Dr. Chapa’s OBGYN Clinical Pearls
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.
Episodes
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 a
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 inven
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-
New Data on CHC with MwA
Currently, the CDC U.S. Medical Eligibility Criteria (USMEC) rate CHCs as category 4 (unacceptable health risk) for migraine with aura, versus category 2 for migraine without aura; ACOG similarly recommends avoiding estrogen-containing contraception in migraine with aura. But, recent data published in August 2026 from the UK seems to show no increased risk with “modern”/low-dose combination birth
Neg Trich on VP3 but Positive NAAT? Why?
A growing body of research reveals the link between STIs andthe pathogens that cause most cases of vaginitis. Over 90% of vaginitis cases result from BV, yeast, or trich- alone or in combination. But, a recent 2024 study from Schwebke et al., in the J Clinical Microbiology, found that about 1 in 5 women who presented with symptoms of vaginitis also had at least one STI…a good reminder to not just
cfDNA Reflex Testing for Autosomal Recessive Fetal Conditions
An important clinical advantage of cfDNA screening for autosomal recessive conditions is its ability to provide meaningful fetal risk assessment in general-risk pregnancies at an early gestational age, even when partner carrier testing is unavailable. But is this reflex cell-free DNA approach reliable. In this episode, we will review NEW DATA (Oct 2026) from a prospective, multi-site study whose g
ENTG New Removal Guidance (SGP Article in Press)
Welcome back to the show, everyone! Today,we are diving deep into one of the most effective, set-it-and-forget-it contraceptive options available: the Nexplanon implant. With a failure rate of about 0.05%, it is apowerhouse of birth control. You pop it just under the skin of the inner upper arm, and for up to five years, you are covered. Standard removal is usually a quick, straightforward, in-off
Retest GDM Late 3rd Tri for LGA or Poly? (OCT 2026 Data)
Picture this common, late-gestation conundrum: You’re reviewing a 34-week sono. The mid-pregnancy 24-to-28-week glucose screen was completely normal. But now, the sonogram pops up with an estimated fetal weight of over 90%, or maybe a MVP (or AFI) that’s overtly elevated. The classic clinical dilemma hits: Do you order a repeat OGTT this late in the game? Is it actually worth poking the patient ag
Routine pp Hgb?
Today we’re diving into a lab order that almost every ob-gyn, midwife, and labor-and-delivery nurse were traditionally trained to do: the routine Postpartum Day 1 Hemoglobin and hematocrit. For decades, checking a patient’s H&H after delivery was automatic. Didn’t matter if it was a smooth, uncomplicated vaginal birth with minimal blood loss or a complex emergency C-section- come 6:00 AM the n
General Anesthesia and PP Mood Disorders
If you’ve been following health and medical headlines over the past few weeks, you’ve likely seen a renewed and urgent conversation around postpartum depression—a condition that affects millions of new mothers worldwide, often with devastating consequences. While we’ve long understood that postpartum depression is deeply multifactorial—shaped by a complex web of hormonal shifts, psychological stre
MS and Pregnancy (Sept 2026 Expert Review)
MS is a complex polygenic disease with over 200 associated genetic variants. The risk of an offspring developing MS if one parent is affected is relatively low at 2% to 3% (though maternal transmission shows slightly higher heritability), with some possible epigenetic influences. The National Multiple Sclerosis Society reports that up to 4 times as many women have MS as men. The average age at MS
What Defines “Refractory” HTN for Preterm sPreE Delivery?
The ACOG PB 222 states, “In women with preeclampsia with severe features at less than 34 0/7 weeks of gestation, with stable maternal and fetal condition, expectant management may be considered”. The expectant management of preeclampsia with severe features before 34 0/7 weeks of gestation is based on strict selection criteria of those appropriate candidates and is best accomplished in a setting w
The Cerebellum (TCD) as EGA Referee
So, here is a not uncommon situation: A new OB patient presents for initial prenatal care at 28 weeks by “sure LMP” but her ultrasound EGA is just over 3 weeks behind. Simple redating, right? How can we be assured that we are not missing FGR? That is where the “ancillary” use of transcerebellar diameter (TCD) plays a role. In this episode, we will highlight the recent JUNE 2026 data on this and re
Parkland Universal LDA (162mg) Preg Study
Today we are diving into a topic that is incredibly close to my heart—one that has the potential to fundamentally change how we approach prenatal care and protect pregnant patients. We’re talking about low-dose aspirin for the prevention of hypertensive disorders of pregnancy. Now, if you follow current formal guidelines, you probably know the standard protocol: 81 milligrams a day, prescribed bas
“Resolved” Early FGR: Now What?
