Without doubt, the most common reason for requested progestin-intrauterine system (IUS) removal is abnormal bleeding patterns. But do you know what the second most common reason is? It’s acne! In this episode, we will summarize a soon to be released article accepted for print in Obstetrics and Gynecology (the Green Journal). This episode will provide practical clinical pearls to truly obtain informed consent from our patients seeking long acting reversible contraceptives (LARCS).
Weitere Episoden von „Dr. Chapa’s Clinical Pearls.“
“Double Dose” Plan B?
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13:51There is some controversial/conflicting data on whether LNG-based emergency contraception is less effective in patients who are overweight or obese. Can giving a “double dose” of Plan B make-up for this potential short coming in these patients? What is the FDA’s response to these weight-based efficacy claims? In this session we will review a recent publication from June 2022 in Obstetrics and Gynecology which helps answer this very timely question.
“Reverse Sequence” Syphilis Tests
23:39Lots of practical clinical pearls in this episode! “Reverse sequence testing” for syphilis has largely taken over the traditional testing algorithm. Traditionally, non-Treponemal tests (RPR, VDRL) were done first with a reflex to a Treponema specific test if that was positive (MHATP). But this is now considered the antiquated technique. Reverse sequence testing has the advantage of potentially identifying infected patients very early on. In this session, we will give easy to use/practical tools for reverse sequence test interpretation, and how to best manage “discordant“ results.
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Does Ella Cause Abortion?
13:50Over the last several days I have received numerous Facebook messages, podcast voice memos, and personal texts regarding the potential for misapplication of Ulipristal’s mechanism of action as emergency contraception. Will Ella be banned? Does it affect implantation? It’s time to clear the dust and set the record straight.
New ACOG (June 16, 2022) Advisory: “PreP Talk”
17:34On June 16, 2022, the ACOG released a new practice advisory regarding PreP in the ObGyn patient population. This has important implications on how we counsel patients especially after recent STI diagnosis. In this podcast we will cover important aspects of PreP to get you comfortable with this preventative option. What are the 3 currently approved options? Are they safe? What about monitoring? Do adolescent patients qualify? We will answer all of these questions and more in this session.
PCOS and ACUTE PeriPartum Risks
20:16We have come a long way from the first report from Stein and Leventhal describing “polycystic ovaries“ on ultrasound in infertile women back in the 1950s. We already well understand that PCOS raises the risk of certain antepartum complications including gestational diabetes, possible macrosomia, and the development of gestational hypertension or preeclampsia. But there actually is scant data on the risk of acute peripartum complications. In this podcast we will summarize a large study just published June 16, 2022 out of the Journal of AHA. We will also cover the importance of distinguishing between “Odds Ratios” and “absolute numbers” for clinical implications. Ready? Let’s dive into acute PeriPartum risks for women with PCOS.
Monkeypox 101: Effect in Pregnancy and Beyond.
20:56This is your crash course into all things “Monkeypox”. Data for this podcast comes from the CDC, WHO, and the Royal College of Obstetricians and Gynecologists. Information is moving fast and we’re here to keep you evidence-based. How does Monkeypox affect pregnancy? When is a C-Section indicated? What are the treatments available? And what about the 2 vaccines available in the USA… Why is one more problematic than the other? Listen in and find out.
Hydration for Oligo?
20:12Which is better for determining amniotic fluid volume: the AFI or MVP? There’s data to support one or the other. In cases of isolated oligohydramnios in the late preterm interval, is there a role for maternal oral hydration? Does that actually work? We are going to dive into the amniotic fluid (no pun intended) dilemmas now.
Is Myfembree Birth Control?
13:27According to the ACOG, by natural menopause it is estimated that up to 70% of women will have developed a uterine leiomyoma. 70%! Most of course are asymptomatic. For those with symptoms, heavy menstrual bleeding and pain are the most common afflictions. In May 2021, the FDA approved a new triple combination pill for heavy menstrual bleeding associated with fibroids. Can this medication also be used as hormonal birth control? We will review the ACOG, FDA, and manufacture’s information for MyFimbree in this clinical update.