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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

00:14:03

The Non-Palpable Implant

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/05/17

The etonogestrel implant is the most effective LARC available. Well, how many years AFTER the FDA approval of 3 years does the implant remain effective? Also, currently, the usual and customary standard is for the provider and patient to palpate the implant area after insertion. But what happens when the insert is non-palpable? In the session, we will review the evidence-based protocol to find this nonpalpable implant. Can you order a serum etonogestrel level? Do these things “migrate”? Can a

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00:13:18

Is Too Much FM Bad?

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/05/12

Historically, obstetrical providers cautioned patients about decreased fetal movement. But what about maternal perception of INCREASED fetal movement? Is increased fetal movement a harbinger of adverse neonatal outcome? In this session we will highlight and summarize a new publication from the AJOG (April 26, 2022) that helps shed light on this clinical conundrum.

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00:13:43

The Metronidazole Myth!

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/05/08

Since the 1960s, metronidazole has carried a label warning stating that alcohol use while taking the medication can lead to significant side-effects. This was termed a “Disulfurim-like reaction”. However, that’s 100% not true! Where did this metronadazole myth come from? Why has it survived for over 50 years? In this podcast… We’ll set the record straight! Yes, you can have your cake and eat it too… I mean, your beer and drink it too! 🍻🍺🍻🍺🍷🍷🍷

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00:10:38

BUMP1 and BUMP2! (May 2022)

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/05/05

On May 3, 2022, JAMA published 2 separate randomized clinical trials (RCTs) regarding patient’s self-monitoring of blood pressures at home. Historically, clinicians instructed patients either at risk of developing hypertension in pregnancy or those with existing chronic hypertension/hypertensive disorders in pregnancy to self-monitor their blood pressure in-between clinician visits. Is that recommendation clinically useful? Does the data support that? Once again, the world of “hypertension in

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00:19:15

Headaches in Pregnancy: New ACOG Guidance (May 2022)

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/29

In May 2022, the ACOG Will release a new Clinical Practice Guidance (#3). This will cover “Headaches in Pregnancy and Postpartum”. Do you know which classes of medication are considered first line for primary headache prevention during pregnancy? And for acute treatment of migraine, which medications are recommended? Are Ergot alkaloids safe for use? What about Triptans? In this session, we will summarize and highlight Clinical Pearls for the prevention and treatment of primary headache in pregnancy

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00:17:40

Epidural’s Secret Benefit!

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/26

Addressing severe maternal morbidity is a public health priority in the US. Postpartum hemorrhage is one of the driving contributors to severe maternal morbidity/mortality peri-partum. A recent study published in JAMA open network in February 2022 is showing an unusual benefit of labor epidural analgesia which may help close the gap in severe maternal morbidity-related healthcare disparities. In this episode, we will highlight the key findings of this publication and review “epidural’s secret

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00:13:31

NIPTS Takes a HIT (May 2022 New Publication from...

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/22

It could not have been timed any better: Coming off the heels of the recent FDA warning on the use of noninvasive prenatal test (NIPTS), a new study soon to be released in May 2022 is calling its use into further question. Is this a return of the Maternal Serum QUAD screen? Listen in and find out.

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00:17:01

ACOG’s 4/20/22 Response to FDA Warning!

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/21

On April 19, 2022 the FDA released a warning regarding the inappropriate use of cell free DNA genetic screening tests. Within 24 hours, the ACOG (April 20, 2022) issued a statement response. In this podcast we will highlight these two key documents. We will also review what cell free DNA is and is not. What is the role of Ultrasound in genetic screening? Can cell free DNA be repeated after a “no call” result? Lots of important information… Covered here!

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00:09:34

IUS Use and Acne: It’s Real!

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/19

Without doubt, the most common reason for requested progestin-intrauterine system (IUS) removal is abnormal bleeding patterns. But do you know what the second most common reason is? It’s acne! In this episode, we will summarize a soon to be released article accepted for print in Obstetrics and Gynecology (the Green Journal). This episode will provide practical clinical pearls to truly obtain informed consent from our patients seeking long acting reversible contraceptives (LARCS).

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00:06:46

Matthew’s Question: ROM Plus and EGA

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/16

On Friday, April 15, 2022, I received a Facebook question regarding a recent episode on ROM test. We stated that ROM Plus, as a test, has accuracy between 23 to 37 weeks. Where does that come from? In this brief episode, will explain the facts.

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00:04:28

🚨ACOG Practice Advisory🚨: CHAP Trial Response (April...

