Obstetric Knowledge Research Articles

Evaluation of Knowledge, Attitudes, and Practices About HPV Vaccine: A Survey Study of Pediatric and Obstetrics and Gynecology Residents in İzmir, Türkiye

Purpose: The main objective of this study was to evaluate the knowledge, attitudes, and practices of obstetrics and gynecology (OB/GYN) and pediatric residents in Izmir, Turkey, regarding the HPV vaccination. Materials and Methods: This cross-sectional survey study was conducted in five hospitals in Izmir, Turkey, between May and July 2019. The data for this study were obtained from 299 pediatric and 126 OB/GYN residents via an online web-based questionnaire. The statistical analyses were performed using SPSS®. Results: The overall participation rate was 72%. Only 25.2% of the participating residents demonstrated adequate knowledge about the HPV vaccine. The OB/GYN residents had significantly higher knowledge scores than the pediatric residents (median [IQR] = 9.4 [8.4-10.6] vs. 8.4 [7.4-9.8], p=0.007). The vaccination rate among residents was low, with female residents having higher rates of vaccination than male residents (13.6% vs. 1.1%, p

"It feels like you have to choose one or the other": a qualitative analysis of obstetrician focus groups on periviability counseling.

The objective of this study was to gain knowledge and ascertain challenges about periviability counseling among obstetricians to inform curricular development. Focus groups were utilized. A series of open-ended questions was posed to each group of obstetricians; responses were audio recorded and transcribed. Transcriptions were analyzed by two coders using thematic analysis. Four focus groups were convened. Prominent themes included: (1) Obstetrician knowledge about neonatal outcomes is limited, (2) Periviability counseling is both time intensive and time-challenged, (3) Patient processing of information relies on the content, delivery and patient readiness, and (4) Obstetrician bias is toward advocating for maternal safety, which may run counter to parental instinct to "do everything." The last theme was specifically focused on the role of cesarean delivery. Curricula focused on improving obstetrician periviability counseling should focus on neonatal outcomes, the role of cesarean delivery, and utilization of shared decision-making.

Exploring the capabilities of ChatGPT in women’s health: obstetrics and gynaecology

Artificial Intelligence (AI) is transforming healthcare, with Large Language Models (LLMs) like ChatGPT offering novel capabilities. This study evaluates ChatGPT’s performance in interpreting and responding to the UK Royal College of Obstetricians and Gynaecologists MRCOG Part One and Two examinations – international benchmarks for assessing knowledge and clinical reasoning in Obstetrics and Gynaecology. We analysed ChatGPT’s domain-specific accuracy, the impact of linguistic complexity, and its self-assessment confidence. A dataset of 1824 MRCOG questions was curated, ensuring minimal prior exposure to ChatGPT. ChatGPT’s responses were compared to known correct answers, and linguistic complexity was assessed using token counts and Type-Token ratios. Confidence scores were assigned by ChatGPT and analysed for self-assessment accuracy. ChatGPT achieved 72.2% accuracy on Part One and 50.4% on Part Two, performing better on Single Best Answer (SBA) than Extended Matching (EMQ) Questions. The findings highlight the potential and significant limitations of ChatGPT in clinical decision-making in women’s health.

Gendered anti-blackness, maternal health & chattel slavery: OB/Gyn knowledge as a determinant of death of black women

This archival investigation of the Southern Medical and Surgical Journal (SMSJ) focuses on the construction of the American Ob/Gyn profession's medical knowledge system alongside chattel slavery, between 1834 and 1860. I find that language, methods of clinical management of bodies and decision-making processes illustrate the pathways that obstetrical knowledge served as a determinant of death for Black women under chattel slavery. These are byproducts of the condition of possibility, my theoretical framework. The condition, or use of gendered anti-Black logic/practice, specifically the social death and biological indispensability of Black women in the context of chattel slavery, shapes the subjective nature of medical knowledge into a determinant of maternal death for Black women. Using the condition of possibility as a theoretical framework, I will lay the groundwork to reframe the Ob/Gyn knowledge system as a current and ever-present threat to Black women and girls' health. This study's sociological contribution lies in examining medical knowledge construction as a series of social interactions, informed by gendered and racial ideologies, that determine health outcomes for Black women.

