infections. The drug represents the first new antifungal drug class in...
Intracervical Balloon After PROM: June 2021 Meta-Analysis (AJOG).
02 Jun 2021
Contributed by Lukas
PROM complicates 8% of term pregnancies, approximately 270,000 births in the US annually. In this session, we summarize and review a June 2021 Systema...
Hep C Screening (ACOG Advisory May 2021)
29 May 2021
Contributed by Lukas
Hepatitis C is the most commonly reported bloodborne infection in the United States. The ACOG is updating its Hepatitis C screening guidance regrading...
The Obese CS Patient
26 May 2021
Contributed by Lukas
The ACOG will release a new Practice Bulletin in June 2021 discussing obesity in pregnancy. The prevalence of obesity in reproductive age women in the...
Myth-Busting: Preeclampsia Episode (Part 2)
23 May 2021
Contributed by Lukas
The information in this section will shake your foundation regarding what you had previously been told about the origins of preeclampsia. Is the place...
Myth-Busting: Preeclampsia Episode (Part 1)
20 May 2021
Contributed by Lukas
The pathophysiology of preeclampsia continues to be discovered. For decades, the placenta has been portrayed as the “villain“ in the preeclampsia ...
High vs Low-Dose Pitocin: Safety and Effectiveness.
17 May 2021
Contributed by Lukas
Is the high dose Pitocin protocol (6 mU/min) associated with increased C-sections for fetal distress? What about perinatal outcomes? There are a varie...
Term Birth Issues after BMZ?
13 May 2021
Contributed by Lukas
Given the known benefits to BMZ for preterm infants and the difficulty in predicting which women will actually deliver preterm, it is common for p...
Vitamin S: Can Sexual Frustration Cause Depression?
11 May 2021
Contributed by Lukas
Sex can fulfill the human psychological needs of connectedness as well as the physical needs of intimacy. Being alone and lonely can cause major healt...
Adenomyosis (Part 2)
06 May 2021
Contributed by Lukas
In this session we wrap up our review of Adenomyosis. Are you familiar with the MUSA ultrasound criteria? What is the role of MRI in the diagnosis of ...
Adenomyosis (Part 1)
02 May 2021
Contributed by Lukas
Historically, Adenomyosis was a pathological diagnosis only. However, new imaging standards/techniques have moved Adeno into a clinical diagnosis. Is ...
Mood Disorders in Admitted Antepartum Patients: LOOK FOR IT!
28 Apr 2021
Contributed by Lukas
OB Patients admitted with medical or obstetrical complications to an antepartum hospital unit face separation from loved ones, stress from their diagn...
The 4th Trimester: Not Long Enough.
23 Apr 2021
Contributed by Lukas
On April 12, 2021, Illinois agreed to provide Medicaid benefits to eligible mothers for up to 12 months postpartum, a major extension from the previou...
The Acutely Agitated OB Patient
21 Apr 2021
Contributed by Lukas
We often encounter the acutely agitated patient. Acute agitation may be from and uncontrolled medical condition, psychiatric condition, or illicit sub...
Is Caffeine in Pregnancy Bad?
18 Apr 2021
Contributed by Lukas
The ACOG has stated that caffeine consumption in pregnancy should be limited to 200 mg/day. However, a new study published on March 25, 2021 in JAMA N...
Cerebral Venous Sinus Thrombosis & COVID Vaccination
15 Apr 2021
Contributed by Lukas
The CDC released a health alert through its Health Alert Network on April 13, 2021, notifying physicians and other health care practitioners that the ...
Lessons from Midwifery: Maternal Position Changes in Labor
11 Apr 2021
Contributed by Lukas
The field of obstetrics was “birthed“ out of midwifery. The concept of second stage of labor in the lithotomy position was not how it was “alway...
Trauma Informed Care: ACOG April 2021
06 Apr 2021
Contributed by Lukas
The prevalence of trauma is quite sobering. General population surveys have found extremely high rates of traumatic experiences encountered which span...
Hysteroscopy
02 Apr 2021
Contributed by Lukas
Hysteroscopy, and especially office-based hysteroscopy, is a fantastic tool in the evaluation of suspected endometrial abnormalities and/or heavy mens...
