Dr. Chapa’s Clinical Pearls‪.‬ Dr. Chapa’s Clinical Pearls

Traditionally, clinical guidance has incorporated maternal fever as a required criterion for suspected intraamniotic infection. That is exactly what is stated in the ACOG committee opinion #712 from 2017. However, not all patients with clinical IAI have fever! Having fever as a required part of the diagnostic criterion may result in delayed administration of appropriate antibiotics intrapartum. This has now been addressed by the ACOG! Today, on April 29, 2024, the ACOG released a practice update regarding the criteria for the diagnosis of suspected intra-amniotic infection. This is hot of the press, and we will break it down for us all in this episode. 🔥🔥🔥🎙️🎙️🎙️👍👍🙏

Regenerative Medicine is definitively a HOT and marketable offering across a variety of medical disciplines. But it is equally as controversial. The most well known type of regenerative medicine is the use of Platelet Rich Plasma (PRP). This has been proposed as a novel care therapy for musculoskeletal pain disorders, and a variety of GYNECOLOGICAL applications- including POI, pelvic floor dysfunction, uterine infertility treatment, and even some forms of vaginal fistulas. AND YES... RPR is even being used as a type of cosmetic fascial (with a new CDC health investigation underway!). In this episode, we will review the concept of Regenerative Medicine in gynecology, summarizing some key points from a brand new narrative review of the subject published in the Green Journal (Obstetrics Gynecology).

WOW. There has been a lot of new developments in the ObGyn world within the last 48 hours. In this episode, we will highlight 3 big developments/alerts regarding women’s healthcare: 1. the FDA’s approval of a new oral antibiotic for UTIs in females; 2. The updated ACOG practice advisory regarding maternal cell-free fetal RHD testing; and 3. The FDA’s recent (within last 24 hours) clearance of a new digital app for postpartum depression (MAMMALIFT). Special shout out to Dr. Colton for bringing MAMMALIFT to my attention.

(With Resident Co-Host Dr Taylor Apley) Menstrual synchrony is often reported by all-female living
groups and by mothers, daughters and sisters who are living together. Is this real? Is this a pheromone issue? Is there biological signaling occurring here? The answer may surprise you! How does this work? Or does it work at all? And…what is the “MALE Effect”?? Where did this concept come from? This topic of menstrual synchronization is still getting its share of publications, like from November 2023- which we will review. Yep, we’re going to get into this fun topic in this episode. PLUS…DON’T say the “Q” word when all is still in L&D, or the ER. Or the OR! Saying the word QUIET is a sure-fire way to increase hospital admissions and patient pass through, right?! Can you believe there is an RCT that actually studied this? YEP…we’ll check out this issue as well: Fact or FICTION? Listen in, and find out.

Our regular podcast family members know that we have been following the antenatal corticosteroid story (especially in the late pre-term/early term interval) for several years now. A variety of countries have now pulled back from recommending corticosteroids in the late pre-term/early term interval due to concerns of adverse child neurodevelopment, especially when the children deliver at term. But today, April 24, 2024, a new publication from JAMA has provided some reassuring information. Is this data truly reassuring? Or is there more to the story? In this episode, we will dive into this brand new publication, released today, which provides follow-up from the original ALPS Study. This issue of steroids in the late pre-term/early term interval is hot hot hot 🔥🔥🔥. Listen in to get the latest information!

Breast cancer is the second most common cancer among women in the United States (with skin cancer are the most common). About 9% of all new cases of breast cancer in the United States are found in women younger than 45 years of age. Unfortunately, breast cancer is being diagnosed in women under 40 at an increased rate. This was recently published in a Jan 2024 JAMA population-based, cross-sectional study using data from Surveillance, Epidemiology, and End Results database. Every year, more than 1,000 women under age 40 die from breast cancer. Nearly 80% of young women diagnosed with breast cancer find their breast abnormality themselves. Breast cancer is the most common form of cancer in women who are pregnant or have recently given birth. According to US statistics, Breast cancer occurs about once in every 3,000 pregnancies, with some reports stating it may be as high as 1 in 1,000. For those under the age of 40, most are diagnosed between the ages 32 to 38 years. Because many women are choosing to delay having children, it is likely that the number of new cases of breast cancer during pregnancy will increase. In this episode, we’re going to look at breast cancer in reproductive age women with a focus on gestational breast cancer. Is MMG contraindicated in pregnancy? Can chemotherapy be used during pregnancy? What about radiation therapy? And is it better to have a complete mastectomy or breast conservation, during pregnancy? Listen in for details.