International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2024
Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States.
A personal statement is a common requirement in medical residency and fellowship applications. Generative artificial intelligence may be used to create a personal statement for these applications. ⋯ Program directors could not accurately discern if the statements were written by a person or artificial intelligence and would have concerns about an applicant suspected of using artificial intelligence. Medical training programs may benefit from outlining their expectations regarding applicants' use of artificial intelligence.
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Int J Obstet Anesth · Nov 2024
Patients' perspectives on pain relief during childbirth and labor epidurals: A pilot qualitative study among women who chose to deliver without neuraxial labor analgesia.
Studies have identified widespread variation in neuraxial labor analgesia use by race, ethnicity, and geographic location. However, limited research has investigated patient-level factors in the decision not to use neuraxial analgesia for labor. ⋯ Participants described various factors important in their decision to give birth without an epidural, which we mapped onto five primary themes. Our results can be used to guide effective patient-provider interactions centered on mutual understanding, evidence-based medicine, and honoring patients' wishes. The information gathered may provide insight into how providers can incorporate shared decision-making into their practice.
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Int J Obstet Anesth · Nov 2024
Case ReportsInhaled epoprostenol via high-flow nasal cannula and intravenous treprostinil for management of severe pulmonary arterial hypertension during cesarean delivery with epidural anesthesia: a case report.
Current guidelines for managing pulmonary arterial hypertension (PAH) in pregnancy recommend the use of PAH-specific medications, including phosphodiesterase type-5 inhibitors, calcium channel blockers, and prostacyclin analogs. However, there is limited consensus on the optimal agents and routes of administration during delivery. This case report describes a 24-year-old gravida 3 para 1 with Group I PAH, admitted at 29 weeks' gestation, for a planned cesarean delivery at 30 weeks gestation. ⋯ Postoperative management included continued iEpo with a hospital discharge seven days later in stable condition. This report highlights the novel use of iEpo via HFNC for managing PAH during cesarean delivery, suggesting its potential for reducing maternal morbidity and mortality in this high-risk population. Future studies should explore the simultaneous use of inhaled and intravenous prostacyclin analogs in pregnant patients with PAH.
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Int J Obstet Anesth · Nov 2024
Accuracy of Spanish and English-generated ChatGPT responses to commonly asked patient questions about labor epidurals: a survey-based study among bilingual obstetric anesthesia experts.
Large language models (LLMs), of which ChatGPT is the most well known, are now available to patients to seek medical advice in various languages. However, the accuracy of the information utilized to train these models remains unknown. ⋯ ChatGPT-generated answers in Spanish to ten questions about labor epidurals scored lower for accuracythananswers generated in English, particularly regarding the effect of labor epidurals on labor course and mode of delivery. This disparity in ChatGPT-generated information may extend already-known health inequities among non-English-speaking patients and perpetuate misinformation.