New ACOG Guidance on PATH Prenatal Care (May 2025)

Dr. Chapa’s Clinical Pearls.

#Dr. Chapa’s ObGyn Pearls #Medicine #Science #On Covid19

29:53

Steve Preston is the CEO of Goodwill Industries. Though Goodwill is known for big stores where people can donate clothes and buy them secondhand, those stores are just the first level of what Goodwill Industries are about. Those stores fund an international organization that provides job training, employment placement services and other community-based programs for people who face barriers in their employment. Steve joins Jay to discuss the ways Goodwill Industries support veterans and individuals who lack job experience, an education, or face employment challenges, such as those people who are formerly incarcerated. Today's episode was produced by Tani Levitt and Mijon Zulu. To check out more episodes or to learn more about the show, you can visit our website Allaboutchangepodcast.com. If you like our show, spread the word, tell a friend or family member, or leave us a review on your favorite podcasting app. We really appreciate it. All About Change is produced by the Ruderman Family Foundation. Episode Chapters 0:00 intro 1:02 The Goodwill you don’t know 4:33 The troubling reality of work reintegration for formerly incarcerated folks 10:00 How Steve brings his public-sector experience to Goodwill 11:17 Goodwill’s employment centers 15:51 The interplay between Goodwill’s national and local arms 24:07 The case for minimizing recidivism becoming a cross-party cause 27:05 Goodbye For video episodes, watch on www.youtube.com/@therudermanfamilyfoundation Stay in touch: X: @JayRuderman | @RudermanFdn LinkedIn: Jay Ruderman | Ruderman Family Foundation Instagram: All About Change Podcast | Ruderman Family Foundation To learn more about the podcast, visit https://allaboutchangepodcast.com/ Looking for more insights into the world of activism? Be sure to check out Jay’s brand new book, Find Your Fight , in which Jay teaches the next generation of activists and advocates how to step up and bring about lasting change. You can find Find Your Fight wherever you buy your books, and you can learn more about it at ⁠⁠⁠www.jayruderman.com⁠⁠⁠ .…

about a year ago 17:38

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On December 13, 2022, we released an episode describing a new concept in prenatal care, called the PATH model. This was to “redesign” prenatal care, as needed, for those who may have limitations for the “traditional” model of prenatal care visits. Well, what we covered 2.5 years ago is NOW an OFFIICAL guidance from the ACOG and will be out in May 2025. Similarly, the SMFM released their vision for redesigned maternal care teams on 16 April 2025 (J Pregnancy). We will BRIEFLY summarize these 2 publications in this episode.

1011 episodes

New ACOG Guidance on PATH Prenatal Care (May 2025)

Dr. Chapa’s Clinical Pearls.

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published about a year ago

MP3•Episode home

1011 episodes

#Dr. Chapa’s ObGyn Pearls #Medicine #Science #On Covid19

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Dr. Chapa’s Clinical Pearls.

1
Zoliflodacin, Coming to Your Pharmacy Soon 22:38

2 days ago22:38

22:38

Innovation in medicine is happening. In our immediate past episode, we summarized how AI is improving standard mammography to now PREDICT breast cancer rather than just diagnosing it once it was appeared. In a past episode, we covered a new and novel “first in class” oral medication for uncomplicated UTIs in women called Blujepa. This is innovation! Well now, as of June 10, 2025, the FDA has granted a New Drud Application for a new and noval oral antibiotic against gonococcal (GC) infection! In this episode, we will review the current CDC treatment protocols for GC and highlight what this new medication’s MOA is and what to expect from this FDA process.…

Dr. Chapa’s Clinical Pearls.

1
NEW Breast Imaging AI is HERE 20:50

4 days ago20:50

20:50

Each year, more than 2.3 million women worldwide are diagnosed with breast cancer—including over 370,000 in the United States alone. For more than 60 years, mammograms have saved lives by detecting early-stage cancers. Now, advancements in AI have lead to a first of its kind breast imaging algorithm that can PREDICT future (5-year) breast cancer risk in the patient (CLARITY BREAST). This is GROUNDBREAKING. Yes, there has been other new tools, like the recent contrast enhanced mammography data, for early detection of breast cancer, but this is the first technology to help PREDICT it in the future. Nonetheless, questions remain. Listen in for details. (CLARITY is not a sponsor)…

Dr. Chapa’s Clinical Pearls.