HPV Screening & Surveillance
29 Mar 2021
Contributed by Lukas
Algorithms and opinions on cervical cancer screening change quickly. In this session, we will review the uses for HPV testing as a primary screening t...
DON’T DO THESE! (Part 2)
25 Mar 2021
Contributed by Lukas
In this session, we will pick up where we left off with our immediate past podcast covering the SMFM “Choosing Wisely” recommendations. When shoul...
DON’T DO THESE! (Revised SMFM “DON’T DO” LIST)
21 Mar 2021
Contributed by Lukas
Sometimes what sounds good in clinical practice actually is not evidence-based. In March 2021, the SMFM updated the “Choosing Wisely”list of pract...
COVID VACCINE CAUSES INFERTILITY?! (Umm...NO)
17 Mar 2021
Contributed by Lukas
In the era of social media and easy to spread public opinion platforms, misinformation can grow rampant. Is the Covid vaccine associated with infertil...
COVID and Preg: Delivery Timing (SMFM FEB 2021 UPDATE)
10 Mar 2021
Contributed by Lukas
What are the delivery recommendations for pregnant Covid patients? When is expectant management favored compared with elective delivery? Is mechanical...
When to Admit COVID Ob Patients: SMFM UPDATE FEB 2021
09 Mar 2021
Contributed by Lukas
COVID-19 management guidelines change quickly. In this session we will review the February 2021 SMFM update regarding when to consider inpatient care ...
New ACOG CO 818: Medically Indicated Late Preterm/Early Term Births
29 Jan 2021
Contributed by Lukas
In February 2021, the ACOG will release a new committee opinion (818) updating guidelines on “medically indicated late preterm and early term delive...
Non-Dystocia Plexus Injury.
24 Jan 2021
Contributed by Lukas
Historically, brachial plexus palsy was considered proof of shoulder dystocia or traumatic birth. Can brachial plexus injuries occur with normal, unev...
Does COVID-19 Affect Periods?
14 Jan 2021
Contributed by Lukas
There have been a variety of published and accepted clinical presentations of COVID-19: from lack of taste, GI disturbances, muscle aches, to the usua...
CDC RX Update for Gonorrhea.
13 Jan 2021
Contributed by Lukas
Are you still treating urogenital gonorrhea with ceftriaxone and azithromycin? That was a standard for over a decade. But things have now changed. In ...
Opioid Abuse in Pregnancy and MAT
11 Jan 2021
Contributed by Lukas
We all know there is a national opioid epidemic. This, like the current viral pandemic, is robbing people of their lives. Pregnant women are not immun...
Antibiotic timing at CS: New Data
06 Jan 2021
Contributed by Lukas
Historically, CS prophylactic antibiotics were given after umbilical cord clamp and cut to prevent exposure of the neonate to antimicrobials. The reco...
Darkness Within: A Reality-Check on Perinatal Suicide.
26 Dec 2020
Contributed by Lukas
It’s the holiday season, but the holidays can exacerbate depression/anxiety and even increase suicidal ideation in some individuals. Suicide deaths ...
OOOPS!
17 Dec 2020
Contributed by Lukas
A brief explanation regarding our podcast just released, “Ovaries In or Out”!
Ovaries In or Out at Hyst?
17 Dec 2020
Contributed by Lukas
Historically, prophylactic oophorectomy was performed at time of benign hysterectomy in patients at/over 45 years of age. Is this still evidence based...
Steroids and Chorio?
12 Dec 2020
Contributed by Lukas
Considered controversial, traditionally steroids for fetal lung maturation were not given in patients with clinical chorioamnionitis. But is this real...
COVID19 Vaccine Safety in Pregnancy?
09 Dec 2020
Contributed by Lukas
In the very near future, possibly just days away, the FDA is anticipated to approve at least 1 new COVID-19 vaccine. Were pregnant and/or lactating wo...
UNACCEPTABLE! Summary of US Maternal Death CALL TO ACTION Dec 2020
06 Dec 2020
Contributed by Lukas
A woman dies every 12 hours in this country from pregnancy-related complications. 2/3rds of these deaths are preventable! Let that sink in. On Decembe...
“Backdoor” Experiences: From Taboo to Mainstream.
03 Dec 2020
Contributed by Lukas
Once considered TABOO, women having receptive “Backdoor” sexual attention has gained a lot of press in both medical as well as non-medical publica...