Nutrition Education and Nutrition Knowledge Among Obstetrics and Gynecology Residents.

Background: Nutrition in pregnancy is a component of the Council on Resident Education in obstetrics and gynecology core curriculum; however, no studies currently examine adherence to this goal. Objectives: Our objective was to assess obstetrics and gynecology (Ob/Gyn) residents' education and knowledge surrounding nutrition in pregnancy, including (1) amount of dedicated didactic time to and attitudes toward, (2) subjective comfort in counseling patients on, and (3) objective knowledge of pregnancy-related nutrition. Materials and Methods: This is a cross-sectional electronic survey-based study. A 28-item questionnaire was distributed to residents enrolled in Ob/Gyn training programs across the United States in 2022. Results: From 247 Ob/Gyn residency programs, 218 residents across postgraduate years and from geographically diverse locations consented to participation and completed all survey questions. Almost half (48%) of participants reported 0 hours per year of dedicated nutrition-related education, 49% reported 1-2 hours, and 3% reported >2 hours. Most residents (92%) strongly agreed or agreed that education regarding pregnancy-related nutrition guidelines would be useful for clinical practice. However, less than one-third (31%) of residents reported feeling comfortable counseling patients on nutrition in pregnancy. On assessment of residents' objective knowledge of pregnancy-related nutrition, mean percentage of correct responses was 74%. Conclusions: This study identifies a gap in graduate medical education, specifically a disconnect between the recognized impact of nutrition on pregnancy outcomes and residents' ability to confidently and effectively counsel patients on nutrition in pregnancy. Results demonstrate a need to develop curriculum and interventions to educate Ob/Gyn residents about pregnancy-related nutrition.

Delayed Diagnosis of Microperforate Hymen Leading to Urethral Dilation Secondary to Coital Activity.

BACKGROUND: Urethral coitus can occur with vaginal and hymenal anomalies and typically presents with incontinence, dyspareunia, and recurrent urinary infections. Penetration of the urethra occurs unknowingly, and delayed diagnosis permits ongoing urethral coitus and dilation. CASE: A 23-year-old woman presented to a specialty clinic for a possible vaginal anomaly after failed intrauterine device insertion owing to difficulty locating the cervix. She reported regular menses and satisfying intercourse. Clinical examination revealed a dilated urethra from presumed urethral intercourse and a microperforate hymen with a 1-mm opening. CONCLUSION: This case highlights the importance of taking a thorough sexual history paired with careful examination of the external genitalia to correctly identify and diagnose vaginal and hymenal anomalies and to prevent long-term complications.