Dr. Chapa’s OBGYN Clinical Pearls

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Immediate postpartum LARCs are endorsed by the ACOG. This podcast will summarize the ACOG committee opinion 670, and review the new data (October 2018) regarding IUD expulsion rates based on timing of insertion, route of delivery, and IUD types.

This podcast will quickly summarize the ACOG practice bulletin number 201 on pre-gestational diabetes mellitus. This ACOG practice bulletin is set to be released December 2018.

Traditionally, a well-woman visit has included a pelvic examination defined as external genitalia inspection, speculum examination, and bimanual exam. However, the collective body of evidence is actually limited in support or rejection of the routine performance of the pelvic exam in an asymptomatic woman. This podcast will cover the ACOG committee opinion number 754 from the Fall of 2018 discussing the matter.

Endometriosis related pelvic pain affects approximately 8% of reproductive age women. Recently, the FDA approved a new oral GnRH antagonist for treatment of endometriosis related pelvic pain. This podcast will review the indication, data, and dosage options for this new novel medication. This podcast does not represent a specific endorsement of elagolix, and was produced without industry affiliation.

Traditionally, migraines with aura were considered contraindicated for estrogen containing birth control. However, that recommendation was made in the 1960s and 1970s when the dose of estrogen in birth control pills was much higher than dosages used today. The risk of stroke is directly related to the amount of estrogen in birth control, and recent clinical opinions have suggested that ultra-low dose combination contraception is allowable. In this podcast, we will review the latest data and clinical opinions regarding the use of estrogen-containing birth control in patients with migraine with aura.

Neonatal opthalmia refers to conjunctivitis of any cause occurring within the first 4 weeks of newborn life. Gonorrhea now accounts for less than 1% of the condition, however chlamydia is responsible for 2% to 40% of cases. Ocular prophylaxis is not effective against chlamydial conjunctivitis. In this podcast we will review this potentially devastating newborn ocular condition.

In this podcast, we will cover the combined committee opinion from the ACOG and AUGS regarding asymptomatic microscopic hematuria in women. The ACOG deviates from the American Urological Association recommendation for evaluation of asymptomatic microscopic hematuria in women over age 35, as the risk of any urological malignancy is very low. Data taken from the ACOG committee opinion 703, June 2017.

In this brief historical profile, we will cover the inspiring tale of Dr. Ignaz Semmelweis. The story begins in the year 1846. Dr. Semmelweis was the first to investigate childbed fever and proposed handwashing as a way to prevent maternal death. His story is one of research, revelation, and an untimely tragic end.

In this podcast, we will review the new clinical expert series from the ACOG on marijuana use in pregnancy and while breast-feeding. This clinical expert series will be slated to be published in the November 2018 edition of Obstetrics & Gynecology (Metz et al).