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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

00:25:42

New SMFM Stillbirth Checklist Update (July 2025)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/07/05

Stillbirth is one of the most devastating adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. In March 2020, the ACOG released OCC #10, "Management of Stillbirth". Now, formally released July 2025, the SMFM has an updated checklist for stillbirth care, published in the journal Pregnancy. In this episode, we will highlight some nuances in this list. Listen in for details. SMFM Special Statement (July 2025): Society for Maternal-Fetal Medicine Special Statement:

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00:35:07

FOCUS For PPH: A DIY Approach

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/07/02

PPH is terrible. PPH must be assessed quickly via the “4Ts” and acted upon in a timely manner. And listen to this: new data from the Journal of Maternal-Fetal & Neonatal Medicine (June 24, 2025 ahead of print) finds an association with PPH and adverse outcomes years later: the odds of cardiovascular disease (CVD) and thromboembolism disease are increased in patients with postpartum hemorrhage (PPH), to a magnitude of 1.76 fold. That’s why these authors recommended "proactive postpartum care"

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00:32:37

Can Metformin Prevent HG?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/29

Severe nausea and vomiting in pregnancy/hyperemesis gravidarum (HG) takes a toll on patient, and the healthcare system. According to a June 2024 ACOG Clinical Expert Series on the subject, GFD15 and IGFBP7 both play important roles in placentation, appetite, and cachexia that are linked to hyperemesis gravidarum. Specifically, LOW pre-pregnancy GFD15 is associated with increased frequency of HG as GFD15 levels spike post pregnancy in an otherwise "naive" system. Since metformin increases GFD15, can

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00:50:04

SVD or CS After OASIS?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/27

OASIS (3rd and 4th degree perineal lacerations) occur at a rate of 4-11% (average around 5.5%). OASIS lacerations have both short term and ling term potential morbidities. Practice Bulletin 198, from 2018, briefly discusses counseling patients following OASIS on subsequent mode of delivery options. Now, in a soon to be released AJOG publication, authors have provided a wonderful and comprehensive review on "patient-centered" guidance regarding mode of delivery in a subsequent pregnancy following

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00:26:41

You Asked, We Answered (Again)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/24

Ladies and gentlemen, welcome back to another addition of “You asked, We answered”! In this brief episode, we will tackle 2 very appropriate clinical questions:1. Why do cervical psychology reports still state the presence or absence of endocervical cells/TZ component if it does not change management, and 2. Does continued magnesium sulfate infusion during C-section increased blood loss? We have done similar “you asked, we answered” episodes in the past and we will continue to do them as questions

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00:33:42

New Guidance on OB CX Ripening (July 2025)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/21

The Bishop Score was originally developed in 1964 by Dr. Edward Bishop and remains the central assessment tool for determining the appropriateness of cervical ripening for labor induction. We have covered pharmacologic and mechanical methods of cervical ripening for labor induction many times in prior episodes. Ut now, in July 2025, there will be a new clinical practice guideline (#9) from the ACOG which has some notable items. Does the ACOG recognize COMBINATION mechanical and pharmacologic agents

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00:37:27

KO the KB for OB-VB

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/18

Second and/or Third trimester vaginal bleeding is a common reason for L&D Triage patient assessment. The evaluation starts with determining the status of maternal hemodynamic stability. This together with IV access are key first steps. This is followed by an assessment of fetal-placental status. Typically this includes bedside ultrasound for fetal position, visual confirmation of FHTs, amniotic fluid determination, and placental location. At the same time, lab data is obtained to guide care:

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00:36:39

Antenatal Steroids, and Baby Brains, Oh-MY!

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/15

Antenatal Corticosteroids (ACS) for Fetal Lung Maturation (and more) is an ever evolving saga. This is how science and medicine evolve, by always seeking more information. The effect of antenatal corticosteroids on neonatal/child neurodevelopmental outcomes is controversial and may be influenced by the gestational age at which exposure occurred. In this episode we will highlight TWO recent publications, one from May 2025 (JAMA Netw) and the other from June 2025 (Obstet Gynecol). The first adds data

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00:22:38

Zoliflodacin, Coming to Your Pharmacy Soon

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/12

Innovation in medicine is happening. In our immediate past episode, we summarized how AI is improving standard mammography to now PREDICT breast cancer rather than just diagnosing it once it was appeared. In a past episode, we covered a new and novel “first in class” oral medication for uncomplicated UTIs in women called Blujepa. This is innovation! Well now, as of June 10, 2025, the FDA has granted a New Drud Application for a new and noval oral antibiotic against gonococcal (GC) infection! In this

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00:20:50

NEW Breast Imaging AI is HERE

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/10

Each year, more than 2.3 million women worldwide are diagnosed with breast cancer—including over 370,000 in the United States alone. For more than 60 years, mammograms have saved lives by detecting early-stage cancers. Now, advancements in AI have lead to a first of its kind breast imaging algorithm that can PREDICT future (5-year) breast cancer risk in the patient (CLARITY BREAST). This is GROUNDBREAKING. Yes, there has been other new tools, like the recent contrast enhanced mammography data, for

