Reference range for tissue oxygen saturation in pregnancy using near-infrared spectroscopy.

OBJECTIVE: To estimate the reference range of tissue oxygen saturation (StO2) values in pregnancy. Near-infrared spectroscopy-derived StO2 is a noninvasive continuous measure used to predict hypoperfusion. Normal StO2 values have not been established in pregnant women. STUDY DESIGN: We enrolled 154 healthy pregnant women from an obstetric and gynecology resident clinic. Three sequential measurements were taken after securing the StO2 probe to the thenar eminence of one hand. One-way ANOVA was used to test for differences between trimesters and non-parametric methods to establish a reference range with 95% CI on the limits. RESULTS: The reference interval for the entire cohort of pregnant women is 73% (95% CI 72-75) to 92% (95% CI 89-93), similar to the normal range in the general population. We found no statistically significant difference in StO2 measurements between trimesters. Due to inadequate sample sizes we could not estimate a valid reference range for each trimester. CONCLUSION: We estimated a reference range for StO2 values in normal pregnant women. This information may contribute to the study of StO2 monitoring to predict impending shock in the obstetric patient.

Laparotomy operative note template constructed through a modified Delphi method.

OBJECTIVE: An operative note is indispensable to physician documentation and decision-making; however, there are no accepted standards for operative note content. Our aim was to use a modified Delphi consensus-building method to construct a uniform operative note template for laparotomy. STUDY DESIGN: Using Joint Commission on Accreditation of Healthcare Organizations requirements, literature review, and feedback from 15 medical malpractice defense attorneys, we compiled a draft operative note template of 31 elements. We surveyed 37 Association of Professor of Gynecology and Obstetrics/Solvay scholars asking for their input on inclusion of each item as essential content of the operative note. RESULTS: Two iterations of the survey were required to reach a predetermined 75% level of consensus. Nine elements were eliminated from the template: 6 original and 3 expert-suggested elements. CONCLUSION: We provide an operative note template that was compiled through a Delphi process.

Educational games in an obstetrics and gynecology core curriculum.

OBJECTIVE: The purpose of this study was to compare learning satisfaction and effectiveness using traditional lecture or educational game in teaching medical students about ectopic pregnancy. STUDY DESIGN: Third-year medical students were randomized to instruction about ectopic pregnancy through either standard lecture or educational Jeopardy style game. Students in each group completed a pretest, posttest, and satisfaction survey. Experts in ectopic pregnancy validated the pretest and posttest. The satisfaction survey was taken from published validated tests. Paired samples t test was used to compare pretest and posttest scores. Independent samples t tests were used to compare test scores and satisfaction responses between groups. Chi-square tested dichotomous satisfaction responses. RESULTS: All 104 students in both groups showed significant improvement in learning about ectopic pregnancy (P < .001) on pre- and posttest comparison, with scores being almost identical. Students in the group randomized to game format rated it higher in stimulating faculty/student interaction, helping retain information, and overall enjoyment than students participating in the lecture method (P < .001). In addition, students in the game group responded positively that the format was interactive, stimulated their interest, and kept them engaged in class content (P < .001). CONCLUSION: The innovative educational game format was as effective as standard lecture in educating students about ectopic pregnancy, while being more enjoyable and stimulating. Based on these conclusions, we hope to motivate other teachers in obstetrics and gynecology to use innovative teaching methods to provide a more enjoyable, stimulating, and active means of effective medical education.