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1.
Am J Obstet Gynecol ; 230(1): 97.e1-97.e6, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37748528

RESUMEN

BACKGROUND: Clerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past 2 decades in our specialty. OBJECTIVE: This study aimed to investigate obstetrics and gynecology clerkship directors' practices and perspectives in grading. STUDY DESIGN: A 12-item electronic survey was developed and distributed to clerkship directors with active memberships in the Association of Professors of Gynecology and Obstetrics. RESULTS: A total of 174 of 236 clerkship directors responded to the survey (a response rate of 73.7%). Respondents reported various grading systems with the fewest (20/173 [11.6%]) using a 2-tiered or pass or fail system and the most (72/173 [41.6%]) using a 4-tiered system. Nearly one-third of clerkship directors (57/163 [35.0%]) used a National Board of Medical Examiners subject examination score threshold to achieve the highest grade. Approximately 45 of 151 clerkship directors (30.0%) had grading committees. Exactly half of the clerkship directors (87/174 [50.0%]) reported requiring unconscious bias training for faculty who assess students. In addition, some responded that students from groups underrepresented in medicine (50/173 [28.9%]) and introverted students (105/173 [60.7%]) received lower evaluations. Finally, 65 of 173 clerkship directors (37.6%) agreed that grades should be pass or fail. CONCLUSION: Considerable heterogeneity exists in obstetrics and gynecology clerkship directors' practices and perspectives in grading. Strategies to mitigate inequities and improve the reliability of grading include the elimination of a subject examination score threshold to achieve the highest grade and the implementation of both unconscious bias training and grading committees.


Asunto(s)
Prácticas Clínicas , Ginecología , Obstetricia , Estudiantes de Medicina , Humanos , Ginecología/educación , Reproducibilidad de los Resultados , Evaluación Educacional , Obstetricia/educación
2.
Am J Obstet Gynecol ; 231(5): 475-479, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38801933

RESUMEN

Faculty career advisors who guide applicants applying to obstetrics and gynecology residency programs need updated information and resources, given the constant changes and challenges to the residency application process. Initial changes included standardization of the application timeline and interview processes. More recent changes included the utilization of a standardized letter of evaluation, initiation of program signaling, second look visit guidelines, and updated sections in the Electronic Residency Application Service. Challenges in advising include the unmatched applicant and the applicant who is couples matching in the era of program signaling. Additional considerations include applying with the current status of reproductive health law restrictions and preparing for a new residency application platform. The Undergraduate Medical Education Committee of the Association of Professors of Gynecology and Obstetrics provides this updated guide of the prior 2021 resource for advisors to increase confidence in advising students, boost professional fulfillment with advising activities, and aid in satisfaction with advising resources. This guide covers the continuing challenges and future opportunities in the resident application process.


Asunto(s)
Ginecología , Internado y Residencia , Obstetricia , Obstetricia/educación , Ginecología/educación , Humanos , Selección de Personal
3.
Matern Child Health J ; 28(6): 1121-1131, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38539033

RESUMEN

Mental health conditions including substance use disorder are the leading cause of pregnancy-related deaths in the U.S. Unfortunately, fears of child protective services' involvement interfere with maternal self-disclosure of substance use in pregnancy. Seeking to identify more mothers with substance use disorder in pregnancy or at delivery, and responsive to changes to the federal Child Abuse Prevention and Treatment Act (CAPTA), Connecticut requires hospital personnel to submit a deidentified notification to CPS for all newborns with prenatal substance exposure. However, it is unknown whether this approach aligns with maternal self-report on substance use. For the present study, we compared population parameters derived from CAPTA notifications submitted between March-December 2019 with parameters derived from self-report data on substance use in pregnancy from mothers who gave birth during the same timeframe. Results revealed that three times as many mothers self-reported any alcohol or drug use in pregnancy compared to the rate measured with CAPTA notifications. Compared to mothers who self-reported drug use in the third trimester, CAPTA notifications were made for statistically similar rates of Black mothers but half the self-reported rate of White and Hispanic mothers. This disparity reflects that CAPTA notifications were made for twice as many Black mothers as White or Hispanic. Although CAPTA notifications are not punitive in nature, this disparity reveals that the public health aims of this policy are not yet achieved.


