Patient Perceptions of Obstetrician-Gynecologist Practice Related to Hiv Testing

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Infect Dis Obstet Gynecol. 2010; 2010: 583950.

Published online 2010 November 11. doi: 10.1155/2010/583950 PMCID: PMC2989373

Copyright © 2010 Meaghan A. Leddy et al.

Obstetrician-Gynecologists and Perinatal Infections: A Review of Studies of the Collaborative Ambulatory Research Network (2005-2009)

Meaghan A. Leddy,1, 2* Bernard Gonik,3 and Jay Schulkin1

1Research Department, American College of Obstetricians and Gynecologists, 409 12th Street, SW, Washington, DC 20024, USA

2Department of Psychology, American University, 4400 Massachusetts Avenue, NW, Washington, DC 20016, USA

3Department of Obstetrics and Gynecology, Wayne State University School of Medicine, 6071 W. Outer Drive, Detroit, MI 48235, USA

*Meaghan A. Leddy: Email: meg.a.leddy@gmail.com

Academic Editor: Gilbert Donders

Received April 26, 2010; Accepted October 10, 2010.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Other Sections▼

Abstract

1. Introduction

2. Methods

3. Results

4. Discussion

5. Conclusions

ReferencesAbstract

Background. Maternal infection is associated with adverse pregnancy outcomes, and ob-gyns are in a unique position to help prevent and treat infections. Methods. This paper summarizes studies completed by the Research Department of the American College of Obstetricians and Gynecologists regarding perinatal infections that were published between 2005 and 2009. Results. Obstetrician-gynecologists are routinely screening for hepatitis B and HIV, and many counsel prenatal patients regarding hepatitis B and toxoplasmosis. However, other infections are not regularly discussed, and many cited time constraints as a barrier to counseling. A majority discusses the transmission of giardiasis and toxoplasmosis, but few knew the source of cryptosporidiosis or cyclosporiasis. Conclusions. Many of the responding ob-gyns were unaware of or not adhering to infection management guidelines. Obstetrician-gynecologists are knowledgeable regarding perinatal infections; however, guidelines must be better disseminated perhaps via a single infection management summary. This paper identified knowledge gaps and areas in which practice can be improved and importantly highlights the need for a comprehensive set of management guidelines for a host of infections, so that physicians can have an easy resource when encountering perinatal infections.

Other Sections▼

Abstract

1. Introduction

2. Methods

3. Results

4. Discussion

5. Conclusions

References1. Introduction

Pregnant women and their fetuses are at increased risk of complications of viral, bacterial, and parasitic infections. Maternal infection is associated with birth defects as well as adverse pregnancy outcomes, such as intrauterine growth restriction and preterm birth [1] and developmental disabilities [2-4]. For example, cytomegalovirus (CMV) infection can lead to hearing and/or vision loss, as well as cognitive impairment in offspring [5], and human immunodeficiency virus (HIV) can result in infection and illness in the newborn [6]. For most infections, effective preventive strategies are available; however, many pregnant women are not aware of the threat of infection nor are they practicing preventive strategies [7-9]. As such, obstetrician-gynecologists should be knowledgeable about these risks and their prevention, and should provide patients with preconception and prenatal counseling, as well as offering appropriate testing, vaccination and treatment.The American College of Obstetricians and Gynecologists (ACOG) has investigated its physicians' knowledge of perinatal infections, including ACOG and Centers for Disease Control and Prevention (CDC) guidelines, and how they are counseling and managing their pregnant patients. This paper summarizes studies of the Collaborative Ambulatory Research Network regarding bacterial, viral, and parasitic infections published between 2005 and 2009.

Other Sections▼

Abstract

1. Introduction

2. Methods

3. Results

4. Discussion

5. Conclusions

References2. Methods

2.1. Description of the Collaborative Ambulatory Research Network

The Collaborative Ambulatory Research Network (CARN) was created in 1990 to assist in evaluating obstetrician-gynecologists' practices, knowledge, and attitudes regarding a variety of clinical concerns, as well as provide Fellows and Junior Fellows timely information on contemporary practice patterns and elucidate areas in which increased education is needed. This project's aim was to change the way that research was being performed; a majority of information regarding medical practice was based on hospital, as opposed to ambulatory, practice.

The members of CARN are ACOG Fellows and Junior Fellows who have volunteered to participate in several research studies per year. As of March 2009, there were a total of 1,305 CARN members, 50.4% male and 49.6% female. Male members have a mean year of birth of 1954.2 ± 9.8 and a median year of 1953. Female members have a mean year of birth of 1962.5 ± 8.7 and a median year of 1964. In light of this difference, each of the studies reported controlled for age and gender in analysis and compared these groups to identify and report any differences in knowledge, attitudes, or practice. The