Dr. Chapa’s Clinical Pearls.

Debate on universal screening for thrombophilia before OCPs, risks of clot formation, misconceptions about birth control pills, genotype analysis in thrombophilia screening, research on VTE risk with BC pills, increased risk with genetic factors and contraceptive use

Exploring the use of Metformin in pregnancy and its impact on childhood neurodevelopmental outcomes. Discussing the rising prevalence of Gestational Diabetes and the comparison between Metformin and Insulin for perinatal outcomes. Highlighting the findings of a recent study on Metformin's safety and effectiveness in pregnancy.

On this podcast, we have been following this story of the OPill for several months. Previous episodes on the subject can be found in our podcast library. As expected, this first ever daily use progestin only pill is now available over-the-counter in the US. 👏👏. On Wednesday, March 6, 2024, the ACOG released its Practice Advisory presenting some key reminders for clinicians regarding this new over-the-counter contraceptive option. In this episode, we will summarize this practice advisory and answer some real-world questions patients may have regarding this: does the OPill help with acne? Is this approved for endometriosis pain? What happens if a patient misses the next dose at the scheduled time? Listen in for these answers and more.

Explore the safety concerns of using GLP-1 agonists during pregnancy, the history of diabetes treatment from insulin to modern medications, and the limited data available on the impact of these medications on fetal development.

Delve into the history and modern usage of balloon catheters for labor induction. Explore the debate between single and double balloons, volume considerations, and traction effects. Learn about outpatient procedures, outcomes, and the combination of agents for optimal cervical ripening.

It’s very important to stay up-to-date and current with new data. But sometimes you read something that is hot-off-the press and it makes you just stop and say, “hmmm”. In this episode, we will discuss the new USPSTF position statement on screening/treating iron deficiency anemia in pregnancy. We will also review the ACOG August 2023 clinical consensus #4 regarding UTI in pregnancy. In doing so, we present 2 things that “make you go hmmm”.

Exploring the Parkland Management Protocol for GDM, immediate medication initiation based on 3-hour test results, relevance of fasting hyperglycemia as predictor for medication needs, outcomes of gestational diabetes management, individualized blood sugar targets, risks of fasting hyperglycemia, early medication initiation implications, conflicting study data on medication usage, mixed results of metformin therapy for GDM

Exploring the controversy surrounding RhoGAM administration to RH negative patients under 12 weeks gestational age. Insights into the shortage of RhoGAM and alternative products. Geographic disparities in access to blood products for RH factor in pregnancy. Debate on R-H-D testing and R-H-I-G administration in early pregnancies to prevent adverse outcomes.

Delving into the world of hypertension disorders in pregnancy, the podcast covers the latest AHA/ACC recommendations for managing Stage 1 hypertension in pregnancy. They discuss the necessity of medication, antepartum fetal surveillance, and the risks pregnant patients face. Exploring the role of biomarkers, aspirin usage for preventing preeclampsia, and trials testing aspirin effectiveness in high-risk pregnant women. The podcast also touches on the challenges of managing hypertension during pregnancy and the potential impact of biomarkers on patient outcomes.

Exploring new developments in Hyperemesis Gravidarum (HG), including the discovery of 2 protein markers and the potential for a genetic test. The podcast also covers advancements in understanding the condition, electrolyte management, and various treatment options, highlighting the complexities and importance of accurate diagnosis and treatment.