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PODCAST

Dr. Chapa’s OBGYN Clinical Pearls

Dr. Chapa’s Clinical Pearls

Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare! This podcast is intended to be clinically relevant, engaging, and FUN, because medical education should NOT be boring! Welcome...to Clinical Pearls.

science

All Episodes

00:17:13

LDA for Unexplained Recurrent SABs?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/26

Recurrent pregnancy loss (RPL) affects approximately 5% of couples and is an emotional burden on those affected. There is some evidence that vaginal progesterone supplementation may be considered in patients with recurrent pregnancy loss who are experiencing vaginal bleeding during the first trimester. But what about prophylactic low dose aspirin in the first trimester, or preconceptionally, for unexplained RPL? Is that evidence-based? A new publication from the SMFM’s journal Pregnancy has examined

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00:27:48

Change Gloves After Placenta at CS? Yes, and No.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/24

Having data is sometimes different than having clinically applicable data. This is exactly the issue with the proposed plan to reduce surgical site infection (SSI) by changing surgical gloves after placental delivery at C-Section. Just 24 hours ago, we received the question from a PGY4 OBGYN resident asking whether the practice of changing surgical gloves at C-Section after placental delivery to reduce SSI was evidence-based. So, in this episode, we will review the data - which is timely since this

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00:24:45

Refresher of Genetic MD

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/21

Muscular dystrophy (MD) is a group of genetic diseases that affect about 16 to 25 per 100,000 people in the US, with the most common childhood form being Duchenne muscular dystrophy (DMD) and the most common adult form being myotonic dystrophy. The prevalence of DMD is estimated at around 1 in 3,500 live male births. Prenatal carrier screening for this is part of the ACMG Tier 3 expanded carrier panel. This is different from spinal muscular atrophy (SMA). As we recently had a patient who was a MD

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00:35:42

Use GA at CS Electively? Maybe, Maybe.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/19

Regional anesthesia, typically with a spinal or epidural, haslong been favored for cesarean births due in part to concerns about the effects that general anesthesia (GA) may have on newborns at delivery. However, data has shown that up to 1 in 6 women may experience pain with a “topped-off”labor epidural, during the cesarean. A new publication in the journal Anesthesia is now being interpreted as implying that general anesthesia may be a valid alternative electively. Is that what this new study

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00:19:38

Lido Patches After CS? Maybe.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/18

The US has no shortage of lidocaine patch television commercials. Topical lidocaine has a role for local, topical, minor aches and pains. What about lidocaine patches for post-op cesarean section pain? Is there data for that? A brand-new meta-analysis in AJOG-MFM (Nov 13, 2025) looks at this option. However, there has been 3 prior reviews on the same topic from 2019, 2022, and 2023. Do they all arrive at the same result? Listen in for details!1. Smoker J, Cohen A, Rasouli MR, Schwenk ES

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00:30:46

More Measles Material

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/17

Podcast Family, we have covered the subject of Measles previously on this show (links below). Those episodes were a preview of what has now been released ahead of print as a narrative review in the Green Journal! In this episode, we will summarize the KEY points of measles infection in pregnancy and re-state the “rule of 4” and the importance of the number 10 regarding this.1. Feb 24, 2025: Measles 101: https://open.spotify.com/episode/4lXrpqKTJPdDcTXPxpEmcb2. April 27, 2019: Measles!! ACOG Practice

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00:17:44

Self-Hypnosis For Hot Flash Relief.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/12

The term "hypnosis" was first described in 1843 byScottish surgeon James Braid, who published the book Neurypnology. He coined the term "hypnosis" from the Greek word for sleep to describe the trance-like state induced by focusing on a bright object. Self-hypnosis has nowbeen shown to aid in menopausal hot flash reduction! In this episode, we will review this brand new publication from JAMA Network which confirmed via a multicenter RCT that a simple daily hypnosis audio session

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00:31:46

That's So Random!

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/12

Well, from time to time we cover RANDOM tidbits of information which cover RANDOM questions and/or RANDOM patient care issues that we encounter. In this episode we will cover one OB issue related to recurrent pregnancy loss, one GYN issue related to unilateral breast swelling in a patient with SLE, and one RANDOM life perspective response from a mock interview that I participated in for a residency candidate. Listen in fordetails!1. Viviana DO; Giugni, Claudio Schenone MD; Ros, Stephanie T. MD,

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00:14:48

HISTORY MADE: New HRT News TODAY (11/10/25)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/10

On August 15, 2025, we reviewed the data from an FDA expert panel calling on the FDA to remove the exiting Black Box warning on commercial HRT options for menopausal care. In a historic decision, this happened today. Listen in for details! 1. https://www.cbsnews.com/video/fda-chief-explains-changes-to-black-box-warnings-on-some-hormone-therapies-for-menopause/2. https://www.hhs.gov/press-room/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy.html

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00:24:13

A BMI-Based Labor Curve?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/09

The ACOG acknowledges that maternal obesity affects labor curves and recommends allowing more time for cervical dilation before diagnosing labor arrest in obese patients. This approach aims to avoid unnecessary interventions, such as premature cesarean delivery, which may occur if standard labor curves are strictly applied to obese women. In this episode, we will review a new study from the AJOG (08 Nov 2025) which describes labor progression and duration according to maternal body mass index,

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00:28:22

Use Antibiotics at 2nd Degree OB Lac Repair?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/06

