Research Day Recap: Resident Presentations

Presenter: Katherine Wade, MD 

Faculty Advisor: Anthony Shanks, MD, MS, MEd 

Summary: Medical interpreters are vital for communication with Limited English Proficiency (LEP) patients. A substantial number of patients identify as LEP and face increased healthcare barriers. A gap was identified in formal training for residents in using interpreter services. This study aimed to better equip residents to provide compassionate, equitable, and effective patient care by combining education on cultural competency and best practices for working with medical interpreters. This research found that language barriers can create a significant obstacle to accessing medical care and lead to health disparities. Professional medical interpreter services are vital to improving care for LEP patients. There is a clear benefit of formal education for clinicians to improve collaboration with interpreter services to provide more equitable care.

Presenter: Nida F. Hasan, DO

Faculty Advisor: Alissa Conklin, MD 

Summary: The purpose of this study was to better understand the relationship between obesity and postpartum hemorrhage by analyzing the rates of postpartum hemorrhage by body mass index (BMI) categories and assessing relative risks of postpartum hemorrhage according to BMI. The risk of obesity on postpartum hemorrhage is still poorly defined. This study found that patients with Class 3 obesity have a 57% increased risk of postpartum hemorrhage when comparing to patients in the healthy BMI category. 

Presenter: Shae N. Jansen, MD 

Faculty Advisor: Jessica Parker, MD 

Summary: Sarcopenia is the most studied body composition measurement in populations of ovarian cancer patients. Sarcopenia depicts loss of skeletal muscle mass, strength, and function, representing an objective fragility surrogate. There remains a paucity of data regarding disparities in baseline body composition and outcome associations among patients with ovarian cancers. The objective was to evaluate disparities in baseline body composition measurements and 59 outcomes related to race, insurance status, hospital type, and social vulnerability index in patients with advanced epithelial ovarian cancer (EOC). This study found that there are disparities in baseline sarcopenia and SAT among patients with advanced EOC. Further research into additional cancer course outcomes with larger groups of racially diverse patients and patients treated in a public hospital setting is necessary.

Presenter: Allison Polidori, MD 

Faculty Advisor: David Haas, MD, MS 

Summary: Cervical ripening balloons (CRBs) are commonly used during labor induction. Pain management during the placement procedure and patient experiences are not well described. The objective was to characterize the distribution of pain scores and patient experience during CRB placement and if there are differences in those who receive pain medication or not. This study found that pain experienced during CRB placement was not associated with cervical dilation or the amount of pain medication used. 

Presenter: Prakrithi Srinand, MD

Faculty Advisor: David Haas, MD, MS 

Summary: Food insecurity leads to adverse metabolic health outcomes. Poor metabolic health during pregnancy can negatively impact maternal and fetal health. In addition to metabolic disorders, other risk factors of stillbirth include African-American race, advanced maternal age, and substance use, all of which may represent the demographics of those living in food deserts. There is limited data regarding the direct effects of food insecurity on maternal and fetal outcomes, but some small studies have shown correlations between the two. The primary goal was to determine if there is a direct correlation between stillbirth and residing in a food desert. The results do not show significant differences in population demographics between the “food desert” and “no food desert” groups, though there are more women who had stillbirths that reside in food deserts than not. The primary outcome was not able to be analyzed.

Presenter: Kemi Ogunmuko, DO, MBA, MS 

Faculty Advisor: Brownsyne Tucker Edmonds, MD, MPH, MS 

Summary: Recent studies reveal that the rate of maternal mortality is climbing at a steady rate in the United States, and one of the leading causes is maternal hemorrhage. This single-centered pilot study aimed to identify risk factors that place pregnant women at risk for unplanned emergent cesarean delivery and maternal hemorrhage and create protocols and guidelines to reduce poor outcomes. We performed a retrospective review of obstetric patients’ medical records who required unplanned cesarean delivery with subsequent obstetric complications of maternal hemorrhage and need for blood transfusions. This study found that most postpartum hemorrhage occurs secondary to an obstetric or surgical etiology. Given that maternal mortality related to hemorrhage is preventable, the cornerstone of effective reduction of this morbidity involves risk identification, expeditious diagnosis, and timely management. Pregnant women are more likely to have a postpartum hemorrhage if they are high-risk obstetric patients with complex maternal health comorbidities and if they suffer from a prenatal diagnosis of anemia. It is imperative to create a screening protocol to identify patients who are high-risk obstetric patients and have associated anemia so adequate treatment can be implemented prior to the day of delivery.

