Dr. Chapa’s Clinical Pearls.
846 episodes - English - Latest episode: 11 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
“Momnesia”: Your Brain on Pregnancy 🧠😳🧠
April 06, 2023 23:15 - 28 minutes - 26 MBPregnancy causes some well-known and well documented physical changes to the body. While hyperpigmentation, breast enlargement, and increase in vaginal discharge are non-disputed physical changes during pregnancy, other effects on mental capacity (memory and cognition) are more controversial. Does “mommy brain” really exist? Or is it a fulfilled psycho-social expectation? Does pregnancy actually change the brain? In this episode, we’ll present the data and provide some practical tips at the e...
The STI “Testing Window”
April 04, 2023 01:37 - 24 minutes - 22.2 MBFor a patient who presents after an episode of unprotected sexual intercourse, seeking testing for STIs, it’s important to know when to perform the test. The time between infection and a positive test is called the testing window. This testing window can be different for different pathogens. In this episode, we will review the importance of knowing this testing window, and we will also review the differences between pathogen inoculation, incubation/latency, and their overlap with the testing ...
VWD in Pregnancy
April 02, 2023 21:00 - 27 minutes - 25.6 MBVon Willebrand Disease (VWD) is the most common inherited bleeding disorder among American women, and it may present with a history of mucocutaneous bleeding patterns. Ideally, women should be screened/identified with this condition prior to pregnancy- but that is not always the case. How does VWD affect delivery? Is this a cause of immediate PPH? In this episode we will review the clinical manifestations of VWD in pregnancy. We will: 1. review appropriate labs tests for this evaluation, 2. s...
Urine STI Screening: New Data
March 31, 2023 14:55 - 19 minutes - 18.1 MBFor women’s healthcare, there are 3 ways to screen for genital GC, chlamydia, and trichomoniasis: 1. vaginal swab, 2. endocervical swab, or 3. first-catch urine. The CDC states that, “For female screening, specimens obtained with a vaginal swab are the preferred specimen type. Vaginal swab specimens are as sensitive as cervical swab specimens.” Why does it not favor urine screening? Although acceptable at a POPULATION level, there are several caveats to urine screening for STIs at an INDIVIDU...
The 4 PCOS Phenotypes
March 29, 2023 13:52 - 36 minutes - 33.3 MBWe have come a long way in our understanding of the “Stein and Leventhal Syndrome”. First described in 1935, our understanding of the pathogenesis and future health morbidities of PCOS has grown exponentially. We now know that AMH levels may help in the certain PCOS diagnoses. At the center of this clinical condition lies insulin resistance (IR). One of the manifestations of IR is Acanthosis nigricans (AN). (But AN can also be a marker of a much more deadly condition.) It is important to reme...
The Vegan OB Patient
March 26, 2023 21:02 - 28 minutes - 26.5 MBThe rate of vegetarianism in the United States is dramatically on the rise. While in 2014, a national survey found that only 1% of the US population considered themselves vegetarian, current estimates put that number up to 6%. But not all vegetarians are the same. Is being a strict vegetarian (a.k.a., vegan) associated with any adverse perinatal outcomes? Does being vegan increase your risk of preterm birth? In this episode, we will cover the latest data on how diet can affect perinatal outco...
AC < 10% with Normal EFW: Risks?
March 26, 2023 05:03 - 30 minutes - 27.6 MBTraditionally, fetal growth restriction (FGR) was diagnosed when the Hadlock EFW was < 10th percentile. However, in 2020, SMFM updated its publish guidelines endorsing the use of an isolated abdominal circumference (AC) under the 10th percentile as an additional diagnostic criterion. Is the isolated small AC linked to adverse perinatal outcomes? And what are the delivery recommendations for an isolated small AC? It’s a complicated issue with complicated data. In this episode we will provide t...
Birthing Ball: Toy or Labor Tool?
March 24, 2023 03:36 - 17 minutes - 16 MBOur current discipline of obstetrics owes a lot to the practice of Midwifery. In a previous episode, we covered “lessons learned from Midwifery” and that is available on our podcast archive. In this episode, we will discuss the data regarding a practice originally propagated by Midwifery: the Birthing Ball. What is the origin of this, and how did it make its way into obstetrical practice? Is there data for it’s use? Does it really help reduce labor pain? In this episode we will summarize the ...
For Gerri (CNM)! Quick response regarding a common gyn problem!
