Best Dr. Chapa’s ObGyn Pearls Podcasts (2025)

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“CPR” For Decreased Fetal Movement? The CEPRA Trial 36:00

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1h ago36:00

36:00

Maternal perception of decreased fetal movement at term occurs in up to 15% of pregnancies and is a cause for maternal and provider concern. All maternal concerns of decreased fetal movement require an assessment of fetal wellbeing. But what about the patient with recurrent episodes of reduced fetal movements at term? Routine induction of labor is …

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New Intrapartum FHT Guidance: Oct 2025 CPG 10 32:10

3h ago32:10

32:10

In the 1960s, continuous electronic fetal monitoring was introduced as a way to better capture and document the fetal response to labor and uterine contraction pattern. Since then, it has become a fully integrated component of intrapartum care despite its limited ability to prevent neonatal long term neurological complications and fetal death. We h…

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OB? Get Your ZZZZs: Insomnia’s Effects on Pregnancy 27:24

4d ago27:24

27:24

In 2023, we released 2 episodes on obstructive sleep apnea (OSA) and adverse pregnancy. Now, on September 16, 2025, a new publication from JAMA Network Open adds more insights to disturbed sleep and adverse pregnancy outcomes. How does insomnia affect pregnancy? And is there any data on night shift work and its altered circadian rhythms on adverse …

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BNP and proBNP in PreE 26:28

1h ago26:28

26:28

Brain-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels originate from the cardiac cells in response to cardiac strain. This may come from a pulmonary embolus, an acute severe infection (sepsis), or cardiomyopathy. But what is the relationship between these 2 cardiac biomarkers and preeclampsia? Can preeclampsia with severe fe…

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Vag E2 in Women With CVA HX? 22:56

2d ago22:56

22:56

Stroke (CVA) is very common in women, who have a higher risk than men over their lifetime; one in five women between the ages of 55 and 75 will experience a stroke. Stroke is a significant concern for women's health, being the third leading cause of death and causing more deaths than breast cancer. While systematic estrogen containing menopausal HT…

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Does Vit B6 Reduce Mastalgia? New Meta-analysis 09/2025 21:43

4d ago21:43

21:43

Mastalgia is a common breast complaint in reproductive aged women. Mastalgia can be separated into three categories: 1) cyclical, 2) noncyclical, and 3) extramammary. Vitamin B6 is often cited as a homeopathic (non-prescription/pharmacological) remedy for simple mastalgia. Does the published data support its use? A newly published meta-analysis she…

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09.10.2025 1:08

6d ago1:08

1:08

We are delaying today's program, as stated in this message. We will resume our program as soon as possible. Remembering Charlie Kirk.

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Eric's Encounters: Suppl. to Our Prior Episode 8:51

3d ago8:51

8:51

We have a wonderful podacst community! Within 24 hours of our immediate past episode release, one close friend- and fellow OBGYN, Dr. Eric Colton (OB Hospitalist Group) reached out and shared valuable words of wisdom regarding a potentially deadly complication of the CS-scar defect...the CS scar ectopic pregnancy. Listen in for Dr. Colton's cameo a…

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Decidua or No Decidua at CS Closure: "New" Sept 2025 Data 19:46

3d ago19:46

19:46

On Sept 10, 2023, er released an episode titled, “CS Ut Closure: Decidua or No Decidua?”. We highlighted the importance of AVOIDING the decidua at hysterotomy closure at CS. Now, in Sept 2025, in Obstetrics and Gynecology (the Green Journal), there is a new systematic review and meta-analysis on this very topic. Does this new study CONFIRM or REFUT…

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Can SVD Occur After Pelvic Fracture? 26:37

6d ago26:37

26:37

According to the J Am Acad Orthop Surg Glob Res Rev. (2024), the incidence of pelvic ring injuries is 34.3 per 100,000 with trauma being the most obvious causation. Women account for approximately 69.7% of these injuries, 23% of which occur in women of childbearing age. In this specific patient population, concern is raised about one's future repro…

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Add MORE Progestin for Progestin BTB? (New Data) 25:15

21d ago25:15

25:15

Traditionally, we have learned that any imbalance in the estrogen: progesterone relationship can trigger irregular uterine bleeding. That makes sense, right? During anovulation, prolonged unopposed estrogen can result in HMB. In such a case, we give progesterone as both a therapeutic as well as diagnostic intervention. On the contrary, with progest…

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Labor Cervical Exams: 2 hrs, 4 hrs, 8 hrs? 32:58

18d ago32:58

32:58

Routine vaginal examinations (VEs) are a standard component of intrapartum care, traditionally performed at regular intervals to monitor cervical dilation, effacement, and fetal station, which are indicators of labor progression. Yet, the American College of Obstetricians and Gynecologists states that there is insufficient evidence to recommend a s…

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Treating Breast Ca During Pregnancy? (New Guidance) 28:58

14d ago28:58

28:58

Breast cancer is an hormone responsive malignancy, meaning it may use estrogen and progesterone, reduced in high quantities during a pregnancy, for growth. However, as medical evidence evolves quickly, physicians have come to understand that breast cancer diagnosis during pregnancy doesn't always mean worse prognoses. While older studies- including…

