Dr. Chapa’s Clinical Pearls.

Historically, colostrum was expressed by women mid- to late-pregnancy with the intent to avoid engorgement and breast trauma in the postnatal period, but it was not stored for use after birth. But storing colostrum antepartum for newborn feeding has gained attention in social media channels. Is antenatal milk expression, also called colostrum harvesting, evidence-based? Are there benefits to this? Does this run the risk of initiating labor? Are there published studies? In this episode, we will “milk” the data- including a RCT from 2023 – and present some key points to consider about what it is and what it isn’t.

From 2012 to 2021, congenital syphilis cases in the United States increased by 755%. According to the CDC, 88% of congenital syphilis cases in 2022 could have been prevented with timely screening and treatment. Despite repetitive messaging about the need to identify syphilis early in pregnancy, with appropriate treatment, gaps remain. A new publication in the Green Journal (4/17/24) provides shocking information about gaps in diagnosis and treatment. In this episode, we will review that original research as well as summarize the new ACOG Practice Advisory (April 2024) regarding screening for syphilis in pregnancy.

Debate on prescribing testosterone to women for menopause symptoms, rise in testosterone prescriptions, controversy in medical community, evolution of terminology for female sexual disorders, analysis of DHEA and testosterone use in different age groups, understanding testosterone levels and sexual interest in women, exploring long-term testosterone use and ACOG's recommendations

Exploring the impacts of postpartum anemia on maternal health and bonding, the podcast delves into the benefits of IV iron for asymptomatic anemia. Discussions include the correlation between antepartum severe anemia and PPH, along with practical protocols for managing postpartum anemia effectively.

Exploring the debate on using amnioinfusion in cases of suspected infection during labor, assessing risks and benefits, and examining its role in preventing meconium aspiration syndrome. Delving into clinical insights and controversies surrounding the use of amnioinfusion in obstetrics, particularly in cases of recurrent variable decelerations and intra-amniotic infection.

The podcast explores the controversy around acetaminophen use in pregnancy and its alleged association with autism. It discusses the conflicting data and expert opinions over the years, culminating in a recent study of 2.4 million children that found no increased risk of neurodevelopmental issues. The episode also touches on other factors linked to autism, such as labor epidurals, emphasizing the importance of evidence-based medicine.

It has been stated that “Trauma is in the eye of the beholder”. Healthcare providers must be aware that a woman makes experience a birth as traumatic, even if she and her infant are healthy. The ACOG has highlighted perinatal PTSD in several publications, which we will review in this episode. Perinatal PTSD has definitely been in the OB/GYN and psychology literature with an increased frequency just over the last 3 months. In this episode, we will review the very real and devastating condition of perinatal PTSD, its diagnosis, and discuss interventions to reduce its development. We will also review new data on “service dogs“ detecting PTSD in people with trauma histories? NOTE: We will also highlight a real world account of a traumatic birth event from one of our podcast listeners (Deidentified, and shared with permission).

Exploring the application of the Rule of 55 in managing hypertensive disorders of pregnancy, validation of a medication tailoring model for hypertension, diving into the PYTT study on hyperdynamic and non-hyperdynamic blood pressure models in pregnancy, discussing evidence-based practice and controversies around amniotic infusions, and emphasizing the importance of tailored medication for pregnant women based on individual blood pressure dynamics.

On April 8, 2024, parts of the United States will be within the Path of Totality for the total solar eclipse. The state of Texas has already declared a state of emergency as visitors flock to the state to witness the event. This is a fascinating celestial occurrence that is not scheduled to happen again until August 2044. Does the eclipse have a negative effect on pregnancy? Do lunar cycles affect birth rates? What does the data say? Does NASA have a statement on this? And what are neutrinos?! Listen in… And find out. 🌖🌗🌑

The podcast delves into the recent FDA approval of a biomarker test for preeclampsia risk in pregnant women with hypertension. It discusses the significance of biomarkers like plGF and sFLT1 and their predictive value for severe preeclampsia. The update provides insights on interpreting the FDA-approved test and addresses cultural beliefs in pregnancy assessment, emphasizing the complementary role of risk stratification tools in diagnosis.