Today, we are tackling a massive grey area in obstetrics/maternal-fetal medicine: What happens after early fetal growth restriction resolves? When a baby bounces back on the growth chart during the second or third trimester, are they completely out of the woods? Or is there a hidden, lingering risk we aren’t talking about enough? To find out, we’re doing a deep dive into two major publications tha
New CPG on OB CERCLAGE (Sept 2026)
The word CERCLAGE comes from the French word, cercle, meaning "hooping" or "encirclement". Cerclage was traditionally reserved for cervical insufficiency but is now a recognized option for patients with a history of preterm birth and a short cervix noted on ultrasound between 16-24 weeks. There are three (3) main indications for obstetrical, cervical cerclage: History-Based, Ul
New CPU on OPS!
As of August 20th, 2026, the ACOG has released an updated Clinical Practice Update on opportunistic salpingectomy. Here’s why this matters so much: we now know that the vast majority of high-grade serous epithelial ovarian cancers actually start not in the ovaries, but in the fallopian tubes. By removing those tubes during routine pelvic, obstetric, or even non-gynecologic abdominal surgeries, we
Vag Miso vs Vag Dino: New Meta-analysis (Aug 2026)
ACOG recommends the use of oral or vaginal misoprostol, vaginal dinoprostone (either gel or insert), or mechanical methods for cervical ripening. Plus, it states, “Combination methods (pharmacologic and mechanical) are also effective”. The July 2026 ACOG CPG 9 states this regarding vaginal misoprostol compared to vaginal dinoprostone for labor induction: “Vaginal dinoprostone is effective for cerv
Estrogen’s Protection Against Breast CA: The Underappreciated Data
Today, we are taking a deep dive into a medical truth thatsounds completely counterintuitive, almost upside down, based on everything you think you know about women's health. But here’s the kicker: it’s actually nothing new at all. For over two decades, ever since the landmark Women’sHealth Initiative (WHI) study made global headlines back in 2002, the blanket narrative surrounding menopausal
SC v IV Insulin Intrapartum
Historically, continuous intravenous (IV) insulin infusions were established as the standard of care for pregestational diabetes (Type 1 and Type 2 DM) during labor to prevent acute intrapartum hyperglycemia and minimize the risk of neonatal hypoglycemia. Intravenous insulin offers rapid titration, immediate onset, and a short half-life, allowing precise real-time glycemic control during the physi
Intro to REVI EXTEND IMPLANT (Not a sponsor)
Urge urinary incontinence (UUI) places a significant emotional and physical burden on women affected. Sacral neuromodulation has been and remains a well-established implant-based therapy for UUI. The concept originated in the early 1970s from sacral anterior root stimulation research for neurogenic bladder, with human clinical trials beginning in 1982. Medtronic's InterStim device received FDA
The QBL Paradox: Precision vs. Performance in OB Hemorrhage
Today, we are taking a deep dive into an intervention that almost every labor and delivery unit in North America has adopted over the last decade: Quantitative Blood Loss, or QBL. ACOG first recommended quantitative blood loss assessment in Committee Opinion Number 794, published in December 2019. This opinion recommended that every birthing facility implement a standardized, quantitative method f
Routine US for RPOC After 2nd Trimester Loss?
Today, we’re stepping into one of the most clinicallydelicate and emotionally heavy scenarios you can encounter in women's healthcare: a mid-pregnancy loss, say right around that 18 to 20-week mark. It’s a situation where the clinical room feels still, the emotional weight is immense, and every decision you make as a clinician carries profound gravity. Picture the scenario: The delivery has oc
A Mechanic’s Vision: The OdonAssist™ Device (Not Ready for US Approval)
Today, I want to tell you a story that sounds like it was completely made up for a movie script, but it’s 100% real. Imagine an automotive mechanic in Argentina. He has zero medical training, no background in obstetrics, and no clinical degree. One night, he sees a simple party trick on YouTube: how to get a lost cork out of the inside of an empty wine bottle using nothing more than an inflated pl
When Data Gaps Exist: OB HSV Suppression?
