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Summary Background The objective of this project was to study whether a standardised patient clinical encounter learning exercise improved an Obstetrics and Gynaecology (OBGYN) resident's ability to perform patient advocacy, a systems-based practice skill. Methods Case–control study: each of the 12 residents functioned as their own control. Additionally, aggregate data from the programme was reviewed. Results Twelve residents from a mid-sized OBGYN residency programme performed a standardised patient clinical encounter exercise in March of 2014. As demonstrated by the Assessment for Professional Behavior (APB) 360° evaluation, the overall total scores for the programme on patient advocacy improved, with statistical significance, when analysed by the signed ranked test. Additionally, the residents' self-identified capability to perform advocacy improved after the programme, with statistical significance, when analysed by the signed rank test. Conclusions A standardised patient clinical encounter, used as a learning exercise, can demonstrate meaningful improvement in the advocacy skills of a resident doctor. [Evaluating] a standardised patient clinical encounter as a learning exercise

Interconception care provides an irreplaceable opportunity to address existing chronic disease and correct maladaptive health behaviors.Utilizing the postpartum visit as an opportunity to improve interconception health and provide education to patients will not only improve the patient's life, but also impact any future offspring.Optimization of interconception health has the potential to improve population wellbeing and reduce the societal burden poor birth outcomes. Evidence-based recommendations are described.

Background and purpose Obstetrics and gynecology (OB-GYN) morbidity and mortality conferences allow for review of cases with poor or avoidable outcomes. Little data exist on standardized formats for presentation and evaluation. We designed a multidisciplinary morbidity and mortality conference. We formally evaluated resident performance using the milestones format, and evaluated resident understanding of case concepts with a pre- and post-conference survey.

Laryngeal swelling can be life threatening with etiologies including angioedema and cellulitis. While both involve swelling of subcutaneous tissues angioedema involves extravasation of fluid into interstitium while cellulitis is caused by direct extension of a spreading infection. The cause of angioedema involves multiple etiologies with response to treatment varying with underlying pathophysiology. While some exposures are extrinsic, and thus able to be avoided, estrogen or estrogenic excess has been shown to be intimately involved in certain patients presenting with acute angioedema. We present a gravid patient with new onset neck swelling and airway compromise requiring airway protection and emergent cesarean section delivery. The patient provides insight into the multiple risk factors and difficulties in discerning a single inciting event while emphasizing the importance of obstetric physician awareness to angioedema, etiologies, and management.

With increased access to care, current health delivery systems will need expansion to meet higher demands and needs. To define Centering Pregnancy and practical tips for implementation into both private and academic practices. Evidence was gathered through literature reviews. It was found that Centering Pregnancy offers a patient-centered, evidence-based approach to helping with access issues, as well as improving outcomes. This article describes the benefits of Centering Pregnancy to the practice, the provider, and the patient. Practical implementation tips will be offered, with suggestions for negating common implementation barriers.

Background The consequences of intra-amniotic Candida infection can be devastating. Currently, standard management includes delivery. We identified only one previous case reporting intrauterine antifungal therapy, which used transcervical amphotericin B. We present two cases of intra-amniotic Candida infection treated with intra-amniotic fluconazole instilled before membrane rupture. Cases Two patients presented with intra-amniotic Candida albicans infection that was diagnosed during previability. Both underwent cerclage placement before culture results were available. Aggressive antifungal therapy was instituted using oral, vaginal, and intra-amniotic fluconazole instilled through serial amniocenteses. Both fetuses survived without sequelae. Conclusion Intra-amniotic Candida infection is associated with preterm rupture of membranes, preterm labor, severe neonatal infection, and fetal death. Early diagnosis and treatment is essential.