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00:35:06

SFP vs ACOG on EPL

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/08

It’s interesting how, at times, different medical societies can look at the same data and arrive at different recommendations. It happens! In April 2025, the Society of Family Planning (SFP) released its new clinical recommendations for the medical management of early pregnancy loss (EPL), AKA miscarriage. This clinical guidance has 4 remarkably interesting differences when compared to the ACOG practice bulletin # 200 on early pregnancy loss. In this episode, we will review these 4 key differences

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00:44:20

WCH in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/05

The white-coat effect is a measure of blood pressure change from before to during the visit in office/clinic when the blood pressure is recorded by a physician or nurse; this was first described in 1983 by Mancia et al, and was initially thought to represent a benign process. But it was unclear what this actually meant for pregnancy. Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for about 20 years now. Use of this monitoring option has revealed a subgroup of patients who

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00:36:19

The Incarcerated Gravid Uterus

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/06/02

Uterine incarceration in pregnancy, is a rare but troublesome complication. This occurs when a retroverted uterus becomes trapped in the pelvic cavity during pregnancy. This happens when the uterus fails to move forward as it grows, becoming stuck between the sacral promontory and pubicsymphysis. It's more common in women with prior pelvic issues or uterine anomalies. Urinary retention is the most common symptom that occurs because of elongation of the urethra by displacement of the cervix, loss of

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00:17:45

Is At-Home Cervical HPV Screening VALID?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/29

In May 2024, the FDA approved vaginal self-collection for HPV as a cervical cancer screening tool. This was limited to health care settings. While this self collection option can help address some of the emotional deterrents to a speculum examination, it fails to overcome the remaining substantial clinic access barriers cited among those who are underscreened, including time off work, arrangement of child or elder care, and transportation. Then, the FDA approved the first at-home cervical cancer

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00:35:33

LEA And Bladder Catheter: Yea or Nay?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/27

In the US, an estimated 70-75% of women who give birth use an epidural for pain relief during labor. Epidural anesthesia during labor can affect bladder function by delaying the return of bladder sensation and potentially leading to urinary retention. This can be due to the nerves that control bladder function being affected by the epidural, reducing the sensation of bladder fullness and the urge to urinate. Intrapartum, there is no universal guidance regarding bladder management with labor epidural

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00:27:59

Prophylactic CS ABX: What is Too Much? (New Data, May...

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/25

At the end of April 2025, we released an episode summarizing the ERAS update for 2025. In that episode/update, we summarized the data on extended spectrum prophylactic antibiotics at cesarean section in patients living with obesity. The ERAS protocol recognized the value of oral cephalexin and metronidazole for 48 hours in patients with obesity who receive single agent Cephalosporin prophylaxis preop. Now, a new (RCT) publication soon to be released in the Green Journal, evaluates whether using dual

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00:43:38

Vaginal E2 FACE Cream, & ‘Roids: A Two-Fer!

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/22

We have covered menopause on this show on various occasions. That’s fitting and non-surprising as we are a women’s health education podcast! While vaginal dryness and hot flashes get most of the attention in menopause, and they should, less attention often is given to skin changes. Nonetheless, these dermal manifestations of perimenopause and menopause can be just as disturbing to those affected. Estrogen helps skin produce oil and hold onto water, so extremely dry skin during menopause is common

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00:30:26

“GSL” New Data (Obstet Gynecology)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/21

In 2014, the International Society for the Study of Women's Sexual Health together with the North American Menopause Society introduced the term “Genitourinary syndrome of menopause” to replace the prior term vulvovaginal atrophy. Ten years after that, in 2024, a related term “Genitourinary Syndrome of LACTATION, was introduced to better capture the genitourinary issues lactating women may experience. A new systematic review, soon to be released in the journal obstetrics and gynecology, provides

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00:31:36

New DATA on Endo RX for Pain (May 2025)

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/19

Endometriosis is a prevalent gynecologic condition that affects approximately 10–15% of women of reproductive age worldwide. For endometriosis related pelvic pain, continuous combination birth control pills have long been the first-line pharmacologic intervention of choice. But new data published May 15, 2025 (ahead of print) in Obstetrics and Gynecology is challenging that tradition. In this episode , we will summarize the key findings of this brand new network systematic review and metanalysis

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00:36:22

IUD/S Placement NEW Guidance: Was It Racism Before?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/05/17

In August 2024, the CDC updated its MEC. This included a recommendation for local anesthesia for IUD/S placement and also had guidance regarding misoprostol for that procedure. Coming up in July 2025, the ACOG will officially release a new clinical consensus on “Pain Management for In-Office Uterine and Cervical Procedures”. Are these recommendations similar to the CDC’s? What about misoprostol? Was the non-use of local anesthesia for these office-based procedures rooted in racism and sexism? Listen

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