ACOG first recommended antiviral suppressive therapy at 36 weeks of gestation for women with a history of genital herpes in 2007, with the publication of Practice Bulletin No. 82 ("Management of Herpes in Pregnancy," June 2007). This was the first ACOG practice bulletin specifically dedicated to genital herpes management in pregnancy, and it established the 36-week suppressive therapy re
(MIPI) Multidose Ibuprofen Prior to IUD?
Today, we’re diving straight into a topic that hits close to home for millions of patients and providers alike: IUD insertion pain, and more importantly, how we can actually make it better. Now, if you’ve been practicing or following clinical guidelines for a while, you know the frustrating backstory here. For years, the standard advice was simple: "Just take 800 milligrams of ibuprofen an ho
Ferritin at iOB: Told Ya! (Aug 2026 Data)
Podcast family, we pride ourselves on this show on being avant-garde and forward thinking on the topics we choose. For example, on February the 20th, 2026, we released an episode called “New Data: Screen Maternal Ferritin with Prenatal Care?” In that episode we reviewed a publication from the previous month (January 2026) that was released in Lancet Hematology. This study made the case for screeni
IUDs Cause Uterine Adhesions & Infertility?
If you’ve scrolled through your feeds recently, you’ve probably seen the video that’s causing a stir: a prominent infertility doctor sharing her “Hot Take” personal observations on social media, claiming that IUDs are a hidden cause of intrauterine adhesions- or severe uterine scar tissue. Now, Listen. It is completely natural to see a specialist standing in a white coat making a passionate claim
Rescue ACS with PPROM?
Antenatal corticosteroids are a MAJOR win in the management of preterm labor. An initial course of antenatal corticosteroids has been shown to reduce morbidity and mortality in patients with preterm prelabor rupture of membranes. For patients who remain undelivered after the initial course of antenatal corticosteroids, it is uncertain whether a booster course of antenatal corticosteroids reduces n
Bakri Shortened In-Utero Time: An RCT (July 2026)
The Bakri Postpartum Balloon was described and first used clinically in 1999 by Dr. Younes N. Bakri (Georgia, USA). It is intended to treat postpartum hemorrhage (PPH). In the United States, it received its first major FDA clearance (via 510(k) for commercial marketing) on April 17, 2002. Manufacturer guidelines for the Bakri (Cook Medical) state that the balloon may be left indwelling for a maxim
COCs Lead to Binge Eating?
Gonadal hormones have a complicated influence on appetite. Estradiol generally suppresses appetite, whereas progesterone opposes estradiol's action such that their combined presence represents a high-risk hormonal milieu for Binge Eating (BE). Testosterone is thought to be associated with increased BE in females but appears protective in males. In some reports, combination oral contraceptive (
DIY Home Vag Sonos? YEP
The DIY at-home gynecology health market has EXPLODED. There is at-home vaginal/cervical HPV testing, screening for STIs, and even a blood test for multi-cancer screening (Cancer Guard). These provide a potential solution for access to care and social determinants of health. Now, a new study is seeking to add DIY at-home transvaginal ultrasounds to that mix. Yep…at home. This was published in Jama
RAFT Realities: “Robbing Peter to Pay Paul” ? (July 2026 Data)
As healthcare professionals, we should all seek and encourage scientific and medical discovery and new therapies. That’s one big goal of the scientific process: to bring new therapies to otherwise lethal condition. For example, back in the 80s and 90s, HIV uniformly led to AIDS, which was a death sentence. But now, HIV is 100% manageable with appropriate medical care and medical therapy. That’s a
Circumventing Previa at Hysterotomy Creation (Surgeon’s Corner)
Placenta previa has an incidence of about 0.4% to 0.5% (or 1 in 200 to 1 in 250 deliveries). Anterior placenta previa poses a unique obstacle in fetal extraction at CS: Is it best to transect (enter) the placenta or to cause a marginal abruption at the placental edge for fetal extraction? In this episode we will review an upcoming “Surgeon’s Corner” in the AJOG (July 2026) which provides some tips
40 to 40.6 EGA as Best Delivery timing?
