Fertility Preservation and Infertility Treatment in Female Surgical Trainees in Alberta: A Survey of Trainee Knowledge, Attitudes, and Needs.

Objectives: This study aimed to describe fertility knowledge and views on family planning and fertility preservation/treatment among female surgical trainees in Alberta.

Methods: A voluntary, anonymous online survey was sent to surgical program coordinators in Alberta to forward to their respective trainees. Participants included surgical trainees from cardiac surgery, general surgery, neurosurgery, obstetrics and gynaecology, ophthalmology, orthopaedics, otolaryngology, plastic surgery, urology, and vascular surgery.

Long-term neurodevelopmental outcomes at three years in preterm infants born before 29 Weeks gestation following Preterm Premature Rupture of Membranes (PPROM).

Objective: To determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental impairment (NDI) at 3 years corrected age (CA) in infants born before 29 weeks of gestational age (GA).

Design/methods: Infants born before 29 weeks GA between 2005 and 2017 were included. The primary outcome was a composite of death or NDI (full-scale intelligence quotient<85, cerebral palsy, vision or hearing impairment) at 3 years of CA.

Surgical Cancellations and Postponements by Surgeon and Patient Sex: A Retrospective Cohort Study in Alberta, Canada.

Objective: The objective of this work was to estimate the association between surgeon sex with surgical postponements or cancellations.

Summary Background Data: Female surgeons receive lower hourly, per patient, and total compensation than their male colleagues. Bias in the decision to postpone or cancel surgical cases may contribute to compensation inequality, since this results in unpaid surgeon time.

Postnatal acetaminophen exposure and neurodevelopmental outcomes at 18-21 months corrected gestational age in preterm infants <29 weeks gestation: a retrospective cohort study.

Background: Studies have reported prenatal acetaminophen exposure is associated with abnormal neurodevelopment. There is limited and conflicting data on neurodevelopmental outcomes following postnatal acetaminophen exposure. Our objective was to investigate the neurodevelopmental outcomes of preterm infants < 29 weeks gestation postnatally exposed to acetaminophen.

Utility of the 21-month neurodevelopmental outcome for predicting neurodevelopmental impairment at 36 months for preterm infants <29 weeks gestation.

Objective: To determine the sensitivity and specificity of the 21-month neurodevelopmental outcome for predicting the presence of neurodevelopmental impairment at 36 months corrected age in a population of preterm infants under 29 weeks gestation.

Study Design: This is a retrospective observational cohort study. Preterm infants born under 29 weeks gestation who were followed up at both 18-21 months and 36 months corrected age with outcome data available were enrolled.

The association of maternal overweight on long-term neurodevelopmental outcomes in premature infants (< 29 weeks) at 18-24 months corrected age.

Objective: To determine the association of maternal pre-pregnancy body mass index (BMI) and neurodevelopmental impairment (NDI) at 18-24 months corrected age (CA) in infants born < 29 weeks gestation.

Study Design: Infants born between 2005 and 2015 at < 29 weeks gestation were included. BMI was categorized into BMI [18.

Neurodevelopmental Outcomes of Preterm Infants Born <29 Weeks with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Multicenter Study.

Objective: This study aimed to determine neurodevelopmental outcomes of preterm infants born at <29 weeks' gestational age (GA) with bronchopulmonary dysplasia and pulmonary hypertension (BPD-PH) at 18 to 24 months' corrected age (CA).

Study Design: In this retrospective cohort study, preterm infants born at <29 weeks' GA between January 2016 and December 2019, admitted to level 3 neonatal intensive care units, who developed BPD and were evaluated at 18 to 24 months' CA in the neonatal follow-up clinics were included. We compared demographic characteristics and neurodevelopmental outcomes between the two groups: Group I: BPD with PH and Group II: BPD with no PH, using univariate and multivariate regression models.

The REDUCED trial: a cluster randomized trial for REDucing the utilization of CEsarean delivery for dystocia.

