EIGHTY-EIGHTH ANNIVERSARY PACIFIC COAST OBSTETRICAL AND GYNECOLOGICAL SOCIETY

Eighty-sixth Annual Meeting

October 23-27, 2019 The Rancho Bernardo Inn

San Diego, California

Continuing Medical Education credit is provided through joint providership with The

American College of Obstetricians and Gynecologists.

PROGRAM COMMITTEE

Caryl Reinsch, Chair

C. Andrew Combs Marc Winter Aaron B. Caughey Lori Marshall

ARRANGEMENTS COMMITTEE

Ronald Reinsch, Chair REGISTRATION Coordinators Vera & Dennis Stucky HOSPITALITY Coordinators Marilyn Laughead & Bob Newman AUDIO/VISUAL Chair Tom Powers EDITOR SCIENTIFIC PROCEEDINGS Aaron Caughey INDUSTRY LIAISON CHAIR Robert Israel ON SITE INDUSTRY LIAISON Albert Phillips PHOTOGRAPHER Kathy Gregory

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OFFICERS

President James A. Macer

Pasadena, California

President-Elect Fung Lam

San Francisco, California

Secretary-Treasurer Thomas G. Gaylord

San Diego, California

Assistant Secretary Lori Marshall

Seattle, Washington

BOARD OF DIRECTORS

Arzou Ahsan

Kathleen Bradley

Aaron B. Caughey

Jane Dimer

Barbra Fisher

Thomas G. Gaylord

Martha Goetsch

David C. Lagrew, Jr.

Fung Lam

James A. Macer

Lori Marshall

Vera Stucky

Mark Tomlinson

Heidi Wittenberg

HISTORIAN

Martha Goetsch

SOCIETY ADMINISTRATOR

Linda G. Hinrichsen

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ROSTER OF MEETINGS AND PRESIDENTS November 19-20, 1931 – San Francisco

Organization Meeting Albert Mathieu, Chairman

December 8-10, 1932 – Los Angeles Frank W. Lynch

October 19-21, 1933 – Portland Albert Mathieu

November 21-24, 1934 – Del Monte Lyle G. McNeile

November 6-9, 1935 – Los Angeles J. Morris Slemons

November 11-14, 1936 – Seattle Clarence A. DePuy

November 3-6, 1937 – San Francisco Ludwig A. Emge

November 30-December 3, 1938 – Los Angeles Raymond E. Watkins

November 1-4, 1939 – Portland Edmund M. Lazard

November 6-9, 1940 – San Francisco Alice F. Maxwell

November 5-8, 1941 – Pasadena John Vruwink

November 5-7, 1942 – Oakland T. Floyd Bell

November 3-5, 1943 – San Francisco C. Frederic Fluhmann

November 6-9, 1946 – San Francisco Goodrich C. Schauffler

October 1-4, 1947 – Seattle Henry N. Shaw

November 10-13, 1948 – Los Angeles Phillip H. Arnot

November 9-12, 1949 – San Francisco William Benbow Thompson

November 4-19, 1950 – Timberline Lodge Albert W. Holman

December 5-8, 1951 – Coronado Roy E. Fallas

October 15-18, 1952 – Del Monte Karl L. Schaupp

October 21-24, 1953 – Victoria, B.C. Theodore W. Adams

October 27-30, 1954 – Santa Barbara Emil J. Krahulik

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October 6-9, 1955 – Sun Valley Henry A. Stephenson

October 31 – November 3, 1956 – San Francisco Donald G. Tollefson

October 30 – November 2, 1957 – Palm Springs Bernard J. Hanley

October 15-18, 1958 – Seattle Donald J. Thorp

October 21-24, 1959 – San Francisco Donald A. Dallas

September 28 – October 1, 1960 – Yosemite George E. Judd

September 20-23, 1961 – Yosemite Donald W. de Carle

October 3-6, 1962 – Portland Daniel G. Morton

September 18-21, 1963 – Yosemite Howard C. Stearns

November 4-7, 1964 – Santa Barbara Charles T. Hayden

September 29 – October 2, 1965 – Vancouver, B.C. Alfred M. McCausland

November 2-5, 1966 – Santa Barbara Robert K. Plant

November 29 – December 2, 1967 – Phoenix L. Grant Baldwin

October 2-5, 1968 – Shalishan Keith P. Russell

October 1-4, 1969 – Yosemite Robert D. Dunn

November 9-14, 1970 – Kauai Ralph C. Benson

October 5-10, 1971 – La Costa Ernest W. Page

October 3-7, 1972 – Harrison Hot Springs Purvis L. Martin

October 29 – November 4, 1973 – The Wigwam Charles F. McLennan

October 6-10, 1974 – Sun River Paul G. Peterson

October 6-11, 1975 – Del Monte Ralph H. Walker

November 7-13, 1976 – Kona Carl Goetsch

October 4-8, 1977 – Santa Barbara Melvin W. Breese

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September 26-30, 1978 – Salishan William J. Dignam

September 26-30, 1979 – Palm Springs Leon J. Shulman

October 6-11, 1980 – Monterey Leon P. Fox

September 27 – October 3, 1981 – Kauai Colin C. McCorriston

September 26-30, 1982 – Pebble Beach Ivan I. Langley

September 6-10, 1983 – Vancouver, B.C. Canada George A. Macer

October 21-27, 1984 – Tucson Jesse A. Rust, Jr.

September 29 – October 4, 1985 – Napa Edward C. Hill

September 21-25, 1986 – Salishan Charles D. Kimball

September 27 – October 2, 1987 – Pebble Beach Charles F. Langmade

November 12-19, 1988 SS Independence Eugene C. Sandberg

September 17-21, 1989 – Coronado David C. Figge

September 9-14, 1990 – Sun Valley James M. Maharry

September 9-12, 1991 – Ashland Richard N. Bolton

October 11-16, 1992 – Ojai Walter S. Keifer

September 7-12, 1993 – Bellingham Gilbert A. Webb

October 24-29, 1994 – Scottsdale David Pent

September 16-21, 1995 – Squaw Valley E. Forrest Boyd, Jr.

October 2-6, 1996 – Sunriver Theodore W. Loring

September 17-21, 1997 – Coeur d’Alene James C. Caillouette

September 16-20, 1998 – Whistler E. Paul Kirk

October 20-24, 1999 – Cancun Michael R. Smith

November 14-19, 2000 – Hawaii S. Gainer Pillsbury, Jr.

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October 3-7, 2001 – Ashland W. Gordon Peacock

October 22-27, 2002 – Rancho Mirage Robert Israel

September 16-21, 2003 – Anchorage Emmet J. Lamb

October 19-24, 2004 – Phoenix Russell K. Laros, Jr.

September 28-October 2, 2005 – Kauai P. Ronald Millard

October 4-8, 2006—Sun Valley, Idaho Kenneth A. Burry

October 10-14, 2007—Henderson, Nevada Frank R. Gamberdella

October 15-19-2008—Victoria, B. C., Canada Jerry M. Shefren

September 30-October 4, 2009—La Jolla, California Lyman A. Rust

September 29-October 3, 2010—Kohala Coast, Hawaii J. T. (Bill) Parer

September 14-18, 2011—Sunriver, Oregon Robert Prins

October 3-7, 2012—Newport Beach, California John A. Enbom

October 2-6, 2013—Walla Walla, Washington Marilyn K. Laughead

October 22-26, 2014 - Marana, Arizona Donald Barford

September 2-6, 2015 - Kahuku, Hawaii Phillip E. Patton

September 28-October 2, 2016, Sun Valley, Idaho Thomas W. Powers

November 1-5, 2017, Palm Desert, California Patricia A. Robertson

September 26-30, 2018, Coeur d’Alene, Idaho David C. Lagrew, Jr.

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RECIPIENTS OF PCOGS FRANK LECOCQ

LIFETIME ACHIEVEMENT AWARD

Frank LeCocq - November 18, 2000

Robert C. Goodlin - October 6, 2001

William Dignam - October 20, 2002

Robert (Bob) Israel - October 3, 2009

Jerry M. Shefren - September 29, 2010

Linda G. Hinrichsen - October 6, 2012

James C. Caillouette - October 23, 2014

John A. Enbom - September 29, 2016

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Acacio Adams Adamson Aghajanian Ahsan Asrat Atamdede Autry Barkley Bednarek Behera Benoit Bradley Branigan Broberg Brown Buchanan Burlingame Busse Cabrera Card Caughey Chandler Cheng Cohen Coleman Combs Coonrod Craig Curtis Daskalos deCastro Dimer Druzin Dunsmoor-Su Durinzi Eckert Ellsworth El-Sayed

Esakoff Fassett Finberg Fisher Foley Francois Friedman Fuller Furukawa Futoran Garrett Gilbert Goldberg Gorman Gosewehr Grady Gravett Greenberg Greenspan Gregory, Kathy Gregory, Kim Hassan Hedriana Hicks Hobel Hoffman Houmard Houston Huerta-Enochian Incerpi Israel, J. Jacobson Jensen, J. Johnson Katz, M. Keith Kettel Khieu Kilpatrick

Kim, L. Korman Kosasa Lagrew, Jr. Lam Lamb, J. Larsen Lee, R. Lenihan Lentz Leslie Lofquist Luthy Macaulay Macer Manriquez Maples Margolin Marrs Marshall McNulty Melville Mercer Miksovsky Miller Moran Morcos Muderspach Mukul Mullin Munro Mutch Nageotte Nelson, A. Nelson, H. P. Nelson, L. Nichols Norrell Norton

Ogasawara Oliver, John O’Reilly-Green Ouzounian Paek Paley Palmer Pandipati Partoll Paulson Peterson Phillips Platt Powers Prins Reed Reisner Ribbink Robboy Robertson Rogers Roloff Rowles Schlaerth Shaffer, B. Shaffer, L. Shah Shahine Shaw Shields Simpson Smith, W. Snell Steinke Stempel Thomas Tomlinson Tomsen Valenzuela

ACTIVE FELLOWS

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Vasilev Veljovich Walker Wentross Wesol Wickman Wiggins Williams Winch, G. Jr. Winter, M. Winter, W. Wittenberg Wohlmuth Woods Yee Zheng Total Fellows - 172

ACTIVE FELLOWS continued

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Allen Ambrose Barbis Barford Berek Boyle Cain Clayton Clewell Cole Collins Corlett Corwin Creasy Davis Deasy, K. Deasy, S. Der Yuen Dotters Enbom Fearl Forsythe Freeman Gaylord Giudice Goetsch Golditch Goodno Goodwin Graham Haesslein

Hanson Hanss Hartman Henderson Hickok, D. Hickok, L. Hindle Hoag Israel, R. Katz, V. Kirk Lamb, E. Lamey Laughead Lowensohn Main, D. Main, E. Mayo McCausland Mouer Nakayama Nelson, R. Neilson Novy Oliver, Joseph Patton Paul Peacock Peters, III Pillsbury Pitkin

Plaut Quilligan Reinsch, C. Reinsch, R. Resnik Roberts Schlesinger Schrinsky Schwartz Segal Shefren Shy Smith, D. Smith, M. Smith, R. Soderstrom Spanos Stucky Tamimi Unzelman Veltman Vontver Wallace Watson Welch Whitelaw Wolter Total Retired Fellows – 89

RETIRED FELLOWS

HONORARY FELLOWS

Jensen, H. Smith-Sehdev

NON-RESIDENT FELLOWS Ballon Blanchette Brewster Felix Gabbe Garite Hale

Kim Lanouette Learman Martin-Cadieux Towers Total Fellowship - 275

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A LOGO TO IDENTIFY A

FIFTY-YEAR TRADITION

A logo is a symbol of identity and, as such, should be filled with symbolism and, in fact, tell a story. With this in mind the Logo Committee, seeking symbols, re-searched the name of the Society-first the region, Pacific Coast; second our specialty, obstetrics and gynecology; and third our birth, a Society founded in 1931, three ele-ments suggesting a Trinity or three-part logo. The first effort was to derive symbols from Pacific Coast which would relate to our region and specialty: sun, energy, birth, life. The most common symbol in the Pacif-ic is the sun. Pacific is, of course, from the Latin word Pacificus, meaning "more peaceful"-sunny and more peaceful. It was Magellan who named the Pacific Ocean in 1520 and appropriately so. Since the sun gives life and is symbolic of our region, it was chosen for the outer protec-tive circle of our logo.

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The middle circle contains essential information provid-ing the initials for Pacific Coast Obstetrical and Gyne-cological Society and the founding date, 1931. The third part, and the heart of the logo, re-quired difficult decisions. Once again, symbols began to flow: feminine, dynamic, classic, historic, anatomic, scientific, timeless, cyclic, lunar. It seemed appropriate to draw from the work of one of the three great artists of all time, one who was also an anatomist, engineer, inventor-a true Renaissance man, a person to emulate-Leonardo de Vinci. The artist, Dorothy Koll, adapted Leonardo's work "Canon of Proportions" from his anat-omy notebook "Quarderni di Anatomia," volume VI, folio 8r. This drawing was sketched at approximately the same time that Magellan was naming the Pacific Ocean. What a fitting coincidence for our logo. The central figure is appropriately female rather than Leo-nardo's male. The anatomy is clear. The figure illus-trates structure and movement, depicting the dynamic, cyclic, and ever-changing life of the female. James C. Caillouette Chairman, Logo Committee Kauai 1981 50th Anniversary Meeting

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IN

MEMORIAM

Kurt Benirschke 1972-2018

Philip J. DiSaia

1980-2018

Teiichiro Fukushima 1999-2018

Frank R. Gamberdella

1984-2019

Robert Goodlin 1970-2018

George Lee 1986-2017

R. Elgin Orcutt

1967-2019

Lyman A. Rust 1985-2019

Edward W. Savage, Jr.

