Routine third trimester control ultrasound examination for low-lying or marginal placentas diagnosed at mid-pregnancy: is this indicated?

Objective: To determine what proportion of placentas described as low lying or marginal at the mid-pregnancy ultrasound examination are still so described in the third trimester, necessitating delivery by Caesarean section.

Methods: A retrospective chart review of all women delivering at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) from April 1, 2009, to March 31, 2011, was undertaken, and placental location at the mid-pregnancy ultrasound examination was noted. For all cases in which the placenta was described as previa (complete, partial, marginal, or low lying), the control third trimester ultrasound examination, when performed, was revised and so was the mode of delivery, vaginal or Casearean section.

Toxic shock syndrome due to Clostridium sordellii: a dramatic postpartum and postabortion disease.

We describe a young woman who developed Clostridium sordellii toxic shock syndrome after having had an abortion medically induced by mifepristone (RU-486; Mifeprex [Danco Laboratories]) 7 days before admission to our hospital. Although the patient was aggressively treated, death occurred <3 days after admission. It is hoped that very early recognition of this disease will decrease the mortality associated with this rarely reported ailment that occurs among young, otherwise healthy women.

Comparison of an aggregate scoring method with a consensus scoring method in a measure of clinical reasoning capacity.

Background: Diversity of clinical reasoning paths of thought among experts is well known. Nevertheless, in written clinical reasoning assessment, the common practice is to ask experts to reach a consensus on each item and to assess students on a unique "good answer."

Purposes: To explore the effects of taking the variability of experts answers into account in a method of clinical reasoning assessment based on authentic tasks: the Script Concordance Test.