Asunto(s)
Trastornos Relacionados con Sustancias , Humanos , Femenino , Embarazo , Trastornos Relacionados con Sustancias/epidemiología , Prevalencia , Adulto , Autoinforme , Connecticut/epidemiología , Madres/estadística & datos numéricos , Madres/psicología , Complicaciones del Embarazo/epidemiología
4.
Am J Obstet Gynecol ; 228(4): 369-381, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36549568

RESUMEN

Obstetrician-gynecologists can improve the learning environment and patient care by addressing implicit bias. Accumulating evidence demonstrates that racial and gender-based discrimination is woven into medical education, formal curricula, patient-provider-trainee interactions in the clinical workspace, and all aspects of learner assessment. Implicit bias negatively affects learners in every space. Strategies to address implicit bias at the individual, interpersonal, institutional, and structural level to improve the well-being of learners and patients are needed. The authors review an approach to addressing implicit bias in obstetrics and gynecology education, which includes: (1) curricular design using an educational framework of antiracism and social justice theories, (2) bias awareness and management pedagogy throughout the curriculum, (3) elimination of stereotypical patient descriptions from syllabi and examination questions, and (4) critical review of epidemiology and evidence-based medicine for underlying assumptions based on discriminatory practices or structural racism that unintentionally reinforce stereotypes and bias. The movement toward competency-based medical education and holistic evaluations may result in decreased bias in learner assessment. Educators may wish to monitor grades and narratives for bias as a form of continuous educational equity improvement. Given that practicing physicians may have little training in this area, faculty development efforts in bias awareness and mitigation strategies may have significant impact on learner well-being.


Asunto(s)
Ginecología , Obstetricia , Femenino , Embarazo , Humanos , Sesgo Implícito , Curriculum , Sesgo
5.
Am J Obstet Gynecol ; 227(2): 236-243, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35489442

RESUMEN

Health systems science addresses the complex interactions in healthcare delivery. At its core, health systems science describes the intricate details required to provide high-quality care to individual patients by assisting them in navigating the multifaceted and often complicated US healthcare delivery system. With advances in technology, informatics, and communication, the modern physician is required to have a strong working knowledge of health systems science to provide effective, low-cost, high-quality care to patients. Medical educators are poised to introduce health systems science concepts alongside the basic science and clinical science courses already being taught in medical school. Because of the common overlap of women's healthcare subject matter with health systems science topics, such as interprofessional collaboration, ethics, advocacy, and quality improvement, women's health medical educators are at the forefront of incorporating health systems science into the current medical school educational model. Here, the authors have described the concept of health systems science and discussed both why and how it should be integrated into the undergraduate medical education curriculum. Medical educators must develop physicians of the future who can not only provide excellent patient care but also actively participate in the advancement and improvement of the healthcare delivery system.


Asunto(s)
Curriculum , Educación de Pregrado en Medicina , Atención a la Salud , Femenino , Humanos , Facultades de Medicina , Salud de la Mujer
6.
Am J Obstet Gynecol ; 224(2): 148-157, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33038302

