Dr. Chapa’s OBGYN Clinical Pearls

In this short session, we will cover recommended delivery times for women with chronic hypertension as well as breast-feeding on antihypertensive medications.

Chronic hypertension affects 3 to 5% of all pregnancies. In this session, we will cover the SMFM and ACOG bulletins on the subject. Which patients need treatment? What meds should be used? What are the risks of chronic hypertension in pregnancy? Answers to these questioms AND MORE will be covered.

In January 2018, the ACOG changed the terminology for PROM, now referred to as pre-labor rupture of membranes. In this session, we will review practice bulletin 188 and discuss the clinical management of both term and preterm PROM.

In this session, we will review the process of mammogenesis and lactogenesis as well as the process of lactation. Mastitis and breast abscess management will also be reviewed.

Fetal macrosomia predisposes both the mother and child to increased risks. In this review, a summary of the ACOG practice bulletin #173, we will review risk factors for fetal macrosomia, the diagnosis, and when a primary elective C-section should be considered for the condition.

This is part 2 of our series on maternal alloimmunization. In this session, we will review prevention of RH isoimmunization with a brief review on RhoGAM use according to the ACOG practice bulletin # 181.

In March 2018, the ACOG released an updated practice bulletin on the management of alloimmunization during pregnancy. The ability to determine genotype of an RH positive father and the use of middle cerebral artery Doppler ultrasound have revolutionized the care of alloimmunization. This is part one of a two-part series.

Multifetal gestations are either dizygotic or monozygotic. The rate of monozygotic twins tends to be constant worldwide. Twin and triplet pregnancies are at risk of certain maternal and fetal complications. In this session, we will cover the ACOG practice bulletin on multifetal gestations as well as the SMFM bulletin on the topic.

In this session we will cover general surgery comditiond in pregnancy. The three most common non-obstetrical surgical conditions in pregnancy are: appendicitis, gallbladder disease, and acute intestinal obstruction. In this session, we will cover the diagnostic evaluation and treatment of these non-obstetrical surgical conditions.

Cell free DNA screening evaluates short segments of DNA in a maternal serum and can be used to screen for fetal aneuploidy, fetal RH type, and sex chromosome abnormalities. In this session, we will review the data on cell free DNA screening from the ACOG practice bulletin number 163.