Simulation as an Innovative Teaching Pedagogy for Baccalaureate Male Students Undertaking a Maternal Health Course in the Arab world: A Pilot Project

Background: The nursing profession is attracting more male students at the baccalaureate level. Nursing faculty face difficulty in finding appropriate clinical opportunities in obstetrics for male baccalaureate nursing students in the conservative Arab culture.Methods: A simulated environment was created comprising four beds in a ward setting. A standardized patient (SP) was placed on each bed. Each SP was trained to provide a history and respond to triggers based on questions posed by male students. The scenarios were: an antenatal patient admitted for induction of labor, a primipara with edema and severe headache, a multigravida who delivered spontaneously and was preparing for discharge, and a cesarian case on the first postoperative day. In the latter two scenarios, newborns were placed in bassinettes near the SP’s and the male students were also expected to take care of the baby. This innovative educational project highlighted simulation using low fidelity manikins and SPs. Male students reported simulation was an effective teaching strategy to acquire obstetric knowledge and develop critical thinking as they responded to cues given by the SP (e.g., antenatal abdominal pain). In addition, the students gained a level of proficiency in examining antenatal and postnatal women. Furthermore, they reported that debriefing following the training consolidated their learning.Conclusion: Male students reported they would not have been able to achieve the course outcomes for thematernity clinical rotation without the introduction of simulation. This project sets the stage for introducingsimulation into other clinical courses across the baccalaureate curriculum.

Knowledge and Confidence of Obstetrics and Gynecology Residents in the Evaluation and Management of Heavy Menstrual Bleeding Due to Inherited Bleeding Disorders.

Heavy menstrual bleeding (HMB) is common, and 20-30% of patients presenting with HMB are diagnosed with an inherited bleeding disorder (IBD). Despite the frequent association of HMB with bleeding disorders, specific learning objectives on this topic are lacking for Obstetrics and Gynecology (OBGYN) residents. We sought to determine the exposure of OBGYN residents to didactics, clinical training, and confidence in evaluation and management of patients with HMB due to IBDs. Prospective survey of OBGYN residents through email solicitation. Residents were invited to complete an anonymous 26-item survey, querying residents' confidence in evaluation and management of HMB in patients with and without IBDs. In total, 239 OBGYN residency programs were invited to participate and 20 programs responded. Among 388 residents, 84 completed the survey (21.6%). The majority reported didactics on HMB evaluation (n = 71, 85.5%) and treatment (n = 77, 92.8%); however, for HMB due to IBDs, only 35 residents (42.4%) reported didactics on evaluation and 28 (33.7%) reported didactics on treatment. Confidence in evaluation and management of HMB was high but decreased significantly with an IBD. Residents who received didactics on IBDs reported more confidence in their evaluation than residents who did not receive didactics (mean Likert scale score of 3.67 vs. 3.23, p = 0.002). Increasing postgraduate year level was associated with more confidence in treatment (p < 0.001) and did not differ based on type of training program (p = 0.825). OBGYN residents have decreased confidence in evaluation and management of HMB due to IBDs. Resident confidence increases with didactics and training. Residents would benefit from curricula designed to address this deficit in training.

Pharmacological labour pain interventions: South African midwives’ perspective

BackgroundWomen of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives’ perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch’s open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician’s prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives’ ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.

System barriers to the provision of quality maternal health care in two regional teaching and referral hospitals in Kenya: a qualitative study

ObjectiveSub-Saharan Africa accounts for 66% of global maternal deaths. In Kenya, 362 maternal deaths occur in every 100 000 live births. Most of these deaths occur as a result of suboptimal quality care of mothers during labor, delivery, or within 24 h of delivery. This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods. MethodsA qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants’ experiences. Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya. Eligible participants were nurse-midwives in charge of the maternity unit. The discussion was conducted in English, tape-recorded, and transcribed verbatim. Data were analyzed thematically, following Braun and Clarke 6-step framework. Nvivo version 7.0 computer software was used to facilitate this process. ResultsTwo focused group discussions each involving seven participants were conducted. The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern. Further, maternal care in the two hospitals was substandard. Themes that emerged as barriers were: inadequate supplies; inadequate obstetric knowledge and skills; shortage of nurse-midwives, and inadequate support supervision. The underlying factors include inadequate funding by the county government and high staff turnover. ConclusionThis study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care. This is mainly due to system failures and inadequate nurse-midwife numbers. Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.

Study on core competencies of midwives in China.