Presenter: Lindsey Burleson, MD 

Faculty Advisor: Anthony Shanks, MD, MS, MEd 

Summary: Large Language Models (LLMs) are a type of deep learning model that uses vast amounts of data to make predictions based on human input prompts. LLMs incorporate databases of information and use knowledge of human language to produce unique output. LLMs can contribute to patient education on clinical topics by making healthcare information accessible, easily understood, and more personalized. There is a paucity in the literature of the assessment of LLMs and their application to patient education in topics specific to Obstetrics and Gynecology. We assessed the clinical accuracy and specificity of LLMs as a tool for patient education in topics specific to OB/GYN by having expert OBGYNs review answers to 10 FAQs written by CoPilot, ChatGPT, and Gemini. While CoPilot demonstrated higher mean scores by expert reviewers, those reviewers were more likely to recommend the ACOG FAQ or ChatGPT responses to patients when providing clinical counseling. This study supports that LLMs have the potential to accurately counsel patients in topics relate to OB/GYN. 

Presenter: Komal Kumar, MD 

Faculty Advisor: Amy Caldwell, MD 

Summary: Women of reproductive age who receive their primary care from general internists rather than OBGYNs are more likely to have chronic medical conditions that place them at higher risk of complications from unplanned pregnancy. We assessed the efficacy of a didactic educational intervention on attitudes toward and knowledge of contraception and contraceptive counseling for Indiana University School of Medicine internal medicine residents. Additionally, we sought to increase awareness of clinical support resources and available referral pathways for contraceptive care. This study found that contraception counseling falls within the scope of internal medicine physician practice. Providing education on the basics of history taking and contraception, resources for medically complex patients, and how to prescribe combined hormonal contraception via a lecture series increases comfort with prescribing contraception and knowledge of referral systems and contraceptive resources. 

Presenter: Emma Ryan, MD 

Faculty Advisor: David Haas, MD, MS 

Summary: Access to high-quality nutrition is an important part of a healthy pregnancy, and multiple risk factors for poor maternal nutrition have been identified. The study examined the relationship between self-reported diet quality and living in a food desert during early pregnancy. Secondary outcomes included examining the relationship between diet quality and measures of antenatal depression and stress during early pregnancy. This study found that residing in a food desert was not found to be independently associated with diet quality in early pregnancy. Lower maternal age and pre-pregnancy obesity were associated with poorer diet quality in early pregnancy.

Presenter: Paige Schultheis, MD 

Faculty Advisor: Douglass Hale, MD 

Summary: Urethral bulking exists as an option for surgical management of intrinsic sphincter deficiency, a subclass of stress urinary incontinence. Morbid obesity has been identified as a risk factor for mid-urethral sling failure, but no data exists on the effect of body mass index (BMI) on outcomes after urethral bulking. Our objective is to identify the effect of BMI on outcomes after Bulkamid injection for stress urinary incontinence. This study found that there is no significant difference in symptom improvement after Bulkamid injection for stress urinary incontinence across the BMI spectrum. It is a reasonable option for symptom improvement, even for patients with morbid obesity. 

Presenter: Riana Kahlon, MD 

Faculty Advisor: Nicole Scott, MD 

Summary: In August 2023, Indiana passed legislation significantly restricting access to abortion care. The aim of this study was to identify the possible impact such abortion restrictions have on the decisions of Indiana medical residency graduates to stay or leave the state for future clinical practice. This study showed that abortion restrictions should be carefully evaluated to assess their impact on physician and resident retention.