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Objective This study aimed to evaluate the effects of a financial literacy curriculum on resident and fellow's sense of well-being and financial stress. Study Design This single institution pilot study prospectively enrolled obstetrician/gynecologist (OB/GYN) medical trainees (residents and fellows) to take part in a five-part personal financial literacy curriculum during the 2019 to 2020 academic year. Topics covered included the following: financial education and its relationship to personal well-being, overview of financial terms and principles, budgeting, debt planning, and investing and giving. Primary outcomes were the improvement in well-being as measured by the Expanded Well-Being Index (E-WBI) and financial stress as measured by the Financial Stress Scale-College Version (FSS-CV) survey. Results Of the 35 residents and fellows who participated in the study, 21 (60%) completed the postintervention survey. After course completion, there was significant improvement in the individual's E-WBI (p < 0.05) and no significant improvement in their FSS-CV (p = 0.06). After completing the course, trainees agreed that financial literacy improved their sense of well-being (p = 0.018). Conclusion Cultivating financial literacy is associated with an improvement in the sense of well-being in residents and fellows and should be considered for inclusion in other graduate medical education (GME) programs.

Objective Evaluate fetal echocardiography's ability to detect critical (lesions requiring immediate neonatal intensive care) congenital heart disease (CHD) after normal anatomic cardiac views on detailed ultrasound. Methods Singletons with both a detailed ultrasound at 18 + 0 to 22 + 6 weeks and echocardiogram performed at least 14 days later and at 20 + 0 to 24 + 6 weeks. Cases with cardiac pathology on detailed ultrasound were excluded. Different combinations of cardiac views were described: Basic (four‐chamber, outflow tracts), Expanded (plus three‐vessel view), and Complete (plus ductal/aortic arches). “Normal” was defined on either 2D gray scale or color Doppler. Primary outcome was rates of critical CHD missed on ultrasound but seen on fetal echocardiogram. Results One thousand two hundred twenty‐three women had normal Basic cardiac views. One thousand one hundred ninety (97.3%) were confirmed normal on echocardiogram. Twenty‐one (1.71%) total CHDs were missed, and three were critical (0.25%; 95% CI, 0.03%‐0.53%). Of the 1,223 women, 763 had Complete views. Ten (1.31%) total CHDs were missed and one (0.13%; 95% CI, 0.13%‐0.36%) was confirmed critical. Conclusion Fetal echocardiography can increase CHD detection despite normal cardiac anatomy on detailed ultrasound; however, CHDs missed are rarely critical. Approximately 750 fetal echocardiograms need to be performed to detect one critical CHD with Complete normal cardiac views on detailed ultrasound.

Background: Today in the United States, approximately 30% of deliveries are performed by cesarean section. Wound infections and other post-operative complications represent a frequent morbidity which may be improved with an understanding of local risk factors. Objective: This project used a retrospective analysis of cesarean section incision complications and infection events along with patient chart information to identify potential risk factors associated with incisional wound complications at our institution. Methods: ICD9 codes identified 618 cesarean sections from July 2012 through June 2013. Of these, 59 were excluded. Twelve different data elements were examined and complications were divided into two categories: presence of infection and presence of seroma/hematoma. Statistics included univariate analysis and multiple logistic regressions to identify an odds ratio for associations using P < 0.05 as significant. Results: 73 (13.1%) of 559 patients developed a post-partum incision complication. Five logistic variables were included in amultiple logistic regression model for all incision complications. Three of the five variables had a significant odds ratio: emergent cesarean section, stapled skin closure, and preeclampsia. Five logistic variables were included in another multiple logistic regression model for all wound infections. Two of the five variables had a significant odds ratio: BMI > 33.4 and preeclampsia. Conclusions: Cesarean section rates account for approximately 30% of deliveries, with significant maternal morbidity associated with incisional wound complications. This study found multiple significant risk factors for both wound complications and infections. Preeclampsia was an indepen-* Corresponding author. C. Newlin et al. 790 dent risk factor for both wound complications and infections.