Dr. Chapa’s Clinical Pearls.

Discover the surprising connection between sleep positions and stillbirth risk during pregnancy. Recent studies show conflicting data about the impact of how a mother sleeps. While some suggest there's no link, other research highlights the importance of sleeping on your side as pregnancy progresses. Delve into the timeline of research from 2011 to now, and learn why the starting position can be crucial for fetal safety. It's a fascinating exploration that sheds light on pregnancy outcomes beyond just sleep habits.

Internal manual aortic compression is a procedure that may be used intraoperatively in the management of massive pelvic bleeding. But what about EXTERNAL aortic compression? In February’s 2025 AJOG (Grey Journal), under their Surgeon’s Corner section, there will be a very nice video recap of an easy to adopt maneuver which may “buy time” in OB hemorrhage cases as surgical intervention is being planned. This is called the EAC maneuver. First described in 1994, this technique has regained the spotlight as rates of PPH have been on the rise. How is EAC done? Does it work? If so, why is this not part of the OB Hemorrhage bundle? Listen in for details.

Discover the groundbreaking potential of menstrual blood-derived mesenchymal stem cells (MenSCs). Learn how researchers are exploring their uses in diverse medical conditions from Alzheimer’s to infertility. The podcast tackles the challenges of collecting these stem cells non-invasively, while also critiquing the hype surrounding regenerative medicine. Engaging insights discuss regulatory hurdles and the importance of rigorous scientific evidence to legitimize stem cell therapies. Could there be a miracle cure hidden in menstruation? Tune in for this fascinating conversation!

Tachycardia in pregnancy is more common than you might think, but distinguishing between normal and concerning cases can be tricky. Recent research has clarified heart rate limits during pregnancy, unraveling when further evaluation is essential. The conversation dives into vital guidelines and studies surrounding maternal tachycardia. Discover the real increase in heart rate during pregnancy, and what to do when it spikes unexpectedly. Understanding these nuances could lead to better outcomes for both mothers and their babies!

Stillbirth rates in the U.S. are alarmingly high, showing a need for urgent reform. The podcast highlights comparisons with countries like Japan, the UK, and Australia, where effective prevention bundles have been implemented. It underscores the emotional toll on families and advocates for a national strategy to combat stillbirths, detailing systematic approaches that include smoking cessation and fetal monitoring. Recent legislative advancements and education are also examined as critical steps toward reducing these tragic losses.

Guillain-Barré syndrome (GBS) is a rare disorder that causes muscle weakness and sometimes paralysis. It's caused by the body's immune system damaging nerves. While most cases are triggered by respiratory or gastrointestinal infections, vaccinations have also been linked to GBS pathogenesis. GBS can last from weeks to years, but most people start to recover within a few weeks. The earlier symptoms improve, the better the outlook. Physical therapy is important to prevent muscle contractures and deformities. Some people may experience long-term weakness, numbness, fatigue, or pain. A small percentage of people with GBS may have a relapse, which can cause muscle weakness years after symptoms end. On Jan 7, 2025, the FDA required and approved UPDATED safety labeling changes to the Prescribing Information for Abrysvo (Respiratory Syncytial Virus Vaccine) manufactured by Pfizer Inc. and Arexvy (Respiratory Syncytial Virus Vaccine, Adjuvanted) manufactured by GlaxoSmithKline Biologicals. Specifically, FDA has required each manufacturer to include a new warning about the risk for Guillain-Barré syndrome (GBS) following administration of their Respiratory Syncytial Virus (RSV) vaccine. Who is most at risk for GBS? Where pregnant women affected? This is important information….listen in for details.

Sometimes you read a new study and you just have to say, "You Don't Say?!" In this episode, we will highlight 2 publications which were released Dec 26. 2024 and Jan 6, 2025 which make you say just that. This is a brief, fun, YET STILL EDUCATIONAL, episode...Listen in for details.

In this episode, we will cover 2 topics: the first is brand new in print (01/06/2025 ), and the second is just weird. In the “new” portion we'll summarize a new randomized study published in JAMA Network dealing with gestational diabetes. Should we add glyburide to metformin for GDM control? Listen in for details. In the second portion, we'll focus on unilateral ovarian absence not related to previous removal. Yep! This is why it's very important to check the adnexa at “routine” C-section or “routine” gynecological surgery. It is possible to be missing an ovary…and its weird! Listen in for details!

The podcast dives into the complexities of delivering preterm infants, especially in the critical periviable window. It examines the latest guidelines on mode of delivery, questioning if cesarean or vaginal birth affects neonatal outcomes. The discussion highlights the high risks involved for infants born at 22 to 24 weeks, comparing survival rates and resuscitation strategies. There's a particular focus on the implications of breech presentations versus vertex births, emphasizing the importance of informed decision-making for expecting mothers.

In most regions of the United States, RSV season starts in the fall and peaks in the winter. In September 2023, the ACOG released a Practice Advisory recommending a single dose of Pfizer’s RSV vaccine (Abrysvo) for eligible pregnant individuals between 32 0/7 and 36 6/7 weeks of gestation who do not have a planned delivery within 2 weeks, using seasonal administration, to prevent RSV lower respiratory tract infection (LRTI) in infants. This is recommended from September to January. Currently, the US recommendation is for this to be given once, with subsequent deliveries receiving neonatal Beyfortus in RSV season. The recommendation from NICE is to have this vaccination with every pregnancy. The prescribing information for Abrysvo includes a warning to inform patients that a numerical imbalance in preterm births in Abrysvo recipients (5.7%) occurred compared to those who received placebo (4.7%). This imbalance was only seen in trial participants residing in low- to middle-income countries with no temporal association to vaccination or association with other adverse events in the mother or the newborn. Now, that phase 3 clinical data has gone through peer review and is a new publication. This is the MATISSE global study and will be officially published in the Green Journal February 2025…but we will summarize the results NOW in this episode! Listen in for details.