Andrea Alatorre, Nick Chartrand
Our study analyzed the top 60 videos in eight hashtags relating to HPV and cervical cancer on TikTok, and each video was categorized based on educational quality of information, source, and overall attitude toward screening and prevention. Overall, the pattern of social media consumption in the realm of HPV and cervical cancer appears to favor educational content and patient experiences rather than misinformation and neutral rather than negative or positive attitudes with a statistically insignificant predominance of interaction with information shared by OBGYNs.
HPV is the most common sexually transmitted infection and the leading cause of cervical cancer worldwide. Although effective screening and preventative methods for this exist, we live in an era in which information on these topics can be shared on social media extensively and instantaneously. The quality of this information remains largely unstudied, particularly in relatively newer social media platforms such as TikTok. Given TikTok’s popularity among the age group most heavily targeted by HPV prevention and beginning cervical cancer screening, it is critical to evaluate the quality and consumption of information regarding these topics that exists on this platform. Our study analyzed the top 60 videos in eight hashtags relating to HPV and cervical cancer on TikTok. Each video was categorized based on educational quality of information, source, and overall attitude toward screening and prevention. We found that educational videos and patient experience videos received significantly more views, comments, and likes than videos containing misinformation (p<0.05). OBGYNs received the most views, comments, and likes on average, although not significantly more than any single profile type (laypersons, other MD/DOs, other healthcare providers). Videos with neutral attitude toward screening and prevention received significantly more views, likes, and shares than either positively or negatively oriented videos (p<0.05). Overall, the pattern of social media consumption in the realm of HPV and cervical cancer appears to favor educational content and patient experiences rather than misinformation and neutral rather than negative or positive attitudes with a statistically insignificant predominance of interaction with information shared by OBGYNs. The findings of our study are meant to generate discussion regarding the quality of information that is being shared online, as well as consider the opportunity to use TikTok or other social media reels as a platform to generate meaningful educational content from reliable sources.
Beatriz Bassaco
Inpatient resources are limited compared to the comprehensive supportive given my cultural health navigators to refugee patients in the outpatient setting. This study evaluates the difference in medication fill rates postpartum in refugee patients compared to non-refugee patients and identifies gaps for improvement.
Background: Refugee patients deliver at Valleywise Health and Medical Center (VHMC), an urban academic safety-net hospital with level 1 NICU services. In the outpatient setting ‘Cultural Health Navigators’ translate, set up appointments and transportation, community outreach, and get medications from pharmacy. For inpatient care, the standard of care is phone interpreters and printed materials are limited to English and Spanish. The primary objective is to evaluate the prescription fill rate of insured refugee postpartum patients upon discharge from their delivery admission when medications sent to a VHMC pharmacy.
Methods: A retrospective chart review identified 135 refugee patients meeting inclusion criteria, delivery at VHMC between January and December 2022, and discharge medications sent to a VHMC pharmacies. Refugee patients were identified by pre-existing refugee registry. The data was collected and placed into REDCap. Primary outcome was timing of pickup of prescribed medications after discharge. Secondary outcomes included diabetes or hypertension diagnoses, route of delivery and primary language. A Chi square analysis was used to identify significance.
Results: Preliminary results showed that postpartum refugee patients are significantly less likely to fill their prescriptions (N=21), partially fill or fill their prescriptions late (>48h of discharge; N=49) (p=0.023) when compared to control group. Postpartum refugee patients identified spoke sixteen languages, while nonRefugee majorly spoke English and/or Spanish.
Conclusion: This study demonstrated refugee patients were not receiving their discharge medications as prescribed. This highlights the need for improved communication at discharge. The plan is to expand the languages in which discharge instructions are available in the electronic medical record.
Danielle Dukes, DO
Common approaches to the treatment of placenta accreta include planned preterm cesarean hysterectomy. The risks include injury to surrounding organs, hemorrhage, and death. Even within the setting of a comprehensive multidisciplinary team, surgery with cesarean hysterectomy in high grade cases has a significant risk for morbidity, and thus warrants the investigation of novel approaches to management. Delayed hysterectomy and single drug regime with Etoposide was utilized successfully in the cases presented.
It’s estimated that 1/533 deliveries are affected by invasive placental implantation, a condition that severely increases maternal risk for hemorrhage and subsequent morbidity and mortality. The primary management technique includes cesarean hysterectomy, the rate of this procedure as increased by a factor of 10 over the last 50 years. Improvement in diagnosis through advanced Ultrasound (US) mapping and Magnetic Resonance Imaging (MRI) imaging modalities, and the creation of expert centers for this condition has had a signification impact on improving maternal and neonatal morbidity for pregnancies affected by this condition. The goal of this presentation is to evaluate the outcomes of two cases that utilized delayed hysterectomy and single drug regime with Etoposide in the management of placenta accreta spectrum.
Utilization of etoposide for the treatment of placenta accreta spectrum (PAS) is a novel approach with the potential for lowering the morbidity and mortality associated with high grade disease. Single agent adjunctive therapy with either delayed hysterectomy or uterine preservation has been used in the past successfully in the treatment of placenta percreta with adjacent organ invasion, and may lower the morbidity associated with primary hysterectomy. Adjuvant chemotherapy in the treatment of PAS is intended to increase reabsorption by decreasing trophoblastic tissue activity, and decreasing placental vascularity. Etoposide has been used to preserve ovarian function in large trophoblastic placental tumors and ectopic pregnancy. Complications of etoposide include, myelosuppression, anemia, nephrotoxicity, premature ovarian failure, and hair loss. Further investigation is needed to determine the best treatment course for high grade PAS.
