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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

00:21:10

Another Nail in the Coffin for Late PT Steroids: New...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/02/11

YES, it’s true… Not even Super Bowl Sunday 🏈🏈can stop us from getting our podcast episode up and out! In this episode, we will summarize the key findings of a newly released RCT (ahead of print, Obstetrics and Gynecology) that is yet another “nail in the coffin” for late pre-term/early term steroids. This is perfect timing, as we just covered this topic on a separate episode last week. So listen in as we summarize this newly released, triple-blind RCT with eye-opening results.

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00:27:55

New Data on Naltrexone in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/02/08

We are still in an opioid crisis. The number of women with opioid-related diagnoses at delivery has increased by 131% over the last several years (CDC, Data and Statistics, 2023). The ACOG has recommended the use of opioid agonist pharmacotherapy for MOUD during pregnancy. Traditionally, medically supervised withdrawal has not been endorsed for pregnancy. However, some patients may elect to discontinue opioid therapy in favor of an opioid antagonist like naltrexone. In this episode, we will review a

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00:51:57

TOKOPHOBIA: Pregnant & Petrified

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/02/07

It is completely natural, and part of the human experience, to have some anticipatory concern about an upcoming delivery/childbirth. However, when that concern becomes overwhelming, it can develop into a debilitating phobia called Tokophobia. First coined as a term in 2000, there’s been growing awareness of this specific type of anxiety disorder/phobia. Even though it was first described in 2000, this extreme fear of pregnancy and childbirth has, of course, been part of the human experience For

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00:50:10

The OB Steroid WARNING FLAGS: When CONS>PROS

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/02/05

In 1972, Liggins and Howie published their landmark study on the benefits of antenatal corticosteroids (ACS) regarding their reduction of prematurity’s morbidity and mortality. This led to the weekly administration of ACS until 34 weeks. Weekly courses of steroids are no longer given, but the steroid story keeps evolving. In 2016, the ALPS trial demonstrated reduction in short-term respiratory morbidity when steroids were given in the late pre-term interval. Many professional societies and

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00:50:47

Putting LNG-IUS EC In Perspective

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/02/03

On January 28, 2021, a non-inferiority RCT was published in the NEJM, “Levonorgestrelvs Copper T Device for Emergency Contraception”. This study concluded that the LNG 52mg IUD was “noninferior” to the CopperT IUD for emergency BC up to 120 hours after ill-protected intercourse. Since that time, use of the LNG 52mg IUS has remained controversial with some organizations endorsing its use as EC while others take a more cautionary stance. Now, as a February 1, 2024, a new commentary in the Green

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00:35:38

The Incredible VIBRATING belt (Osteoboost device):...

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/02/01

On January 18, 2024, the FDA cleared a novel new device for osteopenia treatment. This is a vibrating belt (wearable device) that transmits low-amplitude, high-frequency (20 to 40 Hz) vibration to the spine and hips. This belt is called Osteoboost. Osteoboost previously received a breakthrough designation from the FDA in Dec 2020. This FDA clearance has already generated a lot of commentaries regarding the single RCT results. In this episode, we will review the results critically and explain why

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00:31:37

Place IUD/S if BV Present? What Would You Do?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/30

Bacterial vaginosis (BV) is the most common vaginal aberrant condition in women, in the general population. Even still, the majority of women with BV are asymptomatic. If BV is found at time of elective IUD/S placement, can the device still be inserted? Or is it an independent risk factor for upper tract infection? What category in the CDC MEC is vaginitis/vaginosis for IUD placement? There definitely is some confusion about this in clinical practice, highlighted by the 3 different clinicians which

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00:32:29

More Bad News Re: PreEclampsia

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/27

Hypertensive Disorders of Pregnancy (HDP) affect 5 to 15% of women worldwide, and their increasing incidence is likely related to the growing levels of obesity, metabolic syndrome and advancing maternal age. It is widely accepted that women who have preeclampsia are at increased risk of future hypertension, cardiovascular disease, stroke, chronic kidney disease, and even diabetes in later life. But what is the association between HDP and dementia? In this episode, we will review the latest data from

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00:52:47

OB Issues After IUD Perf?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/25

Uterine wall perforation at time of IUD placement has been published to occur, in general, about 1-2/1,000 cases. It happens! While there are some risk factors for uterine perforation (very antiflexed, retroflexed, recent postpartum state, lactating), sometimes uterine perforation can happen even with the best of technique and no risk factors. While most providers are concerned about immediate short-term gynecological complications like infection and bleeding, we don’t really consider the

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00:20:39

Extencilline, Linezolid, & STUFF

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/22

Yep, Medicine moves fast! On Friday, January 5, 2024, I participated in a medical news report published in “The Guardian”. In that news commentary I stated that “Bicillin-LA is the only medication approved for syphilis during pregnancy”. We’ve all heard that statement, and it is a true statement. However, 5 days later on January 10, 2024, the FDA announced the importation allowance of “Extencillin” to combat the Bicillin-LA shortage. Yep, Medicine moves fast. Now we have this medication available as

