Dr. Chapa’s Clinical Pearls.

I love my home state of TEXAS. I am definitely full of Texas pride. We have Texas barbecue, Texas, hospitality, and of course, the Texas music scene! Our state definitely has some issues to improve on, mainly access to maternity care. We have a HUGE state and 50% of our counties are maternity care deserts. It’s a vast vast Land to cover! Texas has also received a lot of criticism regarding its heartbeat law originally named SB8, wh...

There have been various publications and commentaries published on “evidence-based” cesarean section techniques. Still, one of the persistent controversies on abdominal wall closure relates to the rectus. With transverse fascial entries, should we close/reapproximate the rectus or not? In June 2025, a new RCT looking at this very issue will be printed in the European J Obstetrics Gynecology and Reproductive Biology. Listen in for d...

On December 13, 2022, we released an episode describing a new concept in prenatal care, called the PATH model. This was to “redesign” prenatal care, as needed, for those who may have limitations for the “traditional” model of prenatal care visits. Well, what we covered 2.5 years ago is NOW an OFFIICAL guidance from the ACOG and will be out in May 2025. Similarly, the SMFM released their vision for redesigned maternal care teams on ...

Pelvic congestion syndrome is a controversial entity that does not currently have validated diagnostic criteria. In the ACOG PB 218 (2020), it states, “Pelvic congestion syndrome is a proposed etiology of chronic pelvic pain related to pelvic venous insufficiency. Although venous congestion appears to be associated with chronic pelvic pain, evidence is insufficient to conclude that there is a cause-and-effect relationship. In addit...

On Monday April 7, 2025, the UK’s publication The Guardian wrote, “Surgeons are hailing an ‘astonishing’ medical breakthrough as a woman became the first in the UK to give birth after a womb transplant. Grace Davidson, 36, who was a teenager when diagnosed with a congenitally absent uterus, said she and her husband had been given ‘the greatest gift we could ever have asked for’. Grace’s sister donated her own womb during an eight-h...

On March 19. 2025, The American College of Clinical Pharmacy published, "A review of antibiotic safety in pregnancy- 2025 Update". In this episode, we will review some of the confusion surrounding aminoglycosides, sulfa, and nitrofurantoin in pregnancy. Its interesting how different professions view certain medications in pregnancy. Does ACOG say you can use Sulfa in the third trimester? Can you use nitrofurantoin in the...

Animal bites in humans are a common problem in the United States, with two to five million occurring each year. The vast majority of animal bites are caused by dogs (85 to 90 percent), with the remainder caused by cats (5 to 10 percent) and rodents (2 to 3 percent). Children are bitten more often than adults. The most feared complication of an animal bite is rabies, although skin infection is the most common complication. In our co...

VVC is second to BV in vaginitis type, here in the USA. data indicate that 75% of women have experienced at least one episode of genital candida throughout their lives . VVC is currently classified as uncomplicated (sporadic infection with mild-to-moderate clinical symptoms in non-immunocompromised women) or complicated (recurrent or clinically severe infection that eventually affects immunocompromised women or is caused by non-Alb...

Postural Orthostatic Tachycardia Syndrome (POTS), first described in the 1940s, is a heterogeneous and often debilitating condition affecting the autonomic nervous system, estimated to affect between 0.3% and 1% of the U.S. population. Its incidence is believed to be rising among people with a prior COVID-19 infection, as a likely component of so-called long COVID. The condition is characterized by chronic orthostatic intolerance i...

Hematuria remains one of the most common urologic diagnoses, estimated to account for over 20% of urology evaluations. Women with hematuria have been especially prone to delays in evaluation, often due to practitioners ascribing hematuria to a urinary tract infection (UTI) or gynecologic source, resulting in inadequate evaluation and delay in cancer diagnosis. In this episode, we will review the recently released joint guidance for...

Metabolic syndrome (MetSyn) is a cluster of conditions, such as increase in waist circumference, dyslipidemia (elevated triglyceride levels and reduced HDL), increased blood pressure, and increased fasting blood sugar levels that is related to insulin resistance, diabetes, and elevated risk of cardiovascular disease. Women with PCOS have a significantly higher prevalence of metabolic syndrome (MetS) compared to the general populati...

Throughout their lifetime, over 50% of women experience uUTIs, with recurrent infection reported in approximately 30%. Today, on March 25, 2025, the FDA approved a new first-in-class oral antibiotic for uncomplicated UTIs in women! This is Blujepa! In this episode, we will review the EAGLE clinical trial data and review the main side effects reported in the study population. How does this new antibiotic work? Will it be approved fo...

Medicine has traditionally been practiced “in silos”. But compartmentalization of medical practice/interventions can leave gaps in patient care. Patients win when they have increased access to a variety of medical therapies or contraceptive options. In this episode, we will review a brand new publication (released ahead of print) from the AJOG. We've decided to call this episode, “Internists, IUDs, and Inspiration”. Listen in f...

TWICE BEFORE, we have covered Pitocin use intrapartum: 1. On Oct 24, 2022 we covered, “Save the Pitcoin! Safe to Stop Pit Once in Active Phase?”, and 2. On Sept 24, 2024 we covered, “Labor Hacks: Pit Breaks”. Nonetheless, today's episode yet again focuses on pitocin in labor. On March 18, 2025, a new systematic review and meta-analysis was released ahead of print in the AJOG. This looks at cesarean delivery rates with discontin...

Fresh off the heels of our immediate last episode, we bring you a perspective from the trenches! Sarah, a Clinical Pearls podcast family member, is a health professional who works with autistic individuals. Sarah has provided clear and evidence-based data which helps to explain the rise of autism in the US over the last decades. Our podcast community is Incredible! Her noted and data driven perspective are the core concepts highlig...

Autism Spectrum Disorder (ASD) has an alarming trend of rise in the US. Currently, 1 in 36 (or 1 in 40 in some reports) have an ASD diagnosis. For this reason, ASD remains in the spotlight as researchers remain dedicated in explaining its origin. Over the last few years, there have been publications suggesting a link between one of the most common symptoms of pregnancy (nausea and/or nausea together with vomiting) and autism spectr...

Fasting during the lunar month of Ramadan (Feb 28 to March 30, 2025) is a core practice for Muslims across the world. During Ramadan, Muslims abstain from food and drink from dawn to sunset. However, during a singleton pregnancy, the ACOG recommends adding approximately 340 extra calories per day in the second trimester and 450 extra calories per day in the third trimester. Does fasting during Ramadan have negative perinatal outcom...