Introduction:The incidence of placenta accreta spectrum (PAS) has increased, but the optimal management and the optimal way to achieve vascular control are still controversial. This study aims to compare maternal outcomes between different methods of vascular control in surgical PAS management. Material and methods: A retrospective cohort study on consecutive cases diagnosed with PAS between 2013 and 2020 in single tertiary hospital. The final diagnosis of PAS was made following preoperative ultrasound and confirmation during surgery. Management of PAS using cesarean hysterectomy with internal iliac artery ligation (IIAL) was compared with two types of vascular control in uterine conservativeresective surgery (IIAL vs identification-ligation of the upper vesical, upper vaginal, and uterine arteries).Results: Over an 8-year period, 234 pregnant women were diagnosed with PAS meeting the inclusion criteria. Uterine conservative-resective surgery (200 cases) was associated with lower mean blood loss compared with cesarean hysterectomy with IIAL (34 cases) in all PAS cases (1379 ± 769 mL vs 3168 ± 1916 mL; p < 0.001). In subanalysis of the two uterine conservative-resective surgery subgroups, the group with identification-ligation of the upper vesical, upper vaginal, and uterine arteries had a significantly lower blood loss compared with uterine conservative-resective surgery with IIAL (1307 ± 743 mL vs 1701 ± 813 mL; p = 0.005). Women in the hysterectomy with IIAL group had more massive transfusion (35.3% vs 2.5%; p < 0.001; odds ratio[OR] 21.3, 95% confidence interval [CI] 6.9-66), major blood loss (>1500 mL) (70.6% vs 34%, p < 0.001; OR 4.7; 95% CI 2.1-10.3), catastrophic blood loss (>2500 mL)

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Background: Elevating rates of caesarean section was happened in around the world nowadays. The health professionals are required to expert in this surgery in order to provide safely procedures, especially obstetrics and gynecology residents. However, Covid-19 emergence became a barrier of residents to practice their surgery skills. Consequently, it had to discover alternative strategies for residents to achieve caesarean section skills. This study’s purpose was to identify the effect of virtual video, mannequins, and the combination of video-mannequins on resident’s knowledge and confidence regarding caesarean section. Method: This research was a quasy-experimental study with pre-test and post-test designs. Based on stratified random sampling, this research involved 33 obstetrics and gynecology residents as study respondent. These samples were divided into 3 groups. These three groups received different interventions, such as learning using video, mannequins, and video-mannequins combination. This study used 2 kinds of questionnaires to examine resident’s knowledge and their confidence level. The collected data was analysed further employing three statistical tests, such as Wilcoxon-Signed Ranked Test, Kruskal Wallis Test, and Mann Whitney Test. Result: This study consisted of 4 levels of residentials according to their semester periods. More than half respondents had more than three times clinical experiences in the hospital related to the obstetrics and gynecology sciences. All the study methods such as video tutorial (0.42(CI95%-0.11-0.9)), mannequin simulation (0.60(CI95%-0.04-1.25)), and the combination of video-mannequin (1.3(CI95%0.73-1.93)) significantly increased resident’s knowledge. Besides, video and mannequin learning methods could increase resident’s confidence due to caesarean surgery practice. Conclusion: All media could improve resident’s knowledge about caesarean section clinical practice. The combination of video tutorial and mannequin simulation became the best method to achieve competency in caesarean surgery, compared to the single video tutorial and mannequin simulation. In addition, these educational strategies enhanced resident’s confidence during clinical practice of caesarean section.

COVID-19 is a pandemic that has spread in various countries. The health care system in hospitals is burdened with widespread infections and health problems. In addition, educational aspects, especially obstetrics and gynecology education, have problems in clinical practice. This study reviews the role of the learning media in supporting the competence of resident doctors in specialist education for obstetrics and gynecology. Narrative review is done by reviewing some literature that explores the use of media in supporting medical education competencies. The search was performed using MeSH keywords in the PubMed, Google Scholar and ScienceDirect databases. The literature used is research conducted in the last 5 years. The collected data is then arranged in a narrative manner. The challenges experienced in medical resident education, especially the focus on obstetrics and gynecology during the COVID-19 pandemic, have become a consideration for the need for innovative media so that learning can run as usual. All aspects need to ensure quality education for resident doctors because they will continue to provide health services in the future. Keywords: Maternal health, COVID-19, Media, Obstetrics and gynecology