RESUMEN

This article, from the "To the Point" series by the Undergraduate Medical Education Committee of the Association of Professors of Gynecology and Obstetrics, is a guide for advising medical students applying to Obstetrics and Gynecology residency programs. The residency application process is changing rapidly in response to an increasingly complex and competitive atmosphere, with a wider recognition of the stress, expense, and difficulty of matching into graduate training programs. The coronavirus disease 2019 pandemic and societal upheaval make this application cycle more challenging than ever before. Medical students need reliable, accurate, and honest advising from the faculty in their field of choice to apply successfully to residency. The authors outline a model for faculty career advisors, distinct from mentors or general academic advisors. The faculty career advisor has detailed knowledge about the field, an in-depth understanding of the application process, and what constitutes a strong application. The faculty career advisor provides accurate information regarding residency programs within the specialty, helping students to strategically apply to programs where the student is likely to match, decreasing anxiety, expense, and overapplication. Faculty career advisor teams advise students throughout the application process with periodic review of student portfolios and are available for support and advice throughout the process. The authors provide a guide for the faculty career advisor in Obstetrics and Gynecology, including faculty development and quality improvement.


Asunto(s)
Selección de Profesión , Educación de Pregrado en Medicina/métodos , Ginecología/educación , Internado y Residencia , Obstetricia/educación , Criterios de Admisión Escolar , Docentes Médicos , Humanos , Tutoría , Rol Profesional , Estudiantes de Medicina/psicología , Estados Unidos
7.
Nat Commun ; 15(1): 8379, 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39333481

RESUMEN

Scar tissue formation is a hallmark of wound repair in adults and can chronically affect tissue architecture and function. To understand the general phenomena, we sought to explore scar-driven imbalance in tissue homeostasis caused by a common, and standardized surgical procedure, the uterine scar due to cesarean surgery. Deep uterine scar is associated with a rapidly increasing condition in pregnant women, placenta accreta spectrum (PAS), characterized by aggressive trophoblast invasion into the uterus, frequently necessitating hysterectomy at parturition. We created a model of uterine scar, recapitulating PAS-like invasive phenotype, showing that scar matrix activates mechanosensitive ion channel, Piezo1, through glycolysis-fueled cellular contraction. Piezo1 activation increases intracellular calcium activity and Protein kinase C activation, leading to NF-κB nuclear translocation, and MafG stabilization. This inflammatory transformation of decidua leads to production of IL-8 and G-CSF, chemotactically recruiting invading trophoblasts towards scar, initiating PAS. Our study demonstrates aberrant mechanics of scar disturbs stroma-epithelia homeostasis in placentation, with implications in cancer dissemination.


Asunto(s)
Cicatriz , Inflamación , Canales Iónicos , Placenta Accreta , Trofoblastos , Femenino , Embarazo , Humanos , Placenta Accreta/metabolismo , Placenta Accreta/patología , Cicatriz/metabolismo , Cicatriz/patología , Canales Iónicos/metabolismo , Canales Iónicos/genética , Animales , Inflamación/metabolismo , Inflamación/patología , Trofoblastos/metabolismo , Trofoblastos/patología , Decidua/patología , Decidua/metabolismo , Ratones , FN-kappa B/metabolismo , Cesárea/efectos adversos , Proteína Quinasa C/metabolismo , Proteína Quinasa C/genética , Interleucina-8/metabolismo , Útero/patología , Útero/metabolismo
8.
J Surg Educ ; 81(7): 896-899, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38749813

RESUMEN

Clerkship directors must balance the mental wellbeing of their medical students with the demanding schedule that rotations in procedural specialties such as surgery and obstetrics and gynecology require. In this paper, the Undergraduate Medical Education Committee of the Association of Professors of Obstetrics and Gynecology argues the importance of maintaining adequate clinical exposure for learners. Involving students in overnight call provides additional clinical involvement, improved relationships with the clinical team, and a better perspective on specialist lifestyle. Educators should improve the experience for students by promoting resilience and creating a welcoming learning environment. Preparing medical students for the rigorous requirements of these clerkships allows them to thrive in the learning environment while still providing a realistic preview of the clinical experiences and demands of these specialties.