The aim of this study is to investigate the core competencies of midwives in China. Combination of qualitative research and quantitative research. A total of 100 midwives in 3 tertiary (Grade 3) hospitals in Shijiazhuang were investigated by using the Midwife Core Competency Scale, and simultaneously followed by semi-structured interviews with 12 midwives. The questionnaire survey showed that the average score of core competencies of midwives was 4.17 ± 0.17. The scores of midwives' competency for labor and delivery care (4.31 ± 0.09), new-born care (4.29 ± 0.04), and postpartum care (4.25 ± 0.13) were relatively high, while the prepregnancy care had the lowest score (3.88 ± 0.07). The interview results showed that the self-perception of core midwifery competencies was not bad, the limitations of midwives' work scope affect the core competencies, and midwifery education needs to strengthen the humanistic care and the training of obstetric knowledge and technology.

Managing medical emergencies: Sustainable pre-hospital medical education in Rwanda

&#x0D; &#x0D; &#x0D; INTRODUCTION: In Rwanda, non-communicable diseases accounted for 44% of all reported deaths as of 2016. Yet, there is very limited data on pre-hospital management of emergency medical conditions in LMICs. We evaluated the impact of a pre-hospital medical emergencies training course and train-the-trainers program for Service d’Aide Medicale Urgente (SAMU) to address the burden of NCDs.&#x0D; METHODS: A 100-question baseline assessment was administered to 25 SAMU staff to assess knowledge of basic anatomy, physiology, medicine, obstetrics, pediatrics, trauma, and scene safety. A two-day Emergency Medical Care Course (EMCC) was developed. Two cohorts (one for instructors and another one for staff) from ten district and provincial hospitals. EMCC 1 and a one- day educator course were conducted for the instructor core. They then taught the second cohort of trainees (EMCC 2).&#x0D; RESULTS: In the baseline assessment of 25 SAMU staff, the median score was 56% overall and 54% in medical. EMCC 1 median scores were 43% vs 86% (pre vs post), p&lt;0.001 using matched pair analysis of 18 participants. EMCC 2 median scores were 45% vs 82% (pre vs post), p&lt;0.001 using matched pair analysis of 16 participants. A one-way ANOVA mean square analysis showed no statistically significant difference between the two cohorts post-training, with similar post- assessment scores.&#x0D; DISCUSSION: This study showed that the course improved knowledge for an instructor core and staff from district and provincial hospitals, confirming the effectiveness of a train-the-trainers model, which will allow for sustainability in pre-hospital emergency medical training in Rwanda.&#x0D; &#x0D; &#x0D;

Development of a Departmental Resident Educational Program to Increase Knowledge and Confidence Related to Obstetric Anal Sphincter Injuries [ID: 1375536

INTRODUCTION: Obstetric anal sphincter injuries (OASIS) have been reported in up to 35% of vaginal deliveries; thus, understanding these injuries is a critical part of obstetrics and gynecology training. Formal educational programs with incorporated simulation training can have an advantageous effect, particularly when provided as part of residency education. This project seeks to evaluate the positive effect of departmental resident education related to OASIS, on confidence and knowledge of obstetrics and gynecology residents at Wake Forest University. METHODS: A structured OASIS curriculum was developed by the urogynecology program, including 2 hours of didactic lecture followed by stepwise simulation with swine models to demonstrate and practice anatomic repair techniques. Participants completed pre- and post-class surveys including skill confidence assessments via Likert scale (range 1–10), and standardized knowledge assessments adapted from ACOG Obstetric Laceration Repair Module, along with educational experience reports. These items were scored and analyzed. RESULTS: In August 2022, 16 residents (4 per residency year) participated. Prior to education, mean confidence level with techniques was 4.2 among all areas (range 1.6–7.4), with mean knowledge assessment score 64% (range 33–100%). Post-education, confidence improved across several domains including effectively applying perineal support (7.3–7.9), identifying lacerations and performing rectal examinations (6.1–8.0), and OASIS repair (1.9–5.4) (P&lt;.05). Knowledge assessment scores remained similar, at 70% (P&gt;.05). In qualitative analysis, all individuals reported beneficial aspects of the program. CONCLUSION: Introduction of an OASIS curriculum including repair simulation utilizing an animal model, increased resident skill confidence. Future research will investigate longitudinal data to improve outcomes.