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You Asked, We Answered! (YES, Another One) 30:51

18d ago30:51

30:51

YEP…Its another episode of You Asked, We Answered! In this episode, we will look at the data to answer 2 questions that came into the show within the last 24 hrs: 1. Is oral or topical therapy best for first treatment of uncomplicated vulvovaginal candidiasis? (We have new data- AJOG, Sept 2025, to answer that), and 2. Is urine PCR testing for UTI …

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T for Her: Who, What, & How 31:13

20d ago31:13

31:13

In the last 2 episodes we covered new updates in menopausal hormone therapy. However, we did not address TESTOSTERONE use. This episode idea comes from one our podcast family members and good friend, Eric. Eric is 100% correct: Testosterone replacement, when done correctly, has come along way. When is this indicated? Is this endorsed by professiona…

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MHT Micronized progesterone vs MPA & the Breast 20:04

22d ago20:04

20:04

This is a requested follow up to our most recent episode. Menopausal hormone therapy (HT) prescribing practices have evolved over the last few decades guided by the changing understanding of the treatment’s risks and benefits. We know that dose, route of administration, and choice of agent (estradiol versus a more synthetic option, and micronized p…

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HRT "Black Box" Warning: Time To Go 30:38

1M ago30:38

30:38

There’s a lot of fear and misinformation around HRT, and one of the biggest myths is that HT is a highly significant cause of breast cancer. That is not the case. This is a remnant concept from 2002, with MANY caveats. Calls for the removal of the black box warning on hormone replacement therapy (HRT) stems primarily from the outdated and limited n…

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Two Forgotten STIs: July 2025 AJOG Review 29:16

1M ago29:16

29:16

Well, I hate to say it, but I'm going to say it: "I Told You So". Back in 2019, we released an episode called "Mycoplasma genitalium: An Overlooked STI". Then, in Sept 2023, we released an episode called, "The Neglected STI", referring to trichomoniasis. Well, on July 22, 2025, a new commentary was released in the AJOG which is making the case why …

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OB Anesthesia New Review 30:32

1M ago30:32

30:32

Thank goodness for William Morton and Horace Wells- pioneers in anesthesia. Anesthesia has come a long way since them and there is even a professional medical society for OB anesthesia called SOAP. Today, August 07, 2025, there is a new Clinical Expert Series which was just released in the Green Journal. That publication (which is ahead of print) i…

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EMDR for PP PTSD 08/2025 Data 21:41

2M ago21:41

21:41

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a recognized and effective treatment for postpartum PTSD, particularly when related to a traumatic birth experience. EMDR helps individuals process traumatic memories and reduce the associated distress, allowing for a more adaptive way of remembering the event. On Aug 4, 2025, a new pu…

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The Change in Counseling in T13 & T18 (AAP Update) 16:29

1M ago16:29

16:29

Edwards syndrome (trisomy 18) affects approximately 1 in 5,000 to 6,000 live births. Patau syndrome (also known as Trisomy 13) is even less common, occurring in about 1 in 8,000 to 12,000 live births. About 20% of cases of Patau syndrome are caused by translocation. On the other hand, approximately 10% of Edwards syndrome cases are caused by a gene…

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NEW DATA (CPU) on DCC in Preterm Births! 22:59

2M ago22:59

22:59

Delayed (AKA deferred) Cord Clamping (DCC) is extremely beneficial for both the preterm and term neonate. In September 2025, a new Clinical Practice Update (CPU) will be released by the ACOG regarding the amount of time DCC should be done for preterm newborns. This updates data from a Clinical Expert Series which was released in 2022, called “Manag…

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FEAR the HELLP (& Liver Rupture): RESPECT the MAG 32:50

2M ago32:50

32:50

Podcast family, in this episode we will reply to 2 questions raised by our 2 of our podcast family members. The first pertains to a real world, HORRIBLE tragedy of hepatic rupture in pregnancy (no identifiable information released). We will review how and why this happens and what is the single, 5-letter, clinical diagnosis that makes this a possib…

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When to Deliver for Mod/Severe Poly 25:38

2M ago25:38

25:38

Polyhydramnios may be due to excess urine production or impaired fetal swallowing. The ACOG CO 831 states that mild, idiopathic polyhydramnios may be delivered at 39 weeks and 0 days and thereafter, but there is no specific mention regarding moderate to severe poly. In this episode we will cover delivery of moderate to severe poly. Is that data in …

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Yes, More Stuff on CS Skin Closure 36:40

2M ago36:40

36:40

What’s best for skin closure at C-Section? Staples or suture? This debate has raged for over 20 years. Past data has shown greater odds of wound complications with metal staples compared to suture. But new a meta-analysis from June 2025 is challenging the prior results. In this episode, we will explore the data from 2010 to present day. PLUS, we wi…

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Continue LDA PP For PreE Prevention? New Data 31:11

2M ago31:11

31:11

We have covered Low Dose Aspirin (LDA) for pre-natal preeclampsia prevention MANY times before. But here's a good clinical question: Since preeclampsia can also pop-up in the first 6 weeks postpartum (pp), should we continue it in the immediate pp interval? There is a new publication, an RCT, in the AJOG that looked to answer this- and we will high…