1992-2018

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HISTORIAN’S CORNER

LEARN ABOUT PCOGS HISTORY! On our PCOGS web site (www.pcogs.org) under Society Info you can find the drop down called “Historian’s Corner.” Visit it to find many offerings. You’ll find accounts of the founding years, biog-raphies of some members including members honored by memorial funds. Many of the early presidential addresses are there, giving a flavor of the times and perspectives of members on challenging societal and medical issues. These offerings will transport you back in time to earlier years of our profession, as will selected scientific papers presented at meetings over the years. Interviews with members describe im-portant Ob/Gyn history, offer fond recollections, and a few wild stories.

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PCOGS MEMBERSHIP PROCESS The Pacific Coast Ob Gyn Society (PCOGS) was founded in 1931 and has a long tradition of excel-lent annual scientific meetings that offer presenta-tions from all areas of the specialty. The Society is composed of five regional caucuses representing the geographic organizations of the PCOGS struc-ture. Members (Fellows) reside in seven western states stretching from Arizona to Alaska, including Hawaii. Membership in the society has always been by invitation, and presentation of a scientific paper is the steppingstone to membership. It is hoped that new members will come to value the society, regu-larly attend meetings, and contribute with subse-quent presentations, formal discussions, and/or in the informal discussions from the floor. In order to evaluate the Society and decide whether guests wish to pursue membership, interested physi-cians can come to an annual meeting as a member’s personal guest. The formal process to join begins in the applicant’s geographic caucus where a member sponsors a guest physician’s application. Caucus members then vote to invite applicants to be a guest of the Caucus at the following annual scientific meeting. This provides an official introduction to the larger group, allows more exposure to the pro-cess, and starts the timeline for presentation of a paper two years later. Guests committed to mem-bership can come in the intervening year as a guest of the Board of Directors if they wish. In years past the candidate always waited out a year before pre-senting, but prospective members can be welcomed each year. Meeting registration and expenses are the responsibility of invited guests for each meet-ing.

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Two years after becoming a Caucus Guest, and following caucus and board approval, candidates will be invited as a Society Guest to present a sci-entific paper. Following each annual scientific meeting, the PCOGS members vote on the Society guests, and the board sends its confirmation of membership. Society guests always present their papers in an oral format for admission to the society. The sci-entific program also includes presentations by Fel-lows. Posters are a second presentation format, and every year ObGyn residents and fellows from pa-cific coast medical centers are invited to exhibit posters as guests of the society. Residentsfellows submitting manuscripts compete for an oral presen-tation, the Frank Lynch Memorial Essay, which includes an honorarium. The best poster is awarded an honorarium, The Charles Kimball Award, at the meeting. Poster presenters give an oral 5-minute summary from the podium at the meeting so that they can be formally introduced to the member-ship. A mentoring process for PCOGS Society guests is in place to facilitate the best project possible with the least distress for the candidate. Each caucus matches the candidate with a suitable mentor. This person will be able to help guests understand the process and find those knowledgeable in their area of research. Some projects require assistance from several mentors to facilitate the planning process, IRB approval, and data analysis. As IRB approval can take time, it is important to factor this in. Your caucus chair should assist in arranging a mentor who suits you. Please ask for more assistance if this does not seem to be working.

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The society has always prided itself on the quality of papers presented. Presentations have historically been the culmination of a process of collecting original data, analyzing it, drafting a manuscript suitable for publica-tion, and presenting it orally at the annual meeting. For-mal presentation of the manuscript at the meeting is followed by a formal discussion from a member of the society. That member has volunteered to critique the manuscript and therefore needs to have received the completed manuscript before the meeting. They provide several questions to the presenter. After the formal dis-cussion, audience members have the opportunity to ask further questions which the presenter then answers from the podium. Historically, the various regional ObGyn societies in the country, such as PCOGS, have had a relationship with the American Journal of ObGyn, and papers were first submitted there. As of 2018, there is no longer a prioritized journal to which papers are to be sent. Pre-senters are expected to submit their paper for publica-tion, but the choice of journal is left to the author and mentor. In order to bolster manuscript quality, the Soci-ety offers candidates the expert critique of the society’s editor of scientific proceedings in a non-mandatory pre-submission review, or “pre-review.” PCOGS is a member-run organization. Many members devote time to making the organization work. There is only one employee, a masterful administrative assistant, who manages correspondence and organizational de-tails. Guests attending a meeting will soon realize that member-volunteers and spouses manage all of the ar-rangements, the registration and the entire agenda. At-tention to provided information and instructions, cou-pled with timely responses, will help the efforts and efficiency of the hard-working PCOGS Fellows who make these meetings so successful.

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The society blends those in community practice and those in academic practice, essentially academic clini-cians and clinical academicians, and welcomes their families to meetings. Members take pride in the so-cial aspects of the society, which open opportunities to develop lasting friendships with members geo-graphically distant from their own communities. The addition of enthusiastic new members is vital to the continuation of the Society. We hope our guests will be interested in learning more and pursuing member-ship. Martha F. Goetsch & John A. Enbom

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2018 PRESENTATIONS PUBLISHED

IN AJOG

OR ALTERNATE JOURNALS

Concordance of Pelvic Mass Laterality: from Pre-operative Imaging to Surgical Pathologic Findings-Who owns the consent? Michele Benoit - European Journal of Gyn Oncology

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2017 PRESENTATIONS PUBLISHED

IN AJOG

OR ALTERNATE JOURNALS An Evidence-Based Quality Improvement Project to Reduce Chorioamnionitis and Surgical Site Infection Rates at a Military Treatment Facility Edward R. McClellan - American Journal of Infection Control - 2018 Nov 30. pii: S0196-6553(18)30953-2. doi: 10.1016/j.ajic.2018.09.023 Gestational Weight Gain During Pregnancy as an Important Factor Influencing a Successful Trial of La-bor Following Two Previous Cesareans James Sargent - American Journal of Perinatology 2018 Sep 19 PMID 30231273 A Standardized Approach for Category II Fetal Heart Rate With Significant Decelerations: Maternal and Fetal Outcomes Laurence Shields - American Journal of Perinatology 2018 Jun 12. doi: 10.1055/s-0038-1660459

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SOCIETY GUESTS

Heather Macdonald (Jonathan Boswell) Irvine, California (Los Angeles Caucus) Sponsor - Robert Israel Joshua Press Seattle, Washington (Seattle Caucus) Sponsor - Chirag Shah Larissa Romero (Zack) Phoenix, Arizona (San Diego/AZ Caucus) Sponsor - James Mouer Erica Wang Los Angeles, California (Los Angeles Caucus) Sponsor - John Williams, III

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CAUCUS GUESTS Nyima S. Ali (Umair Khan) Phoenix, Arizona (San Diego/AZ Caucus) Sponsor - Dean V. Coonrod Lisa L. Bayer (Jeff ) Portland, Oregon (Portland Caucus) Sponsor - Paula Bednarek Richard Benoit Los Angeles, California (Los Angeles Caucus) Sponsor - Kathleen Bradley Marni Carlyle (Philip Pridmore-Brown) Portland, Oregon (Portland Caucus) Sponsor - Brian Shaffer Aaron Esptein (Ritu Kumar) Los Angeles, California (Los Angeles Caucus) Sponsor - Robert Israel D. Yvette LaCoursiere (Terry) La Jolla, California (San Diego/AZ Caucus) Sponsor - Kathryn Macaulay

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CAUCUS GUESTS John Ozimek Los Angeles, California (Los Angeles Caucus) Sponsor - John Williams, III Emmanuelle Pare Portland, Oregon (Portland Caucus) Sponsor - Brian Shaffer Alan C. Schlaerth (Jocelyn Dee, MD) Arcadia, California (Los Angeles Caucus) Sponsor - Thomas Powers Neetu K. Sodhi (Rishi) Tarzana, California (Los Angeles Caucus) Sponsor - Anita Nelson Brandi Vasquez (Scott Kosmecki) Oregon City, Oregon (Portland Caucus) Sponsor - Barbra Fisher

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PERSONAL GUESTS Laila A. Al Marayati (Salam) Los Angeles, California (Los Angeles Caucus) Sponsor - Bob Israel Sylvana Bennett Portland, Oregon (Portland Caucus) Sponsor - Laura Greenberg Herb Brar (Barbara Brar, MD) Riverside, California (Los Angeles Caucus) Sponsor - Kathryn Shaw Christina Buchanan Honolulu, Hawaii (Los Angeles Caucus) Sponsor - Dennis Buchanan Melissa C. Bush (Jesus Valadez) Laguna Hills, California (Los Angeles Caucus) Sponsor - David Lagrew, Jr. Sigita Cahoon Los Angeles, California (Los Angeles Caucus) Sponsor - Bob Israel Taimur Chaudhry (Suzanne) Santa Maria, California (Los Angeles Caucus) Sponsor - Larry Shields

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PERSONAL GUESTS

Sara Durkee (Jarrod) Seattle, Washington (Seattle Caucus) Sponsor - Lori Marshall Katherine Eastwood Seattle, Washington (Seattle Caucus) Sponsor - Suzanne Peterson Laurie Gregg (Jeff Gregg, MD) Sacramento, California (San Francisco Caucus) Sponsor - Susan Gorman Christopher N. Herndon (Smita Yudav, PhD) (Seattle Caucus) Seattle, Washington Sponsor - Lori Marshall Brian Iriye (Kelly) Las Vegas, Nevada (Los Angeles Caucus) Sponsor - David Lagrew, Jr. Kiran Kavipurapu San Diego, California (San Diego/AZ Caucus) Sponsor - Ronald Reinsch Nah Yong Moom (Alex Kim) San Marcos, California (San Diego/AZ Caucus) Sponsor - Vera Stucky

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PERSONAL GUESTS Lynn Ngo (Ryan Kihara) San Diego, California (San Diego/AZ Caucus) Sponsor - Ronald Reinsch Mona Orady San Francisco, California (San Francisco Caucus) Sponsor - Fung Lam Emily Rangel (Ryan) Portland, Oregon (Portland Caucus) Sponsor - Duncan Neilson Hellen Rodriguez (Richard Armas) (Los Angeles Caucus) West Covina, California Sponsor - Kathleen Bradley Kimberly Suriano Portland, Oregon (Portland Caucus) Sponsor - Philippa Ribbink Sara Twogood (Josh Gordon) Los Angeles, California (Los Angeles Caucus) Sponsor - Bob Israel

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GUESTS OF THE BOARD OF DIRECTORS

Margaret Bates (Scott Johnson) Los Angeles California Melody Besharati San Jose, California Ted Adams Scholarship Award Hannah Chapman Phoenix, Arizona Ted Adams Scholarship Award Thinh Duong (Tamula Patterson, MD) Los Angeles California Barbara Durrant, PhD San Diego, California Combined Luncheon Speaker Kristina Eaton Anchorage, Alaska D. Katie Fitzpatrick (Paul Johnson, MD) Portland, Oregon Leandra Fraser Los Angeles, California Ted Adams Scholarship Award Anthony Garcia Bakersfield, California Daniel Grossman San Francisco, California James C. & Joan Caillouette Lecture Kathy Hsiao San Francisco, California

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GUESTS OF THE BOARD OF DIRECTORS

Jenny Jaque Riverside, California Dawn Kopp (John) Spokane, Washington Yumi Mendez-Ishizaki Los Angeles, California Ted Adams Scholarship Award Danielle Ofri New York, New York Keynote Lecture William Parker Del Mar, California Guest Lecture Tamula Patterson (Thinh Duong,MD) Downey, Cali-fornia Meghan Smith Los Angeles, California Frank Lynch Memorial Essayist Sharon Stortz San Diego, California Ted Adams Scholarship Award Veronique Tache Sacramento, California Patrice Weiss Roanoke, Virginia Presidential Choice Address

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GENERAL INFORMATION

Registration for Activities Day participants will be Tuesday, October 22nd 4-6pm in the Loggia 1 Meeting registration starts at 2:00pm Wednesday, October 23, 2019 - Loggia 1 The registration fee includes: Wednesday evening Welcome Reception and Dinner Party - Casual New Members’ Gathering, following welcome reception/dinner Wednesday evening - Casual Continental Breakfast for attendees and companions on Thursday, Friday and Saturday Thursday Combined Luncheon Lecture for attendees and companions Thursday evening reception/dinner at Bernardo Winery - Casual Saturday Evening Presidential Address/Reception and Dinner/Dance – Business Casual Sunday Farewell Brunch - Casual Coffee Breaks for scientific sessions (Thurs. Fri., Sat.)

PLEASE WEAR YOUR IDENTIFICATION BADGE

TO ALL FUNCTIONS

*Attire for scientific sessions - business casual

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PRESENTATION GUIDELINES

There are 2 types of presentations. The thirty (30) minute presentations - 15 minutes is for your presentation, 5 minutes for formal discussion and 10 minutes for discussion from the assembly and the twenty (20) minute presentations - 10 minutes is allowed for your presentation with 10 minutes allowed for written questions and discussion from the assembly. Adherence to the time schedule is important and all are ex-pected to cooperate.

