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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

00:40:49

A Mini-Plethora of ObGyn News

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/13

Well, in the last 4 weeks there have some interesting developments in the sphere of OBGYN medical news. In October 2024, out of the American Society of Anesthesiologists, came a study on the possibility of using serum FAR to predict preeclampsia with severe features in admitted patients (don’t worry, we’ll discuss what FAR is!). PLUS, some exciting, although preliminary, data has been published out of Baylor College of Medicine raising the possibility of a non-invasive test for endometriosis

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00:29:45

Was the ARRIVE Trial an IOL Mandate? (New ACOG CPU)

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/09

The ARRIVE was published in the New England Journal of Medicine on August 8, 2018 1. This study was a large unmasked multicenter trial conducted from March 2014 to August randomized 6,106 nulliparous women to either IOL or expectant management at full term. The trial was conducted at 41 facilities across the United States. This validated that eIOL at 39 weeks, in that patient population, had the ability to reduce cesarean sections and rates of hypertensive diseases of pregnancy. Since that time,

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00:41:22

New Data for UTI in Women

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/07

Urinary tract infections (UTIs) are a leading cause of health care visits in the USA and around the world. In the US, they have a cost burden of $3.5 billion annually. Half of women experience at least one UTI in their lifetime, and approximately 25% of these women develop recurrent UTIs! On October 31, 2024, a study was published in Obstetrics Gynecology (the Green Journal) looking at UTI treatment trends in nonpregnant women. With the increased use of tele-visits, there is now a conundrum between

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00:33:55

Does OB Superficial Thrombophlebitis (SVT) Need LMWH?...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/11/05

Everyone understands that VTE (DVT and/or VTE) requires life-saving anticoagulation. That's simple. No controversy there. But what about pregnancy-associated superficial thrombophlebitis (AKA superficial venous thrombosis) in an extremity? Does that need anticoagulation? We have been traditionally taught that superficial venous issues are benign and do not require LMWH. Is that correct? The answer is NOT as straightforward as you would think. In this episode, we will review the 2018 ASH guidelines

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00:29:04

24-28 Hour Post-CS Discharge: New Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/31

According to the UK’s National Institute for Health and Care Excellence (NICE; 2024), women who are S/P scheduled CS and recovering well, who are afebrile, and do not have complications, should be discharged early (after 24 h) and followed at home because this is not related to the readmission of the baby or mother. However, the first 24 hours after a C-section can be challenging, with many of the same challenges as a vaginal delivery PLUS the usual post-surgical issues: The mother will be adjusting

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00:41:51

Q&A: ABRYSVO® Every Pregnancy? Clitoxin™?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/28

Welcome Back to another episode of "You ask, We Answer"! As Abrysvo (RSV vaccine) now has some time on the market, some women may find themselves with a subsequent pregnancy after first receiving the injection in the prior pregnancy. Is another RSV vaccine recommended with each pregnancy, like TDap? The answer to that question depends on where you live. We will discuss in this episode. PLUS, have you heard of CLITOXIN? Its a little botulinum toxin injected into the clitoris for "enhanced sexual

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00:51:03

Can Placental Volume on Sono Predict IUFD?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/26

Ultrasound assessment of placental volume has been proposed as an important aspect of prenatal care. It involves measuring the size and volume of the placenta, which may provide critical information regarding fetal health and development. Abnormal placental volume can be associated with various complications such as FGR, preeclampsia, and other pregnancy-related conditions. Some advocates suggests the volume and vascularity of the first trimester placenta may be linked to the most devasting adverse

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00:27:38

New AHA/ASA 2024 Guidance: WH Focus

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/24

Stroke is also a leading cause of adult-onset disability;among individuals who survive 6 months, almost half are dependent in at least 1 activity of daily living. In October 2024, the AHA/ASA released their 2024 Primary Prevention of Stroke guidance. This document has a striking focus on women's health, namely adverse pregnancy outcomes and certain gynecological conditions (Endometriosis, POI, PCOS). Listen in for details.

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00:33:29

The Enigma of Endo and Early Birth

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/23

Several observational studies have suggested that women with endometriosis have a slightly increased risk for preterm birth. The cause seems to be related to factors associated with pathogenesis of endometriosis, such as inflammation, reactive oxygen species, progesterone resistance, and alterations in the junctional zone of uterus leading to the shallow invasion of the placenta and to preterm birth. But is this association firmly established? It is actually more an enigma than solid evidence. In

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00:47:00

Insulin Initiation Made Easy

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/20

In November's Green Journal, Drs Amy Valent and Linda Barbour will publish their Clinical Expert Series (CES) on insulin management in GDM and Type 2 DM in pregnancy. This is a FANTASTIC document and is our subject matter in this episode. Here, we will give clinical pearls for insulin initiation in pregnancy based on 3 regimens (NPH/Reg; NPH/RAAs; Basal-Bolus) and their initiation in an easy to follow format. Congratulations to Drs Valent and Barbour on a wonderful CES.

