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Obstetrics and Gynecology

Mary Herlihy, Kendall Harcourt, Alan Fossa, Patricia Folcarelli, Toni Golen, Sigall K Bell
OBJECTIVE: To assess obstetrics and gynecology patients' interest in reading their ambulatory visit notes, identification of documentation errors, and perceptions of sensitive language through a quality improvement (QI) initiative. METHODS: Beginning April 2016, as part of a QI project all obstetrics and gynecology patients (except family planning) were invited to read their ambulatory visit notes and provide feedback using a patient reporting tool codeveloped with patients...
June 11, 2019: Obstetrics and Gynecology
Abigail Davenport, Sydney Stark, Anna Quian, David Sheyn, Jeffrey Mangel
OBJECTIVE: To explore the decision-making process in women who do not pursue treatment with onabotulinumtoxinA, sacral neuromodulation, or percutaneous nerve stimulation in patients with overactive bladder (OAB). METHODS: This was a qualitative research study. Participants were females aged 18-80 years with a diagnosis of OAB and were evaluated by a urologic or urogynecologic physician between January 2017 and March 2018. Patients who were counseled for third-line therapy, refractory to two or more medications, or lost to follow-up after initiating a second medication were considered study candidates...
June 11, 2019: Obstetrics and Gynecology
Keith M Reisinger-Kindle, Matthew Wollenschlaeger, Deborah Levy, Nancy C Chescheir
No abstract text is available yet for this article.
June 11, 2019: Obstetrics and Gynecology
Stephanie T Ros
This month we focus on current research in recurrent pregnancy loss. Dr. Ros discusses four recent publications, which are concluded with a "bottom-line" that is the take-home message. A complete reference for each can be found on Box 1 on this page along with direct links to abstracts.
June 11, 2019: Obstetrics and Gynecology
Nina K Ayala, Dwight J Rouse
No abstract text is available yet for this article.
June 11, 2019: Obstetrics and Gynecology
Amanda R Schwartz, Kristen Russell, Beverly A Gray
The transgender community has faced a long-standing history of prejudice and discrimination that has negatively affected their health. A lack of health care provider education and comfort with transgender medicine further challenges the ability of this population to obtain competent, gender-affirming medical care. As with all patients, a thorough patient history with avoidance of assumptions of sexual orientation based on gender identity is integral to providing appropriate care for transgender individuals...
June 11, 2019: Obstetrics and Gynecology
Maria Small, Urania Magriples, Rahel Ghebre, Lisa Bazzett-Matabele, David Ntirushwa, Doee Kitessa, Diomede Ntasumbumuyange, Paul Lantos, Eugene Ngabonziza, Washington Hill, Kenneth Ruzindana, Jean Damascene Rukundo, Alexandra N Moscovitz, Patrick Bagambe, Haywood Brown, Stephen Rulisa
OBJECTIVE: To evaluate the first 5 years of the Human Resources for Health Rwanda program from the program onset in the July 2012-2016 academic years, and its effects on access to care through examination of: 1) the number of trained obstetrician-gynecologists (ob-gyns) who graduated from the University of Rwanda and the University of Rwanda-Human Resources for Health program and 2) a geospatial analysis of pregnant women's access to Rwandan public hospitals with trained ob-gyns. METHODS: We used GPS coordinates in this cross-sectional study to identify public (government) hospitals with ob-gyns in 2011 (before initiation of the program) compared with 2016 (year 5 of the program)...
June 11, 2019: Obstetrics and Gynecology
Florencia Greer Polite, Rhonda Graves Acholonu, Nzinga Harrison
As physicians who represent differing specialties of obstetrics and gynecology, psychiatry, and pediatrics, we have repeatedly experienced stories of sexual assault in the context of our various patient encounters. Although our individual specialties give detailed guidelines for physicians and cover the medical, legal, and mental health aspects, we propose that all physicians should use another category called social responsibility. The mainstay of our social responsibility is to provide the victim with the support and resources to overcome this trauma...
June 11, 2019: Obstetrics and Gynecology
Maureen Cho, Amanda Ulrich, Clarissa Lam, Veronica Lerner
BACKGROUND: Hysterectomies are the most common benign gynecologic surgical procedures performed in the United States. Currently, there are no tissue models that exist to teach trainees the techniques for colpotomy during laparoscopic hysterectomy. To address this educational gap, we have created a laparoscopic colpotomy model using a porcine stomach attached to a uterine manipulator. METHODS: A segment of a porcine stomach is secured onto a uterine manipulator to simulate the cervicovaginal junction...
June 11, 2019: Obstetrics and Gynecology
Connie F Lu, Sara E Vargas, Melissa Guillen, Jaime J Ramirez, Sofia L Carbone, Melissa L Getz, Yaa Frimpong, Kelley Alison Smith, Julia G Shaw, Iris Tong, Melanie Hill, Robert E Berry, Kate M Guthrie
OBJECTIVE: To elucidate the effects of the intravaginal ring, oral contraceptive pill (OCP), and spermicide plus condom on women's sexual experiences through an in-depth understanding of the physical characteristics of these contraceptive methods. METHODS: We conducted qualitative in-depth interviews with women (aged 18-45 years) who used up to three contraceptive methods (intravaginal ring, OCP, and spermicide plus condom). Women completed in-depth interviews after each 3-month use period...
