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Browsing by Author "Rouse, Caroline"
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Item Assessment of the Placental Cord Insertion Using 3‐Dimensional Ultrasound at the Time of the Structural Fetal Survey(Wiley, 2019-07) Rouse, Caroline; Cantonwine, David E.; Shipp, Thomas D.; Obstetrics and Gynecology, School of MedicineObjectives The influence of placental morphologic characteristics on pregnancy outcomes is poorly understood. Our objective was to evaluate the relationship of the distance of the placental cord insertion from the placental edge (PCI‐D) with associated placental characteristics as well as birth outcomes. Methods We performed a retrospective cohort study of nulliparous women with singleton gestations undergoing obstetric ultrasound examinations between 14 and 23 weeks’ gestation with a cervical length of greater than 3.0 cm who delivered between 24 and 42 weeks. A 3‐dimensional volume of the placenta was evaluated. The PCI‐D was obtained with Virtual Organ computer‐aided analysis software (GE Healthcare, Milwaukee, WI). Generalized linear regression and generalized additive models were fitted to explore the associations between the PCI‐D in relation to demographic and clinical characteristics. Results A total of 216 pregnancies were included in the analysis. The PCI‐D did not correlate with maternal age, gestational age at delivery, mode of delivery, or 5‐minute Apgar score. Although not statistically significant, the birth weight z score (P = .09) was associated with a longer PCI‐D, and gravidity was associated with a shorter PCI‐D (P = .10). A low‐lying placenta or placenta previa was associated with a longer PCI‐D (P = .03). Conclusions The PCI‐D is associated with a low placental position in the second trimester. These data are helpful for understanding placental development. The PCI‐D may be associated with pregnancy‐related factors such as birth weight and multigravidity. More research is required to evaluate the effects of pregnancy‐related factors on the PCI‐D and the effect of the PCI‐D on pregnancy outcomes.Item Describing Self-confidence in Ultrasound Performance with Increased Exposure(2020-03-06) Shanks, Anthony L.; Schultz, Katherine; Bhamidipalli, Surya; Rouse, Caroline; Scott, NicoleItem MS4 Satisfaction with an Online Ultrasound Elective as an Alternative to Clinical Experience(2021-04-22) Shanks, Anthony L.; Baugh, Kyle; Darwish, Audrey; Sharifi, Mitra; Rouse, CarolineINTRODUCTION/BACKGROUND: A fourth year (MS4) elective in OBGYN US has traditionally been offered as a month-long rotation. MS4 students shadow Maternal-Fetal Medicine physicians and enhance knowledge with clinical exposure. Historically, the rotation provides adequate understanding of US in pregnancy. However, the COVID pandemic forced clinical experience to be replaced with virtual learning. To ensure MS4 students still had an opportunity to learn about US in pregnancy, a virtual, online curriculum was created. Using Kern’s six-step approach to curriculum, we developed a month-long OBGYN US virtual experience to replace clinical interaction. It is unclear if this transition was associated with high MS4 satisfaction. STUDY OBJECTIVE/HYPOTHESIS: To determine if converting a traditional hands-on ultrasound (US) elective to an online course for MS4 students was associated with course satisfaction. METHODS: Kern’s six-step approach to curriculum building was utilized to create a virtual course in US for MS4 students. This online course was created in Canvas based on US Milestones in the Residency Training Program Consensus Report (Abuhamad 2018). Self-directed modules and quizzes were created and administered weekly. Additionally, a weekly hour-long session using Nearpod technology – an interactive online website – was utilized to enhance instruction. Students completed an anonymous survey on Qualtrics at the completion of the elective. Satisfaction on a Likert scale of 1-7 was reported. Descriptive analysis and ANOVA were used when appropriate with SPSS 27. RESULTS: Nine MS4 students completed the course from May-July, 2020. Satisfaction was high for the course overall (mean 6.11, SD 1.96). Nearpod lecture (6.89, 0.31), Canvas modules (6.7, 0.47), and weekly quizzes (6.78, 0.42) were all rated highly with no statistically significant difference between the methods of instruction. Formative feedback from participants found the course material and Nearpod highly engaging. More students were able to complete the virtual class (9) compared to historical attendance of one student per month (3). DISCUSSION: An online US elective was associated with high satisfaction from participants. The course served as an adequate substitute for participants during COVID restrictions and allowed for greater enrollment. Future directions include integrating this online module with in-person clinical experience.Item The Impact of COVID-19 on Postpartum Depression and the Responsibility of the Healthcare System(Springer Nature, 2022-08-09) DiGregory, Sydney; Githere, Nancy; Crites, Kundai; Rouse, Caroline; Shanks, Anthony L.; Obstetrics and Gynecology, School of MedicinePeripartum depression is a common complication of pregnancy with the potential for dangerous consequences to maternal and infant health if left untreated. The disorder was previously classified as a global public health issue due to the high prevalence of the disorder and the mismatch between available treatment options and successful completion of those options. The coronavirus disease 2019 (COVID-19) pandemic increased the incidence of mental health disorders globally, with an even greater effect on peripartum mothers. A preliminary study on fetal implications suggests the resulting increased maternal stress and depressive mood symptoms correlates to worsened fetal brain development. The pandemic highlighted existing barriers to the treatment of peripartum mood disorders. The drastic increase in the use of telemedicine as a modality of treatment in response to the public health crisis has the potential to address some of these barriers. Future global disasters are inevitable with peripartum mothers highly susceptible to worsened mental health outcomes. We are thus highlighting the responsibility of clinicians, professional organizations, and policymakers to support, identify, and facilitate the treatment of postpartum depression for this vulnerable population to prevent short-term and long-term repercussions.