March 22, 2023 02:01 - 3 minutes - 3.4 MBGerri, thank you for your voice message today! Welcome to our podcast family. Here’s some helpful notes for you. 😊😊
Back to Amnioinfusion for Mec? New Metaanalysis Data (03/2023)
March 20, 2023 19:52 - 21 minutes - 20.1 MBIn Oct 2006, the ACOG released Opinion Number 346. This stated that “Based on current literature, routine prophylactic amnioinfusion for the dilution of amnioinfusion for meconium-stained amniotic fluid should be done only in the setting of additional clinical trials”. Back then, some experts criticized the decision to abandon amnioinfusion for meconium based on the limitations of the 2005 study which helped to motivate the ACOG decision. And now, a new systematic review and meta-analysis (pu...
Unexplained Infertility: New LIFE-CHANGING Genetic Data.
March 18, 2023 23:52 - 25 minutes - 23.1 MBInfertility. It’s real. It affects 10-15% of couples in the US. After a thorough investigation, 30% of couples will be left without an identifiable cause for their infertility. This has been termed unexplained infertility. While traditionally this may have been considered a reassuring result, new data is raising the yellow flag of caution in these patients. Research has now established the link between infertility and some potential future negative health outcomes. As “next generation“ geneti...
OB Anti-Thyroid Antibody Tests: 👍or👎
March 14, 2023 20:12 - 22 minutes - 20.6 MBSuch a small gland… Yet so much confusion, and controversy: the THYROID gland in pregnancy. Let’s start with this foundational question: should we universally screen for thyroid abnormalities in pregnancy? And as a follow-up question, should we be checking for anti-thyroid antibodies? The answer to both of those queries depends on who you ask! In this episode, we will solve the conundrum of whether we should be screening for anti-thyroid antibodies pre-pregnancy and/or during pregnancy itself...
HELLP w/o HTN? YES.
March 11, 2023 21:22 - 21 minutes - 19.6 MBThe traditional explanation and assumed pathophysiology of HELLP syndrome stated that it was a late manifestation/further progress of preeclampsia with severe features. But can HELLP present clinically without hypertension? What about without proteinuria? If a patient has lab criteria of HELLP alone, without hypertension, does she still require magnesium sulfate? In this episode, we will summarize data from 3 sources (ACOG practice bulletin on thrombocytopenia, ACOG practice bulletin on gesta...
Fezolinetant: A Revolutionary Medication.
March 09, 2023 16:11 - 19 minutes - 17.5 MBThe pathophysiology of menopausal hot flashes has remained largely a mystery until about a decade ago when KNDy neurons were found to be the key triggers of the hot flash. Since then, research and development has been going fullsteam to develop a non-hormonal, receptor-based therapy for the common hot flash. In April 2023 in the journal, Obstetrics and Gynecology (the Green Journal), new safety data will be published on the revolutionary new medication, Fezolinetant. With Phase 3 study result...
Nonreactive NST: Give OJ?
March 07, 2023 23:44 - 28 minutes - 26 MBThe fetal NST is a hallmark of antepartum fetal surveillance and a key component of the BioPhysical Profile (BPP). Historically, and still done today, one of the low-risk interventions for rectifying a non-reactive NST has been the maternal administration of glucose/PO challenge. Is this evidence-based? Does maternal hypoglycemia contribute to a nonreactive NST? In this episode, we will review the data spanning a 40-year interval that has sought to answer this question. And what about fetal m...
Do Rescue ACSs Affect Neurodevelopment? New March 2023 Data.
March 05, 2023 21:56 - 23 minutes - 21.4 MBThe Liggins and Howie trial demonstrating the benefit of antenatal corticosteroids (ACSs) on fetal lungs was published in 1972 in the journal Pediatrics. First adopted as weekly injections, ACSs were then found to be associated with decreased birth weights and decreased head circumferences. Hence, weekly administration was abandoned in the late 1990s. But the ACOG/SMFM does still recognize a single repeat dose “based on clinical scenario”, called a rescue dose. Is a rescue dose of steroids as...
UPDATE: Israel, “French CSs”, & Patient Groups.
