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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

00:12:08

Malignant GTD

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/31

Malignant GTD includes choriocarcinoma, invasive mole, and placental site trophoblastic tumor. When is single agent chemotherapy indicated? What about multiagent care? What is the classification system for malignant GTD? In this episode we will review the diagnosis, work up, and management of this condition.

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00:14:12

Molar Pregnancies

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/30

Gestational Trophoblastic Neoplasia is a complex condition with various histological and clinical distinct entities. In this episode, we will review the benign variants of GTN, hydatidiform moles (complete and partial). We will review their clinical presentations, diagnosis, management, and follow up. Data for this podcast comes from the ACOG practice bulletin 53 as well as the SGO.

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00:11:18

Throat/Rectal STI

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/27

Currently, the CDC does not recommend “routine screening” for extragenital gonorrhea or chlamydia in women, although it does make that recommendation for MSM or bisexual males. However, as most extragenital infections are asymptomatic, this is potentially missing a large reservoir of infection. In this episode, we will review the USPSTF and CDC screening guidelines and compared that to evolving prevalence data of extragenital STIs.

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00:10:39

Naltrexone for Pregnancy OUD.

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/24

Opioid use disorder (OUD) Is a national crisis. Pregnancy is not immune to OUD. Traditionally, methadone and buprenorphine have been used as medical treatments for this condition in pregnancy, with concerns about naltrexone (an opioid antagonist) use. In January 2020, a new prospective cohort study (AJOH) adds reassuring data on the safety and effectiveness of this medication option.

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00:18:28

Vaginal Vit C for BV? Yep, it’s DATA.

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/18

Up to 30% of initial BV diagnoses will have a recurrence. Does partner therapy (male or female) help reduce recurrence? Most of the original data which stated “No”, is now outdated. Additionally, what is the data on vaginal Vit C for recurrence prevention? Does that actually work? Let’s examine both of these questions...now.

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00:16:00

Vaginismus

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/16

Vaginismus is the involuntary tightening of pelvic floor muscles that surround the vagina; this can make penetration very painful, if not impossible. The DSM5 reclassified female sexual dysfunction into 4 main categories, with vaginismus fitting in the “penetration disorder“ group. What role does medical therapy play with this condition? Does physical therapy have a role? In this session, we will review the July 2019 practice bulletin from the ACOG (213) focusing specifically on vaginismus.

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00:08:15

Beyond the AFFIRM Trial: Fetal Movement Counting...

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/13

In 2018, the Lancet released the AFFIRM trial. They reported a NONsignificant decrease in the stillbirth rate from 4.40/1,000 births in the control group to 4.06/1,000 births in the fetal movement counting intervention group. In February 2020, a new systematic review and meta-analysis reveals additional information on the clinical utility of maternal perception of fetal movement. Let’s review that data now.

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00:12:01

HCV in Pregnancy: IDSA Update

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/12

Currently, the ACOG and SMFM recommend a “risk-based” approach to HCV screening in pregnancy. HOWEVER, a soon to be published original article (February 2020) in Obstet Gynecol confirms that “The reported prevalence of maternal HCV infection has increased 161% from 2009 to 2017”. The IDSA has called for UNIVERSAL screening of HCV. In the session, we will review the Nov 2019 IDSA HCV screening recommendations and provide key points from the Rossi et al Feb 2020 Green Journal publication.

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00:06:03

HT VTE Risk by Route of Administration.

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/09

Most studies on the risks of post menopausal hormone therapy have focused on the oral route of administration. Does the transdermal route of estrogen delivery reduce the risk of VTE? In this episode, we will review the ACOG committee opinion (556) and ASRM guidelines on the use of transdermal estrogen vs oral estrogen therapy.

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00:12:51

Vaginal E2 after Breast CA? Yes or No? ACOG CO 659.

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/07

Is vaginal E2 therapy safe in women with a history of breast cancer? What is the data regarding systemic absorption levels? Are you familiar with the recently FDA approved medication IMVEXXY? In the session, we will review the data behind the use of vaginal estrogen and vaginal, non-estrogen therapy for persistent genital atrophy symptoms in women with a current or past history of breast cancer.