FORMAL DISCUSSION/REVIEW GUIDELINES

FORMAL DISCUSSANT - assigned to 30 minute presenta-tions - Formal discussants will present their discussion orally. Maximum five (5) minutes is allowed for formal discussion. FORMAL DISCUSSIONS are to be uploaded through the Society web site prior to the annual meeting. References, if any, should be formatted according to the "Information for Au-thors" in the AMERICAN JOURNAL of OBSTETRICS AND GYNECOLOGY. A revised discussion will be accepted by the Editor if received within 2-weeks of the last day of the Annual Meeting. Submit through the Society web site - www.pcogs.org FORMAL REVIEWER - assigned to 20 minute presenta-tions. Formal reviewers submit written questions prior and do not take the stage. Review manuscript submitted through the Society’s web site, prepare 1-3 questions for the presenter to respond to during their presentation, submit the questions to the presenter 6 weeks prior to the annual meeting in the form of a PowerPoint slide.

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ACCME Accreditation This activity has been planned and implemented in ac-cordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Edu-cation (ACCME) through the joint providership of The American College of Obstetricians and Gynecologists and Pacific Coast Obstetrical and Gynecological Society. The American College of Obstetricians and Gynecologists is accredited by the ACCME to provide continuing medical education for physicians. AMA PRA Category 1 Credit(s)™ The American College of Obstetricians and Gynecol-ogists designates this live activity for a maximum of 14 AMA PRA Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity. College Cognate Credit(s) The American College of Obstetricians and Gynecol-ogists designates this live activity for a maximum of 14 Category 1 College Cognate Credits. The College has a reciprocity agreement with the AMA that allows AMA PRA Category 1 Credits™ to be equivalent to College Cognate Credits. Disclosure of Faculty and Industry Relationships In accordance with College policy, all faculty and plan-ning committee members have signed a conflict of inter-est statement in which they have disclosed any financial interests or other relationships with industry relative to topics they will discuss at this program. At the beginning of the program, faculty members are required to disclose any such information to participants. Such disclosure allows you to evaluate better the objectivity of the infor-mation presented in lectures. Please report on your evalu-ation form any undisclosed conflict of interest you per-ceive. Thank you!

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LEARNING OBJECTIVES 1) To learn about specific research projects and their application to clinical practice in obstetrics and gynecology, through oral presentations and poster sessions by different members of the Pacific Coast Obstetrical and Gynecological Society and their invited guests. 2) To review a controversial topic in the field of obstetrics and gynecology, by inviting a national expert to present and review data. 3) To network professionally with leaders in the field of obstetrics and gynecology as regards the future of the spe-cialty, residencies, and medical students.

MISSION STATEMENT The Pacific Coast Obstetrical and Gynecological Society is composed of individuals dedicated to excellence in the health care of women, dedicated to promoting coopera-tive efforts and unity between private practice physicians and the academic sector, providing continuing medical education for its membership, and advancing knowledge in the specialty. The Society also deals with concerns in the specialty other than direct patient care, including social issues, health care delivery, and patient education. The Society is dedicated to the continuance of the physi-cian's professional learning from medical school through residency/fellowship training and beyond.

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FRANK LYNCH MEMORIAL ESSAYISTS PCOGS’ 1st President, 1932

2001-2018

Vance McCausland USC 2001 Jennifer Dizon-Israel USC 2002 Arus Zograbyan USC 2003 Iris Colon Stanford 2004 Chad Hamilton Stanford 2005 Katherine Gabriel-Cox Kaiser SF 2006 Anjali Kaimal UCSF 2007 Brian L. Shaffer UCSF 2008 Tania F. Esakoff UCSF 2009 Christine Hiebert USC 2010 Pavithra Venkat UCSF 2011 Not awarded n/a 2012 Jessica Atrio USC 2013 Marc Gualtieri USC 2014 Jonas J. Swartz OHSU 2015 Alexandra Rzepka Univ of AZ 2016 Nicole B. Kurata Univ of HI 2017 Whitney Wellenstein Kaiser Oakland 2018

CHARLES KIMBALL AWARD President—1986

2008-2018

Tania Esakoff UCSF 2008 Tevy Tith UCLA 2009 Clara Ward UCSF 2010 Manijeh Torki USC 2011 Uyen Huynh Kaiser-Santa Clara 2012 Melissa Rosenstein UCSF 2013 Sigita Cahoon USC 2014 Kristl Tomlin PIROG 2015 Neetu K. Sodhi UCLA 2016 James A. Sargent OHSU 2017 Martha Tesfalul UCSF 2018

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ANTI HARASSMENT POLICIES

NON DISCRIMINATION POLICY The Pacific Coast Obstetrical and Gynecological Society does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disabil-ity, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of members and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, members, candidates, guest speakers, scholarship candidates and recipi-ents. The Society’s nondiscrimination policy also extends to the industry supporters of the Society, whether by education grants or by exhibits. The Pacific Coast Obstetrical and Gynecological Society is an equal opportunity employer. We will not discriminate and will take affirmative action measures to ensure against discrimination in em-ployment, recruitment, advertisements for employ-ment, compensation, termination, upgrading, pro-motions, and other conditions of employment against any employee or job applicant on the bases of race, color, gender, national origin, age, religion, creed, disability, veteran's status, sexual orientation, gender identity or gender expression.

SEXUAL HARASSMENT POLICY It is the policy of the Pacific Coast Obstetrical and Gynecological Society that the workplace, meet-ings, and society activities are conducted in an en-vironment free from sexual harassment. This policy applies to all attendees at Society activities, includ-ing members, speakers, students, guests, staff, con-tractors, exhibitors, and volunteers. The Pacific Coast Obstetrical and Gynecological Society

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strongly disapproves of offensive or inappropriate sex-ual behavior and participants must avoid any action or conduct which could be viewed as sexual harassment. Sexual harassment is defined by the Equal Employ-ment Opportunity Commission (EEOC) as any unwel-come sexual advance, request for sexual favors, or oth-er verbal or physical conduct of a sexual nature, when: (1) submission to the harassment is made either explic-itly or implicitly a term or condition of employment or membership ; (2) submission to or rejection of the har-assment is used as the basis for employment or mem-bership decisions affecting the individual; or (3) the harassment has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile, or offensive working environment. Any employee or Society participant who has a com-plaint of sexual harassment by anyone, should first clearly inform the harasser that his/her behavior is of-fensive or unwelcome and request that the behavior stop. The Society strongly urges reporting of all inci-dents of harassment, regardless of the offender's identi-ty or position by contacting the Caucus Chair and/or a member of the Board of Directors, who can be reached at (contact members only site at www.pcogs.org). If deemed necessary by those experiencing harassment, the Board of Directors/Caucus chair will assist in con-tacting convention center/hotel/venue security or local law enforcement. He or she is not required or expected to discuss the concern with the alleged offender. All complaints will be treated seriously and be investigated promptly. Confidentiality will be honored to the extent permitted as long as the rights of others are not com-promised. If the Caucus Chair and or Board Member knows of an incident of sexual harassment, they shall take appropri-ate remedial action immediately. If the alleged harass-ment involves any types of threats of physical harm to the victim, the alleged harasser may be immediately suspended or expelled from the Society. All complaints

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will be investigated by the Pacific Coast Obstetrical and Gynecological Society Board of Directors. The Board of Directors will name an impartial investiga-tor, usually a Society Officer or Caucus member. Any named investigator who believes they have a conflict of interest should not serve as an investiga-tor. In most cases, the complainant will be inter-viewed first and the written complaint reviewed. If the complainant has not already filed a formal com-plaint, he or she should be asked to do so. The de-tails of the complaint should be explained to the alleged offender by the investigator. The alleged offender should be given a reasonable chance to respond to the evidence of the complainant and to bring his or her own evidence. If the facts are in dis-pute, further investigatory steps may include inter-viewing those named as witnesses. If, for any rea-son, the investigator is in doubt about whether or how to continue, he or she will seek appropriate counsel. When the investigation is complete, the investigator should report the findings to the Board of Directors. If the investigation supports charges of sexual harassment by the Board of Directors, disci-plinary action against the alleged harasser will take place and may include suspension, expulsion, or other disciplinary actions. If the investigation re-veals that the charges were brought falsely and with malicious intent, the charging party may be subject to disciplinary action, including termination or ex-pulsion by the Board of Directors.

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PROGRAM SUMMARY TUESDAY, OCTOBER 22, 2019 4:00-6:00pm Early Registration for Activities Day - Loggia 1 LUNCH AND DINNER ON OWN WEDNESDAY, OCTOBER 23, 2019 Birding - ON YOUR OWN - self guide maps available 9:00 am Biking - meet in lobby 10:00am Golf - Rancho Bernardo Inn Course 10:30am Stone Brewery Tour - meet in lobby 9:00-1:30pm Tour of Midway Aircraft Carrier - Buses at lobby entrance 2:00-6:00pm Arrival and Registration – Loggia 1 2:00-5:30pm Hospitality Suite* - Castillo Parlor 2:00-3:00pm Arrangements Committee Meeting Granada 3:00-4:00pm Program Committee Meeting Granada 4:00-6:00pm First Board of Directors Meeting Granada 6:30-7:00pm Welcome Reception* - Veranda Patio 7:00pm Dinner* - Veranda Patio 9:00pm New Members Gathering* - Buena Vista Terrace (elected within 5 years) 9:00pm-11:00pm Hospitality Suite - Castillo Parlor THURSDAY, OCTOBER 24, 2019 6:00-7:00am Yoga - Valencia Lawn 7:00-7:40am Attendees - Breakfast Buffet*

Members & Guests – Aragon Lawn 8:00-9:30am Companions’ Breakfast Buffet* North Lawn 7:30-7:45am Opening Remarks Aragon I & II 7:45-8:15am Resident/Fellow Oral Synopses of Ted Adams Scholarship Award Poster presentations Aragon I & II

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8:15-9:45am Presentation 1, 2, 3 Aragon I & II 9:45-10:15am Poster Presentations & Informal Discussion - Aragon South Lobby Exhibits/Industry Representatives - Aragon III 10:15-11:15am Presentation 4, 5 Aragon I & II 11:15-11:45am Lecture - Lori Marshall

“The Myth of Anonymity in Third Party Reproduction” Aragon I & II 12:00-1:00pm Guest Lecture/Luncheon* Barbara Durrant, PhD-San Diego Zoo

“The San Diego Zoo Northern White Rhino Initiative and Conservation Efforts”

COMPANIONS INVITED Aragon I & II Buffet - Aragon Terrace West 1:15pm Pictures - Guests – TBA 1:15-1:45pm First Business Meeting - Aragon I & II 1:50pm Pictures - Fellows – TBA 2:00-2:30pm Presentation 6 Aragon I & II 2:30-3:30pm Lecture - William Parker

“Morcellation: Everyone is Entitled to Their Own Opinion, But Not to Their Own Facts”

3:30-4:00pm Poster Presentations & Informal Discussion - Aragon South Lobby Exhibits/Industry Representatives - Aragon III 4:00-5:00pm Panel Discussion

“Abnormal Uterine Bleeding” Anita Nelson, Moderator; Malcolm Munro, William Parker 5:00-6:00pm Hospitality Suite* - Castillo Parlor 5:30pm Buses Board for Bernardo Winery Hotel Lobby 6:00-9:00pm Reception/Dinner at Bernardo Winery 9:15pm Buses Board for Rancho Bernardo Inn

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FRIDAY, OCTOBER 25, 2019 7:00-7:50am Attendees -Breakfast Buffet*

Members & Guests - Aragon Lawn 7:00-7:50am Caucus Meetings

Los Angeles - Catalina East Portland - Andalucia II San Francisco - Andalucia I Seattle - Catalina West

8:00-9:30am Companions’ Breakfast Buffet* - North Lawn 8:00-8:30am Frank Lynch Memorial Essay Aragon I & II 8:30-9:00am Paper 7 Aragon I & II 9:00-10:00am James C. & Joan Caillouette Lecture “Demedicalizing Reproductive Health Care: from OTC Oral Contraceptives to Self-managed Abortion” Daniel Grossman Aragon I & II 10:00-10:30am Poster Presentations & Informal Discussion - Aragon South Lobby Exhibits/Industry Representatives - Aragon III 10:30-11:30am Paper 8, 9 Aragon I & II 11:30-12:00pm Lecture

“Transgender Surgery Updates” Heidi Wittenberg Aragon I & II

AFTERNOON FREE 1:00pm Birding - ON YOUR OWN - self guide maps available 1:00pm Biking - meet at front entrance of hotel 1:00pm Hiking - meet in hotel lobby 1:30pm Golf - Oaks North Course 1:00pm Stone Brewery Tour - meet hotel lobby 1:00-5:00pm Tour to Safari Park Buses at lobby entrance 1:00-5:00pm Hospitality Suite—Castillo Parlor 6:00-9:00pm Caucus Receptions/Dinners

Los Angeles - Promenade Portland - Buena Vista Terrace San Diego/AZ - TBD

San Francisco - Andalucia II Seattle - Andalucia I 9:30-11:00pm Hospitality Suite* - Castillo Parlor

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SATURDAY, OCTOBER 26, 2019 6:00-7:00am Yoga - Valencia Lawn 7:00-7:50am Attendees Breakfast Buffet* Members & Guests - Aragon Lawn 7:00-7:50am Membership Track Breakfast* Open to Caucus & Personal guests La Taberna/La Taberna Balcony 8:00-9:30am Companions’ Breakfast Buffet* North Lawn 8:00-9:00am Keynote Lecture Danielle Ofri

“What Patients Say, What Doctors Hear” Aragon I & II 9:00-10:00am Paper 10 & 11 Aragon I & II 10:00-11:00am Presidential Choice Lecture Patrice Weiss

“The Second Victim: Helping Providers Recover from Medical Errors”

Aragon I & II 11:00-11:30am Poster Presentations & Informal Discussion - Aragon South Lobby Exhibits/Industry Representatives - Aragon III 11:30-12:30pm Panel Discussion

“Update and Controversies in Robotics and Minimally Invasive Gyn Surgeries”

