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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

00:34:50

PUR and Peppermint Oil?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/15

Estimates of Postpartum Urinary Retention (PUR) incidence vary widely from 1.5% to 17.9%, with undiagnosed cases making the true incidence difficult to determine. A postvoid residual (PVR) volume of <150 mL is typically considered appropriate for normal bladder emptying, but this has been in the nonpregnant/non-postpartum population. In this group, some have proposed a PUR of up to 500ml as normal! That protocol, using the 500ml cut off, was just recently published in the J Matern Fetal Neonatal

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00:23:48

PP Ibuprofen with HDP? “NEW info”.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/12

In 2013, The ACOG’s Hypertension Task Force suggested that NSAIDS not be used in postpartum patients with hypertensive disorders of pregnancy due to theoretical concerns on BP aggravation. But “medicine moves fast”. In 2020, the ACOG “green lighted” ibuprofen use postpartum in these patients if no evidence of renal insufficiency was present. In episode, we will review a brand-new publication (soon to come out), in AJOG, released ahead of print on February 10, 2025. This study is a randomized trial

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00:44:18

The Survey Says....! (FULL EPISODE)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/11

(We were made aware that this original posting had the last section DROPPED accidentally)...here is the full episode! Ahhh...TECHNOLOGY! *This is why AI will likely replace our production team...Just kidding production team, just kidding).Episode Details:Well, we typically focus on ONE or maybe TWO publications to highlight and review. However, in this episode, which we have decided to call, “Survey said…!”, we will go through some common and REAL WORLD “mental battles”regarding what is and what is

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00:34:08

The Survey Says...! (PLEASE SEE UPDATED VERSION 2/11/25)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/10

Well, we typically focus on ONE or maybe TWO publications to highlight and review. However, in this episode, which we have decided to call, “Survey said…!”, we will go through some common and REAL WORLD “mental battles” regarding what is and what is not part of a diagnostic criteria. These are every day OBGYN things that we KNOW, but when asked to define them…we can easily get ourselves confused. We are going to clear these up…Game Show style! First, when only one abnormal value is found in the

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00:43:53

Severe CHTN or Superimposed PreE w/Severe Features?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/06

Yep, its an area of debate and confusion. Controversy surrounds the diagnosis of CHTN with severe BPs vs superimposed preeclampsia with severe features. Do you need “new onset proteinuria” for the diagnosis of superimposed preeclampsia over CHTN? What about “with severe features”? This is something that is very clear to understand, yet muddy; there is well defined guidance here which is grey! Yep, we will cover this controversy and give PRACTICAL insights for the care of CHTN with severe BPs in the

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00:38:19

Eclampsia = Brain Scan?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/04

According to the ACOG, eclampsia is a low frequency, high acuity emergent condition. The rate of an eclamptic seizure is 1/200 in those with preeclampsia without severe features but is 4 fold higher ( 4/200 ) in those with preeclampsia with severe features. Traditionally, “textbook eclampsia” management did not include cranial imaging. However, that consensus is changing! In this episode, we will review data making the case for a standardized approach to eclampsia, which includes universal

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00:40:09

“Sounds Reasonable”! 3 Things to Consider.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/01

Well, in this episode we have a “3-in-1” subject review. Often in medicine, we find ourselves with some data to guide us, but definitely not a “predominance of evidence”. So in caring for our patients, we often come to the conclusion that doing a course of action can possibly help, and can't hurt... and therefore our plan “sounds reasonable”. That's the focus of our episode today! We're going to have fun with this one and cover three topics where we do have some data to guide us, but not

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00:38:23

No Need for PP LMWH VTE Prophylaxis?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/28

Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is responsible for 9–30% of pregnancy-related mortality in high resource countries and remains a significant, increasing cause of severe maternal morbidity. Peripartum, 50% of VTE events occur in the postpartum interval, which has a 6-fold higher risk compared to antepartum. There is wide variation in LMWH pharmacological postpartum prophylaxis guidance. The RCOG, for example, recommends 10 days of LMWH for all

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00:30:05

"CNN" Update (Chapa News Network): 1. ACOG RSV-GBS...

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/24

This- is-CNN. No, that THAT CNN...This is Chapa News Network! WE have late-breaking news developments on 2 fronts: 1. The ACOG has released a clinical update (ACOG ROUNDS) in response to a recent study associating the RSV vaccine and GBS (we covered this study in a past episode). 2. The FDA has EXPANDED the label for an intranasal therapy for Treatment Resistant depression (TRD). Listen in for details.

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00:40:29

Is Sleep Position REALLY Linked to Stillbirth?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/23

Around a third of a person’s life is spent asleep. Previous studies have reported an association between sleep disordered breathing, like OSA, and pregnancy complications such as pre-eclampsia, gestational diabetes, and preterm birth. We recently discussed a stillbirth bundle from Australia which includes patient education on sleeping practices and stillbirth risk. Does maternal sleeping position ready influence stillbirth risk? Some data says NO, but there’s a catch to those. Other population level

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00:29:15

External Aortic Compression: Buying Time in Pelvic...

