DEPARTMENT OF OBSTETRICS & GYNECOLOGY

Virginia Commonwealth University School of Medicine

Annual Report 2012-2013

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CONTENTS Message from the Chair

3

Clinical Services General Obstetrics and Gynecology Pediatric and Adolescent Gynecology Midwifery Maternal Fetal Medicine Reproductive Endocrinology and Infertility Gynecologic Oncology Female Pelvic Medicine and Reconstructive Surgery

5 6 13 14 17 23 26 28

Research

30

Education Medical School Residency

34 35 37

Appendix Publications Abstracts Presentations Grand Rounds

39 40 44 47 50

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Chair’s Message The 2012-13 annual report is coming together 6 months late. Over the last three years, you have probably realized I’m somewhat obsessive about keeping administrative tasks on schedule. As I prepared to write this message, I reflected back on both the year and thought a lot about the reason for the delay. The late start is clearly because we just had so many time intensive, important other good things happening. 2012-13 was an excellent year in and of itself, but even more important, included development of significant infrastructure and groundwork for bigger and better things to come. Our physical plant will soon be commensurate with the incredible clinical care that we provide. Nelson clinic began renovations and Stony Point completed them. Plans are underway for significant renovations on 8-E for our ante- and postpartum patients. Most important, work has begun on labor delivery. Many long term department members who had previously seen plans discussed but never started expressed significant skepticism about renovations ever happening. Doubts were fully laid to rest when Hourigan Construction arrived with men in hardhats with sledgehammers who began demolition. As of July 2013, we were working in tight quarters in part of the old unit while the rest of the sixth floor of main hospital was taken down past the studs and renovated. Phase 1 ultimately opened on schedule in October, but more on that in the 2013-14 report, which will come out on time. I am grateful to the entire clinical staff, whose willingness to work extra hard to maintain our high quality care in the midst of drywall dust, air hammers, and concrete drilling has ensured that this huge project will complete on time and within budget. More important than bricks and mortar are our people. The department continued its tradition of working incredibly hard, maintaining a supportive environment that is fun and rewarding in which to work, and providing compassionate high quality care while recruiting to cover vacant positions and working amid construction. We were extraordinarily successful with our recruitment. Jori Carter will be joining Weldon Chafe as our new gynecologic oncologist. Jori completed her gynecologic oncology training at the University of Minnesota, and is a superb minimally invasive surgeon. In addition to developing her clinical program, she will assume responsibility for the GYN ONC research program. Sarah Milton was an absolutely tremendous VCU resident, and will be staying to join the Division of General Obstetrics and Gynecology. She will work with Nicole Karjane, expanding our pediatric and adolescent gynecology program. We are very pleased to have recruited Francis Casey, a graduate of the Ryan program at MedSTAR Washington Medical Center, who will begin our program in Family Planning. Our educational mission continued through all these transitions. Nicole Karjane has done a truly superb job and fully adjusted to her new role as residency program director. Fidelma Rigby completed the APGO Solvay Scholars Program and has been doing a tremendous job both running the student program and designing the new curriculum. It is tremendously rewarding to hear the “buzz” from resident applicants and our own students that our residency has a reputation for both for being a superb training program and a genuinely nice place to work.

2012-13 OB/GYN Annual Report - 4 We have also continued to grow academically. There were a growing number of posters presented and papers published. Zhibing Zhang, one of our basic scientists received R01 funding. The department began work on its first book, co-edited by Christine Isaacs and Ashley Carroll. Nearly all of the faculty and residents committed to writing chapters. We look forward to the book being published in 2014. They were numerous honors received by faculty, which will be well described in the individual sections of the report. Of all of them, one stands out. We are very proud of PJ Coney, who was elected to the Institute of Medicine, an absolutely incredible recognition for Dr. Coney, the department, and the institution. We are part of a very small number of OB/GYN departments that have more than one faculty member in the IOM. We have had another great year, and have made significant strides through renovations and recruiting towards the vision of the department expressed to me by the faculty and dean when I interviewed a few years ago. I can tell you from the 6 months of the 2013-14 academic year that have already passed that the groundwork laid in this academic year is already showing results. David Chelmow Leo Dunn Chair of OB/GYN February 9, 2014

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Clinical Services

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GENERAL OBSTETRICS AND GYNECOLOGY Faculty Joseph F. Borzelleca, Jr., MD, MPH, Associate Professor Ellen L. Brock, MD, MPH, Associate Professor Frances Casey, MD, MPH, Assistant Professor David Chelmow, MD, Professor, Department Chair Philippe Girerd, MD, Associate Professor Aaron Goldberg, MD, Assistant Professor Christine Isaacs, MD, Associate Professor Nicole Karjane, MD, Associate Professor, Residency Program Director Sarah Milton, MD, MS Assistant Professor Nan G. O’Connell, MD, Assistant Professor John G. Pierce, MD, Associate Professor Nicole Calloway Rankins, MD, MPH Assistant Professor Nathan Webb, MD, Assistant Professor Introduction The 2012-2013 academic year was another robust year for the Division of General Obstetrics and Gynecology at VCU Medical Center. We continue to evolve and thrive under the leadership of our chairman, Dr. David Chelmow, and welcomed 2 accomplished colleagues to our division: Drs. Casey and Milton. We remain dedicated to teaching, clinical service, and research as evidenced in the publications, awards and accomplishments of our group. As we tirelessly promote patient safety and customer service, our camaraderie and collaborative efforts within the division are the cornerstones of our practice. Clinical Activities The Division of General OB/GYN remains extremely active and productive, providing comprehensive gynecologic and obstetric care to women in the Richmond and surrounding areas. The generalist faculty staff over 20 clinic sessions per week in their faculty practice. In addition, they oversee an average of 15 resident clinic sessions per week, a LEEP/colposcopy clinic, a pediatric and adolescent gynecology clinic, a surgical posting clinic, and staff three surrounding Richmond health departments (East Henrico, West Henrico, and Chesterfield County). Our health department role has also now expanded to include coverage of the Rappahannock Area Health Department. In addition, we continue to offer coverage for the local Crossover Ministry Clinic, providing free prenatal care services to those in underserved regions. In addition to these efforts, the generalist faculty oversee four nurse practitioners and five Certified Nurse Midwives (Kathryn Beaton, Meghann Batten, Amber Price, Leslie Fehan and Brenda Brickhouse) offering collaborative services in a full range of patient-centered care experiences. The Generalist Division provides the majority of Labor and Delivery care and supervision, and over the academic year is responsible for overseeing more than 2,000 deliveries. We celebrated the opening of phase 1 of our newly renovated Labor and Delivery unit in August 2013 which

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provides a state-of-the-art, family-centered birth experience to our patients. The Nelson Clinic and Stony Point offices serve as our outpatient centers where, in collaboration with our subspecialists, we provide the full scope of OB/GYN services and office procedures, with over 10,000 patient visits per year. Education The Division continues to be integrally involved in all educational aspects of the department, including student and resident teaching. Dr. Nicole Karjane has served as residency program director since July, 2012. She oversees 24 residents. Dr. Ellen Brock continues to direct the Center for Human Simulation and Patient Safety advancing and evolving the curriculum for student and resident education and technical training. In addition, the Department continues the traditions of a multidisciplinary quality assurance conference and preoperative planning conference, both led by the generalist division faculty. Academic Highlights Peer Reviewed Publications: ACOG Committee Opinion ACOG Practice Bulletin American Journal of Obstetrics and Gynecology Journal of Lower Genital Tract Disease Journal of Women’s Health Medscape Reference from WebMD Obstetrics and Gynecology Postgraduate Obstetrics and Gynecology Reproductive Science Seminars in Perinatology Chemistry and Biodiversity Local and National Lectures including: Ob/Gyn Core Lecture Series at VCU How to Treat a Woman Lecture Series at VCU Department of Surgery Grand Rounds at VCU Department of OB/GYN Grand Rounds at VCU VCUHS Patient Safety Conference VCU Women’s Health Conference VA Department of Health Annual Clinician Conference Ware-Dunn Society Annual Meeting Virginia Patient Safety Summit

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International Meeting on Simulation in Healthcare ACOG District IV Meeting Virginia Tech-Carillon Medical School Washington Hospital Center Cancer Institute McGuire VA Medical Center ACOG District IV Meeting Virginia Orthopedic Society Thomas Jefferson University Editorial Boards: Medscape Reference Post Graduate Obstetrics and Gynecology Residency Program Director’s Alert Journal Reviewers: American Journal of Obstetrics and Gynecology Journal of Pediatric and Adolescent Gynecology Journal of Women’s Health Obstetrics and Gynecology Service to National Organizations: ABOG Board of Directors ABOG Maintenance of Certification Exam Committee ABOG Oral Examiners ABOG Written Exam Committee American College of Obstetricians and Gynecologists' Advocacy Division ACOG Gyn Practice Bulletins Committee ACOG CREOG Examination Committee American Society for Colposcopy and Cervical Pathology International Urogynecology Association Workshop NASPAG Abstract Committee NASPAG Resident Education Committee North American Menopause Society Planning Committee Presidents Cancer Panel Society for Academic Specialists in General Obstetrics and Gynecology Organizing Committee Society in Europe for Simulation Applied to Medicine Virginia Health Commissioner’s Infant Mortality Workgroup Honors and Awards: Best Doctors in America Richmond “Top Docs” Election into American Gynecology and Obstetrics Society

