Objective: To create an instructional app that includes medical knowledge, procedural steps, and assessments based on the American Congress of Obstetricians and Gynecologists (ACOG) curriculum for vaginal hysterectomy. Methods: A survey of recent medical education literature and the use of app technology found that millennial trainees prefer engaging in technology-enhanced learning opportunities. The vaginal hysterectomy procedure currently has a variety of resident evaluations and case tracking methods. Results: Key features of the application include: 1) ACOG curriculum for vaginal hysterectomy, 2) a complete step by step live and simulated surgical video tutorial, 3) a procedural step by step assessment (10 steps-- 0-10 score), 4) a global surgical rating scale (7 metrics), and 5) a knowledge-based assessment (4 metrics, 0-4 scale). The data captured on the app can be accessed via IPAD and iPhone mobile devices and is verified by Apple. The evaluations can be directly emailed to any database. Conclusion: A comprehensive instructional surgery app coupled with real-time assessment will provide greater learning efficiency and will more effectively improve surgical skills. This app has the potential to standardize surgical evaluation in the operating room and provide a more efficient method to track surgeon competency using ACOG guidelines. The assessment is currently employed by the ACOG Simulation Consortium Working group during vaginal hysterectomy simulation and is part of a surgical simulation course certified by the ABOG for MOC credits.

Hypertensive disorders of pregnancy (HDP) were discovered a long time ago but our knowledge about their etiopathogenesis are still limited. These disorders can affect many pregnant women all over the world putting them, their families and their countries under significant health burden. The main goal of all research efforts regarding treatment of HDP is how to prevent highly morbid complications and mortality of HDP that may affect both mother and fetus. Delivery is the main line of treatment for severe cases but we have to put in our mind risk of prematurity as a possible outcome in case of termination besides the possibility of incidence of complications like eclampsia and hypertensive emergency postnatally. Researchers believed that studies working on prevention would result in major improvement of overall women care worldwide, and screening will definitely allow prompt starting therapy for those patients and prevent further sequences. Recently many guidelines support and recommend Aspirin 81 mg for the prevention of preeclampsia in high-risk patients using evidence-based data about the time and indications of its intake. Great efforts have been contributed to developing evidence-based guidelines to enhance our strategies to deal with these disorders. Reviewing, pooling, and comparing these guidelines would help us to refine our questions that may need to be answered by further studies. Trials confirmed that the application of standardized strategies for treating HDP significantly improves both maternal and fetal outcomes. In this article, we are going to review recent updates and guidelines about the treatment of HDP and provide references for your further readings.

Objective: Implantation of the pregnancy in a cesarean scar is a rare condition named; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with early diagnosis and appropriate management. It is a Prospective clinical study to evaluate the efficacy and success rate of single-dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in the management of women with cesarean scar pregnancy (CSP). Methods: 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under the guidance of ultrasound after 48 preceded by vaginal misoprostol 2 tablets (200 mg) 4 hours ago. Results: The mean gestational age at diagnosis was (8.5±1.6) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560) and The mean gestational age of pregnancy was (8.5±1.6 ). 88.7% is the success rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foleys catheter for 24 hours as mechanical hemostasis. 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent a subtotal hysterectomy. Conclusion: Systemic single-dose MTX injection followed by D&S is effective and harmless management for CSP. Nevertheless, more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in the treatment of CSP.

Objective: To create an instructional app that includes medical knowledge, procedural steps, and assessments based on the American Congress of Obstetricians and Gynecologists (ACOG) curriculum for vaginal hysterectomy. Methods: A survey of recent medical education literature and the use of app technology found that millennial trainees prefer engaging in technology-enhanced learning opportunities. The vaginal hysterectomy procedure currently has a variety of resident evaluations and case tracking methods. Results: Key features of the application include: 1) ACOG curriculum for vaginal hysterectomy, 2) a complete step by step live and simulated surgical video tutorial, 3) a procedural step by step assessment (10 steps-- 0-10 score), 4) a global surgical rating scale (7 metrics), and 5) a knowledge-based assessment (4 metrics, 0-4 scale). The data captured on the app can be accessed via IPAD and iPhone mobile devices and is verified by Apple. The evaluations can be directly emailed to any database. Conclusion: A comprehensive instructional surgery app coupled with real-time assessment will provide greater learning efficiency and will more effectively improve surgical skills. This app has the potential to standardize surgical evaluation in the operating room and provide a more efficient method to track surgeon competency using ACOG guidelines. The assessment is currently employed by the ACOG Simulation Consortium Working group during vaginal hysterectomy simulation and is part of a surgical simulation course certified by the ABOG for MOC credits.

Objectives: To determine if there is any observable effect of pre implantation genetic diagnosis (PGD) on obstetrical outcome and perinatal morbidity and mortality, birth defects, neonatal outcome in addition, finding the rate of misdiagnosis. Setting: King Faisal Specialist Hospital and Research Center (Reproductive Medicine & Perinatology Sections) at Riyadh, Saudi Arabia. Design: A retrospective chart review of PGD patients from Jan 2001- Dec 2009. Materials and Methods: A total of 70 PGD pregnancies and 70 matching spontaneously conceived pregnancies were reviewed. The main outcome measures were rate of multiple pregnancies, gestational age (GA) at delivery, mode of delivery, sex, apgar score (A/S), birth weight, presence of birth defects, misdiagnosis and perinatal and neonatal mortalities. Results: Data were collected from 79 children born after PGD and compared to 72 children born after spontaneous pregnancies. PGD group had significantly more multiple pregnancies. However, there was no statistically significant difference between other outcomes in terms of: birth weight, GA at delivery, sex distribution, perinatal mortality and presence of congenital malformations. The misdiagnosis rate was 1.4%. Conclusion: PGD does not add risk factors to the health of babies born after the procedure. The perinatal death rate and rate of congenital malformations were not higher for PGD group in this study.