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/21

Internal manual aortic compression is a procedure that may be used intraoperatively in the management of massive pelvic bleeding. But what about EXTERNAL aortic compression? In February’s 2025 AJOG (Grey Journal), under their Surgeon’s Corner section, there will be a very nice video recap of an easy to adopt maneuver which may “buy time” in OB hemorrhage cases as surgical intervention is being planned. This is called the EAC maneuver. First described in 1994, this technique has regained the

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00:30:10

The Miracle Med in Menses? MenSCs.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/20

Mesenchymal stem cells (MSCs) are multipotent adult stem cells which can differentiate into multiple cell types. MSCs can be isolated from the bone marrow, umbilical cord blood, adipose tissue, muscle, and dental pulp. However, the use of these MSCs involves a number of barriers. Human umbilical cord is limited to collection at birth. Bone marrow and fat biopsy are painful and requires general anesthesia. If only there was an easily obtainable method to collect these MSCs, like maybe even once a

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00:36:20

Maternal Tachycardia: When to Eval.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/17

Tachycardia in pregnancy is common and distinguishing between physiological and pathological causes can be a challenge. Plus, until recently, there had not been a well-defined or universally accepted definition of the upper limit of normal for heart rate in pregnancy. But a study published in 2020 from the Green Journal, from the NHS in London has shed light on this issue. The finding of persistent tachycardia beyond a certain rate (and we’ll discuss that rate in this episode), regardless of

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00:30:41

Time for Stillbirth Prevention Bundle: NOW.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/13

The stillbirth rate in the US is considerably higher than in many countries with similar resources. In 2021, the United States stillbirth (loss before birth at ≥20 weeks’ gestation) ratio was 5.73 per 1000 births or 1 in 175 pregnancies with 21,000 stillbirths occurring annually. Contrast that to the rate in Japan which is 1.6/1000! The UK and Australia have both implemented stillbirth prevention bundles which have proved worthwhile. It is long past due for the US to have its won national stillbirth

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00:34:00

*FDA Warning*: RSV Vacc and GBS (Breaking it Down)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/10

Guillain-Barré syndrome (GBS) is a rare disorder that causes muscle weakness and sometimes paralysis. It's caused by the body's immune system damaging nerves. While most cases are triggered by respiratory or gastrointestinal infections, vaccinations have also been linked to GBS pathogenesis. GBS can last from weeks to years, but most people start to recover within a few weeks. The earlier symptoms improve, the better the outlook. Physical therapy is important to prevent muscle contractures and

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00:21:19

Response to 2 New Pubs: “Ya Don’t Say?!” (Sarcasm Added)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/08

Sometimes you read a new study and you just have to say, "You Don't Say?!" In this episode, we will highlight 2 publications which were released Dec 26. 2024 and Jan 6, 2025 which make you say just that. This is a brief, fun, YET STILL EDUCATIONAL, episode...Listen in for details.

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00:40:57

2 Topics: 1.New, and 2.Weird!

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/07

In this episode, we will cover 2 topics: the first is brand new in print (01/06/2025 ), and the second is just weird. In the “new” portion we'll summarize a new randomized study published in JAMA Network dealing with gestational diabetes. Should we add glyburide to metformin for GDM control? Listen in for details. In the second portion, we'll focus on unilateral ovarian absence not related to previous removal. Yep! This is why it's very important to check the adnexa at “routine” C-section or

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00:41:39

Mode of Delivery for Periviable PTB: Does it Matter?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/05

Preterm infants, especially those born at periviability, are at inherent risk of a variety of short-term neonatal complications- depending on their gestational age- including sepsis, respiratory distress, IVH, and have an overall higher mortality compared to term born infants. Well known interventions are intended to reduce these complications; these include antenatal corticosteroids, magnesium sulfate for CNS protection, and antibiotics for latency in PPROM. This is an even bigger issue for those

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00:26:17

MATISSE Trial: Maternal RSV Vaccine Outcomes

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/01/03

In most regions of the United States, RSV season starts in the fall and peaks in the winter. In September 2023, the ACOG released a Practice Advisory recommending a single dose of Pfizer’s RSV vaccine (Abrysvo) for eligible pregnant individuals between 32 0/7 and 36 6/7 weeks of gestation who do not have a planned delivery within 2 weeks, using seasonal administration, to prevent RSV lower respiratory tract infection (LRTI) in infants. This is recommended from September to January. Currently, the US

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00:21:21

FDA Lit Review on Tampon Safety Released

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/28

In August 2024, researchers at Columbia University published a study that found measurable concentrations of 16 metals in multiple brands of tampons. The study evaluated levels of metals like cadmium, manganese, and arsenic in 30 tampons across 14 different brands. The study concluded that using tampons may be a potential source of metal exposure. We covered this publication in JULY 2024 before it was released! In response to the study, the FDA launched an investigation that includes 3 parts: 1. An

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1,066 results

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