1
SFP vs ACOG on EPL 35:06

6 days ago35:06

35:06

It’s interesting how, at times, different medical societies can look at the same data and arrive at different recommendations. It happens! In April 2025, the Society of Family Planning (SFP) released its new clinical recommendations for the medical management of early pregnancy loss (EPL), AKA miscarriage. This clinical guidance has 4 remarkably interesting differences when compared to the ACOG practice bulletin # 200 on early pregnancy loss. In this episode, we will review these 4 key differences and summarize the latest recommendations for the medical management of miscarriage. Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
WCH in Pregnancy 44:20

9 days ago44:20

44:20

The white-coat effect is a measure of blood pressure change from before to during the visit in office/clinic when the blood pressure is recorded by a physician or nurse; this was first described in 1983 by Mancia et al, and was initially thought to represent a benign process. But it was unclear what this actually meant for pregnancy. Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for about 20 years now. Use of this monitoring option has revealed a subgroup of patients who have persistently high blood pressure (BP) in the presence of health care providers, but a normal ambulatory or self-measured BP. This phenomenon has been termed “White Coat Hypertension” (WCH). In 2013, The International Society for the Study of Hypertension in Pregnancy (ISSHP) published the revised classification for hypertensive disorders in pregnancy, that included WCH, not previously included. The ISSHP guidelines also emphasize that a diagnosis of white coat hypertension in pregnancy should only be considered before 20 weeks of gestation. We now know that WCH, outside of pregnancy, is not an entirely benign process. The role of metabolic risk factors in patients with white-coat hypertension was first outlined in 2000 by Kario and Pickering. When metabolic risk factors are present in association with white-coat hypertension, the increased risk of target organ damage is determined not only by the blood pressure characteristics but also by the metabolic abnormalities. Recognizing the potential risks of white coat hypertension was also published in a commentary in 2016 out of the European Society of Cardiology. That article’s title was, “White-coat hypertension: not so innocent”. But what is the latest data on WCH in pregnancy? Is WCH linked to poor obstetrical outcomes? Does WHC need medication therapy? We have data from 2024 to help us. Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
The Incarcerated Gravid Uterus 36:19

12 days ago36:19

36:19

Uterine incarceration in pregnancy, is a rare but troublesome complication. This occurs when a retroverted uterus becomes trapped in the pelvic cavity during pregnancy. This happens when the uterus fails to move forward as it grows, becoming stuck between the sacral promontory and pubicsymphysis. It's more common in women with prior pelvic issues or uterine anomalies. Urinary retention is the most common symptom that occurs because of elongation of the urethra by displacement of the cervix, loss of the urethro-vesical angle, and mechanical compression of the bladder neck. It is estimated to occur in 1 in 3000 patients. How do we release an incarcerated uterus? Is laparoscopy an option? And how can an ultrasound probe help (April 2025publication)? Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
Is At-Home Cervical HPV Screening VALID? 17:45

16 days ago17:45

17:45

In May 2024, the FDA approved vaginal self-collection for HPV as a cervical cancer screening tool. This was limited to health care settings. While this self collection option can help address some of the emotional deterrents to a speculum examination, it fails to overcome the remaining substantial clinic access barriers cited among those who are underscreened, including time off work, arrangement of child or elder care, and transportation. Then, the FDA approved the first at-home cervical cancer screening test on May 9, 2025. This test, called the Teal Wand (FDA-approved prescription device), allows individuals to self-collect vaginal samples at home to test for Human Papillomavirus (HPV). But is at-home testing valid? Does this work? A new publication in JAMA Network Open (May 19, 2025) answers this important question. Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
LEA And Bladder Catheter: Yea or Nay? 35:33

18 days ago35:33

35:33

In the US, an estimated 70-75% of women who give birth use an epidural for pain relief during labor. Epidural anesthesia during labor can affect bladder function by delaying the return of bladder sensation and potentially leading to urinary retention. This can be due to the nerves that control bladder function being affected by the epidural, reducing the sensation of bladder fullness and the urge to urinate. Intrapartum, there is no universal guidance regarding bladder management with labor epidural analgesia (LEA). Does one method of bladder care intrapartum affect mode of delivery more than the other? Is it better to have an indwelling catheter or to perform intermittent caths. What about patient self-voiding with a bedpan. Let’s summarize the data.…

Dr. Chapa’s Clinical Pearls.

