Multiple gestation: time interval between delivery of the first and second twins.

Journal ArticleA clinical investigation was undertaken to challenge the commonly accepted view that the interval between the birth of the first and second twins should be preferably within 15 minutes and certainly no more than 30 minutes. During 1981 and 1982, 115 patients with live-born twins at 34 or more weeks' gestation underwent an attempted vaginal delivery at four regional perinatal centers. The interval between vaginal delivery of the first and second twins (mean, 21 minutes, range, one to 134 minutes) was 15 minutes or less in 70 (61%) cases and more than 15 minutes in 45 (39%) cases. Excluding conditions associated primarily with prematurity, all second twins delivered beyond 15 minutes did well despite the delay and had no signs of excess trauma or low five-minute Apgar scores. Maternal complications were also uncommon, although combined vaginal-abdominal delivery was more frequent if there was a delay of more than 15 minutes (eight of 45 versus two of 70, P less than .02). The authors conclude that if there is continuous fetal and uterine monitoring, a time restriction for the delivery interval between the first and second infants is not necessary

A simple flip of an obstetrics clerkship lecture focusing on interactive learning

Abstract Objective: To determine the value of interactive learning after a low-tech flip of a traditional lecture during an obstetrics and gynecology clerkship. Design: All third-year medical students completed a flipped learning experience between May 2014 and April 2016. Central to the change was replacement of a mid-clerkship lecture ("late term and prolonged gestation") with interactive learning at seven stations by student pairs (one each on separate obstetrics and gynecology services). Before class, students electronically received a handout that described learning objectives, subject background, and interactive stations. The stations featured manipulative models, instruments, data, and images involving prenatal care, fetal growth and testing, and labor and delivery decision-making. Results: The flipped model was easily executed with proper preparation. The 178 consecutive students completed the two mandated surveys. The median score given by students about the same instructor's effectiveness increased from 4.0 (previous two years) to 4.4 (on a 5-point scale). Compared with traditional lectures by other clerkship faculty, the flipped classroom was judged by students to be easier for understanding and more interactive. Students perceived being more responsible for learning with better recall and application to practice. Conclusions: A low-tech approach to the flipped classroom was easily executed with favorable responses from students about interactive learning

Effect of Adjunctive Systemic Azithromycin With Periodontal Surgery in the Treatment of Chronic Periodontitis in Smokers: A Pilot Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141533/1/jper1887.pd

Obstetri dan ginekologi (Obstetrics and gynecology)/ Rayburn

x, 359 hal.: ill.; 24 cm

Obstetri dan ginekologi/ Rayburn

x, 390 hal. : ill.; 21 cm

Obstetri dan ginekologi/ Rayburn

x, 390 hal. : ill.; 21 cm