Dr. Chapa’s OBGYN Clinical Pearls

I love how our medical community can come together to discuss and brainstorm on better ways to care for our patients. Last night I received a message from Allison, from Chicago. Thanks Allison! She had a question regarding our recent RLS podcast and the potential role for magnesium supplementation for the condition. Is magnesium an effective treatment choice for RLS? Let’s review that data now.

Welcome to Part 2! In this session we will complete our discussion of RLS in Pregnancy and review its workup and management strategies.

Restless Leg Syndrome (RLS), now often referred to as Willis–Ekbom Disease (WED), is a common sensorimotor disturbance much more prevalent in women and during pregnancy. Do you know the potential pathophysiological tie between pregnancy and this condition? What are RLS symptoms? What about treatment? Let’s dive into this very common, yet largely overlooked, issue in the session.

The FDA has approved Brexafemme, an antifungal drug, for treating vaginal yeast infections. The drug represents the first new antifungal drug class in 20 years. How does this new medication work? and What's the dose? Does this work for recurrent vaginal cases? Please note that there are also some cautionary items that WE MUST address here... Lets cover that now!

PROM complicates 8% of term pregnancies, approximately 270,000 births in the US annually. In this session, we summarize and review a June 2021 Systematic Review/Meta-Analysis (of RCTs) where an intracervical balloon catheter was compared with a pharmacologic agent for the induction of labor after PROM,including preterm PROM.

Hepatitis C is the most commonly reported bloodborne infection in the United States. The ACOG is updating its Hepatitis C screening guidance regrading pregnancy. In this session, we will review the May 2021 ACOG Practice Advisory regarding hepatitis see screening in pregnancy.

The ACOG will release a new Practice Bulletin in June 2021 discussing obesity in pregnancy. The prevalence of obesity in reproductive age women in the United States is 39.7% In this session we will review some key practical issues regarding cesarean sections in the obese patient. Is one type of skin closure better than the other? What is the optimal VTE pharmacological protocol? Tune in and see!

The information in this section will shake your foundation regarding what you had previously been told about the origins of preeclampsia. Is the placenta the villain or the victim? This is Part 2 of our Myth-Busting Preeclampsia Episode. We will review the maternal cardiovascular changes that actually PRE-EXIST the development of preeclampsia.

The pathophysiology of preeclampsia continues to be discovered. For decades, the placenta has been portrayed as the “villain“ in the preeclampsia saga. But is it? Evolving data is putting that into question and is eliminating previously held concepts previously thought to be true. In this episode we will myth-bust some long-standing beliefs regarding preeclampsia.

Is the high dose Pitocin protocol (6 mU/min) associated with increased C-sections for fetal distress? What about perinatal outcomes? There are a variety of Pitocin protocols in L&D units across the country. In this episode, we will review a soon to be released publication out of Obstetrics and Gynecology. We will summarize an RCT comparing high-dose versus low-dose Oxytocin for labor augmentation in nulliparous women.