The care of pregnant women with bladder exstrophy requires multidisciplinary management and careful delivery planning. Successful vaginal delivery can be attained in these patients.

No abstract

Resident physicians' scores on the REI section of the CREOG exam are traditionally low, and nearly 40% of house staff nation-wide perceive their REI knowledge to be poor. We aimed to assess whether an interactive case-based group-learning curriculum would narrow the REI knowledge gap by improving understanding and retention of core REI concepts under the time constraints affecting residents. A three-hour case-based workshop was developed to address four primary CREOG objectives. A multiple-choice test was administered immediately before and after the intervention and 7 weeks post-workshop, to evaluate both knowledge and confidence. Following the intervention, residents self-reported increased confidence with counseling and treatment of PCOS, ovulation induction cycle monitoring, counseling and treatment of POI, and breaking bad news related to infertility (p < 0.05). The multiple-choice exam was re-administered 7 weeks post-intervention, and scores remained significantly improved compared to pre-workshop scores (p < 0.05). At that time, all residents either strongly agreed (91.7%) or agreed (8.3%) that the case-based interactive format was preferable to traditional lecture-based teaching. In conclusion, a nontraditional curriculum aimed at teaching core REI concepts to residents through interactive case-based learning can be successfully integrated into a residency curriculum, and significantly improves knowledge and confidence of critical concepts in REI.

Fetal growth restriction is commonly defined as an estimated fetal weight (EFW) that is below the 10th percentile for gestational age. It is associated with an increased risk of intrauterine demise, neonatal morbidity, and neonatal death; therefore, antenatal detection and surveillance with the optimization of delivery timing are necessary to improve pregnancy outcomes. If the estimated due date has been verified and the EFW is below the 10th percentile for gestational age, the underlying cause should be investigated, since the clinical management, outcome, and counseling options are largely dependent on the cause of the growth restriction. Serial ultrasonography (US) for the evaluation of fetal growth and umbilical artery Doppler velocimetry are used to guide pregnancy management decisions. This article describes the accurate US detection and surveillance of fetal growth restriction, discusses the current obstetric and radiology literature regarding the use of Doppler velocimetry in the setting of fetal growth restriction, and describes the techniques for performing umbilical artery Doppler velocimetry. Although various Doppler techniques have been described in the setting of fetal growth restriction, only umbilical artery Doppler assessment is recommended to identify fetuses most at risk for poor outcome and to guide the timing of delivery. The use of other Doppler waveforms in this setting remains investigational. RSNA, 2017.

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