Developmental origins of health and disease: knowledge, attitude and practice of obstetrics & gynecology residents, pediatric residents, and medical students

ABSTRACT Developmental Origin of Health and Disease (DOHaD) explains how the health of the mother influences the offspring’s risk of non-communicable diseases in later life. However, this remains underutilized in clinical practice. This study aimed to investigate the knowledge, attitude, and practice (KAP) of medical students, Obstetrics and Gynecology (O&G) and Pediatrics residents, toward DOHaD, identify potential barriers to DOHaD counseling, and translate DOHaD concepts into clinical practice. This cross-sectional study was conducted with a multi-section digital questionnaire, rated on a five-point Likert scale (1–5), with a higher score indicating better KAP. The scores between groups were compared using ANOVA. A total of 117 participants, comprising medical students (n = 75, 64.1 percent), O&G (n = 33, 28.2 percent) and Pediatric residents (n = 9, 7.7 percent), completed the questionnaire. The mean scores for the “Knowledge,” “Attitude” and “Practice” sections were 3.73 (standard deviation 0.82), 4.27 (0.59) and 3.03 (0.52), respectively. O&G residents scored higher for the “Practice” section than Pediatric residents (mean scores 3.17 vs. 2.16; p = .048). Overall, the participants demonstrated good knowledge and attitude, but poor practice toward DOHaD. Thus, there is a need to improve education and training for health care professionals, develop a structured implementation framework, and provide a transdisciplinary care continuum for mother and child.

Gynaecology and Obstetrics in Charaka Samhita

It is accepted that, Ayurveda is the ancient system of medicine which is rich enough to guide the society in different aspects of health. The system is rich with the measures for prevention of the diseases and also with the description of medicines, diets and behaviours for treatment of different ailments. Charaka Samhita written by Charaka is the basic classic of the Ayurvedic system of medicine. Charaka Samhita, though deals with Kayachikitsa (Medicine), then also not left the other branches. Charaka has includes Obstetrics and Gynaecology also in his Samhita elaborately. Knowledge of Gynaecology and Obstetrics (Prasuti Tantra and Stree Roga) is available in Charaka Samhita in different references. The descriptions are containing some salient features which are seemed to be important and informative even in present time

Assessment of the knowledge, attitudes, and perceptions of Filipino obstetrics and gynecology residents on fertility preservation: A cross-sectional study.

As primary reproductive healthcare providers, residents-in-training must be equipped with the knowledge of proven and available methods for fertility preservation. The study evaluated Filipino obstetrics and gynecology residents' current knowledge, attitudes, and perceptions about fertility preservation. A cross-sectional survey was conducted among obstetrics and gynecology residents in the Philippines. A 24-item questionnaire was distributed to the different accredited training institutions of the Philippine Obstetrical and Gynecological Society by electronic mail. Univariate descriptive statistics were reported as mean for continuous variables and frequency with percentage for categorical variables. The chi-square test was used to determine differences in responses. A total of 143 respondents from different year levels of training were enrolled in the study. Most were female trainees (88.11%) from the National Capital Region (44.76%). Most respondents agreed that discussions about childbearing intentions (99.30%) and age-related fertility decline (98.60%) should be initiated during a patient's gynecological consult. Residents were most familiar with oocyte freezing (84.62%), fertility-sparing surgeries (83.22%), and the use of GnRH agonists (80.42%) as fertility preservation techniques. Despite being most familiar with oocyte freezing, the respondents have mainly referred patients for fertility-sparing surgeries (48.95%) and the use of GnRH agonists (48.25%). There was an overall reassuring perception and attitude of obstetrics and gynecology residents on fertility preservation. A standardized curriculum with teaching-learning activities on fertility preservation may be used to improve trainees' knowledge. There was a disparity in the knowledge and actual referral or utilization of the different methods, reflecting the inaccessibility of the procedures specific to their institutions. This highlights the need to improve accessibility and offer fertility preservation as a public health service.

Knowledge of obstetrician and family medicine doctors in Saudi Arabia about women with epilepsy

BackgroundWomen have a slightly lower prevalence of epilepsy and unprovoked seizures than men; however, women with epilepsy have several exceptional dilemmas, including the use of anti-seizure medications (ASMs) in addition to the effects of ASMs on sexual function, contraception, pregnancy, childbirth, congenital fetal malformations, and breastfeeding. This study assessed the knowledge of obstetricians and family medicine physicians about relevant topics and concerns of women with epilepsy (WWE) in Saudi Arabia.ResultsOut of 108 participants recruited for the study, the largest percentage (62%) was residents, while 17.6% were consultants and the remaining 20.4% were specialists or fellows. In terms of specialty, 61.1% of the participants were obstetricians, while the remaining 38.9% were family medicine physicians. The participants showed varied levels of knowledge about important health issues ranging from 71.3% (ASMs and breastfeeding) to 11.5% (percent of children at risk for major birth defects) for WWE. Knowledge scores of health issues for WWE were significantly higher among obstetricians compared to family medicine physicians (6.16 ± 2.75 vs. 4.29 ± 1.95; p < 0.001). Similarly, scores were significantly higher among consultants/fellows compared to residents/specialists (7.27 ± 1.62 vs. 4.65 ± 2.56; p < 0.001).ConclusionsInadequate knowledge about several vital WWE issues was observed, particularly the hormonal influence of estrogen and progesterone on the control of convulsions, high likelihood of osteomalacia among WWE, and high rate of sexual dysfunction among them. This insufficient knowledge among healthcare providers could negatively influence epilepsy-related counseling for WWE.

