Dr. Chapa’s Clinical Pearls.

Progesterone has long been hoped to be a remedy for 1st trimester pregnancy loss. Does progesterone help reduce miscarriage risk? The data is ever evolving. In this session we will review 2 landmark studies that helped answer this question (PROMISE, PRISM). We will also cover a 2020 Cochran systematic review that helped change the 2021 NICE practice guidelines on the subject. Lastly, we will also cover the latest data on this from May 2022 (ACOG ACM).

Oh, the twisted love story of progesterone and pre-term birth! Ever since the Meis trial in 2003, we have been fascinated with the use of progesterone as a possible cure-all of all things preterm birth. But the data keeps piling in, with results just contrary to that. In this episode we will review the publication history of progesterone and it’s fight against PTB. We will also highlight a new publication from the AJOG coming out September 1, 2022 analyzing vaginal progesterone’s effectiveness against PTB. Does it work? Let’s find out.

In 1949, Priscilla White published her landmark study on diabetes in pregnancy, launching the “White Classification”. This has been a staple of pre-pregnancy diabetes nomenclature since that time. However, despite its historical role in obstetrics, is this scale still relevant? In this episode we will review the history, definitions of, and proposed alternative nomenclature to the traditional White Classification.

Epilepsy/seizure disorders disproportionately affects women of reproductive age over men. The influence of sex hormones on seizure prevalence is well documented. As women’s healthcare providers, it’s vital for us to understand the influence of seizure disorders on women’s overall care. In this session, we will review important aspects regarding contraception and review the data on pregnancy outcomes in women with epilepsy.

There are so many things to go over with our pregnant patients especially at their initial intake visit. However, one thing that should not be left off that discussion list includes food items to avoid! Listeriosis during pregnancy can be devastating for the fetus. Are you familiar with the work up and CDC recommended treatment for this condition? In this episode we will present an easy to remember protocol for managing patients with a possible exposure to listeria monocytogenes.

I’ll let this episode title speak for itself… LOL. Hope this makes you smile.

Endometriosis is a devastating condition. Once thought to have its impact only during reproductive age, endometriosis has been linked to an increased risk of stroke later in life. Any new medication which shows safety and efficacy in menstrual pain reduction is welcome in this space. In this session we will review a new FDA approval of an existing medication in the battle against endometriosis. (Special guest co-host, Kacie Mitchell, 3rd medical student)

The discussion focuses on the evolving standards for magnesium sulfate in fetal neuroprotection. It highlights the necessity for updated guidelines in light of recent data regarding neonatal viability. Listeners explore the controversial consideration of administering magnesium sulfate at just 22 weeks. The podcast provides a comprehensive timeline of research findings from 2017 to the present, shedding light on how practices are changing in obstetrical care.

Over the last several years, the “limit of viability” for neonates has decreased dramatically. The new “lower limit” of neonatal viability can now be considered to be as early as 22 gestational weeks. But there’s a lot more to that statement! In this session, we will review the latest data on neonatal survival in the Periviable interval. We will highlight and summarize a new publication from the Lancet published on July 25, 2022. Should we be performing “universal resuscitation” at 22 weeks? Or should we take a more “selective” approach? Let’s summarize the latest data.

Polyhydramnios affects from 0.2 to 2% of all pregnancies. Which is preferred for diagnosis, MVP or AFI? Is amnioreduction an effective intervention? When is indomethacin indicated? In the session we will dive into the issue of polyhydramnios, its workup, and delivery implications.