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Dr. Chapa’s Clinical Pearls.
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Dr. Chapa’s Clinical Pearls.

Author: Dr. Chapa’s Clinical Pearls

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Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare! This podcast is intended to be clinically relevant, engaging, and FUN, because medical education should NOT be boring! Welcome...to Clinical Pearls.
446 Episodes
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There is a whirlwind of false/misleading information on social media regarding the COVID-19 vaccines. Some social media posts state that breast-feeding should be STOPPED after this vaccine. Is that evidence-based? What does the Academy of Breast-Feeding Medicine recommend? In this session, we will review a recent report from JAMA Pediatrics (July 2021) which provides some much needed clarification on breast-feeding after COVID-19 (mRNA) vaccination.
Our understanding of Intrahepatic Cholestasis of Pregnancy has changed just over the last 5 years. What is the best laboratory test to help diagnose this condition? At what level of total serum bile acids is the risk of fetal death greatest? What does the SMFM say about induction of labor for these patients? In this episode, we will highlight and summarize the latest clinical brief on ICP from the SMFM (2021). This is SMFM consult series # 53.
In this session, we will wrap up our summary review of the ABOG MOC article. What is the most predictive ultrasound marker for torsion? Are most affected organs anterior, posterior, or lateral of the uterus? Let’s find out these answers and more!
Adnexal torsion can present in women of all ages but is most likely to occur during the reproductive years. Is removal of a torsed adnexa considered first line? What side is ovarian torsion most likely to occur? In this session, which is Part 1, we will begin our summary of the ABOG MOC (2021) Gynecology article by Moro et al.
Why we do this!

Why we do this!

2021-07-1201:30

Thank you for sharing your message! And, most importantly, congratulations on your board certification! Hope this makes someone else smile, as it did for me.
Atypical Breast Hyperplasia may present either as Atypical Ductal Hyperplasia or Atypical Lobular Hyperplasia. Which of these two is considered the more “pre-malignant”? Is surgical excision necessary for all atypical breast hyperplasia? Who qualifies for tamoxifen? And, how does breast tomosynthesis fit into the management scheme? We will dive into these questions and more in this session.
Correction of iron deficiency anemia in pregnancy is not just about fixing a low “H & H”. Iron deficiency during pregnancy is associated with real adverse maternal and neonatal outcomes. What is the best way to take oral iron supplementation? What about IV iron? Does “intramuscular” iron injection have a place in practice? Let’s cover these questions and more in this session.
Nifedipine is one of the most common medications used for tocolysis. However, does it actually improve neonatal outcomes? What about tocolysis in general? In this session we will review a new randomized trial from Parkland, published in July 2021 in Obstetrics Gynecology (Green Journal).
According to the latest US Census Bureau report analyzing the use of languages in the United States, over 20% of Americans speak a language other than English at home. Of this population, greater than 24% report that they do not speak English well or do not speak English at all. With a US population of more than 300 million, this makes over 70 million people with limited English proficiency. In this session, we will review best practices for using medical translation with our patients and why using family members as “ad hoc translators“ can land us in hot water (aqua caliente!)
Our understanding of gestational diabetes has changed over the last two decades, and more changes are sure to come! The traditional screen between 24 to 28 weeks may actually be too late. Enter the “GO MOMs” study. This NIH study, starting now, aims to answer the persistent unknowns regarding maternal blood levels during gestation. Listen to how this remarkable study may impact our screening, diagnosis, and management of gestational diabetes in the very near future.
LEEP or CKC? Part 2

LEEP or CKC? Part 2

2021-06-2010:32

Welcome back! In this session, we will review the contraindications for LEEP and the specific indications for CKC.
In 2019, the ASCCP made some impactful changes to the management algorithm for cervical dysplasia. Why was the treatment algorithm divided between those under the age of 25 years and those over 25 years of age? When is observation without excision preferred? And, what’s the best way to perform surveillance after an excision procedure? In this session, which is Part 1, we will review the guidelines related to surgical excision of high-grade dysplasia.
Cesarean section is the most common laparotomy performed worldwide. So, you would think we would have a standardized way of closing the uterine incision. But we don’t! What does the data say about single layer hysterotomy closure compared to two layer closure? Is one really better for TOLAC? Is one associated with more complications than the other? The answer is a little bit more complicated than you think. In this session, we will review the aggregate data on this persistent debate.
I love how our medical community can come together to discuss and brainstorm on better ways to care for our patients. Last night I received a message from Allison, from Chicago. Thanks Allison! She had a question regarding our recent RLS podcast and the potential role for magnesium supplementation for the condition. Is magnesium an effective treatment choice for RLS? Let’s review that data now.
Welcome to Part 2! In this session we will complete our discussion of RLS in Pregnancy and review its workup and management strategies.
Restless Leg Syndrome (RLS), now often referred to as Willis–Ekbom Disease (WED), is a common sensorimotor disturbance much more prevalent in women and during pregnancy. Do you know the potential pathophysiological tie between pregnancy and this condition? What are RLS symptoms? What about treatment? Let’s dive into this very common, yet largely overlooked, issue in the session.
The FDA has approved Brexafemme, an antifungal drug, for treating vaginal yeast infections. The drug represents the first new antifungal drug class in 20 years. How does this new medication work? and What's the dose? Does this work for recurrent vaginal cases? Please note that there are also some cautionary items that WE MUST address here... Lets cover that now!
PROM complicates 8% of term pregnancies, approximately 270,000 births in the US annually. In this session, we summarize and review a June 2021 Systematic Review/Meta-Analysis (of RCTs) where an intracervical balloon catheter was compared with a pharmacologic agent for the induction of labor after PROM,including preterm PROM.
Hepatitis C is the most commonly reported bloodborne infection in the United States. The ACOG is updating its Hepatitis C screening guidance regrading pregnancy. In this session, we will review the May 2021 ACOG Practice Advisory regarding hepatitis see screening in pregnancy.
The Obese CS Patient

The Obese CS Patient

2021-05-2615:17

The ACOG will release a new Practice Bulletin in June 2021 discussing obesity in pregnancy. The prevalence of obesity in reproductive age women in the United States is 39.7% In this session we will review some key practical issues regarding cesarean sections in the obese patient. Is one type of skin closure better than the other? What is the optimal VTE pharmacological protocol? Tune in and see!
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