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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

00:13:32

Pitocin For Early D&C? No!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/26

Somethings in medicine are done by tradition. The use of Oxytocin during first trimester uterine evacuation is one such thing. Evidence seems to be lacking for the use of this common intervention. Remember, physiologically, oxytocin receptors show a linear increase in concentration as pregnancy progresses- rising quickly after 36 weeks of pregnancy, and are only present in negligible quantities on the myometeium in the first trimester! In this session, we will review the data on oxytocin use for

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00:08:31

Brexanolone for PP Depression: Facts and Precautions.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/22

In March 2019, the FDA approved the first medication specifically targeted for postpartum depression, brexanolone (Zulresso). However, this medication requires a 60 hour, inpatient, IV-continuous infusion and there are some safety concerns. In May 2019, the Cleveland Clinic announced that it would release a pilot inpatient program (at one of its sites) for this medication. In this session, we will review this new medication and the Cleveland Clinic’s protocol for Zulresso.

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00:07:34

SMFM Dont’s! (Part 2)

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/21

Does finding an isolated echogenic cardiac focus or choroid plexus cyst require amnio? What about MTHFR testing for thrombophilia? AFI or deepest vertical pocket? Does cervical length screening matter after cerclage?In this session, which is part 2, we will complete our “OB don’ts“ from the SMFM.

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00:11:27

SMFM Don’ts!! (Part 1)

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/21

(Part 1) Cerclage for twins? What about progesterone? Do gestational diabetics controlled with diet (A1) alone require antepartum fetal surveillance? In this session, we will review 10 (out of 15) obstetrical DON’TS from the Society of Maternal Fetal Medicine.

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00:01:12

Send a Voice Message!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/17

Now, regardless of which venue/platform you are listening to the podcast through, you can leave us a voice message! Simply go to “episode notes“ and scroll to the bottom of the note section. Click on, “send a voice message“ and record your message! Your voice memo will go directly to our inbox and we will get back to you as timely as we can! Thanks for listening… and feel free to be part of the conversation!

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00:11:17

CALL TO ACTION: US Maternal Mortality and CVD

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/14

The CDC confirmed in a report recently released that about 700 women die each year in the United States from cardiovascular conditions, infections, hemorrhages and other complications related to their pregnancies — up to a year after delivering their babies. In about 60% of the cases, the deaths could have been prevented, in part, with proper medical intervention, better access to care, and early recognition of risk factors/signs. The leading cause of death is CV conditions, such as heart disease

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00:14:17

Am. Soc. Breast Surgeons: Updated Breast CA Screening...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/11

Controversy surrounding screening mammography guidelines has resulted in conflicting recommendations from physicians and uncertainty for women. The Am Society of Breast Surgeons has released detailed/conservative screening recommendations for both average and high risk women. In this session, we will review their updated recommendations. We will also briefly review the following 4 supplemental screening modalities: 1. Contrast-enhanced Breast Magnetic Resonance Imaging (MRI), 2. Ultrasound, 3

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00:10:37

Skin to Skin at CSection: Part 2

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/09

In this session (Part 2), we will cover skin to skin neonatal contact at time of Cesarean birth. Is this possible? What does the data show? This will wrap up our two-part series.

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00:14:19

Skin to Skin Neonatal Contact: What’s the Big Deal?

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/08

Skin to Skin neonatal contact is endorsed/recommended by the AAP, AWHONN, the CDCP, and the WHO. What’s the data behind his practice? Are there any potential risks or safety concerns? And… What about C-Section deliveries? In this episode (PART 1) we will provide an introductory overview and discuss the data behind neonatal, post-birth, skin to skin contact.

