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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

00:23:05

NEW HPV Vaccine ADVISORY: Use After CIN2+ Therapy...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/28

We have learned so much about the natural progression of HPV induced cervical abnormalities. In 2019/2020, the ASCCP published its updated guidance using a “risk-based” algorithm for management of cervical intraepithelial neoplasia. Traditionally, HPV vaccination was considered ineffective once cervical dysplasia already was present. But recent data has proven this concept incorrect! In this episode, we’re going to summarize a brand new ACOG practice advisory released today, on July 28, 2023,

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00:34:05

Amniotic Fluid Injections? 😳💉💉💉

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/26

There are, indeed, FDA indicated applications for purified, amniotic membrane (wound healing). Is there also a role for the use of purified amniotic fluid as a “regenerative medicine” treatment option? Can amniotic fluid injections help repair osteoarthritis and aching joints? Can it be used as EYE DROPS for dry eyes? The subject is trendy on certain social media channels and on certain websites. But this concept of injecting amniotic fluid into various body locations has landed one Texas healthcare

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00:40:13

HS in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/25

Skin conditions can't affect pregnancy outcomes, right? After all, the skin is just the skin. WRONG! As a chronic inflammatory disease, hidradenitis suppurativa (HS) exemplifies the link between integumentary and comorbid systemic disease through shared inflammatory pathways. Patients have double the comorbidity burden compared with the general population, and hidradenitis suppurativa has independent associations with several individual comorbid diseases. During pregnancy, HS also is associated with

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00:40:22

AHA BP Cutoffs Helpful in Pregnancy? (Aug 2023 Data)

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/23

In Feb 2023, the USPSTF recommended that clinicians “screen for hypertensive disorders of pregnancy”. Specifically, they stated that “measuring blood pressure at each prenatal visit is the best approach”. Mind blowing I know. 😳😊 But sarcasm aside, a new publication- set to be released next month in AJOG (Slade LJ et al; Aug 2023)- validates this recommendation…not that it needed validation, for frequent BP monitoring during pregnancy. This has to do with the “sensitivity” of BP results in

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00:36:31

BV RX to Prevent PTB?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/22

On April 5,2023 the U.S. FDA withdrew its approval of Makena and generic forms of 17-a hydroxyprogesterone caproate for the prevention of recurrent preterm birth. Having the only medication which had been FDA approved for the prevention of preterm birth taken away, has left clinicians investigating other possible strategies that can cause a dent in preterm birth rate. As Bacterial vaginosis (BV) is the most common vaginal abnormality in reproductive age women, naturally the spotlight would fall on

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00:01:38

Up, Up, and AWAY!😊👋😊👋😊

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/14

FYI. We just released our episode for today, July 14, 2023, and will be out until July 23!

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00:34:23

Does Walking Induce Labor? 🚶‍♀️🚶‍♀️🤰

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/14

Its hard to be pregnancy in the late third trimester, especially in a HOT state like TEXAS in the summer. Pregnant individuals will try just about anything "to just get this baby to come out already!" Historically, walking, spicy foods, and SEX have been "employed" to get the labor process going. Does it work? In this episode we will look at the data examining whether labor can induce spontaneous labor. Is this a myth or a real thing? What about CURB WALKING?! That works, right? Lots to cover and

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00:33:04

False Positive “Confirmation” Syphilis Test?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/13

There’s no such thing as a “false positive syphilis confirmation test”, is there? After all… It’s right there in the name, CONFIRMATION test! Well, not all positive confirmation tests are true positives, especially when that test is the FTA-ABS. Yes, it’s true, the specificity for this is very good between 95 to 98%. But there are cases of BFPs (Biologic False Positives), which have been reported and published in the literature. This is why putting the test results in clinical context is very

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00:33:46

The Bandl Band

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/11

The Bandl Constriction Ring. It is real. It exists. Its true incidence is unclear as it lacks uniform reporting when found at time of cesarean. As labor guideline are more permissive of slowed labor progress, some fear that the incidence of Bandl's Band may rise. What is this ring? What is the pathophysiology of this abnormal uterine response? Can ultrasound detect this labor abnormality? In this episode we will cover the fascinating and controversial history of the Bandl Band and review some key

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00:05:33

How the Sausage is Made! 🤣😊😳

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/10

Just a little description of what happens “behind the scenes“! Enjoy. 😊😊❤️❤️😩😩

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00:30:05

Early GDM RX New Data: 👎😕🙁😔

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/09

Gestational diabetes (GDM) is a risk factor for adverse perinatal outcomes. Currently, the ACOG recommends early screening for GDM for women “at risk”. However, other experts disagree with this approach. On October 6, 2022 we released a podcast episode called “Early GDM Screening: Evidence-based?”. In that episode we covered the controversy regarding early GDM screening, in other words- screening under 24 weeks. We have been following this story and debate for over 2 years now; we first released the