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Outstanding Teacher Award for Best Teacher, MIII Ob/Gyn Clerkship Outstanding Teacher Award for High Evaluation, MI Women’s Health Course 2013 School of Medicine Innovation in Education Award VCU Physician Champion Faculty: Joseph Borzelleca, MD enters his twenty fourth year as faculty in the Department of Obstetrics & Gynecology Generalist Division. His primary interests remain focused on office-based practice, including contraception, management of ectopic pregnancy, gynecologic ultrasound, chronic pain syndromes and obesity. He continues his involvement in a research group looking at genetic vulnerability to cancers (primarily breast and colon), and participates as a clinician researcher in the Vaginal Human Microbiome Project here at VCU. He was invited to lecture on Contraceptive Updates at the Virginia Department of Health Annual Clinician Conference this year, and trains residents and students in general contraception and contraceptive procedures. In addition to his administrative responsibilities as medical director of the Nelson Clinic, he remains highly active in our Centering Pregnancy Program where he is a group facilitator and member of the Centering Core Team. Ellen Brock, MD, MPH divides her time between the Department of Ob/Gyn and the VCU Center for Human Simulation and Patient Safety, where she continues to serve as the Director. Dr. Brock and the Simulation Center Staff were honored with the 2013 School of Medicine Innovation in Education Excellence Award, one of the institution’s highest honors. In addition, she continues her clinical practice in the Nelson Clinic office, focusing primarily on minimally invasive surgery and vulvovaginal disorders. She is an examiner for the American Board of Obstetrics and Gynecology and taught internationally at the International Urogynecology Association workshop in 2013. Her educational interests are primarily in the areas of surgical skills curriculum and interprofessional simulation based team training. Frances Casey, MD, MPH recently joined the faculty as the director of family planning services. Hired to initiate a Ryan Program here at VCU, she has given multiple grand rounds and workshops to faculty and staff with respect to the necessity and importance of access and training in comprehensive reproductive healthcare. This past year, she published in Seminars in Reproductive Medicine, worked as a fellow in the American College of Obstetricians and Gynecologists' Advocacy Division, presented abstracts for meetings at the Society for Family Planning and for the Population, Family and Reproductive Health Department, Johns Hopkins Bloomberg School of Public Health. Her research interests include contraceptive access, cervical ripening in the second trimester and resilience from and emotional impact of perinatal loss. David Chelmow, MD David Chelmow continues to go to a lot of meetings. He is currently on the Board of Directors for MCV Physicians and Chairs the Strategic Planning and Business Development Committee and serves on a number of other medical school, hospital, and

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practice plan committees. Obstetrics and Gynecology.

In between, he sees patients within the Division of General

He was appointed a Director of the American Board of Obstetrics and Gynecology. He continued on several consensus panels for guideline development for cervical cancer prevention. He authored the ACOG Practice Bulletin on screening for cervical cancer and coauthored the Practice Bulletin on management of abnormal cervical cancer screening test results and cervical cancer precursors. He is Vice Chair of the ACOG GYN Practice Bulletin Committee. He was appointed to the Board of Directors for the American Society for Colposcopy and Cervical Pathology. He serves as Editor-in-Chief for the Medscape OB/GYN Reference. Philippe Girerd, MD has been a member of the General OB/GYN Division for over 20 years. He continues active clinical practice and teaching in all aspects of General Obstetrics and Gynecology. His research interests include Microbiology and Immunology pertaining to female reproductive health and surgical site infections. He is actively involved in leading the clinical activities of the Human Microbiome Project (vaginal section). Philippe also serves as the liaison to the Chesterfield Health department and regularly staffs our Labor and Delivery unit. Aaron Goldberg, MD completed both medical school and residency at VCU, and has since become a busy practitioner seeing patients at both our Nelson Clinic and Stony Point sites. His practice includes the full range of general OB/GYN and his particular interests include minimally invasive gynecologic surgery, including the use of the DaVinci Surgical Robot. He is actively engaged in both resident and medical student teaching and has found time to pursue his interest in legislative efforts affecting health policy and women's health. Ongoing research projects include investigations on the treatment of chorioamnionitis and the impact of obesity on various aspects of pregnancy. He has published papers in Obstetrics and Gynecology in the past year. He has also established, and teaches, a basic surgical skills course for senior medical students. Christine Isaacs, MD continues to serve as the division chair, overseeing the responsibilities of 13 generalist faculty physicians. In addition, she is the medical director of the midwifery service and supervises the practice of 5 Certified Nurse Midwives. Clinically, she maintains a busy office practice at Stony Point with special interests in natural childbirth, reproductive health, and contraceptive choices. She also maintains an active role as a Centering Pregnancy facilitator and is the PI on our local March of Dimes Foundation Community Grant for Centering Pregnancy. This past year, she has been busy editing a text book, participating in SASGOG Program Committee meetings, and now serves as an ABOG Oral Board Examiner. She has served as a reviewer/editor for Obstetrics & Gynecology, Medscape, and Postgraduate Obstetrics & Gynecology. She has again been honored with Richmond’s “Top Doc” award and continues to receive teaching awards from the medical students. Nicole W. Karjane, M.D: Nicole has continued in her role as Residency Program Director since May, 2012, after serving as Associate Program Director for three years. In addition to running

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the residency program, she maintains an active clinical practice in general obstetrics and gynecology with a special emphasis on pediatric and adolescent gynecology. She has been invited to speak at numerous meetings throughout the region on topics in pediatric and adolescent gynecology as well as HPV and cervical cancer screening. Nicole continues to serve as a reviewer for the Journal of Pediatric and Adolescent Gynecology, the American Journal of Obstetrics and Gynecology, and the Journal of Women’s Health. In addition, she has been appointed to ACOG’s CREOG Examination Committee, the North American Society of Pediatric and Adolescent Gynecology’s Resident Education and Abstract Committees, and was again named one of Richmond Magazine’s “Top Docs” in 2013. Sarah Milton, MS, MD joined the faculty in September of 2013. In addition to general obstetrics and gynecology, she subspecializes in pediatric and adolescent gynecology. She has a particular interest in minimally invasive surgery and is a certified DaVinci Robotic Surgeon. Dr. Milton completed medical school and her residency in obstetrics and gynecology at Virginia Commonwealth University. She served as an administrative chief resident in her final year of training and received the Society of Laparoendoscopic Surgeons Award for Resident Achievement. Dr. Milton has already become active in education within the department, having given several resident and medical student lectures. She also lectures to local middle school girls on adolescent health. In addition to continuing to build her clinical practice at Nelson Clinic and Stony Point Women’s Health Clinic, she looks forward to continuing to pursue teaching and research opportunities both within the VCU system and in the community. Nan O’Connell, MD has furthered her interest in menopause health this year by becoming more active with the North American Menopause Society, serving as a member of the planning committee for the 2014 annual meeting, as well as by giving several resident presentations on menopausal issues. She has been working hard to get the residents more clinical experience in caring of the menopausal patient while maintaining a busy clinical practice in general OB/GYN and keeping an active presence in labor and delivery. She serves on the Faculty Senate for VCU and was appointed to the newly formed Clinical Competency committee for resident education. For the fourth year she was the program director for the annual meeting of the Ware-Dunn Society. She was also named a “Physician Champion” by VCU Medical Center in recognition of exceptional service and leadership and commitment to patient care. John G. Pierce, Jr., MD served as the VCU Residency Program Director for the Department of Obstetrics and Gynecology from June 2009-June 2012. John currently remains active in education for the students, residents, and the institution. He has been involved in presentations at APGO as well as for the VCU Graduate Medical Education office. He has served on review boards including the Saving Lives at Birth Foundation. He is also active within the community as Co-Medical Director of the Pregnancy Resource Center and President of the Richmond Christian Medical and Dental Association. He staffs the CrossOver Community Ministry Center providing maternity care and a safety net for many women in our community. Nicole Calloway Rankins, MD, MPH joined the general obstetrics and gynecology division in September 2012 in a primarily research position. Her research focuses on evaluating the role of

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the intestinal microbiome in metabolism within pregnancy, with a focus on elucidating its contribution to gestational weight gain. She is taking an active role in resident research education through lectures, project mentorship, and becoming the Director of Resident Research. She also served as a reviewer for the American Journal of Obstetrics and Gynecology. Nathan Webb, MD joined the faculty in August 2012. He is a graduate of the Medical College of Georgia and completed his residency training in obstetrics and gynecology at Vanderbilt, where he received awards for clinical research and was selected as the AAGL Special Resident in Minimally Invasive Gynecology. His research and clinical interests include benign gynecology and gynecologic surgery, particularly minimally invasive surgery.

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PEDIATRIC AND ADOLESCENT GYNECOLOGY Faculty Nicole W. Karjane, MD, Associate Professor of Obstetrics and Gynecology and Pediatrics Clinical Program The Pediatric and Adolescent Gynecology (PAG) program at VCU began in 2004 and has been growing ever since. The program cares for patients from birth to adolescence who present with a wide variety of problems including vulvovaginitis, labial adhesions, trauma, pubertal aberrancies, menstrual irregularities, congenital anomalies of the reproductive tract, and pelvic and abdominal masses. In addition, we provide gynecologic care for young women with developmental delay or other handicaps. Dr. Karjane sees patients in the Nelson Clinic and at the Women’s Health Center at the Stony Point campus. In 2013, we plan to expand the program by adding another generalist with expertise in PAG. The primary goals of the PAG program are to provide high quality, compassionate care of the pediatric and adolescent gynecology patient; to continue physician referral feedback and to serve as consultants to physicians in the community; and to continue to educate residents and students in the field of PAG. OB/GYN residents rotate in the PAG clinic during their PGY-2 year as part of the rotation in Reproductive Endocrinology and Infertility. In addition, Pediatric residents occasionally rotate through the PAG clinic as part of their Adolescent Medicine rotation. Dr. Karjane actively teaches medical students and residents during rotations as well as through lectures. Lectures topics include but are not limited to teen pregnancy prevention, menstrual disorders in adolescents, the gynecologic evaluation of the child, and primary amenorrhea.