In 2018, the ARIVE trial was published in the NEJM revealingthat induction of labor at 39 weeks reduced cesarean deliveries and gestational hypertension/preeclampsia in low-risk nulliparous women who had labor induced,compared to expectant management. Then, in 2025, and partly in response to L&D units across the country becoming saturated with low- risk, nulliparous patients awaiting their inducti
“New” Data: CS Skin Incision To Delivery Interval (AJOG-MFM)
If you practice obstetrics, you already know that our entire world is ruled by a stopwatch. Think about it: we are obsessed with time. We wait exactly 60 or 120 minutes for a gestational diabetes challenge. We stare at a monitor for a strict 30 minutes timing a biophysical profile. The entire pregnancy is dictated by an Estimated Date of Delivery that has us counting down the literal days. But wha
More Steroid Stuff (July 2026)
Think about the last time you had to time something perfectly. Maybe it taking that perfect swing at the baseball, or catching a flight after a commute, or making a high-stakes decision. In the world of high-risk pregnancy, clinicians play a constant game of high-stakes timing with a usual medication called antenatal corticosteroids. Given to moms at risk of giving birth early, these steroids are
MOPP & PP BP Control
More than 60% of maternal deaths occur during the postpartum period, and hypertensive disorders of pregnancy are a major, preventable driver of that statistic. For too long, the transition from labor and delivery to home has been a vulnerable blind spot—leading to high rates of avoidablereadmissions. But the landscape has shifting. In this episode, we are diving deep into why OB providers must opt
Peripartum Cardiomyopathy (PPCM): When the Left Heart Falters
Welcome back to the show, everybody! Today, we are diving deep into the intersection of maternal-fetal medicine and cardiology. We’re tackling a condition that keeps every OB/GYN, MFM, and cardiologist up at night: Peripartum Cardiomyopathy, or PPCM. And to keep our clinical gears turning, we are framing this discussion squarely through the lens of Society for Maternal-Fetal Medicine (SMFM) Consul
The “20-minute” Rule for VAVD: 2026 Data
Podcast Family, in this episode we will focus on the “20-minute rule” for vacuum assisted vaginal delivery. This is an important aspect of neonatal safety and is a vital part of procedure documentation. Documentation for vacuum assisted vaginal delivery should include station at application, number of tractions, number of pop-offs and the total traction time and the vacuum trackable time (time fro
2026 Lp(a), AHA, and OBG: What Now?
The March 2026 ACC/AHA Guideline on the Management of Dyslipidemia made a major pivot regarding Lipoprotein(a) by establishing a formal recommendation for universal screening in adults. This 2026 guideline, published in the Journal of the American College of Cardiology, issued a Class 1 recommendation stating that every adult should have their Lp(a) measured at least once in their lifetime. Becaus
CS: UT in or UT out? New July 2026 Data
Hey everyone, thanks for tuning in. If you’ve spent any time in the OR during a cesarean delivery, you know that the choice between uterine exteriorization and in situ repair usually comes down to how you were trained or personal surgeon preference. It’s a debate as old as modern obstetrics. But a major piece of clarity is coming down the pipeline. This episode, we are getting a sneak peek at a br
SHOCKING: ACSs INCREASE Risk in Twins? (Listen in)
In the ACOG PB 231, Multifetal Gestations Twin Triplet and Higher-Order Multifetal Pregnancies, it states, “based on the improved outcomes reported in singleton gestations, the National Institutes of Health recommends that, unless a contraindication exists, a course of antenatal corticosteroids should be administered to all patients who are at risk of delivery within 7 days and who are between 24
5mm v 1-cm Fascial Closure at CS: MINI EPISODE
Historically we were taught as surgeons that 1-centimeter bites that between suture throws on a Pfannenstiel (low transverse) fascial closure was enough to prevent hernia formation and optimize facial healing. But is this still evidence based? We can extrapolate data from a May 2026 systematicreview/meta-anlysis as well as a separate study from the Dutch published in 2021. Both of these studies we
NIPT CONFIRM Test SPECIAL GUEST: Blurring the Line between Screening & Confirmation of Fetal Aneuploidy
Today, we are talking about a true paradigm shift in prenatal genetics. For decades, we’ve relied on cell-free DNA for screening, but when it came to definitive confirmation of fetal aneuploidy, we’ve had to counsel our patients through the anxiety and physical risks of invasive procedures like amniocentesis and CVS. But what if the line between screening and confirmation just blurred? In this epi
OB, ED, and STDs: Gaps Noted!
