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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

00:35:51

IM Vit K Avoidance at Birth: Alternatives?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/06/09

Hemorrhagic disease of the newborn (HDNB) was first identified over a century ago, and presents as unexpected bleeding, often with gastrointestinal hemorrhage, ecchymosis and, in many cases, intracranial hemorrhage. In newborns, HDNB is typically caused by vitamin K deficiency as neonates are innately deficient in vitamin K secondary to very little vitamin K transferred through the placenta to fetuses in utero, limited liver storage of vitamin K, and low amounts of vitamin K in breast milk. IM

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00:24:20

🔥NEW PRACTICE UPDATE: Paternal & Fetal Genotyping...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/06/05

Proving that our podcast tagline, “Medicine Moves Fast” is true… this episode highlights something that is, once again, 🔥🔥🔥 Off the Press! on June 4, 2024, the ACOG released a new Practice Update regarding the determination of paternal and fetal RBC genotyping in pregnancies affected by alloimmunization. This builds upon and updates PB #192 from 2018. There are 3 big areas of change here… And we will highlight each one!

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00:22:01

cCMV (Part 2): Prevention, and Care.

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/06/05

June is CMV awareness month. And that’s the keyword there… Awareness! The way we prevent CMV transmission is by awareness. It would be great to have a vaccine against this virus, but we just don’t…yet. Until a safe and effective CMV vaccine is clinically available, primary prevention of cCMV relies on patient education and hygiene measures. In this episode, will take a look at this strategy and see what the data has to say about it. Will also discuss the very controversial (and non-ACOG recommended)

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00:50:08

cCMV (Part 1): Presentation, Transmission, & Workup

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/06/03

In 2011, Congress passed a resolution naming June "National CMV Awareness Month," to raise awareness about the most common congenital infection in the US, affecting 1 of 200 live births. It is the leading VIRAL cause of IUFD & miscarriage & the leading cause of neonatal hearing loss, second only to genetic causes. Furthermore, cCMV is more common than many other neonatal conditions, such as spina bifida and fetal alcohol syndrome. Neonates affected by the virus can experience a wide array of

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00:35:13

Does BDP Cause Adverse Preg Outcomes?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/29

(VACAY EDITION) Recently in our high-risk OB clinic, I saw a patient who was disappointed that she “had to stop breastfeeding” as she entered her 3rd trimester with her 2nd child. Her first pregnancy was via vaginal birth, at term, with no complications. This situation is not frequently addressed and is a clinical dilemma. First, when nursing coincides with pregnancy, there is frequently a significant cultural taboo leading many women to wean their infants when they become pregnant again. Secondly,

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00:26:48

The Remedy for Painful IUD Insertion?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/28

In our podcast archive, we have an episode titled, “TikToc’s #IUD is Killing a Good LARC”. In that episode, I discussed our protocol of using viscous lidocaine applied topically to the cervix, cervical canal, and coating the IUD device for placement. This works! In this episode, we will build on that concept by reviewing a publication released on May 23, 2024 in the AJOG. Could this be the remedy for painful IUD insertion? Plus, have you heard of the CAREVIX device? Listen in for details.

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00:31:38

UPDATE: Universal CX Length Screening and More...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/23

It definitely is interesting how published data tends to have sporadic “groupings” in print. For example, last week 2 publications were released which could be placed under one “group”: prediction/prevention of spontaneous preterm birth. One publication (AJOG MFM) presented a systematic review and meta-analysis on universal cervical length screening. The second publication, SMFM’s consult series # 70, pertains to the management of a short cervix in individuals without a history of spontaneous

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00:28:36

New GDM Guidance!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/22

It’s exciting to know that we are practicing a type of medicine that is alive and ever-evolving! Such is the case regarding our clinical practice/management of gestational diabetes. In this episode, we will review brand new (as of May 21, 2024) clinical guidance from the ACOG regarding gestational diabetes. Should we be screening for diabetes before 24 weeks? Is there one diagnostic threshold which is suggested for use over the other (CC versus NDDG)? And is it possible to screen for postpartum DM

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00:42:52

Fluoride in Drinking Water Harmful in Pregnancy? Fake...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/21

The United States began adding fluoride to community water supplies in 1945. At that time, Grand Rapids, Michigan became the first community in the world to add fluoride to tapwater. Over the last several years, with an increase in reporting and media stories over the last 3 months, fluorinated drinking water has come under scrutiny and controversy. Does fluoride in drinking water affect children in the womb? Is this a cause of altered neurocognitive development? Does this lower IQ scores? This is a

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00:36:59

Fun Stories From ACOG… & MORE!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/19

Podcast family, this episode is recorded on the last day of the ACOG ACSM. Wanted to share with you some encouragement that I received from our podcast family members over these last 2 to 3 days. AND of course, in typical style, I’ll share with you a brand new publication which was released on May 17, 2024 in the AJOG (GRAY Journal) regarding “optimal dose of antenatal corticosteroids”. And lastly, I’ll share 3 Special Announcements, as an FYI.