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CERTIFIED NURSE MIDWIVES Faculty Meghann Batten, MSN, CNM, Assistant Clinical Professor, Director of Midwifery Services Kathryn Beaton, CNM, Assistant Clinical Professor Brenda Brickhouse, MS, CNM, WHNP-BC, Assistant Clinical Professor Leslie Fehan, MSN,CNM, WHNP-BC, Assistant Clinical Professor Amber Price, MSN, CNM, Assistant Clinical Professor Introduction The VCU Nurse-Midwifery service is an ever-growing presence within the department. Offering low intervention natural childbirth, the midwives provide women with an alternative birthing experience at VCU. The midwives have established a strong, collaborative relationship with the generalist physicians, enhancing our delivery of safe, evidence-based maternity care to women. We also offer a unique educational perspective as specialists in normal birth. Clinical Activities The nurse-midwives' primary focus is on clinical care. The midwives staff over 20 clinic sessions per week at our Stony Point and Nelson Clinic locations, offering the full scope midwifery care across the lifespan. In addition, the midwives provide staffing to the Rappahannock Area Health Department system and support residency education by staffing labor and delivery during the resident didactic sessions each week. The midwives also run our CenteringPregnancy program and act as facilitators for the majority of the groups. We also showed a strong presence in labor and delivery with 180 women delivering with the midwifery service in 2012. The nurse-midwives offer low-intervention birth services to women desiring natural childbirth, including women desiring a trial of labor after cesarean. The midwives are proud of their 87% vaginal birth rate for 2012 and 79% VBAC success rate. The nurse-midwives created and successfully implemented a portable hydrotherapy system to maintain tub accessibility during labor and delivery renovations. We also worked with the renovation planning committees to increase our offerings of hydrotherapy in the new Labor and Delivery Unit that opened in August 2013. Education The nurse-midwives play an active role in education within the department. We act as preceptors for students from the VCU School of Nursing, Georgetown, and Frontier School of Midwifery. We also provide labor and delivery education to the OB/GYN and off service residents during our labor and delivery coverage, as well as having residents observe midwife birth practices. Academic Highlights Grants Strong Start $1 million

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Auxiliary grant $9100 March of Dimes $35,267 March of Dimes STEP grant: CenteringPregnancy Assessment at Stony Point $3000 Chapter grant: High Risk Centering $27,695 STEP grant: Integrating residents into Centering $2942 Lectures/Presentations/Speaking events Virginia Commonwealth University Birth Matters of Virginia NPR

Faculty: Meghann Batten, MSN, CNM was named Director of Midwifery Services in 2012. She oversees the midwifery practice, tracks and reports statistics for the midwives, and acts as a liaison to the medical director of the midwifery service. She serves on the Executive Board for the Council of Advanced Practice Professionals within the health system and assisted with formatting and revising credentialing paperwork. She has spoken at Birth Matters and VCU School of Nursing events and served as preceptor to midwifery, WHNP and FNP students. She also maintains a busy full scope midwifery clinical practice. Kathryn Beaton, CNM served as CenteringPregnancy Director in 2012. As director, she helped VCU attain over a million dollars in grant funding to maintain and expand the CenteringPregnancy program at VCU. She serves as a primary CenteringPregnancy facilitator and as a Centering Core team member. She is also a preceptor to nurse-midwife, WHNP and FNP students and has provided SIM lab training to medical students. In addition to her active role in Centering, she provides full scope midwifery care at VCU. Brenda Brickhouse MS, CNM, WHNP-BC maintains a busy clinical practice, providing full scope midwifery care. She also provides CenteringPregnancy care and serves as a Centering Core team member for the Stony Point location. She wrote and received grant monies from the March of Dimes for a CenteringPregnancy assessment at Stony Point. She led the team in creating and coordinating a portable hydrotherapy system for use during our labor and delivery renovations and collaborated with the construction teams to develop the new hydrotherapy offerings in the renovated Labor and Delivery unit. Leslie Fehan MSN, CNM, WHNP-BC joined the VCU Nurse-Midwives in 2013. This was more of a homecoming as she was first a nurse-midwife at VCU in 1998. In addition to the busy VCU midwifery service, she provides care at the Rappahannock Area Health Department system. She spoke at a Birth Matters event and edited online nursing modules and test questions for Lippencott/Wiley Obstetric Hemorrhage and Induction of labor. She has an interest in

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education and has taken on the role of student coordinator for the nurse-midwives to assist with student placements and better tracking of students from outside institutions. Amber Price MSN, CNM took over as CenteringPregnancy Director in 2013. Her new role coincided with the receipt of the Strong Start grant, whose goal is to put 1200 Medicaid-funded women through the CenteringPregnancy program in the next three years. She has pioneered a hybrid model for high risk women to participate in Centering and is working on strategies to increase recruitment and retention in the program. She has spoken about midwifery at the VCU School of Nursing, on NPR, and at multiple Birth Matters events. She also provides education on normal birth to OB/GYN and off-service resident physicians while covering labor and delivery each week. She does all of this while also maintaining a full midwifery clinical practice.

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MATERNAL FETAL MEDICINE Faculty Ronald Ramus, MD, Professor, Division Director, Thomas Peng, MD, Professor Susan Lanni, MD, Associate Professor Fidelma Rigby, MD, Associate Professor John Seeds, MD, Professor, Chairman Emeritus, Scott Walsh, PhD, Professor Lauren Vanner-Nicely, MS, Genetic Counselor Division Administrative Assistant Amy Helvey High Risk Clinic Coordinator Karen Brown, RN Ultrasound Supervisor Donna Justis, RDMS

Introduction The 2012-2013 academic year can be characterized as a year of stability for the Division of Maternal-Fetal Medicine. The prior academic year, we doubled in size and brought in a new Division Director. In the next academic year we will move into our brand new Labor & Delivery unit. This year the focus was on preparing for the transition to a new L&D facility. The Division’s clinical responsibilities remain focused on the care of women that will deliver at VCU. These patients come from our clinics on campus, our Stony Point office south of the James River, the regional Health Department Clinics. We care for patients referred from providers in the community with significant complications or special needs best met at VCU. We also provide consultation services for local physicians. We continued our relationship with the Bon Secours Hospital system here in Richmond by providing MFM services at St. Francis Hospital two days a week.

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Clinical Activities The MFM Division staffs all the High Risk OB Clinics at VCU (four half-days each week). In this clinic we supervise and teach residents and medical students to provide prenatal care for women with complicated pregnancies. Many of these patients are pregnant women initially seen at regional Health Departments that required referral for specialized care. We also staff the antepartum service for inpatients at VCU. Rounds are done on a daily basis with the third year resident running the service and any assigned medical students. The physicians in our Division each have their own private practice to provide more personalized care for women with complex pregnancies. Dr. Ramus sees patients at our Stony Point office, and Drs. Peng, Lanni, and Rigby provide this service at our Nelson Clinic office on the main campus of VCU. The Division is responsible for the provision of all ultrasound services in the Department. Our main site is in the Nelson Clinic. We have three ultrasound machines (two Voluson E8’s and one E6) and a room for antenatal testing (two NST machines). We perform both obstetric and gynecologic ultrasound in this suite. We work with a group of four full-time sonographers, and residents in Radiology and Ob/Gyn receive their ultrasound training with us at our Nelson Clinic site. We also have a satellite ultrasound facility at Stony Point (with one Voluson E8) so that patients receiving care there can also get their ultrasound studies performed at the same convenient location. Genetic counseling services are provided by Lauren Vanner-Nicely. Lauren is a Board Certified genetic counselor in our Division, and typically sees patients in our Nelson Clinic ultrasound suite. Lauren coordinates our first trimester screening program, and facilitates specimen ordering and communication of results to patients when we perform chorionic villous sampling, amniocentesis, or fetal blood sampling. Education The Division is very involved in the educational mission of the Department. Daily work rounds are performed with the residents and medical students in Labor and Delivery; the MFM Attending on the Antepartum service is present at these rounds to discuss patients in L&D, in addition to interesting cases seen the night before. We work closely with our house officers assigned to the antepartum service on inpatient care, and see patients together with our residents and students in clinic and ultrasound.

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Dr. Fidelma Rigby serves as the supervisor of all medical student education within the Department. She arranges the fourth year student rotations that include blocks on Labor & Delivery, the antepartum service, or ultrasound. There is also a specialized elective (longitudinal AI) that stations a student in clinic for most of their fourth year to follow patients over a longer period of time, to help foster the concept of continuity of care, and to be involved throughout an entire pregnancy (including delivery). The residents and medical students receive significant didactic teaching during the academic year. This mainly occurs on Monday afternoons and at Grand Rounds on Thursday morning. Our Division is responsible for all lectures that cover topics in Maternal-Fetal Medicine, and some of the material relating to Obstetrics. There is a course on Reproductive Medicine for the second year medical students; Dr. Rigby also supervises this course and the MFM faculty lecture to these students on relevant topics. Division members also are active in providing continuing medical education through regional presentations and participation in postgraduate courses. Research Activities The Division actively participates in the research performed within the Department. This includes both basic research (see separate section for details) and clinical research. Several faculty made presentations at national meetings, served as journal reviewers, and published papers. The Division Director is the principle investigator of a grant evaluating the model of Centering in Pregnancy for High Risk patients, which is funded by the March of Dimes.

Academic Highlights for the year Publications: Rigby FB, Goldberg A, Webb C, Chelmow C. Working Toward the Milestones: Revamping of Longitudinal OB/GYN Curriculum. Poster presentation at CREOG/APGO Annual Meeting, Phoenix, Arizona February 2013. Anemia and Thrombocytopenia in Pregnancy. Medscape Chapter Update, January 2013. Cholestasis of Pregnancy. Medscape Chapter Update, January 2013. Co-chair of the working group that wrote PROLOG Patient management in the office, 6 th edition

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Drafting of Guidelines for serious safety even reporting and review for ACOG (in press) Lectures: Ob/Gyn Core Lecture Series at VCU Department of Pediatrics Grand Rounds at VCU Department of Ob/Gyn Grand Rounds at VCU VCUHS Patient Safety Conference Ware-Dunn Society Annual Meeting Grand Rounds at Univ. South Carolina. Hemoglobinopathies in Pregnancy April 2013.

Editorial Boards and Committees: ACOG Ethics Committee CREOG In-Training Examination Committee Abbott Research Award on Nutrition in Pregnancy Committee Medscape Reference Virginia State Board of Health CDC Maternal Mortality Review Committee Advisor

Journal Reviews: Obstetrics & Gynecology American Journal of Obstetrics & Gynecology

Honors and Awards: Best Teacher, MII Womens Health Course, 2012-3 Outstanding Teacher Award : OB/GYN Clerkship 2013 APGO Scholar 2011-13 Enrique Gerszten Faculty Excellence in Teaching Award in 2013 CREOG National Faculty Teaching Award, VCU Ob/Gyn Residency Program, 2013.