O5 - A review of post-dates induction of labour research: a critical discourse analysis

Despite equivocal evidence, induction of labour (IOL) for post-dates pregnancy is an increasingly common birth intervention that impacts well women and their babies. Birth interventions can cause iatrogenic harm to mothers and babies. Recent evidence shows that routine post-dates IOL does not reduce the chance of stillbirth. Previous studies have shown how assumptions and beliefs within biomedical discourse filter into medical research. Discourse influences clinical practice guidelines, policies and how information is communicated to women. We used Foucauldian discourse analysis to critically analyse the biomedical literature on IOL, adding to current knowledge about both the intervention itself and how it is shaped by medical discourse. We purposively sampled biomedical, quantitative research on IOL, published in the last five years, using key search terms. Twelve studies met the criteria. In this presentation, we show how current biomedical literature concerns itself with “the dangerousness of [prolonged] pregnancy”, which prioritises the safety of the fetus, while maintaining a narrative that post-dates IOL is “safe and necessary”, despite this not necessarily being the case, at least not for every woman. This exposes the “invisibility of women” in the research and practice of IOL for post-dates. We juxtapose these discourses and extend our findings, drawing on current qualitative literature to demonstrate how women’s experiences reflect these medical assumptions, feeling that IOL is inevitable, or that they do not have a choice. This is concerning, because although constructed as a “safe” intervention, it is not without risk, and raises questions about informed consent. There is increasing concern about overmedicalisation of birth. Critiquing the dominance of obstetric knowledge claims is important to give space for women’s voices, to recognise other forms of knowledge and to humanise birth.

Increasing Student-Perceived Readiness for Obstetrics and Gynecology Clerkship Using a Student-Created Curriculum [A56

INTRODUCTION: Among third-year medical students at a community-based medical school, students report feeling less prepared at the start of an obstetrics and gynecology clerkship compared to other clerkships. We sought to determine if a student-led curriculum is an effective resource for third-year clerkship preparation and how this curriculum affects student interest in obstetrics and gynecology, perceptions of the obstetrician-gynecologist attending lifestyle, comfort with obtaining a specialty-specific history and physical (H&amp;P), and obstetric ultrasound techniques. METHODS: Fourth-year medical students pursuing obstetrics and gynecology designed clerkship-specific curricula and administered a lecture to third-year medical students via Zoom. This lecture focused on obtaining obstetrics and gynecology-specific H&amp;P, interpreting tests of fetal well-being, labor and delivery (L&amp;D) triage cases, and obstetric ultrasound techniques. An eight-question pre and postlecture survey using a Likert scale was distributed to all attendees. RESULTS: The pre and post lecture survey had 26 and 22 respondents, respectively. Attendees reported increased comfort with obstetrics and gynecology-specific patient presentations (P&lt;.001), taking obstetric and gynecologic histories (P&lt;0.001, P&lt;.001), performing a pelvic exam (P&lt;.001), and performing obstetric ultrasound (P&lt;.001) after attending the lecture. Respondents overall felt more prepared for the obstetrics and gynecology clerkship relative to Family Medicine (P&lt;.001). In terms of career guidance, students believed obstetrics and gynecology to be less demanding post-lecture (P&lt;.03); however, student interest in the specialty did not significantly change. CONCLUSION: This study suggests that a single, remotely conducted, upperclassmen-led lecture centered on applied clinical knowledge in obstetrics and gynecology significantly improves third-year medical student comfort with performing specialty-specific history and physical exams, obstetric ultrasound techniques, and perception of attending lifestyle. It also confirms that student-led curriculum is an effective resource for third-year clerkship preparation.

