Dr. Chapa’s Clinical Pearls.

Dr. Leslie Clark delves into the importance and effectiveness of biophysical profiles in antepartum fetal surveillance. The discussion covers misconceptions, predictive value, and comparison of tests. Exploring criteria for fetal well-being, the session clarifies the role of various methods in assessing fetal movements and fluid levels. Understanding the interpretation of fetal surveillance data and the significance of not overlooking high scores are key takeaways from the podcast.

In this session I am joined by one of our upper level (Senior) wonderful residents, Dr. Catherine Jimenez. Dr. Jimenez and I recorded this as an impromptu podcast covering antepartum fetal surveillance. Does maternal eating actually affect fetal movement? Do kick counts really work to prevent fetal morbidity? We will cover these questions, and more, in this episode (Part 1).

Here’s a question for you: would you rather have motivation, or inspiration? Used interchangeably in common dialogue, the two can actually be polar opposites. This is a brief review of the power of inspiration, not just in our daily work, but in living life overall. Taken from psychological studies and CBT, this session will hopefully INSPIRE you in your daily life. Choose inspiration over motivation!

PTSD has come a long way from its original designation as “shellshock”relating to veterans of war. PTSD is also possible following childbirth, even in otherwise “uncomplicated” Labor And Delivery events. Childbirth-related PTSD has been historically overlooked. In this session we will summarize the DSM5 criteria for this condition in order to better recognize and diagnose the condition.

In this session we wrap up our discussion of emergency contraception. Is there a preferred option for those with larger BMIs? What if the patient has emesis after a dose of oral EC? We will summarize the evidence/data here.

Despite its use for decades, misinformation and misperceptions about emergency contraception still persist. Are all options the same? What is their efficacy? Does bodyweight affect EC’s ability to prevent pregnancy? And what about medical contraindications to birth control use? In the session, which is Part 1, we will dive into the facts regarding emergency contraception.

The US is ranked 65th among industrialized nations for maternal morbidity and mortality outcomes. That is unacceptable! Maternal levels of care initially began in Texas. Now, there is a plan to make this nationwide. With the goal of reducing maternal mortality and morbidity in the United States, ACOG has partnered with The Joint Commission on the development of a new Maternal Levels of Care (MLC) Verification program, effective January 1, 2022. This session, we will review what this program will look like as well as its primary goal.

Available mAbs are directed against a large number of antigens and used for the treatment of immunologic diseases, reversal of drug effects, and cancer therapy. Now of course they are also being used against COVID-19. As these are IgG based, is the use of monoclonal antibodies allowed in pregnancy? What is the ACOG/SMFM position statement? In this session, we will review the latest data regarding monoclonal antibody use in the OB patient.

Tranexamic Acid’s use in obstetrics skyrocketed in 2017 after the release of the WOMEN trial. At that time, the ACOG endorsed TXA for use with diagnosed PPH, not for its prevention. Does TXA prophylaxis reduce postpartum hemorrhage? Does it matter whether it is used at vaginal birth or cesarean? Data moves fast and we will highlight those new answers here.

(Part 2) In this session, we will wrap up our summary review of the ACOG September 2021 Clinical Consensus bulletin on postpartum pain management. What are “ultra rapid metabolizers” of opioid medication? How does that affect our prescriptions for postpartum pain control? In this session we will answer these questions and more! ⚕️⚕️⚕️⚕️