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Faculty: Ronald Ramus, MD joined the Department in August of 2011. After completing residency training at UTSW/Parkland Memorial Hospital and fellowship at UCSF he spent 11 years on the faculty of UT Southwestern. This was followed by 7 years running the Perinatal Service for the Bon Secours system (3 hospitals) in Richmond. In 2011 he felt the calling to join VCU to return to full-time academic practice. In addition to running the Division he is the medical director of our Ob/Gyn Ultrasound service, leads the Perinatal Practice Committee, and is a member of the Obstetric QA Committee. He is an editor of the eMedicine Ob/Gyn textbook and a reviewer for the Green Journal and Gray Journal. In 2013 he received the CREOG Faculty Teaching Award from the Ob/Gyn residents at VCU. He is the Principal Investigator for the Centering in Pregnancy grant looking at this model of prenatal care in high risk pregnancies. Susan Lanni, MD has worked in the Department for 14 years. She completed residency training at Penn State/Hershey Medical Center and did her fellowship at Brown University. She serves as medical director of Labor & Delivery at VCU. She works on the statewide multidisciplinary team that assesses maternal mortality, and is involved in the publishing of their summary reports. She is the principal investigator of the Virginia Department of Health grant-supported regional Infant mortality team. She is also a co-investigator in studies of the vaginal microbiome in high risk obstetric patients and the use of umbilical blood stem cells for regenerating hepatic cells. She has been named to Richmond's Top Doc list numerous times, and has been an invited speaker at many VDH sponsored conferences. Her interests include management of the obese gravida, diabetes in pregnancy, cardiovascular disease in pregnancy, prenatal diagnosis and fetal echocardiography. Thomas Peng, MD has spent over 20 years teaching and practicing Maternal-Fetal Medicine, mostly at VCU. He was a resident, and completed his fellowship at Johns Hopkins Hospital. He is an editor of the eMedicine Ob/Gyn textbook and serves as Department liaison to the VCU hospital system on our electronic medical record due to his experience and expertise in this area. He is a member of the following ACOG committees: 2011 Co-chair of the PROLOG Patient management in the office, 6th edition, 2012 Clinical document review committee, Abbott Research Award on Nutrition in Pregnancy Committee, the CREOG In-Training Examination Committee and the MFM Section leader of the CREOG In-Training Examination Committee. Fidelma Rigby, MD continues her active teaching roles at VCU. She was a resident, and completed her fellowship at LSU New Orleans. This year she oversaw the graduation of 12 seniors matching in OB/GYN and is preparing for the next senior class of 22 students. She continues in her roles as third year clerkship director, mentor to the OB/GYN interest group and

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fourth year mentor/elective director. She is the Director of our second year Women’s Health Course. She is overseeing this courses evolution into a new Reproductive Health course in the new medical school curriculum, which will happen in 2014. She continues as Co-Director for the second year Careers in Medicine Course. She graduated from the APGO Scholars Program this year; this was a 15 month mentoring process to further her teaching and leadership skills. She serves on the Medical Schools Teaching Awards Committee. She was inducted into the VCU Chapter of Alpha Omega Alpha Medical Honor Society in April 2013. She was again awarded a teaching pin for the highest rated teacher in the MII course. Finally, Dr. Rigby was honored to receive the Enrique Gerszten Faculty Excellence in Teaching Award in 2013. This is the highest award given to a faculty member at VCU annually in recognition of their teaching accomplishments. John Seeds, MD is the former Chairman of the Department. He is now Senior Associate Dean for Professional Education Programs at VCU, but continues to work part-time in the Division, primarily in our ultrasound suite. He serves as Vice Chair of the ACOG Ethics Committee, is a member of the Virginia State Board of Health and is on the Board of the Virginia Birth Injury Compensation Program.

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REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY Faculty: Richard S. Lucidi, M.D. – Director, Reproductive Endocrinology and Infertility and Medical Director, VCU Center for Advanced Reproductive Medicine, Associate Professor PonJola Coney, M.D. – Senior Associate Dean for Faculty Affairs, Professor Introduction: The REI division continued to grow during the 2012-1013 academic year. Division members were very active with clinical, academic, educational and administrative activities. Division members perform these activities at multiple sites including: Medical College of Virginia Hospital (MCVH), Stony Point Women’s Health, Stony Point Surgical Center and Virginia IVF and Andrology. Of special note this year, Dr. PonJola Coney was elected to the Institute of Medicine, one of the highest honors in the fields of health and medicine. Clinical Highlights: Our assisted reproductive technologies treatment volume increased from 19 cycles in 2011 to 34 cycles in 2012 and 72 cycles in 2013. We have expanded our treatment capabilities and had our first successful donor oocyte and donor embryo pregnancies as well as two successful preimplantation genetic diagnosis (PGD) pregnancies. We have also expanded our fertility preservation treatments for cancer patients. Division members have established beneficial relationships with other departments including Endocrinology, Pediatric Endocrinology, Urology, Oncology and Genetics. Dr. Lucidi was listed in the annual “Richmond’s Top Docs” edition of Richmond magazine. Academic Highlights: Education: The Division continues to be involved in all educational aspects of the Department including student and resident teaching. Division members are actively involved in teaching of Virginia Commonwealth University medical students. Division member participate in the second year Women’s Health course by leading the REI small group sessions. Third year medical students spend one week on the REI service during their OB/GYN rotation. Division members are also actively involved in instruction of the OB/GYN residents. Second year residents spend 8 weeks on REI which includes experience in the clinic, operating room and embryology

2012-13 OB/GYN Annual Report - 24 lab. In addition, Division members regularly participate in the Department’s didactic lecture schedule and Journal Club. Medical Endocrine fellows spend one half day per week with Dr. Lucidi. Dr. Lucidi received the Association of Professors of Gynecology and Obstetrics National Faculty Award in 2013. Research: Dr. Lucidi was the Principal Investigator at VCU for the Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) study. This large multicenter trial compared clomiphene with letrozole for the treatment of anovulatory infertility in women with PCOS. This study has successfully completed enrollment and data collection and publication is pending. Women who conceived during the PPCOS II study were offered enrollment in the Pregnancy Registry study which followed them through the pregnancy and the children conceived through three years of life. Dr. Lucidi is also the PI for this study. Dr. Lucidi is also PI on a recently started, industry sponsored study that will evaluate the efficacy of a novel new drug for the treatment of pelvic pain due to endometriosis. This study, known as Violet Petal, is sponsored by AbbVie. Editorial Boards: Dr. Lucidi is the Chief Editor of Medscape Reference – Reproductive Endocrinology and Infertility. Journal Review: The REI faculty regularly review articles for multiple journals, including: Reproduction, Fertility and Sterility, and Obstetrics and Gynecology. Administrative Highlights: Dr. Coney continues to serve as the Senior Associate Dean for Faculty Affairs and Director of the Virginia Commonwealth University Center on Health Disparities. Dr. Lucidi is the Division Director of the Division of Reproductive Endocrinology and Infertility and Medical Director of the Assisted Reproductive Technologies (ART) practice. Faculty Highlights: Richard S. Lucidi, M.D.: Scott is a graduate of the Saint Louis University School of Medicine. He completed his residency in Obstetrics and Gynecology at the University of South Florida and his fellowship in Reproductive Endocrinology and Infertility at the University of Texas Health Science Center at San Antonio. Scott continues his busy clinical practice at Stony Point focusing on reproductive

2012-13 OB/GYN Annual Report - 25 endocrinology and infertility. He continues as the Medical Director of the VCU Center for Advanced Reproductive Medicine and as the Division Director for Reproductive Endocrinology and Infertility. PonJola Coney, M.D.: PJ is a graduate of the University of Mississippi School of Medicine. She completed her residency in Obstetrics and Gynecology at the University of North Carolina and her fellowship in Reproductive Endocrinology and Infertility at Pennsylvania Hospital. Dr. Coney continues as Senior Associate Dean of Faculty Affairs and Director of the Virginia Commonwealth University Center on Health Disparities. She remains active clinically seeing patients at Stony Point Women’s Health. This year PJ was elected to the Institute of Medicine, one of the highest honors in the fields of health and medicine.

2012-13 OB/GYN Annual Report - 26 GYNECOLOGIC ONCOLOGY

Faculty Weldon Chafe, MD Professor Introduction The 2012 – 2013 academic year was a transitional year for the Division of Gynecology Oncology at Virginia Commonwealth University Medical Center. As a division we remain committed to the mission of teaching, clinical service and clinical research at VCU. Early in the year, Dr. Cecelia Boardman departed the division to enter private practice. The activities of the division were carried on while a search was conducted for her replacement. Dr. Jori Carter was recruited from fellowship training at the University of Minnesota and will join the faculty at VCU in September 2013. Melissa Foster ARNP joined the division in November 2012 and was quickly integrated into all services provided by the division. Clinical activities The division has remained extremely active and productive clinically, providing full service gynecology oncology care to women from Richmond and the surrounding. Clinics were held all day Monday and Wednesday in Dalton Oncology clinic in the Massey Cancer Center and one half day each week on Thursday at the Stony Point Women’s Health Center. Surgery was carried out on Tuesdays and Fridays and on other occasions as warranted by the demands of the service. Full consultative care is provided in the ambulatory setting at Stony Point and Massey. Services provided in our clinics included surgical education and scheduling as well as active ambulatory chemotherapy. Patients on active treatment and those who have completed treatments for an assortment of gynecologic cancers are also seen on a regular basis. Education and Research The division is involved in all educational aspects of the department, including student and resident education. The longitudinal Acting Internship at the M-IV student level, introduced in 2011, has continued to be a popular rotation. An M-II student was proctored in the fall semester in the Foundations of Clinical Medicine Course. The weekly Multidisciplinary Gyn Onc Tumor Board continues to provide a forum for discussion of all active patients. Details of patient care, radiological investigations and pertinent pathology are reviewed on each patient presented and dispositions for future care discussed. Inclusion on active clinical trials is a major focus of discussion for each patient. This past year, 662 patients were presented at our tumor board for discussion and planning of care. A total of 17 patients were enrolled on GOG clinic trials in the past year, with considerable discussion and evaluation of many others. We were somewhat hampered by lack of open trials

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for uterine cancer, our number one disease site. Overall 120 patients were considered and actively discussed for inclusion on a clinical trial. Academic highlights for the year Journal Reviewers Journal of Surgical Oncology Obstetrics and Gynecology Local, Regional and National Lectures Obstetrics and Gynecology Core Lecture series at VCU M-II Lectures in Gynecology Oncology Sports Backers Richmond Virginia Newfoundland and Labrador Athletic Association Health Fair (Athletes North East) Honors and Awards US News Magazine Top Doctors in America Richmond Magazine “Top Docs in Richmond” Faculty Highlights: Weldon Chafe, MD continues to serve a division director of Gynecology Oncology. Over the past year he continued to be an active member of the Gynecology Oncology Group by participating in enrolling a number of patients on clinical trials for both treatment and prevention of a variety of gynecologic malignancies. He continues to serve as a peer reviewer for the Journal of Surgical Oncology and Obstetrics and Gynecology. He was named again to Richmond’s Magazine “Top Docs in Richmond “for 2013.

