Purpose: Our objective was to compare the frequency that providers in Family Medicine (FM) and Gynecology (GYN) document a history of pregnancy complications versus a general medical history at well-woman encounters.
Background: Pregnancy complications such as preeclampia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs) impact long term health.
Methods: We conducted a retrospective cohort study of women with at least one prior birth who presented to our institution for a well-woman encounter in 2019-2020. Charts were reviewed for documentation of general medical history (hypertension, diabetes, and mood disorders) versus their obstetric equivalents (preeclampsia, GDM, and PMADs). Results were compared using McNemar’s and chi-squared tests as appropriate.
Results: In 137 encounters, providers in both specialties were more likely to document general medical conditions compared to their pregnancy equivalents, including hypertensive disorders (OR 2.45, 95% CI 1.18-5.48), diabetes (OR 7.67, 95% CI 3.27-22.0), and mood disorders (OR 10.5, 95% CI 3.81-40.3). GYN providers were more likely to document an obstetric history (OR 4.5, 95% CI: 1.24-16.27); however, they were no more likely to report specific complications (OR 2.49, 95% CI: 0.90-6.89). Overall, the rate of pregnancy complication documentation was low at well-woman visits in FM and GYN clinics at 8.8 and 19 percent, respectively.
Discussions: GYN providers more frequently document a basic obstetric history compared to those in FM at well-woman visits. Both specialties, however, report pregnancy complications infrequently and at a lower rate than general medical conditions.
Topics: CREOG & APGO Annual Meeting, 2022, Student, Resident, Faculty, Patient Care, Practice-Based Learning & Improvement, GME, UME, Assessment, Standardized Patient,
Eli Medvescek, Uniformed Services University; Sorana Raiciulescu, MSc; Andrew Thagard, MD; Katerina Shvartsman, MD