Background: To reduce cesarean delivery rates in nulliparous women, guidelines for diagnosing nonprogressive labor have been developed by the National Institute of Child Health and Human Development, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine. These are mainly based on data from the Consortium for Safe Labor study. The guidelines have not been tested in a clinical trial, so the efficacy and safety of this new approach is uncertain.

Neuroprotection care bundle implementation is associated with improved long-term neurodevelopmental outcomes in extremely premature infants.

Objective: To study the impact of an evidence-based neuroprotection care (NPC) bundle on long-term neurodevelopmental impairment (NDI) in infants born extremely premature.

Study Design: An NPC bundle targeting predefined risk factors for acute brain injury in extremely preterm infants was implemented. We compared the incidence of composite outcome of death or severe neurodevelopmental impairment (sNDI) at 21 months adjusted age pre and post bundle implementation.

Impact of a Clinical Intervention to Decrease Opioid Prescribing in a Post-Cesarean Delivery.

A quality assurance study was completed following the implementation of a standardized opioid prescribing and education protocol post cesarean delivery. The primary goal was to determine the need for a policy on postpartum opioid prescribing practices and whether the protocol worked. There was a decrease in the number of tablets provided post intervention and no statistically significant maternal or neonatal readmissions for suspected opioid toxicity or pain control.

Critical examination of relationships between early growth and childhood overweight in extremely preterm infants.

Objectives: To identify the prevalence and risk factors for childhood overweight and obesity (OWO) at 3-year corrected age in children born <1500 g <29 weeks gestation.

Study Design: A multicentre retrospective cohort study for preterm infants admitted to neonatal intensive care units between 2001 and 2014.

Results: Data were available for 911 (89.

Changes in the Frequency of Cesarean Delivery in Nulliparous Women in Labor in a Canadian Population, 1992-2018.

Objective: To examine the relative contribution of changes in patient demographics and physician management to changes in the cesarean delivery rate in labor among nulliparous women.

Methods: We conducted a retrospective cohort study of 485,451 births to nulliparous women who experienced labor at or beyond 35 weeks of gestation in Alberta, Canada, from 1992 to 2018. The data were from a province-wide perinatal database.

Caesarean section and neonatal survival and neurodevelopmental impairments in preterm singleton neonates.

Introduction: Evidence is lacking regarding the benefit of caesarean section (CS) for long-term neurodevelopmental outcomes in singleton preterm neonates. Therefore, uncertainty remains regarding obstetrical best practice in the delivery of premature neonates.

Objective: Our objective was to determine the association between the mode of delivery and neurodevelopmental outcomes in preterm singleton neonates who were delivered by vaginal route (VR), CS with labour (CS-L), or CS without labour (CS-NL).

Perinatal outcome and prognostic factors of fetal megacystis diagnosed at 11-14 week's gestation.

Objectives: To evaluate aneuploidy rate, prognostic factors, and perinatal outcomes following a diagnosis of fetal megacystis at 11-14 week's gestation.

Methods: A retrospective study of first trimester fetal megacystis from 2010 to 2020 was performed, including ultrasound finding, perinatal outcomes, pathology reports, genetic tests, and neonatal investigations.

Results: A total of 98 cases of first trimester fetal megacystis was identified with an overall aneuploidy rate of 12%.

Weight, length, and head circumference at 36 weeks are not predictive of later cognitive impairment in very preterm infants.

Objective: To assess diagnostic accuracy of 36-week anthropometric weight, length, and head circumference <10th and <3rd percentiles to predict preterm infant cognitive impairment.

Study Design: Cohort study of 898 preterm <30-week very-low-birth weight (<1500 g) infants. Anthropometric measures' accuracy to predict cognitive impairment (Bayley-III Cognitive Composite score) <80, 21-months corrected age (CA) and Wechsler Preschool and Primary Scale of Intelligence Quotient (intellectual outcomes) <70, 36-months CA, were determined using receiver operating characteristic (ROC) curves.

Antenatal Diagnosis of Marginal and Velamentous Placental Cord Insertion and Pregnancy Outcomes.