Asunto(s)
Prácticas Clínicas , Educación de Pregrado en Medicina , Estudiantes de Medicina , Humanos , Educación de Pregrado en Medicina/métodos , Estudiantes de Medicina/psicología , Femenino , Obstetricia/educación , Masculino , Cirugía General/educación , Ginecología/educación , Competencia Clínica
9.
Am J Obstet Gynecol MFM ; 5(9): 101090, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37437693

RESUMEN

The labor and delivery floor is a unique learning environment that poses challenges to teaching medical students, with a potentially detrimental effect on their evaluations of the obstetrics and gynecology clerkship. This article, from the "To the Point" series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, offers specific suggestions for improving undergraduate medical education in obstetrics with attention to student preparation, faculty development, nonphysician staff involvement, and patient education. Optimizing the learning environment in labor and delivery would improve student experiences and perceptions of our specialty.


Asunto(s)
Prácticas Clínicas , Educación de Pregrado en Medicina , Ginecología , Obstetricia , Estudiantes de Medicina , Humanos , Obstetricia/educación
10.
Disabil Rehabil ; : 1-5, 2023 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-37073781

RESUMEN

PURPOSE: This article is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee and provides educators recommendations for optimizing inclusive education for our students with disabilities. Medical educators are increasingly encountering students with disabilities and have the responsibility of ensuring requirements are met. METHOD: Medical education committee members from the US and Canada reviewed the literature on disabilities in medical student education to identify best practices and key discussion points. An iterative review process was used to determine the contents of an informative paper. RESULTS: Medical schools are required to develop technical standards for admission, retention, and graduation of their students to practice medicine safely and effectively with reasonable accommodation. A review of the literature and obstetrics and gynecology expert opinion formed a practical list of accommodation strategies and administrative steps to assist educators and students. CONCLUSION: Medical schools must support the inclusion of students with disabilities. We recommend a collaborative approach to the interactive process of determining reasonable and effective accommodations that includes the students, a disability resource professional and faculty as needed. Recruiting and supporting medical students with a disability strengthens the diversity commitment and creates a more inclusive workforce.IMPLICATIONS FOR REHABILITATIONMedical School EducationMedical schools have the responsibility to train a diverse physician workforce including those with disabilities.The integration of students with disabilities is important and should be done in a structured and timely manner that maximizes the individual's abilities and incorporates reasonable accommodations in the clinical learning environment.Though the definition of disability traverses a wide variety of diagnoses, this review highlights sensory and physical disabilities and the various accommodations to facilitate access and successful completion of required objectives.

11.
AJOG Glob Rep ; 3(2): 100187, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37064782

RESUMEN

BACKGROUND: Given the increasing complexities of the residency application processes, there is an ever-increasing need for faculty to serve in the role of fourth-year medical student career advisors. OBJECTIVE: This study aimed to investigate obstetrics and gynecology clerkship directors' confidence and fulfillment with serving in the role of faculty career advisors. STUDY DESIGN: A 25-item electronic survey was developed and distributed to the 225 US obstetrics and gynecology clerkship directors in university-based and community-based medical schools with active memberships in the Association of Professors of Gynecology and Obstetrics. Items queried respondents on demographics, confidence in fourth-year advising, satisfaction with this aspect of their career, and resources used for advising. RESULTS: Of 225 clerkship directors, 143 (63.6%) responded to the survey. Nearly all clerkship directors (136/143 [95%]) reported advising fourth-year students. A median of 5.0 hours (interquartile range, 3.0-10.0) was spent per student in this advisory role, with 29 of 141 clerkship directors (20.5%) reporting some form of compensation for advising. Confidence in the ability to advise fourth-year medical students correlated significantly with number of years as a faculty, number of years as a clerkship director, and a higher full-time equivalent allotted as clerkship director. Fulfillment as a faculty career advisor was correlated with number of years as a clerkship director and a higher number of students advised. CONCLUSION: Obstetrics and gynecology clerkship directors regularly serve in the crucial role of faculty career advisor. Confidence in advising fourth-year students, advising fulfillment, and satisfaction with advising resources were all significantly correlated. We recommend that clerkship directors review resources available for advising and that they be provided academic time to serve as career advisors.