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00:48:57

Preg Test in ESRD: Going Down the Rabbit Hole?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/21

If you had 5 reproductive age women, all late on their menstrual cycle, who were having unprotected sex, and all have a positive pregnancy test… What would be your diagnosis? The most likely diagnosis would be that there are five pregnancies! Right?! But what if 1 of those patients had end stage renal disease (ESRD), on hemodialysis. Is there anything else to consider? While ruling out pregnancy is priority #1, it is possible that this HCG is a phantom result. This is a slippery slope discussion and

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00:46:30

You Asked, We Answered!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/18

Periodically, we respond to podcast family members’ questions as data is available. In this episode, we will cover 3 very clinically relevant questions from our podcast listeners. The first question is regarding our immediate past podcast topic, which was propranolol as a labor stimulant. The question is, “Does the ACOG have a statement on adjuvent propranolol use during labor?“. We’ll answer that question in this episode. The second question is whether the placebo/pill-free interval of combination

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00:40:18

Can Propranolol Rescue Labor?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/17

It has been well reported that rates of elective induction have risen nationally and internationally since the adoption of the ARRIVE trial. But as medicine is at times controversial, some studies have suggested an increase in cesarean section rates with elective induction of labor at 39 weeks. While we will briefly discuss those studies, they are not the focus of this episode. However, as induction of labor becomes more common place, there has been renewed interest in use of adjuvant medications to

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00:27:18

More Data on LUST (Follow up to 12/31/23 Episode)

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/15

On New Year’s Eve 2023 we released “LUST for TOLAC”. LUST stands for lower uterine segment thickness. This is a very enticing, and controversial, approach to TOLAC counseling and direction. I encourage you to go back and listen to that episode, if you have not yet, before listening to this one as this is more data to support those conclusions. In this episode, we will highlight a multi-center, cluster-randomized trial out of Canada, the PRISMA study. This fantastic investigation sheds more light on

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00:41:55

Beyond the 22 Week Birth

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/13

The gestational age boundary termed viability has shifted dramatically during the past 50 years, and more so in the last 15 years. In 1971, a widely used neonatology textbook stated that, “The lower limit of viability is probably around 28 weeks, at which time most infants weigh two pounds, four ounces (1000 g).” Today, the most immature infants routinely cared for by neonatologists in some parts of the world are born at 22 weeks of gestation, with many weighing around 500 grams. While most studies

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00:06:09

NIPTS Clarify: “46 XX or 46 XY”?

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/12

This is NOT our regularly scheduled episode. Based on an incredible comment from Rachel – one of our podcast family members, which I received just moments ago, this was too good to not put out. A brief clarification on NIPTS and “46XX or 46XY”. (This is a supplement to our immediate past episode.) 😊😊🧐🧐

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00:50:39

NIPT’s Sex Chromosome Abnormalities: Clinical Pearls.

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/11

NIPT is a prenatal SCREENING method that involves analysis of cell-free fetal DNA (cfDNA) in maternal blood. Prenatal screening for sex chromosome aneuploidies (SCAs) has become readily available through expanded non-invasive prenatal testing (NIPT). NIPTs became commercially available in 2011 and has since been introduced in more than 60 countries around the world and is now part of mainstream obstetrical practice. Initiallyoffered as a secondary screen for pregnancies with a high probability of a

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00:48:26

No Data, No Problem!

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/07

We take pride as healthcare providers in being “evidence based“. But sometimes things that we do, even in 2024, sound, reasonable and sound practical, but actually are NOT evidence-based. But lacking evidence means 2 things: 1. Studies have proven something does not work, or 2. Studies have not been done to confirm or refute the intervention. In this episode, we will discuss 2 common interventions that are recommended in pregnancy that actually don’t have the evidence behind them. First is the “test

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00:36:04

UPDATES Re: RHD Alloimmunization

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/05

Before the 1960s, there was no method available to prevent Rh sensitization during Rh-incompatible pregnancies. Then, in 1968, the FDA approved the use of RhoGAM to help prevent Rh immunization. This was a landmark move in the field of Obstetrics. More recently, ever evolving data and medical genomic technology has brought new insights to RHD alloimmunization care. Can maternal RH typing be avoided with early pregnancy loss (under 12 weeks)? Why about in cases of pregnancy termination? Is that safe

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00:50:29

Teratoma's "Crazy" Side: The "Brain on Fire"

Dr. Chapa’s OBGYN Clinical Pearls ·

2024/01/03

Historically a range of psychiatric and medical conditions have been erroneously attributed to 2 gynecological organs/function. During the time of Hippocrates, the “wandering womb” theory blamed emotional disturbances in women on this condition. Not only was that erroneous, it was nonsensical. However, certain gynecological conditions can indeed manifest with neuro-behavioral disturbances. One of these syndromes can be triggered by the presence of an ovarian dermoid. Anti-N-methyl-D-aspartate

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1,072 results

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