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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.

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All Episodes

00:27:49

You Ask, We Answer!

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/02/08

Well podcast family, we are back with another installment of our “You ask, We answer” edition. We've got 2 fascinating and real-world clinical conundrums in this episode, both suggested by two separate podcast family members. The first has to do with RH IG maternal administration. Here's the question: If a patient receives routine, prophylactic RH IG at 28 weeks but then has maternal trauma say 1 or 2 weeks after, does she still require an additional dose of RH IG? That's a good question

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00:29:58

Understanding Fetal Microcephaly

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/02/05

Fetal Microcephaly has an incidence of 2 to 12 in10,000 births in the USA and can be diagnosed prenatally via ultrasound (in second or early third trimester) or postnatally via measurement of head circumference (HC). Antepartum, this is a unique diagnosis since we are mainly used to using PERCENTAGES for biometrics and for fetal weight, butmicrocephaly is not diagnosed by HC percentage- but by Standard Deviation (SD). Microcephaly has been linked to developmental delay, seizures, as well as

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00:18:44

OB Cough Induced Rib Fracture? YEP. It’s a Thing.

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/02/02

Stress fractures are common injuries in athletes and military recruits, that’s’ understandable- based on the physical forces placed on the long bones. A stress fracture can be defined as a partial or complete fracture of the bone that is a result from repeated application of stress lower than that required to fracture the bone in a single loading situation. In pregnancy, the body is subjected to various physiological changes that make women more vulnerable. In this pregnancy, we will highlight a

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00:17:05

When ZMAX if OUT for CS: Alternative?

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/31

We have learned a lot about extended spectrum coverage of prophylactic antibiotics for cesarean section. The landmark C/SOAP trial randomized 2,013 women undergoing nonelective cesarean delivery to azithromycin 500 mg IV plus standard prophylaxis versus placebo, demonstrating a 51% reduction in the composite outcome of endometritis, wound infection, or other infection. Adjuvant Zmax (plus standard first-generation cephalosporin) is now recognized as evidence-based antibiotic coverage for intrapartum

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00:22:03

Another Pub on Hysterotomy Closure

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/29

We have covered the subject of whether to include the decidual (innermost) layer when closing the uterine incision during cesarean section (CS) on at least 2 episodes. The most recent was in September 2025, when we focused on a published (September 2025) systematic review and meta-analysis from the Green Journal. Back then, we compared those new findings to our prior episode from 2023 on the same matter. Well, we are back at it again with the same subject as there is a new EXPERT REVIEW from the

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00:24:39

New Data on MVP or AFI For Poly

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/26

As OB healthcare providers, we have several pieces of guidance regarding determination of amniotic fluid volume antepartum. The SMFM has Consult Series #46 (2018), which describes the management of polyhydramnios. We'll touch on that in this episode. However, while we have clear understanding of the increased risks of oligohydramnios, where an MVP is preferred for diagnosis over AFI, we have less information about polyhydramnios. But a new study published in BJOG (January 2026) provides more

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00:16:57

“Expression of Concern” Over a Green Journal Article

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/24

Back in March of 2025, the green journal (obstetrics andgynecology) published A systematic review and meta-analysis on 2 medications (non-hormonal) and their efficacy in menopausal hot flash relief period these medications were Fezolinetant and Elinzanetant. However, the editors have just recently released an “Expression of Concern” about this review. Listen in for details. 1. Menegaz de Almeida, Artur MS; Oliveira, PalomaMS; Lopes, Lucca MD; Leite, Marianna MS; Morbach, Victória MS; Alves

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00:12:45

FDA’s ENG Label Change: What To Know

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/23

Implanon (etonogestrel implant) first received FDA approval in 2006, followed by the improved, radiopaque version, Nexplanon, approved by the FDA in 2010, which is now the only contraceptive implant available in the U.S. It was originally FDA approved for a 3-year use duration, although peer reviewed clinical data had demonstrated efficacy through year 5. Now, as of January 2026, the FDA has formally agreed to extend the label for 5-year use. In this episode, we will review the clinical data that

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00:37:46

Does Ursodiol Reduce Adverse Outcomes in ICP?

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/21

Ursodiol (ursodeoxycholic acid) is a prescription bile acid medication used to dissolve cholesterol gallstones, prevent gallstones during rapid weight loss, and treat liver diseases like primary biliary cholangitis (PBC) by reducing toxic bile acids and cholesterol production. It works by changing bile composition, making it less saturated with cholesterol, and is available as oral medication. Of course, it is also the foundational medication for treatment of diagnosed Intrahepatic Cholestasis of

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00:26:56

New CC #11: Positive HCG in the Non-OB/Non-Gyn CA...

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/18

HCG is a heterodimeric glycoprotein typically produced by trophoblastic tissue. However, there are occasions where a serum HCG is obtained that remains low level POSITIVE, yet the patient is not pregnant, nor does she have a gynecologic malignancy. Why dose this happen. Not all these instances can be explained by the “PHANTOM” HCG. In this episode, we will review a new Clinical Consensus guideline from the ACOG officially being released in Feb 2026. Like the finding of an aberrant aneuploidy on

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00:23:07

TXA for ENG Implant Bleeding?

