Dr. Chapa’s OBGYN Clinical Pearls

Dr. Chapa’s Clinical Pearls
  • 4.0 (475)
  • Science
  • Updated Semiweekly

Relevant, 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.

  1. 12h ago

    Choline in Pregnancy: New Oct 2026 RCT

    Choline is not a nutrient that the human body can synthesize in sufficient quantities; it must be obtained from dietary sources (eggs, meat, fish, dairy products, grains, and nuts). Its a water-soluble amine that serves as a precursor for phospholipids, which are vital components of cell membranes. Plus, it’s a vital component of acetylcholine, a neurotransmitter involved in numerous brain functions. Inadequate choline intake during fetal organogenesis is associated with neural tube defects and cognitive deficits in offspring. In the mother, low choline use has been associated with preeclampsia, preterm birth and possible fetal growth restriction. While choline is crucial for fetal development and maternal outcomes, studies suggest that many pregnant women don’t meet the recommended dietary intake, potentially risking maternal and fetal health. ACOG recommends that pregnant women consume 450 mg of choline each day, although there is no universal internationally agreed upon dose for proper maternal supplementation. Of note, the current recommendations for pregnant women were set in 1998 and were based on the amount of choline needed to prevent liver dysfunction in men, not on the more relevant outcome of offspring neurocognitive development. In this episode, we will highlight a new RCT (Article in Press-AJOG; Oct 19, 2026) on Choline supplementation in pregnancy and early childhood behavioral and cognitive outcomes. While the results were promising, there are some limitations to this study. Listen in for details. 1. Jaiswal A, Dewani D, Reddy LS, Patel A. Choline Supplementation in Pregnancy: Current Evidence and Implications. Cureus. 2023 Nov 8;15(11):e48538. doi: 10.7759/cureus.48538. PMID: 38074049; PMCID: PMC10709661. 2. Hunter S, Hoffman M, Law A .Prenatal Maternal Phosphatidylcholine and Children’s Behavior and Cognition through 4 Years of Age: Randomized Clinical Trial. American Journal of Obstetrics & Gynecology, 2026; 3. Bahnfleth CL, Strupp BJ, Caudill MA, Canfield RL. Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial. FASEB J. 2022 Jan;36(1):e22054. 4. Cai F, Young BK, Mccoy JA. Commercially Available Prenatal Vitamins Do Not Meet American College of Obstetricians and Gynecologists Nutritional Guidelines. Am J Perinatol. 2024 May;41(S 01):e2547-e2554.

  2. 3d ago

    A DCC Conundrum

    Delayed cord clamp is standard of care. On today’s episode, we are stepping into a high-pressure dilemma in the labor and delivery room. Imagine this (which doesn’t need a lot of imagination, because it is a real event which occurred to one of our podcast family members): A mother has carefully drafted a birth plan. One of her non-negotiable requests is delayed cord clamping for two full minutes. But the moment the baby is delivered, it becomes clear that the infant is non-vigorous: floppy, pale, and not breathing. The baby urgently needs immediate resuscitation. The physician reaches for the cord shears, but the mother demands: "No! Wait the two minutes! It's my decision!" What happens next? Whose rights win out? Today, we’re exploring clinical guidelines, the core ethical principles, the legal mandates, and state FOUR established norms that govern the delivering professional’s actions. 1. American College of Obstetricians and Gynecologists Committee on Clinical Consensus–Obstetrics. ACOG Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates. Obstet Gynecol. 2025 Jul 24;146(3):442-444. doi: 10.1097/AOG.0000000000006020. PMID: 40706055. 2. Jabeen S, Salam SS, Gillespie S, Hasan M, Islam S, Chowdhury AT, Ameen S, Balen J, Rahman AE, Arifeen SE, Nahar Q, Anumba DO. Delayed cord clamping: Perceptions, practices and influencers among the healthcare providers of selected healthcare facilities in Bangladesh. PLoS One. 2024 Dec 5;19(12):e0313938.

