table 2020-04-16¢  successful treatment of spontaneous heterotopic pregnancy with ongoing...

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  • TABLE OF CONTENTS 

    Abstract Title Presenter Category Abstract Poster Use of Dextrose Containing Parenteral Solution in Induction of Labor in Nulliparous and Multiparous Patients

    Dr. Megan Avesian AWARD 1 2

    Inappropriate prophylactic use of antibiotics in gynecologic surgeries in inner city hospital

    Dr. Jacquelyn Boyd AWARD 3 4

    Severe fetal academia (umbilical cord pH

  • 2020 2020 POSTER PRESENTATION COMPETITION

    Category: AWARD

    Use of Dextrose Containing Parenteral Solution in Induction of Labor in Nulliparous and Multiparous Patients Author: Avesian, Megan DO

    Institution: Henry Ford Macomb Hospital

    Co-authors: Dr. Stephen Redding M.D.

    FINAL ABSTRACT: Objective: A study in 2017 (DEXTRANS) trial looked at reducing total labor time in nulliparous women undergoing induction of labor (IOL) by comparing a dextrose containing solution to normal saline in induced nulliparous women, with the primary outcome being total time of active labor. The trial found that the average length of labor was decreased in the dextrose group without adverse effects. The purpose of this prospective cohort study is to determine whether using a dextrose containing solution will shorten time to delivery during IOL in both nulliparous and multiparous women in a community hospital setting. Methods: Women admitted for IOL were given D5LR at 125 mL/hr. Exclusion criteria included patients requiring cervical ripening, patients with diabetes, and any patients on magnesium sulfate. The control population included all inductions from the previous year. Data was obtained via chart review. Results: Total labor time was calculated using the time Oxytocin infusion was started until delivery time. The mean labor times and SD were calculated. Mean time in the non-dextrose group compared to the dextrose group: 495 min and 469 min (p=0.477). Mean labor time in multiparous patients receiving dextrose compared to the non-dextrose group: 441 min and 465 min (p= 0.42) In nulliparous patients times in dextrose group and non- dextrose group: 621 min and 654 min (p=0.83). Conclusions: There is evidence that using dextrose may decrease labor time in IOL and could be considered

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  • 2020 2020 POSTER PRESENTATION COMPETITION

    Category: AWARD

    Inappropriate Prophylactic Use of Antibiotics in Gynecologic Surgeries in an Inner City Hospital Author: Boyd, Jacquelyn DO

    Institution: SSM Health - St. Anthony Hospital

    Co-authors: Kristin Kniech, DO, SSM Health - St. Anthony Hospital

    FINAL ABSTRACT: As antibiotic resistance is an increasing healthcare issue, promotion of antibiotic stewardship within hospitals has led to research into their proper use. The American College of Obstetricians and Gynecologists (ACOG) has specific recommendations for antimicrobial prophylaxis prior to gynecologic procedures. We hypothesized that patients in an inner-city hospital in Oklahoma City, Oklahoma undergoing gynecologic procedures were receiving prophylactic antibiotics that were otherwise not indicated for their surgery. A retrospective chart review was performed from July, 2017 to June, 2018. 314 surgeries were performed in this time and 169 cases met inclusion criteria as gynecologic procedures with no indication for antimicrobial prophylaxis. Of the 169 included cases, 98 (57.99%) revealed antibiotics were inappropriately given (p<0.5). The most common procedure in which misuse was noted were laparoscopic procedures without entry into the bowel or vagina, composing 61.2% of cases. Cefazolin was the most frequently used medication and was given in 84.7% of the cases. These results reflect the overuse of antibiotics for surgical prophylaxis, which contributes to increasing antibiotic resistance in women undergoing elective gynecologic procedures. Overall, this is hindering the progressive movement towards promotion of antibiotic stewardship. We hope that these study results will limit the misuse of antibiotics in a hospital setting, and specifically in surgical specialties.