Chirag Shah, Moderator, John Lenihan, Pamela Paley, Marc Winter Aragon I & II 12:45-1:15pm Second Business Meeting - Aragon I & II 1:30-4:00pm Second Board of Directors Meeting - La Taberna/La Taberna Balcony

AFTERNOON FREE 1:30-4:30pm Hospitality Suite* - Castillo Parlor 5:15-6:15pm Presidential Address - Aragon Ballrooms 6:15-7:00pm Presidential Toast/Reception* - Aragon Lawn 7:00-11:-00pm Presidential Dinner/Dance* Aragon Ballrooms 10:00-11:00pm Hospitality Suite* - Castillo Parlor

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SUNDAY, OCTOBER 27, 2019 6:30-10:00am Farewell Breakfast* - Aragon Ballroom

COMPANIONS ACTIVITIES

THURSDAY, OCTOBER 25, 2019 12:00-1:00pm Guest Lecture/Luncheon* Barbara Durrant, PhD-San Diego Zoo

“The San Diego Zoo Northern White Rhino Initiative and Conservation Efforts”

Aragon I & II FRIDAY, OCTOBER 26, 2019 10:00AM Book Club - Castillo Parlor Terrace -(Hospitality Suite Terrace) “Educated: a memoir” by Tara Westover *INCLUDED IN REGISTRATION FEE

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LOCATION OF FUNCTIONS Academic/Social

Day Location Activities Day Arrival T Loggia 1 Activities Day W Birding on your own Biking Hotel lobby Golf Rancho Bernardo Inn Course Tour to Midway Aircraft Carrier meet in hotel lobby Stone Brewery Tour meet in hotel lobby Registration W Loggia 1 Arrangements Committee W Meeting Granada Program Committee W Meeting Granada Board of Directors’ Meeting W Granada Welcome Reception W Veranda Patio Buffet Dinner W Veranda Patio New Members Gathering W Buena Vista Terrace Hospitality Suite W,Th,F,S Castillo Parlor Breakfast Buffet Th, F, S Members and Guests Aragon Lawn Spouse/Companions North Lawn Yoga Th, S Valencia Lawn Scientific Sessions Th,F,S Aragon I & II Poster Presentations & Th,F,S Informal Discussion Aragon South Lobby Exhibits/Industry Reps Th,F,S Aragon III

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LOCATION OF FUNCTIONS

Academic/Social

Day Location Combined Luncheon Th Buffet Aragon Terrace West Lecture Aragon I & II Pictures Th TBA Members/Guests Reception/Dinner Th Bernardo Winery Board buses Hotel Lobby Caucus Meetings Fri. Los Angeles Catalina East Portland Andalucia II San Francisco Andalucia I Seattle Catalina West Book Club Fri Castillo Parlor Terrace Birding Fri. on your own Biking Fri. Hotel lobby Golf Fri Oaks North Course Hiking Fri Hotel Lobby Safari Tour Fri Hotel Lobby Stone Brewery Tour Fri Hotel Lobby

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LOCATION OF FUNCTIONS

Academic/Social

Day Location

Caucus Receptions Fri Los Angeles Promenade Portland Buena Vista Terrace San Diego/AZ TBA San Francisco Andalucia II Seattle Andalucia I Membership Track Sat. La Taberna/ Breakfast La Taberna Balcony Board of Directors’ Meeting Sat La Taberna/ La Taberna Balcony Presidential Address Sat Aragon Ballrooms Presidential Reception Sat. Aragon Ballrooms Dinner/Dance Sat. Aragon Ballrooms Farewell Breakfast Sun. Aragon Ballrooms

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HISTORY OF THE MEMORIAL FUNDS

FRANK LYNCH MEMORIAL ESSAY Frank W. Lynch was the first PCOGS President and was honored after death by initiation of a prize and lecture at each meeting; these now go to the best manuscript sub-mitted by a resident/fellow. TED ADAM SCHOLARSHIP AWARD Ted Adams was a charter member from Portland. His wife gifted the society with seed money to start a fund supporting scholarships for resident presenters. CHARLES KIMBALL MEMORIAL FUND Charlie Kimball was a member from Seattle who gifted money to the Society. The Board approved utilizing these funds for an award for the “best poster presentation” at each annual meeting. JAMES C. & JOAN CAILLOUETTE GUEST LECTURESHIP James “Jim” and Joan Caillouette funded an annual meet-ing lecture on the topic of population & family planning. MEMBERSHIP DEVELOPMENT FUND The newly formed “Membership Development Fund" honors many of our recently passed members (Bill Parer, Russ Laros and others*). When fully vested, it will help defray the registration costs for Caucus guests and sup-port PCOGS membership. *gifts designated “In Memory of...” at time of donations

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CONTRIBUTORS TO THE MEMORIAL FUNDS

Arzou Ahsan Frederick Ambrose Donald Barford Millie Behera Raydeen Busse Peter Chandler Richard Ellsworth Kurt Finberg Abby Furukawa Jim Gosewehr Shaun Grady Hanns Haesslein Joseph Hanss Rosetta Hassan Linda Hinrichsen Robert Israel Hanne Jensen Vern Katz William Khieu Matthew Kim Jeanette Lager David C. Lagrew, Jr.

Fung Lam Marilyn Laughead Melissa Larsen James Macer James Moran Carol Morcos Anita Nelson Laura Norrell Christopher O’Reilly-Green Joseph Ouzounian Gainer Pillsbury Robert Prins Dale Reisner Patricia Robertson Martin Schwartz Arthur Segal Jerry Shefren Vera Stucky Steven Vasilev Dan Veljovich John Williams, III

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THOSE HONORED BY CONTRIBUTORS

Kurt Benirschke Val Davajan Marsha Gorrill William K. Graves Russell Laros, Jr. George Macer Bill Parer Sterling Pillsbury Lyman Rust Gene Sandberg Gilbert Webb Bill Young

IN MEMORY OF

IN HONOR OF

Donald Barford Jack Enbom

Bob Israel Fung Lam

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ALPHABETICAL LISTING OF PRESENTERS/PRESENTATIONS Barkley, Joel - Fellow Identification of Endometrial Cancer Specific Mirna Biomarkers in Endometrial Fluid Collected Using Sa-line Infusion Sonohysterography Techniques Friday, October 25; 10:30-11:00am - Pg. 79 Besharati, Melody - Guest of the Board of Directors Examination of Fetal Growth Trajectories Following Infertility Treatment Thursday, October 24; 7:45-8:15am - Pg. 52 Chandler, Peter - Fellow Initiation of Trial of Labor After Cesarean Delivery at a Safety Net Hospital: Maternal and Perinatal Out-comes 2009-2019 Saturday, October 26; 9:30-10:00am - Pg. 87 Chapman, Hannah - Guest of the Board of Directors Evaluating Impact of Universal Screening of Hepatitis C In Prenatal Care Thursday, October 24; 7:45-8:15am - Pg. 54 Coonrod, Dean V. - Fellow A Two Country Study of Pregnancy Intent: Cameroon and USA Thursday, October 24; 10:45-11:15am - Pg. 68 Durrant, PhD Barbara - Guest of the Board of Direc-tors The San Diego Zoo Northern White Rhino Initiative and Conservation Efforts Thursday, October 24; 12:00-1:00pm - Pg. 70 Fraser, Leandra - Guest of the Board of Directors Postpartum Contraceptive Uptake Prior to Discharge at a Safety-Net Hospital Thursday, October 24; 7:45-8:15am - Pg. 55 Grossman, Daniel - Guest of the Board of Directors JAMES C. & JOAN CAILLOUETTE LECTURE Demedicalizing Reproductive Health Care: From OTC Oral Contraceptives to Self-Managed Abortion Friday, October 25; 9:00-10:00am - Pg. 78

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Lenihan, John - Fellow PANEL DISCUSSION - Update and Controversies in Robotics and Minimally Invasive Gyn Surgeries Saturday, October 26; 11:30-12:30pm - Pg. 89 Macdonald, Heather - Society Guest Impact of Meditation and Mindfulness on Perioperative Distress and Pain in Newly Diagnosed Breast Cancer Patients Saturday, October 26; 9:00-9:30am - Pg. 85 Marshall, Lori - Fellow The Myth of Anonymity in Third Party Reproduction Thursday, October 24; 11:15-11:45am - Pg. 70 Mendez-Ishizaki, Yumi - Guest of the Board of Directors Accuracy of Estimated Versus Quantitative Blood Loss For the Assessment of Postpartum Hemoglobin Drop Thursday, October 24; 7:45-8:15am - Pg. 57 Munro, Malcolm - Fellow PANEL DISCUSSION - Abnormal Uterine Bleeding Thursday, October 24; 4:00-5:00pm - Pg. 73 Nelson, Anita - Fellow PANEL DISCUSSION - Abnormal Uterine Bleeding Thursday, October 24; 4:00-5:00pm - Pg. 73 Ofri, Danielle - Guest of the Board of Directors KEYNOTE LECTURE What Patients Say, What Doctors Hear Saturday, October 26; 8:00-9:00am - Pg. 84 Ogasawara, Keith - Fellow Code Crimson, A Unique Adaptation of the Massive Transfusion Protocol for Obstetrical Hemorrhage Friday, October 25; 8:30-9:00am - Pg. 76 Paley, Pamela - Fellow PANEL DISCUSSION - Update and Controversies in Robotics and Minimally Invasive Gyn Surgeries Saturday, October 26; 11:30-12:30pm - Pg. 89 Pandipati, Santosh - Fellow Anticipated Impacts of Climate Change on Women’s Health Thursday, October 24; 8:45-9:15am - Pg. 62

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Parker, William - Guest of the Board of Directors Morcellation: Everyone Is Entitled to Their Own Opinion, But Not to Their Own Facts Thursday, October 24; 2:30-3:30pm - Pg. 73 Parker, William - Guest of the Board of Directors PANEL DISCUSSION - Abnormal Uterine Bleeding Thursday, October 24; 4:00-5:00pm - Pg. 73 Press, Joshua Z. - Society Guest Role of Robotic Surgery for Interval Cytoreduction of Ovarian Cancer After Neoadjuvant Chemotherapy Thursday, October 24; 10:15-10:45am - Pg. 66 Roloff, Kristina - Fellow Outpatient Induction of Labor With Misoprostol in Low Risk Pregnancies at 39 Weeks Saturday, October 26; 11:00-11:30am - Pg. 81 Romero, Larissa - Society Guest Oxytocin Protocol: Does Implementation of a New Protocol Impact Postpartum Hemorrhage Rates? Thursday, October 24; 2:00-2:30pm - Pg. 71 Shah, Chirag - Fellow PANEL DISCUSSION - Update and Controversies in Robotics and Minimally Invasive Gyn Surgeries Saturday, October 26; 11:30-12:30pm - Pg. 89 Smith, Meghan - Guest of the Board of Directors FRANK LYNCH MEMORIAL ESSAY Examining Pre-Term Birth (Ptb) and Cesarean Section (Cs) Rates in Gestational Carrier (Gc) Pregnancies Friday, October 25; 8:00-8:30am - Pg. 74 Stortz, Sharon - Guest of the Board of Directors Rates of Follow Up for Interval Postpartum Long-acting Reversible Contraception (LARC) Placement in Women with Universal LARC Access Through the Military Health System Thursday, October 24; 7:45-8:15am - Pg. 58 Wang, Erica - Guest of the Board of Directors Androgenicity and Fertility Treatment in Women with Unexplained Infertility Thursday, October 24; 9:15-9:45am - Pg. 64

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Weiss, Patrice M. - Guest of the Board of Directors PRESIDENTIAL CHOICE LECTURE The Second Victim: Helping Providers Recover from Medical Errors Saturday, October 26; 10:00-11:00am - Pg. 89 Wittenberg, Heidi - Fellow Minimally Invasive Option for Abdominal Cervico-Isthmic Cerclage with Cystoscopy Via Vaginal Approach Thursday, October 24; 8:15-8:45am - Pg. 60 Wittenberg, Heidi - Fellow Transgender Surgery Updates Friday, October 25; 11:30-12:00pm - Pg. 83 Winter, Marc - Fellow PANEL DISCUSSION - Update and Controversies in Robotics and Minimally Invasive Gyn Surgeries Saturday, October 26; 11:30-12:30pm - Pg. 89

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NOTES

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2019 PROGRAM THURSDAY: 6:00-8:15am OCTOBER 24, 2019 6:00-7:00am Yoga - Valencia Lawn 6:30am Breakfast Buffet Members & Guests - Aragon Lawn

FIRST SCIENTIFIC SESSION 7:30-7:45am Opening Remarks 7:45am

ORAL SYNOPSES OF TED ADAMS SCHOLARSHIP AWARD

POSTER PRESENTATIONS P-01. EXAMINATION OF FETAL GROWTH TRAJECTORIES FOLLOWING INFERTILITY TREATMENT Melody Besharati, San Jose, California (By Invitation) OBJECTIVE: Birthweight is a powerful predictor of childhood and chronic disease. Although the majority of children born following infertility treatment are of normal birthweight, singletons conceived after in vitro fertilization (IVF) with fresh embryo transfer (ET) have an increased risk for low birthweight compared to the general popula-tion, and children conceived via frozen embryo transfer (FET) have an increased risk for macrosomia. However, little is known about fetal growth during pregnancies con-ceived after infertility. This study is the first to compare fetal growth kinetics during the second and third trimesters for intrauterine insemination (IUI) ovulation induction, fresh ET, FET, and spontaneous conception following in-fertility. DESIGN: A retrospective analysis was performed on 893 women at a single fertility center, who conceived viable

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pregnancies from years 2011 to 2018 and consented to participate in a study examining pregnancy outcomes fol-lowing infertility. All women achieved pregnancy either by treatment or spontaneously after a diagnosis of infertil-ity. Inclusion criteria included autologous singleton preg-nancies with available ultrasound data (n=395), compris-ing ovulation induction with IUI (n=69), fresh ET after controlled ovarian stimulation (n=82), FET (n=146), and spontaneous conception (n=98). Excluded were pregnan-cies from donor oocytes (n=53), twins (n=60), unavaila-ble ultrasound data (n=333), and treatment methods with small number of participants (n=52). Demographic and ultrasound information was obtained from the electronic health record. Outcomes of interest were head circumfer-ence (HC), abdominal circumference (AC), HC/AC ratio, and estimated fetal weight (EFW). Gestational age was calculated based on conception data and initial ultrasound date. Conditional growth curve models were constructed with calculation of first and second order slopes. The study was IRB-approved. RESULTS: There were 395 women who met the inclu-sion criteria, and a total of 1,024 ultrasound examinations were available for review. Baseline demographics were comparable between the groups. Growth curves were se-lected for each outcome of interest based on best fit to the plotted data points. For ovulation induction with IUI, IVF including fresh ET plus FET, and spontaneous concep-tion, the slope analysis of linear, quadratic, or cubic growth curves for per-week growth rate of HC, AC, HC/AC ratio, and EFW demonstrated no difference (p values of 0.6, 0.8, 0.9, and 0.6, respectively). Change in EFW over time for the same groups yielded a p value of 0.2. A subgroup analysis of fresh ET and FET groups, for the same outcomes of interest, showed no difference (p val-ues of 0.3, 0.2, 0.5, and 0.4, respectively). Change in EFW over time for the subgroups yielded a p value of 0.7. A review of neonatal outcomes demonstrated mean birth weights of 3262g +/- 614g (p = 0.4) and 3415g +/- 551g (p = 0.3) for fresh ET and FET neonates, respectively.

