Impact of an Online Question Bank on Resident In-Training Exam Performance.

Objective: In-training exams (ITEs) are administered annually to Obstetrics and Gynecology (OBGYN) residents and have been demonstrated to correlate with success on licensing examinations. Our study objective was to determine the impact of a question bank and mock exam on the performance of Council on Resident Education in Obstetrics and Gynecology (CREOG) ITEs. Secondarily, we investigated the correlation between the extent of question bank usage and performance on the exam.

Resident Research Mentoring Teams: A Support Program to Increase Resident Research Productivity.

Background: Scholarly activity is a requirement for most graduate medical education training programs. However, barriers exist for residents to accomplish projects.

Objective: To evaluate the correlation between a resident research mentoring team (RRMT) program and meeting presentations and publications of resident research projects.

Marijuana use, fetal growth, and uterine artery Dopplers.

Objective: Marijuana (MJ) use is associated with adverse effects on fetal growth. We aimed to investigate the timing of suboptimal fetal growth onset in MJ-exposed pregnancies. In addition, we aimed to explore the relationship between MJ-exposure and both abnormal uterine artery (UtA) Doppler parameters and small for gestational age (SGA).

The Impact of Hepatitis C Virus Infection on Buprenorphine Dose in Pregnancy.

Objective: Buprenorphine (BUP) is commonly used for opioid maintenance therapy in pregnancy. Our goal was to determine whether liver dysfunction related to hepatitis C virus (HCV) infection impacts BUP dosing requirements in pregnancy.

Study Design: This was a retrospective cohort study of pregnant women with antenatal exposure to BUP to compare dosing between individuals positive versus negative for HCV infection.

Controversies in antenatal corticosteroids.

Antenatal corticosteroids (ACS) successfully reduce the rates of neonatal mortality and morbidity after preterm birth. However, this translational success story is not without controversies. This chapter explores some contemporary controversies with ACS, including the choice of corticosteroid, use in threatened preterm birth less than 24 weeks' gestation, use in late preterm birth, use at term before cesarean delivery, and issues surrounding repeated and rescue dosing of antenatal corticosteroids.

A comprehensive severity score for the morbidly adherent placenta: combining ultrasound and magnetic resonance imaging.

Background: Ultrasound (US) is the first-line imaging modality to assess the morbidly adherent placenta, but sensitivity and specificity are lacking.

Objective: This investigation aims to improve diagnostic accuracy with a comprehensive score using clinical history, US, and magnetic resonance imaging (MRI).

Materials And Methods: We conducted a retrospective cohort study of pregnant women who received both transvaginal US and MRI with suspicion for morbidly adherent placenta between 2009 and 2016.

Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes.

Background: Although leisure-time physical activity (PA) contributes to overall health, including pregnancy health, patterns across pregnancy have not been related to birth outcomes. We hypothesized that women with sustained low leisure-time PA would have excess risk of adverse pregnancy outcomes, and that changing patterns across pregnancy (high to low and low to high) may also be related to risk of adverse pregnancy outcomes.

Methods: Nulliparous women (n = 10,038) were enrolled at 8 centers early in pregnancy (mean gestational age in weeks [SD] = 12.

Acute Appendicitis in Pregnancy: Predictive Clinical Factors and Pregnancy Outcomes.

 The objective of this study was to identify clinical factors predictive of appendicitis in pregnant women and associated obstetric outcomes.  We performed a single-center, retrospective cohort study of pregnant women who underwent magnetic resonance imaging for suspected appendicitis from 2007 to 2012. Rates and odds of appendicitis based on presenting signs and symptoms were estimated.

Advanced Maternal Age and the Risk of Major Congenital Anomalies.

 This study aims to determine if advanced maternal age (AMA) is a risk factor for major congenital anomalies, in the absence of aneuploidy.  Retrospective cohort study of all patients with a singleton gestation presenting for second trimester anatomic survey over a 19-year study period. Aneuploid fetuses were excluded.

