Dr. Chapa’s OBGYN Clinical Pearls

Latest Episodes:

Antibiotic timing at CS: New Data Jan 06, 2021

Show notes

Historically, CS prophylactic antibiotics were given after umbilical cord clamp and cut to prevent exposure of the neonate to antimicrobials. The recommendation then changed, in line with typical surgical practice, to give prophylactic antibiotics before skin incision. However, new data published in December 2020 is calling this practice into question. In this session we will review this new publication, co-authored from Rutgers university, which has some surprising results.

Darkness Within: A Reality-Check on Perinatal Suicide. Dec 26, 2020

Show notes

It’s the holiday season, but the holidays can exacerbate depression/anxiety and even increase suicidal ideation in some individuals. Suicide deaths are a leading cause of maternal mortality in the US, yet the prevalence and trends in suicidality (suicidal ideation and/or intentional self-harm) among childbearing individuals remain poorly described. Oddly, the CDC data excludes deaths from "accidental or incidental causes," such as suicide, overdose, or homicide in their maternal mortality reporting. In this session, we will review US maternal mortality rates and review new data regarding perinatal suicidal ideation and acts.

OOOPS! Dec 17, 2020

Show notes

A brief explanation regarding our podcast just released, “Ovaries In or Out”!

Ovaries In or Out at Hyst? Dec 17, 2020

Show notes

Historically, prophylactic oophorectomy was performed at time of benign hysterectomy in patients at/over 45 years of age. Is this still evidence based? Is the reduction in ovarian cancer development a net win or net loss compared to ovarian conservation? In this podcast we will review the data regarding risks/benefits of ovarian conservation at time of benign hysterectomy in the general population.

Steroids and Chorio? Dec 12, 2020

Show notes

Considered controversial, traditionally steroids for fetal lung maturation were not given in patients with clinical chorioamnionitis. But is this really evidence-based? And since most patients will be delivered quickly after this diagnosis, how fast can steroids be expected to have a benefit on the child? In this session we will summarize a December 2020 Expert Review from the AGOG on that subject.

COVID19 Vaccine Safety in Pregnancy? Dec 09, 2020

Show notes

In the very near future, possibly just days away, the FDA is anticipated to approve at least 1 new COVID-19 vaccine. Were pregnant and/or lactating women included in the phase III vaccine clinical trials? What is the safety data for the vaccine in pregnancy? Are pregnant and/or lactating women part of the vaccine distribution framework? These are tough, and even controversial, aspects that must be considered. In this session, we will review the current state of the vaccine and how it applies to pregnant/lactating women.

UNACCEPTABLE! Summary of US Maternal Death CALL TO ACTION Dec 2020 Dec 06, 2020

Show notes

A woman dies every 12 hours in this country from pregnancy-related complications. 2/3rds of these deaths are preventable! Let that sink in. On December 3, 2020, the US Surgeon General released a CALL TO ACTION to rectify this reality. In particular, ONE race is carrying this burden more than others. In this podcast we will summarize the main points of this 71 page monograph, and tie in potential solutions.

“Backdoor” Experiences: From Taboo to Mainstream. Dec 03, 2020

Show notes

Once considered TABOO, women having receptive “Backdoor” sexual attention has gained a lot of press in both medical as well as non-medical publications. Does ACOG have a committee opinion on this? YES. And in this podcast we will discuss data on prevalence of, orgasmic response to, and possible STI implications of “backdoor activities” in women.

Reglan/Benadryl for OB Migraine. Nov 29, 2020

Show notes

The two most common types of headaches in pregnancy are tension type and migraine. Is Imitrex safe to use in pregnancy? A common alternative medication regimen includes the use of Benadryl and Reglan for acute headache. Is there data for this? And what about Botox in pregnancy? In this podcast we will review the data on the medical management of migraine headaches in pregnancy.

UPDATED ACOG CO#814: Delayed Cord Clamping (Dec2020) Nov 20, 2020

Show notes

In December 2020, ACOG will release an updated committee opinion on delayed umbilical cord clamping with 3 additional areas addressed: 1. multiple gestations, 2. cord milking in extreme premature infants, and 3. the effect of delayed cord clamping on umbilical cord blood collection. We will summarize these key points in this session!

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