Eleanor Johnston
The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language.
Background: Underserved communities were disproportionately affected during the coronavirus (COVID19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language.
Objective: The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status.
Study Design: A cross-sectional study examined parturient patients admitted to an urban safety-net hospital from May 2020 to May 2022 who were tested for SARS-CoV-2 on admission. Percentages and prevalence ratios of SARS-CoV-2 between refugee status, insurance type, vaccination status, and race/ethnicity were calculated across four time periods, corresponding with variant surges of the pandemic.
Results: 3,502 patients delivered, 476 (13.6%) were refugees. Self-pay (46.4%) and Medicaid (46.4%) were the most frequent insurance types with a Hispanic predominance (64.5%) by race/ethnicity. Only 12.8% of patients received at least one vaccine before delivery: 13.2% in non-refugees versus 10.3% refugees. 192 (5.5%) of the mothers tested positive during the study period with 6.1% refugees positive versus 5.4% among non-refugees, (prevalence ratio, 1.13; P = 0.53, 95% confidence interval [0.77, 1.66]). Positive tests ranged between 4.7% and 6.3% across insurance types and between 4.4% and 7.5% across race/ethnicity categories. The highest prevalence ratio (refugee/non-refugee) of 2.01 was during the Delta Surge (P = 0.12, 95% confidence interval [0.84, 4.82]) and the lowest prevalence ratio of 0.64 was during the Omicron Surge (P = 0.21, 95% CI [0.32, 1.30]). Among refugees when examined by primary language, 51.7% of positive tests were from those speaking languages of the African Great Lakes region (Kinyarwanda, Kirundi, Swahili, Kiswahili).
Conclusion: We observed only small differences in SARS-CoV-2 prevalence between refugees and nonrefugees or in vaccination status. Variations in prevalence ratio were seen by refugee status by variant surge. Subsets of the refugee population, when grouped by language/region, appeared to be more affected. This warrants future research on the impact of the SARS-CoV-2 pandemic on specific refugee communities, rather than refugee communities as a heterogenous unit.
Annie Kump
Post placental IUD placement is cost effective for teenage patients from the maternal perspective. The cost effectiveness of the strategy is contingent on the likelihood of removal within the next year and of unplanned pregnancy without an IUD in place.
Introduction: The time surrounding a teen’s first pregnancy represents an ideal period to counsel on effective contraception and prevent additional unplanned pregnancies. It has yet to be examined if post placental IUD placement is cost effective in teenage patients relative to routine placement in the office.
Methods: A decision analytic model was built using TreeAge software to compare outcomes and costs among teenagers receiving either post placental or routine IUD placement. Outcomes, associated healthcare costs, and maternal quality-adjusted life years were compared. All probabilities, utilities, and costs were derived from the literature. Costs were in 2021 US dollars with a cost effectiveness threshold of $100,000/QALY. Sensitivity analyses were performed to assess how variation in baseline assumptions impacted model outputs.
Results: In a theoretical cohort of 300,000 teen births, post placental IUD placement yielded 35,620 more QALYs but cost $32 million more than routine placement. Post placental placement prevented 9740 additional unplanned births -- including 1585 preterm births -- and 5595 abortions. Post placental placement was no longer cost effective when the likelihood of IUD removal within the next year rose from our baseline estimate of 0.14 to 0.46 or when the rate of subsequent unplanned teen pregnancy without an IUD fell to 0.007.
Conclusion/Implications: Post placental IUD placement is cost effective for teenage patients from the maternal perspective. The cost effectiveness of the strategy is contingent on the likelihood of removal within the next year and of unplanned pregnancy without an IUD in place.
Michelle Goforth, BS
My abstract looks at how high adverse childhood experiences could impact obstetrical outcomes. Although none of our findings were significant, our study did show that patients with high scores were more likely to have gestational diabetes, have preterm delivery or miss their post partum visit.
Adverse childhood experiences (ACEs) have a lifelong impact on the health of those with elevated scores. Patients with higher scores have been reported to have a higher incidence of a number of chronic diseases as well as hypertensive disorders in pregnancy and a higher rate of preterm birth. High scores have been shown to affect outcome regardless of socioeconomic status. 3 High scores are reported by 16.7% of U.S. obstetrical patients. We sought to determine if a high ACE score would predict adverse obstetrical outcomes.
We found that our patients were 50% more likely to report a high ACE than what has previously been reported in U.S. obstetrical patients. Although our study did not reach statistical significance due to small numbers, it illustrates a trend that merits further investigation. Our study was also limited by excluding a large number of our patients whose native language was not English or Spanish. Since our patient population is disproportionately high risk by virtue of being from underserved groups with high rates of poverty, limited health literacy and reduced access to care, we may not have seen the effect of a high ACE score as prominently as would be seen in groups with a lower background risk of adverse outcomes
Join now & support your local OB/GYN community!
Membership in the Phoenix Ob/Gyn Society is open to all providers specializing in the OB/GYN field including Physicians, Nurse Practitioners and Physician Assistants. Your membership entitles you to our 7 dinner meetings (including dinner for a guest or spouse at our Spring Social Meeting).
Click here to learn more »Meetings are on the 3rd Thursdays of the month at Mastro's City Hall Steakhouse. Dinner meeting topics include a wide variety of subjects of interest to our specialty.
Interested in supporting our annual Resident Research Night, sponsoring a Society dinner meeting, or advertising with us?
Learn more about sponsorship opportunities »
Home Become a Member Events RSVP Sponsors Become a Sponsor Dues Job Board Contact
© 2024 Phoenix Obstetrical & Gynecological Society. Phoenix, AZ
