Dr. Chapa’s Clinical Pearls.
846 episodes - English - Latest episode: 10 days ago - ★★★★★ - 252 ratingsRelevant, 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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Episodes
HT Causes Dementia?! New June 2023 Data.
July 06, 2023 03:37 - 31 minutes - 29 MBThe headline from CNN Health form June 28, 2023 reads, "HRT use by younger women linked to dementia, study says". That is FRIGHTENING to any patient using hormone therapy for menopausal symptoms. Does HT cause dementia? Or is HT a "easy suspect"? The question of HT and cognitive function has been a subject of controversy for many years. In this episode we will summarize the NAMS position statement on HT for cognitive issues (2022) as well as summarize this new June 2023 publication from BMJ c...
The “Antiquated” Apgar Score
July 03, 2023 21:02 - 36 minutes - 33.3 MBFirst published in 1952, the Apgar Score has remained unchanged over 70 years and is entrenched in current OB/Pediatric/Neonatal care. The ACOG highlighted the Apgar Score in 2015 in CO 644. In that release, the ACOG reminds us that although it provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed, it has important limitations: A. The healthy preterm infant with no evidence of asphyxia may ...
CBD in Pregnancy, OK? New Data
July 01, 2023 04:44 - 32 minutes - 30 MBListen to this! According to recent US statistics from both consumer reports and statista.org: 26% of Americans used CBD in 2022, 24% of people owning pets use CBD for their animals and themselves, 33% of Americans have used CBD products at least once, 64% of Americans have used CBD for pain, 49% of Americans use it for anxiety and stress, and 42% of Americans have used it for sleep and insomnia. CBD is super common, and it is super unregulated. CBD, or cannabidiol, is one of the numerous can...
Placental Lakes on Sono: Implications?
June 29, 2023 17:35 - 25 minutes - 23.5 MBThis episode subject was requested by Emily, one of our podcast family members. She has noticed the reporting of “large placental, venous lakes” on antepartum ultrasound. Placental lakes are enlarged spaces in the placenta filled with maternal blood. These spaces are also called intervillous spaces because they are found between the placental villi the finger-like projections of the placenta that contain fetal blood vessels . The placental villi float in the intervillous spaces and absorb oxy...
Genetic Screen or E-phoresis For Hemoglobinopathy? Is One Better Than the Other?
June 28, 2023 11:59 - 33 minutes - 30.6 MBWe recently had a patient in our OB high-risk community clinic whose maternal carrier screen result was either late or lost. Thinking the test may be lost, another resident ordered hemoglobin electrophoresis. The electrophoresis was NEGATIVE (that is, no abnormal hemoglobin was found at detectable levels)…by the way, good for that resident! After calling the lab for the genetic screen and not getting a clear answer from that location, they had the self- initiative in ordering a back-up test. ...
Can GBS Cause Vaginitis? New Data on Aerobic Vaginitis.
June 27, 2023 01:03 - 42 minutes - 38.6 MBDesquamative inflammatory vaginitis (DIV) made its debut in the medical literature in 1965, by the hands of Gray and Barnes. In that paper, they presented their findings on 478 women complaining of vaginal discharge. Then, in 2002, Donders et al. described a new entity, referred to as aerobic vaginitis (AV). This term emphasized the clear contrast with the far more common and acknowledged form of dysbiosis: bacterial vaginosis (BV). These 2 clinical conditions are now thought to exist on a clin...
Circumvallate Placenta: Maleficent or Meh?
June 23, 2023 14:41 - 28 minutes - 26.3 MBThe word placenta, first used in a 1638 anatomy textbook, was borrowed from the New Latin phrase placenta uterina, meaning "uterine cake", because the circular, flat shape of the organ was thought to resemble a traditional Roman flat cake. Circumvallate is another Latin derived term meaning the "encircled placenta, by a rampart". Circumvallate placentas are a form of extrachorial placenta where the basal plate extends past the margins of the chorion plate resulting in the chorion and amnion f...
Syphilis' Vertical Transmission (Congenital Syphilis)
June 21, 2023 19:45 - 31 minutes - 28.8 MBOver the past decade, there’s been about a 700% increase in the cases of congenital syphilis in the United States. That’s 700%! Rates of congenital syphilis, meaning the number of cases for every 100,000 live births, are highest in the South and Southwest, in states such as Arizona, New Mexico, Louisiana, Mississippi and Texas. Individual states have seen increases that are even more astounding. From 2016 to 2021, cases shot up 3,300% in Mississippi, nearly 3,000% in Oklahoma, more than 2,200...
