Best Dr. Chapa Podcasts (2024)

1
Random Questions: Specific Answers! 37:01

1h ago37:01

37:01

Welcome to this episode of "Random Questions: Specific Answers"! In this episode we will (surprise) answer random questions- with specific answers- from our podcast family members: 1. Can administration of IV Calcium at intrapartum CS reduce QBL?, 2. What are the 4 classes of CS performance urgency? and 3. If a normal MVP for amniotic fluid is 2-8c…

1
The REFEREE: MORE SSRI and PTB Info (Sept 2024) 16:45

1h ago16:45

16:45

on 09/02/2024, we released an episode called, "Do SSRIs Raise PTB Risk?". In that episode, we highlighted a new publication from the AJOG (August 30. 2024) which indicated that SSRIs may raise PTB risk. This is in contrast to a separate cohort study released Feb 2024. This is a classic case of "He Said, She Said". But now we have a REFEREE on the f…

1
Failure Rates S/P Tubal Sterilization: NOT What we Thought. 34:59

1d ago34:59

34:59

Tubal sterilization goes back to the 1880s. The first collaborative review of sterilization effectiveness was the CREST study published in 1996 in the AJOG. But that was with prior sterilization techniques. As a way to update the data researchers looked at the national survey for family growth (NSFG) from 2002 to 2015 to determine failure rates aft…

1
Do SSRIs Raise PTB Risk? 40:17

1h ago40:17

40:17

Depressive disorders during pregnancy are common, with estimated prevalence ranging from 11% to 16%. Accordingly, antidepressant drugs, most commonly selective serotonin reuptake inhibitors (SSRI), are used by approximately 3–4% of pregnant women worldwide, with a higher prevalence in the United States compared to Europe. As antidepressants cross t…

1
OROPOUCHE! 32:10

1h ago32:10

32:10

Just when we thought we had put coronavirus in our rearview mirror for the most part, here comes mPOX again. We covered that in a previous episode. Unfortunately, that is not the only pathogen to be concerned about. Enter: OROPOUCHE VIRUS (OROV). This virus was first reported in 1955, but it is making news today due to a rapid increase in cases. Co…

1
“New” Info on PCOS: Name Change? OB Implications? 31:06

8m ago31:06

31:06

Polycystic ovary syndrome (PCOS) was first described in 1935 by Irving Freiler Stein and Michael Leo Leventhal at the Central Association of Obstetricians and Gynecologists. Since that time, it has gone through several name changes: Stein-Leventhal syndrome, PCOD, and currently PCOS. Nonetheless, proponents and scientists are still recommending yet…

1
BRAND NEW Lexicon for 1st Trimester US (08/27/24)! 27:18

2h ago27:18

27:18

Our immediate past episode focused on the “C-section scar pregnancy”. In that episode we discussed the ultrasound markers of early pregnancy (first trimester). Now – today – HOT 🔥🔥OFF THE PRESS- is a new publication in the AJOG, which is “A Lexicon For First Trimester US: Society of Radiologists in Ultrasound Consensus Conference Recommendations“. …

51
CS Scar Pregnancy 48:52

3d ago48:52

48:52

Cesarean scar pregnancy (CSP) occurs when an early pregnancy implants on the cesarean scar defect (CSD), myometrial tissue previously disrupted by cesarean delivery. The first case of CSP was reported in 1978 in a patient with a previous cesarean section (CS) who had heavy bleeding and abdominal pain after uterine curettage for a suspected miscarri…

1
Make it TIGHT! 😳 41:33

1d ago41:33

41:33

(DISCLOSURE: Sexual Content) Back in April 2023, we released an episode on the “Jade Vaginal Egg” and vaginal weights for vaginal tightening. While we tackled the Jade Egg successfully, we now have a new player on the field: the VAGINAL TIGHTENING STICK. This over the counter “sex aid” can lead to chemical burns and severe vaginal dryness/agglutina…

1
Series 5: Creating Safe Spaces Via ADR: How can Employees in the US Report Discrimination, Harassment & Bullying without fear of losing their jobs with Ed Watt 27:35

