Dr. Chapa’s OBGYN Clinical Pearls

Thanksgiving 2021 is upon us! However, did you know that mental health experts make the very important distinction between gratefulness, thankfulness, and gratitude? While being thankful is important, it is much more vital to live in a state of Gratitude. In this session, I am joined by Lisa Chapa (LCSW). We will explore this concept and the Science of Gratitude.

(Introducing Dr. Garrett Dunn as guest resident on today’s episode!) The CDC estimates that more than 1.1 million people in the US are living with HIV infection, and 1 of 7 individuals is unaware of their infection. HIV care has come a long way over the years. In this episode, we will review QUICK FACTS from the SMFM on HIV care during pregnancy. Data summarized is from the last SMFM update on HIV...

How do you diagnose vaginitis? Do you treat BV/yeast/trichomoniasis found on Pap smear? Do you use the Wet Prep, or molecular/DNA test? An ePub recently released in Obstetrics and Gynecology (the Green Journal), revealed some disappointing results for the Wet Prep. In the session, we will summarize key points from this article, as well as remind all of us of some key information released by the AC...

This session is a follow-up to our immediate pest episode. Are there any evidence-based true alternatives to the 50 g screening test for GDM? What about hemoglobin A-1 C? What about home blood glucose monitoring? Let’s dive into the data and see. We will also introduce you to… “Chapa chocolates”. 😳😊😆

It’s true, patients do NOT enjoy the 50 gram oral glucola test for gestational diabetes screening. And, the 100 gram test is even worse! Online sources claim that consuming a certain number of jellybeans is comparable to the standard screening/diagnostic test. Is that valid information? In this session we will review this jellybean theory and review what the data actually says.

The prevalence of Hepatitis C viral infection in pregnancy has doubled over the past 10 years. Active hepatitis C viral infection in pregnancy increases the risk for both maternal and neonatal morbidity. In the session, we will review this alarming trend along with key screening and management recommendations from the ACOG/CDC/SMFM.

In this episode, a simple to follow algorithm for management of APS in pregnancy will be presented. We will cover both antepartum and postpartum care.

Antiphospholipid syndrome has well established diagnostic criteria. Nonetheless, healthcare providers still find the condition- and it’s management-somewhat confusing. In this session, we will cover the diagnostic criteria for APS and who qualifies for investigation. In Part 2, we will cover specific management algorithms in pregnancy.

Fetal renal pelvic dilation occurs in 1% to 5% of all pregnancies. Although most are benign, it can be associated with genetic and structural disorders. Are you familiar with the CAKUT syndrome? When should Chromosomal MicroArray Analysis (CMA) be offered? What about prognosis? In the session, we will summarize and highlight the main points of the SMFM consult series #4 covering fetal renal pelvis...

Just a quick message response for one of our listeners, Liane. Great points Liane… I take your message to heart! Here’s is our response. Thank you for being a contributing part of our listening family.

October is Domestic Violence Awareness month. This is such an important issue to discuss, and we will give into it here! Making her podcast debut is one of our residents, Dr. Katie Light. AND… as you will learn at the end of the podcast, she’s also a very proud Texas A&M Aggie! WHOOP.

Molnupiravir is now on the scene as a potential new therapy for mild to moderate COVID-19. As an oral administered medication, this could revolutionize care of the condition. In this session, we will review the early origins of this medication, its MOA, and what the data in the phase 3 study showed.

There continues to be a lot of faulty assumptions regarding testosterone therapy in women. In 2014 the Endocrine Society joined an international panel and provided an evidence-based review of testosterone use in women. This was reaffirmed in 2017 and 2019. Most recently, in October 2021, the ACOG released a “clinical commentary” ahead of print, “Testosterone Therapy in Women”. In the session, we w...

Sexual climax has been defined not only as a bodily/physiological reaction but as a mental process as well. First termed “the little death” historically, the phrase focused on the altered state of awareness following sexual release. But there’s many reasons/benefits why sexual release may be voluntarily delayed (by mutual agreement) during intimacy. In the session, we will approach the once taboo...

Thank you to Dr. Leslie Clark (Senior Resident) for your great work in wrapping up our discussion on antepartum fetal surveillance. In this session, we cover one of the most misunderstood tests in fetal surveillance, the biophysical profile. Is the NPV for the modified version the same as the full? Which test is the “most reassuring”? We will answer this question and more in the session!

In this session I am joined by one of our upper level (Senior) wonderful residents, Dr. Catherine Jimenez. Dr. Jimenez and I recorded this as an impromptu podcast covering antepartum fetal surveillance. Does maternal eating actually affect fetal movement? Do kick counts really work to prevent fetal morbidity? We will cover these questions, and more, in this episode (Part 1).

Here’s a question for you: would you rather have motivation, or inspiration? Used interchangeably in common dialogue, the two can actually be polar opposites. This is a brief review of the power of inspiration, not just in our daily work, but in living life overall. Taken from psychological studies and CBT, this session will hopefully INSPIRE you in your daily life. Choose inspiration over motivat...

PTSD has come a long way from its original designation as “shellshock”relating to veterans of war. PTSD is also possible following childbirth, even in otherwise “uncomplicated” Labor And Delivery events. Childbirth-related PTSD has been historically overlooked. In this session we will summarize the DSM5 criteria for this condition in order to better recognize and diagnose the condition.

In this session we wrap up our discussion of emergency contraception. Is there a preferred option for those with larger BMIs? What if the patient has emesis after a dose of oral EC? We will summarize the evidence/data here.

Despite its use for decades, misinformation and misperceptions about emergency contraception still persist. Are all options the same? What is their efficacy? Does bodyweight affect EC’s ability to prevent pregnancy? And what about medical contraindications to birth control use? In the session, which is Part 1, we will dive into the facts regarding emergency contraception.

The US is ranked 65th among industrialized nations for maternal morbidity and mortality outcomes. That is unacceptable! Maternal levels of care initially began in Texas. Now, there is a plan to make this nationwide. With the goal of reducing maternal mortality and morbidity in the United States, ACOG has partnered with The Joint Commission on the development of a new Maternal Levels of Care (MLC)...

Available mAbs are directed against a large number of antigens and used for the treatment of immunologic diseases, reversal of drug effects, and cancer therapy. Now of course they are also being used against COVID-19. As these are IgG based, is the use of monoclonal antibodies allowed in pregnancy? What is the ACOG/SMFM position statement? In this session, we will review the latest data regarding...

Tranexamic Acid’s use in obstetrics skyrocketed in 2017 after the release of the WOMEN trial. At that time, the ACOG endorsed TXA for use with diagnosed PPH, not for its prevention. Does TXA prophylaxis reduce postpartum hemorrhage? Does it matter whether it is used at vaginal birth or cesarean? Data moves fast and we will highlight those new answers here.

(Part 2) In this session, we will wrap up our summary review of the ACOG September 2021 Clinical Consensus bulletin on postpartum pain management. What are “ultra rapid metabolizers” of opioid medication? How does that affect our prescriptions for postpartum pain control? In this session we will answer these questions and more! ⚕️⚕️⚕️⚕️

Uncontrolled postpartum pain can lead to postpartum depression, impaired maternal-child bonding, and even chronic pain syndromes. Uncontrolled postpartum pain can also lead, in some individuals, to a form of PTSD. In this session, we will review the September 2021 Clinical Consensus statement from the ACOG on using a “MultiModal Stepwise Approach” to Postpartum pain management. Do NSAIDS increase...