March 03, 2023 19:31 - 9 minutes - 8.54 MBThis is a brief update regarding our recent podcast on “the French C-section”. Having an Israeli member of our podcast family…is priceless! ❤️Listen to the latest development regarding the extraperitoneal C-section in Israel and how this situation bears similarities to the US approval of ADDYI in 2015. Thank you Liel N.!! 😊😊
The Scary State of Syphilis
March 03, 2023 02:32 - 31 minutes - 29.1 MBIn 1999, the CDC had a national plan of action to “completely eliminate syphilis” by the year 2005. Although rates of syphilis did dramatically decrease to record lows during that time, we are now experiencing record HIGH rates of congenital syphilis. Some states are having a close to 500% increase in congenital cases. How did we get to this point? In this episode, we will review and summarize 3 key recent publications regarding the rise of congenital syphilis (Journal Women’s Health Issues [...
BEWARE The French C-Section!
March 01, 2023 04:48 - 21 minutes - 19.4 MBThe historic saying is, “there is nothing new under the sun”. So true! Such is the case with the extraperitoneal C-section. First advocated in 1823 by French obstetrician, Louis-Auguste Baudelocque, this complex technique fell to the waste-side with the advent of antibiotic availability. But now, this extra-peritoneal cesarean technique, A.K.A. the "French AmbUlatory Cesarean Section" technique (FAUCS), is trending on social media. Is this safe? Does this have any advantage over a traditional...
Pravastatin For Preeclampsia: New (Feb 2023) Data (AJOG).
February 26, 2023 15:05 - 19 minutes - 17.9 MBThe “cure” for preeclampsia is NOT delivery. Preeclampsia is an important signal for future cardiovascular complications once pregnancy is over. While there may not be a true “cure”, we do have options for chemoprophylaxis of preeclampsia. Currently, only low-dose aspirin is ACOG/SMFM endorsed for preeeclampsia prevention. But pravastatin is gaining steam. Pravastatin was previously classified (in the now discontinued FDA label) Category X. However, the FDA recently removed the warning regard...
The Short Interpregnancy Interval (IPI)
February 25, 2023 01:01 - 23 minutes - 21.9 MBSome obstetrical publications discuss adverse perinatal outcomes based on a short interpregnancy interval (IPI). A separate, yet related topic, is a short interdelivery interval (IDI). Most obstetrical care providers are aware of the adverse obstetrical outcomes following a short IPI. However, short IPI has also been linked to adverse neurodevelopmental disorders in the child. Are repeat fetal growth ultrasounds indicated in a pregnancy following a short IPI? Is antepartum fetal surveillance ...
The 34-36 WK PPROM Dilemma
February 23, 2023 17:29 - 21 minutes - 20 MBIn 2018, the ACOG recommended immediate induction of labor/delivery for patients with PPROM, who had sure gestational dating, and were at 34 weeks and 0 days or more. This was in order to reduce the risk of neonatal sepsis. This changed, however, in 2020 with ACOG Practice Bulletin 217 which discussed expected management for PPROM in the late preterm interval. Nonetheless, as is our tagline for this podcast, “medicine moves fast”. In February 2023, a current commentary was published in BJOG a...
Is Proliferative Endometrium in Menopause Benign?
February 20, 2023 20:20 - 20 minutes - 19.2 MBAs part of our medical training and education, we often learn diagnoses in isolation. For example, we have learned that Proliferative Endometrium on EMB is a non-pathological finding. That result can be left alone without therapy, correct? But what if that is found in the context of a postmenopausal patient. Is it still considered a nonpathological finding? In this episode, we will summarize the current nomenclature for endometrial pathology and why one classification scheme is favored over t...
Marginal Cord Insertion: Benign or Not?
February 19, 2023 06:09 - 20 minutes - 19.1 MBMarginal cord insertions can be found on antenatal ultrasound. What is the data regarding marginal cord insertion and adverse neonatal outcomes? Is there a relationship, or is this a benign finding? Are serial growth ultrasounds recommended? What about antepartum fetal surveillance for isolated marginal cord insertion? In this episode, we will review the latest data on pregnancies with marginal cord insertion. We will end the episode with a summary of the expert opinions regarding best practi...
Beyond the PHQ9: Dr. Leon-Arango’s Case
February 16, 2023 21:54 - 7 minutes - 7.21 MBThis is our impromptu podcast session in-between patients in our OB Clinic. In this episode, Dr. Leon-Arango (Senior Resident) highlights the importance of looking “deeper” into a patient’s persistent complaint of depression despite a negative PHQ9 score, based on her encounter from today. This real example of a physician’s perception of need for intervention likely helped to change the trajectory of this patient’s life. Listen in as we go “beyond the PHQ9”.
