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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

00:34:02

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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00:52:30

Use 130/80 Cut-off in OB? Depends! (CHIP, CHAP, & CLIP).

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/10/01

In the ACOG practice bulletin 203, the ACOG states that, “Traditionally, the diagnosis of hypertension (HTN) in pregnancy has been 140/90, on 2 occasions at least 4 hrs apart“. The keyword there is… “Traditionally”. In 2017, the ACC/AHA redefined hypertension with Stage I HTN being 130/80. Do some societies recommend the use of this lowered blood pressure criteria in pregnancy? It’s a complicated answer. Does aspirin help prevent preeclampsia in women with Stage I (130/80) hypertension? The answer

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00:34:25

D-MER: Breastfeeding's Ugly Side

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/28

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional "drop" that occurs in some women just before milk release and continues for not more than a few minutes. Although research is still evolving, one study Published in 2019 (Breastfeeding Medicine) states that up to 9% of breastfeeding women may experience dysphoric milk ejection, although the true incidence is still unknown. The brief negative feelings range in severity from wistfulness to self-loathing. In Arch Gynecol Obstet, in July

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00:17:21

It's a Small World

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/26

Podcast Family, every once in a while we need a little reminder that we are all wired for community. Despite differences in geographic locations, cultures, and family history, we really do have a lot in common. In this episode, I'll share with you 3 examples which prove that we really do live in a very small world. I hope this brings a smile to your face and encourages you! PLUS, of course, we will provide one main clinical pearl regarding CS-Hysterotomy closure while keeping with our

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00:37:34

Does LNG-IUS Increase Breast CA?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/24

The LNG-IUS has been on the U.S. market since 2001. Since 2005, there have been several studies examining the association (if any) of LNG-IUS users and the diagnosis of breast cancers. This is a controversial and conflicting story. In this episode, we will highlight a soon to be released publication (OCT 2024) from the AJOG looking into this relationship. PLUS, we will very quickly walk down history’s timeline starting in 2005 and ending in October 2024 looking at the cumulative data on the subject

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00:42:38

Labor Hacks? Pit Breaks, Propranolol, & Calcium

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/22

We all what to win in life, right? That’s why we have life hacks…to beat the system. Sometimes those tricks are tremendously successful while some other random hack can be- well, just WACK. Such is the case for LABOR HACKS! We all want our inductions and augmentations of labor to be successful, and there have been some labor hacks promoted throughout the years. But is there evidence of their effectiveness? Is a Pitocin break effective at kickstarting the uterus back up? We will cover that in this

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00:31:58

New Meta-Analysis on Immediate PP GTT (Sept 19, 2024)

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/20

On May 22, 2024, we summarized a then soon-to-be-released ACOG CPU on Screening for GDM in Pregnancy and Postpartum. That CPU was officially released July 2024. That update endorsed the possibility of immediate postpartum GTT testing with a 75-gram OGTT. Now, on September 19, 2024, authors from UT Houston have published a systematic review/meta-analysis on this subject. In this episode, we will review what this data is and what it isn't. Listen in for details.

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00:46:04

The "Tradition" of 24-Hrs PP MagSo4

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/17

Magnesium Sulfate for preeclampisa can be traced back to the work of Horn in 1906! Yet, despite such a long history of use, there are still questions about mag sulfate use that we just don’t have good answers for, and that’s indicative of the all the continued articles and commentaries on the subject that are still being released. For example, there are still sparse data regarding the ideal dosage of magnesium sulfate for preeclampsia with severe features. Even the therapeutic range of 4–8 mEq/L

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00:44:57

Alpha-Gal Syndrome in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/13

Filet Mignon, Pork Loin, Rib-Eye….all delicious (unless you are vegetarian)! If you are a meat- eater, be aware of AGS. Alpha-gal syndrome (AGS), also known as Red Meat Allergy, is a potentially life-threatening allergic reaction that can occur after a tick bite from a Lone Star tick or other tick species. While clustering within the US, Alpha-gal syndrome is found on every continent except Antarctica. With the tick bite, the tick transfers alpha-gal, a sugar molecule found in most mammals, into the

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00:21:21

NEW SPECIAL REPORT: FDA SAFETY NOTICE for Veozah

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/13

Today, 9/12/24, the FDA released a SAFETY COMMUNICATION regarding Veozah. As you may recall, we have been following this novel medication since March 2023. This episode is NOT our regularly planned episode- that topic will come out as scheduled tomorrow AM 9/13/24! This is a SPECIAL REPORT episode in response to the FDA's communication released today. Listen in for important information regarding fezolinetnet.

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00:24:26

New CPU from ACOG (9/10/24): RH IG Under 12 weeks

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/11

Back in January 2024, we summarized the SFP's position statement on RH IG use (or rather non-use) under 12 weeks IUP gestations. Then, in February 2024, we released an episode summarizing the more conservative stance from the SMFM. Well now, 7 months after that episode, we have a new Clinical Practice Update from the ACOG on this very issue. That is the focus of this episode...and as we have said better, WORDING matters. We will discuss in this episode.

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00:46:59

ONE MORE Random Question/Specific Answer: ABX with...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/10

In our last episode we tackled random questions with specific answers. After that episode went live, one of our nurses asked about the value of antibiotics with a Bakri balloon in place. This conversation happened as we were placing the balloon for PPH in a patient on Mag-Sulfate for Preeclampsia with Severe Features. That's antibiotic question is another random question that needs to be answered! So in this episode we will examine the data on prophylactic antibiotics with Bakri balloon for

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00:37:01

Random Questions: Specific Answers!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/09/08

Welcome to this episode of "Random Questions: Specific Answers"! In this episode we will (surprise) answer random questions- with specific answers- from our podcast family members: 1. Can administration of IV Calcium at intrapartum CS reduce QBL?, 2. What are the 4 classes of CS performance urgency? and 3. If a normal MVP for amniotic fluid is 2-8cm on ultrasound, does an MVP of >8cm still get "2-points" at mBPP or full BPP? Listen in for details!

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