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00:24:09

Lioness Device: New Hope for PTB?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/16

We all can agree that we need a new ally against the foe of pre-term birth. With the disappointing results regarding the (lack of) efficacy of progesterone in reducing preterm birth, the search is out for a new, effective tool to reduce pre-term birth rates. Enter: the Lioness(tm) device. In this episode, we will review a new “safety and efficacy” study published today (May 16, 2024) in the AJOG. Is this ready for prime time? And how does this device work? Listen in for details.

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00:32:06

🔥OFF THE PRESS: Best Dose of UFH for Antepartum...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/14

Unbelievable timing! In our immediate past episode, we discussed the controversy surrounding pharmacoprophylaxis for antepartum inpatients. Just 3 days from that episode, a new RCT has been published in the Green Journal (Obstet Gynecol) discussing this very subject! This new RCT (published May 14, 2024) investigates the “best dose” of unfractionated heparin (UFH) during antepartum admissions? is there an advantage to “gestational – age based” dosing? Or should standard UFH dosing be used?

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00:49:37

Lovenox for Antepartum Inpatients?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/11

All of us can agree that the rates of obesity are progressively climbing, not just in the US, but globally. Obesity is a known independent risk factor in pregnancy for VTE. Several professional societies (ACOG, CMQCC, RCOG, SMFM) have clear recommendations for VTE pharmacoprophylaxis in patients considered at high risk. These include having a high risk thrombophilia, having a personal history of VTE, or having multiple risk factors. But these recommendations address POSTPARTUM prophylaxis. The ACOG

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00:34:38

DQC: New Hope for Vaginosis

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/09

Bacterial vaginosis (BV) is known as a normal vaginal microbiota resulting in low lactobacilli; it affects one-quarter to one-third of reproductive-age women. The BV treatment landscape has not appreciably changed in decades: in the US, metronidazole and clindamycin are recommended as first-line treatments for symptomatic BV, and secnidazole and tinidazole are used as alternatives. Although these treatments are effective in the short term, up to 60% of women experience BV recurrence within 1 year of

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00:46:13

Tocolysis Confusion!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/07

Preterm birth is the leading cause of death in newborns and children. Tocolytic drugs aim to delay preterm birth by suppressing uterine contractions to allow time for administration of corticosteroids for fetal lung maturation, magnesium sulphate for neuroprotection, and transport to a facility with appropriate neonatal care facilities. However, there is still uncertainty about their effectiveness and safety. Plus, more than 90% of the data regarding tocolytic use comes from patients with threatened

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00:42:01

Puerperal Group A Streptococcus Infection

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/05

Haemorrhage, hypertensive disorders, and sepsis are responsible for more than half of maternal deaths worldwide. Further, it is estimated that for every death, there are 50 pregnant people with life-threatening morbidity from sepsis. Heartbreakingly, the incidence of puerperal sepsis has risen over the last decade, in some cases doubling, with increasing rates of severe sepsis contributing to mortality. Underlying this trend is increasing virulence of group A streptococcal (GAS) infection. This is

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00:37:31

The HRT Makeover

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/03

Menopausal HRT is getting a big, big facelift! Get ready for new research trials, physician education programs, and patient awareness campaigns on menopause! Since the WHI study was released in 2002, the world of menopausal HRT has gone through some major changes. WHI initially led to confusion and fear regarding the use of menopausal HRT. But now, 30 years later, where do we stand? In this episode, we will highlight 2 brand new publications released on May 1, 2024, which prove that we are finally

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00:46:43

What the What?!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/05/01

Just the other day in my University clinic, in one single morning, I had 3 separate patients with three very interesting histories; these became the basis of this episode. It’s amazing what’s out there in daily practice! So, we will dive into these 3 main questions which arose from these 3 patient encounters: 1. What single test is recommended before initiation of combination birth control pills? And if this is recommended, how do online pharmacies prescribe prescription birth control? 2. Does PCOS

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00:19:46

NEW TODAY! USPSTF MMG Update

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/04/30

Well, once again… Late breaking news! Today, April 30, 2024, the USPSTF released its updated recommendations for breast cancer screening (mammography) in average risk patients. This follows a firestorm of controversy and backlash over the last 1 to 2 years as the USPSTF continued to recommend initiation of mammogram at age 50, despite the increased incidence of breast cancer in women in their 40s. In this episode, we will review this brand new recommendation and summarize the ACOG response from ACOG

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00:23:58

🔥 Clinical Practice UPDATE: IAI and FEVER (April 29,...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/04/30

Traditionally, clinical guidance has incorporated maternal fever as a required criterion for suspected intraamniotic infection. That is exactly what is stated in the ACOG committee opinion #712 from 2017. However, not all patients with clinical IAI have fever! Having fever as a required part of the diagnostic criterion may result in delayed administration of appropriate antibiotics intrapartum. This has now been addressed by the ACOG! Today, on April 29, 2024, the ACOG released a practice update

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1,071 results

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