Eating Disorders in Adolescents (ABOG MOC Review)
February 14, 2023 00:46 - 28 minutes - 26 MBEating disorders are not a person’s personal choice. Data has confirmed that eating disorders are not choices, but serious biologically influenced illnesses. Did you know that anorexia nervosa has a highest mortality rate of all psychiatric disorders? Were you aware that the term “female athlete triad” has now been replaced by RED-S? Are Birth Control pills protective of bone loss in these patients? this episode, we will review key facts and clinical pearls regarding eating disorders in adole...
Pregnancy Care After IVF; SMFM #60 (ABOG MOC Review)
February 10, 2023 19:52 - 18 minutes - 17.4 MBSuccessful in vitro fertilization was first described in 1978. Births from IVF now account for 1.6% of all births and up to 18% of all multiple births in the US. While these techniques offer infertile couples hope for childbearing, they are not without some risks. Pregnancies resulting from IVF are at increased risk for both perinatal and maternal morbidity. What is the data surrounding genetic abnormalities following these procedures? What about congenital anomalies? Is the placenta affected...
Pregnancy at Age 35+ (ABOG MOC review)
February 09, 2023 02:06 - 21 minutes - 19.3 MBAccording to the CDC, there has been a continued upward trend in the mean age of pregnant women in the US. This is also being seen globally. Women, age 35 years and older are at higher risk for adverse pregnancy outcomes. Are growth ultrasounds recommended in the third trimester in this population? Are congenital anomalies more frequent? And at what age is antepartum surveillance recommended? In this episode, we will review the ACOG Obstetric Care Consensus # 11 from August 2022, which is als...
TVUS ES in AA Women (ABOG MOC Review)
February 06, 2023 15:41 - 23 minutes - 21.2 MBEndometrial cancer is the fourth most common cancer in the US and is increasing in incidence each year. Heartbreakingly, despite postmenopausal bleeding presenting as the main symptom in all patients with endometrial cancer, there is a large racial disparity in endometrial cancer mortality in African-American women compared to White women. The 2 largest factors contributing to this are advanced stage of diagnosis and histological cancer type. In this episode, we will review the ABOG MOC artic...
Obesity in Pregnancy (ABOG MOC Review)
February 04, 2023 21:48 - 26 minutes - 24.2 MBObesity is the most common health problem in women of reproductive age. Over the last 2 decades, the rates of obesity have increased resulting in a range of complications in pregnancy and in overall health. Does obesity in pregnancy contribute to preterm birth? What about congenital anomalies? Are obese women more likely or less likely to breastfeed? In this episode, we will review the publication from the New England Journal of Medicine (July 2022) reviewing that data on the subject, which i...
Winning Against Placenta Accreta Spectrum
February 01, 2023 15:06 - 27 minutes - 25 MBThe first case of placenta accreta listed on PubMed was reported in 1927 by Dr D.S. Forster out of Montreal. That was 1 case in 8000 deliveries! Now, according to the National Accreta Foundation, PAS occurs in 1 in 272 pregnancies. How did we get to this rate? In this episode we will highlight data from ACOG, SMFM, and the National Accreta Foundation. We will highlight key ultrasound markers, patient risk stratification, and review what a PAS Care Center is. This is how we win the battle agai...
Non-vigorous Baby & Umbilical Cord Milking: New Feb 2023 Data
January 29, 2023 17:39 - 14 minutes - 13.5 MBDelayed cord clamping (DCC) provides vital placental transfusion to newborns and is endorsed by ACOG, SMFM, March of Dimes, and the ACNM. However, DCC in nonvigorous newborns may not be provided owing to a perceived need for immediate resuscitation. Umbilical cord milking, in late-term and full-term neonates, is an alternative in these cases. In December 2020, the ACOG’s Committee Opinion stated a lack of outcomes data for umbilical cord milking in nonvigorous newborns. This Level 1 data has ...
IUD Use After Ectopic?
January 27, 2023 18:04 - 18 minutes - 17.3 MBHistorically, IUDs where considered contraindicated in a patient with a prior ectopic pregnancy. This was due to concerns that IUDs may be causative of tubal gestations. Is this true? Are IUDs contraindicated with a past history of ectopic pregnancy? In this episode we will review the data from the CHOICE project, the CDC (US), and the Royal College of OBGYN (UK). We will also summarize key findings from a May 2022 Green Journal publication that investigated this very issue, and we will expla...