VACCUM IS THE PREFERRED INSTRUMENT AMONG OBSTERICIANS IN RECENT TIMES

Obstetricians must be able to perform operative vaginal birth (OVB). It is the most common obstetric emergency intervention, and it necessitates a high level of expertise. To nd out which tool obstetricians prefer when doing surgical vaginal births, as well as the prevalence and hazards of vacuum or forceps assisted vaginal deliveries (AVD). The ACS Medical and Hospital in Chennai conducted this cross-sectional investigation. The survey comprised 500 obstetricians in all. All obstetricians in Chennai were issued an online survey. The best approach for a given situation, tool preference [vacuum or forceps], and perspectives on the difculties associated with both vacuum and forceps use during vaginal delivery were all investigated. We calculated averages and percentages for the overall group and different subgroups based on the responses. The statistical analysis comprised a risk assessment of the result with exposure as an appropriate p-value. The questionnaire had a response rate of 92 percent (460/500). According to the data, obstetricians preferred vacuum because it was easier to use. The two groups had identical baseline characteristics. The most prevalent complication was a failed vacuum owing to cup slippage (65%), followed by caput succedaneum (22%), both of which were statistically signicant. The most important nding was that maternal injuries in the vacuum group were only 3%, which was signicantly lower than maternal injuries in the forceps group (70%) with a p-value of 0.001. The majority of obstetricians seemed to prefer using a vacuum during delivery. The use of a vacuum extractor instead of forceps for assisted delivery appeared to lower maternal morbidity, whereas neonatal injuries were more prevalent in vacuum-delivered babies. The equipment chosen should be tailored to the patient's needs as well as the obstetrician's knowledge and skill.

Vaping in pregnancy: a geographically focused assessment of OBGYN provider knowledge regarding the safety and usage of electronic nicotine delivery systems

Background: Electronic nicotine delivery systems (ENDS), or vaping, usage has become increasingly popular and generally has a positive perception by the public. However, ENDS are known to contain harmful chemicals and teratogens that induce numerous health consequences to both the pregnant mother and fetus. Despite this, physician knowledge and discussion of ENDS with their pregnant patients remains limited. The main objective of this study was to assess the knowledge of Obstetrics and Gynecology (OBGYN) providers regarding the safety and usage of ENDS in pregnancy. A secondary objective was to understand providers’ practices to increase patient education and awareness of the effects of ENDS on pregnant women and developing fetuses. Methods: A 40-question online anonymous survey was developed for this study. The survey aimed at assessing OBGYN providers’ understanding of the usage of ENDS and potential harms. The questionnaire was distributed to OBGYN providers in the Midwest and South of the United States of America. Results: One Hundred and four respondents completed the survey (95% response rate). While 96% of providers investigated alcohol and tobacco use during prenatal visits, only 44% routinely inquired about ENDS use. Most providers noted that they had received no formal education about ENDS usage and 55% of providers reported an insufficient understanding of vaping. Conclusions: These results demonstrate that providers lack the education and knowledge about ENDS usage in pregnancy. This is concerning as ENDS usage is rapidly increasing in the United States of America. It is essential to develop educational resources for providers about the risks of vaping and incorporate questions ENDS usage into the social history, especially in pregnancy.

Knowledge, attitude, and practice among primary health-care and obstetrics and gynecology physicians in postpartum care services in National Guard Hospital, Saudi Arabia.

The postpartum period, also known as the fourth trimester, is defined as the first 12 weeks postpartum. Primary health care (PHC) plays an important role in providing a comprehensive postpartum care to mothers. This study aimed to assess knowledge, attitude, and practice of postpartum care among PHC physicians and obstetrics and gynecology physicians. This is a cross-sectional study to assess the knowledge, attitude, and practice of PHC physicians and obstetrics and gynecology physicians in postpartum care services at Western Region, Saudi Arabia. A structured questionnaire was used for data collection. The Statistical Package for the Social Sciences (SPSS; version 27.0) was used for data analysis. Proportions and tables were used to summarize categorical data. A total of 159 responses were analyzed with 65.4% response rate. The median (interquartile range [IQR]) for knowledge score was 15 (13-17). The median (IQR) for attitude was 20 (18-22), while the median (IQR) for practice total scores was 3 (2-4). Knowledge and practice scores showed significant differences between all the groups. On the other hand, attitude only showed significant differences between males and females, favoring a better attitude among females (P = 0.014). There were good levels of KAP associated especially with female physicians and higher physician levels. Minor differences were noticed between different groups in our sample according to age, gender, specialty, and years of experience.