Back in June 2024, we highlighted surprising data from JAMA Network Open regarding adolescent care in the ED. Because many adolescents use the ED as their primary care provider, it’s a good opportunity for them to have contraception addressed regardless of why they presented. But that’s not what was happening. That publication from two years ago showed significant gaps in addressing contraception
When to Best Deliver With a Uterine "Window"
It's a QUICKY: IMPROMPTU episode in clinic today..
Treat Non-Severe PreE with BP Meds?
Welcome back, everyone. Today we're diving into one of the most hotly debated topics in obstetrics- should we be treating preeclampsia without severe features with antihypertensive medications during expectant management? Now, if you've been following the literature- and our show, you know that the landmark CHAP trial changed the game for chronic hypertension in pregnancy. It showed us tha
The WILDCARD: LUS Window on Prenatal Sono, TOLAC?
The American College of Obstetricians and Gynecologists (ACOG) does not recommend routine ultrasound measurement of the lower uterine segment (LUS) thickness as part of the evaluation for trial of labor after cesarean delivery (TOLAC). ACOG Practice Bulletin No. 205 (2019) on Vaginal Birth After Cesarean Delivery does not include LUS measurement among its recommendations for TOLAC candidacy assess
Home Self-Check Urine Protein for gHTN?
Should patients check their own urine protein at home when they have a gestational hypertension DX? After all, home-based BP monitoring is an established part of HDP care. Is there data on home urine protein dipstick tests in gestational hypertension? What do professional guidelines say? And what are the pros and cons of home self-monitoring of urine protein? Thank you, SJ, for the podcast topic s
Is OB HPBM “Evidence-Based”? BUMP1&2 vs SMFM Special Statement
The vast majority of the time, “community standard of care” reflects evidence-based recommendations. This means that both the predominance of clinical data and what is clinically practice align one with another period but at times, clinical standard practice doesn't always align with what the data shows. How is this possible? This is exactly the case for home blood pressure monitoring in pregn
Patient Self-Titration of Insulin for GDM?
Outside of pregnancy, guidelines emphasize diabetes self-management education and support to facilitate informed decision making, self-care behaviors, problem solving, and active collaboration with health care professionals. This includes, in those with good health literacy, the concept of patient-led self-titration of basal insulin results which has data that it improves glycemic management compa
VOMIT Trial: Mirtazapine vs Ondansetron for HG
Hyperemesis gravidarum (HG) represents the most severe end of the nausea and vomiting of pregnancy spectrum. It has a reported incidence of approximately 0.3–3% of pregnancies and is the most common cause of hospitalization in early pregnancy and the second most common cause of hospitalization in pregnancy overall. In June 2024, the ACOG published a Clinical Expert series summarizing the inpatient
The “Half-Cm” Cervical Exam: Is that a thing? (With our PGY1 Guest)
Cervical exams can be tricky for the novice practitioner. Think about this: it’s a blind exam, we measure that distance using only two fingers, through a layer of tissue, sometimes with a patient moving up on the bed as we examine. That is the reality of a cervical exam. Intrapartum, some nursing staff and clinicians use qualitative descriptors like "a tight 4" or "a generous 5"
PMOS: The “New” PCOS (5/12/26)!
Oh, What’s in a Name? Irving F. Stein and Michael L. Leventhal first described the syndrome, originally known as Stein-Leventhal syndrome, in 1935, in the AJOG. They published a case series of seven women displaying a triad of symptoms, including hirsutism, amenorrhea (absent menstruation), and bilaterally enlarged polycystic ovaries. We now know that PCOS affects 1 in 8 women globally (170 millio
BOGO! (With Hanna, PGY1)
As I have said many times before, some podcast ideas come from REAL clinic encounters. In this episode, Dr Hanna V, our dedicated PGY1 on our call team, and I will answer TWO real questions which arose just today on morning rounds, on our service: 1. Does NORMOTENSIVE HELLP still need Mag Sulfate? And 2. Does an indwelling foley s/p iatrogenic bladder injury at CS require prophylactic antibiotic c
Hantavirus & Pregancy FAQ
Hantavirus was first discovered in the early 1950s near the Hantaan River in South Korea. The US has seen this before: the 1993 Four Corners outbreak was the first recognition of the virus in the United States, causing a deadly respiratory syndrome. Now, Hantavirus is in the news again with 17 Americans currently (5.10.26) enroute back to the US for specialized observation. In this episode, we wil
Do Unintended Uterine Extensions Increase Rupture?
