The Use of a Game-Based Decision Aid to Educate Pregnant Women about Prenatal Screening: A Randomized Controlled Study.

PURPOSE: This project developed and evaluated the efficacy of a game decision aid among pregnant women about prenatal screening in a randomized controlled study. STUDY DESIGN: Participants were recruited from an obstetric clinic of an academic urban medical center and randomized (n = 73) to one of two study groups: the control group (n = 39) that used a brochure or the intervention group (n = 34) that also used a game decision aid. RESULT: Participants who played the game had higher knowledge scores (m = 21.41, standard deviation [SD] = 1.74) than participants in the control group (m = 19.59; SD = 3.31), p = 0.004. The median time of game playing was 6:43 minutes (range: 2:17-16:44). The groups were similar in frequency of completing screening after the study, control = 6 (15%) versus intervention = 11 (32%), p = 0.087. However, the more interaction with the game resulted in more positive attitudes toward screening. CONCLUSION: The addition of a game decision aid was effective in educating pregnant women about prenatal screening. As other genetic testing decisions continue to increase within clinical care, game-based decision tools may be a constructive method of informed decision-making.

Torsed Ovarian Dermoid.

Ovarian dermoids constitute the most common ovarian neoplasm and make up approximately 20% of all ovarian neoplasms. Dermoids are most common in the reproductive age group, but unlike other ovarian germ cell tumors, their age distribution is quite broad. Torsion may occur in approximately 15% of cases and is more common during pregnancy and in the 6 weeks immediately after delivery. We present a 17-year-old who came to the emergency department in her puerperium with severe right lower quadrant pain. The diagnosis of a 12-cm dermoid was missed at ultrasound. We discuss the reasons for the mistake on ultrasound and give strategies to prevent this from happening in the future. Three commonly overlooked teaching points regarding dermoids are discussed. Ultrasound and computed tomographic imaging, operative course, and correlative intraoperative and pathological images are presented.