5d ago27:35

27:35

I was privileged to engage in a stimulating and thought-provoking conversation with Ed Watt on Expert Views on ADR (EVA) Vid/Podcast Show. He started his forty (40) year career in transportation as a front-line worker at the New York City Transit Authority (NYCTA). He rose to the position of Financial Secretary of the largest transit local in North…

1
The “Broken” IUD: Detection and Clinical Management 32:02

1h ago32:02

32:02

The IUD is a very safe and supremely effective contraceptive method. Given its increasing rate of use, practitioners are bound to see its relatively infrequent complications with greater regularity. Typical complications are considered “lost strings“, uterine perforation at placement, and expulsion. But there is another complication, device FRACTUR…

1
Umbilical Cord Gases: What, Why, When? 46:16

3d ago46:16

46:16

In 1958, James et al. first described umbilical cord blood gas analysis to evaluate the fetus's metabolic condition at the time of delivery. It's recommended by both the British and American Colleges of Obstetrics and Gynecology for all high-risk deliveries. Cord blood gas provides the most accurate and objective evidence of fetal acidosis at the t…

1
FDA HPV Self-Swab Ready Aug 15, '24: NOT FOR HOME (Listen for Details) 22:15

1h ago22:15

22:15

According to the National Institutes of Health, almost 13,000 women in the United States are diagnosed with cervical cancer each year, resulting in around 4,000 deaths, with most of the deaths occurring among under-screened women. Now, there is potentially a barrier-breaker. As of August 15, 2024, self-collection kits for cervical cancer screening …

1
NEW Syphilis At-Home Test: Promises and Problems 32:30

1h ago32:30

32:30

The rise of home testing for STIs/HIV started long before the recent pandemic (the FDA approved its first HIV home test collection kit way back in 1996), but COVID-19 seems to have accelerated the popularity of getting tested from the comfort of our homes. In Nov 2023, the Food and Drug Administration granted marketing authorization, the first of i…

1
2024 UPDATE: Mpox in Pregnancy 41:32

6d ago41:32

41:32

The World Health Organization declared on 8/14/24 that the increasing spread of Mpox in Africa is a global health emergency, warning the virus might ultimately spill across international borders. Mpox, also known as monkeypox, was first identified by scientists in 1958 when there were outbreaks of a “pox-like” disease in monkeys. Until recently, mo…

1
Boar’s Head, Listeria, and Pregnancy 43:18

2h ago43:18

43:18

On July 26, 2024, Boar’s Head issued its recall of 7 million pounds of ready-to-eat meat and poultry products that might be contaminated with the potential harmful bacteria, listeria. Sporadic listeria outbreaks are nothing new; in June 2024, chicken-based products were recalled for the same concern in Canada. The US recall includes more than 70 pr…

1
New Way to Reduce HDFN?: Enter, Nipocalimab 35:23

22d ago35:23

35:23

Our tagline, “Medicine moves fast“, is the absolute truth! Historically, identification of fetuses at risk of hemolytic disease of the fetus/newborn (HDFN) required amniocentesis for determination of the Delta OD450, Liley Curve. This was the first screen, which would then trigger cordocentesis for determination of the fetal hematocrit. We’ve now m…

1
We’re Here to Help: When Guardianship Goes Wrong with Author ‘Diane Dimond’- Can ADR Help? 30:19

3d ago30:19

30:19

I was privileged to engage in a stimulating and thought-provoking conversation with Diane Dimond, a multiple award-winning freelance journalist, author, syndicated columnist, and former television correspondent who specialises in crime and justice issues, on Expert Views on ADR (EVA) Vid / Podcast Show. She wears many hats, so I have left the link …

1
The Return to LT-O-Whole Blood (LTOWB) for OB Transfusion 39:51

6d ago39:51

39:51

Prior to the 1970s, when component therapy became the preferred method of resuscitation, whole blood (WB) was the resuscitative medium of choice for hemorrhagic shock. In modern medicine, sometimes it turns out that the old way is better than the new…and using whole blood for transfusions is one example. Research is emerging that shows whole blood …

1
2024 CDC MEC UPDATE! HOT OFF THE PRESS! 51:05

5d ago51:05

51:05

MEC CHANGES ARE HERE! During January 2022, the CDC held virtual scoping meetings that included 27 participants with expertise in contraception, adolescent health, and thrombosis, as well as representatives from partner organizations, to solicit their individual input on the scope for updating both the 2016 U.S. MEC. The 27 invited participants repr…