IUD(S) Insert with BV? IUD(S) Pearls.
June 18, 2023 23:34 - 24 minutes - 22.8 MBLARCS provide remarkable contraception. The IUD and the IUS are both HIGHLY effective, although they do not have the same typical-use failure rates. While it is common knowledge that active mucopurulent cervicitis is a contraindication for IUD/IUS placement, what about the presence of bacterial vaginosis (BV)? BV has been identified for years as an independent risk factor for Pelvic Inflammatory Disease. Is placement of an IUD/IUS in a patient with current BV contraindicated? What do the guid...
Bacteria Causes Endometriosis? Surprising New Data From June 2023.
June 15, 2023 21:50 - 29 minutes - 27.2 MBEndometriosis is caused by endometrial-like tissue containing endometrial glands and extensive fibrotic tissue growing outside the endometrial cavity, most often in the pelvic peritoneum or ovaries, resulting in chronic pelvic pain and infertility. It is reported to affect 10 to 15% of women of reproductive age, with an unknown percentage of women who go on undiagnosed or misdiagnosed. For decades, Sampson's Theory has survived as the most "likely" to explain the pathogenesis of endometriosis...
New Data on PP Home BP Checks: June 2023 Systematic Review
June 15, 2023 04:23 - 28 minutes - 26.3 MBThe world of "Hypertension (HTN) in Pregnancy" is an ever-evolving environment! Many clinicians have adopted patients' home monitoring of blood pressure (BP) in their management of hypertensive disorders in pregnancy. Do you recommend home BP monitoring in your OB patients? On May 4, 2022 we summarized the results of 2 RCTs examining whether home BP monitoring during antepartum care prevents HTN morbidity and mortality. These were BUMP1 and BUMP2 (JAMA). We will again summarize the key findin...
MSAFP “Addendum”: Thank you Maggie Ray!
June 13, 2023 23:45 - 3 minutes - 3.25 MBJust a quick clarification regarding a previous statement, on an earlier episode, regarding MSAFP….thank you Maggie Rey! ❤️❤️❤️this community.
The Pill Causes Depression? New June 2023 Data
June 13, 2023 22:48 - 26 minutes - 24 MBDoes the combination birth control pill cause depression? This has been a controversial subject for over 2 decades. While some observational studies have described a possible association, randomized clinical trials have shown little to no connection. On June 12, 2023, a new population-based cohort study from the UK sought to evaluate this possible association. This resulted in some interesting claims! These results, just within 24 hours, have now made their way to major news outlets and socia...
NAMS 06/2023 NonHormonal Position Statement
June 11, 2023 11:41 - 29 minutes - 26.9 MBI recently received a message from one of our podcast family members requesting more gynecological topics...that was perfect timing, since the NAMS just released its 2023 Position Statement on "NonHormonal Therapies" for vasomotor symptoms on June 1st. In this episode we will summarize this 18 page monograph. The NAMS expert working work critically evaluated the published literature on all nonhormonal therapies for hot-flashes and grouped them into 5 categories: lifestyle modifications; mind-...
Dermatoses of Pregnancy (Pt 2)
June 09, 2023 00:51 - 24 minutes - 22.2 MBWelcome back to part 2. In this episode we will wrap up our discussions on dermatoses of pregnancy, focusing on atopic eruptions of pregnancy and ICP. Do you know what the 3 comorbidities are which may follow a diagnosis of ICP? We’ll cover that here. AND we’ll throw in a weird one as our final discussion point, one that is considered by some to be the 5th dermatosis of pregnancy. This is the Triple P: Pustular Psoriasis of Pregnancy.
Dermatoses of Pregnancy (Pt 1)
June 07, 2023 00:42 - 23 minutes - 21.1 MBI’ve said this many times before: I ❤️ our podcast community. This podcast topic idea comes from Jerry, an OBGYN Resident in Virginia. 👏👏 Jerry writes, “I wanted to know if you could do a topic on the Dermatoses of Pregnancy. My program has had some interesting cases recently and most of what I could find was in UpToDate. I couldn’t find a specific PB or CO on the topic, so I wanted to reach out.” Honestly, I hadn’t even thought of this topic…and it is a good one! We do see patients with thes...
IDA + BetaThal Trait in OB: Fe, or No Fe?
