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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

00:21:19

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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00:42:41

Take Aspirin to Prevent PP HTN?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/26

Low-dose aspirin (LDA), typically prescribed at a dosage of 81 mg daily, is primarily used during pregnancy to prevent or delay the onset of preeclampsia. However, the question of whether to continue LDA postpartum is less clear and requires careful consideration of the benefits and risks associated with its use in the postpartum period. After all, the American College of Cardiology and American Heart Association recommend that low-dose aspirin use (75 to 100 mg/d) might be considered for the

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00:32:12

The Controversy of Cerclage and PPROM

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/23

Somethings in medicine are pretty cut and dry. Others...not so much. Such is the case with obstetrical management of PPROM with a cervical cerclage in place. Should it be removed, or left in place? While the ACOG has some guidance from March 2020, there has been additional publications released, including one from SMFM. PLUS, a November 2024 review on the topic (AJOG MFM) has suggested a practical approach to this clinical scenario. Listen in for details.

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00:32:15

2025 SFP Statement on BC and Body Weight

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/19

In late 2024, the CDC updated their MEC on contraception in those with medical co-morbidities. Obesity (BMI >/= 30) was also referenced in that revision. NOW, coming out officially in 2025, The Society of Family Planning has released their committee statement on "contraception and body weight". Is there a certain BMI class where a type of BC is contraindicated? Does BC make you fat?! Listen in for details.

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00:36:07

Fetal RHD Positive, Yet RH Blood Type Negative at...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/16

We have made SIGNIFICANT progress in our ability to screen for fetal RH factor using cell free DNA from maternal blood. Cell-free DNA to determine the fetal RHD genotype from the maternal circulation was first described in 1993. We have come so far since them. In March 2024, the ACOG released a Practice Advisory stating, “the use of NIPT to prioritize use of RhIg and conserve RhIg supply is a reasonable consideration”. Two U.S. companies have introduced cell-free DNA assays for RHD as part of their

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00:36:36

Best ASA Admin Time? YEP, there IS one.

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/13

The saying says, “The Devil is in the details”. This idiomatic phrase that means even the grandest project depends on the success of the smallest components. So is the case with low dose ASA for preeclampsia prevention. Currently, the ACOG states, “Low-dose aspirin (LDA) (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery” (ACOG CO 743; 2018). But

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00:32:34

BRAND NEW USPSTF Recs (12/10/24) on HPV Screening

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/11

EVERYTHING CHANGES! So true. And now, the USPSTF has changed (UPDATED) their recommendations for cervical cancer screening in regards to HPV primary screening. This is BRAND NEW, within the last 24 hours. Primary HPV screening for cervical cancer has gained a lot of steam and is progressing quickly. The FDA approval of “dual stain” testing of hrHPV positive results, the recent FDA approval for patient self-collection for HPV vaginal samples in a clinical setting, and now this new draft

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00:48:06

Episode: OB Sono “Issues”: 2 for 2.

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/09

Well, in this episode we have 2 very interesting andchallenging clinical situations. These come from real world clinical encounters so we thought we would share these with you because they are brain teasers and should be discussed. They both have to do with OB ultrasound. First, is there a “minimal” CRL to estimate gestational age? In other words, is there a CRL that is too small to be accurate? It’s an intriguing question and we will give an answer! Second, in women with regular and predictable

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00:27:08

NEW DATA: Acetaminophen in OB=ADHD & ASD! (Not So Much.)

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/06

Acetaminophen (Paracetamol) is a common over-the-counter medication that has gained substantial media attention regarding its use by pregnant women. Although estimates vary considerably, most studies and surveys report that around 40–65% of women take acetaminophen sometime during their pregnancy. Historically considered safe, concern was initially raised back in 2014 with a JAMA Pediatrics publication stated that use in pregnancy lead to ADHD in the offspring. Seven years later, in 2021, a

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00:35:16

Another Nail in the 81mg ASA Coffin? Move to 162mg?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/12/02

In November 2013, ACOG issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin (81mg) beginning in the late 1st trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks, or for women with more than one prior pregnancy complicated by preeclampsia. The following year, the USPSTF published a similar guideline, although the list of indications for low-dose aspirin use was more expansive. Since then, the ACOG has

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00:37:39

The Fertility Anxiety Panic: Freeze Eggs in 20s?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/28

The first successful births from frozen eggs were twins, born in Australia in 1986. IVF serves a valuable role for those with persistent infertility issues or other conditions where natural conception is hindered. Although oocyte cryopreservation was initially used as a fertility preservation strategy for medical indications, currently, it is increasingly used to circumvent age-related infertility. This process of elective egg retrieval and cryopreservation- targeting women in their 20s- has gotten

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00:09:50

Avoiding Sex While Pregnant, To Avoid Pregnancy? And...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/26

Introducing one of our Senior Residents, Dr. Mauldin: Dr. Mauldin just told me of a real patient encounter she had just today, that I felt we HAD to share with everyone. This real encounter is WHY we are passionate about EVIDENCE-BASED medicine! PLUS, we will introduce our NEXT episode which will focus on "elective egg harvesting and freezing" for young women who may have "delayed fertility" due to career path. The social media influence on what has come t be called "social egg harvesting" by some,

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00:31:37

Chewing Gum to Prevent Preterm Birth! Maybe.

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/23

In the United States, more than 400,000 babies are bornprematurely each year, which is about 1 in 10 babies. Over the last several decades, multiple studies have shown a link between poor oral health and increased occurrence of preterm birth. Researchers have looked at various ways to improve dental health during pregnancy, including doing a “deep-teeth cleaning” (also called ‘scaling and planing’), which involves removing plaque and tarter on the teeth and below the gum line. However, despite

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00:30:58

Understanding Dual Stain in HPV Triage (ASCCP 2024...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/20

The U.S. Preventive Services Task Force and the World Health Organization recommend primary HPV screening, starting at age 25, as an option (some as preferred) for cervical cancer screening. Although primary HPV screening is as effective as cotesting at detecting cervical cancer, primary HPV screening decreases the number of lifetime screenings needed. The primary HPV screening tests approved by the U.S. Food and Drug Administration (FDA) are the Roche Cobas and BD Onclarity tests. HPV results for

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00:32:18

New Data: Vaginal Estrogen Use in Breast CA Survivors

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/18

With an estimated 3.8 million breast cancer survivors in the United States, OBGYNs and other women's healthcare providers often are on the front lines of addressing survivorship issues, including the hypoestrogenic-related adverse effects of cancer therapies or early menopause in survivors. Although systemic and vaginal estrogen are used widely for symptomatic relief of genitourinary syndrome of menopause in the general population, among individuals with a history of hormone-sensitive cancer, there

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00:26:28

Steroids & Studies & "Shared-Decisions": Oh My!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/15

Yep! We have definitely covered the evolving saga and controversy regarding antenatal corticosteroids in the late preterm/early term interval. It's like Dorothy in the Wizard of Oz: "Lions and Tigers and Bears, Oh My!" More fitting for our discussion, its "Steroids, and Studies, and Shared-Decisions, Oh My!" In this episode we will highlight TWO pieces of literature coming out in DECEMBER 2024 in the Green Journal on this topic. The article is by Clapp et al and the associated editorial piece will

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