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Dr. Chapa’s Clinical Pearls.

Podcast Dr. Chapa’s Clinical Pearls.
Dr. Chapa’s Clinical Pearls
Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare...

Available Episodes

5 of 947
  • Excessive Maternal Wt Gain (gwg) = Stillbirth?
    One in five women in the U.S. have a BMI of 30 or more at the START of pregnancy. Around 1 in 5 women gain more than 40 pounds during pregnancy, which is more than any woman should gain. Only about one-third of women gain the recommended amount of weight during pregnancy. Gaining too much weight during pregnancy can increase the risk of HDP, GDM, fetal macrosomia, and can cause complications of birth, such as shoulder dystocia or preterm birth. Excessive weight gain during pregnancy can also increase the likelihood of postpartum weight retention. But what about stillbirth risk? Does excessive maternal weight gain during pregnancy increase still birth risk? The ACOG recommends antepartum fetal surveillance based on pre-pregnancy BMI. Why is maternal weight during pregnancy not an indication for an antepartum fetal surveillance? The data may surprise you! Listen in for details.
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    29:49
  • PUR and Peppermint Oil?
    Estimates of Postpartum Urinary Retention (PUR) incidence vary widely from 1.5% to 17.9%, with undiagnosed cases making the true incidence difficult to determine. A postvoid residual (PVR) volume of <150 mL is typically considered appropriate for normal bladder emptying, but this has been in the nonpregnant/non-postpartum population. In this group, some have proposed a PUR of up to 500ml as normal! That protocol, using the 500ml cut off, was just recently published in the J Matern Fetal Neonatal Med in Dec 2023. PUR is classified into 2 groups: overt (AKA symptomatic) and covert (asymptomatic) urinary retention; overt PUR traditionally has been defined as an inability to spontaneously void 4-6 h after vaginal delivery or the need for re-catheterization 4- 6 h after catheter removal following cesarean section. What’s the recommended plan of care after diagnosing PUR? Does bethanechol help? Can peppermint oil vapor help? Well…this is SOME data on this! Listen in for details.
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    34:50
  • PP Ibuprofen with HDP? “NEW info”.
    In 2013, The ACOG’s Hypertension Task Force suggested that NSAIDS not be used in postpartum patients with hypertensive disorders of pregnancy due to theoretical concerns on BP aggravation. But “medicine moves fast”. In 2020, the ACOG “green lighted” ibuprofen use postpartum in these patients if no evidence of renal insufficiency was present. In episode, we will review a brand-new publication (soon to come out), in AJOG, released ahead of print on February 10, 2025. This study is a randomized trial also evaluating the effect of ibuprofen on blood pressure control in those with hypertensive disorders of pregnancy. Did they find something new? This highlights the importance of going through an entire study’s materials and methods focusing on the years of patient recruitment to properly interpret results. Listen in for details!
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    23:48
  • The Survey Says....! (FULL EPISODE)
    (We were made aware that this original posting had the last section DROPPED accidentally)...here is the full episode! Ahhh...TECHNOLOGY! *This is why AI will likely replace our production team...Just kidding production team, just kidding).Episode Details:Well, we typically focus on ONE or maybe TWO publications to highlight and review. However, in this episode, which we have decided to call, “Survey said…!”, we will go through some common and REAL WORLD “mental battles”regarding what is and what is not part of a diagnostic criteria. These are every day OBGYN things that we KNOW, but when asked to define them…we can easily get ourselves confused. We are going to clear these up…Game Show style!  First, when only one abnormal value is found in the two-step, 100-gram GTT,  it is called borderline GDM, or impaired glucose tolerance. But what is it called when there is an abnormal (failed) 1-Hour 50 gram, but completely normal 3-Hr 100-gram GTT? Is this also called “impaired glucose tolerance”? We….the Survey Said…! (Yep, we’ll get to that). Secondly, does the criteria for Preeclampsia with Severe Criteria include platelets of 100,000 or not? The Survey Said…! (Yep, we’ll cover that). We will also review the numbers for MVP oligo, for a “normal” postmenopausal ES, and MORE! Listen in for details!
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    44:18
  • The Survey Says...! (PLEASE SEE UPDATED VERSION 2/11/25)
    Well, we typically focus on ONE or maybe TWO publications to highlight and review. However, in this episode, which we have decided to call, “Survey said…!”, we will go through some common and REAL WORLD “mental battles” regarding what is and what is not part of a diagnostic criteria. These are every day OBGYN things that we KNOW, but when asked to define them…we can easily get ourselves confused. We are going to clear these up…Game Show style! First, when only one abnormal value is found in the two-step, 100-gram GTT, it is called borderline GDM, or impaired glucose tolerance. But what is it called when there is an abnormal (failed) 1-Hour 50 gram, but completely normal 3-Hr 100-gram GTT? Is this also called “impaired glucose tolerance”? We….the Survey Said…! (Yep, we’ll get to that). Secondly, does the criteria for Preeclampsia with Severe Criteria include platelets of 100,000 or not? The Survey Said…! (Yep, we’ll cover that). We will also review the numbers for MVP oligo, for a “normal” postmenopausal ES, and MORE! Listen in for details!
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    34:08

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About Dr. Chapa’s Clinical Pearls.

Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare! This podcast is intended to be clinically relevant, engaging, and FUN, because medical education should NOT be boring! Welcome...to Clinical Pearls.
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