June 04, 2023 20:10 - 26 minutes - 23.9 MBIt has long been considered that iron deficiency does not exist in Thalassemia syndromes, including Thalassemia major as well as Trait (Thal minor). But that is incorrect. Recent studies have shown the occurrence of iron deficiency in patients with Beta-Thalassemia Trait. Iron deficiency anemia (IDA) during pregnancy has been associated with an increased risk of low birth weight, preterm delivery, and perinatal mortality and should be treated with iron supplementation in addition to prenatal ...
Sterile or Clean Gloves for Labor Checks? New RCT Data (June 2023)
June 02, 2023 04:27 - 32 minutes - 30.1 MBWhen performing cervical examinations during labor, providers in the United States commonly use sterile gloves, even when there is no rupture of membranes. Is this an evidence-based practice or is it simply tradition? This debate has been going on for decades. In this episode, we will highlight some interesting/intriguing hospital policies and procedures, and walk-down our history timeline of data. We will start in 2010 and end with a recent publication from June 2023 from the AJOG-MFM. Final...
GDM Screen After 28 Weeks? Yay or Nay.
May 31, 2023 17:20 - 31 minutes - 28.4 MBHere’s a real world clinical conundrum: A patient first presents for prenatal care in the 3rd trimester. As healthcare providers, we play a game of “catch-up” with routine serum tests ordered to make up for time lost. But what about specific pregnancy tests that are restricted to gestational age? Take, for example, GDM screening. Currently, traditional screening for GDM occurs at 24 to 28 weeks based on the original studies by O’Sullivan and Carpenter-Coustan. Or take this parallel, clinical ...
The 39 Week IOL “Dilemma”
May 29, 2023 04:13 - 36 minutes - 33.2 MBWe are now 5 years into the publication of the Arrive trial (2018) which opened the door to elective induction of labor at 39 weeks in an otherwise low risk pregnancy. But five years later authors and researchers are still debating whether a 39 week elective induction is helpful or not. Yep, the rebuttals and retorts against the ARRIVE trial began shortly after its publication, and they are still active even now- with a recent publication, from February 2023, having an opposing view. Yep…Whil...
Nonhypoxic Antepartum Fetal Bradycardia
May 26, 2023 12:03 - 23 minutes - 21.3 MBThe fetal heart rate is controlled by various integrated physiological mechanisms, most importantly by a balance of parasympathetic and sympathetic nerve impulses. Intrapartum, fetal bradycardia may be in direct response to an evolving or acute hypoxic event, including tachysystole, uterine rupture, or placental abruption. Antepartum, excluding acute events like maternal trauma which could lead to an acute hypoxic episode, most fetal brady arrhythmias will be nonhypoxia related. We recently e...
New Serum Biomarker Test for sPreeclampsia (The Praecis Study).
May 23, 2023 14:40 - 23 minutes - 21.1 MBOn May 19, 2023, the FDA cleared a novel biomarker serum test for the risk stratification for severe preeclampsia in hypertensive pregnant women. This clearance is the first given to any blood-based biomarker test for assessing preeclampsia risk. The company is Thermo Fisher Scientific (no disclosures). But what does this test actually check for? Who qualifies for this? And what was the clinical investigation that the FDA based its clearance decision on? And most importantly…what do we do wit...
Umbilical Vein Injection for 3rd Stage?
May 22, 2023 13:11 - 32 minutes - 29.7 MBThe 3rd stage of labor is the time from child's birth to delivery of the placenta. Delayed placental separation and expulsion is a potentially life-threatening event because it hinders expected postpartum uterine contraction, which can lead to PPH. The concept of umbilical vein injection of a variety of substances (saline, pitocin, plasma expanders) is nothing new. It was first described in the 1930s! This had found new life in the 1980s and 1990s but soon thereafter again fell into ambiguity...
Laughing Gas in Labor.
May 20, 2023 02:29 - 25 minutes - 23.3 MBAlthough labor epidural remains the gold standard for labor analgesia, some patients may opt for a trial of a less invasive analgesic agent. While IV/IM narcotics are an option, others may prefer a trial of nitrous oxide (N2O). In this episode, we will review the crazy history of this useful inhalational agent, and how it has ties to the manufacturing of the Colt45 handgun, how it transformed dentistry, and review the contribution to medicine by Dr. Horace Wells. We will review N2O's current ...