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/16

The ENG implant has data placing it as the most reversible, hormonal contraceptive agent available with a typical use failure rate of 0.05%. Unfavorable bleeding patterns, such as frequent or prolonged bleeding, affect approximately 40% of ENG implant users within the first 3 months but typically improve over time. Nonetheless, it is the main reason for patient discontinuation. In the past, various medications have shown to have at least some short-term reduction in bothersome breakthrough bleeding

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00:33:03

Does Uterine Incision-to-Delivery Interval Matter?

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/13

It’s a controversial topic: the impact of uterine incision (hysterectomy) on the neonate delivery interval (also called the U-D interval). Does it matter? Just to be clear, we’re talking about time from uterine entry to fetal extraction, not skin incision to fetal extraction. Past publications have produced conflicting results, often limited by small sample sizes, heterogeneous indications for delivery, and reliance on surrogate markers (like apgar scores) rather than clinical morbidity. But a new

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00:37:09

cfDNA: Jan 2026 Practice Advisory

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/10

In January 2026, the ACOG released its Practice Advisory on Screening for fetal Chromosomal Abnormalities. This comes after its Nov 2025 endorsement of the SMFM’s Consult Series #74, “Cell-free DNA screening for aneuploidies: Updated guidance”. In this episode we will review the key parts of this PA. Is screening for microdeletions recommended? PLUS, we will focus on cfDNA for sex chromosomal abnormalities. Should screening for sex chromosomal abnormalities (SCAs) be an “opt in” or “opt out” process

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00:33:46

TOLAC, PIT, and Internals: The Latest

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/08

Uterine rupture or dehiscence associated with TOLAC results in the most significant increase in the likelihood of additional maternal and neonatal morbidity. It should be noted that the terms “uterine rupture” and “uterine dehiscence” are not consistently distinguished from each other in the literature and often are used interchangeably. Furthermore, the reported incidence of uterine rupture varies in part because some studies have grouped true, catastrophic uterine rupture together with

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00:27:50

The 2025 Big Baby Trial

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/05

Currently, as of today’s date, neither the ACOG nor SMFM currently support routine early induction of labor for suspected fetal macrosomia, instead recommending individualized counseling and reserving elective cesarean for extreme estimated fetal weights. However, a 2025 multicenter, open-label, randomized controlled trial was published in the Lancet comparing induction of labor versus standard care in pregnant women with fetuses suspected to be large for gestational age. The study used a

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00:26:15

Brain Zapping at Home Now Approved!

Dr. Chapa’s OBGYN Clinical Pearls ·

2026/01/02

In mid-December 2025, the FDA approved an at home devicethat aims to treat depression by sending electric current into a part of the brain (the prefrontal cortex) known to regulate mood. This has been available in the UK since 2019 but it is new to the US. The manufacturer has stated that over 55,000 patients have used the device across Europe, the UK, Switzerland, and Hong Kong. How does this work? Is there data to support this new therapy? In this episode, we will summarize three consecutive years

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00:32:00

New Data on VO-CPP (PeVD) Therapy

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/12/30

While endometriosis is highly associated with Chronic Pelvic Pian (CPP), some women may suffer from a different primary or coexistent secondary etiology: pelvic vascular congestion, called vascular origin (VO)- CPP. Although controversial as an entity, there have been diagnostic algorithms published (via pelvic ultrasound. MRI, or venography) for this condition. Approximately 10-40% of chronic pelvic pain cases may be attributed to pelvic vascular congestion (now termed pelvic venous disorder),

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00:01:06

Emily's Thanks to You

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/12/28

A brief THANK YOU prior to 2025 end.

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00:24:10

FHT Baseline Change (110-160) in Labor: Danger, or...

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/12/27

In 2002, the National Institute of Child Health and Human Development (NICHD) proposed the 3-Tier fetal heart rate (FHR) classification system that was subsequently adopted by many organizations, categorizing tracings into three groups: Category I (normal), Category II (indeterminate), and Category III (abnormal). Recently, our podcast team received an interesting question form one of our podcast family members: “If there is a change in the fetal heart rate tracing intrapartum, but it is still in

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00:19:29

PFM Question: IAI WITHOUT Fever?

Dr. Chapa’s OBGYN Clinical Pearls ·

2025/12/24

Podcast Family, in our immediate past episode we tackled the discrepancy that is often found between a clinical diagnosis of intra-amniotic infection/chorioamnionitis and histological chorioamnionitis. From that episode, we received a fantastic question from one of our podcast family members: Can a patient have IAI without fever? That question is really deep and highlights a gap in the current diagnostic scheme/ criteria from the ACOG. Listen in for details!1. ACOG CO 7122. Sukumaran S, Pereira V,

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