Browsing by Subject "obstetrics"

Now showing 1 - 7 of 7
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    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 Medicine
    Objectives 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.
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    Describing Self-confidence in Ultrasound Performance with Increased Exposure
    (2020-03-06) Shanks, Anthony L.; Schultz, Katherine; Bhamidipalli, Surya; Rouse, Caroline; Scott, Nicole
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    Medical Racism and Black Health Activism in Indianapolis and Beyond: Learning Modules for Health Professionals
    (2024) Nelson, Elizabeth
    This set of modules, designed for health care professionals, focuses on the history of health disparities in the United States, with a special focus on Indianapolis. Health disparities between different racial and ethnic groups have been documented since the 1800s. Anti-Black racism has played a central role in the making of modern medicine in the US; Dr. Martin Luther King Jr., considered discrimination in medicine to be the most “shocking and inhuman” form of racism. Civil Rights activists and Black health care professionals have led efforts to minimize health disparities, in Indianapolis and beyond, over many decades. But there is more work to be done. As we build toward a more equitable future, we would be wise to inform ourselves of this past.
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    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, Caroline
    INTRODUCTION/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.
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    Offering Induction of Labor for 22-Week Premature Rupture of Membranes: A Survey of Obstetricians.
    (NPG, 2015-08) McKenzie, Fatima; Tucker Edmonds, Brownsyne; Department of Obstetrics & Gynecology, IU School of Medicine
    Objective: To describe obstetricians’ induction counseling practices for 22-week preterm premature rupture of membranes (PPROM) and identify provider characteristics associated with offering induction. Methods: Surveyed 295 obstetricians on their likelihood (0–10) of offering induction for periviable PPROM across 10 vignettes. 22-week vignettes were analyzed, stratified by parental resuscitation preference. Bivariate analyses identified physician characteristics associated with reported likelihood ratings. Results: Obstetricians (N=205) were not likely to offer induction. Median ratings by preference were: resuscitation 1.0, uncertain 1.0, and comfort care 3.0. Only 41% of obstetricians were likely to offer induction to patients desiring comfort care. Additionally, several provider-level factors, including practice region, parenting status, and years in practice, were significantly associated with offering induction. Conclusions: Obstetricians do not readily offer induction when counseling patients with 22-week ruptured membranes, even when patients prefer palliation. This may place women at risk for infectious complications without accruing a neonatal benefit from prolonged latency.
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    Offering induction of labor for 22-week premature rupture of membranes: a survey of obstetricians
    (Nature Publishing Group, 2015-08) McKenzie, Fatima; Tucker Edmonds, Brownsyne; Department of Obstetrics and Gynocology, IU School of Medicine
    Objective: To describe obstetricians’ induction counseling practices for 22-week preterm premature rupture of membranes (PPROM) and identify provider characteristics associated with offering induction. Methods: Surveyed 295 obstetricians on their likelihood (0–10) of offering induction for periviable PPROM across 10 vignettes. Twenty-two-week vignettes were analyzed, stratified by parental resuscitation preference. Bivariate analyses identified physician characteristics associated with reported likelihood ratings. Results: Obstetricians (N=205) were not likely to offer induction. Median ratings by preference were as follows: resuscitation 1.0, uncertain 1.0 and comfort care 3.0. Only 41% of obstetricians were likely to offer induction to patients desiring comfort care. In addition, several provider-level factors, including practice region, parenting status and years in practice, were significantly associated with offering induction. Conclusions: Obstetricians do not readily offer induction when counseling patients with 22-week ruptured membranes, even when patients prefer palliation. This may place women at risk for infectious complications without accruing a neonatal benefit from prolonged latency.
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    To Flip or Not to Flip: Learning Style Preferences among Millennial Physician Assistant Students
    (Cureus Inc, 2021-02) Schultz, Katherine; Schaffer, Alicia; Rebman, Rebecca; Shanks, Anthony L.; Obstetrics and Gynecology, School of Medicine
    Introduction: Presenting material in a manner that is most palatable to students is important to improve the learning process. We evaluated the efficacy of different teaching styles including the flipped classroom and assessed the learning style preferences of a cohort of medical learners in a preclinical obstetrics and gynecology course. Methods: We conducted three teaching sessions with 35 physician assistant students. A different teaching style was implemented for each session including a traditional lecture with interactive learning technology augmentation, a flipped classroom, and a hybrid approach incorporating lecture and group work. Students were surveyed using a Likert scale regarding the efficacy of the format, clinical relevance of the material, and their learning preference for future sessions. Results: Students rated the traditional approach as the most effective, most relevant, and most preferred method. Students preferred the flipped classroom least, but they rated it as slightly more effective and relevant than the hybrid approach. Conclusion: The teaching style of various coursework including the preclinical obstetrics and gynecology curriculum may not need to be altered for millennial learners. This study showed the flipped classroom was the least favored teaching style and that there was a marked preference by students for a more traditional didactic lecture.