Do medical student mental stress and burnout vary with virtual versus in-person residency interviews.

Aim: This study aimed to identify medical student stressors and mitigation methodologies based on interview modality.

Materials & Methods: A survey was administered to obstetrics and gynecology applicants in in-person (IP) and virtual (VR) National Resident Matching Program cycles. This included demographics, the Mayo Clinic Medical Students Well-Being Index and stressor questions.

Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review.

Aim: To describe the relationship between cesarean skin incision type and postoperative wound complications (WCs) in obese pregnant patients.

Materials & Methods: MEDLINE (PubMed and OVID), Embase, Scopus, Web of Science Core Collection, Cochrane Library and ClinicalTrials.gov databases were used for publication search.

The Rising Triad of Cesarean Scar Pregnancy, Placenta Percreta, and Uterine Rupture: A Case Report and Comprehensive Review of the Literature.

As the rate of cesarean sections continues to rapidly rise, knowledge of diagnosis and management of cesarean scar pregnancies (CSPs) is becoming increasingly more relevant. CSPs rest on the continuum of placental abnormalities which include morbidly adherent placenta (accreta, increta, and percreta). A CSP poses a clinical challenge which may have significant fetal and maternal morbidity.

Maternal Obesity Is an Independent Risk Factor for Intensive Care Unit Admission during Delivery Hospitalization.

Objective: We aim to quantify the impact of obesity on maternal intensive care unit (ICU) admission.

Materials And Methods: This is a population-based, retrospective cohort study of Ohio live births from 2006 to 2012. The primary outcome was maternal ICU admission.

Atrial Fibrillation as a Rare Complication of the Use of Nifedipine as a Tocolytic Agent: A Case Report and Review of the Literature.

Calcium channel blockers are commonly used tocolytic agents on Labor and Delivery units worldwide as part of the management of preterm labor. Despite their overall reassuring safety profile, rare cardiovascular complications have been reported. In this report, we describe the case of threatened preterm labor managed with nifedipine with subsequent development of atrial fibrillation.

Use of an Amnioport to Maintain Amniotic Fluid Volume in Fetuses with Oligohydramnios Secondary to Lower Urinary Tract Obstruction or Fetal Renal Anomalies.

Objective: We describe a technique to maintain amniotic fluid in fetuses with severe oligo-/anhydramnios secondary to lower urinary tract obstruction or fetal renal disease when urine production is inadequate to maintain a normal amniotic fluid volume (AFV).

Methods: An amnioport was inserted into the amniotic space. The catheter was secured to prevent dislodgment and tunneled to a subcutaneous reservoir.

Relationship of trimester-specific smoking patterns and risk of preterm birth.

Background: In 2011, the US national rate of smoking early in pregnancy was 11.5%. Unfortunately, our home state of Ohio had a rate twice as high at 23%.

Factors Associated with Smoking Cessation in Pregnancy.

Objective The objective of this study was to quantify the influence of various patient characteristics on early smoking cessation to better identify target populations for focused counseling and interventions. Study Design This study was a population-based retrospective cohort study of 1,003,532 Ohio live births more than 7 years (2006-2012). Women who quit smoking in the first trimester were compared with those who smoked throughout pregnancy.

Association of reported trimester-specific smoking cessation with fetal growth restriction.

Objective: To assess the association of reported smoking cessation at various time points during pregnancy with fetal growth restriction.

Methods: This was a population-based retrospective cohort study of singleton nonanomalous live births using Ohio birth certificates, 2006-2012. Outcomes of women who reported smoking only in the 3 months before conception and women who reported smoking through the first, second, or third trimester were compared with a referent group of nonsmokers.

Acute kidney injury during pregnancy.

Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy.

Giant chorioangiomas: perinatal outcomes and techniques in fetoscopic devascularization.

Objective: To evaluate the intrauterine management and perinatal outcome of pregnancies complicated by giant placental chorioangioma (>4 cm) and elaborate on various devascularization techniques.