12.
Acad Med ; 98(12): 1351-1355, 2023 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-37478137

RESUMEN

ABSTRACT: Recognition of the spectrum of gender identities has been a recent phenomenon in the medical profession. Over the past 20 years, medical literature related to gender identity diversity has increased several-fold, yet it more commonly addresses clinical care rather than aspects related to medical education. Medical educators continue to struggle with appropriate language and inclusive approaches when discussing gender-based aspects of medical education. Reproductive health education, including obstetrics and gynecology clerkships, is particularly vulnerable to missteps and anachronisms regarding gender identity.This article aims to provide preclinical and clinical medical educators with strategies to identify and predict situations where missteps related to gender identity inclusivity may occur in their curriculum or learning environment, and to develop approaches to improve gender identity inclusivity within medical education. The authors explore 3 areas that commonly pose challenges for medical educators: inclusive language and terminology, anatomy education, and reproductive genetics and genetic counseling. They hope the tools and strategies provided here will be useful to reproductive health medical educators across specialties to enable the realization of a more inclusive learning environment in reproductive health.


Asunto(s)
Educación Médica , Ginecología , Obstetricia , Humanos , Masculino , Femenino , Identidad de Género , Aprendizaje
13.
Acad Med ; 98(4): 431-435, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36347017

RESUMEN

The June 2022 U.S. Supreme Court decision on Dobbs v Jackson Women's Health Organization resulted in state-specific differences in abortion care access across the country. The primary concern in the obstetrics and gynecology education community has been the impact on resident and fellowship training programs. However, the impact on undergraduate medical education and the broad implications for future generations of physicians are crucial to address. It is estimated that 48% of matriculants to MD-granting medical schools will receive their medical education in the 26 states with significant abortion restrictions or bans. Undergraduate medical educators need to continue to adequately teach the basic science, clinical care, and population health outcomes of reproductive medicine, including pregnancy and abortion. In addition, students in states with more restrictions on abortion will have less or no clinical exposure, and those in states with few restrictions may be excluded due to overcrowding of learners from restricted states. Students' own health care also needs to be considered, as access to abortion care for themselves or their partners may create applicant pool demographic shifts by state as applicants consider options for where to pursue their medical education. It is important to ensure that teaching of foundational science of pregnancy, abortion, and reproductive health continues throughout the United States. Undergraduate and graduate medical educators will need to closely monitor the downstream impact of decreased clinical exposure of abortion. Further study of the personal health impact of abortion care access for medical students and awareness of the changing applicant pool demographics by state is needed.


Asunto(s)
Aborto Inducido , Educación de Pregrado en Medicina , Embarazo , Femenino , Estados Unidos , Humanos , Salud Reproductiva , Atención a la Salud , Recursos Humanos
14.
J Opioid Manag ; 18(3): 229-236, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35666479

RESUMEN

OBJECTIVE: To analyze the effect of the Connecticut Prescription Monitoring and Reporting System (CPMRS) on the number of opioid tablets prescribed to gynecologic oncology patients post-operatively. DESIGN/PARTICIPANTS: This was a retrospective chart review of patients who received surgery for suspicious masses, premalignant, or malignant conditions of uterus, tubes, ovaries, or cervix. Charts were divided into two groups before and after the implementation of an updated prescription monitoring system in July 2016. Quantitative data were collected on the number of opioids prescribed from hospital discharge summaries. Qualitative data included prescription and/or -recommendation of nonopioid analgesics and type of procedure (open versus minimally invasive). Demographic information included age, ethnicity, and insurance coverage. OUTCOMES: We identified a statistically significant, 50 percent decrease in opioid tablets in the After July 2016 group (n = 226) compared with the Before July 2016 group (n = 136) (p < 0.001). As anticipated, fewer opioid tablets were prescribed following minimally invasive procedures compared to open cases (p = 0.007). On examining nonopioid analgesic data, we found more patients received a prescription for nonopioid analgesics in the After July 2016 group compared with the Before July 2016 group (p < 0.001). CONCLUSION: This study confirms a decrease in opioid tablets prescribed to post-operative gynecologic oncology patients since July 2016. This difference cannot be attributed to the implementation of the CPMRS alone, but chronologically relates to updated requirements. Additionally, our results re-emphasize that minimally invasive surgery has a reduced number of prescribed opioids. A multi-institutional study is required with more patients to detail the factors involved in further decreasing opioid prescribing.


