Dr. Chapa’s OBGYN Clinical Pearls

In May 2020, the ACOG will release a new committee opinion regarding tobacco/nicotine use during pregnancy. What are the risks of nicotine use during pregnancy? Are medications to assist smoking cessation in pregnancy endorsed by the ACOG? In this session, we will highlight and summarize this new committee opinion.

In 2018, the ACOG stated that screening for bacterial vaginosis before gynecological procedures “can be considered“ as a way to reduce infection. However, in March 2020, a new expert review was published in the AJOG making a much stronger recommendation. In this session, we will review the publication from March 2020 from the American Journal of ObGyn highlighting this stronger recommendation to s...

Women with seizure disorders often have altered menstrual function, with or without anti-seizure medications. One anti-seizure medication has even been linked to the development of PCOS. Seizure disorders in reproductive age women can also influence contraceptive choice. Do you know what makes Lamotrigine unique? In this session, we will summarize the upcoming May 2020 ACOG committee opinion (806)...

Data on exercise during pregnancy and the postpartum period has evolved. For example, once considered relatively contraindicated, jogging during pregnancy is not prohibited. Does exercise cause preterm birth? What about exercise in women with pre-existing diabetes or hypertension? In this session we will cover the April 2020 committee opinion clarifying myths/misperceptions regarding exercise in t...

Maternal oxygen administration in labor has been used as a traditional tool for intrauterine fetal resuscitation. However, excluding times of maternal hypoxemia, the practice could actually be detrimental to fetal well-being. In this session, we will review data from the SMFM annual meeting from February 2020.

Being deaf and blind in the late 1800s (and a female!) was a prime recipe for failure and poverty. However, one young woman beat incredible odds to change American history. During these uncertain times of COVID19, we can still learn from Ms. Helen Keller, and her proven formula for overcoming life’s challenges: self-motivation, and personal encouragement.

Elmiron (pentosan polysulfate sodium) is the only oral FDA approved medication for interstitial cystitis/painful bladder syndrome. Initially approved in the late 1990s, recent evidence (within two years) has described a new medication associated ocular pathology: retinal maculopathy. In the journal Obstetrics and Gynecology, a new commentary will soon be released on this topic. In this podcast, we...

The AAGL and the RCOG have released position statements regarding the use of laparoscopy during this viral pandemic. Can surgical plume from energy devices transmit infection? Is laparotomy safer for the OR team? In this podcast we will highlight and summarize the position statements of these professional societies regarding non-elective surgical procedures during this viral pandemic.

ARDS in pregnancy carries an increased rate of maternal and perinatal mortality. Specific respiratory physiological changes make care of the pregnant ARDS patient more complex than in the non-pregnant individual. Is temporary hypocapnia or hypercapnia more favorable? What about ventilation pressures? We will review maternal respiratory changes and ARDS care in this session (Source: SMFM Critical C...

The SMFM has just released new labor guidelines for SARS-CoV2 patients under investigation/confirmed COVID-19. This new practice guideline addresses oxygen use for fetal decelerations, amniotomy, labor epidural, HCW protection during 2nd stage of labor, as well as antenatal corticosteroids and magnesium sulfate. We will review these points in this session.

COVID-19 MEMEs are plentiful across social media platforms. Cynical medical humor has been around for decades. This phenomenon was made public in the late 1970s with a book called, “The House of God“. What does the literature say about the pros/cons of dark medical humor? Is this helpful or detrimental? And, what does dark humor have to do with “mind medicine”? We will dive into these questions in...

Phenylketonuria is better known as Phenylalanine Hydroxylase Deficiency (PAH-D). This genetic condition can have significant implications for the reproductive age woman including adverse pregnancy outcomes and congenital fetal malformations. In April 2020, the ACOG will release a new committee opinion (802) on the management of women with PAH-D. What Maternal serum levels are optimal to prevent ad...

In April 2020, the ACOG will release a new committee opinion (803) on adolescent confidentiality and ObGyn. What is the difference between a “mature minor” and an “emancipated” minor? Can minors receive contraception without parental consent? What about emergency care? In this podcast we will highlight (and expand upon) very important points made in this new committee opinion. We will also address...

It doesn’t matter who you are, what your title/position is, or how physically strong you are, times of social distancing and quarantine can take a mental toll on everyone. Nonetheless, we have a non-prescription, powerful anti-depressant at our disposable. Medical science has proven that the act of gratitude can physically affect not only our mindset, but can physically alter our brain, and impact...

The AHA has just released interim guidance for healthcare providers performing CPR on suspected or known COVID-19 patients. This guidance include the restriction on procedures that can generate aerosols (bag-valve masks, nebulizers, non-invasive positive pressure ventilation). This guidance is divided into pre-hospital/transport care, and hospital care. In this podcast we will summarize the AHA gu...

This current global viral pandemic has shed light on the value of telemedicine. The ACOG endorses the use of telemedicine for pregnancy care as a way to “enhance“ prenatal/antepartum services. In this podcast we will review an effective model for prenatal telemedicine services, review its implementation, and discuss barriers to use.

March 20, 2020: Currently, we are in desperate need of some encouraging news. Social distancing, times of quarantine, and a viral pandemic can easily overwhelm the strongest of individuals. So, this is our inaugural podcast for MIND MEDICINE. In this episode we will cover 2 incredible stories of 2 physicians who overcame incredible odds by the power of their will to survive: Dr. Leo Rogozov and Dr...

Stay encouraged, focused, and passionate.

Even though we have covered this topic in a prior podcast, the urgent need for Hepatitis C screening in pregnant women still leads the medical literature. In the journal Obstetrics and Gynecology, a new current commentary will soon be released titled, “A call to action: the urgent need for hepatitis C screening in pregnant women“. In this podcast, we will summarize the key aspects of this current...

Welcome back! In this session, we will cover the echogenic cardiac focus, short humerus and femur length, fetal pyelectasis, and single umbilical artery!

In this session, Part 1, we will review soft markers of aneuploidy and their management. Soft markers of aneuploidy can be isolated or multiple. They can be associated with chromosomal, genetic, infectious causes, or they can be normal variants. In this session we will cover: ventriculomegaly, choroid plexus cysts, absent/hypoplastic nasal bone, nuchal folds, and echogenic bowel. Data for this pod...

In the ACOG committee opinion (743) on low-dose aspirin in pregnancy, the College states that more data is necessary before low-dose aspirin can be recommended for the prevention of spontaneous preterm birth. However, that was in 2018. Data since then (including data from January 2020 from the NIH) is supportive of aspirin use for the prevention of preterm birth. What does this data look like? In...

Virtual reality is well-established in the gaming community, but data is expanding regarding its utility and effectiveness for a variety of medical conditions. In February 2020, at the annual meeting of SMFM, researchers released their findings on a randomized controlled trial using VR headsets for labor pain. In this podcast we will briefly review VR technology and its application for medical pai...

Worried about airline travel amid global health concerns? Well, you’re not alone. What does the CDC say about airline infectious disease precautions? And what about air travel during pregnancy in general? In this podcast, we will review the CDC recommendations regarding viral precautions and highlight some key points from the ACOG committee opinion, 746, regarding air travel in pregnancy.

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.