Dr. Chapa’s Clinical Pearls.

Algorithms and opinions on cervical cancer screening change quickly. In this session, we will review the uses for HPV testing as a primary screening tool as well as post treatment surveillance. Are you familiar with which HPV tests can be used as primary screening? What is the frequency of tests? Let’s cover this now.

In this session, we will pick up where we left off with our immediate past podcast covering the SMFM “Choosing Wisely” recommendations. When should we screen for MTHFR for adverse pregnancy outcomes? When should we start screening for FGR with Umbilical Dopplers? We’ll answer these questions and much more in this session as we wrap up the SMFM “don’t do” list.

Sometimes what sounds good in clinical practice actually is not evidence-based. In March 2021, the SMFM updated the “Choosing Wisely”list of practices/recommendations for OB care. Should routine screening for microdeletions be done? What about serum screening for preterm labor? In this session we will cover the most recent 5 “don’t do“ items released by SMFM.

In the era of social media and easy to spread public opinion platforms, misinformation can grow rampant. Is the Covid vaccine associated with infertility in the general population? Where did this idea come from? What is “Syncytin-1” and how is this related to this controversy? Here we will review the origin of this story, any theoretical basis for the claims, and the conclusions from the CDC, FDA, and multiple professional societies regarding this.

What are the delivery recommendations for pregnant Covid patients? When is expectant management favored compared with elective delivery? Is mechanical ventilation alone an indication for delivery? This is our second session in which we will wrap up our summary of the SMFM updated treatment guidelines for pregnant Covid patients (February 2021).

COVID-19 management guidelines change quickly. In this session we will review the February 2021 SMFM update regarding when to consider inpatient care for COVID-19 in pregnancy. Do you know which 02 saturation categorizes severe compared to moderate disease? What dose of dexamethasone is recommended for pregnant Covid patients that require oxygen? Is outpatient anticoagulation recommended? We will cover these and more in this session! (Source: SMFM COVID-19 in pregnancy guidance February 2021).

In February 2021, the ACOG will release a new committee opinion (818) updating guidelines on “medically indicated late preterm and early term deliveries”. Are steroids still recommended in this preterm interval? How has new data on fetal morbidity with intrauterine growth restriction and intrahepatic cholestasis affected these guidelines? Listen… And find out!

Historically, brachial plexus palsy was considered proof of shoulder dystocia or traumatic birth. Can brachial plexus injuries occur with normal, uneventful deliveries? Do brachial plexus palsies happen even at C-section? The answer may surprise you. In this episode, we will review the different types of brachial plexus injuries and review the most recent data on the pathophysiology of these nerve conditions. Reference: Johnson et al. Obstetrics and Gynecology, October 2020,

There have been a variety of published and accepted clinical presentations of COVID-19: from lack of taste, GI disturbances, muscle aches, to the usual fever and shortness of breath. But this COVID-19 affect a woman’s menstrual cycle? There is increased chatter on the ever accurate Internet regarding this. But is there data? In this session we will go over the possible association between COVID-19 and irregular cycles.

Are you still treating urogenital gonorrhea with ceftriaxone and azithromycin? That was a standard for over a decade. But things have now changed. In December 2020, the CDC updated the treatment regimen for urogenital infections with neisseria gonorrhea. Is “dual-agent” still a therapy? Does cefixime still have a treatment role? What about test of cure? We will cover these questions and more in the session.