Epidurals=Autism? New 2023 Data.
January 25, 2023 00:33 - 12 minutes - 11.2 MBA 2020 publication from JAMA Pediatrics reported that labor epidural analgesia may be associated with an up to 37% increased risk of offspring autism spectrum disorder. The ASA has rejected those results based on methodologic limitations of the study, the lack of biological plausibility. But some remain fearful of labor epidurals because of that publication. In February 2023, a new publication in AJOG will help put this matter to rest with the largest population-based analysis done to date. I...
PRP Ovarian “Rejuvenation”
January 22, 2023 22:53 - 24 minutes - 22.3 MBPlatelet Rich Plasma (PRP) therapy is a HOT and TRENDY item right now. PRP use was initiated in sports medicine in the 1970s. It has since expanded into many medical specialty fields, and now it is being heralded as the new hope for diminished ovarian reserve for those desiring pregnancy…even in menopause! Can injecting the ovaries with PRP really rejuvenate the ovary? We’ll examine the evidence as it sits as of January 2023.
Routine OB Urine Dips per Visits?
January 19, 2023 22:49 - 17 minutes - 16.3 MBRoutine, repetitive urine dipsticks (meaning at each prenatal visit) were introduced into prenatal care back in the 1960s and 70s. The idea was to act as an early screen for bacteriuria (ASB), proteinuria as a screen for preeclampsia, and glycosuria as a screen for GDM. That was based more on expert opinion rather than clinical trials. The utility of urine dipstick testing in pregnant women has been debated for years, with studies suggesting minimal use in asymptomatic patients. Urine dips as...
IUDs Don’t Cause Abortion
January 17, 2023 22:58 - 21 minutes - 19.8 MBParagard, Mirena, and Liletta IUDs are the most effective types of emergency contraception. Data from the 1980s, now seemingly forgotten, showed that IUDs work primarily on inhibition of fertilization rather than implantation effects. Nonetheless, misperceptions regarding the IUDs mechanisms of action persist, with some websites stating IUDs are abortive agents. Do IUDs cause abortion? Let’s examine the evidence.
The Placenta Menu? Placentophagy Reviewed.
January 15, 2023 16:54 - 20 minutes - 19 MB“Placentophagy” is not a new concept. Most non-human mammals eat their placentas after giving birth but humans, historically, have not. Is there evidence to support this practice? Where did this idea come from? How did Rolling Stone magazine help launch this phenomenon back in the 1970s? Is Kim Kardashian onto something cutting edge by advocating for Placental encapsulation? In this episode we will walk through history and learn some pretty remarkable things about this practice. Grab your fav...
Max Pitocin Infusion Rate (mU/min)?
January 12, 2023 04:46 - 21 minutes - 19.6 MBThe American College of Obstetricians and Gynecologists supports the use of both low-dose and high-dose oxytocin regimens to induce and augment labor, but does not specify MAXIMUM DOSE RATES. Most hospitals, however, have protocols that impose a maximum dose rate of oxytocin infusion. Is this evidence-based? Is there a danger with going above a certain threshold of infusion, for example, greater than 20 milliunits/minute? A new publication coming out in Obstetrics and Gynecology (the Green Jo...
Don’t Do Surveillance For These!
January 10, 2023 17:07 - 18 minutes - 16.6 MBThe ACOG states, “In spite of its unproven value, antepartum fetal surveillance is widely integrated into clinical practice in the developed world”. Antepartum fetal surveillance can be done by a variety of techniques and, despite its unproven value, is a mainstay of obstetrical management. At what BMI should we offer fetal surveillance? Is this current BMI or pre-pregnancy BMI? And what about advanced maternal age? What is recommended for that? Did you know that there was a change in the ACO...
Don’t Do Surveillance for these!
January 10, 2023 17:07 - 18 minutes - 16.6 MBThe ACOG states, “In spite of its unproven value, antepartum fetal surveillance is widely integrated into clinical practice in the developed world”. Antepartum fetal surveillance can be done by a variety of techniques and, despite its unproven value, is a mainstay of obstetrical management. At what BMI should we offer fetal surveillance? Is this current BMI or pre-pregnancy BMI? And what about advanced maternal age? What is recommended for that? Did you know that there was a change in the ACO...
