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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.

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All Episodes

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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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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