Melissa Foster, WHNP-BC,OCN joined the division in the fall of 2012 after working as an oncology staff nurse at MCVH for 3 years. She has very quickly distinguished herself as an important member of the oncology team and has championed the cause of chemotherapy management for the service. She presented a poster on “Down with the Neutropenic Diet” at the Oncology Nursing Society Annual meeting in Dallas in November 2013.

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Female Pelvic Medicine and Reconstructive Surgery Faculty Edward J. Gill, MD – Division Chief and Professor Ashley P. Carroll, MD – Assistant Professor Elizabeth Lamb, WHNP Introduction The Division of Female Pelvic Medicine and Reconstructive Surgery (FPMRS) enjoyed another productive year with several academic and research projects. It continued its busy clinical practice, providing subspecialty care for women with both common and complex pelvic floor disorders at the Nelson Clinic and Stony Point offices. Female Pelvic Health and Continence Program The Female Pelvic Health and Continence Program is a multi-disciplinary project which provides outstanding specialty care to the women of central Virginia and beyond. It includes specialty representation from Urogynecology, Urology, Colorectal Surgery, Gastroenterology and Pelvic Floor Physical Therapy. It is a referral center for all women with Pelvic Floor Disorders including urinary and anal incontinence, pelvic organ prolapse, voiding disorders, and defecatory dysfunction. In addition, the combined expertise is invaluable for evaluating and treating more complex problems including genital and gastrointestinal tract fistulas and congenital anomalies. Clinical Activities The clinical practice continues to thrive with referrals from throughout the Commonwealth and beyond. All options for evaluation and treatment of pelvic floor disorders are available and utilized. Our minimally invasive focus on treating pelvic floor disorders including the robotics program has been very successful. In addition to general urogynecology, Dr. Carroll’s specialties include Interstim as a treatment for urinary and anal incontinence, and endoanal ultrasound for the evaluation of anal incontinence. She has also developed the Perineal Clinic, a busy specialty clinic for women who have sustained pelvic floor disorders from childbirth. Education Education remains a top priority for the division, focusing on subspecialty fellowship training, resident and medical student education. Dr. Carroll is the Associate Residency Program Director and director of Simulation for Gynecology Surgery education at VCUMC. Drs. Carroll and Gill have been speakers at postgraduate meetings and Dr. Carroll was an invited lecturer at the International Urogynecology meeting in Ireland this year. Research and other Academics The division has published several papers this year as well as several abstracts. In addition to presenting their work at the American Urogynecology Society (AUGS) national scientific meeting in Las Vegas, Dr. Carroll taught a post graduate course at the International Urogynecology (IUGA) scientific meeting in Dublin. Dr. Gill recently completed his term as the AUGS representative to the National Quality Forum GI/GU Steering Committee.

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Faculty: Ashley Carroll, MD completed a three year fellowship in Female Pelvic Medicine and Reconstructive Surgery at the VCU Medical Center. She received an additional appointment in the Division of Urology, Department of Surgery. She serves as the Medical Director of the Women’s Surgical Unit as well as the Associate Residency Program Director. She attended the annual meetings of both IUGA and AUGS where her research was presented. She leads the simulation training for gynecology surgery program and she was recently awarded the National CREOG faculty award for excellence in resident education. She is editor for a new case based textbook on acute care and emergency gynecology. Edward J. Gill, MD is the Division Chief of Female Pelvic Medicine and Reconstructive Surgery (FPMRS). He was promoted to Professor and received an additional appointment as Professor in the Department of Surgery, Division of Urology. In addition, he is a member of the first group to ever achieve Board Certification in FPMRS which was awarded this year. He serves on several hospital and department committees and chairs the GYN Practice Committee. He maintains a busy clinical practice based at the Stony Point office and was honored with a “Top Doc” in Urogynecology from Richmond Magazine and was named a US News Top Doctor. He has published several articles this past year. Most recently, Dr. Gill completed his term serving on the National Quality Forum GI/GU Steering Committee. Elizabeth Lamb, WHNP. Beth continues in her role as the Case Manager for Urogynecology, which she has done for the last 13 years. She also maintains a busy clinical practice at both the Stony Point and Nelson Clinic offices. Beth is an invaluable resource to the nurses on the postoperative floor, coordinating both pre- and post-operative care for our Urogynecology surgery patients. She is a featured lecturer at the VCU School of Nursing and serves a preceptor for nursing and nurse practitioner students. She leads the Pelvic Floor Center’s program for Posterior Tibial Nerve Stimulation for treating incontinence. Beth also maintains an extensive database for our division that has been instrumental in many of our recent published papers and research projects.

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Research

2012-13 OB/GYN Annual Report - 31 Division of Reproductive Biology Research Annual Report Faculty Scott W. Walsh, Ph.D., Division Chief and Professor Elizabeth A. McGee, M.D., Associate Professor Jerome F. Strauss, III, M.D., Ph.D., Professor and Dean of the School of Medicine Zhibing Zhang, Ph.D., Associate Research Professor Eun Lee, Ph.D., Adjunct Assistant Professor Joint Appointed Faculty Kimberly Kay Jefferson, Ph.D., Assistant Professor, Department of Microbiology and Immunology Karen Dolores Hendricks-Munoz, M.D., M.P.H., F.A.A.P., Professor, Department of Pediatrics, Division of Neonatology Timothy P. York, Ph.D., Assistant Professor, Department of Human Genetics and Molecular Genetics Students and Postdoctoral Fellows William H. Nugent, Ph.D., Postdoctoral Fellow Maria Teves, Ph.D., Postdoctoral Fellow Bhavi Madi, Ph.D. Graduate Student Wei Li, M.D., Postdoctoral Fellow Research Personnel Sonya L. Washington, M.S., Research Coordinator, Lab Specialist Sara Wagner, R.N., Research Nurse

Summary of Division Research Researchers in the Division of Reproductive Biology Research are actively pursuing research in several areas important to women’s health, including preterm birth, preeclampsia, ovarian function and sperm motility. Research is supported by grants from the National Institutes of Health (NIH), VCU Massey Cancer Center and Novartis. An NIH Center Grant from the National Institute on Minority Health and Health Disparities is supporting a multidisciplinary research team in basic and clinical research that will help identify African American women at risk of adverse pregnancy outcomes and evaluate new interventions to improve maternal and neonatal health. Dr. Strauss who is a member of the Division and Dean of the School of Medicine is the PI for the Center. Dr. Walsh is PI for the Center’s Research Core. The primary focus of the Center is to explore reasons for the high occurrence of preterm birth among African Americans, which is one of the leading causes of infant morbidity and mortality. Dr. Strauss’s project is focused on genetic mechanisms relating to preterm birth. Dr. Walsh is pursuing studies relating to epigenetic and inflammatory mechanisms. Dr. York is evaluating social, economic, behavior and stress-related measures relating to

2012-13 OB/GYN Annual Report - 32 epigenetic mechanisms of preterm birth, and Dr. Jefferson is studying the vaginal microbiome and altered vaginal flora as a cause of preterm birth. Dr. Strauss also has active research programs concerning admixture mapping of preterm birth genes, linkage studies for polycystic ovarian syndrome (PCOS) and in collaboration with Dr. Jefferson studies concerning disease, genetics and environmental influences on the vaginal microbiome. Dr. Walsh’s research on preeclampsia is investigating the immunological role of neutrophils as a cause of preeclampsia. Studies have demonstrated extensive infiltration of neutrophils into systemic vasculature of mothers with preeclampsia where they induce vascular inflammation and enhance vascular responsiveness to vasoconstrictor hormones. Research also focuses on epigenetic alterations in genes involved in inflammation that may be caused by neutrophil induced vascular inflammation. In addition to preterm birth and preeclampsia, Division researchers have active programs related to PCOS, infertility related to dysfunctional sperm motility, and the microbiome of the preterm infant. Studies relating to PCOS conducted by Dr. McGee concern signal transduction mechanisms that regulate growth of ovarian follicles. She has found that transforming growth fac proteins play important roles in follicular development and gene knockout mice that lack certain SMAD proteins have abnormal follicular development. Dr. Zhang has shown SPAG6, a central pair apparatus protein of cilia, has an important role in spermiogenesis and sperm motility. Dr. Hendricks-Munoz is studying the microbiome of the preterm infant and how it relates to later risk of obesity.

Highlights of the Year The American Heart Association and the North American Society for the Study of Hypertension in Pregnancy invited Dr. Walsh to be a plenary speaker for their meetings. Magee-Women’s Hospital at the University of Pittsburgh invited Dr. Strauss to present the Margaret Prine Joy Lecture and the Celebration of Life Lecture, and the University of California at San Francisco invited him to present the Earnest W. Page Lecture. Division members published papers in several prestigious journals: Hypertension, Reproductive Sciences, American Journal of Pathology, American Journal of Physiology-Cell Physiology, Fertility and Sterility, PLoS One, Andrology and Molecular Human Reproduction, Diabetologia, Journal of Clinical Endocrinology and Metabolism, BMC Urology, Journal of Women’s Health, Andrology, American Journal of Respiration and Cellular Molecular Biology. Division members served on several Editorial Boards: Reproductive Sciences, Hypertension in Pregnancy, Reproduction, Gene Expression to Genetical Genomics, International Journal of Gynecological and Obstetrical Research, Journal of Andrology & Gynecology, and the Medical Journal of Obstetrics/Gynecology.

