AJP reports
-
Objective This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood loss determined by a novel colorimetric system. Agreement between the reference assay and other measures was evaluated by the Bland-Altman method. ⋯ The correlation between the assay method and the colorimetric system was more predictive (standardized coefficient = 0.951, adjusted R2 = 0.902) than either visual estimation (standardized coefficient = 0.700, adjusted R2 = 00.479) or the gravimetric determination (standardized coefficient = 0.564, adjusted R2 = 0.304). Conclusion During cesarean delivery, measuring blood loss using colorimetric image analysis is superior to visual estimation and a gravimetric method. Implementation of colorimetric analysis may enhance the ability of management protocols to improve clinical outcomes.
-
Case Reports
Management of Breast Cancer during Pregnancy: Are We Compliant with Current Guidelines?
Introduction The purpose of this study was to evaluate the management of patients with breast cancer in pregnancy treated at the Advocate Health Care, to determine whether these patients were treated according to guidelines for pregnant patients, which aim to maximize both fetal and maternal outcomes. Methods A retrospective chart review was performed at the Advocate Lutheran General Hospital, Christ Medical Center, and Illinois Masonic Medical Center from 2002 to 2012 on patients diagnosed with breast cancer during pregnancy using ICD-9 (International Classification of Diseases - 9th version) codes. Results Eleven patients between 12 and 37 weeks' gestation matched the search criteria. ⋯ Two patients underwent sentinel node biopsy. Conclusion The diagnosis of breast cancer in pregnancy is an infrequent but devastating diagnosis that is likely to increase. Although sentinel lymph node biopsy is not generally recommended in pregnancy, this may be an outdated guideline as using a low-dose lymphoscintigraphic technique appears to be safe in pregnancy.
-
Case Reports
Development, Implementation, and Assessment of a Genetics Curriculum Across Institutions.
Objective Many residency programs offer limited exposure and minimal didactic time genetics, despite its frequent use in obstetrics and gynecology. The objective of this study was to develop, pilot, and assess a three-module women's health genetics curriculum for residents that was easily transferable between institutions. Methods An interactive three-module genetics curriculum covering basic principles, prenatal screening/diagnosis, and cancer genetics was developed. ⋯ However, 8/13 scored > 70% on the posttest (p = 0.002). Instructors at both institutions described the curriculum as easy to use/implement. Conclusion This three-module workshop on women's health genetics was easily implemented across institutions and led to increased knowledge.
-
Perineal groove is a rare congenital malformation that is characterized by an exposed wet sulcus with nonkeratinized mucous membrane that extends from the posterior vaginal fourchette to the anterior ridge of the anal orifice. This condition is one of the uncommon anomalies of urogenital/anogenital region that is unknown to many clinicians. ⋯ This lesion could be misdiagnosed as contact dermatitis, trauma, or even sexual abuse. Therefore, recognition of the congenital perineal groove at birth is important for the health care providers to deliver an appropriate parental counseling and appropriate follow-up.
-
Case Reports
Phlegmasia Cerulea Dolens and May-Thurner Syndrome in the first trimester of Pregnancy.
Background Venous thromboembolism in pregnancy remains one of the leading causes of morbidity and mortality. Case A young, gravid patient presented with a cyanotic, edematous left lower extremity with no distal pulses palpable. ⋯ Conclusion Timely diagnosis and prompt surgical management are necessary due to the limb-threatening nature of this condition. Despite maternal radiation exposure, the nature and extent of fetal effects depends upon radiation dose and gestational age.