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/11

Today, April 11, 2022, the ACOG updated its practice advisory regarding chronic hypertension in pregnancy. This follows the statement from the Society of Maternal Fetal Medicine recognizing the change in practice based on the CHAP trial. In this session we will summary ACOG’s response.

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00:14:57

Ovaries OUT! (New Data On Age of BSO at Benign Hyst)

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/10

Since 2005, experts have advocated for ovarian conservation, until the age of 65, at time of hysterectomy for benign indication. However, a soon to be released publication is calling for a retraction of that opinion! Based on brand new data, do you know the age NOW at which ovarian removal is recommended? In this session, we will review this brand new information that will greatly impact how we perform hysterectomy for benign indications.

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00:07:12

🚨ACOG ALERT🚨 (April 6, 2022): CHAP Trial

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/07

A study published on April 2, 2022 in The New England Journal of Medicine, "Treatment for Mild Chronic Hypertension during Pregnancy” (CHAP Trial) has resulted in ACOG calling to order its Practice Advisory Committee to prepare a “practice update” regarding the management of mild to moderate hypertension in pregnancy. This recent publication is practice changing! While we await the revised guidelines and official statement from the ACOG, this podcast will review the current state of affairs

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00:14:09

ROM Tests: Not All Are The Same.

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/04/02

This is Part 2 where we will wrap up our review of commercially available screening tests for ROM. Do you know what each test specifically checks for? Which test seems to outperform the others? And what about ferning and pH testing? Are those still done? Let’s wrap up our 2-part series with these answers and more.

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00:17:18

Understanding ROM Tests: Pitfall Prevention Pearls...

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/03/30

PROM is a common diagnosis in Labor and Delivery. However, making a false positive diagnosis OR a false negative one may place the pregnancy at risk of either unnecessary interventions or adverse perinatal outcomes- or both. In this session, we will review best practices for exam based diagnosis. Are you aware of the FDA “Dear Doctor” letter regarding ROM biomarker testing (2018)? This session is Part 1. In Part 2, we will dive deep into the 3 main biomarker tests for ROM- how they differ, how they

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00:18:24

Send The Placenta? Hmm…likely NO.

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/03/26

Some things in medical practice stem more out of tradition than true clinical evidence. Such is the case for histological examination of the placenta. When is pathological examination of the placenta actually helpful? Should we send of the placenta in cases of multifetal birth? What about meconium or chorioamnionitis? In the session, we will review a soon to be released clinical brief from Obstetrics and Gynecology (ACOG) coming out April 2022. This new evidence review questions our current clinical

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00:15:15

Prevention of HBV Vertical Transmission: New Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/03/22

There is a recommendation for universal screening of Hepatitis B surface antigen in pregnancy. Which antiviral medication is recommended for prevention of Hep B vertical transmission in pregnancy? Is there a antiviral medication approved for Hepatitis C in pregnancy? In this session, we will review new data which is soon-to-be released in the American Journal of OB/GYN (Gray Journal) reviewing antepartum (maternal) antiviral medication used to prevent mother to child transmission of Hepatitis B. We

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00:16:03

Duration of PP MagSulfate: New Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/03/14

Why is Magnesium Sulfate the first-line medication for preeclampsia/eclampsia? How did that arise into the current, international, standard-of-care regiment for that condition? Is 24 hours of Postpartum Mag evidence-based? In this episode we will review the evolution of magnesium sulfate for eclampsia prevention/treatment. We will also summarize a soon to be released systematic review and meta-analysis publication from Obstetrics & Gynecology examining the duration of postpartum MagSulfate use

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00:18:42

OB Care After ART (SMFM Series #60; 2022)

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/03/07

Pregnancies that arise after assisted reproductive technologies (ART) are at higher risk of maternal, fetal, and even placental complications. In this session we will summarize and highlight key prenatal management pearls for pregnancies that arise after ART. This is a summary of the SMFM consult series # 60, from March 2022.

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00:16:03

Statins and Preeclampsia Prevention: Yes or No.

Dr. Chapa’s OBGYN Clinical Pearls ·

2022/03/03

Preeclampsia occurs in 3 to 5% of the general OB population. It has even higher prevalence among those with high-risk conditions. Currently, aspirin stands alone as the most evidence-based pharmacological option for preeclampsia prevention (risk reduction). But over the last decade new interest has arisen for the use of statins for preeclampsia prevention. Well, do statins work? What is the state of statin therapy as of 2022? In this session we will review the latest data and review the key

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