Dr. Chapa’s Clinical Pearls.

One of the most common techniques to assess fetal status intrapartum is the fetal scalp stimulation test. First proposed in 1936, its incorporation in modern obstetric practice is still evident. However, there are some common misapplications and misunderstandings of this intervention. Does fetal scalp stimulation help resolve a fetal deceleration? Or could it be potentially harmful? In this podcast we will set the record straight to prevent misuse of the fetal scalp stimulation test. Thank you Abby for the podcast topic and bringing this to my attention.

In this session, we will continue our brief summary of the NAMS 2022 clinical update on hormone therapy. Is hormone therapy allowed in patients with known BRCA genetic mutations? Is Bazedoxifene safe? What about vaginal estrogen therapy? We will answer these questions and more in this session.

Medical information moves fast. We know a lot more about risks and benefits of hormone therapy since the impactful WHI study was first released. In this session we will review important new concepts from the NAMS Hormone Therapy update just released Summer of 2022. Is it safe to continue hormone therapy beyond the age of 65? Is “lowest dose for shortest duration” still a valid concept? We will tackle this question and more in this session!

For several years, data has validated the value of water immersion during labor (1st stage). However, when it comes to the 2nd stage of labor, the AAP and the ACOG are unified in their positions which is at odds with the ACNM. But what does the new data support? In this session we will cover a new systematic review and meta-analysis from BMJ Open which was published July 2022. Let’s set the record straight on water immersion during the first and second stages of labor.

Sleep disruption and poor sleep quality are not unusual during pregnancy. That’s obvious! What’s not so obvious is whether a common over-the-counter sleep agent, melatonin, is safe to use during pregnancy or not. While traditionally, options like diphenhydramine and doxylamine have been used as sleep aids during pregnancy, up to 4% of women (reportedly) use this over-the-counter supplement during gestation. What does the data say? Let’s address this common supplement use…now.

Lots of practical clinical pearls in this episode! “Reverse sequence testing” for syphilis has largely taken over the traditional testing algorithm. Traditionally, non-Treponemal tests (RPR, VDRL) were done first with a reflex to a Treponema specific test if that was positive (MHATP). But this is now considered the antiquated technique. Reverse sequence testing has the advantage of potentially identifying infected patients very early on. In this session, we will give easy to use/practical tools for reverse sequence test interpretation, and how to best manage “discordant“ results.

Discover the truth behind emergency contraception and the misconceptions surrounding Ella. The discussion clears up how ulipristal acetate works to prevent ovulation without affecting implantation. The conversation emphasizes the significance of accurate information for women's health and the potential implications of misinformation. Tune in for a thought-provoking examination of emergency contraception and its role in reproductive healthcare.

On June 16, 2022, the ACOG released a new practice advisory regarding PreP in the ObGyn patient population. This has important implications on how we counsel patients especially after recent STI diagnosis. In this podcast we will cover important aspects of PreP to get you comfortable with this preventative option. What are the 3 currently approved options? Are they safe? What about monitoring? Do adolescent patients qualify? We will answer all of these questions and more in this session.

We have come a long way from the first report from Stein and Leventhal describing “polycystic ovaries“ on ultrasound in infertile women back in the 1950s. We already well understand that PCOS raises the risk of certain antepartum complications including gestational diabetes, possible macrosomia, and the development of gestational hypertension or preeclampsia. But there actually is scant data on the risk of acute peripartum complications. In this podcast we will summarize a large study just published June 16, 2022 out of the Journal of AHA. We will also cover the importance of distinguishing between “Odds Ratios” and “absolute numbers” for clinical implications. Ready? Let’s dive into acute PeriPartum risks for women with PCOS.

Well…so there’s this. 😳😳😳