2012-13 OB/GYN Annual Report - 33 Members reviewed papers for: Placenta, Reproductive Sciences, Hypertension, Hypertension Research, Molecular Human Reproduction, Systems Biology of Oxidative Stress, PLoS ONE, Human Pathology, and Molecular and Cellular Endocrinology, Cilia. Members served on regional and national organizations, including Women's Health and the Membership Committee of the American Society of Andrology. Faculty Elizabeth A. McGee, M.D. is a reproductive endocrinologist conducting research in the regulation of ovarian function. Her studies concern signal transduction mechanisms that regulate growth of ovarian follicles. She presented several abstracts at national and international professional meetings on both the biology of the vaginal mucosa and the role of growth factors in ovarian function. She mentored a postdoctoral fellow, an undergraduate in the VCU HERO program, and medical students in summer research. Clinically, she worked in clinics at both Nelson and Stony Point. She received specialized CME in sonography over the past three years and was included in the recent AIUM recertification of the OB/GYN Ultrasound unit. Dr. McGee resigned her position June 30, 2013 for a position in the Department of Obstetrics and Gynecology at the University of Vermont. Jerome F. Strauss, III, M.D., Ph.D. is Dean of the School of Medicine and Executive Vice President for Medical Affairs for VCU Health System. Despite his busy administrative role he remains involved in the research efforts of the division. He is the overall PI of the Center Grant from the National Institute on Minority Health and Health Disparities, as well as the PI or co-investigator on other grants in the division and medical school. Dr. Strauss meets weekly with students and faculty regarding ongoing research in the division. He is also active in the training and mentoring of graduate students and postdoctoral students in the division. Scott W. Walsh, Ph.D. is Division Chief. He is the PI of a R01 NIH grant from the National Heart, Lung and Blood Institute and he is the PI of the Research Core of the Center Grant from the National Institute on Minority Health and Health Disparities. He directs active research programs in preeclampsia and preterm birth in which he trains graduate students and postdoctoral students. Dr. Walsh also teaches endocrinology and reproductive physiology in the Department of Physiology and Biophysics. He teaches in courses for medical students, dental students, nursing students, certificate students and graduate students. He served on two committees for the development of the new medical school curriculum and chaired the Department of Obstetrics and Gynecology Promotion and Tenure Committee for two faculty. He is active in the Society for Gynecology Investigation and has won several SGI President’s Presenter Awards for presentations at the society. Zhibing Zhang, M.D., Ph.D. During the past year, Dr. Zhang submitted 2 NIH R01 proposals, one of which was funded. He submitted four manuscripts for publication, two of which have been published. He also served as a committee member on VCU and national organizations and was invited to review manuscripts for several journals. Dr. Zhang has an active molecular research program in the area of cilia and sperm motility.

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Education

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Medical School Education The Department of Obstetrics and Gynecology at the VCU MCV Campus is the primary teaching site for the VCU School of Medicine’s third year clerkship. In addition, students rotate to the INOVA campus for their third and fourth years. Dr. Fidelma Rigby is the Clerkship Director for VCU on the MCV Campus. She works closely with Dr. Emily Marko who is clerkship director for our INOVA campus. Drs Rigby and Marko are both extensively engaged in implementing the new Milestones portion of the OB/GYN educational experience. Dr. Rigby graduated from the APGO Scholars program in March 2013 and Dr. Marko was recently accepted into the program. Both of their program topics included working on Milestone I, which involves the preparation students need as they enter an OB/GYN residency. The experience offered during our 6 week third year rotation covers the full range of general obstetrics and gynecology as well as exposure to the subspecialties of reproductive endocrinology, gynecologic oncology, and maternal fetal medicine. We have recently starting sending third year students for rotations at Planned Parenthood and the Olde Towne Medical Center in Williamsburg and are very happy to be able to offer these additional experiences. We are also talking with other local hospitals about the possibility of rotating third year students to their campuses. Student experience on the rotation involves direct patient care in both inpatient and outpatient settings, night or day shifts on Labor and Delivery, an REI rotation and the recent addition of a GU rotation. Dr. Chelmow’s Chair rounds, where he meets weekly with the students on the rotation to discuss cases from the previous week, continue to be very popular. In addition, we have weekly Case Based conferences which are followed by Practical Sessions such as knot tying and simulated deliveries. We make good use of the hard work Dr. Ellen Brock has put into the Simulation Center, using it for our orientation sessions as well as our final practical exams. The students very much enjoy the opportunity to have one on one faculty interaction with Dr. Pierce at the Crossover clinic and Dr. O’Connell at the Henrico Health Department. Our fourth year medical student curriculum continues to evolve. We currently have Acting Internships in Ultrasound, Labor and Delivery Days and Nights, GYN, GYN Oncology and High Risk Obstetrics. We have recently added Longitudinal Internships in Oncology, Crossover Clinic and Routine OB clinic. In addition, work continues on the Milestones project. The biggest challenge currently facing the medical school education division is the evolution of the medical curriculum which coincides with the completion of the new medical school. Dr. Rigby is chair of the Committee designing the Reproductive Course for the new curriculum for the medical school and we are all hard at work trying to help our faculty adjust to more active learning in the classroom. The next annual report will update the creative responses we will have to the challenge of using active learning techniques for the 215 students in our revamped three week Reproductive Course this Spring! We may be a little tired as we give the old version of the course in March to the current second year class and then give the revamped version 5 weeks (!) later at the end of the new MI curriculum.

2012-13 OB/GYN Annual Report - 36 Our current roster of Case Based Conferences, which are led by the faculty on Monday afternoons, includes: Pap Smear Sexually Transmitted Diseases Gyn Cancers Ectopic Pregnancy Infertility Amenorrhea and Hirsutism Preterm Labor Hypertension in Pregnancy Abnormal Uterine Bleeding Third Trimester Bleeding

2012-13 OB/GYN Annual Report - 37 RESIDENCY PROGRAM The Virginia Commonwealth University Residency Program had another outstanding year and continues its long tradition of high quality training and excellence in all aspects of Obstetrics and Gynecology. Our affiliate, CJW Medical Center, continues to provide important training opportunities for our residents. In addition, we developed a new affiliation with Southside Regional Medical Center for further surgical training opportunities. Over the course of the year, our residents continued to provide outstanding clinical care and have made significant contributions to the field. As usual, our faculty and residents received high praises from students for their teaching efforts. Virginia Commonwealth University Medical Center: VCU Medical Center continues to be the primary site for the residency program and provides a diverse patient population in Obstetrics and Gynecology with depth and breadth of disease processes. The department continues to be quite stable, and the faculty members provide exceptional clinical care, teaching, and scholarly activity. In addition to handson patient care and educational experiences, residents continue to benefit from our simulation curriculum in the state-of-the-art Center for Human Simulation and Patient Safety. CJW Medical Center: CJW Medical Center continues to provide a superb training experience for one resident per block. Under the supervision of Dr. Randy West, the residents focus on their surgical skills as they work with him in his busy Gynecologic Oncology practice. During this rotation, residents acquire a tremendous volume of cases in gynecologic surgery, including robotics. We are grateful to Dr. West for his dedication to resident training. Southside Regional Medical Center: In January, we began an affiliation with Southside Regional Medical Center. Under the direction Dr. Keith Roberts, Dr. Tracey Jones, and Dr. Charles Smith, our PGY3 residents perform gynecologic surgery five days per week. This rotation has proven to be a great success and has served to drastically improve resident exposure and skill in performing vaginal hysterectomies. Residency Administration: Dr. Nicole Karjane made a smooth transition into her role as Program Director. In addition, our Program Coordinator, Donna Barrett has continued to do an outstanding job keeping the program running seamlessly. In fact, she was awarded the institution’s Leadership in Graduate Medical Education Program Coordinator Award for her exceptional efforts. Dr. Ashley Carroll, MD, has continued her work on our gynecology surgical curriculum in her role as Associate Program Director. We are grateful to Sarah Milton and Audra “Jo” Hill for their hard work as our administrative chiefs and are looking forward to working with Kirk Matthews and Breanna Walker, who are replacing them in the role. We are certain they will live up to our expectations and that we will have another smooth and successful year.

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The Residents: We are pleased to have matched an exemplary group of energetic and well-qualified interns who will begin their training in June. They are: Amy Brown, MD Jennifer Cross, MD Layson Denney, MD Amy Hempel, MD Jordan Hylton, DO Elisabeth McGaw, MD

Medical University of South Carolina West Virginia University University of Mississippi Virginia Commonwealth University Virginia College of Osteopathic Medicine East Tennessee University

Over the past year, our current and recently graduated residents have authored and co-authored numerous publications, including some published in Obstetrics and Gynecology, The American Journal of Obstetrics and Gynecology, and the Journal of Women’s Health. In addition, several presented their work at local, regional, national, and international meetings. Though we are sad to see them go, we are proud of yet another fabulous group of graduating residents and look forward to the bright careers ahead of them. Mychael Anderson Thomas, MD Audra “Jo” Hill, MD Sara Ivey, MD Sarah Milton, MD Eryn Clipp, MD Kimberly Woods McMorrow, MD

Faculty, Christiana Care, Wilmington, DE Urogynecology Fellowship, Cleveland Clinic, Ohio Private Practice, Richmond, VA Academic Practice, VCU, Richmond, VA Private Practice, Burlington, NC Private Practice, Richmond, VA

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Appendices

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PUBLICATIONS Baker B, McGrath J, Pickler R, Jallo N, Cohen S. Competence and responsiveness in mothers of late preterm infants versus term infants. Journal of Obstetric, Gynecologic and Neonatal Nursing, JOGNN, 2013;42:301-10. Brady M, Chelmow D. Contraceptive implant placement. Medscape Reference from WebMD. Updated August 16, 2012. Available at: http://emedicine.medscape.com/article/2047217overview. Carroll A, Brady M. Evaluation and treatment of fecal incontinence. Postgraduate Obstetrics and Gynecology 2013;33:1-6. Castro-Leyva V, Espejel-Nuñez A, Barroso G, Zaga-Clavellina V, Flores-Pliego A, Morales-Mendez I, Giono-Cerezo S, Walsh SW, Estrada-Gutierrez G. Preserved ex vivo inflammatory status in decidual cells from women with preterm labor and subclinical intrauterine infection. PLoS One, 7: e43605, 2012. Chelmow D. Screening for cervical cancer. ACOG Practice Bulletin Number 131. Obstetrics and Gynecology. 2012;120:1222-38. Chelmow D, Waxman A, Cain JM, Lawrence HC. The evolution of cervical screening and the specialty of obstetrics and gynecology. Obstetrics and Gynecology. 2012;119:695-9. Chelmow D, Waxman A. Patient management using LAST terminology. Pathology Case Reviews. 2013;18:195-9. Coney P, Demers LM, Dodson WC, Kunselman AR, Ladson G, Legro RS. Determination of vitamin D in relation to body mass index and race in a defined population of black and white women. Int J Gynaecol Obstet. 2012;119:21-5. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff. The Lower Anogenital Squamous Terminology standardization project for HPV-associated lesions: Background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Journal of Lower Genital Tract Disease/ 2012;16:205-42, Archives of Pathology and Laboratory Medicine. 2012;136:1266-97, and Int J Gynecol Pathol. 2013;32:76-115. (Chelmow listed under workgroup 2 and technical reviewers for manuscript).

