INTRODUCTION:The utility and accuracy of hysterosalpingogram in a community hospital setting were evaluated for accuracy in predicting uterine cavity pathology.METHODS: A retrospective chart review was performed for all hysteroscopic procedures that had a hysterosalpingogram performed between August 1, 2012, and August 25, 2014, at a single community hospital in an inner-city setting. Hysterosalpingogram reports by a radiologist were reviewed, and hysteroscopy operative reports were reviewed that were performed by a reproductive endocrinologist. RESULTS:A total of 60 patients were identified. Average age was 31.3 years (median 34 years). Findings correlated for tubal diagnosis in 88.4% of patients. However, for uterine cavity defects, the accuracy was lowest for the finding of uterine septum on hysteroscopy; hysterosalpingogram reported normal findings on all six patients encountered in this series. High sensitivity and correlation were found for findings of intrauterine adhesions (95%), submucosal myomas, and endometrial polyps (90%). The findings for submucosal myomas and endometrial polyps were confirmed with final pathology.CONCLUSION: Hysterosalpingogram has a low sensitivity for finding of uterine septum in this setting. Further studies are needed for correlation with clinical impression by a reproductive endocrinologist.INTRODUCTION: Reproductive health care providers need recommendations on applications (apps) for patient use, particularly apps for menstrual cycle and fertility tracking, because these apps are frequently downloaded by women and can be used by clinicians when evaluating menstrual problems. METHODS: We searched PubMed and OVID MEDLINE for literature on women's reproductive health apps and searched the Apple iTunes store for menstrual cycle and fertility tracking apps. We recorded price, user rating, functionality, and whether an app was developed or recommended by medical experts. RESULTS:We identified six articles, all published since 2012, that discuss apps for patient use regarding women's reproductive health; none focused specifically on menstrual cycle or fertility tracking. The apps search identified 94 unique apps for menstrual cycle tracking, priced from free to $16.99. Sixteen (17%) free apps also had paid versions. User ratings ranged from 1.5-4.5 of 5 stars. App functionality included the ability to create a password (43%), tailor for irregular cycles (23%), back up or restore data (22%), select a pregnancy mode (20%), export or e-mail data (10%), or connect to social media (7%).

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fetal heart tones. At the time of delivery, a dusky umbilical cord suggestive of thrombosis was noted. Placental pathology revealed 40% occlusion of umbilical vein and chorangiosis. Chorangiosis is a vascular change of the placenta involving terminal chorionic villi, proposed to result from longstanding, low-grade hypoxia in placental tissue. It has been associated with diabetes, intrauterine growth restriction (IUGR), and hypertensive conditions. Clinical significance has not been studied extensively but case reports suggest correlation with increased fetal morbidity and mortality. METHODS:We identified 56 cases of "chorangiosis" on placental pathology at Henry Ford Hospital from 2010-2015. We reviewed factors such as: maternal age, BMI, smoking status, maternal health conditions, antenatal fetal issues, gestational age, mode of delivery and fetal outcome. RESULTS:Average age was 27.6 years; 20% of advanced maternal age. 16% of cases associated with hypertensive disorders, 11% with diabetes, 11% with IUGR and 45% associated with maternal obesity. 30% associated with current or former smokers. One resulted in neonatal death, 1 intrauterine fetal demise and 18% of deliveries were pre-term. 52% of deliveries were by cesarean section, with the most noted indication being abnormal fetal heart tones.CONCLUSION: Chorangiosis may contribute to increased rates of cesarean section due to abnormal fetal heart tones from longstanding hypoxia coupled with the stress of labor. Further studies are needed to characterize the association of chorangiosis with subsequent infant health outcomes.