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AFS in Second Trimester: Implications? 30:15

2M ago30:15

30:15

Amniotic Fluid Sludge (AFS) has been theorized to be sonographic evidence of an underlying infection/inflammation. Others have proposed it may represent an organized clot from the placental surface. At the same time, the finding of AFS may be more common as a benign finding especially at/after 40 weeks as the amniotic fluid accumulates shed skin ce…

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BIG Announcement! 6:31

2M ago6:31

6:31

Podcast family, we are in process of an exciting rebrand! Dr. Chapa's Clinical Pearls will soon become our legacy show as we change names and channels to, "Dr. Chapa's OBGYN No Spin Podcast". This will allow us to better align with our mission. Listen in for details and FIND US, as Dr. Chapa's OBGYN No Spin Podcast!!…

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New ICP Proposed Schema 32:10

2M ago32:10

32:10

Intrahepatic Cholestasis of Pregnancy (ICP) has dichotomous effects: Benign for the mother (although the itching it causes may be a qualify of life issue, yet potentially devasting for the child in-utero. In 2021, SMFM released Consult series 53 on the subject. This, together with the ACOG 's CO 831 (Medically Indicated Late Preterm and early term …

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New SMFM Stillbirth Checklist Update (July 2025) 25:42

2M ago25:42

25:42

Stillbirth is one of the most devastating adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. In March 2020, the ACOG released OCC #10, "Management of Stillbirth". Now, formally released July 2025, the SMFM has an updated checklist for stillbirth care, published in the journal Pregnancy. In this episode, we will highl…

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FOCUS For PPH: A DIY Approach 35:07

3M ago35:07

35:07

PPH is terrible. PPH must be assessed quickly via the “4Ts” and acted upon in a timely manner. And listen to this: new data from the Journal of Maternal-Fetal & Neonatal Medicine (June 24, 2025 ahead of print) finds an association with PPH and adverse outcomes years later: the odds of cardiovascular disease (CVD) and thromboembolism disease are inc…

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Can Metformin Prevent HG? 32:37

2M ago32:37

32:37

Severe nausea and vomiting in pregnancy/hyperemesis gravidarum (HG) takes a toll on patient, and the healthcare system. According to a June 2024 ACOG Clinical Expert Series on the subject, GFD15 and IGFBP7 both play important roles in placentation, appetite, and cachexia that are linked to hyperemesis gravidarum. Specifically, LOW pre-pregnancy GFD…

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SVD or CS After OASIS? 50:04

3M ago50:04

50:04

OASIS (3rd and 4th degree perineal lacerations) occur at a rate of 4-11% (average around 5.5%). OASIS lacerations have both short term and ling term potential morbidities. Practice Bulletin 198, from 2018, briefly discusses counseling patients following OASIS on subsequent mode of delivery options. Now, in a soon to be released AJOG publication, au…

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You Asked, We Answered (Again) 26:41

3M ago26:41

26:41

Ladies and gentlemen, welcome back to another addition of “You asked, We answered”! In this brief episode, we will tackle 2 very appropriate clinical questions:1. Why do cervical psychology reports still state the presence or absence of endocervical cells/TZ component if it does not change management, and 2. Does continued magnesium sulfate infusio…

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New Guidance on OB CX Ripening (July 2025) 33:42

3M ago33:42

33:42

The Bishop Score was originally developed in 1964 by Dr. Edward Bishop and remains the central assessment tool for determining the appropriateness of cervical ripening for labor induction. We have covered pharmacologic and mechanical methods of cervical ripening for labor induction many times in prior episodes. Ut now, in July 2025, there will be a…

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KO the KB for OB-VB 37:27

3M ago37:27

37:27

Second and/or Third trimester vaginal bleeding is a common reason for L&D Triage patient assessment. The evaluation starts with determining the status of maternal hemodynamic stability. This together with IV access are key first steps. This is followed by an assessment of fetal-placental status. Typically this includes bedside ultrasound for fetal …

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Antenatal Steroids, and Baby Brains, Oh-MY! 36:39

3M ago36:39

36:39

Antenatal Corticosteroids (ACS) for Fetal Lung Maturation (and more) is an ever evolving saga. This is how science and medicine evolve, by always seeking more information. The effect of antenatal corticosteroids on neonatal/child neurodevelopmental outcomes is controversial and may be influenced by the gestational age at which exposure occurred. In…

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Zoliflodacin, Coming to Your Pharmacy Soon 22:38

3M 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…

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NEW Breast Imaging AI is HERE 20:50

3M 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 ri…

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SFP vs ACOG on EPL 35:06

3M 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 in…

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WCH in Pregnancy 44:20

3M 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 blo…

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The Incarcerated Gravid Uterus 36:19

3M 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 o…

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

3M 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 un…

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

4M 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, reduci…

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

4M 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…

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

4M 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 menop…

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

4M 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 th…

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

4M 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 Gyne…

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

4M 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 recommendatio…

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POPs=Asthma? New Data 39:24

4M 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 popu…