June 11, 2019: Obstetrics and Gynecology
Roxane C Handal-Orefice, Alexander M Friedman, Sujata M Chouinard, Ahizechukwu C Eke, Bruce Feinberg, Joseph Politch, Ronald E Iverson, Christina D Yarrington
OBJECTIVE: To evaluate whether cervical ripening with oral misoprostol increases cesarean delivery risk and prolongs time to vaginal delivery compared with vaginal misoprostol in a predominantly overweight population. METHODS: This single center, retrospective cohort study was performed at a tertiary care academic medical center and compared labor induction outcomes with vaginal misoprostol to outcomes with oral misoprostol after a complete institutional shift to oral misoprostol...
June 11, 2019: Obstetrics and Gynecology
Richard B Mayer, Sabine Enengl, Herbert Witzany, Philip Trautner, Omar Shebl, Peter Oppelt
BACKGROUND: In the general population, the incidence of accessory breast tissue, a congenital malformation, is 1-5%. The most common site is the lower axilla. Detecting such tissue may be problematic, and accessory breasts below the umbilicus are extremely rare. CASE: This report describes the case of a 5-day postpartum 29-year-old woman, G2P2, with painful vulvar swelling 6 cm in diameter. The patient was diagnosed with polymastia in the vulva, without polythelia, with galactostasis due to suturing of a birth laceration covering an excretory duct...
June 11, 2019: Obstetrics and Gynecology
Sarah C Lassey, Gnankang Sarah Napoe, Daniela Carusi, Julianna Schantz-Dunn, Julian N Robinson
BACKGROUND: Hypovolemic hyponatremia has not been widely reported in the obstetric literature. Anecdotally, we noticed severe hyponatremia in several of our patients who presented as home birth transfers, leading to a review of home birth cases and hyponatremia. Given the morbidity associated with hyponatremia, it is important to be aware of its potential occurrence. CASE: We present the cases of two patients transferred to our hospital with hyponatremia after prolonged labor...
June 11, 2019: Obstetrics and Gynecology
Jalal A Nanji, Nan Guo, Edward T Riley, Bethan Faulkner, Christina Do, Brendan Carvalho
OBJECTIVE: To evaluate whether an order set change that halved the initial dose of oxycodone and allowed the remainder to be given 1 hour later, if requested, was associated with reduced opioid use and side effects after cesarean delivery. METHODS: This retrospective, clinical practice study reviewed electronic medical records after implementation of a new order set for cesarean delivery. Oxycodone orders changed from 5 mg (for verbal pain score of 4/10 or lower) and 10 mg (for 5-10/10) to 2...
June 11, 2019: Obstetrics and Gynecology
Kalinda Dennis Woods, Michael Lindsay, Kesley Robertson
No abstract text is available yet for this article.
June 11, 2019: Obstetrics and Gynecology
Bruce I Rose, Samuel Brown
The world's first babies with CRISPR-Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats)-edited genes were born on November 25, 2018. Dr. Jiankui He of Southern University of Science and Technology in Shenzhen performed this gene editing. Dr. He's objectives and an assessment of how well they were achieved are discussed in the context of existing research in this area.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4...
June 11, 2019: Obstetrics and Gynecology
Carey S Pulverman, Suzannah K Creech, Michelle A Mengeling, James C Torner, Craig H Syrop, Anne G Sadler
OBJECTIVE: To examine whether the relationship between childhood sexual abuse and sexual function in civilian women is also found among female veterans, and to consider the additional effects of sexual assault in the military. METHODS: Using a retrospective cohort design, participants (N=1,004) from two midwestern Department of Veterans Affairs medical centers and associated clinics completed a telephone-assisted interview on sexual assault, sexual pain, and mental health...
June 11, 2019: Obstetrics and Gynecology
Sbaa Syeda, Ling Chen, June Y Hou, Ana I Tergas, Fady Khoury-Collado, Alexander Melamed, Caryn M St Clair, Cande V Ananth, Alfred I Neugut, Dawn L Hershman, Jason D Wright
OBJECTIVE: To compare the outcomes of women with stage III uterine cancer treated with chemotherapy alone, external beam radiation alone, and combination chemotherapy and radiation. METHODS: The National Cancer Database was used to identify women with stage III endometrioid, serous, and clear cell uterine cancer treated with either chemotherapy (with or without vaginal brachytherapy) alone, external beam radiation (with or without brachytherapy), or combination chemotherapy and external beam radiation (with or without vaginal brachytherapy) from 2004 to 2015...
June 11, 2019: Obstetrics and Gynecology
Jennifer A Callaghan-Koru, Andreea A Creanga, Bonnie DiPietro, Katrina Mark, Ardy Sowe, Nour Aboumatar, Ann B Burke, Geoffrey Curran
OBJECTIVE: To describe the status of implementation of the Alliance for Innovation in Maternal Health's primary cesarean birth patient safety bundle in Maryland after 1 year (2016-2017), and assess whether hospital characteristics and implementation strategies employed are associated with bundle implementation. METHODS: The Alliance for Innovation in Maternal Health's bundle to decrease primary cesarean births includes 26 evidence-based practices that hospitals can adopt based on specific needs...
June 11, 2019: Obstetrics and Gynecology
Sarah C Haight, Nancy Byatt, Tiffany A Moore Simas, Cheryl L Robbins, Jean Y Ko
OBJECTIVE: To describe national, state-specific, and sociodemographic trends in diagnoses of depressive disorders recorded during delivery hospitalizations. METHODS: Data were analyzed from the National Inpatient Sample (2000-2015) and 31 publicly available State Inpatient Databases (2000-2015) of the Healthcare Cost and Utilization Project. Delivery hospitalizations were identified by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes for obstetric delivery...
May 9, 2019: Obstetrics and Gynecology
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