Dr. Chapa’s OBGYN Clinical Pearls

Given the known benefits to BMZ for preterm infants and the difficulty in predicting which women will actually deliver preterm, it is common for providers to administer antenatal corticosteroids in an effort not to miss the opportunity to give them before delivery and to try and get the maximal time benefit. However, many of these babies will be born at term. Do these term born babies benefit or experience adverse outcomes after steroid exposure? In this session, we will review an article that is published ahead of print from the AJOG. The results may surprise you. (Reference: McKinzie, A., et al. Are Newborn Outcomes Different for Term Babies Who Were Exposed to Antenatal Corticosteroids? AJOG 2021)

Sex can fulfill the human psychological needs of connectedness as well as the physical needs of intimacy. Being alone and lonely can cause major health and psychological problems for many. Is there data that sexual frustration impairs well-being? This session will review this often controversial subject as well as summarize an eye-opening study previously published from Carnegie Mellon describing state of happiness based on frequent of sex.

In this session we wrap up our review of Adenomyosis. Are you familiar with the MUSA ultrasound criteria? What is the role of MRI in the diagnosis of Adenomyosis? And is there a role for hysteroscopic diagnosis? Let’s wrap up our discussion on Adenomyosis now.

Historically, Adenomyosis was a pathological diagnosis only. However, new imaging standards/techniques have moved Adeno into a clinical diagnosis. Is there a patient risk profile for this condition? Is this strictly a gynecological issue or is there adverse perinatal outcomes as well? Welcome to Part 1 of Adenomyosis where we will answer these questions and more.

OB Patients admitted with medical or obstetrical complications to an antepartum hospital unit face separation from loved ones, stress from their diagnosis, face isolation, and are prone to develop perinatal mood disorders. In this episode, we will review a soon to be released publication from the Green Journal (May 2021) addressing this under diagnosed and under recognized issue.

On April 12, 2021, Illinois agreed to provide Medicaid benefits to eligible mothers for up to 12 months postpartum, a major extension from the previous 60-day limit. Follow up of postpartum women for 12 months after delivery is gaining favor as data is evolving which shows that “the 4th trimester” (the first 12 weeks postpartum) is just not long enough to detect postpartum complications. In this episode we will review a new editorial which states that “the 4th trimester” is not long enough.

We often encounter the acutely agitated patient. Acute agitation may be from and uncontrolled medical condition, psychiatric condition, or illicit substance induced. The acutely agitated patient is also at increased risk of some prenatal complications. In this session we will review the evidence-based protocols for management of the acutely agitated OB patient.

The ACOG has stated that caffeine consumption in pregnancy should be limited to 200 mg/day. However, a new study published on March 25, 2021 in JAMA Network Open is questioning that recommendation. In this study, we will review this longitudinal cohort publication stating that “there may be no safe limit to caffeine consumption”.

The CDC released a health alert through its Health Alert Network on April 13, 2021, notifying physicians and other health care practitioners that the CDC and FDA are reviewing data involving six U.S. cases of a rare type of blood clot in individuals after receiving the Johnson & Johnson COVID-19 vaccine. In this session, we will review what CVST is, how it can present, the work-up, and potential treatment options. Do you give heparin for this? What is a correlation with thrombocytopenia? This is a vital summary of data that all healthcare practitioners should know.

The field of obstetrics was “birthed“ out of midwifery. The concept of second stage of labor in the lithotomy position was not how it was “always done”. In this episode we will review the evidence behind the “flexible sacral positions” and learn how maternal positional changes can assist with the labor process.