Dr. Chapa’s OBGYN Clinical Pearls

Exploring the evolution of PROM terminology, controversies in diagnosis and management, pitfalls of relying solely on ROM tests, and the importance of using these tests correctly to prevent unnecessary interventions and adverse perinatal outcomes.

Some things in medical practice stem more out of tradition than true clinical evidence. Such is the case for histological examination of the placenta. When is pathological examination of the placenta actually helpful? Should we send of the placenta in cases of multifetal birth? What about meconium or chorioamnionitis? In the session, we will review a soon to be released clinical brief from Obstetrics and Gynecology (ACOG) coming out April 2022. This new evidence review questions our current clinical practice of routine placental histological evaluation.

Learn about the importance of universal screening for Hepatitis B in pregnancy and the use of antiviral medications to prevent mother to child transmission. Explore the new data soon-to-be released in the American Journal of OB/GYN and the SMFM guidelines for managing Hepatitis B viral infection during pregnancy.

Why is Magnesium Sulfate the first-line medication for preeclampsia/eclampsia? How did that arise into the current, international, standard-of-care regiment for that condition? Is 24 hours of Postpartum Mag evidence-based? In this episode we will review the evolution of magnesium sulfate for eclampsia prevention/treatment. We will also summarize a soon to be released systematic review and meta-analysis publication from Obstetrics & Gynecology examining the duration of postpartum MagSulfate use.

Pregnancies that arise after assisted reproductive technologies (ART) are at higher risk of maternal, fetal, and even placental complications. In this session we will summarize and highlight key prenatal management pearls for pregnancies that arise after ART. This is a summary of the SMFM consult series # 60, from March 2022.

Preeclampsia occurs in 3 to 5% of the general OB population. It has even higher prevalence among those with high-risk conditions. Currently, aspirin stands alone as the most evidence-based pharmacological option for preeclampsia prevention (risk reduction). But over the last decade new interest has arisen for the use of statins for preeclampsia prevention. Well, do statins work? What is the state of statin therapy as of 2022? In this session we will review the latest data and review the key pathogenesis in preeclampsia formation.

Couples trying to conceive often ask questions like these: When is the best time to have sex to get pregnant? Is there a better sexual position to have sex in order to conceive? Is one type of over the counter lubrication better than the other? Well despite weird myths and misperceptions about these subjects, there are firm answers we can give. In this podcast we will cover the January 2022 ASRM Bulletin on ways to “optimize natural fertility”.

Hydrotherapy (water immersion) has a proven safety record and proven benefits in the first stage of labor. But what about actually delivering with water immersion? In January 2022, the AAP released a Committee Opinion regarding water immersion delivery. The AAP echoes the words from the ACOG regarding water immersion births. However, the ACNM does not agree. In this session, we will review the established and conflicting viewpoints from these organizations regarding water immersion in labor and delivery.

The old adage, “Too much of anything is a bad thing”, is traditionally credited to Mark Twain. Was he right? Does the same apply to medical information?What about finding incidental genetic carrier states from online companies like “23AndMe”? In a patient with no personal or family history of any medical complication or malignancy, is this information helpful or more psychologically harmful? In this episode we will review a recent real-world case of how gynecological care was impacted by a patient’s curiosity regarding her genetic makeup.

Semen allergy is a real (although rare) immune reaction. Do you know what the presenting signs/symptoms are?The ISSM has established diagnostic criteria for this. In this session, we will review the diagnostic algorithm for a patient presenting with possible semen allergy.