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CONCLUSION: There was no significant difference in fetal growth during the second and third trimesters be-tween IUI ovulation induction, fresh ET, FET, and sponta-neous conception following infertility. It is possible there were no differences in growth trajectories between these conception methods because the majority of children born following infertility are of normal birth weight. These data contribute to the very limited literature on fetal growth trajectories following infertility treatment. While overall reassuring, additional research with larger samples is war-ranted. P-02. EVALUATING IMPACT OF UNIVERSAL SCREENING OF HEPATITIS C IN PRENATAL CARE K. M. Devin, J. Balducci, D. V. Coonrod Hannah Chapman, Phoenix, Arizona (By Invitation) OBJECTIVE: Determine the benefits of a policy of uni-versal screening for hepatitis C in prenatal care in an un-derserved population. STUDY DESIGN: Maricopa Integrated Health System in Phoenix, Arizona has been performing universal, opt-out screening in its emergency department for 2 years, 21,000 tests. As an extension of this program, universal screening of new prenatal patients has been implemented in our prin-cipal prenatal clinic since September 2018. To assess the effects of this policy, rates of screening, screen positives (antibody and RNA) will be compared one year prior to and one year during universal screening implementation. Assessment and results of risk factor screening will be concurrently evaluated. RESULTS: In the first 6 months 441 of the 685 eligible new prenatal patients have been screened, with improve-ment in rates of screening from 16% in month 1 to 82% cumulative rate in month 6. 37% of those screened were

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Medicaid insured and 16% were self-pay or uninsured. Additionally, 6 of 441 (1.4%) patients have screened posi-tive; 5 with no viral load and 1 with RNA detected. Chart review indicated 2 of the positives had risk factors and 4 had no risk factors identified. Risk factors assessed to date include of substance use (past/current) and current/past incarceration. CONCLUSION: We describe a policy of universal screening for hepatitis C in a prenatal population of under-served patients. Our rates of positivity are consistent with the literature’s rate of 1-4%. Our preliminary finding of the rate of pregnant women infected with no risk factors is consistent with reports that about half of women infected have no risk factors. P-03. POSTPARTUM CONTRACEPTIVE UPTAKE PRIOR TO DISCHARGE AT A SAFETY-NET HOSPITAL Leandra Fraser, Los Angeles, California (By Invitation) OBJECTIVES: Ensuring patients receive their desired postpartum contraceptive prior to hospital discharge is an essential component of providing quality, patient-centered family planning services. At our public hospital where all contraceptive methods are available at no cost, including immediate postpartum long-acting reversible contracep-tives (LARC), we reviewed the influence of discussing and documenting a contraceptive plan during the prenatal peri-od on receipt of contraception prior to discharge. METHODS: This was a retrospective chart review of all deliveries at LAC+USC Medical Center from June 2015 to January 2016. Postpartum contraceptive plans documented prior to delivery were compared to postpartum contracep-tion received prior to discharge from the hospital. Demo-graphic data and reproductive history were examined as potential determinants of contraceptive uptake. Descriptive

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information was summarized as numbers and column per-centages with differences in postpartum uptake status as-sessed by Pearson's chi-squared test, and associations be-tween categorical and continuous variables and uptake sta-tus were estimated using with Chi-square and ANOVA tests of association, respectively. All tests were assessed at a significance level of p<0.05. RESULTS: Data were abstracted from 539 charts. The majority of women were single (57%), Hispanic/Latina (53%), multiparous (61%), and had received prenatal care through LA County Department of Health Services clinics (80%). Documented discussion of a contraceptive plan during prenatal care was associated with receipt of that plan prior to discharge (94%; p<0.001). Of women who planned to obtain contraception prior to discharge from the hospital specifically, 69% (N=41/59) received the request-ed permanent Tier 1* method; 80% (N=129/162) received requested reversible Tier 1 method; 75% (N=51/68) re-ceived requested Tier 2 method, and 83% (N=44/53) re-ceived requested Tier 3 method. Women more likely to go home with contraception (p<0.05) were Hispanic/Latina, received care at a DHS-Affiliated Clinic, or were having their first baby. Women were less likely to obtain postpar-tum contraception prior to discharge if they had a demise or had a BMI <25 or >50 (p<0.01). Age, marital status, language spoken or pregnancy and delivery complications did not appear to influence uptake (p>0.05). *Permanent Tier 1: bilateral tubal ligation and salpingecto-my; Reversible Tier 1: intrauterine devices and implants; Reversible Tier 2: pills, patches, rings and injectables; Re-versible Tier 3: condoms, diaphragms, fertility awareness, spermicide and withdrawal. †Patients may have received more than one method, there-fore total percentages may exceed 100%.

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CONCLUSION: Routinely discussing and documenting contraceptive plans in the antenatal period is associated with receipt of desired postpartum contraception prior to discharge. LAC+USC Medical Center may serve as a model for other institutions in providing postpartum con-traception prior to discharge given routine education throughout pregnancy regarding contraception and wide-spread availability of contraceptive methods in the post-partum period, including immediate postpartum LARC. P-04. ACCURACY OF ESTIMATED VERSUS QUANTITATIVE BLOOD LOSS FOR THE ASSESSMENT OF POSTPARTUM HEMOGLOBIN DROP U. Ihenacho, V. Cortessis, J. Cooperman, K. McDaniel, C. Dancz, N. Bender, L.S. Wei Yumi Mendez-Ishizaki, Los Angeles, California (By Invitation) OBJECTIVE: Reliable and efficient quantification of postpartum blood loss leads to early detection and inter-vention for postpartum hemorrhage, which significantly impacts maternal morbidity and mortality. Our study as-sesses the accuracy of estimated blood loss (EBL) versus quantitative blood loss (QBL) in predicting postpartum hemoglobin drop. METHODS: A retrospective chart review was performed to gather data 6 months pre and post implementation of QBL from 11/1/2016-10/31/2017. Actual versus predicted drop in hemoglobin was calculated based on a drop of 1.0g/dL for every 500 mL of blood loss. Receiver Operat-ing Curves were developed to depict the accuracy of the blood loss measure type in estimating a hemoglobin blood drop. Test for differences in the area under the curve were estimated using Pearson's chi-squared test. All tests were assessed at a significance level of p<0.05. RESULTS: A total of 924 subjects were included in our

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study. QBL group consisted of 526 and EBL group con-sisted of 398. The QBL vs EBL method accurately predict-ed a hemoglobin drop of 1.0g/dL or more 39.8% of the time (QBL) vs 48.5% of the time (EBL) when the blood loss was at or over 500mL. For blood loss above 1000mL, accuracy for QBL and EBL groups were 15.5% and 7.4%, respectively. There was no statistically significant differ-ence in the correlation between postpartum hemoglobin drop and blood loss by blood loss measure type. CONCLUSION: Our study compared quantitative blood loss versus estimated blood loss by evaluating postpartum drop in hemoglobin. In our study we did not find a signifi-cant difference between quantitative blood loss and esti-mated blood loss in predicting hemoglobin drop. P-05. RATES OF FOLLOW UP FOR INTERVAL POSTPARTUM LONG-ACTING REVERSIBLE CONTRACEPTION (LARC) PLACEMENT IN WOMEN WITH UNIVERSAL LARC ACCESS THROUGH THE MILITARY HEALTH SYSTEM Sharon Stortz, San Diego, California (By Invitation) OBJECTIVE: To evaluate if universal access to LARC improves interval postpartum LARC uptake in women planning this method of postpartum contraception. Our study is unique in that all women delivered at a military treatment facility and had access to a walk-in contraceptive clinic with same-visit LARC placement. DESIGN: This retrospective study involved both active duty women and civilian women delivering at a single mil-itary treatment facility between Jun 01, 2017 and Jun 30, 2018. Patient discharge summaries were reviewed for con-traceptive plans; if planning interval LARC, outpatient records were reviewed to determine 1) if LARC was placed within 6 months of delivery 2) the duration of time

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between delivery and placement, 3) other forms of contra-ception received, 4) pregnancy within 18 months of deliv-ery if LARC was planned but not placed. RESULTS: Preliminary data (n=725), showed 20.4% (n=101) of patients desired interval LARC placement; of these women, 58.1% (n=86) received a LARC within six months of delivery. Of women who desired interval LARC but did not have it placed, 8.1% (n=12) experienced preg-nancies within 18 months of delivery. Approximately 11% of women had the LARC placed in the walk-in contracep-tive clinic. CONCLUSION: Women receiving care at a military treatment facility with a walk-in contraceptive clinic had higher rates of interval postpartum LARC placement than published studies from civilian populations (36.5%)1. Pre-viously published data on a military beneficiary population reported 17% postpartum LARC initiation rate, but did not compare intentioned contraception to rate of placement.2 The high rate of interval LARC placement in our study suggests removing both cost and schedule barriers can in-crease access to and implementation of women’s desired postpartum contraception.

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THURSDAY: 8:15-8:45am OCTOBER 24, 2019 O-01. MINIMALLY INVASIVE OPTION FOR ABDOMINAL CERVICO-ISTHMIC CERCLAGE WITH CYSTOSCOPY Heidi Wittenberg, San Francisco, California OBJECTIVE: Evaluation of outcome and complica-tions of 326 pregnancies after abdominal placement of a transvaginal cervico-isthmic cerclages (TVCIC). In-cluding a step by step demonstration of procedure. DESIGN: Patients who were candidates for abdominal cerclages were offered TVCIC. Candidates had a diag-nosis of cervical incompetence and had any one or more of the following: prior cerclages, failed cerclages, rescue cerclages, cervical procedures like LEEP or cone, trachelectomy, bladder surgery, or any urogenital anomalies. RESULTS: From January 1, 2008 until December 18, 2018 we have performed 326 TVCIC. Average mater-nal age was 34 years (range 20-48y/o) with average gestational age 14.4 weeks (range 12-23.5 weeks), with 4 patients having twins. In regards to obstetrical outcomes and complications: There were 10 Preterm births, 6 patients had Preterm premature rupture of membranes, 3 had Placental ab-ruption, 2 hemorrhage and 1 had an infection. Surgical complications were observe in 4 patients: 3 with bladder injury and 1 with rectal injury. All of these were identified in the operating room and were primari-ly repaired without further surgery. CONCLUSION: Adding the cystoscopy has aided in identifying any bladder issues, although the addition of having a Female Pelvic Medicine and Reconstructive Surgery board certified specialist, doing the bladder dissection probably decreases complications. Urologic complication rate is lower in this series than reported in

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prior studies. This procedure is as effective as a transabdominal cer-clage while having the benefits of a vaginal procedure. Benefits of this minimally invasive approach include re-gional anesthesia can be used instead of general for inser-tion and removal and a vaginal delivery can remain an option for delivery of patient. TVCIC with cystoscopy is a safe and effective procedure. Obstetrical outcomes are favorable with low urologic complication rate. Formal Discussant: William Khieu, Salinas, California

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THURSDAY: 8:45-9:15am OCTOBER 24, 2019 O-02. ANTICIPATED IMPACTS OF CLIMATE CHANGE ON WOMEN’S HEALTH Santosh Pandipati, Los Gatos, California OBJECTIVE: Obstetrician/gynecologists are in need of increased awareness of climate change-related ad-verse impacts on women’s health. Obstetrician/gynecologists should understand how they can assist and empower women in confronting the challenges of climate change. DESIGN: A PubMed search, as well as review of ad-ditional evidence-based peer-reviewed sources (including the Intergovernmental Panel on Climate Change and the United States National Climate As-sessment), was undertaken, focusing on the keywords of climate change, health, women, and women’s health. RESULTS: Global mean surface temperature has in-creased by 1 degree Celsius since pre-industrial times, concomitant with an increase in atmospheric CO2 lev-el from 280 parts per million (ppm) to 410 ppm. This increase has been unequivocally attributed to human activities, and is expected to worsen unless there is a significant reduction in human-related emissions of global warming gases in the near-term future. Mitiga-tion of, and adaptation to, emissions-related climate change will be key determinants of humanity’s surviv-al in the face of this existential crisis. Anticipated adverse impacts on human health from climate change include increased exposures to extreme weather events, including droughts, flooding, and ex-tremes of temperature; altered food-, water-, and vec-tor-borne infectious disease; reduced food, water and air quality; decreased food security; loss of access to healthcare resources due to political and economic