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  • 2020 2020 POSTER PRESENTATION COMPETITION

    Category: AWARD

    Severe fetal acidemia (umbilical cord arterial pH < 7) was poorly predicted by the three-tiered fetal heart rate interpretation system (Category I, II, and III) Author: Brendel, Katelyn DO

    Institution: Einstein Medical Center Philadelphia

    Co-authors: Sarah Gan, MD, Chase White, MD, Jay Goldberg, MD, David Jaspan, DO

    FINAL ABSTRACT: The purpose of this study was to evaluate EFM during the hour prior to birth in babies born with an umbilical cord arterial pH < 7 for predictors of severe acidemia. A retrospective cohort study was performed on babies with umbilical cord arterial pH < 7. The last hour of EFM was reviewed. Maternal, neonatal, labor and delivery characteristics were compared using the Chi-squared test for independence and the Fisher’s Exact Test. Thirty babies were identified with umbilical cord arterial pH < 7. 27%, 73%, and 0% of FHTs during the last hour of EFM of babies with severe acidemia were Category I, II, and III, respectively. 85% and 54% of the severely acidemic babies had moderate variability and accelerations, respectively. Only 8%, 8%, 19%, and 15% of severely acidemic babies had fetal tachycardia, fetal bradycardia, recurrent variable decelerations or recurrent late decelerations, respectively. Delivery was expedited only in the presence of recurrent late decelerations. The presence of a Category I tracing, moderate variability or accelerations was falsely reassuring such that delivery was less likely to be expedited.

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  • 2020

    2020 POSTER PRESENTATION COMPETITION

    Category: AWARD

    Accuracy of Estimated Fetal Weight in the Third Trimester Author: Hussain, Ayesha DO Institution: UPMC Pinnacle Harrisburg Co-authors: Bertha Vasquez, Andrea Sebright, Terry Tressler, Claudia Taboada

    FINAL ABSTRACT: OBJECTIVE: Determine if fetal growth scans performed at/after 37 weeks gestation can give an accurate EFW to help to guide antenatal management and delivery recommendations. Accepted margin of error between EFW and ABW is 15%. EFW is considered acceptable, for delivery management within 10%. METHODS: Retrospective descriptive qualitative study of 1785 cases where EFW within 3 weeks of delivery was compared with ABW. Significant difference between EFW and ABW was tested by paired t-test. Pearson's correlation used to detect significant linear relationship between EFW and ABW. Difference in error rates among the weight categories and GA categories assessed by chi-square test. p-value < 0.05 considered statistically significant. RESULTS: Error rate of <15% was 81%, 86% and 83% for ABW of <2500 gm, >2500 gm to <4000gm, and >4000gm respectively. Error rate of <10% was 66% for ABW of <2500 gm and >2500 gm to <4000 gm and 65% for ABW of >4000 gm. Error rate of <5% was 41%, 38% and 37% for ABW of <2500 gm, of >2500 to <4000 gm of >4000 gm respectively. Error rates of <15% <10% and <5% for GA of 37 to 40 weeks was 86%, 68% and 38% respectively. Error rate of <15% for GA of <37 weeks was lower compared to the GA in other categories. CONCLUSION: Estimated fetal weight measurements at/after 37 weeks may be considered accurate; error rate is below the acceptable rate of <15%. With increasing gestational age and increased ABW, our EFW are within acceptable error rates.

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  • 2020

    2020 POSTER PRESENTATION COMPETITION

    Category: AWARD

    A Comparison of Estimate Blood Loss (EBL) and Quantitative Blood Loss as Predictors of Postpartum Hemoglobin Change Author: O'Nan, Sarah DO Institution: Henry Ford Wyandotte Hospital Co-authors: Salvatore Finazzo, DO Henry Ford Wyandotte Hospital

    FINAL ABSTRACT: Objective: To determine whether quantitative blood loss is more effective than estimate blood loss in predicting changes in hemoglobin levels associated with cesarean delivery.

    Study Design: Data collected included EBL, QBL and lab-measured pre- and post-delivery hemoglobin levels which were compared to blood loss determined by QBL and EBL in patients who had undergone cesarean deliveries. This was a retrospective chart review performed at Henry Ford Wyandotte and Henry Ford Hospital from January - May 2019. Pearson correlation coefficients were calculated for evaluating the relationship between EBL and change in hemoglobin, and QBL and change in hemoglobin. Hemoglobin changes were measured as post-cesarean hemoglobin minus pre-cesarean hemoglobin. Statistical significance was set at p<0.05. Analyses were performed using SAS 9.4.

    Results: The two blood loss groups were treated independently. Both QBL and EBL had weak correlations with changes in hemoglobin as shown by the correlation coefficients of r=-0.07 and 0.02, respectively. There was a very weak negative correlation between QBL and hemoglobin change and a weak positive correlation between EBL and hemoglobin change. A Z-test was conducted to measure any difference in magnitude or strength between the two correlations without regard to positive or negative slope direction.

    Conclusion: There is insufficient evidence to suggest that one measure of blood loss is superior (more highly correlated) with hemoglobin change.

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  • 2020

    2020 POSTER PR

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