Dr. Chapa's OBGYN No Spin Podcast

Today, we’re diving into a topic that has completely transformed prenatal care over the past decade—non-invasive prenatal testing, or NIPT. Thanks to recent technological leaps, cfDNA, cell-free fetal DNA, is giving us unprecedented visibility through just a simple maternal blood draw. Take Fetal Focus by Natera, for example, or the UNITY Reflex Screen from BillionToOne. These options offer single...

Choline is not a nutrient that the human body can synthesize in sufficient quantities; it must be obtained from dietary sources (eggs, meat, fish, dairy products, grains, and nuts). Its a water-soluble amine that serves as a precursor for phospholipids, which are vital components of cell membranes. Plus, it’s a vital component of acetylcholine, a neurotransmitter involved in numerous brain functio...

Delayed cord clamp is standard of care. On today’s episode, we are stepping into a high-pressure dilemma in the labor and delivery room. Imagine this (which doesn’t need a lot of imagination, because it is a real event which occurred to one of our podcast family members): A mother has carefully drafted a birth plan. One of her non-negotiable requests is delayed cord clamping for two full minutes....

Here is a sobering fact: Iron deficiency is one of the most common health conditions in the world. Iron deficiency affects an estimated one in three people, yet many go undiagnosed and untreated despite widespread treatment options. Iron deficiency can progress to iron deficiency anemia. If you’ve been listening for a while, you know we have banged the drum on this podcast time and time again abou...

Innie vs Outies: no, we are not referring to bellybuttons. In this episode, we’re talking about the labia of the Volva! Does it actually matter? Which one is more common? Now, this episode was actually sparked by a brilliant listener who sent us her question to our IG inbox (as a non-clinician): “Can having an innie labia actually cause me to have recurrent bacterial vaginosis?” Such a good questi...

Marfan syndrome is an autosomal dominant, connective tissue disorder. Because it’s autosomal dominant, an affected parent has a 50% chance of passing the genetic mutation to their offspring in every pregnancy. Approximately 25% of cases actually stem from spontaneous, de novo mutations with no prior family history. In the United States, the prevalence of Marfan syndrome is estimated at roughly 1 i...

If you’ve ever managed postpartum preeclampsia, you know the clinical gray zone: after an initial intrapartum course of magnesium sulfate, when do you actually restart it for a postpartum, readmission exacerbation? Always? There’s no standard national guidance on this. Every unit seems to do something a little different. In this episode, we’re summarizing a new study looking at practice patterns a...

If you’ve been listening for a while, you might remember an episode we ran about two years ago where we dove deep into the use of low-titer O-positive whole blood in emergency resuscitation. At the time, the consensus in trauma care was leaning heavily "pro"—advocating for getting O-positive blood into bleeding patients fast, especially given the persistent and severe shortages of O-negative inven...

In June 2026, the ASRM released its updated guidance on recurrent pregnancy loss. This is the most updated guidance in over a decade and includes a decision tree algorithm that starts with a pivotal test. In this episode we will review this “first pass” triage test and provide clinical implications. 1. ASRM CO: https://www.asrm.org/practice-guidance/practice-committee-documents/recurrent-pregnancy...

Currently, the CDC U.S. Medical Eligibility Criteria (USMEC) rate CHCs as category 4 (unacceptable health risk) for migraine with aura, versus category 2 for migraine without aura; ACOG similarly recommends avoiding estrogen-containing contraception in migraine with aura. But, recent data published in August 2026 from the UK seems to show no increased risk with “modern”/low-dose combination birth...

A growing body of research reveals the link between STIs and the pathogens that cause most cases of vaginitis. Over 90% of vaginitis cases result from BV, yeast, or trich- alone or in combination. But, a recent 2024 study from Schwebke et al., in the J Clinical Microbiology, found that about 1 in 5 women who presented with symptoms of vaginitis also had at least one STI…a good reminder to not just...

An important clinical advantage of cfDNA screening for autosomal recessive conditions is its ability to provide meaningful fetal risk assessment in general-risk pregnancies at an early gestational age, even when partner carrier testing is unavailable. But is this reflex cell-free DNA approach reliable. In this episode, we will review NEW DATA (Oct 2026) from a prospective, multi-site study whose g...

Welcome back to the show, everyone! Today, we are diving deep into one of the most effective, set-it-and-forget-it contraceptive options available: the Nexplanon implant. With a failure rate of about 0.05%, it is a powerhouse of birth control. You pop it just under the skin of the inner upper arm, and for up to five years, you are covered. Standard removal is usually a quick, straightforward, in-o...