Bipolar in Pregnancy
May 17, 2023 15:41 - 22 minutes - 21 MBJust the other day I received a text from one of our wonderful FM attendings in our group concerned about refilling a patient’s Lamictal in early pregnancy. When asked if that was acceptable to do, I quickly answered ABSOLUTELY. We’ve come a long way in understanding bipolar disorder and a long way since lithium was first described for its use. While its use in psychiatry dates to the mid-19th century, the widespread discovery of lithium is usually credited to Australian psychiatrist John Cad...
Lactational Mastitis and Abscess: New Data on the Milk Microbiota
May 15, 2023 19:23 - 19 minutes - 17.6 MBThe ACOG recommends exclusive breastfeeding for the first 6 months of life, with continued breastfeeding while complementary foods are introduced during the infant’s first year of life, or longer, as mutually desired by the woman and her infant (ACOG CO 820; 2021). Problems may arise that can keep women from achieving their breastfeeding goals, and only 25.4% of women are breastfeeding exclusively at 6 months. One of the most common reasons women stop breastfeeding is engorgement, which could...
You Asked, We Answered! (#2): 4 Topics Clarified.
May 13, 2023 19:00 - 29 minutes - 26.6 MBThis is our second episode in the format of “You Asked, We Answered!” In this episode we will clarify and discuss 4 topics currently active: (1) Is the FDA approving OTC Birth Control? What is the progestin in the OPill? Do you know what “Free the Pill” is? We’ll discuss here. (2) Why did the USPSTF change the MMG screening rec to age 40? Has’nt the ACOG already recommended that? And what did the USPSTF comment regarding dense breasts? We’ll discuss here. (3) What is the “10 and 10” associati...
“Completed” Gestational Weeks?
May 12, 2023 00:46 - 16 minutes - 14.7 MBHistorically, governmental and professional societies referred to gestational "completed" weeks in their definitions of preterm or term deliveries. But this term of "completed weeks" has remained a point of confusion for clinicians and researchers alike. The ACOG favors simply stating the gestational age as clear designations of weeks and days (e.g., 34 weeks 5 days) rather than "completed weeks". Nonetheless, state and national vital statistics reports still rely on documented completed week...
OSA in Pregnancy: Time to Screen?
May 10, 2023 18:20 - 32 minutes - 29.7 MBObstructive sleep apnea (OSA) affects nearly 30 million people in the United States. OSA isn’t just a disruption to pregnant women’s sleep, it is linked to serious pregnancy complications. In this episode will summarize the latest research on OSA and disorganized sleep patterns and their associated pregnancy outcomes. Should we screen for this in pregnancy? Is CPAP safe in pregnancy? Should these patients be on low dose aspirin? Does treatment for OSA prevent the adverse perinatal outcomes? S...
Pregnancy After Stillbirth: Does Timing Matter?
May 09, 2023 15:29 - 24 minutes - 22.7 MBStillbirth is one of the most common adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. The optimal interpregnancy interval (IPI) after stillbirth is unclear. Currently, many organizations recommend IPIs greater than 18 months due to findings that, after live birth, a short IPI is associated with increased risk of spontaneous preterm birth, small for gestational age (SGA), and, sometimes, stillbirth. But this was based largely on expert opinion and not peer rev...
Slowed Fetal Growth Trajectory & Neonatal Outcomes
May 08, 2023 17:12 - 34 minutes - 31.3 MBThe ACOG defines FGR as fetuses with an estimated fetal weight or abdominal circumference that is less than the 10th percentile for gestational age (ACOG PB 227). BUT, some argue against this cut off. There may be a subgroup of AGA fetuses with placental insufficiency who display slowing of fetal growth trajectory while in utero, but do not end up with a birthweight <10th centile at term, and so not classed as FGR. Such a cohort that has declined in weight centiles in late pregnancy may be an...
FASD and Paternal ETOH Use
May 06, 2023 15:49 - 22 minutes - 20.4 MBCan you believe that in 1977, the public health guidelines issued by the National Institutes of Health suggested a two-drink-per-day limit for pregnant women? It's TRUE. Ethanol had even been investigated, and promoted, and an "effective tocolytic agent". We now, of course, understand that there is no safe amount of ethanol use during pregnancy. Our understanding of FASD has evolved over the years, so much so that we now understand that FASD is possible by PATERNAL use of alcohol in the preri...
