Dr. Chapa’s OBGYN Clinical Pearls

Throughout their lifetime, over 50% of women experience uUTIs, with recurrent infection reported in approximately 30%. Today, on March 25, 2025, the FDA approved a new first-in-class oral antibiotic for uncomplicated UTIs in women! This is Blujepa! In this episode, we will review the EAGLE clinical trial data and review the main side effects reported in the study population. How does this new antibiotic work? Will it be approved for pregnancy? And, what other genital condition could it likely be approved for? Listen in for details!

Medicine has traditionally been practiced “in silos”. But compartmentalization of medical practice/interventions can leave gaps in patient care. Patients win when they have increased access to a variety of medical therapies or contraceptive options. In this episode, we will review a brand new publication (released ahead of print) from the AJOG. We've decided to call this episode, “Internists, IUDs, and Inspiration”. Listen in for details.

TWICE BEFORE, we have covered Pitocin use intrapartum: 1. On Oct 24, 2022 we covered, “Save the Pitcoin! Safe to Stop Pit Once in Active Phase?”, and 2. On Sept 24, 2024 we covered, “Labor Hacks: Pit Breaks”. Nonetheless, today's episode yet again focuses on pitocin in labor. On March 18, 2025, a new systematic review and meta-analysis was released ahead of print in the AJOG. This looks at cesarean delivery rates with discontinuation of pitocin in the active phase. Although the title of this new publication states, “Reduced risk of cesarean delivery with oxytocin discontinuation in active labor”, the devil is in the details! There's lots to review here, so listen in for details.

Fresh off the heels of our immediate last episode, we bring you a perspective from the trenches! Sarah, a Clinical Pearls podcast family member, is a health professional who works with autistic individuals. Sarah has provided clear and evidence-based data which helps to explain the rise of autism in the US over the last decades. Our podcast community is Incredible! Her noted and data driven perspective are the core concepts highlighted in this episode. Listen in for details.

Autism Spectrum Disorder (ASD) has an alarming trend of rise in the US. Currently, 1 in 36 (or 1 in 40 in some reports) have an ASD diagnosis. For this reason, ASD remains in the spotlight as researchers remain dedicated in explaining its origin. Over the last few years, there have been publications suggesting a link between one of the most common symptoms of pregnancy (nausea and/or nausea together with vomiting) and autism spectrum in the child. This is obviously a point of concern for those suffering with nausea slash vomiting in pregnancy. Is this association solid? What does the data show? It's controversial, but we will drive through it in this episode. PLUS, we will also highlight 2 recent publications (January 2025, February 2025 ) that provide some comfort for those suffering with these common symptoms. Listen in for details!

Fasting during the lunar month of Ramadan (Feb 28 to March 30, 2025) is a core practice for Muslims across the world. During Ramadan, Muslims abstain from food and drink from dawn to sunset. However, during a singleton pregnancy, the ACOG recommends adding approximately 340 extra calories per day in the second trimester and 450 extra calories per day in the third trimester. Does fasting during Ramadan have negative perinatal outcomes due to the potential caloric restriction? In this episode, we will highlight a Clinical Opinion publication from AJOG (June 2023) to examine the data.

Infants born by vaginal birth are exposed to maternal vaginal bacteria, which are one of the contributing influences on the subsequent development of the infant’s microbiome. This process is altered by cesarean delivery, which changes the initial microbiome of the neonate. It is theorized that infants born by cesarean delivery have an increased risk of chronic inflammatory conditions due to altered early-life microbiome colonization, with associated aberrant immune and metabolic development. Vaginal seeding is the practice of inoculating an infant born by cesarean section with a sampling of fluid, with the use of a guaze, from the vagina of the mother over the child’s face, mouth, and nares. This is performed to introduce the neonate to the mother’s vaginal flora for presumed better health outcomes. Although cautionary statements have been published about this practice, it remains very popular. In Feb 2025, a “viewpoint” was published in JAMA Pediatrics which has brough vaginal seeding back into the limelight. Does this work? What are the official statements about this from the ACOG and AAP? Is there a way to do this “safely”? We will cover this new publication, review the official professional society’s statements….and more, in this episode.

On Feb 24, 2025, the FDA granted approval for MIUDELLA®, a hormone-free, low-dose copper IUD developed by US manufacturer Sebela Women's Health Inc (Georgia) for contraceptive use in females of reproductive potential for up to 3 years. MIUDELLA® utilizes a small, flexible nitinol frame and contains less than half the copper of currently available copper IUD. Where have we seen nitinol before?? How does this compare with the traditional ParaGard IUD? Can this be used for emergency contraception? In this episode, we will review this novel design, low-dose copper IUD with a summary of its new published article released March 2025 (Contraception).

BV is a vaginal dysbiosis resulting from replacement of normal hydrogen peroxide and lactic-acid producing Lactobacillus species in the vagina with high concentrations of anaerobic bacteria. Recurrent BV can occur in 50-70% of women after an initial diagnosis. The concept of treating the male partner for BV recurrence prevention is not new, and the results have been conflicting. However, a new publication from Australia (released 03/5/25, in NEJM) has sparked new interest and new conversations about male partner BV therapy. Listen in for details!

Thank you to our GREAT podcast family members who fixed by history regarding "Hollyweird" ! And thank you DANNY Thomas for your legacy at SJCRH. Go Memphis!