Dr. Chapa’s OBGYN Clinical Pearls

A personal message regarding our last podcast to our listeners. 😁

This is a quick historical perspective of an ingenious approach to a deadly obstetrical problem in history. Dr. William Halstead, the father of modern surgery, is credited with performing the first blood transfusion following postpartum hemorrhage in the United States. However, it was British obstetrician James Blundell that first described blood transfusion to prevent death from postpartum bleeding. Let’s take a look at this amazing historical story.

Thrombocytopenia in pregnancy is defined as a maternal platelet count less than 150,000. In this podcast, we will review the ACOG practice bulletin number 166 reviewing gestational thrombocytopenia, as well as the two most common immune mediated thrombocytopenic conditions: ITP, and fetal-neonatal alloimmune thrombocytopenia.

There have been significant changes – and advancement – in the interparty management of the HIV infected patient. In this session, we will quickly review the intrapartum management of the HIV infected patient based on the IDSA guidelines.

Acute fatty liver of pregnancy is a rare but potentially life-threatening condition which usually presents in the 36th week of pregnancy. In this podcast we will cover the ACG (Am. Coll Gastro) clinical guidelines regarding acute fatty liver disease in pregnancy.

In this session, we will review the ACOG committee opinion on prevention of early onset GBS neonatal infection. This comes from the committee opinion 485.

Levonorgestrel and ulipristal are 2 oral emergency contraceptive options. Since 2010, pharmacokinetic studies have suggested a lower effectiveness of levonorgestrel in overweight and obese women. In this podcast, we will review the pharmacokinetic data as well as professional society opinions on this topic.

In this session, we will review the diagnostic criteria for premenstrual syndrome and premenstrual dysphoric disorder. Options for therapy will also be discussed. Data taken from the ACOG and the APA.

In this session, we will review and obstetrical emergency that has the potential to result in severe Ville and morbidity or even mortality… Umbilical cord prolapse.

In this session, we will review the ACOG practice bulletin (199) from September 2018 on the use of prophylactic antibiotics in labor and delivery. This podcast will cover the optimal dose of intravenous antibiotics before C-section, the use of vaginal cleansing, and the adjuvant use of Zithromax before cesarean birth. Care of the MRSA colonized patient, as well as infective endocarditis prophylaxis will be covered.