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25. In Reply

Author

Saad, Antonio F., Chappell, Lucy, Saade, George R., and Pacheco, Luis D.

Published
2021
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30. Left-Handedness in Obstetrics and Gynecology: A Nationwide Survey of U.S. Trainees and Educators.

Author

Moutos, Christopher P., Arena Goncharov, Daphne D., Saad, Antonio F., Richardson, Gwyn, and Jain, Sangeeta

Subjects
HANDEDNESS, HOSPITAL medical staff, WORK, GYNECOLOGY, COLLEGE teacher attitudes, FISHER exact test, OBSTETRICS, SURVEYS, COMPARATIVE studies, EXPERIENCE, CHI-squared test, DESCRIPTIVE statistics, STUDENTS, EXPERIENTIAL learning, SOCIODEMOGRAPHIC factors, MEDICAL education
Abstract

Objective This study aimed to evaluate the views and influence of left-handedness among obstetrics and gynecology (OBGYN) trainees and educators and to identify perceived obstacles in training by left-handed (LH) trainees. Study Design An online survey was sent to the U.S. Obstetrics and Gynecology training programs. All participants were asked questions on hand preference for various medical and nonmedical activities, as well as on demographics. Participant responses to handedness and their role as a learner or educator directed them toward further questions. Trainees were surveyed on their experience and outlook as a LH physician in OBGYN. Educators were surveyed on their experience and attitudes in working with LH trainees. LH educators were also surveyed on their experience as a LH physician, similar to the LH trainees. Chi-square or Fisher's exact analysis was used as appropriate, with p -value <0.05 considered statistically significant. Results Responses were received from 21 training programs, totaling 304 individuals. Participants included 205 learners (156 right handed and 49 left handed), and 99 faculty (82 right handed and 17 left handed). A lack of LH surgical instrument availability (93.6%) and difficulty using right-handed (RH) instruments (83%) were notable obstacles reported by LH learners. The majority of LH learners (57.4%) did not consider their handedness to be disadvantageous but did note added difficulty when training under RH mentors when compared with training under LH mentors (66%). In contrast to LH educators, RH educators endorsed added difficulty in instructing operative procedures to LH learners (32.1 vs. 13.3%, p = 0.012). Conclusion LH trainees face unique challenges during their OBGYN training. Educators would benefit from guidance on how best to manage these trainees. Educators should work to adapt surgical and procedural techniques to accommodate LH trainees. Key Points LH learners reported more difficulty in training under RH mentors. RH mentors reported increased difficulty in educating LH trainees. Neither trainees nor educators considered being LH a significant disadvantage. [ABSTRACT FROM AUTHOR]

Published
2023
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37. The impact of obstetric laceration simulation on resident education

Author

Benson, Meagan V., primary, Goldman, Brett, additional, Goncharov, Daphne Arena, additional, Wang, Amanda M., additional, Emezienna, Nkechinyere, additional, Shepherd, Megan, additional, Stewart, Kelley, additional, Ellsworth, Katie, additional, Olson, Gayle, additional, Harirah, Hassan, additional, Saad, Antonio F., additional, Clark, Shannon, additional, and Saade, George R., additional

Published
2023
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43. In Reply

Author

Pacheco, Luis D., Hankins, Gary D. V., Saad, Antonio F., Costantine, Maged M., Chiossi, Giuseppe, and Saade, George R.

Published
2017
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46. Differential Gene Expression in Cord Blood of Infants Diagnosed with Cerebral Palsy: a Pilot Analysis of the BEAM Cohort

Author

Dizon, Maria L.V., deRegnier, Raye-Ann O., Weiner, Steven J., Varner, Michael W., Rouse, Dwight J., Costantine, Maged M., Wapner, Ronald J., Thorp, John M., Blackwell, Sean C., Ayala, Nina K., Saad, Antonio F., and Caritis, Steve N.

Subjects
Male, Cerebral Palsy, Infant, Newborn, Alpha-Ketoglutarate-Dependent Dioxygenase FTO, Gene Expression, Fetal Blood, Article, Magnesium Sulfate, Neuroprotective Agents, Pregnancy, Humans, Female, Magnesium, Biomarkers, Infant, Premature
Abstract

The Beneficial Effects of Antenatal Magnesium (BEAM) clinical trial was conducted between 1997–2007, and demonstrated a significant reduction in cerebral palsy (CP) in preterm infants who were exposed to peripartum magnesium sulfate (MgSO4). However, the mechanism by which MgSO4 confers neuroprotection remains incompletely understood. Cord blood samples from this study were interrogated during an era when next generation sequencing was not widely accessible and few gene expression differences or biomarkers were identified between treatment groups. Our goal was to use bulk RNA deep sequencing to identify differentially expressed genes comparing the following four groups: newborns who ultimately developed CP treated with MgSO4 or placebo, and controls (newborns who ultimately did not develop CP) treated with MgSO4 or placebo. Those who died after birth were excluded. We found that MgSO4 upregulated expression of SCN5A only in the control group, with no change in gene expression in cord blood of newborns who ultimately developed CP. Regardless of MgSO4 exposure, expression of NPBWR1 and FTO were upregulated in cord blood of newborns who ultimately developed CP compared with controls. These data support that MgSO4 may not exert its neuroprotective effect through changes in gene expression. Moreover, NPBWR1 and FTO may be useful as biomarkers, and may suggest new mechanistic pathways to pursue in understanding the pathogenesis of CP. The small number of cases ultimately available for this secondary analysis, with male predominance and mild CP phenotype, is a limitation of the study. In addition, differentially expressed genes were not validated by qRT-PCR.

Published
2022

48. Hemorrhagic Stroke in Pregnancy.

Author

Wang, Amanda and Saad, Antonio F.

Subjects
*CRANIAL radiography, *MATERNAL health services, *HEMORRHAGIC stroke, *ANESTHESIA, *CHILD health services, *COMPUTED tomography, *DELIVERY (Obstetrics), *DISEASE complications, *PREGNANCY, PREVENTION of surgical complications
Abstract

Hemorrhagic stroke carries a high risk of disability and mortality. The obstetrical population is at increased risk. Prompt diagnosis and maternal stabilization with a multidisciplinary approach are the mainstays in management. Computed tomography head is the diagnostic imaging of choice and is considered safe in pregnancy. Fetal status optimization before neurosurgery and delivery should be considered if the fetus is viable or if worsening maternal condition. Obstetric indications guide the mode of delivery. Cesarean delivery may be indicated to reduce increasing intracranial pressure. Neuraxial anesthesia should be considered to minimize catecholamine surges, reduce sedation, and control blood pressures. [ABSTRACT FROM AUTHOR]

Published
2023
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