Objective: To evaluate the association between antenatal diagnosis of velamentous and marginal placental cord insertions with adverse perinatal outcomes of small-for-gestational-age (SGA) birth weight (less than the 5th percentile), caesarean birth, and perinatal mortality.

Methods: Using a diagnostic imaging database, we performed a cohort study of all consecutive singleton pregnancies (35,391), including 1,427 cases of marginal and 107 cases of velamentous cord insertion, delivered after 24 6/7 weeks of gestation between January 1, 2012, and December 31, 2015, at a single Canadian tertiary care center. Cases with placenta previa, vasa previa, no documented cord insertion, or fetal anomalies were excluded.

Defining the short-term disease recurrence after loop electrosurgical excision procedure (LEEP).

Background: The goal of cervical cancer screening is to identify dysplastic lesions for subsequent excision in order to prevent invasive disease. There is clinical equipoise, on how to best follow women for disease surveillance after treatment with some Canadian provinces exclusively performing colposcopy and some utilizing Human Papilloma Virus (HPV) testing in addition to cervical cytology. Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision.

Potential Impact of Guidelines for the Prevention of Cesarean Deliveries in a Contemporary Canadian Population.

Objective: This study sought to describe how the implementation of recent labour guidelines may affect the cesarean delivery rate in a population in Alberta.

Methods: This retrospective study was conducted on primiparous women who were in labour with singleton term fetuses with cephalic presentation in Alberta from 2007 to 2016 (n = 181 738), and it used data from a perinatal database. Modelled cesarean delivery rates were calculated to determine the potential impact of the recent guidelines on the cesarean delivery rate by using the percentage of cesarean deliveries that occurred outside the threshold of the recent labour guidelines.

Temporal Summation in Chronic Pelvic Pain.

Objective: This study sought to characterize central sensitization further among women with chronic pelvic pain by identifying temporal summation using a cotton-tipped applicator test that can be used at the bedside.

Method: A total of 36 women (18 with chronic pain and allodynia; 18 without pain) were recruited. Both groups were randomly assigned to receive 3 strokes of a benign stimulus on the abdomen at differing frequencies: 10, 30, or 100 seconds.

Establishing Bayley-III cut-off scores at 21 months for predicting low IQ scores at 3 years of age in a preterm cohort.

Objective: To evaluate predictive validity and establish cut-off scores on the Bayley-III at age 21 months that best predict Intelligence Quotient (IQ) scores <70 or <80) at 3 years in a high-risk preterm cohort.

Method: Bayley-III evaluations at 21 months corrected age and intellectual assessments, primarily with the WPPSI-III, at 3 years corrected age were conducted with 520 infants born less than 29 weeks gestational age or less than 1250 g birth weight. Receiver Operator Characteristic (ROC) curves were used to establish Bayley-III Cognitive Composite cut-off scores that maximized Sensitivity and Specificity in predicting low IQ.

Stillbirth and large for gestational age at birth.

A previous large case-control study had documented association between large for gestational age birth weight and stillbirth. We sought to replicate this novel finding. Retrospective cohort with nested case-control analyses.

Uterosacral vault suspension (USLS) at the time of hysterectomy: laparoscopic versus vaginal approach.

Introduction And Hypothesis: To compare laparoscopic and vaginal approaches to uterosacral ligament vault suspension (USLS) by perioperative data, short-term complications, rates of successful concomitant adnexal surgery and procedural efficacy.

Methods: Retrospective cohort of USLS procedures performed at the time of hysterectomy at a tertiary care center over a 3-year period. Patient demographics, surgical data, concomitant adnexal procedures and complications were abstracted from a surgical database and compared using parametric or non-parametric tests as appropriate.

A prospective study investigating the diagnostic agreement between urodynamics and dynamic cystoscopy in women presenting with mixed urinary incontinence.

Introduction And Hypothesis: Patient history is often insufficient to identify type of urinary incontinence (UI). Multichannel urodynamic testing (UDS) is often used to clarify the diagnosis. Dynamic cystoscopy (DC) is a novel approach for testing bladder function.