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instability, as well as due to mass migration. Given the differing roles men and women play in most societies, as well as women’s unique reproductive burden, climate change impacts are expected to have a differential impact on men versus women. In many cases, adverse impacts are likely to be worse for women than men by widening health disparities that already exist in many parts of the world. Examples of adverse health effects to be felt disproportionately by women include: heat-related morbidity and mortality; respiratory disease; anemia and malnutrition; physical and sexual violence; anxiety, depression, and other mood disorders; numerous pregnancy-related complications (e.g., intrauterine growth restriction, preterm birth, congenital anomalies, stillbirth); and lack of access to prenatal care, contraception, and family planning options. Mitigation and adaptation initiatives will help alleviate the negative impacts of climate change on human health, but to have maximized benefit, they will need to account for these anticipated health disparities between men and women. Despite potential worse outcomes for women, opportunity exists to empower women to act as agents of mitigation and adaptation to climate change due to the unique roles women play in human reproduction, as well as in many societies as educators, caregivers, and social change agents. CONCLUSION: Human-induced climate change is anticipated to have numerous adverse implications to human health. Women, especially throughout their repro-ductive years, are disproportionately vulnerable to poten-tial adverse effects on their health. Nevertheless, women are also uniquely qualified to play a central role in the mitigation of, and adaptation to, climate change. Obste-trician/gynecologists, as primary caretakers of women, should be aware of the potential negative impacts of cli-mate change on their patients, and how they can assist their patients in becoming effective agents of mitigation and adaptation. Formal Discussant: Amy Card, Corvallis, Oregon

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THURSDAY: 9:15-9:45am OCTOBER 24, 2019 O-03. ANDROGENICITY AND FERTILITY TREATMENT IN WOMEN WITH UNEXPLAINED INFERTILITY Erica T. Wang, Los Angeles, California (By Invitation) OBJECTIVE: In the unexplained infertility popula-tion, do serum androgen levels or markers of andro-genic activity predict live birth rate with ovarian stim-ulation using gonadotropins, clomiphene, or letrozole? STUDY DESIGN: This is a secondary data analysis of the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial conducted by the NICHD Cooperative Reproductive Medicine Network, which included 900 couples with unexplained infertility. Women were 18-40 years of age with regular menses, normal uterine cavity with at least one patent fallopian tube, and had a male partner with ≥5 million sperm per milliliter. Women were randomized to receive gonadotropin injection, clomi-phene, or letrozole for up to four treatment cycles and intrauterine insemination. At baseline, all women were also evaluated for androgen excess with serum androgen levels (total testosterone, DHEA-S, andros-tenedione, and SHBG) and clinical markers of andro-genic activity (sebum score, acne, and hirsutism). For this analysis, serum androgen levels and clinical an-drogen markers were used as continuous and categori-cal predictors. The primary outcome was live birth, and secondary outcomes included conception, clinical pregnancy, and pregnancy loss. Multivariate logistic regression models adjusting for treatment group, ma-ternal age, and body mass index were performed. RESULTS: Of the 900 women, 301 received gonado-tropin injections, 300 clomiphene, and 299 letrozole.

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Ovarian stimulation with clomiphene and letrozole result-ed in a lower frequency of live birth (23% and 19% re-spectively vs 32%, P=0.001). When serum androgens were used as a continuous variable, total testosterone was associated with a small statistical increase in conception (aOR 1.013, 95% CI 1.003-1.023, P=0.009) and clinical pregnancy (aOR 1.011, 95% CI 1.001-1.021, P=0.025), but not live birth (aOR 1.007, 95% CI 0.998-1.017, P=0.126). DHEA-S, androstenedione, sebum score, acne, and hirsutism score as continuous measures were not as-sociated with primary and or secondary outcomes. Wom-en with serum androgens in the top quartile did not have a higher live birth rate compared to women with serum an-drogens in the lowest quartile. CONCLUSIONS: In a randomized cohort of women with unexplained infertility, serum and clinical measures of androgens did not predict live birth rate after treatment with gonadotropin injections, clomiphene, or letrozole. Sources of support: R25 HD075737 (to NS) Formal Discussant: Brenda Houmard, Spokane, Washington 9:45-10:15am - POSTER PRESENTATIONS/ INFORMAL DISCUSSION - Aragon South Lobby EXHIBITS/INDUSTRY REPS - Aragon III

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THURSDAY: 10:15-10:45am OCTOBER 24, 2019 O-04. ROLE OF ROBOTIC SURGERY FOR INTERVAL DEBULKING OF OVARIAN CANCER AFTER NEOADJUVANT CHEMOTHERAPY N. Kretzer, A. E. BonDurant, C. W. Drescher, C. A. Shah, D. S. Veljovich Joshua Z. Press, Seattle, Washington (By Invitation) OBJECTIVE: When compared with primary radical debulking surgery, the strategy of treating newly diag-nosed ovarian cancer with neo-adjuvant chemotherapy followed by interval debulking surgery (IDS) can result in similar progression-free survival and overall surviv-al, while showing significantly less surgical morbidity. To further reduce surgical morbidity, surgeons have elected to follow neoadjuvant chemotherapy with mini-mally invasive robotic IDS. DESIGN: This single institution, retrospective study evaluated all patients having robotic IDS after neoadju-vant chemotherapy for newly diagnosed advanced stage (III or IV) ovarian cancers between 2006 - 2016. Outcomes will be compared between these robotic IDS and matched-cases of traditional IDS performed with midline open laparotomy. RESULTS: The use of robotic technique for ovarian cancer IDS increased at our center between 2006 and 2016, and consisted of 12 cases of advanced stage (III or IV) ovarian cancer. There was 1 conversion from planned robotic IDS to midline laparotomy due to ina-bility to adequately ventilate while in the required trendelenberg position resulting in progressive hyper-capnia. The 12 advanced stage robotic IDS completed at least 6 cycles of chemotherapy, with a maximum of 9 cycles. Chemotherapy consisted mostly of combi-

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for 1 patient who received Carboplatin/Doxil after having a severe allergic reaction to Paclitaxel. Patient ages ranged from 48 – 91 (average 65). Analysis of surgical data re-vealed that 6/12 (50%) robotic IDS achieved optimal cy-toreduction, with surgical time ranging from 163 - 356 minutes (average 233 minutes), and blood loss ranging from 50 – 250cc (average 113cc). Post-operatively there were no major complications, 1 minor port site cellulitis treated with antibiotics, with length of stay ranged from 21 - 47 hours (average 35 hours), and no ICU admissions. Seven of the patients had comprehensive follow-up allow-ing analysis of progression-free survival after primary chemotherapy which ranged from 4 to 15 months, with an average of 8 months. CONCLUSION: The use of neoadjuvant chemotherapy before IDS has become more prevalent since the publica-tion of randomized trials showing similar oncologic out-come to upfront primary debulking surgery with signifi-cantly less morbidity. Our series supports the feasibility of using a robotic approach for IDS to minimize surgical morbidity, while maintaining oncologic outcome. Formal Discussant: William Winter, Portland, Oregon

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THURSDAY: 10:45-11:15am OCTOBER 24, 2019 O-05. A TWO COUNTRY STUDY OF PREGNANCY INTENT: CAMEROON AND USA B. Bhattarai, G. E. Halle-Ekane, C. Johnson-Agbakwu, J. Nsom, M. Manriquez, T. Egbe Obinchemti, J. Nizigiyimana, M. Sutton Dean V. Coonrod, Phoenix, Arizona OBJECTIVE: This is a study comparing the degree of in-tention of a current pregnancy among Cameroon and US based respondents using a psychometrically validated meas-ure of pregnancy intent. DESIGN: Subjects in affiliated clinics with the University of Buea (n=245) and at Maricopa Integrated Health System, Phoenix a safety net institution in Phoenix (n=250) were interviewed and responses collected. The London Measure of Unplanned Pregnancy (LMUP) was used to measure pregnancy intent (scored 0 to 12 with 12 indicated high in-tent). Demographic features and other characteristics of the respondents in both locations were described. Continuous variables were summarized and compared between two lo-cations using Wilcoxon rank sum test after the Shapiro-Wilk normality test. Association of categorical variables to these two locations were evaluated with chi-square tests. RESULTS: Basic demographic features including lan-guage, time spent at current location, and marital status were different in these respondents from these two geo-graphical locations (P<0.001). 81% of respondents were married versus 64% of US respondents (p<0.001). 82% respondents from Cameroon were educated at or beyond high school compared to 71.3% in the US (P=0.048). 31% of Cameroon respondents were employed compared to 23% respondents in the US (P=0.04). Except for similar propor-tion of respondents (28.6% -Cameroon vs. 28.7%- US) who reported a clinic or hospital as source of

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reproductive health information and similar proportion of primigravida (26.5% Cameroon compared to 20.7% in the US, P= 0.127), other reproductive health measures including the use of some form of contraception (36.7% in Cameroon vs. 72.9% in US) and percentage of re-spondents planning next child (73.1% in Cameroon vs.52.6% in US), were significantly different(p<0.001). With major characteristic differences between these two groups of patients, the average (median, range) of total LMUP scores were 8.7 (10, 0-11) and 7.9 (9. 0-12) for Cameroon and US respondents, respectively (P=0.005). The difference in distribution of scores was markedly different in the 2 groups (Figure). Specific pregnancy behaviors varied between the settings with 92% indicat-ing they made no changes vs 51% in the US group with 23% indicating the use of folic acid in the US vs 1% in Cameroon. Interestingly when subgroups in the US were compared the median LMUP for the African origin groups were high (10) for the Kirundi and Somali groups and lowest for the Spanish-speaking group (7). CONCLUSION: This study illustrates marked differ-ences in the populations studied with higher pregnancy intent scores noted in the Cameroon sample and a much different distribution of scores. Of note was that contra-ception use was much higher in the US which had more unintended pregnancies. Formal Discussant: Anita Nelson, Manhattan Beach, California

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THURSDAY: 11:15am-1:50pm OCTOBER 24, 2019

SPECIAL LECTURE

THE MYTH OF ANONYMITY IN THIRD PARTY REPRODUCTION Lori Marshall, Seattle, Washington 12:00-1:00pm

GUEST LECTURE

THE SAN DIEGO ZOO NORTHERN WHITE RHINO INITIATIVE AND CONSERVATION EFFORTS

BUFFET LUNCHEON - ALL INVITED

1:15pm First Business Meeting 1:15pm Photos - Guests - TBA 1:50pm Photos - Fellows - TBA

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THURSDAY: 2:00-2:30pm OCTOBER 24, 2019 O-06. OXYTOCIN PROTOCOL: DOES IMPLEMENTATION OF A NEW PROTOCOL IMPACT POSTPARTUM HEMORRHAGE RATES? Larissa Romero, Phoenix, Arizona (By Invitation) OBJECTIVE: Postpartum Hemorrhage (PPH), occur-ring in 1-5% of deliveries is a component of maternal morbidity and mortality that is largely preventable. At our large, academic medical center, we have experi-enced higher than expected rates of PPH (6-7%). In mid 2017, a new oxytocin protocol was implemented and this examines if the institution was successful in de-creasing the PPH rate. DESIGN: This quality improvement project examined data routinely tracked at our institution via our event reporting system. The PPH rates were compared before and after implementation of the oxytocin protocol. This protocol mirrors the AWHONN protocol and standard-izes the amount of oxytocin given, in the postpartum period. Implementation occurred in 2017, with a start date mid year and full compliance in October. Our re-sults were calculated via the chi-square test to evaluate pre and post intervention rates of PPH. RESULTS: A total of 12,599 deliveries were analyzed between January 2016 and December 2018. 6900 deliv-eries were included in the pre implementation group (pre) and 5699 deliveries in the post implementation group (post), excluding a 5-month timeframe of transi-tion. Our PPH rates were as follows: 6.74% pre and 4.44% post, p <0.001. Transfusion rates were 2.57% pre and 1.84% post, p 0.006. Cesarean section rates and operative vaginal delivery rates remained steady during the study time period.