Do you routinely order prophylactic antibiotics at time ofsecond-degree laceration repair? Is there data for that? While the use of prophylacticantibiotics “is reasonable” (per ACOG PB 198) for OASIS lacerations, what doesthe data look like for second degree lacs? Well, the answer is both supportiveAND non-supportive of that practice! In this episode, we will cover a brand newpublication (RCT) from BMJ on this very issue, and also highlight a meta-analysisfrom Plos One (May 2025) that also examined

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00:30:38

“New” PCOS Info: 4 Types (AGAIN)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/05

On March 29, 2023, we released an episode titled, “The 4 PCOS Phenotypes”. That was in 2023! Now, on 29 October 2025, in the journal Nature Medicine, researchers have published, “Data-driven (FOUR) subtypes of polycystic ovary syndrome and their association with clinical outcomes”. PCOS is not ONE condition: is a constellation of metabolic, endocrine, and ovulatory dysregulation. We covered these 4 phenotypes back then. Is this what the “new data” found? Or what it something else? And how does these

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00:29:02

Folic Acid Update: Women on Epilepsy Meds Do NOT Need...

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/11/02

Taking folic acid prior to conception and during pregnancy can help protect the unborn baby from developing abnormalities. Supplements are particularly important for women who have epilepsy, as anti-seizure medication (previously known as anti-convulsants or anti-epileptic drugs) can lead to a deficiency in folic acid. Until 2023, high doses of 4-5 mg per day were recommended. However, this has changed as the data has changed. Did you know the SMFM no longer recommends “high dose” folic acid

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00:21:24

Whole Blood for PPH!

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/31

Back on August 9, 2024, we released an episode (link in the show notes) reviewing the renewed interest in transfusing whole blood for PPH rather than component therapy. Now, in O&G open, authors from my Alma Mater (UT Southwestern) have published new data bolstering the use of whole blood for PPH. Listen in for details.1. Clinical Pearls Episode 2024: https://open.spotify.com/episode/0ZhqoIE9wMcAboDlevq9OW?si=rM32uK8ER8uuWmq4mf5dzA2. Ambia, Anne M. MD; Burns, R. Nicholas MD; White, Alesha MD;

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00:21:57

New Med For Hot Flashes

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/29

Elinzanetant, sold under the brand name Lynkuet, receivedapproval from the U.S. Food and Drug Administration (FDA) on October 24, 2025, for the treatment of moderate to severe hot flashes due to menopause. How is this different than Fezolinetant, which was approved in 2023? Listen in for details. 1. Menegaz de Almeida, Artur MS; Oliveira, Paloma MS; Lopes, Lucca MD; Leite, Marianna MS; Morbach, Victória MS; Alves Kelly, Francinny MD; Barros, Ítalo MS; Aquino de Moraes, Francisco Cezar MS;

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00:21:28

Vaginal Vit C For BV? AGAIN!

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/27

On January 18, 2020, we released an episode called “Vaginal Vit C for BV? Yep, it’s DATA”. That was 5 years ago! Now, in the Green Journal, a new systematic review and meta-analysis is examining this subject….AGAIN. Plus, this is not the only systematic review to investigate this; a similar review was published in Acta Obstétrica e Ginecológica Portuguesa earlier this year (2025) in March. So, did we get it right 5 years ago? Can vaginal Vit C help in eliminating BV? Listen in for

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00:30:28

AFLP vs Preeclampsia with Severe/HELLP

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/24

Here is a real-world clinical case with a tricky differential: Our team recently readmitted a patient 6 days postpartum/post C-section (which was done for ICP and fetal macrosomia at close to 4500 grams, with A2GDM). She had elevated blood pressures, a frontal headache, some midepigastric pain/RUQ discomfort. Pretty clear picture right: sounds like preeclampsia (PreE) with severe features based on BP elevation and symptoms. So, we started her on mag-sulfate per protocol. Well, her transaminases were

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00:16:01

Does IV Pitocin Increase Abruption Risk?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/21

I was recently asked to OPINE on the labor management for a patient who was receiving IV Pitocin for augmentation, who experienced a placental abruption. One physician stated that in "his opinion", Pitocin increased the risk of placental abruption intrapartum, a point which the original treating physician refuted. So, I was asked to be the "referee" on the play. IV Pitocin can result in some maternal-fetal complications but is abruption one of them as a stand-alone complication

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00:29:27

Does Oral PCN Affect OB GBS Culture Result?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/19

Current guidelines recommend universal collection of a vaginal-rectal swab for GBS colonization at 36-37 weeks and 6 days for the identification of patients who require intrapartum IV antibiotic coverage to prevent early onset neonatal GBS infection/sepsis. Recently, we had a patient in clinic whose GBS culture at 36 weeks was negative. Good right? Well, the patient was on amoxicillin at the time for pharyngitis. Did that course of oral PCN based therapy affect the GBS culture result? Should we

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00:26:31

New CPU: Male RX for BV (10/16/25)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/10/17

On March 7, 2025, we released an episode summarizing key aspects of a NEJM publication regarding male partner therapy for women with recurrent BV. Although that study had limitations, the results were very surprising. Now, on 10/16/25 (7 months later), the ACOG has a new Clinical Practice Update (CPU) on this very issue. In this episode we will briefly summarize that March 2025 NEJM publication and highlight the TWO updated clinical recommendations from the ACOG regarding male partner therapy for

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