Dr. Chapa’s OBGYN Clinical Pearls

The use of fertility drugs that may cause alterations in endogenous hormones and multiple ovulations has raised concerns about the long-term safety of such medications. One concern is that are invasive ovarian cancer. Is this concern evidence-based? In this session, we will review the ASRM Practice Guideline on the subject (2016), as well as a more recent updated ASCO/ESHRE review from 2018.

Amniotic fluid embolism is a rare but potentially lethal condition. Because of the rarity of this condition, most physicians and institutions have limited experience with the management of amniotic fluid embolism. The typical presentation of AFE includes a triad: sudden hypoxia hypotension, and coagulopathy. In this podcast, we will cover the latest data from the SMFM, ACOG, and AHA on this terrifying condition.

Serum uric acid levels are often ordered for the evaluation of hypertensive disorders of pregnancy. But why is this done? Is this test able to guide clinical management? A staple of PIH evaluation in the 1970s and 1980s, uric acid levels are still around. In this session, we will review why uric acid determinations for hypertensive disorders of pregnancy is not clinically useful – in general. Reference: Sept 2019 ACOG publication, “Questioning Clinical Practice”; Obstet Gynecol.

Yes...it’s a real diagnosis. Sexual headaches may be PRIMARY (without other etiology) or secondary (due to a more serious issue). Primary sexual headaches are divided into 2 types: orgasmic, and pre-orgasmic. In this episode, we will review the data from the International Headache Association regarding sex headaches.

If you have never heard the story of Julie Moss (1982), start listening to this episode! This is an example of not just being interested in a project/work activity/hobby, but is an example of being PASSIONATELY committed. Let’s quickly review her story, now.

Surgery for biliary tract disease is among the top 3 reasons for non-obstetrical surgery during pregnancy (1:1500 to 1:10,000 pregnancies). What is the data on ERCP during pregnancy? Is radiation exposure a concern? What does ACOG recommend regarding intraoperative fetal monitoring? In this podcast, we will cover the ACOG, and AGA recommendations for this procedure in pregnancy.

💥Hurricanes💥! No… Not the traditional and historic drink from New Orleans! 🍹🍹We’re talking about the intense, devastating, natural weather phenomena⚡️⚡️🌊💨🌪. We are in hurricane season! Do hurricanes cause women to enter labor, or affect pregnancy outcome? Is it an “old wives tale”, or is it true? Let’s examine the evidence....now.

Stillbirth is a pervasive problem worldwide. Maternal perception of reduced fetal movement has been identified as a potential strategy for stillbirth prevention. But is the strategy evidence-based? In this episode, we will review the 2018 randomized trial, the AFFIRM study (Lancet).

Vaginal steaming has become a cult phenomenon since 2010. But this “alternative“ practice has some real potential risks. Where did this even come from? Why is it done? And what are the potential morbidities? This podcast will cover these questions, as well as a recent (August 2019) case report highlighting the harms of this practice.

Because of the increased risk for breast cancer, BRCA mutation carriers may have concerns about taking oral contraceptives or using hormone replacement therapy after a premenopausal prophylactic bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes). Here, we review the current literature about hormone use by BRCA mutation carriers.