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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

00:17:00

Understanding Microdeletions in OB Genetics

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/10

Commercial laboratories offering cell free DNA for fetal prenatal screening are offering microdeletion testing. Is this valid? Microdeletions are varied and include 22q and 15q syndromes. In this session, we will review the pathophysiology of microdeletions and review 22q and 15q conditions. What does the SMFM have to say about cell free DNA screening for these conditions? How is Angelman syndrome related to Prader –Willi condition? Let’s cover this now.

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00:13:47

Pregnancy Spacing After Stillbirth: 2019 Data

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/07

The “ideal“ interpregnancy interval depends on the outcome of the immediate, prior pregnancy. For example, the recommended interpregnancy interval following a 1st trimester miscarriage is different compared to a live, term birth. But what about the interpregnancy interval after a stillbirth? Are the recommendations the same? In this podcast will review updated data from 2019 regarding interpregnancy interval following stillbirth. The reference for this podcast summary is Regan AK, et al; Lancet,

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00:14:07

“Informed Refusal” of a Recommended C-section: An...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/03

You find that there is a medical indication for a cesarean birth- yet the patient refuses! What are your next steps? Should you seek a court order to intervene? “Informed refusal” encompasses a complex, multifaceted, ethical dilemma. In this session, we will review some clear guidelines from the American Academy of Pediatrics, the ACOG, and the AMA regarding the management of this difficult situation.

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00:18:56

Cesarean Section History: From “Lex Regia” to Modern...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/12/01

No! Julius Caesar was not born by cesarean birth. What does a pig-gelder in 1500 have to do with CS History? From Jacob Nufer to Munroe Kerr, we will walk down the path of the cesarean’s incredible history.

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00:18:30

Burnout? Moral Injury? Here’s the VACCINE for both.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/29

Medicine: it’s an incredibly rewarding profession. The opportunity and ability to comfort and heal the sick is an absolute privilege. BUT...if you are not careful, that wonderful of all professions can consume you, and may devour you. Two theories have been proposed to explain this: Burnout, and Moral Injury. But are these 2 separate conditions? How does the issue of mindset (fixed or growth) apply? In the session, we will review the latest (as of December 2019) on this ever evolving issue.

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00:10:28

Ob QUANTITATIVE Blood Loss: Dec 2019 ACOG CO

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/25

In December 2019, the ACOG will release committee opinion 794 covering quantitative blood loss in obstetrics. Does QBL use ALONE improve clinical outcomes? The answer may surprise you! Nonetheless, there is great value in utilizing obstetric hemorrhage toolkits/bundles such as the California Maternal Quality Care collaborative strategy. In the session, we will review the use of QBL in practice in why having it as part of a larger toolkit helps reduce maternal morbidity and mortality.

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00:12:00

Lactational Mastitis and Abscess

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/22

Breast-feeding mastitis is a common occurrence and a source of disruption of breast-feeding and negatively affects quality-of-life. In this session, we will review the Academy of Breastfeeding Medicine’s treatment protocol for the condition. When is abscess identification required? What about drainage? We will answer these questions and more in this episode!

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00:20:49

Obesity-Stillbirth Link

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/20

Obesity is a known modifiable risk factor for complications of pregnancy- both antepartum and intrapartum. Data has confirmed a direct link/risk of stillbirth with obesity. In this session, we will review the data on this link as well as the effect of gestational age on the risk of stillbirth. We will also briefly review the ACOG practice bulletin on gestational diabetes and how this may relate to obesity’s risk of stillbirth. This podcast will also summarize the (conflicting) data on elective

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00:17:37

Periviable Birth

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/17

Periviable birth is defined as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When is the earliest time to consider antenatal steroids for fetal lung maturation, and what about magnesium sulfate for neuroprotection? When should tocolytics be utilized? And when is the earliest just stational age to consider a C-section for fetal benefit? In this session, we will cover these questions according to the ACOG consensus statement #6.

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00:13:56

MTHFR: The FACTS

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/14

MTHFR... Yep, it gets blamed for a variety of health and pregnancy concerns. But does the data actually confirm the presence of adverse pregnancy and adverse health issues with MTHFR variants? In this session, we will review the difference between the 2 most common variants (C677T, A1298C) and true MUTATIONS. We will also review statements from the ACOG, ACMG, SMFM, as well as the Canadian Guidelines regarding MTHFR screening.

