Despite vitamin supplementation, a vitamin profile of pregnancy indicates that vitamin deficits exist during the trimesters. Also, combination hypovitaminemias of deficient vitamins were noted; this indicates that a vitamin deficit during pregnancy does not occur in isolation.

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Introduction: One Key Question® is a patient-centered tool that seeks to understand patient pregnancy intention and counseling. This pilot study aimed to assess implementation of OKQ at an urban healthcare facility and improve understanding of short interpregnancy intervals (IPI). Methods: We describe the implementation of OKQ in our setting using the Diffusion of Innovation Theory as a framework. We broke this up into two phases -the first to assess provider acceptance of the OKQ integration into the clinic workflow and the second to assess how well documentation of OKQ answers occurred in our EMR. Results: Most providers in the first phase reported awareness of the inclusion of OKQ in the EHR, yet most physician providers reported only using OKQ at "some visits" (n=5) compared to the MAs, who reported using OKQ at "every visit" (n=8). Most providers felt that OKQ was an effective method of providing preconception and contraception care for women of reproductive age (n=10). Sixty-four patients completed a survey on OKQ after their visit who identified as young (mean age 28.7), either Black (46.9%) or Hispanic (51.6%) and pregnant (61%). Of those, 83% reported that they were not asked OKQ and 42% reported receiving counseling on optimal IPI. In those patients, 78% had documentation of usage of OKQ in the medical record. Discussion: The implementation of OKQ provided an opportunity to provide standardized preconception and contraception care to our patient population and improve information regarding short IPI. However, challenges existed in implementation which much be overcome to benefit from OKQ. Significance: OKQ has been used successfully in primary care and other settings to assess pregnancy intentions. This article adds to the literature by investigating the implementation of OKQ in a low-resource setting during prenatal and gynecology care. It shares struggles of implementing OKQ in an electronic medical record and how to roll out this program in a setting where pregnancy intention already is including in various forms by our providers.

This study aimed to evaluate the morbidity and pregnancy outcome of myomectomy in infertile women with uterine fibroids. This was a cross-sectional study. Records were reviewed for 100 consecutive women in the Rotunda Hospital who underwent myomectomy in the years 1995-1996. A questionnaire regarding subsequent fertility was sent. The study was carried out in the infertility unit at the Rotunda Hospital, Dublin, Ireland. Seventy-five women responded. Multiple myomectomy was performed in 52 (70%). Mean fibroid size was 6.8 cm (range 2-14.5 cm). Nine women (12%) developed complications; five had menstrual problems, two had wound discomfort and two had abdominal discomfort. Twenty-five women (33%) became pregnant. Seven (28%) were IVF pregnancies. Overall six (24%) miscarried. In 19 of 25, pregnancy occurred where fibroids were the only identifiable cause of infertility. We conclude that abdominal myomectomy is associated with a favourable outcome in infertile women particularly if no other confounding variable is present.

SUMMARYA screening questionnaire designed to take an alcohol history was used on 996 patients attending the London Hospital Accident and Emergency Department. Questions concerned with 'binge' drinking detected many problem drinkers who were not identified by questions on weekly alcohol intake or 'CAGE' questions. The relative increase in detection was particularly marked in women.