Epidural Related Maternal Fever (ERMF)
May 03, 2023 16:14 - 31 minutes - 28.5 MBEpidural anesthesia remains the gold standard for relieving labor pain. Currently, there are 3 techniques for providing epidural related analgesia (traditional epidural, combined spinal- epidural, and dural scrape/puncture epidural). A controversial subject dating back to the 1990s, epidural related maternal fever (ERMF) has been extensively studied. In this episode, we will summarize two recent publications on the subject from the AJOG and review historical data. What is the pathophysiology ...
MH in L&D: Recognize & Act
May 01, 2023 16:41 - 22 minutes - 20.7 MBMedical/Nursing simulations which focus on high-acuity, low-frequency crisis events improve team dynamics, team morale, and most importantly patient outcomes. One such high-acuity, low-frequency event is malignant hyperthermia (MH). On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and most commonly used anesthetics. However, general anesthesia is performed when the case is emergent (stat), when the regional anesthesia level is insufficient, or regional ...
Daily Dilemmas, Easy Answers!
April 29, 2023 16:16 - 29 minutes - 27.5 MBOne of the sources of ideas for our podcast topics is our daily clinical practice. During my recent shift in ultrasound clinic, we encountered 4 clinical scenarios which became wonderful teaching opportunities at that moment. In this episode, we will share these common- at times, daily – clinical dilemmas, and we will provide evidence-based, easy answers!
CGM in Diabetic Pregnancies
April 27, 2023 10:44 - 29 minutes - 27.3 MBIn June 1999 the FDA approved the first continuous glucose monitor for diabetic intervention. We have come along way since 1999. Continuous glucose monitors (CGMs) come in 2 different varieties: real-time CGM, and intermittent/“flash” monitor devices. The use of these devices in pregnancy has exponentially grown. In this episode, we will summarize the key findings from the landmark study, published in 2017 in patients with Type I diabetes in pregnancy (the CONCEPTT study). Is there evidence s...
Literature References!
April 26, 2023 14:34 - 2 minutes - 1.96 MBYou asked… We did! Listen in and find out what this means.
Incidental HCG in Menopause?
April 26, 2023 02:06 - 28 minutes - 26 MBIt’s a rather uncommon, but not rare, phenomenon: the incidental hCG finding in a postmenopausal patient. What are we supposed to do with that? Is this automatically cancer? In this episode, we will highlight a real clinical case from one of our podcast listeners, Cynthia. We will review the likely causes of low-level hCG levels in a postmenopausal woman (who is not pregnant). You may be surprised of some possible etiologies. Towards the end of the episode, we will also provide an evidence-ba...
Max Misoprostol Total Dose For Ripening?
April 24, 2023 22:02 - 24 minutes - 22.2 MBThe earliest studies of misoprostol’s use in cervical ripening and labor induction were done by South American investigators, who reported their experience using intravaginal misoprostol. This was published in the Lancet in 1992. Despite its widespread incorporation into obstetrical practice, there’s still some lack of uniformity in its administration. Is there a cumulative maximum dose allowed for cervical ripening? What about time… is there a maximal amount of time in which misoprostol can ...
IUPC Pros &Cons vs EUM
April 23, 2023 20:22 - 30 minutes - 27.9 MBThe concept of measuring intrauterine contractions strength was first proposed in 1949, and eventually published in 1952. The use of an IUPC is well ingrained in modern obstetrical/intrapartum practice. Even though it is so commonly performed, we tend to forget some potential limitations and possible risks of this procedure. In this episode, we will review the history and purpose of the IUPC and remind ourselves of some real (though rare) limitations and risks. We will also touch on an evolvi...
Can “Shrooms” Cure HPV?
April 20, 2023 23:12 - 28 minutes - 26.5 MBOnce considered on the fringe of main-stream medicine, “alternative therapies” are becoming more accepted into clinical practice. Such is the case of psilocybin (a mushroom extract) for certain mood disorders. 🍄 And now, another mushroom extract (AHCC) has gained attention in gynecology. Could this extract help eliminate the most common viral STI? Is this evidence-based? The research may surprise you. Let’s review the data on ‘shrooms and HPV. Thank you Leah for the episode suggestion! Keep u...