Materials And Methods: Retrospective review of 10 cases of giant placental chorioangioma evaluated between January 2005 and August 2012. Maternal demographics, prenatal imaging, response to fetoscopic treatment, obstetrical complications, and perinatal outcomes were evaluated.

Design considerations for point-of-care clinical trials comparing methadone and buprenorphine treatment for opioid dependence in pregnancy and for neonatal abstinence syndrome.

Rationale: In recent years, the U.S. has experienced a significant increase in the prevalence of pregnant opioid-dependent women and of neonatal abstinence syndrome (NAS), which is caused by withdrawal from in-utero drug exposure.

Initial experience with a dual-balloon catheter for the management of postpartum hemorrhage.

Objective: When uterotonics fail to cause sustained uterine contractions and satisfactory control of hemorrhage after delivery, tamponade of the uterus can be effective in decreasing hemorrhage secondary to uterine atony.

Study Design: These data are from a postmarketing surveillance study of a novel dual-balloon catheter tamponade device, the Belfort-Dildy Obstetrical Tamponade System (ebb).

Results: A total of 57 women were enrolled: 55 women had the diagnosis of postpartum hemorrhage, and 51 women had uterine balloon placement within the uterine cavity.

Risk factors for a prolonged length of stay in women hospitalized for preeclampsia in Texas.

Objectives: To identify correlates of a prolonged length of stay (PLOS) in women hospitalized for preeclampsia/eclampsia in Texas, USA.

Methods: Statewide hospital data were obtained, and the records of women who were discharged in 2004 and/or 2005 with a principal discharge diagnosis of preeclampsia or eclampsia were extracted using ICD-9-CM codes. PLOS was defined as a stay greater than 5 days.

Bell's palsy and pregnancy.

Objective: To describe the epidemiology, pathophysiology, presentation, treatment, and prognosis of Bell's palsy (BP) in pregnancy.

Results: The incidence of BP in pregnant women is not significantly greater than expected compared to all women of childbearing age. There is a high incidence of cases in the third trimester and corresponding low incidence during early pregnancy.

Detection of gestational diabetes mellitus by homeostatic indices of insulin sensitivity: a preliminary study.

Objective: We investigated whether homeostatic indices of insulin sensitivity might suitably screen for gestational diabetes mellitus.

Study Design: One hundred twenty-three pregnant women who were between 24 and 28 weeks of gestation completed a 3-hour 100-g oral glucose challenge test and fasting insulin level in a nested case-control study design. Insulin sensitivity indices were calculated and tested for their ability to detect gestational diabetes mellitus.

Burns in pregnancy.

Background: Treatment of a major burn injury during pregnancy must incorporate modifications in management resulting from gestational physiologic changes.

Case: A 25-year-old woman, at 34 weeks of gestation, sustained a major burn injury at home. She required ventilatory support, invasive hemodynamic monitoring, and massive fluid resuscitation.

Getting the right cells to the array: Gene expression microarray analysis of cell mixtures and sorted cells.

Background: Most biological samples are cell mixtures. Some basic questions are still unanswered about analyzing these heterogeneous samples using gene expression microarray technology (MAT). How meaningful is a cell mixture's overall gene expression profile (GEP)? Is it necessary to purify the cells of interest before microarray analysis, and how much purity is needed? How much does the purification itself distort the GEP, and how well can the GEP of a small cell subset be recovered?

Methods: Model cell mixtures with different cell ratios were analyzed by both spotted and Affymetrix MAT.

Documentation of amniotic fluid embolism via lung histopathology. Fact or fiction?

Objective: To evaluate pulmonary histopathology for confirming amniotic fluid embolism.

Study Design: The Capra hircus (goat) model with fresh, homologous amniotic fluid was used. Raw fluid (n = 8), fluid filtered through a 5-microns filter (n = 14) and meconium-stained fluid with 1-7% solid debris (n = 7) were injected.