Faculty and resident preference for two different forms of lecture evaluation.

Objective: This study was undertaken to compare the use of 2 different lecture evaluation forms developed for obstetrics and gynecology residents to evaluate core curriculum lectures given by faculty.

Study Design: Content and delivery of faculty lectures were evaluated by residents using (1) a 10-question evaluation form that used a 5-point rating scale and (2) a checklist evaluation form that offered multiple options to improve lectures but provided no numerical score. Each form was used exclusively for 4 months.

The microbiologic effect of digital cervical examination.

Objective: The purpose of this study was to determine whether digital examination introduces vaginal organisms into the cervix.

Study Design: Thirty-five women with reported ruptured membranes at >/=34 weeks' gestation underwent a sterile speculum examination and a standardized semiqualitative, semiquantitative endocervical culture before and immediately after digital cervical examination.

Results: Cultures taken before digital examination demonstrated a mean of 2.

Spontaneous rupture of a primigravid uterus secondary to placenta percreta. A case report.

Background: Uterine rupture secondary to placenta percreta has been observed in multiparous patients. These cases are typically associated with a prior history of uterine trauma or infection: hysterotomy, myomectomy, cornual resection, dilatation and curettage, manual removal of the placenta or endometritis. Spontaneous rupture of the primigravid uterus without a history of trauma or infection is an exceedingly rare occurrence.

Identifying twin gestations at low risk for preterm birth with a transvaginal ultrasonographic cervical measurement at 24 to 26 weeks' gestation.

Objective: Because twins are a high-risk group for preterm birth, many clinicians routinely use prophylactic interventions such as home bed rest, hospital bed rest, oral tocolytics, or home uterine activity monitoring to prevent preterm delivery. We sought to identify twin gestations at low risk for spontaneous preterm birth with transvaginal ultrasonography of the cervix to avoid the unnecessary use of prophylactic interventions in these pregnancies.

Study Design: We measured cervical length at 24 to 26 weeks' gestation by transvaginal ultrasonography in women with twin gestations referred to our prematurity prevention clinic.

Tumour necrosis factor-alpha induces cyclo-oxygenase-2 gene expression in first trimester trophoblasts: suppression by glucocorticoids and NSAIDs.

Tumour necrosis factor-alpha (TNF-alpha) is a pleiotropic cytokine which stimulates the synthesis and release of prostaglandins (PGs) in several in vitro and in vivo models of preterm labour. While TNF-alpha simulated PG production has been described in decidual, amnion and myometrial cells, to date no studies have focused on the role of TNF-alpha in the stimulation of arachidonic acid metabolism in placental trophoblast cells. Cyclo-oxygenase-2 (COX-2) is the rate-limiting enzyme in PG biosynthesis and is expressed de novo during cellular activation by cytokines.

Characterization of the inflammatory cytokines in the vagina during pregnancy and labor and with bacterial vaginosis.

Objectives: 1) To characterize the presence of interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in the vagina during pregnancy and in labor; 2) to compare the vaginal levels of these inflammatory cytokines between laboring and nonlaboring patients; and 3) to compare the vaginal levels of these cytokines between women with and without bacterial vaginosis (BV).

Methods: Vaginal fluid was obtained by lavage from pregnant women with intact membranes at various gestational ages and during labor at term. These samples were analyzed for specific cytokine levels using standard enzyme-linked immunosorbent assay techniques.

Glucocorticoid use in patients with preterm premature rupture of the fetal membranes.

Antenatal glucocorticoid use in patients with preterm premature rupture of membranes (PPROM) is controversial. The majority of prospective, randomized studies on antenatal glucocorticoid use evaluate the effect of this intervention on preterm infants delivered due to multiple, diverse etiologies, only one of which is PPROM [corrected]. These studies present a variety of conflicting conclusions; meta-analysis indicates a potential benefit of steroids in the reduction of RDS, intraventricular hemorrhage, and mortality.