You Asked, We Answered. 🤔👏🤔
April 18, 2023 00:58 - 33 minutes - 30.7 MBWe ❤️ our podcast community! Over the last 3 recent episodes, we have received similar “themed“ listener questions. So in this episode, we are going to respond to some recent inquiries regarding three recent episodes: 1. combination birth control and estrogen levels (and Perimenopausal use), 2. vaginal progesterone for patients without a history of preterm birth, and 3. the use of vaginal dilators for vaginismus. This is how we all grow together! Now… Let’s get to your questions. 😊😊😊🤔🤔🤔
Jade Egg, & Vaginal Weight Lifting 🤔
April 16, 2023 20:07 - 31 minutes - 29 MBI recently had a patient (young reproductive age, without prolapse or urinary incontinence) ask me about using the “Jade Egg” vaginally for better sex. Women’s sexual intimacy is a big dollar commercial industry. What’s the history behind this Jade Egg and/or other vaginal insertion weights? Is there a benefit to using these inside the vagina for pelvic floor training and enhanced sexual intimacy? Are these any better than regular Kegel exercises? In this episode, we’ll do a deep-dive into th...
Does Mec Staining Correlate to Duration of Exposure?
April 14, 2023 20:30 - 24 minutes - 22.3 MBPresence of meconium stained membranes/placental tissue has been used in medico-legal cases by both plaintiffs and the defense alike. Using the presence of meconium stained tissue has been used as a tool to “timeline” fetal hypoxia. Is this evidence-based? In the session, we will review the historical data (1985) that fueled this concept, and give the latest scientific and medical expert opinion regarding the possibility of this theory (highlighting a new Expert Review in the AJOG, April 2023...
Cerclage, Vag Prog, & PTB: SMFM April 13 Statement.
April 13, 2023 19:31 - 10 minutes - 9.56 MBOh, the ever evolving drama of “progesterone in high risk obstetrics”. Today, April 13, 2023, the SMFM released its Special Statement response to the recent change in the progesterone PTB prevention landscape. Where does cerclage fit in? In this episode we will summarize the current recommendation for cerclage for preterm birth prevention and how it fits in to the vaginal progesterone story. Is cervical ultrasound surveillance after vaginal progesterone initiation warranted? We will make it c...
PostPartum IUDs: Best Time to Place?
April 12, 2023 20:31 - 24 minutes - 22.5 MBWe have come a long way in our understanding regarding the safety of intrauterine contraception. Once withheld from adolescents and immediately postpartum patients, the safety in both populations is now well established. Postpartum IUD/IUS placement is a balance between risk of expulsion and patient loss to follow up. In this episode, we will summarize a new RCT from JAMA discussing this very subject. Is it better to place immediately Postpartum, at 2 weeks after delivery, or as an interval p...
Low-dose ComboBC VTE Risk (PLUS HRT E2 Serum Levels)
April 10, 2023 22:28 - 25 minutes - 23.7 MBThis episode is in reply to one of our fantastic podcast family members who had some wonderful clinical questions regarding dosage of combination BC after listening to our past episode. In our immediate past episode, we discussed hypoestrogenemic symptoms on ultra low-dose pills in certain patients (young, thin). Is a 20 µg BC pill less thrombotic than a 30 or 35 µg pill? What does the data say? In this episode will answer this question and also dive deeper into serum estradiol levels not onl...
ComboBC & Serum E2 Levels
April 08, 2023 21:49 - 20 minutes - 18.5 MBIn 1972, a publication in which a radioimmunoassay measured serum estradiol levels in participants taking oral combination birth control concluded that levels of serum estrogen were “sufficient to prevent symptoms of estrogen deficiency”. Knowing NOW what we do, and looking back to that article, those authors’ conclusions were completely incorrect! Is it possible for a patient to experience hypoestrogenic symptoms despite taking an estrogen containing birth-control? What are normal, endogenou...
New Practice Advisory on Dense Breasts at MMG (ACOG PA April 2023) 🚨
April 07, 2023 22:28 - 10 minutes - 9.33 MBHere’s proof that our catchphrase, “Medicine Moves Fast“ is 100% true! On October 30, 2022, and again on November 1, 2022, we released episodes on “Dense Breasts on MMG? What to do?”. Those episodes were in response to Katie Couric’s public outcry for the need for additional screening at time of mammogram in the setting of dense breasts. On March 9, 2023, the FDA issued a new ruling/guidance on patient notification of breast density at screening mammogram. And now, in April 2023, the ACOG has...
Makena is GONE.
April 07, 2023 01:18 - 8 minutes - 7.51 MBA quick update and commentary on the recent (April 6, 2023) FDA decision to withdraw approval of Makena for preterm birth prophylaxis.