Dr. Chapa’s OBGYN Clinical Pearls

Latest Episodes:

GBS in Pregnancy Sep 20, 2018

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In this session, we will review the ACOG committee opinion on prevention of early onset GBS neonatal infection. This comes from the committee opinion 485.

Does BMI affect emergency birth-control effectiveness? Sep 15, 2018

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Levonorgestrel and ulipristal are 2 oral emergency contraceptive options. Since 2010, pharmacokinetic studies have suggested a lower effectiveness of levonorgestrel in overweight and obese women. In this podcast, we will review the pharmacokinetic data as well as professional society opinions on this topic.

PMS and PMDD: Clinical Review Sep 06, 2018

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In this session, we will review the diagnostic criteria for premenstrual syndrome and premenstrual dysphoric disorder. Options for therapy will also be discussed. Data taken from the ACOG and the APA.

Umbilical Cord Prolapse Aug 30, 2018

Show notes

In this session, we will review and obstetrical emergency that has the potential to result in severe Ville and morbidity or even mortality… Umbilical cord prolapse.

Prophylactic Antibiotics in Labor & Delivery Aug 28, 2018

Show notes

In this session, we will review the ACOG practice bulletin (199) from September 2018 on the use of prophylactic antibiotics in labor and delivery. This podcast will cover the optimal dose of intravenous antibiotics before C-section, the use of vaginal cleansing, and the adjuvant use of Zithromax before cesarean birth. Care of the MRSA colonized patient, as well as infective endocarditis prophylaxis will be covered.

Ovarian Vein Thrombosis Aug 20, 2018

Show notes

Ovarian vein thrombosis was recently the subject of a clinical review by the American College of OBGYN in November 2017. Ovarian vein thrombosis occurs in 1 and 600 to 1 in 2000 pregnancies and may have severe sequelae including pulmonary embolism. In this podcast, we will review the latest information from the ACOG and the ACCP on the pathophysiology, diagnosis, and treatment of ovarian vein thrombosis.

Clarification- Klumpke's palsy: "Neuropathy at gyn surg". Aug 18, 2018

Show notes

Alright, as occasionally happens… There was an error in the editing of our prior podcast regarding nerve injury at gynecological surgery. This very brief section will clarify the occurrence of klumpke's palsy during steep trendelenburg positioning.

Nerve Injury at Gyn Surgery Aug 17, 2018

Show notes

Gyn surgery can be associated with iatrogenic nerve injury. Neuropathy can be classified into three types: neuropraxia, axonotmesis, and neurotmesis. The most severe form of injury is nerve transaction or complete nerve ligation (neurotmesis). In this session, we will review the mechanism of nerve injury during Gyn surgery, their presentations, and prevention tips. Material is taken from the AAGL and the Society of Gyn Surgeons.

Management of Intra-Amniotic Infection Aug 12, 2018

Show notes

In this podcast, we will review the ACOG updated guidelines regarding intra-amniotic infections. Three classifications have been given by the ACOG: 1. Isolated maternal fever in labor, 2. Suspected intra-amniotic infection, and 3. Confirmed intra-amniotic infection. We will review these three categories, their diagnosis, and treatment recommendations. Data taken from the ACOG committee opinion 712.

Delayed umbilical cord clamping after birth (ACOG CO 684) Aug 06, 2018

Show notes

The ACOG, as well as the AAP, recommends delayed umbilical cord clamping in stable term as well as preterm neonates. While once considered necessary to keep the Neonate at or below the level of the placenta, new data shows that placental to child transfusion still occurs if the child is placed on the maternal chest for skin to skin contact. Additionally, the presence of meconium stained fluid – in vigorous neonates – is not a contraindication to delayed umbilical cord clamping. In this podcast, we will review the ACOG committee opinion on delayed umbilical cord clamping.

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