Dr. Chapa’s Clinical Pearls.

As of December 23, 2021 the FDA has granted Emergency Use Authorization to 2 different oral medications (Pfizer; Merck) in the fight against Covid-19. Do you know the differences between PAXLOVID and molnupiravir (LAGEVRIO)? What are their indications for use? Are both allowable in pregnancy? This information is “hot off the press” and will update you on these 2 new, novel therapies.

In our previous podcast, we stated that – due to lack of data – early cord clamping may be considered with nonvigorous neonates. However, the babies that may benefit the most (preterm or extremely pre-term) are often “nonvigorous” at birth. So how do we reconcile this issue? This podcast will answer this dilemma, summarizing points from the January 2022 CME publication on “Placental Transfusion of the Neonate“.

There are 3 umbilical cord management strategies at time of delivery: (1) Early cord clamping, (2) Delayed clamping, and (3) Cord milking. How long should umbilical cord clamping be delayed? Is cord milking beneficial or potentially harmful? Are you familiar with the contraindications to delayed umbilical cord clamping? In this session, we will review this soon to be released CME article from Obstetrics & Gynecology (The Green Journal) covering “placental transfusion of the neonate”.

The clinical gold standard for the diagnosis of ruptured membranes is the sterile speculum examination (SSE). Tests like Amnisure or ROM+ are considered ancillary and supplemental. What is best clinical practice for performing a SSE? In the session we will review this procedure, discuss ancillary testing, and answer the age-old-question… “To lube or not to lube”.

Postpartum neuropathies are an infrequent occurrence but can significantly impact a patient’s quality of life. Are you familiar with “strawberry picker’s” neuropathy? It is the most common type of nerve injury during vaginal delivery. In the session, we will review safe maternal positioning during vaginal delivery.

New onset hypertension in the postpartum period should be assumed to be preeclampsia until proven otherwise. Up to 26% of eclamptic seizures occur beyond 48 hours and as late as 4-6 weeks after delivery. However, most of eclamptic seizures occur within the first 7 days after birth. In this session, we will review the recently updated CMQCC healthcare provider toolkit focusing on delayed postpartum hypertension/eclampsia. We will also point out a frequently forgotten fact about a potential risk of methyldopa use in the postpartum interval.

Thanksgiving 2021 is upon us! However, did you know that mental health experts make the very important distinction between gratefulness, thankfulness, and gratitude? While being thankful is important, it is much more vital to live in a state of Gratitude. In this session, I am joined by Lisa Chapa (LCSW). We will explore this concept and the Science of Gratitude.

(Introducing Dr. Garrett Dunn as guest resident on today’s episode!) The CDC estimates that more than 1.1 million people in the US are living with HIV infection, and 1 of 7 individuals is unaware of their infection. HIV care has come a long way over the years. In this episode, we will review QUICK FACTS from the SMFM on HIV care during pregnancy. Data summarized is from the last SMFM update on HIV care in pregnancy (Checklist data).

How do you diagnose vaginitis? Do you treat BV/yeast/trichomoniasis found on Pap smear? Do you use the Wet Prep, or molecular/DNA test? An ePub recently released in Obstetrics and Gynecology (the Green Journal), revealed some disappointing results for the Wet Prep. In the session, we will summarize key points from this article, as well as remind all of us of some key information released by the ACOG in January 2020 regarding vaginitis in the non-pregnant patient.

This session is a follow-up to our immediate pest episode. Are there any evidence-based true alternatives to the 50 g screening test for GDM? What about hemoglobin A-1 C? What about home blood glucose monitoring? Let’s dive into the data and see. We will also introduce you to… “Chapa chocolates”. 😳😊😆