  3. 6d ago

    ASH New Ferritin Recs for Women (Sept 2026)

    Here is a sobering fact: Iron deficiency is one of the most common health conditions in the world. Iron deficiency affects an estimated one in three people, yet many go undiagnosed and untreated despite widespread treatment options. Iron deficiency can progress to iron deficiency anemia. If you’ve been listening for a while, you know we have banged the drum on this podcast time and time again about why serum ferritin matters. We’ve talked about how so many people suffer from low iron stores even when their basic blood work comes back looking "normal," and why we have to look way beyond just standard iron deficiency anemia. Well, guess what? The medical establishment is officially catching up! In September 2026, the American Society of Hematology (ASH) released brand new, evidence-based recommendations that are set to completely change how we diagnose iron deficiency. Published in ASH’s prestigious, peer-reviewed journal Blood Advances, these new guidelines were brought together by a multidisciplinary team of experts across multiple medical specialties to redefine critical thresholds- especially for women and during pregnancy. Today, we are diving deep into what these new guidelines actually mean for us. Listen in for details 1. https://www.hematology.org/newsroom/press-releases/2026/ash-sets-new-standards-for-diagnosing-iron-deficiency 2. https://ashpublications.org/bloodadvances/article/doi/10.1182/bloodadvances.2025015950/570502/American-Society-of-Hematology-2026-guidelines-for

  4. Oct 19

    Innie v Outie Labia: Listener Question

    Innie vs Outies: no, we are not referring to bellybuttons. In this episode, we’re talking about the labia of the Volva! Does it actually matter? Which one is more common? Now, this episode was actually sparked by a brilliant listener who sent us her question to our IG inbox (as a non-clinician): “Can having an innie labia actually cause me to have recurrent bacterial vaginosis?” Such a good question, right? So today, we’re going to break down what the medical literature actually says about anatomy and BV. Plus, well answer the question: What is ACOG’s stance on elective labioplasty? Grab a cup of coffee, get comfortable, and let’s normalize the normal. 1. Lykkebo AW, Drue HC, Lam JUH, Guldberg R. The Size of Labia Minora and Perception of Genital Appearance: A Cross-Sectional Study. J Low Genit Tract Dis. 2017 Jul;21(3):198-203. doi: 10.1097/LGT.0000000000000308. PMID: 28369012. 2. Aydın A, Atılgan AE, Sönmez MG, Sönmez L, Boğa MS, Balasar M. Do variations in labial anatomy have an effect on recurrent urinary tract infection? Int Urogynecol J. 2020 Oct;31(10):2129-2136. doi: 10.1007/s00192-020-04310-8. Epub 2020 May 9. PMID: 32388633. 3. Elective Female Genital Cosmetic Surgery. American College of Obstetricians and Gynecologists. 2020. Committee on Gynecologic PracticeGuideline 4. ACOG Committee Opinion 795: Elective Female Genital Cosmetic Surgery; 2020 (reaffirmed 2026)

  5. Oct 15

    Marfan Syndrome in Pregnancy

    Marfan syndrome is an autosomal dominant, connective tissue disorder. Because it’s autosomal dominant, an affected parent has a 50% chance of passing the genetic mutation to their offspring in every pregnancy. Approximately 25% of cases actually stem from spontaneous, de novo mutations with no prior family history. In the United States, the prevalence of Marfan syndrome is estimated at roughly 1 in 5,000 individuals. It affects males and females equally across all ethnic backgrounds. Although this topic and condition might sound rare at first glance- Marfan syndrome in pregnancy- it is in our communities, and we need to be ready for the potential complications that come with it. When is vaginal delivery allowable here? Do these patients need any maintenance meds during pregnancy? What about postpartum surveillance? Grab your coffee, get comfortable, and let's jump right in! 1. Elkayam U et al. High-Risk Cardiac Disease in Pregnancy: Part II. J Am Coll Cardiol. 2016 Aug 2;68(5):502-516. doi: 10.1016/j.jacc.2016.05.050. 2. Milleron O, Arnoult F, Delorme G, et al. Pathogenic FBN1 Genetic Variation and Aortic Dissection in Patients With Marfan Syndrome. J Am Coll Cardiol. 2020 Mar 3;75(8):843-853. 3. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022 Dec 13;80(24):e223-e393. 4. Narula N. et al. Pregnancy-Related Aortic Complications in Women With Marfan Syndrome. J Am Coll Cardiol. 2021 Aug 31;78(9):870-879.

