Dr. Chapa’s OBGYN Clinical Pearls

Latest Episodes:

Adenomyosis (Part 1) May 02, 2021

Show notes

Historically, Adenomyosis was a pathological diagnosis only. However, new imaging standards/techniques have moved Adeno into a clinical diagnosis. Is there a patient risk profile for this condition? Is this strictly a gynecological issue or is there adverse perinatal outcomes as well? Welcome to Part 1 of Adenomyosis where we will answer these questions and more.

Mood Disorders in Admitted Antepartum Patients: LOOK FOR IT! Apr 28, 2021

Show notes

OB Patients admitted with medical or obstetrical complications to an antepartum hospital unit face separation from loved ones, stress from their diagnosis, face isolation, and are prone to develop perinatal mood disorders. In this episode, we will review a soon to be released publication from the Green Journal (May 2021) addressing this under diagnosed and under recognized issue.

The 4th Trimester: Not Long Enough. Apr 23, 2021

Show notes

On April 12, 2021, Illinois agreed to provide Medicaid benefits to eligible mothers for up to 12 months postpartum, a major extension from the previous 60-day limit. Follow up of postpartum women for 12 months after delivery is gaining favor as data is evolving which shows that “the 4th trimester” (the first 12 weeks postpartum) is just not long enough to detect postpartum complications. In this episode we will review a new editorial which states that “the 4th trimester” is not long enough.

The Acutely Agitated OB Patient Apr 21, 2021

Show notes

We often encounter the acutely agitated patient. Acute agitation may be from and uncontrolled medical condition, psychiatric condition, or illicit substance induced. The acutely agitated patient is also at increased risk of some prenatal complications. In this session we will review the evidence-based protocols for management of the acutely agitated OB patient.

Is Caffeine in Pregnancy Bad? Apr 18, 2021

Show notes

The ACOG has stated that caffeine consumption in pregnancy should be limited to 200 mg/day. However, a new study published on March 25, 2021 in JAMA Network Open is questioning that recommendation. In this study, we will review this longitudinal cohort publication stating that “there may be no safe limit to caffeine consumption”.

Cerebral Venous Sinus Thrombosis & COVID Vaccination Apr 15, 2021

Show notes

The CDC released a health alert through its Health Alert Network on April 13, 2021, notifying physicians and other health care practitioners that the CDC and FDA are reviewing data involving six U.S. cases of a rare type of blood clot in individuals after receiving the Johnson & Johnson COVID-19 vaccine. In this session, we will review what CVST is, how it can present, the work-up, and potential treatment options. Do you give heparin for this? What is a correlation with thrombocytopenia? This is a vital summary of data that all healthcare practitioners should know.

Lessons from Midwifery: Maternal Position Changes in Labor Apr 11, 2021

Show notes

The field of obstetrics was “birthed“ out of midwifery. The concept of second stage of labor in the lithotomy position was not how it was “always done”. In this episode we will review the evidence behind the “flexible sacral positions” and learn how maternal positional changes can assist with the labor process.

Trauma Informed Care: ACOG April 2021 Apr 06, 2021

Show notes

The prevalence of trauma is quite sobering. General population surveys have found extremely high rates of traumatic experiences encountered which span all races, ages, and socioeconomic status is. Nonetheless, some groups are disproportionately affected by trauma compared to others. This is why all healthcare providers should be aware of “trauma informed care” practices. In this episode, we will summarize the ACOG committee opinion from April 2021 on the subject. Do you know what the “4 Rs“ of trauma informed care are? How do we screen for this? Are traumatic events linked to chronic physical diseases as well? Let’s cover this very important topic now.

Hysteroscopy Apr 02, 2021

Show notes

Hysteroscopy, and especially office-based hysteroscopy, is a fantastic tool in the evaluation of suspected endometrial abnormalities and/or heavy menstrual bleeding. In this session, we will review the ACOG committee opinion on hysteroscopy. At what fluid deficit should you stop the procedure if using normal saline? What about glycine? What is the significance of a “mill-wheel” murmur. Do you know what the Durant maneuver is? We answer all of these questions and more in this session!

HPV Screening & Surveillance Mar 29, 2021

Show notes

Algorithms and opinions on cervical cancer screening change quickly. In this session, we will review the uses for HPV testing as a primary screening tool as well as post treatment surveillance. Are you familiar with which HPV tests can be used as primary screening? What is the frequency of tests? Let’s cover this now.

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