Dr. Chapa’s OBGYN Clinical Pearls

There continues to be a lot of faulty assumptions regarding testosterone therapy in women. In 2014 the Endocrine Society joined an international panel and provided an evidence-based review of testosterone use in women. This was reaffirmed in 2017 and 2019. Most recently, in October 2021, the ACOG released a “clinical commentary” ahead of print, “Testosterone Therapy in Women”. In the session, we will review this soon to be released current commentary and provide key clinical pearls regarding the use of testosterone replacement in women.

Sexual climax has been defined not only as a bodily/physiological reaction but as a mental process as well. First termed “the little death” historically, the phrase focused on the altered state of awareness following sexual release. But there’s many reasons/benefits why sexual release may be voluntarily delayed (by mutual agreement) during intimacy. In the session, we will approach the once taboo subject which has now gone mainstream. So let’s talk about “the edging experience” and what medical evidence there is to support it.

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.