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CONCLUSION: Implementation of a standardized oxy-tocin protocol was successful in decreasing the institu-tional PPH rate. Also of importance, the transfusion rate showed a decrease. Although the decrease in PPH rate may well be multifactorial, the implementation of a spe-cific protocol and high compliance decreased the PPH rate at a high volume, academic medical center. Formal Discussant: Laura Mercer, Phoenix, Arizona

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THURSDAY: 2:30-5:00pm OCTOBER 24, 2019

SPECIAL LECTURE

MORCELLATION: EVERYONE IS ENTITLED TO THEIR OWN OPINION, BUT NOT TO THEIR OWN FACTS William Parker, Del Mar, California (By Invitation) 3:30-4:00pm - POSTER PRESENTATIONS/ INFORMAL DISCUSSION - Aragon South Lobby EXHIBITS/INDUSTRY REPS - Aragon III 4:00-5:00pm

PANEL DISCUSSION

ABNORMAL UTERINE BLEEDING Anita Nelson, Moderator, Los Angeles, California Malcolm Munro, Los Angeles California William Parker, Del Mar, California (By Invitation) 5:00-6:00pm Hospitality Suite - Castillo Parlor 5:30pm Board buses to Bernardo Winery meet in hotel lobby 6:00-9:00pm Reception/Dinner Bernardo Winery 9:15pm Board buses to Rancho Bernardo Inn

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FRIDAY: 7:00-8:30am OCTOBER 25, 2019 7:00-7:50am Attendees Breakfast - Members & Guests - Aragon Lawn CAUCUS MEETINGS

Los Angeles - Granada Portland - Andalucia II San Francisco - Catalina West Seattle - Catalina East

SECOND SCIENTIFIC SESSION

8:00am

FRANK LYNCH MEMORIAL ESSAY

EXAMINING PRE-TERM BIRTH (PTB) AND CESAREAN SECTION (CS) RATES IN GESTATIONAL CARRIER (GC) PREGNANCIES Meghan Smith, Los Angeles, California (By Invitation) OBJECTIVE: This study sought to report on the route and gestational age at delivery of gestational carrier (GC) pregnancies with respect to the GCs’ prior obstetric histo-ry. METHODS: A retrospective analysis of all GC pregnan-cies from one of the largest surrogacy agencies in Califor-nia between 2008-2018 was performed. Available demo-graphic data and obstetric history, including a history of prior cesarean section (CS) and preterm birth (PTB), were collected for each GC and correlated to outcomes of the index GC pregnancy. Primary outcomes for the index GC pregnancies included delivery route and gestational age at delivery. RESULTS: 836 GCs were included in our analysis. 319 (38.2%) delivered via CS, and 517 (61.8%) delivered vagi-nally. 60 (18.8%) of the CS deliveries were due to multiple gestation. Primary CS rate in singleton GC pregnancies was 38.5%. In women without a history of CS, neither age,

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body mass index (BMI) interpregnancy interval, prior parity, nor year of delivery impacted the primary single-ton CS rate (all, P>0.05). Of GCs with a history of a pri-or CS (n= 350, 41.9%), 218 (62.3%) had a vaginal deliv-ery after CS (VBAC) and 132 (37.7%) had a repeat CS. Women who had successful VBACs were significantly younger than those who had repeat CS (mean 33.7 vs. 35.2 years, P=.003). BMI was lower in patients who had a VBAC compared to those that had a repeat CS (mean BMI 24.6 vs. 25.5, P=0.074), although this did not reach statistical significance. In GCs with a history of CS, in-terpregnancy interval, year of delivery, prior parity, and multiple gestation in the index GC pregnancy did not impact mode of delivery. VBAC rates did not change over the study period (P=0.757). Overall PTB rate was 15.1%. Most PTB in GC pregnancies were in those with a history of PTB, and PTB was more likely in singletons rather than multiple gestations (76.7% in singletons vs 30% in multiples) in patients with history of PTB (P<0.001). Those with no history of PTB and who car-ried multiples had a low rate of PTB; in fact, in this group, only 1 out of 35 patients had a PTB with multi-ples. CONCLUSION: Both primary CS and PTB rates in singleton GC pregnancies are higher than national aver-ages. CS rates are independent of age, BMI, and inter-pregnancy interval. In GCs with a history of a CS, VBAC rates well exceed national averages and are high-er in younger GCs with a lower BMI. PTB rates are im-pacted primarily by the GCs obstetric history. In those GCs without a history of PTB, rates of PTB are low, even in those with a multiple gestation.

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FRIDAY 8:30-9:00am OCTOBER 25, 2019 O-07. CODE CRIMSON, A UNIQUE ADAPTATION OF THE MASSIVE TRANSFUSION PROTOCOL FOR OBSTETRICAL HEMORRHAGE L. S. Chong Tim, M. Wong, S. Honda Keith K. Ogasawara, Honolulu, Hawaii

OBJECTIVE: The America College of Obstetrics and Gynecology recommends all obstetric facilities should have a standardized hospital wide process for the manage-ment of obstetrical hemorrhage. A key element is a des-ignated multidisciplinary response team to manage a staged postpartum hemorrhage protocol that includes guidelines for escalation of care and a functioning massive transfusion protocol. STUDY DESIGN: This was a quality improvement pro-ject initiated at the Kaiser Permanente Moanalua Medical Center in Honolulu Hawaii. This is a tertiary teaching hospital with a level 3 nursery and full-service obstetrical service. The purpose was to adapt the hospital’s massive transfusion protocol with a “Code Crimson” page that ac-tivates a specialized obstetrical hemorrhage “rapid re-sponse” team specifically for massive obstetrical related hemorrhage. The purpose of this team is to insure the availability of appropriate personnel to respond to an ur-gent patient care situation involving massive OB related hemorrhage where a massive transfusion protocol was initiated and is ongoing. This team includes the obstetri-cal, neonatal, blood bank, laboratory, anesthesia, critical care and mother baby services, Standardized guidelines for escalation and defined care team member duties were established. The entire team was then involved with mul-tidisciplinary simulation training including didactic and hands on training. Ninety nine percent of team members and medical staff were trained. After each activation of the team an immediate debrief its performance. Later all

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cases were subjected to a systematic quality review and learnings incorporated into the process. RESULTS: After simulation training was completed the team was activated 8 times over the next 18 months. All deliveries involved postpartum hemor-rhages in term cesarean sections and one 20-week D+E with an abruption. There were two suspected amniotic fluid embolism, two laceration/extensions and one hys-terectomy. All cesarean deliveries were emergent ex-cept for a scheduled primary twin delivery with know placenta previa. All mothers and newborns survived and were doing well at time of discharge. The ongoing and systematic review of all cases has led to changes in protocol and in management of postpartum hemor-rhage. This process has improved the comfort and competency level of staff and physicians in manage-ment of massive obstetrical hemorrhage. CONCLUSION: The Code Crimson team improved performance over time compared to the generic mas-sive transfusion protocol. The team culture emphasiz-es learning, debriefing and systematic review of all events in a safe environment that improves perfor-mance and outcomes. Formal Discussant: Dale Reisner, Seattle, Washington

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FRIDAY 9:00-10:00am OCTOBER 25, 2019

JAMES C. & JOAN CAILLOUETTE LECTURE

DEMEDICALIZING REPRODUCTIVE HEALTH CARE: FROM OTC ORAL CONTRACEPTIVES TO SELF-MANAGED ABORTION Daniel Grossman, San Francisco, California (By Invitation) 10:00-10:30am - POSTER PRESENTATIONS/ INFORMAL DISCUSSION - Aragon South Lobby EXHIBITS/INDUSTRY REPS - Aragon III

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FRIDAY 10:30-11:00am OCTOBER 25, 2019 O-08. IDENTIFICATION AND VALIDATION OF ENDOMETRIAL CANCER SPECIFIC MIRNA BIOMARKERS IN ENDOMETRIAL FLUID J. Yang, K. Firouzi, B. Bhattarai, D. Coonrod, F. Zenhausern Joel Barkley, Phoenix, Arizona OBJECTIVES: Abnormal uterine bleeding is a common benign gynecologic complaint around the time of menopause and is also the most common symptom of endometrial can-cer. This complaint prompts in-office endometrial biopsy to screen for malignancy in high risk women. Unfortunately, endometrial biopsy can miss early cancers, due to the limited amount of endometrium that it samples. Biomolecules have proven to be useful tools in cancer screening and diagnosis, but have not been applied to endometrial cancer. MicroRNA (miRNA) are a class of small molecules related to cellular gene expression that have shown promise in cancer detec-tion. This project is the first stage in developing a method to improve the detection and diagnosis of endometrial cancer in women using miRNA for liquid biopsy. DESIGN: Patients were recruited who planned to undergo hysterectomy for either benign indication or for a known endometrial cancer diagnosis. We collected endometrial flu-id prior to surgery using a technique similar to that used in sonohysterography. The miRNA was extracted and purified. The product was used to amplify and quantify miRNA can-didate markers using RT-PCR. These steps were performed in two phases for initial biomarker discover (84 miRNA spe-cies, n=60) and validation (14 miRNA species, n=20). Final group assignment for cancer and control patients was based on surgical pathology. Patient demographic and health infor-mation was collected to be used in the final analysis along with the details of pathology. RESULTS: In total, 80 patient samples were collected and processed (40 cancer and 40 controls). Variations in expres-sion fold-change were calculated for the miRNA species.

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Markers with at least a two-fold increase or decrease in ex-pression were considered candidates for validation. We chose to narrow this field to fourteen markers with the great-est variation in expression for validation and comprehensive statistical analysis. CONCLUSION: This simple technique has the potential to improve the evaluation of abnormal bleeding and endometri-al cancer diagnosis. Biomarker analysis can also be used for treatment prognosis and ported for point of care use in low resource settings. Large scale studies are needed to strength-en this result. Support: Valley Research Partnership P2 grant ($80,000), University of Arizona College of Medicine, Phoenix Formal Discussant: Laura Korman, Portland, Oregon

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FRIDAY 11:00-11:30am OCTOBER 25, 2019 O-09. OUTPATIENT INDUCTION OF LABOR WITH MISOPROSTOL IN LOW RISK PREGNANCIES AT 39 WEEKS K. Nalbandyan, N. C. Froutan, C. Okekpe, S. Cao, G. Valenzuela Kristina Roloff, Redlands, California OBJECTIVE: The optimal time to have a baby in opti-mally dated pregnancies is the 39th week of gestation. Elective induction at 39 0/7 to 39 6/7 weeks in a low risk pregnancy has been shown to reduce a mother’s chance of cesarean delivery, as well as reduce the chance of fe-tal macrosomia and meconium passage. The American College of Obstetrics and Gynecology (ACOG) and the Society for Maternal Fetal Medicine (SMFM) have rec-ognized this evidence, as well as the operational burden that it places on labor and delivery units. Induction in women with less than optimal or “un-ripe cervix” may result in a prolonged inpatient stay, increased medical expense, and stress and exhaustion to the patient and her support people. Here, we review our experience with outpatient induction with misoprostol as an alternative to inpatient induction of labor in low risk pregnancies. DESIGN: This is a retrospective review of low risk pregnancies that underwent elective outpatient induction through our institution. Cases were compared to two matched controls for parity (nulliparous vs. parous) and gestational age. Controls were selected from deliveries closest in time to the outpatient induction case. Time from start of induction to delivery, induction agents, presence of tachysystole, mode of delivery, length of hospitalization, NICU admission, and low APGAR scores were compared. RESULTS: Fourty patients were scheduled for outpa-tient induction, of which 6 (15%) did not undergo outpa-tient induction for various reasons (contracting too often

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for safe misoprostol administration, concern for com-pliance, attending preference). The mean time from admission to delivery was 17.7 hours in the outpatient induction cohort, and 19.4 hours in the inpatient induc-tion group (P=0.512) in preliminary analysis. CONCLUSION: Outpatient induction with miso-prostol may prove to be a feasible alternative to inpa-tient induction in the low risk pregnancy, and may help reduce the operational burden that elective induction confers upon labor and delivery units. Formal Discussant: Abby Furukawa, Portland, Oregon

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FRIDAY 11:30am-11:00pm OCTOBER 25, 2019

SPECIAL LECTURE

TRANSGENDER SURGERY UPDATES Heidi Wittenberg, San Francisco, California

AFTERNOON FREE

1:00pm Birding - on your own Self guided maps available 1:00pm Biking - meeting hotel lobby 1:30pm Golf - Oaks North Course 1:00pm Tour to Safari Park Board buses in hotel lobby 1:00pm Stone Brewery Tour Meet in hotel lobby - transportation to and from the brewery 1:00-5:00pm Hospitality Suite - Castillo Parlor 6:00-10:00pm CAUCUS RECEPTIONS/ DINNERS

Los Angeles - TBA Portland - TBA San Diego/AZ - TBA

San Francisco - TBA Seattle - TBA 9:30-11:00pm Hospitality Suite - Castillo Parlor

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SATURDAY 6:00am-9:00am OCTOBER 26, 2019 6:00-7:00am Yoga - Valencia Lawn 7:00-7:50am Attendees Breakfast Buffet Members & Guests - Aragon Lawn 7:00-7:50am Membership Track Breakfast Caucus & Personal Guests - La Taberna/LaTaberna Balcony

THIRD SCIENTIFIC SESSION

8:00am

KEYNOTE LECTURE

WHAT PATIENTS SAY, WHAT DOCTORS HEAR Danielle Ofri, New York, New York (By Invitation)

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SATURDAY 9:00-9:30am OCTOBER 26, 2019 O-10. IMPACT OF MEDITATION AND MIDFULNESS ON PERIOPERATIVE PAIN AND DISTRESS IN NEWLY DIAGNOSED BREAST CANCER PATIENTS A. Wijeyakumar Heather Macdonald, Los Angeles, California (By Invitation) OBJECTIVE: To evaluate the impact of a new medita-tion and mindfulness practice on pain and distress scores in women with newly diagnosed breast cancer undergo-ing primary surgical management. DESIGN: At initial surgical consultation for new breast cancer diagnosis, women are offered enrollment in a mindfulness and meditation program, after baseline doc-umentation of distress and pain levels using nationally validated instruments: National Comprehensive Cancer Network Distress Thermometer and MD Anderson Can-cer Center Brief Pain Inventory (short form). Once con-sent is obtained, before surgery, patients undergo a one on one coaching session with a professional meditation coach. Patients institute a twice daily meditation and breathwork practice, lasting 12 minutes. Patients undergo primary surgical treatment for breast cancer and usual postoperative care per surgeon recommendation and pa-tient preference. Meditation practice is supported by rec-orded guided meditations, contact with study nurse and follow up visit with meditation coach. Patients maintain a daily log of completed meditations, medication use and distress and pain scores for 12 weeks. Patients are re con-tacted at 24 weeks to determine persistence of meditation practice.

