Dr. Chapa’s OBGYN Clinical Pearls

Latest Episodes:

Does Progesterone Prevent Miscarriage? Aug 28, 2022

Show notes

Progesterone has long been hoped to be a remedy for 1st trimester pregnancy loss. Does progesterone help reduce miscarriage risk? The data is ever evolving. In this session we will review 2 landmark studies that helped answer this question (PROMISE, PRISM). We will also cover a 2020 Cochran systematic review that helped change the 2021 NICE practice guidelines on the subject. Lastly, we will also cover the latest data on this from May 2022 (ACOG ACM).

FAIL! Disappointing New Data on Vaginal Progesterone Aug 24, 2022

Show notes

Oh, the twisted love story of progesterone and pre-term birth! Ever since the Meis trial in 2003, we have been fascinated with the use of progesterone as a possible cure-all of all things preterm birth. But the data keeps piling in, with results just contrary to that. In this episode we will review the publication history of progesterone and it’s fight against PTB. We will also highlight a new publication from the AJOG coming out September 1, 2022 analyzing vaginal progesterone’s effectiveness against PTB. Does it work? Let’s find out.

White Classification: Still Relevant? Aug 20, 2022

Show notes

In 1949, Priscilla White published her landmark study on diabetes in pregnancy, launching the “White Classification”. This has been a staple of pre-pregnancy diabetes nomenclature since that time. However, despite its historical role in obstetrics, is this scale still relevant? In this episode we will review the history, definitions of, and proposed alternative nomenclature to the traditional White Classification.

Epilepsy and Women’s Care Aug 17, 2022

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Epilepsy/seizure disorders disproportionately affects women of reproductive age over men. The influence of sex hormones on seizure prevalence is well documented. As women’s healthcare providers, it’s vital for us to understand the influence of seizure disorders on women’s overall care. In this session, we will review important aspects regarding contraception and review the data on pregnancy outcomes in women with epilepsy.

OB Listeriosis Aug 14, 2022

Show notes

There are so many things to go over with our pregnant patients especially at their initial intake visit. However, one thing that should not be left off that discussion list includes food items to avoid! Listeriosis during pregnancy can be devastating for the fetus. Are you familiar with the work up and CDC recommended treatment for this condition? In this episode we will present an easy to remember protocol for managing patients with a possible exposure to listeria monocytogenes.

InTOXiCaTED? Aug 11, 2022

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I’ll let this episode title speak for itself… LOL. Hope this makes you smile.

New Med for ENDO! (With Guest Co-Host) Aug 08, 2022

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Endometriosis is a devastating condition. Once thought to have its impact only during reproductive age, endometriosis has been linked to an increased risk of stroke later in life. Any new medication which shows safety and efficacy in menstrual pain reduction is welcome in this space. In this session we will review a new FDA approval of an existing medication in the battle against endometriosis. (Special guest co-host, Kacie Mitchell, 3rd medical student)

Mag Neuroprotection at 22 Weeks? Aug 02, 2022

Show notes

Yesterday, 08/01/2022, we released a podcast on “The 22 Week Birth”. As a follow-up to this, and in response to 5 separate questions (all related to the use of magnesium sulfate for fetal neuroprotection) from podcast members, we decided to get this episode out! While we all understand the upper limit for magnesium sulfate for CNS protection to be 32 weeks and 0 days, is magnesium sulfate a consideration at 22 weeks? We will lay out the timeline of data from 2017 to current day in this session.

The 22 Week Birth Aug 02, 2022

Show notes

Over the last several years, the “limit of viability” for neonates has decreased dramatically. The new “lower limit” of neonatal viability can now be considered to be as early as 22 gestational weeks. But there’s a lot more to that statement! In this session, we will review the latest data on neonatal survival in the Periviable interval. We will highlight and summarize a new publication from the Lancet published on July 25, 2022. Should we be performing “universal resuscitation” at 22 weeks? Or should we take a more “selective” approach? Let’s summarize the latest data.

Polyhydramnios Jul 28, 2022

Show notes

Polyhydramnios affects from 0.2 to 2% of all pregnancies. Which is preferred for diagnosis, MVP or AFI? Is amnioreduction an effective intervention? When is indomethacin indicated? In the session we will dive into the issue of polyhydramnios, its workup, and delivery implications.