Uterine hysterotomy unintended extensions happen. For sure. This has been analyzed over many years, and it is still making news. Look at this mini-timeline: Back in 2018, authors published “Unintended hysterotomy extension during caesarean delivery: risk factors and maternal morbidity”. Moving up the timeline to 2020, others published in J Maternal-Fetal Neonatal Medicine, “Risk factors for uterin
Weird cfDNA Results and ISSUES: May 2026 Data
Genome-wide noninvasive prenatal testing (GW-NIPT) was introduced in 2015 and became widely available in 2019. Nonetheless, we are still learning more about this important prenatal screening test. In January 2026, the ACOG released a new PA on this, which we will also review in this episode. Our main publication ti review, however, will be the AJOG May 2026’s systematic review and meta-analysis on
GLP1 Periconception Exposure and OB Outcomes
There is no denying it, you know of one or MORE individuals or patients currently on a GLP1 agent. Although not FDA approved for PCOS as a stand-alone diagnosis, there is growing evidence supporting their offlabel use in PCOS, and international guidelines now include them as a conditional recommendation. In women, the weight loss associated with these medications may trigger the return of spontane
HG: IVFs, Dextrose, & Ketones? (Lancet, 2026)
The belief that IV dextrose is necessary to clear ketones in hyperemesis gravidarum originated from a logical, and now known to be outdated, extrapolation of basic starvation ketosis physiology and the treatment paradigm for diabetic ketoacidosis (DKA). The original experiments that led to this conclusion go back to the 1960s (Foster data). Not only is this outdated, but it is also physiologically
Allegra + Pepcid for PMDD? (AUDIO FROM INSTA VIDEO)
AUDIO EXCERPT from our recent Instragm post on this Social Media trend. Silly or Science? Listen in for details.
Novel LUS Compression Sutures for Previa Bleeding
Uterine compression sutures are effective, uterus-sparing techniques for managing severe postpartum hemorrhage (PPH) due to atony, avoiding hysterectomy. Keytypes include the B-Lynch suture (vertical, brace-like), Hayman suture (simplified vertical), and Pereira sutures (multiple, comprehensive sutures), and Cho Compression (quadrant square anterior to posterior closures), are applied when pharmac
NEW ACOG Cervical Cancer Screening Info
(From our Instagram Video Post): A very quick recap of the brand new ACOG Cervcial Caner Screening Update from April 24, 2026.
Kerri's Keen Knowledge
Just a VERY QUICK episode in rsponse to my sweet friend's question. Kerri is an MFM in another part of the country and she had KEEN insights on our recent episode on "Best Perioperative ose for Ketorolac at CS". Listen in for more good stuff!
Best Dose of Ketorolac for C-Section Pain Prophylaxis?
The ACOG recommends a multimodal approach to postoperative pain that includes nonsteroidal NSAIDs, acetaminophen, and opioids. Ketorolac is a favored NSAID for postop pain control. However, the optimal dose of ketorolac after cesarean delivery has not been determined. In this episode, we will summarize a brand new randomized, controlled, single-blind trial of pregnant women undergoing cesarean del
DIY PPH Tools: FOCUS, STUT, and/or U-CaVIT
Uterine hemorrhage remains a significant complication following abortion loss and in the postpartum period and contributes to substantial morbidity and mortality among pregnant patients. Although some FDA approved devices are on the market (Bakri balloon and Jada vacuum), they may be cost prohibited in some settings and/or some uterine cavities may be very small for either option, like after a mid
QUICKIE EPISODE: Good Vibrations and the V (AJOG April 2026)
“GOOD VIBRATIONS”: Its not just a Marky Mark song, but it is also part of GYNECOLOGIC SEXUAL HEALTH! In this episode, we will highlight an April 2026 new qualitative study on women’s vibrator use, as well as a separate publication (on a similar topic) also released in April 2026 in the journal Menopause.1. Leong KA, Carlton CE, Deverdis EC, Grimes CL, Jacobs BE, Rogers RG, Roberts BL. Intimacy and
NEW CPU: PMB Bleed Eval
In the ACOG CO 734 from 2018, it states, “Transvaginal ultrasonography usually is sufficient for an initial evaluation of postmenopausal bleeding if the ultrasound images reveal a thin endometrial echo (less than or equal to 4 mm), given that an endometrial thickness of 4 mm or less has a greater than 99% negative predictive value for endometrial cancer”. But medicine moves fast. This is NO LONGER
DÉJÀ VU: LPS and Neonatal Sugars (April 2026 AJP)
Yes we have covered antenatal corticosteroids in the late preterm interval on several episodes in the past- it's DEJA VU! However, there is new data in the American Journal of Perinatology (April 2026 ) that is helpful for us as clinicians as we do “shared decision making” with patients in offering betamethasone in the late preterm interval. Listen in for details.1. Zigron R, Rotem R, Erlichma
New Insights on pregnancy Anemia
Iron-deficiency anemia during pregnancy is associated withseveral adverse pregnancy outcomes, including severe maternal morbidity, preeclampsia, placenta previa, and placental abruption. It makes sense that diagnosing and treating anemia and its underlying causes in earlypregnancy may reduce the risk of adverse outcomes, but evidence has been scarce…until now. In this episode, we will review a new
Fetal AC> 90%: Diagnosis?