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RESULTS: Feasibility study of 24 patients is ongoing. Upon its completion a trial randomizing patients to routine care with or without meditation teaching is planned. Formal Discussant: Debra Wickman, Phoenix, Arizona

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SATURDAY 9:30-10:00am OCTOBER 26, 2019 O-11. INITIATION OF TRIAL OF LABOR AFTER CESAREAN DELIVERY AT A SAFETY NET HOSPITAL: MATERNAL AND PERINATAL OUTCOMES 2009-2019 A. Arias, C. Liem, A. B. Caughey Peter Chandler, Salinas, California OBJECTIVE: Trial of labor after prior cesarean delivery had not been offered in Monterey County, California since 2004. The purpose of this study is to compare ma-ternal and perinatal outcomes of women who underwent trial of labor after prior cesarean (TOLAC) delivery from 2009 to 2019 to women who had an elective repeat cesar-ean delivery the year prior to initiation of our trial of la-bor program (2008). STUDY DESIGN: This is a retrospective cohort study examining perinatal outcomes pre- and post- TOLAC availability. In May 2009 Natividad Medical Center be-gan permitting trial of labor after prior cesarean delivery. Maternal and perinatal outcome data was collected from all women who had their first elective repeat cesarean delivery in 2008 and compared to outcome data from women undergoing a trial of labor between 2009 and 2019. RESULTS: The patients were primarily Hispanic (88%, 87%; repeat cesarean and TOLAC respectively) and insured through MediCal or managed MediCal (93%, 87%). Vaginal delivery was attempted by 1576 women and 239 women underwent repeat cesarean delivery. Successful vaginal delivery occurred in 67% of the wom-en undergoing labor. There were 14 cases of uterine rup-ture in the TOLAC group. There were no cases of mater-nal death, neonatal death, or stillbirth in either cohort. There were 4 cases of hypoxic ischemic encephalopathy

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(HIE) in the TOLAC group and none in the repeat ce-sarean group. There was a higher frequency of neona-tal intensive care unit admissions in TOLAC patients (4.2%, 9.3%;p=.009), an increase in maternal adverse events in the repeat cesarean section patients (2.9%, 0.95%; p=.01), and a trend for a longer hospital stay for infants in the repeat cesarean section patients (72.0 hrs, 61.0 hrs; p=0.06). There was no significant difference in length of stay for the mother, transfusions, or throm-botic events between the two cohorts. CONCLUSIONS: In the first ten years after initiating a TOLAC program, 1055 repeat cesarean sections were avoided. The TOLAC cohort had a higher frequency of HIE, and NICU admissions while maternal adverse events were higher and length of stay was longer in the infants in the repeat cesarean section group. Formal Discussant: Fred Coleman, Portland, Oregon

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SATURDAY 10:00am-11:00pm OCTOBER 26, 2019

PRESIDENITAL CHOICE LECTURE

THE SECOND VICTIM: HELPING PROVIDERS RECOVER FROM MEDICAL ERRORS Patrice M. Weiss, Roanoke, Virginia (By Invitation) 11:00-11:30am - POSTER PRESENTATIONS/ INFORMAL DISCUSSION - Aragon South Lobby EXHIBITS/INDUSTRY REPS - Aragon III 11:30am-12:30pm

PANEL DISCUSSION

UPDATE AND CONTROVERSIES IN ROBOTICS AND MINIMALLY INVASIVE GYN SURGERIES Chirag Shah - Moderator John Lenihan, Seattle, Washington Pamela Paley, Seattle, Washington Marc Winter, Laguna Hills, California 12:45-1:15pm Second Business Meeting 1:30-4:00pm Second Board of Directors Meeting La Teberna/La Taberna Balcony 1:30-4:30pm Hospitality Suite - Castillo Parlor 5:15-6:15pm Presidential Address - Aragon Ballrooms 6:15-7:00pm Presidential Toast/Reception - Aragon Lawn 7:00-11:00pm Presidential Dinner/Dance - Aragon Ballrooms 10:00-11:00pm Hospitality Suite—Castillo Parlor

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SUNDAY 8:00-10:00am OCTOBER 27, 2019 8:00-10:00am Farewell Breakfast—Aragon Ballroom

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SOCIETY MEMBERSHIP BY CAUCUS (GEOGRAPHICAL)

LOS ANGELES: Kathleen Bradley, Caucus Director (2017-2019) (74)

Acacio - Laguna Niguel-F Aghajanian - LA-F Asrat - Mountain View-F Atamdede - LA-F Bradley - LA-F Brown - Newport Beach-F Clewell - Santa Maria-RF Cohen - Bakersfield-F Corlett - Santa Barbara-RF Davis - Pacific Palisades-RF Durinzi - Studio City-F Ellsworth, Hanford-F Esakoff - LA-F Fassett - LA-F Finberg - Bakersfield-F Freeman - Long Beach-RF Friedman – Burbank-F Fuller - Anaheim-F Futoran - LV, NV-F Goodno - LA-RF Goodwin - LA-RF Gorman - Sacramento-F Grady - San Gabriel-F Gregory, Kim - LA-F Hassan - LA-F Hindle - LA-RF Hobel - LA-F Incerpi - LA-F Israel, J. - LA-F Israel, R. - LA-RF Kilpatrick - LA-F Lagrew - Orange-F Lee, R. - LA-F Macer, - Pasadena-F Maples - Downey-F Margolin - LA-F Marrs - LA-F

McNulty, J. - LA-F Miller – LA-F Moran - Santa Monica-F Muderspach - LA-F Mullin - LA-F Munro - LA-F Mutch - Glendale-RF Nageotte - Long Beach-F Nelson, A. - Torrance-RF Nelson, R. - LA-RF Oliver, Joseph - Pasadena-RF Ouzounian – Pasadena-F Paul - LA-RF Paulson - LA-F Phillips, - LA-F Pillsbury - Long Beach-RF Pitkin - LA-RF Platt - LA-F Powers - Arcadia-F Quilligan - Irvine-RF Robboy - Newport Beach-F Roloff - Redlands-F Schlaerth - LA-F Schlesinger - Yorba Linda-RF Segal - San Luis Obispo-RF Shaw - LA-F Shields - LA-F Spanos - Del Mar-RF Steinke - Fresno-F Valenzuela - Colton-F Vasilev - LA-F Walker - Pasadena-F Wallace - LA-RF Williams, III - LA-F Winter, M - LA-F Wohlmuth - LA-F Yee - Long Beach-F

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PORTLAND: Mark Tomlinson, Caucus Director (2019-2021) (54)

Adams - P-F Allen – P-RF Barford - P-RF Bednarek - P-F Boyle - Corvallis-RF Cain - P-RF Card - Corvallis-F Caughey - P-F Coleman, Vancouver, WA-F Collins - P-RF Corwin - P-RF Curtis - P-F Daskalos - Albany-F deCastro - P-F Dotters - Eugene-RF Fearl - P-RF Fisher - P-F Furukawa - P-F Garrett - Springfield-F Goetsch - P-RF Gosewehr - P-F Greenberg - P-F Hicks - P-F Hoffman - P-F Huerta-Enochian - Corvallis-F Jensen, J - P-F Johnson - P-F

Kaplan - Eugene-RF Katz, V. - Eugene-RF Kirk - P-RF Korman - P-F Leslie - P-F Lowensohn - P-RF Miksovsky - Hillsboro-F Morcos - Corvallis-F Mukul - P-F Neilson - P-RF Nichols - P-F Novy - P-RF Patton - P-RF Plaut - Vancouver, WA-RF Ribbink - P-F Roberts - P-RF Schrinsky – Tualatin-RF Schwartz - P-RF Shaffer, B. - P-F Shaffer, L. - P-F Smith, W. – P-F Stempel - P-F Tomlinson – P-F Veltman - P-RF Watson - P-RF Wentross - P-F Winter, W. - P-F

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SAN DIEGO/ARIZONA: Vera Stucky, Caucus Director (2019-2021) (27)

Barkley - Phoenix-F Behera - Scottsdale-F Coonrod - Phoenix-F Craig - Scottsdale-F Deasy, K. - Flagstaff-RF Deasy, S - Flagstaff-RF Francois - Scottsdale-F Gaylord - Las Vegas-RF Greenspan - Phoenix-F Hanss - Phoenix-RF Kettel - La Jolla-F Lamb, E. - Scottsdale-RF Laughead - Phoenix-RF Macaulay - SD-F

Manriquez - Phoenix-F Mayo - SD-RF Mercer - Phoenix-F Mouer - Phoenix-RF Nelson, L. - Phoenix-F Reinsch, C. - La Jolla-RF Reinsch, R.- La Jolla-RF Resnik - SD-RF Snell - Scottsdale-F Stucky – San Marcos-RF Welch - Cave Creek-RF Wickman - SD-F Zheng - Phoenix-F

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SAN FRANCISCO: Arzou Ahsan, Caucus Director (2017-2019) (60)

Adamson - Cupertino-F Ahsan - Oakland-F Autry - SF-F Barbis - Sacramento-RF Berek - Stanford-RF Broberg - Provo-F Burlingame - Honolulu-F Busse - Honolulu-F Cabrera - SF-F Chandler - Salinas-F Cheng - SF-F Clayton - Salt Lake City-RF Combs – Los Gatos-F Creasy - Corte Madera-RF Druzin – Stanford-F El-Sayed - Stanford-F Enbom - Carmel-RF Forsythe - Berkeley-RF Gilbert - Sacramento-F Giudice - SF-RF Goldberg - SF-F Golditch - SF-RF Gonzalez-Velez - SF-F Gregory, Katherine - SF-F Haesslein - Sacramento-RF Hedriana - Sacramento-F Henderson, S.- SF-RF Hoag - Berkeley-RF Houston - SF-F Jacobson - SF-F Katz, M. - SF-F

Keith - Carmel-F Khieu - Salinas-F Kim, L. - SF-F Kosasa - Honolulu-F Lager - SF-F Lam – SF-F Larsen - Salinas-F Lofquist - SF-F Main, D. - SF-RF Main, E. - SF-RF McCausland - Sacramento-RF Nakayama - Honolulu-RF Nelson, H. P. - Oakland-F Norrell - SF-F Norton - SF-F Ogasawara - Honolulu-F O’Reilly-Green - SF-F Pandipati - Campbell-F Peacock - SF-RF Robertson - SF-F Salmeen - SF-F Shefren - Portola Valley-RF Smith, R. - Glen Ellen-RF Thomas - Orinda-F Unzelman - Santa Rosa-RF Whitelaw - Sacramento-RF Wiggins – SF-F Winch, Jr – Elko, NV-F Wittenberg - SF-F

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SEATTLE: Jane Dimer, Caucus Director (2018-2020) (47)

Ambrose - Hayden, ID - RF Benoit - SE - F Branigan - Bellingham-F Cole - SE-RF Der Yuen - SE-RF Dimer - SE-F Dunsmoor-Su - SE-F Eckert - SE-F Graham - Bellevue-RF Gravett - SE-RF Hanson, H. - Anchorage-RF Hartman - Spokane-RF Hickok, D. - SE-RF Hickok, L. - SE-RF Houmard - Liberty Lake-F Lamb, J. - SE-F Lamey - SE-RF Lenihan – SE-F Lentz - SE-F Luthy - SE-F Marshall - SE-F Melville - SE-F Oliver, John – Alaska-F

Paek - Kirkland-F Paley - SE-F Palmer - Seattle-F Partoll - Spokane-F Peters, III - SE-RF Peterson - SE-F Prins - Anacortes-F Reed - SE-F Reisner - SE-F Rowles - Yakima-F Shah - SE-F Shahine - SE-F Shy - SE-RF Simpson - Federal Way-F Smith, D. - SE-RF Smith, M. - SE-RF Soderstrom - SE-RF Tamimi - SE-RF Tomsen - Anchorage, AK-F Veljovich – SE-F Vontver - SE-RF Wesol - SE-F Wolter - Mercer Is.-RF

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NON-RESIDENT: (12) Ballon - Osprey FL Blanchette - Vahalla, NY Brewster - North Carolina Felix - Milwaukee, WI Gabbe – Nashville, TN Garite - Littleton, CO Hale - Herndon, VA Kim, M. - Poughkeepsie, NY Lanouette, Tampa, FL Learman - Boca Raton, FL Martin-Cadieux - FL Towers - Knoxville, TN

HONORARY: (3) Jensen, H - Davis, CA Smith-Sehdev - Portland, OR

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The Pacific Coast Obstetrical and Gynecological Society extends its sincere thanks to the following companies for their support of our educational program:

EXHIBITS

Abbvie Allergan AMAG Pharmaceuticals AMAG Women’s Health Ascend Therapeutics Astellas Avanos Medical Bayer Healthcare Baxter Healthcare Con Med Advanced Surgical Ferring Foundation Medicine Gauss Surgical GE Healthcare Hologic IMDPath Invitae

Medtronic Merck Myriad Genetic Labs Nanosonics Natera Philips Healthcare Progenity Roche Diagnostics Sage Therapeutics Sema4 TESARO TherapeuticsMD UC Davis Fetal Care and Treatment Center UC San Francisco Fetal Treatment Center

Hologic Myriad Genetic Labs TherapeuticsMD

EDUCATIONAL GRANTS

EIGHTY-SEVENTH ANNUAL MEETING

September 2-6, 2020

GRAND WAILEA RESORT HOTEL & SPA

WAILEA, HAWAII MAUI

SAN FRANCISCO CAUCUS HOST