Dr. Chapa’s OBGYN Clinical Pearls

Exploring testing before combination birth control, debunking PCOS myths, and discussing acne treatment in women's healthcare. Delving into evidence-based weight loss meds and unnecessary invasive tests for birth control. Highlighting the link between PCOS, HCG, and pregnancy diagnosis, along with thorough medical investigations for PCOS confirmation. Addressing acne management guidelines for female patients.

The podcast discusses the updated USPSTF recommendations for breast cancer screening, controversy over the starting age, ACOG's response, and the shift towards breast awareness over self-exams. It also covers challenges related to dense breasts and debates over additional screening techniques.

The podcast discusses the updated criteria for diagnosing intra-amniotic infection by ACOG, highlighting the importance of accurate interpretation and prompt antibiotic treatment. It challenges the traditional requirement of fever as a diagnostic criterion and emphasizes the complexity of diagnosing intramniotic infection and maternal fever. The episode also explores recent guidelines on treating intramuniotic infections without fever, based on a Michigan study showing the presence of IAI in sepsis-related deaths even without fever.

Exploring regenerative medicine in gynecology, particularly platelet-rich plasma therapy. Discussing its applications in musculoskeletal pain disorders, gynecological conditions like POI and pelvic floor dysfunction. Highlighting controversies and the CDC investigation on cosmetic fascial. Delving into the potential of bone marrow transplants and the benefits of PRP in treating pelvic floor disorders.

FDA approved new oral antibiotic for UTIs in females, ACOG advisory on maternal cell-free fetal RHD testing, FDA clearance of digital app for postpartum depression (MAMMALIFT).

Dr Taylor Apley discusses menstrual synchronization, debunking myths around pheromones and biological signaling. They also explore the 'male effect' on menstruation and the impact of saying the 'Q' word in hospital settings, backed by surprising research findings.

The podcast explores new reassuring information from a recent publication regarding antenatal corticosteroids in late pre-term pregnancies. The discussion delves into the ALPS study, respiratory morbidity, neurodevelopmental outcomes, concerns about data loss, and revisions in clinical practice guidance.

Breast cancer is the second most common cancer among women in the United States (with skin cancer are the most common). About 9% of all new cases of breast cancer in the United States are found in women younger than 45 years of age. Unfortunately, breast cancer is being diagnosed in women under 40 at an increased rate. This was recently published in a Jan 2024 JAMA population-based, cross-sectional study using data from Surveillance, Epidemiology, and End Results database. Every year, more than 1,000 women under age 40 die from breast cancer. Nearly 80% of young women diagnosed with breast cancer find their breast abnormality themselves. Breast cancer is the most common form of cancer in women who are pregnant or have recently given birth. According to US statistics, Breast cancer occurs about once in every 3,000 pregnancies, with some reports stating it may be as high as 1 in 1,000. For those under the age of 40, most are diagnosed between the ages 32 to 38 years. Because many women are choosing to delay having children, it is likely that the number of new cases of breast cancer during pregnancy will increase. In this episode, we’re going to look at breast cancer in reproductive age women with a focus on gestational breast cancer. Is MMG contraindicated in pregnancy? Can chemotherapy be used during pregnancy? What about radiation therapy? And is it better to have a complete mastectomy or breast conservation, during pregnancy? Listen in for details.

Historically, colostrum was expressed by women mid- to late-pregnancy with the intent to avoid engorgement and breast trauma in the postnatal period, but it was not stored for use after birth. But storing colostrum antepartum for newborn feeding has gained attention in social media channels. Is antenatal milk expression, also called colostrum harvesting, evidence-based? Are there benefits to this? Does this run the risk of initiating labor? Are there published studies? In this episode, we will “milk” the data- including a RCT from 2023 – and present some key points to consider about what it is and what it isn’t.

From 2012 to 2021, congenital syphilis cases in the United States increased by 755%. According to the CDC, 88% of congenital syphilis cases in 2022 could have been prevented with timely screening and treatment. Despite repetitive messaging about the need to identify syphilis early in pregnancy, with appropriate treatment, gaps remain. A new publication in the Green Journal (4/17/24) provides shocking information about gaps in diagnosis and treatment. In this episode, we will review that original research as well as summarize the new ACOG Practice Advisory (April 2024) regarding screening for syphilis in pregnancy.