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Gala R, Orejuela F, Gerten K, Lockrow E, Kilpatrick C, Chohan L, Green C, Vaught J, Goldberg A, and Schaffer J. Effect of validated skills simulation on operating room performance in obstetrics and gynecology residents. Obstetrics and Gynecology. 2013; 121: 578-84. Gill EJ, Tozer BL, Carroll A, Tran A. Routine use of preoperative cystourethroscopy on the surgical management of urinary incontinence and pelvic organ prolapse. Female Pelvic Medicine and Reconstructive Surgery 2012; 18:348-51. Guise JM, Nagel JD, Regensteiner JG; Building Interdisciplinary Research Careers in Women’s Health Directors. Best practices and pearls in interdisciplinary mentoring from Building Interdisciplinary Research Careers in Women's Health Directors. J Womens Health (Larchmt). 2012;21:1114-27. (Strauss) Karjane N, Chelmow D. New cervical cancer screening guidelines – again. Obstetrics and Gynecology Clinics of North America, 2013;40:211-23. Kaur S, Archer KJ, Devi MG, Kriplani A, Strauss JF 3rd, Singh R. Differential Gene Expression in granulosa cells from polycystic ovary syndrome patients with and without insulin resistance: identification of susceptibility gene sets through network analysis. J Clin Endocrinol Metab. 2012 Oct;97(10):E2016-21. doi: 10.1210/jc.2011-3441. Epub 2012 Aug 17. Legro RS, Brzyski RG, Diamond MP, Coutafaris C, Schlaff WD…Lucidi S, et.al, Letrozole versus clomiphene for the treatment of infertility in polycystic ovary syndrome, NEJM, Submitted. Lucidi RS. Polycystic ovarian syndrome. Medscape Reference. Available at: http://emedicine.medscape.com/article/256806-overview. Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M, Solomon D, Wentzensen N, Lawson HW, for the 2012 ASCCP Consensus Guidelines Conference. 2012 Updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstetrics and Gynecology and Journal of Lower Genital Tract Disease. 2013;17:S1S27. (Chelmow coauthor listed in appendix). Miklavcic A, Isaacs C. A survey of obstetrics-gynecology resident knowledge regarding barrier and over-the-counter contraceptives. J Womens Health, 2012;21(11):1196-2000.

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Mousa AA, Archer KJ, Cappello R, Estrada-Gutierrez G, Isaacs CR, Strauss III JF, Walsh SW. DNA methylation is altered in maternal blood vessels of preeclamptic women. Reprod Sci, 2012;19:1332-42. Mousa AA, Cappello RE, Estrada-Gutierrez G, Shukla J, Romero R, Strauss JF 3rd, Walsh SW. Preeclampsia is associated with alterations in DNA methylation of genes involved in collagen metabolism. Am J Pathol. 2012 Oct;181(4):1455-63. Mousa AA, Cappello R, Estrada-Gutierrez G, Shukla J, Romero R, Strauss III JF, Walsh SW. Preeclampsia is associated with alterations in DNA methylation of genes involved in collagen metabolism, Am J Pathol, 2012;181: 1455-63. Nagarkatti-Gude DR, Collodel G, Hill LD, Moretti E, Geminiani M, Zhang Z, Strauss JF 3rd. Genetic variation in SPAG16 regions encoding the WD40 repeats is not associated with reduced sperm motility and axonemal defects in a population of infertile males. BMC Urol. 2012 Sep 10;12(1):27. Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society of Clinical Pathology screening guidelines for prevention and early detection of cervical cancer. Journal of Lower Genital Tract Disease, 2012;16:175-204, CA: A Cancer Journal for Clinicians. 2012;62:14772. and American Journal of Clinical Pathology. 2012;137:516-42. (Chelmow listed under writing committee and workgroup 2). Teves ME, Jha KN, Song J, Nagarkatti-Gude DR, Herr JC, Foster JA, Strauss JF 3rd, Zhang Z. Germ cell-specific disruption of the Meig1 gene causes impaired spermiogenesis in mice. Andrology. 2013 Jan;1(1):37-46. Teves ME, Zhang Z, Costanzo RM, Henderson SC, Corwin FD, Zweit J, Sundaresan G, Subler M, Salloum FN, Rubin BK, Strauss JF 3rd. Spag17 is essential for motile cilia function and neonatal survival. Am J Respir Cell Mol Biol.2013: 48:765-72. Waxman AG, Chelmow D, Darragh TM, Lawson H, Moscicki B. The Lower Anogenital Squamous Terminology (LAST) Project: New recommendations for histopathology terminology of HPVassociated squamous lesions and their implications for management of HSIL of the cervix. Obstetrics and Gynecology, 2012;120:1465-71.

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Webb N, Chelmow D. Ovarian cyst rupture. Medscape Reference from WebMD. Updated November 30, 2012. Available at: http://emedicine.medscape.com/article/253620-overview. Wickenheisser JK, Biegler JM, Nelson-Degrave VL, Legro RS, Strauss JF 3rd, McAllister JM. Cholesterol side-chain cleavage gene expression in theca cells: augmented transcriptional regulation and mRNA stability in polycystic ovary syndrome. PLoS One. 2012;7(11):e48963. doi: 10.1371/journal.pone.0048963. Wojciechowski P, Lipowska A, Rys P, Ewens KG, Franks S, Tan S, Lerchbaum E, Vcelak J, Attaoua R, Straczkowski M, Azziz R, Barber TM, Hinney A, Obermayer-Pietsch B, Lukasova P, Bendlova B, Grigorescu F, Kowalska I, Goodarzi MO; GIANT Consortium, Strauss JF 3rd, McCarthy MI, Malecki MT. Impact of FTO genotypes on BMI and weight in polycystic ovary syndrome: a systematic review and meta-analysis. Diabetologia. 2012 Oct;55(10):2636-45. Xu M, Li X, Walsh SW, Zhang Y, Abais JM, Boini KM, Li P-L. Intracellular two-phase Ca2+ release and apoptosis controlled by TRP-ML1 channel activity in coronary arterial myocytes. Am J Physiol-Cell Physiol. 2013;304: C458-66.

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ABSTRACTS Allen D, Baker B. (June 2013). Supporting mothering through breastfeeding while incarcerated. Poster Presentation: Association of Women’s Health, Obstetric, and Neonatal Nurses: Nashville TN. Carroll A, Brock E. Laparoscopic sacral colpopexy: Design and pilot of a simulation based curriculum. Video presentation at International Urogynecological Association 38th Annual Meeting, Dublin, Ireland, May, 2013. Carroll A. Laparoscopic sacrocolpopexy training module. Workshop Session at International Urogynecological Association 38th Annual Meeting, Dublin, Ireland, May 28, 2013. Carroll A, Brock E. Laparoscopic sacrocolpopexy: A simulation based curriculum. Video presented at Society of Gynecologic Surgeons, Charleston, SC, April 2013. Carroll AW. A comprehensive gynecologic surgical skills curriculum: a step beyond minimally invasive training. Poster #86 presented at 2013 CREOG & APGO Annual Meeting, Phoenix, AZ, February 27 – March 2, 2013. Carroll A, Brock E. Laparoscopic sacral colpopexy: Design and pilot of a simulation based curriculum. Female Pelvic Medicine & Reconstructive Surgery 2013; 19(2 Supp):S43. Carroll A, Brock E. Laparoscopic sacral colpopexy: Design and pilot of a simulation based curriculum. Int Urogynecol J 2013; 24(Supp 1):S106. Espejel-Nunez A, Flores-Pliego A, Espino y Sosa S, Guzman-Grenfell A, Walsh SW, EstradaGutierrez G, Cappello RE. L-arginine supplementation induces the expression of genes related to antioxidant defense in cultures of human vascular endothelial cells: Protective role for preeclampsia. Pregnancy Hypertension, 2: 311, 2012. Presented at the 18th World Congress of the International Society for the Study of Hypertension in Pregnancy, July 9-12, 2012, Geneva, Switzerland, (Abstract PP134, p. 311). Feldman M, Bearman G, Kushinka J, Bodamer C, Brock E, Dow A. Initial validation of the internal medicine simulated practical exam (IMSPE) for 3rd year medical students. International Meeting on Simulation in Healthcare, Orlando, FL, January 2013.

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Hill AJ, Talreja N, Cheang KI, Gill E, Carroll AW. Correlation of endoanal ultrasound findings and clinical symptomatology following anal sphincter laceration repair. Female Pelvic Medicine and Reconstructive Surgery 2012; 18(5 Supp):S108. Hill AJ, Talreja N, Cheang KI, Gill E, Carroll AW. Correlation of endoanal ultrasound findings and clinical symptomatology following anal sphincter laceration repair. Poster #20 presented at 33 rd Annual Scientific Meeting of the American Urogynecologic Society, Chicago, IL, October 3-6, 2012. Hill AJ, Talreja N, Cheng KI, Gill E, Carroll AW. Correlation of endoanal ultrasound findings and clinical symptomatology following anal sphincter laceration repair. Int Urogynecol J 2013; 24(Supp 1):S139. Hill AJ, Talreja N, Cheng KI, Gill E, Carroll AW. Correlation of endoanal ultrasound findings and clinical symptomatology following anal sphincter laceration repair. Oral presentation at International Urogynecological Association 38th Annual Meeting, Dublin, Ireland, May, 2013. Nugent WH, Washington SL, Strauss III JF, Walsh SW. Epigenetic regulation of interleukin-17 cytokines and their role in neutrophil infiltration in preeclampsia. Presented at the 60th Annual Meeting of the Society for Gynecologic Investigation, March 20-23, 2013, Orlando, FL Reprod Sci (Supplement) 20: 267A (Abstract F-257). Nugent WH, Washington SL, Grider JR, Strauss III JF, Walsh SW. Neutrophil elastase in term and preterm labor: A novel and potent uterotonic enzyme that acts via PAR1. Presented at the 60th Annual Meeting of the Society for Gynecologic Investigation, March 20-23, 2013, Orlando, FL Reprod Sci (Supplement) 20: 175A (Abstract T-211). Nugent WH, Solotskaya A, Washington SL, Grider JR, Strauss III JF, Walsh SW. Active MMP-1 is markedly increased in preterm labor and causes uterine contractions via PAR1. Presented at the 60th Annual Meeting of the Society for Gynecologic Investigation, March 20-23, 2013, Orlando, FL Reprod Sci (Supplement) 20: 69A (Abstract O-022). Rigby, F. Redesign of longitudinal fourth year curriculum: Working toward milestone one. APGO CREOG meeting, March 2013. Shermer R, Scott S, Isaacs C, Baker B. Skin-to-skin during cesarean birth: Bringing evidence to practice. Poster Presentation: American Nurses Credentialing Center National Magnet Conference: Los Angeles CA, October 2012.