Asunto(s)
Analgésicos Opioides , Neoplasias de los Genitales Femeninos , Dolor Postoperatorio , Analgésicos no Narcóticos , Analgésicos Opioides/uso terapéutico , Femenino , Neoplasias de los Genitales Femeninos/cirugía , Humanos , Dolor Postoperatorio/tratamiento farmacológico , Pautas de la Práctica en Medicina , Programas de Monitoreo de Medicamentos Recetados , Estudios Retrospectivos
15.
Med Educ Online ; 27(1): 2107419, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35924355

RESUMEN

This article is from the 'To The Point' series from the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee. The purpose of this review is to provide an understanding of the differing yet complementary nature of interprofessional collaboration and interprofessional education as well as their importance to the specialty of Obstetrics and Gynecology. We provide a historical perspective of how interprofessional collaboration and interprofessional education have become key aspects of clinical and educational programs, enhancing both patient care and learner development. Opportunities to incorporate interprofessional education within women's health educational programs across organizations are suggested. This is a resource for medical educators, learners, and practicing clinicians from any field of medicine or any health-care profession.


Asunto(s)
Ginecología , Obstetricia , Curriculum , Femenino , Ginecología/educación , Humanos , Educación Interprofesional , Relaciones Interprofesionales , Obstetricia/educación , Embarazo , Salud de la Mujer
16.
Obstet Gynecol ; 136(4): 830-834, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32826520

RESUMEN

As hospitals and medical schools confronted coronavirus disease 2019 (COVID-19), medical students were essentially restricted from all clinical work in an effort to prioritize their safety and the safety of others. One downstream effect of this decision was that students were designated as nonessential, in contrast to other members of health care teams. As we acclimate to our new clinical environment and medical students return to the frontlines of health care, we advocate for medical students to be reconsidered as physicians-in-training who bring valuable skills to patient care and to maintain their status as valued team members despite surges in COVID-19 or future pandemics. In addition to the contributions students provide to medical teams, they also serve to benefit from the formative experiences of caring for patients during a pandemic rather than being relegated to the sidelines. In this commentary, we discuss factors that led to students' being excluded from this pandemic despite being required at the bedside during prior U.S. public health crises this past century, and we review educational principles that support maintaining students in clinical environments during this and future pandemics.


Asunto(s)
Infecciones por Coronavirus , Educación Médica , Control de Infecciones/métodos , Pandemias , Neumonía Viral , Aprendizaje Basado en Problemas/métodos , Seguridad , Estudiantes de Medicina/psicología , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Educación Médica/organización & administración , Educación Médica/tendencias , Humanos , Modelos Educacionales , Innovación Organizacional , Pandemias/prevención & control , Grupo de Atención al Paciente , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , SARS-CoV-2
17.
Medicine (Baltimore) ; 98(16): e15193, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31008942