Picture this common, late-gestation conundrum: You’re reviewing a 34-week sono. The mid-pregnancy 24-to-28-week glucose screen was completely normal. But now, the sonogram pops up with an estimated fetal weight of over 90%, or maybe a MVP (or AFI) that’s overtly elevated. The classic clinical dilemma hits: Do you order a repeat OGTT this late in the game? Is it actually worth poking the patient ag...

Today we’re diving into a lab order that almost every ob-gyn, midwife, and labor-and-delivery nurse were traditionally trained to do: the routine Postpartum Day 1 Hemoglobin and hematocrit. For decades, checking a patient’s H&H after delivery was automatic. Didn’t matter if it was a smooth, uncomplicated vaginal birth with minimal blood loss or a complex emergency C-section- come 6:00 AM the n...

If you’ve been following health and medical headlines over the past few weeks, you’ve likely seen a renewed and urgent conversation around postpartum depression—a condition that affects millions of new mothers worldwide, often with devastating consequences. While we’ve long understood that postpartum depression is deeply multifactorial—shaped by a complex web of hormonal shifts, psychological stre...

MS is a complex polygenic disease with over 200 associated genetic variants. The risk of an offspring developing MS if one parent is affected is relatively low at 2% to 3% (though maternal transmission shows slightly higher heritability), with some possible epigenetic influences. The National Multiple Sclerosis Society reports that up to 4 times as many women have MS as men. The average age at MS...

The ACOG PB 222 states, “In women with preeclampsia with severe features at less than 34 0/7 weeks of gestation, with stable maternal and fetal condition, expectant management may be considered”. The expectant management of preeclampsia with severe features before 34 0/7 weeks of gestation is based on strict selection criteria of those appropriate candidates and is best accomplished in a setting w...

So, here is a not uncommon situation: A new OB patient presents for initial prenatal care at 28 weeks by “sure LMP” but her ultrasound EGA is just over 3 weeks behind. Simple redating, right? How can we be assured that we are not missing FGR? That is where the “ancillary” use of transcerebellar diameter (TCD) plays a role. In this episode, we will highlight the recent JUNE 2026 data on this and re...

Today we are diving into a topic that is incredibly close to my heart—one that has the potential to fundamentally change how we approach prenatal care and protect pregnant patients. We’re talking about low-dose aspirin for the prevention of hypertensive disorders of pregnancy. Now, if you follow current formal guidelines, you probably know the standard protocol: 81 milligrams a day, prescribed bas...

Today, we are tackling a massive grey area in obstetrics/maternal-fetal medicine: What happens after early fetal growth restriction resolves? When a baby bounces back on the growth chart during the second or third trimester, are they completely out of the woods? Or is there a hidden, lingering risk we aren’t talking about enough? To find out, we’re doing a deep dive into two major publications tha...

The word CERCLAGE comes from the French word, cercle, meaning "hooping" or "encirclement". Cerclage was traditionally reserved for cervical insufficiency but is now a recognized option for patients with a history of preterm birth and a short cervix noted on ultrasound between 16-24 weeks. There are three (3) main indications for obstetrical, cervical cerclage: History-Based, Ultrasound-Based, and...

As of August 20th, 2026, the ACOG has released an updated Clinical Practice Update on opportunistic salpingectomy. Here’s why this matters so much: we now know that the vast majority of high-grade serous epithelial ovarian cancers actually start not in the ovaries, but in the fallopian tubes. By removing those tubes during routine pelvic, obstetric, or even non-gynecologic abdominal surgeries, we...

ACOG recommends the use of oral or vaginal misoprostol, vaginal dinoprostone (either gel or insert), or mechanical methods for cervical ripening. Plus, it states, “Combination methods (pharmacologic and mechanical) are also effective”. The July 2026 ACOG CPG 9 states this regarding vaginal misoprostol compared to vaginal dinoprostone for labor induction: “Vaginal dinoprostone is effective for cerv...

Today, we are taking a deep dive into a medical truth that sounds completely counterintuitive, almost upside down, based on everything you think you know about women's health. But here’s the kicker: it’s actually nothing new at all. For over two decades, ever since the landmark Women’s Health Initiative (WHI) study made global headlines back in 2002, the blanket narrative surrounding menopausal ho...