Dr. Chapa’s OBGYN Clinical Pearls

In 2011, the FIGO adopted a new nomenclature to characterize abnormal uterine bleeding in the reproductive age patient. ACOG subsequently adopted the system. Terms like menorrhagia, metrorrhagia, and dysfunctional uterine bleeding, were abandoned. In this session, we will review the PALM-COEIN nomenclature.

Fibroadenomas are the most common cause of breast masses in adolescent girls and young women. Nonetheless, it is important to remember that the palpable breast mass is still the most common finding of symptomatic breast cancer. In this podcast, we will review the diagnosis and management of the palpable breast mass, according to the ACOG practice bulletin 164. We will also review the BI-RADS class...

This podcast is a review of the ACOG Committee Opinion 760 from December 2018. Dysmenorrhea, or menstrual pain, is the most common menstrual symptom among adolescent girls and young women. Most adolescents with menstrual pain will have primary dysmenorrhea, but secondary dysmenorrhea (endometriosis) may also occur. This podcast will review symptoms, work-up, and therapy of both primary and seconda...

Septic pelvic thrombophlebitis can occur in the deep pelvic vessels alone or may involve the ovarian vein. Ovarian vein thrombosis is most frequent on the right side. This podcast will over the current data on presentation, workup, and use of anticoagulation in SPT cases.

Our mission is to educate, train, and develop healthcare professionals in women’s healthcare. Our podcast has hit a milestone!! This podcast, which is an independent, non-industry sponsored educational platform, has hit 50,000 1st time plays! Thank you for listening, and being a part of Clinical Pearls!!

Immediate postpartum LARCs are endorsed by the ACOG. This podcast will summarize the ACOG committee opinion 670, and review the new data (October 2018) regarding IUD expulsion rates based on timing of insertion, route of delivery, and IUD types.

This podcast will quickly summarize the ACOG practice bulletin number 201 on pre-gestational diabetes mellitus. This ACOG practice bulletin is set to be released December 2018.

Traditionally, a well-woman visit has included a pelvic examination defined as external genitalia inspection, speculum examination, and bimanual exam. However, the collective body of evidence is actually limited in support or rejection of the routine performance of the pelvic exam in an asymptomatic woman. This podcast will cover the ACOG committee opinion number 754 from the Fall of 2018 discussi...

Endometriosis related pelvic pain affects approximately 8% of reproductive age women. Recently, the FDA approved a new oral GnRH antagonist for treatment of endometriosis related pelvic pain. This podcast will review the indication, data, and dosage options for this new novel medication. This podcast does not represent a specific endorsement of elagolix, and was produced without industry affiliati...

Traditionally, migraines with aura were considered contraindicated for estrogen containing birth control. However, that recommendation was made in the 1960s and 1970s when the dose of estrogen in birth control pills was much higher than dosages used today. The risk of stroke is directly related to the amount of estrogen in birth control, and recent clinical opinions have suggested that ultra-low d...

Neonatal opthalmia refers to conjunctivitis of any cause occurring within the first 4 weeks of newborn life. Gonorrhea now accounts for less than 1% of the condition, however chlamydia is responsible for 2% to 40% of cases. Ocular prophylaxis is not effective against chlamydial conjunctivitis. In this podcast we will review this potentially devastating newborn ocular condition.

In this podcast, we will cover the combined committee opinion from the ACOG and AUGS regarding asymptomatic microscopic hematuria in women. The ACOG deviates from the American Urological Association recommendation for evaluation of asymptomatic microscopic hematuria in women over age 35, as the risk of any urological malignancy is very low. Data taken from the ACOG committee opinion 703, June 2017...

In this brief historical profile, we will cover the inspiring tale of Dr. Ignaz Semmelweis. The story begins in the year 1846. Dr. Semmelweis was the first to investigate childbed fever and proposed handwashing as a way to prevent maternal death. His story is one of research, revelation, and an untimely tragic end.

In this podcast, we will review the new clinical expert series from the ACOG on marijuana use in pregnancy and while breast-feeding. This clinical expert series will be slated to be published in the November 2018 edition of Obstetrics & Gynecology (Metz et al).

A personal message regarding our last podcast to our listeners. 😁

This is a quick historical perspective of an ingenious approach to a deadly obstetrical problem in history. Dr. William Halstead, the father of modern surgery, is credited with performing the first blood transfusion following postpartum hemorrhage in the United States. However, it was British obstetrician James Blundell that first described blood transfusion to prevent death from postpartum bleedi...

Thrombocytopenia in pregnancy is defined as a maternal platelet count less than 150,000. In this podcast, we will review the ACOG practice bulletin number 166 reviewing gestational thrombocytopenia, as well as the two most common immune mediated thrombocytopenic conditions: ITP, and fetal-neonatal alloimmune thrombocytopenia.

There have been significant changes – and advancement – in the interparty management of the HIV infected patient. In this session, we will quickly review the intrapartum management of the HIV infected patient based on the IDSA guidelines.

Acute fatty liver of pregnancy is a rare but potentially life-threatening condition which usually presents in the 36th week of pregnancy. In this podcast we will cover the ACG (Am. Coll Gastro) clinical guidelines regarding acute fatty liver disease in pregnancy.

In this session, we will review the ACOG committee opinion on prevention of early onset GBS neonatal infection. This comes from the committee opinion 485.

Levonorgestrel and ulipristal are 2 oral emergency contraceptive options. Since 2010, pharmacokinetic studies have suggested a lower effectiveness of levonorgestrel in overweight and obese women. In this podcast, we will review the pharmacokinetic data as well as professional society opinions on this topic.

In this session, we will review the diagnostic criteria for premenstrual syndrome and premenstrual dysphoric disorder. Options for therapy will also be discussed. Data taken from the ACOG and the APA.

In this session, we will review and obstetrical emergency that has the potential to result in severe Ville and morbidity or even mortality… Umbilical cord prolapse.

In this session, we will review the ACOG practice bulletin (199) from September 2018 on the use of prophylactic antibiotics in labor and delivery. This podcast will cover the optimal dose of intravenous antibiotics before C-section, the use of vaginal cleansing, and the adjuvant use of Zithromax before cesarean birth. Care of the MRSA colonized patient, as well as infective endocarditis prophylaxi...

Ovarian vein thrombosis was recently the subject of a clinical review by the American College of OBGYN in November 2017. Ovarian vein thrombosis occurs in 1 and 600 to 1 in 2000 pregnancies and may have severe sequelae including pulmonary embolism. In this podcast, we will review the latest information from the ACOG and the ACCP on the pathophysiology, diagnosis, and treatment of ovarian vein thro...