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00:00:34

Dr. Chapa’s Clinical Pearls. (Trailer)

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/08

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00:15:57

Acute Bronchitis: Antibiotics?

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/07

Persistent cough, congestion, low-grade fever… Yep, typical symptoms of acute bronchitis! The CDC and the American College of Physicians have published guidelines on antibiotic stewardship regarding acute bronchitis. When are antibiotics indicated? What about beta-agonist therapy? Do mucolytics work? In this podcast we will review the presentation, etiology, and treatment algorithm of this common clinical diagnosis.

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00:11:55

Keeping Patients Safe!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/11/03

“Never events“, “Sentinel events”, and “Near misses”. These terms strike fear in any healthcare provider! The National Quality Forum, the Agency for Healthcare Quality and Research, and the Joint Commission, all have stressed the importance of patient safety in the operating room and medical wards. In this podcast we will review alarming statistics regarding preventable medical errors, and remind ourselves of ways to keep patient safe.

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00:11:42

LUBE Library: Not all are the same.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/31

That’s right… We’re talking about vaginal lubricants! In general, there are 3 main categories: water-based, silicone based, and oil based. Each has their own advantages and disadvantages. Some lubes can actually place the patient at risk of pregnancy if used with a latex condom! In this podcast, we will cover the “lube library“ so that we can better inform our patients since education is key!

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00:08:17

Mirror (Ballantyne) Syndrome

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/28

Mirror syndrome (first described in 1892) is another term for what is also known as Ballantyne Syndrome or triple edema. Maternal mirror syndrome is a rare consequence of fetal hydrops. By convention, delivery is recommended in pregnancies complicated by mirror syndrome due to grave fetal prognosis. Severe maternal morbidity has also been described. In this session, we will review the clinical presentation, similarities to preeclampsia, and management of this grave complication.

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00:04:12

ACOG Clinical Alert: (Oct 25, 2019) Progesterone for...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/25

On October 25, 2019, the American Journal of Perinatology published the results of the PROLONG Trial. This study demonstrated no statistical difference in the co-primary outcome of preterm birth less than 35 0/7 weeks of gestation (P = 0.72) and neonatal composite index (P = 0.73) with 17-OHP use. Similarly, the rate of preterm birth less than 37 weeks and less than 32 weeks were not different. On October 25, 2019, the ACOG released a practice advisory about this. Let’s summarize this now.

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00:16:23

Sepsis in Pregnancy (SMFM Data)

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/25

The rate of sepsis appears to be increasing. Maternal sepsis is a significant cause of maternal morbidity and mortality. Sepsis is not a specific illness, but a syndrome that includes organ dysfunction caused by this regulated host response to infection. In this session we will review the SOFA score and it’s utilization. Is fever necessary for a diagnosis of sepsis? Which antibiotics should be used? What is the rate of IV fluid resuscitation? Are steroids contraindicated in the septic patient? We

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00:13:21

Nitrous Oxide in Labor: YES, PLEASE.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/22

N2O is a nonflammable, tasteless, odorless gas. It was first synthesized by the English scientist and theologian Joseph Priestly in 1772, and was first used as a labor analgesic by Stanislav Klikovich in Poland in 1881. Although much more frequently used in the UK and Canada, interest in nitrous oxide for labor pain management is increasing in the USA. What is its mechanism of action? Is it effective? What are the contraindications? Let’s review this topic...NOW.

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00:15:20

Universal Thyroid Screening in Pregnancy: Pros and Cons.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/20

Universal thyroid screening in pregnancy is a key debate in endocrinology and obstetrics. While some countries advocate universal screening, the UK and USA adopt a “high-risk” based strategy. ACOG’s Practice Bulletin 148 (April 2015) keeps its recommendation to NOT perform routine screening for thyroid disease in pregnancy. BUT, should we screen for thyroid abnormalities universally? This podcast will review the pros and cons and make a push for once stance over the other.

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00:11:18

Intrapartum Fetal Tachycardia

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/10/18

Fetal Tachycardia (FT) is described as increase in baseline fetal heart rate (FHR) above 160bpm, for longer than 10 minutes. In clinical daily practice, management of mild-moderate uncomplicated tachycardia can be challenging because clinicians do not have clear guidelines for intervention in cases of uncomplicated fetal tachycardia (in the absence of maternal pyrexia or decelerations) in cases where tachycardia has not resolved with conservative measures like left lateral tilt, hydration and pain

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1,102 results

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