International journal of obstetric anesthesia
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Int J Obstet Anesth · Dec 2024
Readability, quality and accuracy of generative artificial intelligence chatbots for commonly asked questions about labor epidurals: a comparison of ChatGPT and Bard.
Over 90% of pregnant women and 76% expectant fathers search for pregnancy health information. We examined readability, accuracy and quality of answers to common obstetric anesthesia questions from the popular generative artificial intelligence (AI) chatbots ChatGPT and Bard. ⋯ Bard readability scores were high school level, significantly easier than ChatGPT's college level by all scoring metrics (P <0.001). Bard had significantly longer answers (P <0.001), yet with similar accuracy of Bard (85 % ± 10) and ChatGPT (87 % ± 14) (P = 0.5). PEMAT understandability scores were no statistically significantly different (P = 0.06). Actionability by PEMAT scores for Bard was significantly higher (22% vs. 9%) than ChatGPT (P = 0.007) CONCLUSION: Answers to questions about "labor epidurals" should be accurate, high quality, and easy to read. Bard at high school reading level, was well above the goal 4th to 6th grade level suggested for patient materials. Consumers, health care providers, hospitals and governmental agencies should be aware of the quality of information generated by chatbots. Chatbots should meet the standards for readability and understandability of health-related questions, to aid public understanding and enhance shared decision-making.
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Int J Obstet Anesth · Dec 2024
Review"This is how we do it" Maternal and fetal anesthetic management for fetoscopic myelomeningocele repairs: the Texas Children's Fetal Center protocol.
Prenatal repair of myelomeningocele (MMC) is associated with lower rates of hydrocephalus requiring ventriculoperitoneal shunt and improved motor function when compared with postnatal repair. Efforts aiming to develop less invasive surgical techniques to decrease the risk for the pregnant patient while achieving similar benefits for the fetus have led to the implementation of fetoscopic surgical techniques. While no ideal anesthetic technique for fetoscopic MMC repair has been demonstrated, we present our anesthetic approach for these repairs, including considerations for both the pregnant patient and the fetus. ⋯ Additional considerations for the fetus include monitoring, fetal resuscitation strategies, and the theoretical risk of anesthetic neurotoxicity. Postoperatively, we use a multi-modal, opioid sparing regimen for analgesia. As advances in fetal surgery aiming to minimize risk to the pregnant patient alter the surgical approach, maternal-fetal anesthesiologists must adapt and incorporate the unique considerations of fetoscopy into their anesthetic management.