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00:15:18

Management of Menopausal SXs: ACOG PB 141

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/05

In North America, the median age of menopause is 51 years. Among women reporting menopausal symptoms, vasomotor and vaginal symptoms are the most closely associated with these hormonal changes. Can progesterone use alone relieve vasomotor symptoms? What about the use of testosterone? What is Intrarosa vaginal therapy? Does ospemifene increase endometrial a risk? In this session, we will answer these questions and review the medical management of menopause according to the ACOG practice bulletin

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00:12:51

Endometriosis & Fertility

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/03

Up to 30% to 50% of infertile women have endometriosis, based on laparoscopic diagnosis. Endometriosis affects fertility through a variety of mechanisms. In this session, we will review the ASRM position statement on endometriosis related infertility: work-up and patient management.

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00:18:06

The Infertility Evaluation: ASRM Guidelines

Dr. Chapa’s OBGYN Clinical Pearls ·

2020/01/01

Infertility can affect up to 15% of all couples. Male factor infertility can account for up to 40 to 50% of cases, while in 30% of couples there may no identifiable etiology (unexplained infertility). This session, we will review the ASR M guidelines for the infertility evaluation. Is postcoital testing still recommended? What role does laparoscopy play in the infertility evaluation? We will answer these questions and more in this session.(ACOG CO 781).

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00:13:43

The BRCA Mutation Carrier

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/30

BRCA1 & BRCA2 are tumor suppressor genes; mutations in either are transmitted in an autosomal dominant pattern. Loss of both copies of either BRCA1 or BRCA2 is just the 1st step in the process of potential carcinogenesis. In this session, we will review the pathophysiology of BRCA mutations and review the NCCN guidelines for breast and ovarian cancer screening. We will also review the surgical & chemoprophylactic management of the BRCA positive patient.

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00:13:14

Bartholin’s Abscess: Management Review.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/28

Once considered pathognomonic for gonorrhea or chlamydia, Bartholin’s gland abscesses are now recognized to be polymicrobial. Is I&D alone 1st line therapy for a Bartholin’s abscess? What about Word Catheter use? Are there any alternatives to Marsupialization for recurrent cases? In this session, we will review the data behind diagnosis and management of this common gynecological condition.

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00:12:56

The 2-Vessel Umbilical Cord: Management Review

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/25

There are 4 types of single umbilical artery (SUA), based on pathogenesis. The incidence of SUA is up to 1% of all singleton fetuses, and up to 4.6% of twins. SUA can occur either as an isolated finding or as part of a congenital anomaly syndrome. In this session we will review the pathogenesis, identification of, fetal work-up, and patient management of SUA. Data from the SMFM, and ACOG.

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00:15:04

Understanding METH: MOA, Pregnancy Effects, and FALSE...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/22

Methamphetamine and amphetamine use has greatly increased all throughout the United States. While similar to cocaine, it’s mechanism of action is quite unique and dangerous. In this session we will cover the pharmacology of amphetamines/meth and its affects on pregnancy. We will also cover some common every day medications which can actually test false positive for meth/amphetamines on toxicology screening. Data for this podcast come from the ACOG, SMFM, and the CDC.

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00:12:58

Cosmetic Genital Surgery: ACOG Jan 2020 Update

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/20

Interest in, and performance of, female cosmetic genital surgery increased 50% from 2014 to 2018. As close to 80% of US females have some degree of pubic hair removal, self awareness of vulvar variation is increasing. Although labial hypertrophy can be a true functional/medical concern requiring labial reduction, what about elective cosmetic genital procedures? In January 2020, the ACOG will release its updated committee opinion on this topic. These are important points to review as patients often

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00:14:23

Understanding Factor V Leiden Mutations in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/17

Pregnancy-related venous thromboembolism is the most common cause of maternal death and a significant cause of maternal morbidity. The factor V Leiden (FVL) mutation is the most common known genetic factor that predisposes to thrombosis. How does obstetric management differ regarding a heterozygous or homozygous carrier? When should anticoagulation be used, and at what dose? In this session we will review data from the SMFM, RCOG, and the ACOG practice bulletin 197.

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00:18:44

Adolescent 1st Gyn Visit: Confidentiality & More...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/12

The initial gynecological visit for an early teen/adolescent is crucial in establishing patient trust, education of gynecological health, and establishment of healthy personal and sexual behaviors. At what years should the first visit occur? What about patient confidentiality when dealing with minors? Is a clinical breast exam part of the adolescent screening exam? In this session, we will review the ACOG committee opinion (598) on the first gynecological visit.

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1,102 results

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