Dr. Chapa’s OBGYN Clinical Pearls

Latest Episodes:

Vulvodynia Feb 25, 2020

Show notes

Vulvar pain (vulvodynia) is subdivided into generalized or local. The symptoms can either be spontaneous or provoked. Vulvodynia can result in painful intercourse, and affect other quality-of-life measures. In this session we will review the diagnosis, subcategories, and management of vulvodynia.

PROM March 2020 Update! Feb 23, 2020

Show notes

Pre-labor rupture of membranes should be diagnosed based on clinical assessment. In March 2020, the ACOG will release a new practice bulletin (217) on PROM. This bulletin highlights the potential hazards of over reliance on lab tests for the diagnosis, and offers a new management option for PROM in the late preterm interval. Are steroids contraindicated in the presence of suspected intraamniotic infection? We will take a look at the data in this session.

Chronic Pelvic Pain (ACOG PB 218) Feb 21, 2020

Show notes

Chronic pelvic pain has been redefined by the ACOG and includes a broader range of etiologies. There are 3 main categories of potential etiologies for chronic pelvic pain. In this episode, we will review the March 2020 practice bulletin ( 218) on the subject. What is the Carnett test? Do trigger point injections work? What is the role of SNRI medications in treating chronic pelvic pain? What about lysis of adhesions? We will address these questions and more in this episode!

Cannabis Induced Hyperemesis Feb 11, 2020

Show notes

Cannabinoid Hyperemesis Syndrome: Although widely recognized in the gastroenterology and psychiatry literature, its occurrence in pregnancy is well known. The pathophysiology of this condition is not well known but potential MOAs have been published. How does this present? And what do “hot baths“/“hot showers“ have to do with his condition? In this podcast we will review this interesting and intriguing condition specifically as it relates to pregnancy.

ORAL SEX! (and HPV) Feb 05, 2020

Show notes

In 2013, actor Michael Douglas blamed frequent oral sex with his wife as a cause of his throat cancer. In the 17 years from 1999 through 2015, the mouth and throat replaced the cervix as the most common site of cancer associated with human papillomavirus (HPV) infection in the United States. What is a data show about vaginal to oral HPV transmission, and even oral to oral transmission? Does Gardasil have a role in prevention here as well? In this podcast, we were review published data on oral HPV transmission and trends of acquisition.

Malignant GTD Jan 31, 2020

Show notes

Malignant GTD includes choriocarcinoma, invasive mole, and placental site trophoblastic tumor. When is single agent chemotherapy indicated? What about multiagent care? What is the classification system for malignant GTD? In this episode we will review the diagnosis, work up, and management of this condition.

Molar Pregnancies Jan 30, 2020

Show notes

Gestational Trophoblastic Neoplasia is a complex condition with various histological and clinical distinct entities. In this episode, we will review the benign variants of GTN, hydatidiform moles (complete and partial). We will review their clinical presentations, diagnosis, management, and follow up. Data for this podcast comes from the ACOG practice bulletin 53 as well as the SGO.

Throat/Rectal STI Jan 27, 2020

Show notes

Currently, the CDC does not recommend “routine screening” for extragenital gonorrhea or chlamydia in women, although it does make that recommendation for MSM or bisexual males. However, as most extragenital infections are asymptomatic, this is potentially missing a large reservoir of infection. In this episode, we will review the USPSTF and CDC screening guidelines and compared that to evolving prevalence data of extragenital STIs.

Naltrexone for Pregnancy OUD. Jan 24, 2020

Show notes

Opioid use disorder (OUD) Is a national crisis. Pregnancy is not immune to OUD. Traditionally, methadone and buprenorphine have been used as medical treatments for this condition in pregnancy, with concerns about naltrexone (an opioid antagonist) use. In January 2020, a new prospective cohort study (AJOH) adds reassuring data on the safety and effectiveness of this medication option.

Vaginal Vit C for BV? Yep, it’s DATA. Jan 18, 2020

Show notes

Up to 30% of initial BV diagnoses will have a recurrence. Does partner therapy (male or female) help reduce recurrence? Most of the original data which stated “No”, is now outdated. Additionally, what is the data on vaginal Vit C for recurrence prevention? Does that actually work? Let’s examine both of these questions...now.