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00:25:36

Brand NEW Consensus Statement on OSA in Pregnancy...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/06

Well, Well, Well, this is very interesting. Back in May 10, 2023, we released an episode on "OSA (Obstructive Sleep Apnea) in Pregnancy: Time to Screen?". In that episode, we summarized the impressive data on OSA in pregnancy and its association with some adverse perinatal sequelae. Spring forward to July 6, 2023, the ACOG has now released a brand new Consensus Statement on OSA in pregnancy. This statement is a joint guideline from the Society of Anesthesia and Sleep Medicine and the Society for

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00:31:43

HT Causes Dementia?! New June 2023 Data.

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/06

The headline from CNN Health form June 28, 2023 reads, "HRT use by younger women linked to dementia, study says". That is FRIGHTENING to any patient using hormone therapy for menopausal symptoms. Does HT cause dementia? Or is HT a "easy suspect"? The question of HT and cognitive function has been a subject of controversy for many years. In this episode we will summarize the NAMS position statement on HT for cognitive issues (2022) as well as summarize this new June 2023 publication from BMJ causing

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00:36:19

The “Antiquated” Apgar Score

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/03

First published in 1952, the Apgar Score has remained unchanged over 70 years and is entrenched in current OB/Pediatric/Neonatal care. The ACOG highlighted the Apgar Score in 2015 in CO 644. In that release, the ACOG reminds us that although it provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed, it has important limitations: A. The healthy preterm infant with no evidence of asphyxia may receive

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00:32:48

CBD in Pregnancy, OK? New Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/01

Listen to this! According to recent US statistics from both consumer reports and statista.org: 26% of Americans used CBD in 2022, 24% of people owning pets use CBD for their animals and themselves, 33% of Americans have used CBD products at least once, 64% of Americans have used CBD for pain, 49% of Americans use it for anxiety and stress, and 42% of Americans have used it for sleep and insomnia. CBD is super common, and it is super unregulated. CBD, or cannabidiol, is one of the numerous

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00:25:39

Placental Lakes on Sono: Implications?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/06/29

This episode subject was requested by Emily, one of our podcast family members. She has noticed the reporting of “large placental, venous lakes” on antepartum ultrasound. Placental lakes are enlarged spaces in the placenta filled with maternal blood. These spaces are also called intervillous spaces because they are found between the placental villi the finger-like projections of the placenta that contain fetal blood vessels . The placental villi float in the intervillous spaces and absorb oxygen and

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00:33:27

Genetic Screen or E-phoresis For Hemoglobinopathy? Is...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/06/28

We recently had a patient in our OB high-risk community clinic whose maternal carrier screen result was either late or lost. Thinking the test may be lost, another resident ordered hemoglobin electrophoresis. The electrophoresis was NEGATIVE (that is, no abnormal hemoglobin was found at detectable levels)…by the way, good for that resident! After calling the lab for the genetic screen and not getting a clear answer from that location, they had the self- initiative in ordering a back-up test. AND

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00:42:11

Can GBS Cause Vaginitis? New Data on Aerobic Vaginitis.

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/06/27

Desquamative inﬂammatory vaginitis (DIV) made its debut in the medical literature in 1965, by the hands of Gray and Barnes. In that paper, they presented their ﬁndings on 478 women complaining of vaginal discharge. Then, in 2002, Donders et al. described a new entity, referred to as aerobic vaginitis (AV). This term emphasized the clear contrast with the far more common and acknowledged form of dysbiosis: bacterial vaginosis (BV). These 2 clinical conditions are now thought to exist on a clinical

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00:28:45

Circumvallate Placenta: Maleficent or Meh?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/06/23

The word placenta, first used in a 1638 anatomy textbook, was borrowed from the New Latin phrase placenta uterina, meaning "uterine cake", because the circular, flat shape of the organ was thought to resemble a traditional Roman flat cake. Circumvallate is another Latin derived term meaning the "encircled placenta, by a rampart". Circumvallate placentas are a form of extrachorial placenta where the basal plate extends past the margins of the chorion plate resulting in the chorion and amnion folding

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00:31:29

Syphilis' Vertical Transmission (Congenital Syphilis)

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/06/21

Over the past decade, there’s been about a 700% increase in the cases of congenital syphilis in the United States. That’s 700%! Rates of congenital syphilis, meaning the number of cases for every 100,000 live births, are highest in the South and Southwest, in states such as Arizona, New Mexico, Louisiana, Mississippi and Texas. Individual states have seen increases that are even more astounding. From 2016 to 2021, cases shot up 3,300% in Mississippi, nearly 3,000% in Oklahoma, more than 2,200% in

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1,129 results

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