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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

00:30:44

Ramadan Fasting & Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/14

Fasting during the lunar month of Ramadan (Feb 28 to March 30, 2025) is a core practice for Muslims across the world. During Ramadan, Muslims abstain from food and drink from dawn to sunset. However, during a singleton pregnancy, the ACOG recommends adding approximately 340 extra calories per day in the second trimester and 450 extra calories per day in the third trimester. Does fasting during Ramadan have negative perinatal outcomes due to the potential caloric restriction? In this episode, we will

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00:37:43

Vaginal Seeding…AGAIN?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/13

Infants born by vaginal birth are exposed to maternal vaginal bacteria, which are one of the contributing influences on the subsequent development of the infant’s microbiome. This process is altered by cesarean delivery, which changes the initial microbiome of the neonate. It is theorized that infants born by cesarean delivery have an increased risk of chronic inflammatory conditions due to altered early-life microbiome colonization, with associated aberrant immune and metabolic development. Vaginal

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00:44:22

Introducing: MIUDELLA®

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/10

On Feb 24, 2025, the FDA granted approval for MIUDELLA®, a hormone-free, low-dose copper IUD developed by US manufacturer Sebela Women's Health Inc (Georgia) for contraceptive use in females of reproductive potential for up to 3 years. MIUDELLA® utilizes a small, flexible nitinol frame and contains less than half the copper of currently available copper IUD. Where have we seen nitinol before?? How does this compare with the traditional ParaGard IUD? Can this be used for emergency contraception

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00:35:52

Treat MEN for BV Protection in Women?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/07

BV is a vaginal dysbiosis resulting from replacement of normal hydrogen peroxide and lactic-acid producing Lactobacillus species in the vagina with high concentrations of anaerobic bacteria. Recurrent BV can occur in 50-70% of women after an initial diagnosis. The concept of treating the male partner for BV recurrence prevention is not new, and the results have been conflicting. However, a new publication from Australia (released 03/5/25, in NEJM) has sparked new interest and new conversations about

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00:04:07

Danny vs Dave Thomas!! (Editorial Correction to SMA...

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/06

Thank you to our GREAT podcast family members who fixed by history regarding "Hollyweird" ! And thank you DANNY Thomas for your legacy at SJCRH. Go Memphis!

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00:28:02

Breakthrough in Prenatal SMA Therapy

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/06

Screening for spinal muscular atrophy (SMA) should be offered to all women who are considering pregnancy or are currently pregnant. SMA is an autosomal recessive disease characterized by degeneration of spinal cord motor neurons that leads to atrophy of skeletal muscle and overall weakness. Once identified, oral therapy may be started in the neonatal interval for those with the most severe phenotype (SMA-1). However, on Feb 19, 2025, a medical team piloted an investigational PRENATAL protocol as

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00:36:58

Vit D and PTB (“New” Feb 2025 Data?)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/03/03

Vitamin D gets a lot of attention, and it should, mainly for its known role in bone stability. However, vitamin D has significant additional roles in physiology. Vit D, and its metabolites, also functions as modulator of inflammatory and immune responses. According to a number of recent studies, this important micronutrient plays a complex role in numerous biochemical pathways in the immune system and disorders that are associated with them. In pregnancy, the association of Vit D deficiency and

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00:26:54

ASA Desensitization in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/28

According to published estimates, the prevalence of an NSAID allergy (hypersensitivity) in the general population is estimated to be between 0.5% and 2%, with some studies reporting a range of 1-3% of people experiencing a reaction to NSAIDs; however, this rate can be significantly higher in individuals with conditions like asthma, nasal polyps, or chronic urticaria, where it may reach up to 20-30%. Genetic and epigenetic backgrounds are implicated in various processes of NSAID-induced

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00:23:04

MEASLES 101! What to Know.

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/24

Its BACK. While the current outbreak is in western Texas and Eastern NM, it is expected to spread to other States. Measles is an acute viral respiratory illness characterized by fever, malaise, cough, conjunctivitis, a pathognomonic enanthema (oral lesions), followed by a maculopapular rash. In pregnancy, this could lead to significant maternal and fetal morbidity. What are Koplick Spots? What is the "Rule of 4" with measles, and what is important about the number 10? Listen in for this

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00:21:36

TOLAC: IOL or Wait? (March 2025 Data)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/22

The ACOG's PB 205 (2019; reaffirmed Aug 2024) states that "when compared with spontaneous labor, induced labor is associated with a lower likelihood of achieving VBAC". Additionally, that guidance states, "Several studies have noted an increased risk of uterine rupture in the setting of induction of labor in women attempting TOLAC". These are important observations to review with a patient. However, according to a study soon to be published in March 2025, based on US Vital Statistics birth

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00:30:44

Funic Presentations at Term: CS or Not? Timing?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/20

Funic presentation, the umbilical cord presenting as the leading feal component seen on ultrasound, may be a transient phenomenon and is usually considered insignificant until ~32 weeks. However, its persistence beyond that gestational age raises the possibility of cord prolapse intrapartum as cervical dilation progresses. Cord prolapse is a mostly unpredictable obstetric emergency, in which the umbilical cord comes through the cervical os in advance of (overt prolapse – usually palpable or even

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00:29:49

Excessive Maternal Wt Gain (gwg) = Stillbirth?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/02/17

One in five women in the U.S. have a BMI of 30 or more at the START of pregnancy. Around 1 in 5 women gain more than 40 pounds during pregnancy, which is more than any woman should gain. Only about one-third of women gain the recommended amount of weight during pregnancy. Gaining too much weight during pregnancy can increase the risk of HDP, GDM, fetal macrosomia, and can cause complications of birth, such as shoulder dystocia or preterm birth. Excessive weight gain during pregnancy can also

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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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