Racial disparities in satisfaction with maternal healthcare.

OBJECTIVE: To determine if there is a racial disparity in satisfaction with maternal healthcare, and examine the quality of care mothers of color receive. METHODS: An online survey of women in the United States who had been pregnant at least once was conducted. The study received an exempt determination by our Institution's Review Board. RESULTS: Race, age, income, were all significant indicators for whether a woman was satisfied with maternal healthcare measures. CONCLUSION: Race is one of many indicators for dissatisfaction with maternal healthcare. More in-depth research on patient perception of care is recommended.

Quantifying the Impact of Dysmenorrhea Symptoms on Quality-of-Life and Access to Oral Contraceptives by Income.

Background: Dysmenorrhea, or painful menstrual periods, is one of the most common gynecological complaints. Most reports of uterine contractions range between moderate to severe pain, and patients often elect to cope with their discomfort without assistance from a physician. In the process, women experiencing dysmenorrhea are more likely to report absenteeism from work and school. Objectives: This study measures the reported impact of dysmenorrhea on patients' lives and elucidates a relationship between income and access to oral contraceptives. Methods: Two hundred women completed a survey about their symptoms, level of pain, treatments, and the extent to which dysmenorrhea affected day-to-day obligations. Most questions were multiple-choice while others permitted several answer selections or were free response. The data was analyzed using JMP statistical software. Results: Eighty-four percent of respondents reported moderate to severe pain during menstruation. This discomfort has caused 65.5% of the cohort to miss work and 68% to avoid participating in social gatherings. Pain relief medications are most often used as treatment - 143 respondents took ibuprofen, 93 took acetaminophen, and 51 took naproxen. 29.5% of respondents are prescribed birth control for cramps and blood flow. Income (p = 0.049), age (p = 0.002), and education (p = 0.002) were significant predictors for oral contraceptive pill (OCP) use. The lowest income groups were found to use OCPs at less than half the rate as the highest income respondents. Conclusion: Dysmenorrhea affected most participants in the cohort with an impact that extends beyond professional obligations. Income was found to be positively correlated with increased OCP use, whereas education level was inversely correlated. Clinicians should consider how patients' backgrounds influence their access to OCP options. An improvement on this study's findings would be to establish a causal relationship between these demographic factors and access to OCPs.

Molar pregnancy presenting in the emergency department.

A 27-year-old female grava1 para 0 presented to the emergency department with complaints of intractable nausea and vomiting associated with fatigue and shortness of breath for the past 2 weeks with concerns for pregnancy. Physical exam was benign. Labs were significant for a ß-hcg level of 348,260 mIU/mL. Ultrasonography showed a 12.4 pelvic mass possibly arriving from the anterior uterus concerning for fibroid. US also showed an anechoic focus suggestive of a gestational sac measuring 2.09 cm. The presentation was concerning for hyperemesis gravidarum due to molar pregnancy.

Ascending Aortic Aneurysm With Dissection in the Second Trimester of Pregnancy.

Aortic aneurysm in pregnancy is uncommon. A dissecting aortic aneurysm in pregnancy is less common. If present, a dissecting aortic aneurysm can lead to poor outcomes for both the mother and the fetus, including death. Swift recognition of the signs and symptoms of a dissecting aortic aneurysm can prevent a delay in diagnosis and possibly improve maternal-fetal outcomes. The report discusses a case of a pregnant patient who experienced a dissecting aortic aneurysm in the second trimester despite having none of the commonly associated risk factors. The evaluation, diagnosis, and surgical management of dissecting aortic aneurysm in pregnancy are discussed.