1
New Non-Estrogen Medication for Hot Flashes? Veozah's Competitor 24:04

27d ago24:04

24:04

In May 2023, the FDA approved fezolinetant (Veozah), an oral medication that's the first neurokinin 3 (NK3) receptor antagonist to treat moderate to severe hot flashes caused by menopause. Now, a separate oral medication which blocks the NK 1 and 3 receptor iis on the scene. Although not yet FDA approved, the published phase 1, 2, and 3 data make t…

1
Antepartum AI for Stillbirth Prevention 35:37

1M ago35:37

35:37

Artificial Intelligence (AI) has arrived. Machine Learningis a form of AI which is being investigated/used for improving maternal outcomes. The UK has already launched the TOMMY APP (through the RCOG) for use to reduce PTB and stillbirths in the UK. In this episode we will highlight a new systematic review which assessed Machine Learning’s ability …

1
Maternal Obesity and SUID: New Data 33:54

1M ago33:54

33:54

We all are aware that multiple adverse obstetrical outcomes have been linked to maternal obesity, such as stillbirth, preterm birth, NICUs admission, and congenital anomalies. But once delivery and hospital discharge occurs uneventfully, a new cohort study is raising the alarm for another possible adverse event up until the child’s first year of li…

1
Dispute Resolution | John Jay College of Criminal Justice- City University New York (CUNY); Dispute Resolution Program & Center with Director Prof Maria R. Volpe PhD 28:57

15d ago28:57

28:57

I was privileged to engage in a stimulating and thought-provoking podcast with Professor Maria R. Volpe, PhD, on Expert Views on ADR (EVA) Vid / Podcast Show. She is a professor of Sociology, Director of the Dispute Resolution Program at John Jay College of Criminal Justice - City University of New York, and Director of the CUNY Dispute Resolution …

1
NEW Clinical Practice Update (Aug 2024) 16:56

1M ago16:56

16:56

Our immediate past episode summarized a validation study of cell-free DNA (cfDNA) isolated from maternal plasma for fetal RBC genotyping in alloimmunized patients. And now, in this episode, we will highlight a BRAND NEW ACOG Clinical Practice Update on this very subject! YEP... we now have new ACOG guidance regarding using maternal derived cfDNA fo…

1
cfDNA Fetal RBC Genotyping in Alloimmunized Pregnancies: July 2024 NEW DATA 23:19

17d ago23:19

23:19

In September 2022, a cell-free DNA assay using next-generation sequencing and quantitative counting tech for fetal antigen status determination became clinically available in the USA. This allowed maternal screening for fetal RBC genotypes for RH negative patients. This test was recognized by thre ACOG in March 2024 as one option to “triage” anti-D…

1
Skyrocketing Sex Strangulation Rates: The Alert 45:15

26d ago45:15

45:15

First off, let’s all agree that everyone has a different STYLE of sexual intimacy, and that’s OK. Yep, we all understand that there's always been a lot of sexual act “diversity” in the world… and throughout history. But there is a more recent trend that has increased in popularity, some surveys attribute it to its representation in pornography, tha…

1
Candida as IAI & Perinatal Sepsis? YES. 38:50

1M ago38:50

38:50

Candida in women is being right? Afterall, vulvovaginal candidiasis during pregnancy is common. Candida species may be isolated from the vagina of 15 %-21% of nonpregnant women; this rate increases to 30% during pregnancy. While it is generally benign and isolated to the vagina clinically, some Candida species have the capacity to be troublemakers.…

1
The New PreTRM Biomarker Test 41:05

1M ago41:05

41:05

Biomarker testing has arrived in Obstetrics. Of course, we have been using some biomarkers for years, like PAMG1 (Amnisure) and AFP+ILGFBP1 (ROM Plus) for ROM evaluation. In May 2023, the FDA cleared Thermo Fisher Scientific's maternal serum biomarker test for prediction of preeclampsia with severe features in hospitalized patients (and we have a p…