Breech! ECV and Beyond
January 08, 2023 20:46 - 33 minutes - 30.4 MBBreech presentation at term occurs in approximately 3 to 4% of pregnancies. While the vast majority are simply chance events, breech presentation could be a marker of other fetal comorbid conditions. When should ECV be attempted? Does the ACOG recognize neuraxial analgesia as a tool to increase ECV success rates? What’s better spinal or epidural block? What are relative contraindications to ECV? In this episode, we will summarize the latest data on fetal breech presentations and answer key qu...
Folic Acid, Folate, or L-Methylfolate?
January 04, 2023 18:40 - 24 minutes - 22.2 MBOn some current social media channels, there is a hot debate as to why professional medical societies still recommend prenatal folic acid compared to the more “biologically, active” L-methylfolate. Are they onto something here? Published data has shown that anywhere from 40-60% of the general population may have an MTHFR mutation leading to the inability to process folic acid. Should we be screening for this mutation? What about screening for homocystine levels? Are these medical societies in...
Don’t Forget Prenatal Choline!
January 02, 2023 00:39 - 29 minutes - 27.3 MBCurrently on social media, there seems to be an interest in prenatal choline supplementation. Choline, a B vitamin, is not typically within standard prenatal vitamins. Is this micronutrient important for prenatal supplementation? What do professional/medical societies have to say regarding prenatal supplementation? What’s the data? In this episode, we will summarize choline’s role in fetal/newborn development, examine the data regarding deficiency, and talk supplementation recommendations. (S...
Fibroids, Menopause, and HRT
December 28, 2022 21:38 - 25 minutes - 23.1 MBUterine fibroids are benign tumors that arise from a single genetically altered myometrial stem cell under the influence of gonadal hormones. Traditionally, it has been taught that fibroids universally diminish in size after menopause. However, an article published in 2021 showed a possibility of fibroid growth after menopause in overweight/obese women. Do fibroids need surveillance in menopause? Is HRT contraindicated in the fibroid patient? And which HRT is the most fibroid friendly? We wil...
A Life Lesson From “ER”
December 27, 2022 18:35 - 13 minutes - 12.5 MBI am a fan of the original hit TV show, “ER”. Although mostly melodramatic and outside of bounds of reality Medicine, one episode (season 6, episode 6) has a valuable life lesson for all of us. I originally viewed that episode when it was live and current, and I have never forgotten the message. In this episode, will discuss this important life lesson learned, and I promise you won’t be the same thereafter.
TikTok’s #IUD is Killing a GOOD LARC!
December 23, 2022 18:54 - 27 minutes - 25.5 MBIn January 2023, a new publication in Obstetrics and Gynecology- the Green Journal, will highlight the disheartening statements being made on social media (TikTok) regarding IUDs. IUDs are highly effective forms of contraception and the progesterone releasing variety have significant non-contraceptive benefits. Most of the dissatisfaction stated on social media surrounds pain during insertion. Do you offer topical lidocaine for IUD insertion? Ever consider lavender aromatherapy? What about mu...
Vag Prep at CS UPDATE
December 20, 2022 18:50 - 22 minutes - 21 MBPre-operative vaginal preparation before gynecological surgery has unquestionable benefit for the prevention of postop infectious morbidity. Does the same hold true for vaginal prep at C-section? There has been over a decade of data, but a new publication- soon to be released in AJOG- is calling previous results into question. Does iodine work as a vaginal prep? What about chlorhexidine? There’s answers for all of these questions, and we will summarize them in this episode.
NPWT at CS: Yay or Nay?
December 18, 2022 23:21 - 27 minutes - 24.8 MBSurgical site infection (SSI) is the most common complication resulting from cesarean section. Despite advances in infection control, SSIs remain a significant post-op burden, to the patient first, and to the healthcare system second. Negative pressure wound therapy devices (NPWT) are a potential solution to post C-section. wound infections/complications. Do these devices prevent incisional wound complications after C-section? In this episode, will dive into the data and review the specific C...
Timed IUD Insert After Chlamydia Rx?
December 15, 2022 13:50 - 17 minutes - 16.4 MBTraditionally, the CDC has recommended delaying IUD insertion for 3 months in a woman diagnosed with asymptomatic, cervical Gonorrheal or Chlamydial infection. This is to first confirm a negative test of cure. However, this leaves the patient at a greater risk of unplanned pregnancy compared to the risk of PID. Is this really the most evidence-based approach? The CHOICE CONTRACEPTIVE Study data provides an alternative approach. In this episode, we will discuss this dilemma and allow the data ...