Treatment Utility of Postpartum Antibiotics in Chorioamnionitis Study.

Objective To determine if postpartum antibiotics are necessary for patients with chorioamnionitis after a cesarean delivery (CD). Study Design Multicenter randomized controlled trial. Laboring patients with singleton gestations and chorioamnionitis who underwent CD were eligible.

Accuracy of Estimated Blood Loss in Predicting Need for Transfusion after Delivery.

Objective: The definition of postpartum hemorrhage (PPH) was developed more than 50 years ago. Since then, the obstetric population has changed dramatically. We sought to determine how well we estimated blood loss (EBL) and find thresholds predicting need for transfusion.

Interpreting category II fetal heart rate tracings: does meconium matter?

Objective: Category II fetal heart rate (FHR) tracings are considered indeterminate; thus, improved risk stratification of category II FHR tracings is needed. We estimated whether the presence of meconium increased the risk of adverse neonatal outcomes.

Study Design: This study was conducted within a prospective cohort of 5000 women with singleton pregnancies who were admitted in labor at term.

Stillbirth risk among fetuses with ultrasound-detected isolated congenital anomalies.

Objective: To estimate the risk of stillbirth among pregnancies complicated by a major isolated congenital anomaly detected by antenatal ultrasonography and the influence of incidental growth restriction.

Methods: A retrospective cohort study of all consecutive singleton pregnancies undergoing routine anatomic survey between 1990 and 2009 was performed. Stillbirth rates among fetuses with an ultrasound-detected isolated major congenital anomaly were compared with fetuses without major anomalies.

Clinical accuracy of estimated fetal weight in term pregnancies in a teaching hospital.

Objective: To evaluate whether clinical characteristics alter the accuracy of clinical estimation of fetal weight (EFW) in term pregnancies in a teaching hospital.

Methods: Secondary analysis of a retrospective cohort study of patients presenting for labor at term. Clinical EFW was performed using Leopold maneuvers.

The risks and benefits of internal monitors in laboring patients.

Objective: The purpose of this study was to estimate the impact of internal monitors (fetal scalp electrode [FSE] and intrauterine pressure catheter [IUPC]) on maternal and neonatal outcomes.

Study Design: The study comprised a retrospective cohort of all women who were admitted for labor from 2004-2008. Women with internal monitors (FSE, IUPC, or both) were compared with women without internal monitors.

The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes.

Objectives: The aim of this study was to estimate the incidence of single umbilical artery (SUA) in twin pregnancies and to investigate whether SUA in twin gestations is associated with adverse obstetric outcomes.

Methods: We performed a retrospective cohort study of consecutive twin pregnancies over 17 years at a tertiary care hospital. Primary exposure was SUA in one or both twins documented at routine second trimester anatomic survey.

Medical and nonmedical factors influencing utilization of delayed pushing in the second stage.

Objective: To evaluate factors impacting selection to delayed pushing in the second stage of labor.

Study Design: This case-control study was a secondary analysis of a large retrospective cohort study. Cases included women who delayed pushing for 60 minutes or more in the second stage of labor.

Application of second-stage passive descent in morbidly obese women.

Objective: To estimate whether passive descent in the second stage of labor in morbidly obese parturients is associated with reduced active pushing times and improved labor outcomes compared with immediate pushing.

Methods: This was a retrospective cohort study of all consecutive women with a body mass index (BMI) of 40 or greater admitted for term labor that reached the second stage of labor from 2004 to 2008 at a single institution. Detailed information was collected for maternal demographics, labor progress, and neonatal outcomes.

Fibroid tumors are not a risk factor for adverse outcomes in twin pregnancies.

Objective: Uterine fibroid tumors have been associated with adverse outcomes in singleton pregnancies. We aimed to estimate risk for adverse obstetric outcomes that are associated with fibroid tumors in twin pregnancies.

Study Design: A retrospective cohort study of twin pregnancies with ≥1 fibroid tumor on second trimester ultrasound examination.