1
Sequential CX Ripening: Which Should Be First? 45:52

1M ago45:52

45:52

Published studies, including 2 large network meta-analyses, support the safety and efficacy of misoprostol (PG E1) when used for cervical ripening and labor induction. Based on cumulative data, misoprostol administered vaginally at doses of 50 μg has the highest probability of achieving vaginal delivery within 24 hours. Prostaglandin E2 also has pr…

1
Latent TB Treatment in OB 40:08

26d ago40:08

40:08

Tuberculosis (TB) was historically called "consumption" due to the dramatic weight loss and wasting away experienced by patients. The modern name "tuberculosis" was first published by J. L. Schönlein in 1832. Today, between 3% and 5% of the U.S. population are estimated to be living with latent TB infection. Contrast that with the worldwide statist…

1
Previable and Periviable PPROM (NEW SMFM CS #71) 51:46

28d ago51:46

51:46

Approximately 0.5% of all births occur before the 3rd trimester of pregnancy, and very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. Preterm prelabor rupture of membranes (PPROM) is a known risk factor for preterm birth and is responsible for 30–40% of preterm deliveries. While PROM occurs around 8% …

1
Toxic Tampons?! 34:26

2M ago34:26

34:26

Researchers estimate that more than 100 million women in over 120 countries use tampons during their menstrual cycle. Tampons are generally considered safe and healthy menstrual products. However, a new study conducted by researchers at the UC Berkeley School of Public Health has identified the presence of 16 different heavy metals in tampons from …

1
Does Summer Heat Imprint Childhood Cancer In-Utero? 42:24

2M ago42:24

42:24

It's Summer…and its getting HOT in here! Although the effect of heatwaves in pregnancy has been studied various times, the data remains limited because these studies are observational, with very heterogenous populations, so its hard to prove causation between heat exposure and adverse outcomes. Nonetheless, these associations are indeed concerning.…

1
New Fast Track Designation for ENDO DX tool 29:51

1M ago29:51

29:51

Up to 1 in 10 reproductive-aged women are impacted by endometriosis. Dysmenorrhea is the most common pelvic complaint of adolescents. While most cases of primary dysmenorrhea in adolescents will be primary dysmenorrhea, Endo remains a possibility especially after 2-3 years of progressive symptoms. Although the true prevalence of endometriosis in ad…

1
Well, That's Interesting...Say Whaaaat? 23:28

1M ago23:28

23:28

Well, sometimes the "traditional", evidence-based recommendations don't have the desired result they are supposed to. When the "usual and standard" ways of doing things fail, its time for "shared-decision making"! In this episode, we will highlight, and give KUDDOS, to an OB care team who exampled thinking outside-the-box in order to care for an ac…

1
New Data (July 8, 2024) for Maternal RSV Vaccine 39:23

2M ago39:23

39:23

RSV season is just around the corner (Fall and Winter months). Newborns are 16x more likely to be hospitalized with serious RSV lung infection than the flu. On August 21, 2023, the FDA approved the first RSV vaccine, Abrysvo, for use in pregnant individuals to protect newborns and infants against severe RSV disease in the first 6 months after birth…

1
A Beginner’s Guide to Early Dispute Resolution (EDR) with Co-Chair Ellie Vilendrer 33:56

1M ago33:56

33:56

I was privileged to engage in a stimulating and thought-provoking podcast session with Ellie Vilendrer on Expert Views on ADR (EVA) Vid /Podcast Show. She is the Co-Chair of the Early Dispute Resolution (EDR) committee (2020-2024) of the American Bar Association (ABA) Dispute Resolution Section and Vice Chair of the Orange County Bar Association Le…

1
Is Risk-Reducing OS for Ov Ca Overrated? 47:21

2M ago47:21

47:21

A substantial collection of evidence indicates that the fallopian tube serves as the primary site of origin for a large portion of high-grade serous ovarian cancers. As a result, clinical practice guidelines (including from the ACOG) recommend salpingectomy for permanent contraception- when necessary- rather than simple tubal ligation. But an Augus…

1
SAB: Which Genetic Test is Which, and When? 36:57

2M ago36:57

36:57

Approximately 20% to 25% of pregnancies end in miscarriage, and there are many medical reasons why it may occur. About half are caused by chromosome aneuploidy. However, less than 5% of women will experience a second first trimester loss, and less than 1% will experience three early losses. The incidence of early spontaneous pregnancy loss increase…