The diagnosis of fetal growth restriction can be made with an isolated abdominal circumference less than the 90th percentile. So is the opposite true? Does a fetal abdominal circumference (isolated) of greater than 90% qualify for “LGA” fetus? In this episode we're going to explain why, although it is logically correct, it is diagnostically incorrect. An isolated abdominal circumference on ult
Livi Post-Sex Vaginal Device: Hmmmm
Livi by LiviWell is an FDA-cleared, single-use, soft polyurethane foam device designed to immediately absorb post-intercourse fluids (semen) to support vaginal health. Inserted like a tampon within 15 minutes post-coitus, it works in roughly 60 seconds to restore natural pH, helping to manage odor, dripping, and discomfort. Is this evidence-based? Listen in for details.1. https://www.biospace.com/
CGMs in GDM: Evolving Support
Modern medicine has come a long way in its fight against diabetes. We now have continuous glucose monitors (CGM) and automated insulin delivery (AIDs) systems. These have revolutionized patient care. The FDA has approved devices for use in pregnancy as “nonadjunctive use” (meaning they may be used alone), although capillary finger stick assessments are currently still considered the Gold Standard.
Exploring Encompass RNA PreE (At-Home) Test
Podcast family, we have to be careful what we ask for…Because we might just get it! We have been asking for new ways to predict preeclampsia for close to two decades. Well now we have new biomarker serum tests that are even offered direct- to-consumer. The problem is, what do we dowith a positive test?! In a past episode we covered an FDA cleared serum test by Thermo Fisher for use in patients alr
OPS vs RRS: April 2026 AJOG
Words matter, and equally as important, our actions matter. Sometimes the words opportunistic salpingectomy (OPS or OS) are used interchangeably with risk-reducing salpingectomy (RRS). However, these are two completely different items. In fact, there are 4 very important differences between the two. In the April 2026 AJOG, there's a new Clinical Opinion on this very topic. Listen in for detail
Vaginal GSpot Injection: Again?
Platelet-rich plasma (PRP) injections do not have formal FDA approval for specific clinical indications. PRP is regulated as an autologous blood product and is used "off-label" in clinical practice. However, there is substantial clinical evidence supporting its use for certain dental surgeries and musculoskeletal conditions, particularly lateral epicondylitis, knee osteoarthritis, and pl
TWOFER! (Quickie #4): A. Placental Grading, B. GBS discordant Results
Podcast family, welcome to Quickie #4. This one will be fun: A. Medicine changes, and changes fast. I trained with and learned the Grannum grading placental system (grades 0-III based on ultrasound appearance). Is that still a thing? We recently found a “grade III placenta at 34 weeks” as an incidental finding. Is there specific management considerations for this? Listen in for details. B. What do
The Problem of Proving Pregnancy too Promptly
Well, it's no doubt we live in a culture of immediate gratification. When we need to know something, we must know it immediately! This even applies to couples seeking pregnancy and their desire to find out if their monthly attempts have been successful. However, there is a problem with trying to prove pregnancy too promptly. In this episode, we will review a new publication just released on Ma
AMAZING! Lauren's Lesson: You Go Girl!
What an AMAZING lesson, Podcast Family, in this impromptu episode, we will hear from one of my former medical students, now BOARD-CERTIFIED OBGYN...and an incredible OB case she just had. Sometimes....we find ZEBRAS! Great job, Lauren!
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