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Shermer R, Scott S, Isaacs C, Baker B. Skin-to-skin during cesarean birth: Bringing evidence to practice. Poster Presentation: Virginia Nurses Association Annual Education Day: Richmond VA, October 2012. Tipton A, Carroll AW, Lamb E, Gill E. Uphold vaginal support system in the surgical management of pelvic organ prolapse. Poster 229 presented at 33rd Annual Scientific Meeting of the American Urogynecologic Society, Chicago, IL, October 3-6, 2012. Tipton A, Carroll AW, Lamb E, Gill E. Uphold vaginal support system in the surgical management of pelvic organ prolapse. Female Pelvic Medicine & Reconstructive Surgery 2012; 18(5 Supp):S198. Walsh SW, Solotskaya A, Washington S, Strauss III JF. Epigenetic and neutrophil product regulation of progesterone receptor in decidua with respect to term and preterm labor. Presented at the Science of Eliminating Health Disparities Summit, December 17 – December 19, 2012, National Harbor, MD (Abstract published online). Walsh SW, Solotskaya A, Nugent W, Washington S, Strauss III JF. Epigenetic regulation of MMP1 in decidua with respect to preterm labor. Presented at the Science of Eliminating Health Disparities Summit, December 17 – December 19, 2012, National Harbor, MD (Abstract published online). Wical C, Hable H, Vecchione S, Baker B. (June 2013) Nursing sensitive quality indicators in the perinatal setting. Poster Presentation: Association of Women’s Health, Obstetric, and Neonatal Nurses: Nashville TN.

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PRESENTATIONS Brock, E. Laparoscopic sacrocolpopexy workshop. International Urogynecology Association. Dublin, Ireland. May 2013. Brock, E. Panel discussion: Utilizing in-situ simulation for quality improvement: Methods and approaches for healthcare organizations. International Meeting on Simulation in Healthcare, Orlando, FL, January 2013. Carroll AW. An update on overactive bladder. Practical Frontiers in Primary Care Conference, VCU Department of Internal Medicine, Richmond, VA, October 27, 2012. Carroll AW. Urinary incontinence: It’s more common and treatable than you think. VCUHS CHEC Library, Richmond, VA, September 11, 2012. Carroll AW. Urinary incontinence: It’s more common and treatable than you think. Public seminar at Lewis Ginter Botanical Gardens, Richmond, VA, August 14, 2012. Chelmow D. Presidential Address, Society of Academic Specialists in General Obstetrics and Gynecology Inaugural Meeting, New Orleans, LA, May 5, 2013. Chelmow D. Cervical cancer screening, William Goddard Lecture, University of Colorado, Denver, CO, May 3, 2013. Chelmow D. Revised recommendations for cervical cancer screening and prevention, ACOG Indiana State Meeting, Indianapolis, IN, April 17, 2013. Chelmow D. ASC-H and HSIL, ASCCP Advanced Colposcopy Case-Based Course. Phoenix, AZ, March 22-23, 2013. Chelmow D. CIN-2, CIN-3, and CIN2,3, ASCCP Advanced Colposcopy Case-Based Course. Phoenix, AZ, March 22-23, 2013. Chelmow D. Cervical cancer screening update, Grand Rounds, VCU Department of Internal Medicine, December 13, 2012.

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Chelmow D. Cervical cancer screening update, Cincinnati OB/GYN Society, Cincinnati, OH, November 28, 2012. Chelmow D. Cervical cancer screening update, Advances in Obstetrics and Gynecology 2012, Ware Dunn Society Meeting, Richmond, VA, October 25, 2012. Goldberg A. Roundtable discussion of M4 surgical skills course. APGO Faculty Development Seminar. Isaacs C. OB/Gyn update: Pregnancy in orthopaedics, 66th Annual Meeting, Virginia Orthopaedic Society, Washington, DC, May 4, 2013. Isaacs C. Recent developments in women’s health and gynecology, 11th Annual Alumni Update Course, VCU Medical Center, April 20, 2013. Isaacs C. Female Sexual Dysfunction, Lewis Ginter Lecture Series, Richmond, VA, April 18, 2013. Isaacs C. Mother-baby friendly cesarean section, Best Fed Beginnings Conference, Richmond, VA, February 27, 2013. Isaacs C. Out in the open: A discussion of female sexual disorders, VCU Institute for Women’s Health, How to Treat a Woman: Strategies for Healthcare and Self-Care series. VCU Medical Center, September 19, 2012. Isaacs C. Innovations in obstetric care: Thinking outside the box, Thomas Jefferson University Hospital, Philadelphia, PA, October, 2012. Lucidi RS. The effect of stress on menstruation and fertility, Women’s Health Virginia, Richmond, Virginia, June 14, 2013. Lucidi RS. Reproductive and sexual sequelae of testicular cancer, Virginia Commonwealth University Department of Urology, Bunts-Hackler Lecture, March 22, 2013. Lucidi RS. Evaluation and treatment of infertility, Grand Rounds, Virginia Commonwealth University Department of Obstetrics and Gynecology, August 30, 2012. Lucidi RS. Fertility preservation in the cancer patient, Grand Rounds, Virginia Commonwealth University Department of Hematology/Oncology and Palliative Care, January 31, 2012.

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Lucidi RS. Advances in breast cancer treatment, Patient Education Seminar, Stony Point Surgical Center, Richmond, VA, January 31, 2012. Pierce J. Milestones in Obstetrics and Gynecology Training, Surgical and Cognitive Evaluations in Residency, Medical and Surgical Preparation for Gynecologic Surgery, Case Based Presentations for Medical Students. Continuing Medical Education Seminars and Resident Education Lectures at University Hospital in Skopje, Macedonia. Invited by the Minister of Health in Macedonia, March 30, 2013 to April 13, 2013. Strauss III JF. Earnest W. Page Memorial Lecture, UCSF. Strauss III JF. Margaret Prine Joy Lecture, Magee-Women’s Hospital, University of Pittsburgh. Strauss III JF. 2013 Celebration of Life Lecturer, Magee-Women’s Hospital, University of Pittsburgh. Walsh SW. Invited Plenary Speaker, American Heart Association, High Blood Pressure Research Meeting, “Epigenetics of Hypertension in Preeclampsia”, September 19-21, 2012, Washington DC. Walsh SW. Invited Plenary Speaker, North American Society for the Study of Hypertension in Pregnancy, "Neutrophils: Critical Mediators of Vascular Dysfunction in Preeclampsia" September 7-9, 2012, Kiawah Island, SC.

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Grand Rounds

July July 12, 2012 July 19, 2012 July 26, 2012 August 9, 2012 August 16, 2012 August 23, 2012 August 30, 2012 September 13, 2012 September 20, 2012 September 27, 2012 October 11, 2012 October 18, 2012 October 25, 2012 November 8, 2012 November 15, 2012 November 29, 2012 December 13, 2012 December 20, 2012 January 10, 2013

Presenter Raymond Lewandowski, MD Ellen Brock, MD Fidelma Rigby, MD Nathan Guerette, MD Asha Jayaram, MD Ronald Ramus, MD Scott Lucidi, MD Tammy Ruiz, RN

Topic Genetics and IUFD Postoperative Management Third Trimester Bleeding Anatomy of the Pelvis Neonatal resuscitation Management of the second stage of labor Basics of infertility Speaking to newly bereaved parents.

Ellen Brock, MD

GYN Quality Assurance

Valerie Coleman, RN

Breastfeeding

Sarah Hobgood, MD Steven Cohen, MD Scott Lucidi, MD Ellen Brock, MD

Surgical Care of the Geriatric Patient OB Quality Assurance WARE DUNN Hormone Replacement Therapy GYN Quality Assurance

J. V. (Ian) Nixon MD, FACC, FAHA. Professor of Medicine (Cardiology) Ajay Patil, DO Chief Resident Steven Cohen, MD Gonzalo Bearman, MD

Cardiovascular Risk Management and Cholesterol Control Uterine artery embolization and pregnancy OB Quality Assurance Prevention of Surgical Site Infection

January 17, 2013 January 31, 2013 February 14, 2013 February 21, 2013 February 28, 2013 March 14, 2013 March 21, 2013 March 28, 2013 April 11, 2003

Ellen Brock, MD Laurie K. Crawford, MPA Weldon Chafe, MD Eryn Clipp, MD Chief Resident Steven Cohen, MD Jo Hill, MD Chief Resident Ellen Brock, MD Sara Ivey, MD Chief Resident Sarah Milton, MD Chief Resident

GYN Quality Assurance RADAR curricula for domestic violence Update on Vulvar Dysplasia Genetics in Obstetrics OB Quality Assurance Bowel Injuries in Pelvic Surgery GYN Quality Assurance Sexual Dysfunction Gynecologic Surgery in Pediatric and Adolescent Patients Joint OB and Anesthesia grand rounds - Case Presentations GYN aspects of graft versus host disease Obesity in Pregnancy

April 18, 2013 April 25, 2013 May 2, 2013 May 16, 2013 May 23, 2013 May 30, 2013 June 13, 2013 June 20, 2013

Elizabeth McGee, MD Mychal Anderson Thomas, MD Chief Resident Ellen Brock, MD Aaron Goldberg, MD and Philippe Girerd, MD Kimberly Woods, MD Chief Resident Karen Hendricks Munoz, MD Steven Cohen, MD

GYN Quality Assurance The Pelvic Exam Cancer in Pregnancy Advances and Outcomes in the NICU OB Quality Assurance