1
Do Fireworks Harm a Pregnancy? 17:24

2M ago17:24

17:24

Happy Independence Day, America! We hope you are enjoying this wonderful, national holiday. Yep...Its a PARTY in the USA! In light of the festivities, here's a clinical question for us: Do fireworks affect the fetus? Even broader than that, do loud sounds in general affect the developing child? The answer is both YES and NO. Listen in to this short…

1
Adolescents in the ED Need BC! 26:42

2M ago26:42

26:42

(Here’s a WONDERFUL QI Project for this New Residency Academic Year) With 70.8% of pregnancies among adolescents being unintended, there is a clear need for increased access to contraceptive services. Many adolescents use the emergency department (ED) as their primary healthcare source, highlighting the importance of providing comprehensive sexual …

1
Fear the 37.5-37.9 °C Temp with PROM? 36:21

2M ago36:21

36:21

PROM occurs in approximately 10% of pregnancies and leads to a risk of IAI in women that is 3 times higher than that in non-PROM women. The risk of early-onset sepsis of neonates born to mothers exposed to PROM is 20 times higher than in non-PROM mothers. An increasing time period with PROM increases the risk of infection for both mothers and newbo…

1
THANK YOU (for Daniel and Isaac) 5:33

2M ago5:33

5:33

Podcast Family, I hope this episode gives you pause and brightens your day 🌞. Just a quick work and acknowledgement to likley our YOUNGEST podcast family member and his mother, a Co-OBGYN preparing for oral Boards. 👏👏 Let this speak to you as the message spoke to me! (and introducing callmestevieray & Connor Price, whose words/song- “GRATEFUL”- al…

1
Do OCPS Cause Hypothyroidism? 34:54

2M ago34:54

34:54

Oral Hormonal contraception gets the blame for a lot ofthings, including the development of hypothyroidism. Hypothyroidism is one of the most common endocrine disorders affecting 5 to 10 times more women thanmen, and its prevalence increases with age. This association of OCPs with hypothyroidism comes from a controversial article in BMJ published i…

1
Episode 57: ADR and Arbitration: a UK Perspective with Ijeoma Ononogbu, FCIArb 28:54

2M ago28:54

28:54

I was privileged to engage in a stimulating and thought-provoking podcast session with Ijeoma Ononogbu on Expert Views on ADR (EVA) Vid /Podcast Show. Ms Ononogbu has over fifteen (15) years of international legal experience from working with international law firms in London as a solicitor, specialising in commercial transactions and ADR processes…

1
PROM: Pit or Cytotec? 23:32

2M ago23:32

23:32

Podcast Fam, on March 27, 2024 our episode was called "Balloon for PROM: Yea or Nay". Although mechanical cervical balloons for induction were the focus, we also discussed which medication is better (based on published data) for labor induction after PROM. Well, in this episode, we pick up from March with ANOTHER NEW STUDY released today (June 25, …

1
Maternal Stress & The Fetal Brain 33:31

2M ago33:31

33:31

Anxiety disorders are the most common mental health issue in the United States, affecting nearly 1 in 5 adults, or 40 million people. Another 19 million adults – 8% of the population – has depression. Prenatal mood disturbances are known to affect the fetal brain, and endocrine system. Left amygdalar volumes were smaller in newborns whose mothers h…

1
OB EPO Use & Blood Salvage at CS (IOCS) 41:26

2M ago41:26

41:26

Respect for patient autonomy is a fundamental part of the clinician-patient relationship and discussion of healthcare interventions. Some patients decline transfusion of blood products, either for religious or non-religious reasons, but most frequently as part of the Jehovah’s Witness faith. Acceptance of, and decision-making, surrounding blood pro…

1
Sildenafil Cream for Women? “New” Data (June 18, 2024) 43:42

3M ago43:42

43:42

"HSDD" as a diagnosis has been gone for some time. According to the ACOG, the DSM-V defines the combined entity of female sexual interest/arousal disorder as a complete lack of or a substantial decrease in at least three of the following symptoms for at least six months: interest in sexual activity and sexual or erotic thoughts or fantasies. This i…

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