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00:13:43

Osteoporosis

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/06

Researchers estimate that approximately 10.2 million Americans have osteoporosis, and an additional 43 million have low bone density. Equally stark are the ramifications of these numbers. About 1 out of every 2 Caucasian women will experience an osteoporosis-related fracture at some point in their lifetime. In April 2019, the FDA approved a new dual action medication for osteoporosis therapy in postmenopausal women considered at high risk of fracture. This new medication is Evenity. In this episode,

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00:14:22

The “HYSTerical” Origins of Vibrators!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/05

“Hysteria” referred to a constellation of psychological and physical ailments occurring only in women. It was thought to have its origin in the uterus. This can be traced back to ancient Egypt, the Greeks, and even the Roman era. Even the first FEMALE physician in Europe, Trota of Salerno (11th Century AD) propagated the theory. Ancient treatments for hysteria included “genital massage“ in order to release “unused materials” from the female body! Hence the origins of what persists today... the

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00:12:04

The Non-Fundal IUD. What’s to do?!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/02

Hey, we have all been there at one time or another: The ultrasound report shows an IUD/IUS in the endometrial cavity but it is NOT in the fundal location. What do we do? The answer lies mainly in the TYPE of IUD used! LNG-IUS devices seem to NOT be affected by low lying locations. The data on COPPER Ts, however, is still not clear....but risk of pregnancy is likely quite low. In this session, we will review the evidence regarding management of the non-fundal IUD.

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00:11:32

Why PLACEBO pills in Birth Control Pills? The...

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/05/01

What do Mexican Yams, menses, and the Pope have in common? The answer: the Birth Control Pill! In this session, we will review the interesting and slightly strange history of the oral contraceptive pill and the notion behind “withdrawal” monthly bleeding.

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00:16:13

46XY Females: AIS vs Swyer Syndrome

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/30

Both Androgen Insensitivity Syndrome (AIS) and Swyer Syndrone (Pure Gonadal Dysgenesis) are characterized by phenotypical females who are genetic males (46XY). However, The 2 conditions are very different pathogenically and have different clinical implications. For example, AIS patients can not become pregnant; however, Swyer patients may become pregnant after therapy. In this session, we will review the pathogenesis and clinical implications of these 2 46XY conditions.

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00:13:53

MEASLES!! ACOG Practice Advisory.

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/27

The US is currently experiencing the greatest number of reported cases of measles, also known as rubeola, since the disease was eliminated in 2000. Outbreaks have been confirmed in 22 states. When measles occurs in late pregnancy, congenital infection is possible with variable expression and increased risk of subacute sclerosing panencephalitis. In this session, we will review the April 2019 ACOG practice advisory on management of pregnant and reproductive-age women during a measles outbreak. We

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00:14:35

Female Ejaculation and “Squirting”: HEY...YOU ASKED!!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/23

In the late 1950s, two researchers (Masters and Johnson) began breakthrough research on human sexuality. Since then, “sexologists” have expanded our understanding of the female sexual response including concepts like female ejaculation and even, “squirting”. Yes… We will cover this data!

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00:03:21

LIKE...What NOT to say!

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/18

I’m sorry… I had to release this pent-up frustration regarding a common occurrence! LoL. “Like... I really hope you, like, enjoy this session”.

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00:12:47

Fetal Echogenic Bowel

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/18

Fetal Echogenic bowel is a non-specific finding observed during 0.2 to 1.8% of routine second trimester ultrasound. Possible causes include primary gastrointestinal pathology, aneuploidy, cystic fibrosis, and congenital viral infection. However, most fetuses with this finding, especially when isolated, have no detectable abnormality. In this session, we will review the SMFM algorithm for management of isolated echogenic bowel diagnosed on second trimester ultrasound. (SMFM Brief, isolated fetal

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00:10:52

Does Progestin Only BC Cause Depression?

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/12

Birth control, especially progestin only methods, seem to take a lot of heat regarding their potential role in CAUSING depression. Although past individual studies have suggested a link, the most recent systematic review of 26 studies has debunked that possibility. In this podcast, we will review the study published in 2018, in the journal of Contraception, regarding this topic (Worly. The relationship between progestin hormonal contraception and depression: a systematic review. Contracep

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00:11:02

PreCS Vaginal Prep

Dr. Chapa’s OBGYN Clinical Pearls ·

2019/04/07

In 2016, the CSOAP trial confirmed that adding Azithromycin 500 mg IV to standard cephalosporin antibiotic prophylaxis pre-Cesarian helps reduce post operative infection. However, mounting evidence supports the addition of iodine-based vaginal prep to pre-CS care. However, no trial yet has compared the Zithromax – cephalosporin regimen to vaginal preparation and cephalosporin prophylaxis. In this podcast, we will summarize the current commentary by Duffy et al from April 2019’s Green Journal on

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