1
Prophylactic CS ABX: What is Too Much? (New Data, May 2025) 27:59

20 days ago27:59

27:59

At the end of April 2025, we released an episode summarizing the ERAS update for 2025. In that episode/update, we summarized the data on extended spectrum prophylactic antibiotics at cesarean section in patients living with obesity. The ERAS protocol recognized the value of oral cephalexin and metronidazole for 48 hours in patients with obesity who receive single agent Cephalosporin prophylaxis preop. Now, a new (RCT) publication soon to be released in the Green Journal, evaluates whether using dual agent pre-op prophylaxis (ancef and zithromax) together with post op oral cephalexin and metronidazole has benefit in reduction of SSI composite risk. Does this help? When is too much prophylactic antibiotics, just too much? Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
Vaginal E2 FACE Cream, & ‘Roids: A Two-Fer! 43:38

23 days ago43:38

43:38

We have covered menopause on this show on various occasions. That’s fitting and non-surprising as we are a women’s health education podcast! While vaginal dryness and hot flashes get most of the attention in menopause, and they should, less attention often is given to skin changes. Nonetheless, these dermal manifestations of perimenopause and menopause can be just as disturbing to those affected. Estrogen helps skin produce oil and hold onto water, so extremely dry skin during menopause is common. Plus, according to the American Academy of Dermatology, collagen production drops 30% in the first 5 years of menopause and approximately 2% each year for about the next 20 years. Collagen gives skin its plumpness and structure. The direct-to-consumer market is replete with a variety of over-the-counter estrogen containing products, formulated as facial creams, which are meant to fight the battle of skin aging. But is topical estrogen applied to the face effective? What are the data? You’d be surprised to learn that there is published data on this- even level I data. Are there any safety concerns? We will summarize it in this episode. PLUS, as a “two-for one” special, we will also briefly highlight a brand new publication in the journal JAMA Network Open regarding antenatal corticosteroid dose to delivery interval and fetal benefits.…

Dr. Chapa’s Clinical Pearls.

1
“GSL” New Data (Obstet Gynecology) 30:26

24 days ago30:26

30:26

In 2014, the International Society for the Study of Women's Sexual Health together with the North American Menopause Society introduced the term “Genitourinary syndrome of menopause” to replace the prior term vulvovaginal atrophy. Ten years after that, in 2024, a related term “Genitourinary Syndrome of LACTATION, was introduced to better capture the genitourinary issues lactating women may experience. A new systematic review, soon to be released in the journal obstetrics and gynecology, provides new data on GSL prevalence and characteristics. This is a good reminder for any clinician who evaluates postpartum/lactating women to ask about GSL. How does sexual dysfunction fit into this question? Listen in to the next episode of Dr. Chapa’s Clinical Pearls Podcast for more details.…

Dr. Chapa’s Clinical Pearls.

1
New DATA on Endo RX for Pain (May 2025) 31:36

26 days ago31:36

31:36

Endometriosis is a prevalent gynecologic condition that affects approximately 10–15% of women of reproductive age worldwide. For endometriosis related pelvic pain, continuous combination birth control pills have long been the first-line pharmacologic intervention of choice. But new data published May 15, 2025 (ahead of print) in Obstetrics and Gynecology is challenging that tradition. In this episode , we will summarize the key findings of this brand new network systematic review and metanalysis. Plus, we will also review what is missing from the ACOG PB 114 regarding the management of endometriosis. Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
IUD/S Placement NEW Guidance: Was It Racism Before? 36:22

28 days ago36:22

36:22

In August 2024, the CDC updated its MEC. This included a recommendation for local anesthesia for IUD/S placement and also had guidance regarding misoprostol for that procedure. Coming up in July 2025, the ACOG will officially release a new clinical consensus on “Pain Management for In-Office Uterine and Cervical Procedures”. Are these recommendations similar to the CDC’s? What about misoprostol? Was the non-use of local anesthesia for these office-based procedures rooted in racism and sexism? Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
POPs=Asthma? New Data 39:24

4 weeks ago39:24

39:24

Asthma is more prevalent in adult women than in adult men. Specifically, data from the National Health Interview Survey (NHIS) indicates that 9.7% of adult women had asthma, compared to 5.5% of adult men. This higher prevalence is observed across various racial and ethnic groups within the adult female population. At the end of April 2025, new population-level data was published (UK) describing an alarming association between progastrin only pills and asthma exacerbations. Is this a new finding? Recently, it seems that there has been a barrage of negative press towards progestin only contraceptives: depo provera and brain tumors, progestin releasing IUS and breast cancer, and the progestin IUS and rosacea. What is happening here?! We'll break it all down in this episode.…

Dr. Chapa’s Clinical Pearls.

1
FGM 2025 Update. 28:35

5 weeks ago28:35

28:35

Female Genital Mutilation (FGR) is condemned by the WHO, Unicef, and the US. Nonetheless, it is still being performed worldwide, and in North America. In this episode, we will recently published data (April 2025) from BMC regarding this practice. This episode's topic was brought to me by one of our podcast family members who currently has a pregnant patient with FGR. Does this patient require a cesarean section? What are the 4 types (classifications) of FGR? Listen in for details.…

Dr. Chapa’s Clinical Pearls.

1
Ca-Mg “Love-Hate” Bond: Follow Ca Levels on MagSulfate? 25:55

5 weeks ago25:55