Dr. Chapa’s OBGYN Clinical Pearls

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 dose combination contraception is allowable. In this podcast, we will review the latest data and clinical opinions regarding the use of estrogen-containing birth control in patients with migraine with aura.

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 bleeding. Let’s take a look at this amazing historical story.

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.