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00:24:10

The OCP Makes You Gay?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/19

The relationship between hormonal birth control and sexual orientation has been a topic on social media channels and threads; it is a discussion of controversy. It is essential to clarify that the hormonal birth control pill itself does not determine or change an individual's sexual orientation. While there is evidence to suggest that hormonal birth control can influence sexual desire and partner preferences, there is insufficient data to support the idea that it can change a person's sexual

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00:37:15

Miso for EPF With Prior CSs?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/16

Early pregnancy failure (EPF), pregnancy loss in the first trimester, is a common pregnancy complication, with 15 to 20% of clinically recognized pregnancies ending in the first trimester. It is not uncommon for women with one or more cesarean sections, or myomectomies, to present with EPF. Options for treatment of early pregnancy failure include expectant management, surgical management (D&C), or medical management with medications such as misoprostol (miso). However, the limited information

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00:34:02

RPL with APS: When to Start RX

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/15

The SMFM, ACOG and RCOG all recommend screening for Antiphospholipid Antibody Syndrome (APS) in women with Recurrent Pregnancy Loss (RPL). However, once identified, there has been controversy historically regarding the best TIME to initiate low dose aspirin and prophylactic LMWH. The main controversy regarding this is whether to begin treatment before a confirmed pregnancy, right after a positive pregnancy test, or only after an ultrasound confirms a viable fetus; with some studies suggesting

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00:40:34

CHS in pregnancy (Updated Data)

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/12

Cannabinoid Hyperemesis Syndrome (CHS): Yep, this is definitely an issue and has been in recent print. This was just covered in an expert commentary in J Gastroenterology in May 2024, and CMS was featured as a JAMA Patient Page on October 10, 2024 in JAMA Network. PLUS, we actually covered this back in Feb 10th, 2020! Yep…M-O-R-E information just keeps coming, including a new study in the OCT 2024 Green Journal, which shows that rates of THC in pregnancy are still increasing. This study, again from

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00:44:39

Dehydration Causes OB Contractions? YES, and NO.

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/10

Proper hydration is important for physiology whether male or female, and if female… hydration in pregnancy is important for proper uterine blood flow and proper amniotic fluid production. Interestingly, water recommendations do not specify differential water needs or hydration status recommendations by pregnancy month or trimester, nor do they take into account body composition, knowing that overweight and obesity increase the probability of being underhydrated. During pregnancy, dehydration is

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00:31:48

Dupixent Use in Pregnancy: Sept 2024 Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/09

Eczema is also known as a form of Atopic Dermatitis (AD). Males and females are not equally affected by AD, and studies have shown that AD is more common among males during infancy and childhood. However, around puberty, there is a shift towards more females than males having AD and this female predominance continues into adulthood. Eczema can impact any women during pregnancy. In fact, it is the most common prenatal skin condition. A majority of women with eczema in pregnancy have never it

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00:18:47

Pump the Brakes on "ROUTINE" IV Fluids in Labor (SMFM...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/08

Hurricane Helene has caused massive devastation for a part of the US, and now we are bracing again for Milton, set to affect Florida within the next 24 hours. Baxter, one of the country's leading manufactures for IV fluid bags has closed its plant for an unknown amount of time as it was affected by Helene. On October 4, 2024, the SMFM released a news brief on IVF conservation intrapartum. Listen in for details.

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00:40:09

The Pregnancy “One-Stop Shop”: Screen for BRCA1? HPV...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/06

BRCA1 mutations dramatically increase the lifetime risk of breast, ovarian, pancreatic, and other cancers, yet most BRCA1-positive patients are not identified until after they have been diagnosed with cancer. At prenatal visits, women often undergo obstetrical prenatal carrier screening that can identify hundreds of genetic mutations which can be passed on to offspring and results in an inherited condition — however, BRCA1 and other autosomal dominant mutations are not included on these screening

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00:12:51

'Lil Convo With the (ACOG) Prez!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/05

Podcast family, this episode comes to you NOT FROM THE STUDI, but was recorded LIVE at the ACOG Annual District Meeting (District XI in Texas). This episode is a "lil convo" with Dr. Stella Dantas, our current ACOG President. This is a brief, light-hearted, yet POWERFUL message to encourage you, lighten your day, and make you smile. PLUS, Dr. Dantas will share with us her struggle with something we all have dealt with at one point or another: the Imposter Syndrome! We really are :all in this

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00:32:10

Bed Rest for FGR? Surprising 2024 Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/02

The ACOG defines Fetal Growth Restriction (FGR) as fetuses with an estimated fetal weight or abdominal circumference that is less than the 10th percentile for gestational age. Currently, the ACOG, SMFM, FIGO, and the ISUOG do not recommend maternal bed rest for this condition. However, a recent publication from the AJOG (May 2024) concluded that strict maternal bed rest could in fact reverse FGR in a short two-week interval! Is this possible? In this episode, we will dissect this controversial,

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1,071 results

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