RESUMEN

This study sought to investigate the effects of placental laterality on the measurements of uterine artery (UtA) Doppler velocimetry and their application in predicting early-onset preeclampsia (PE).We conducted a prospective cohort study on all women with singleton, uncomplicated pregnancies scheduled for first-trimester nuchal translucency at our institution. Pulsatility index (PI) for both UtAs was measured by Doppler velocimetry, and placental laterality was determined. Additionally, pregnancy outcome data were abstracted from the medical records. Receiver operating characteristic curves (ROCs) were plotted.Of the 304 patients enrolled, 247 met the inclusion criteria. Among these patients, 240 had uncomplicated delivery, while 7 had early delivery at <34 weeks due to PE. For the uncomplicated pregnancies, PI measurements of the UtA ipsilateral to the placenta were similar (left versus right UtA: 1.06 ±â€Š0.38 vs. 1.04 ±â€Š0.40; P = .745). However, PI measurements of the UtA contralateral to the placenta differed significantly (left versus right UtA: 1.45 ±â€Š0.51 vs. 1.3 ±â€Š0.47; P = .027). In predicting early-onset PE, the ideal cut-off value for the placental side PI was 1.91, with sensitivity 100% and specificity 96.3%. For nonplacental side PI, the ideal cut-off value for PI was 1.975, with sensitivity 57.1% and specificity 79.2%. Using the mean of the left and right UtA PI, the ideal cut-off value was 1.63, with sensitivity 100% and specificity 74.2%.ROC analysis confirmed that PI measurements of the UtA on the placental side were significantly lower than those on the contralateral side, PI measurements of the UtA ipsilateral to the placenta were similar.


Asunto(s)
Preeclampsia/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Arteria Uterina/diagnóstico por imagen , Adulto , Femenino , Humanos , Embarazo , Estudios Prospectivos , Adulto Joven
18.
Obstet Gynecol ; 134(4): 869-873, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31503156

RESUMEN

OBJECTIVE: To monitor demographics and factors associated with quality of life among obstetrics and gynecology clerkship directors. A secondary goal was to compare current demographics and survey responses to a 1994 survey of clerkship directors. METHODS: A 36-item electronic survey was developed and distributed to the 182 U.S. clerkship directors with active memberships with the Association of Professors of Gynecology and Obstetrics. Items queried respondents on demographics, attitudes about being a clerkship director, quality of life, and burnout. RESULTS: A total of 113 of the 182 (62%) clerkship directors responded to the survey. The mean full-time time equivalent allocated for clerkship director responsibilities was 25%. When compared with clerkship directors from 1994, current clerkship directors are younger, work fewer total hours per week, spend more time on patient care, and less time on research. Notably, 78% (87) of respondents were female compared with 21% (31) of respondents in 1994. Overall, most current clerkship directors responded optimistically to quality of life and burnout measures, with 25% (28) reporting symptoms of high emotional exhaustion and 17% (19) reporting symptoms of depersonalization. Clerkship directors' perception of support from their medical school was significantly correlated with increased personal fulfilment and positive quality of life, as well as decreased burnout and emotional exhaustion measures. CONCLUSION: The gender demographics of obstetrics and gynecology undergraduate medical education leadership have dramatically shifted over the past 25 years; however, many of the changes are not correlated with quality of life and burnout. The association between perceived support from the medical school and multiple quality of life measures point to the vital importance of support for our medical educators.


Asunto(s)
Docentes Médicos/psicología , Adulto , Agotamiento Profesional , Prácticas Clínicas , Docentes Médicos/estadística & datos numéricos , Docentes Médicos/tendencias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Encuestas y Cuestionarios
19.
Case Rep Obstet Gynecol ; 2012: 546852, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22720177

RESUMEN

Smooth muscle tumors of undermined malignant potential (STUMP) are atypical smooth muscle tumors. The majority of these tumors are of uterine origin. We report the first known periurethral STUMP. Complete surgical resection is recommended for all cases of STUMP. They can recur in the form of STUMP or leiomyosarcoma.

20.
Gynecol Oncol Case Rep ; 2(3): 87-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-24371628

RESUMEN

► Presentation of a rare case of pelvic gastrointestinal stromal tumor. ► Non-islet cell induced hypoglycemia causing severe hypoglycemia. ► The pathogenesis of non-islet cell induced hypoglycemia due to over-production of precursors of insulin-like growth factor-II. ► Complete resolution of hypoglycemia following resection of the tumor.

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