  6. Oct 12

    Is Mag Always Needed for PP Readmission for PreE?

    If you’ve ever managed postpartum preeclampsia, you know the clinical gray zone: after an initial intrapartum course of magnesium sulfate, when do you actually restart it for a postpartum, readmission exacerbation? Always? There’s no standard national guidance on this. Every unit seems to do something a little different. In this episode, we’re summarizing a new study looking at practice patterns across the country. This study is actually a survey of US MFM fellowship directors across the ACOG Districts. This publication will be officiallyreleased/published in the Journal of Maternal-Fetal and Neonatal Medicine in December 2026. We’ll break down what these fellowship directors would do, why the variation exists, and what this means for your clinical practice. Let’sget into it. 1.    Dellapiana G, Thompson K, Gregory KD. Repeatadministration of magnesium for an exacerbation of postpartum preeclampsia: anational survey. J Matern Fetal Neonatal Med. 2026 Dec;39(1):2738315. doi:10.1080/14767058.2026.2738315. Epub 2026 Sep 28. PMID: 42805980.

  7. Oct 8

    The LT-O Whole Blood CONTROVERSY

    If you’ve been listening for a while, you might remember an episode we ran about two years ago where we dove deep into the use of low-titer O-positive whole blood in emergency resuscitation. At the time, the consensus in trauma care was leaning heavily "pro"—advocating for getting O-positive blood into bleeding patients fast, especially given the persistent and severe shortages of O-negative inventory. Fast forward to today, and the conversation around balancing immediate survival against downstream risks has taken center stage. In just the last two months, two major publications have come out with seemingly conflicting perspectives on this exact issue. First, in July 2026, the American College of Surgeons released their consensus guidance, which attempts to strike a delicate balance between saving lives in acute trauma and mitigating future reproductive risks associated with Rh sensitization in patients of childbearing potential. But then, in September 2026, Obstetrics & Gynecology—the Green Journal—published an editorial by Jacobs et al. offering a very different lens on the practice. In today's episode, we’re unpacking both papers, comparing where they align, where they clash, and what this evolving debate means for trauma protocols, blood bank management, and patient care on the front lines. Let’s dive in. ​Post-Transfusion Management of RhD-Negative Females of Childbearing Potential Who Receive RhD-Positive Low-Titer Group O Whole Blood and Red Blood Cells During Trauma Resuscitation: A Joint Position Statement and Resource Document of the American College of Surgeons Committee on Trauma (ACS-COT), Prehospital Blood Transfusion Coalition (PBTC), National Association of Emergency Medical Services Physicians (NAEMSP), Trauma Hemostasis and Oxygenation Research (THOR) Network, and Allo Hope Foundation (AHF). J Am Coll Surg. July 2026.2. Jacobs, J. W., Callum, J., Adkins, B. D., Abels, E. A., Raza, S., Sharma, D., Wheeler, A. P., Osmundson, S. S., Chooljian, D. M., & Booth, G. S. (2026). RhD-Positive Whole Blood for Patients With Reproductive Potential After Two Randomized Trials of Prehospital Trauma Resuscitation; Obstetrics & Gynecology.

  8. Oct 5

    ASRM RPL “UPDATE” 2026

    In June 2026, the ASRM released its updated guidance on recurrent pregnancy loss. This is the most updated guidance in over a decade and includes a decision tree algorithm that starts with a pivotal test. In this episode we will review this “first pass” triage test and provide clinical implications. 1. ASRM CO: https://www.asrm.org/practice-guidance/practice-committee-documents/recurrent-pregnancy-loss-a-committee-opinion-2026/ 2. de Assis V, Giugni CS, Ros ST. Evaluation of Recurrent Pregnancy Loss. Obstet Gynecol. 2024 May 1;143(5):645-659. doi: 10.1097/AOG.0000000000005498. Epub 2024 Jan 4. PMID: 38176012.

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Relevant, 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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  • Creator
    Dr. Chapa’s Clinical Pearls
  • Years Active
    2018 - 2026
  • Episodes
    1.2K
  • Rating
    Explicit
  • Copyright
    © Dr. Chapa’s Clinical Pearls
  • Show Website
    Dr. Chapa’s OBGYN Clinical Pearls

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