Dr. Chapa’s OBGYN Clinical Pearls

Latest Episodes:

🚨ACOG ALERT🚨 (April 6, 2022): CHAP Trial Apr 07, 2022

Show notes

A study published on April 2, 2022 in The New England Journal of Medicine, "Treatment for Mild Chronic Hypertension during Pregnancy” (CHAP Trial) has resulted in ACOG calling to order its Practice Advisory Committee to prepare a “practice update” regarding the management of mild to moderate hypertension in pregnancy. This recent publication is practice changing! While we await the revised guidelines and official statement from the ACOG, this podcast will review the current state of affairs regarding management of mild to moderate chronic hypertension in pregnancy.

ROM Tests: Not All Are The Same. Apr 02, 2022

Show notes

This is Part 2 where we will wrap up our review of commercially available screening tests for ROM. Do you know what each test specifically checks for? Which test seems to outperform the others? And what about ferning and pH testing? Are those still done? Let’s wrap up our 2-part series with these answers and more.

Understanding ROM Tests: Pitfall Prevention Pearls (Part 1) Mar 30, 2022

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PROM is a common diagnosis in Labor and Delivery. However, making a false positive diagnosis OR a false negative one may place the pregnancy at risk of either unnecessary interventions or adverse perinatal outcomes- or both. In this session, we will review best practices for exam based diagnosis. Are you aware of the FDA “Dear Doctor” letter regarding ROM biomarker testing (2018)? This session is Part 1. In Part 2, we will dive deep into the 3 main biomarker tests for ROM- how they differ, how they perform, their strengths and their weaknesses.

Send The Placenta? Hmm…likely NO. Mar 26, 2022

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Some things in medical practice stem more out of tradition than true clinical evidence. Such is the case for histological examination of the placenta. When is pathological examination of the placenta actually helpful? Should we send of the placenta in cases of multifetal birth? What about meconium or chorioamnionitis? In the session, we will review a soon to be released clinical brief from Obstetrics and Gynecology (ACOG) coming out April 2022. This new evidence review questions our current clinical practice of routine placental histological evaluation.

Prevention of HBV Vertical Transmission: New Data Mar 22, 2022

Show notes

There is a recommendation for universal screening of Hepatitis B surface antigen in pregnancy. Which antiviral medication is recommended for prevention of Hep B vertical transmission in pregnancy? Is there a antiviral medication approved for Hepatitis C in pregnancy? In this session, we will review new data which is soon-to-be released in the American Journal of OB/GYN (Gray Journal) reviewing antepartum (maternal) antiviral medication used to prevent mother to child transmission of Hepatitis B. We will also review the SMFM guidelines for hepatitis B viral infection during pregnancy.

Duration of PP MagSulfate: New Data Mar 14, 2022

Show notes

Why is Magnesium Sulfate the first-line medication for preeclampsia/eclampsia? How did that arise into the current, international, standard-of-care regiment for that condition? Is 24 hours of Postpartum Mag evidence-based? In this episode we will review the evolution of magnesium sulfate for eclampsia prevention/treatment. We will also summarize a soon to be released systematic review and meta-analysis publication from Obstetrics & Gynecology examining the duration of postpartum MagSulfate use.

OB Care After ART (SMFM Series #60; 2022) Mar 07, 2022

Show notes

Pregnancies that arise after assisted reproductive technologies (ART) are at higher risk of maternal, fetal, and even placental complications. In this session we will summarize and highlight key prenatal management pearls for pregnancies that arise after ART. This is a summary of the SMFM consult series # 60, from March 2022.

Statins and Preeclampsia Prevention: Yes or No. Mar 03, 2022

Show notes

Preeclampsia occurs in 3 to 5% of the general OB population. It has even higher prevalence among those with high-risk conditions. Currently, aspirin stands alone as the most evidence-based pharmacological option for preeclampsia prevention (risk reduction). But over the last decade new interest has arisen for the use of statins for preeclampsia prevention. Well, do statins work? What is the state of statin therapy as of 2022? In this session we will review the latest data and review the key pathogenesis in preeclampsia formation.

Optimizing Natural Fertility (ASRM) Feb 26, 2022

Show notes

Couples trying to conceive often ask questions like these: When is the best time to have sex to get pregnant? Is there a better sexual position to have sex in order to conceive? Is one type of over the counter lubrication better than the other? Well despite weird myths and misperceptions about these subjects, there are firm answers we can give. In this podcast we will cover the January 2022 ASRM Bulletin on ways to “optimize natural fertility”.

Water Immersion in Labor: AAP/ACOG vs ACNM Feb 22, 2022

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Hydrotherapy (water immersion) has a proven safety record and proven benefits in the first stage of labor. But what about actually delivering with water immersion? In January 2022, the AAP released a Committee Opinion regarding water immersion delivery. The AAP echoes the words from the ACOG regarding water immersion births. However, the ACNM does not agree. In this session, we will review the established and conflicting viewpoints from these organizations regarding water immersion in labor and delivery.

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