Medicine and Health Sciences Commons^™

Impact Of Excess Weight Gain On Risk Of Postpartum Infection In Class Iii Obesity, Courtney J. Mitchell, Lamani Adkins, Ann Tucker, Haywood Brown, Anne Siegel, Sarah Dotter-Katz

Obstetrics & Gynecology Faculty Publications

Objective: To assess the impact of gestational weight gain >20 pounds (more than Institute of Medicine [IOM] recommendations) on postpartum infectious morbidity in women with class III obesity.

Methods: This is a retrospective cohort of term, nonanomalous singleton pregnancies with body mass index ≥40 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, and missing weight gain data are excluded. Primary outcome is a composite of postpartum infection (endometritis, urinary tract, respiratory, and wound infection). Secondary outcomes include components of composite, wound complication, readmission, and blood transfusion. Bivariate statistics compared demographics, pregnancy complications, …

Folic Acid Intake, Fetal Brain Growth, And Maternal Smoking In Pregnancy: A Randomized Controlled Trial, Korede K. Yusuf, Hamisu M. Salihu, Roneé Wilson, Alfred K. Mbah, William Sappenfield, Karen Bruder, Usman J. Wudil, Muktar H. Aliyu

Obstetrics & Gynecology Faculty Publications

Background: Folic acid supplementation during pregnancy plays an important role in fetal growth and development. To our knowledge, no experimental study has examined the effect of folic acid on fetal brain growth in women who smoke cigarettes during pregnancy. Objectives: The aim of this study was to investigate the efficacy of higher-dose compared with standard-dose folic acid supplementation on prenatal fetal brain growth, measured by head circumference, brain weight, and brain-body weight ratio (BBR). Design: In this randomly assigned, double-blind, controlled clinical trial, we recruited 345 smoking pregnant women attending a community health center in Tampa, FL between 2010 and …

Adnexal Torsion In A Patient With Müllerian Agenesis Undergoing Ovarian Stimulation: A Case Report, Erika P. New, Adrianne R. Mallen, Abigail C. Mancuso, Bradley J. Van Voorhis

Obstetrics & Gynecology Faculty Publications

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments.

Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary.

Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort …

Association Between Obesity, Surgical Route, And Perioperative Outcomes In Patients With Uterine Cancer, Entidhar Al Sawah, Jason L. Salemi, Mitchel Hoffman, Anthony N. Imudia, Emad Mikhail

Obstetrics & Gynecology Faculty Publications

Objective. To study temporal trends of hysterectomy routes performed for uterine cancer and their associations with body mass index (BMI) and perioperative morbidity. Methods. A retrospective review of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) 2005-2013 databases was conducted. All patients who were 18 years old and older with a diagnosis of uterine cancer and underwent hysterectomy were identified using ICD-9-CM and CPT codes. Surgical route was classified into four groups: total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), laparoscopic assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH) including both conventional and robotically assisted. …

Clinical Utility Of Ca-125 In The Management Of Uterine Carcinosarcoma, Koji Matsuo, Malcolm S. Ross, Mayu Yunokawa, Marian S. Johnson, Hiroko Machida, Kohei Omatsu, Merieme M. Klobocista, Dwight D. Im, Shinya Satoh, Tsukasa Baba, Yuji Ikeda, Stephen H. Bush, Kosei Hasegawa, Erin A. Blake, Munetaka Takekuma, Masako Shida, Masato Nishimura, Sosuke Adachi, Tanja Pejovic, Satoshi Takeuchi, Takuhei Yokoyama, Yutaka Ueda, Keita Iwasaki, Takahito M. Miyake, Shiori Yanai, Tadayoshi Nagano, Tadao Takano, Mian M. Shahzad, Frederick R. Ueland, Joseph L. Kelley, Lynda D. Roman

Obstetrics & Gynecology Faculty Publications

No abstract provided.

Comparing Single And Dual Console Systems In The Robotic Surgical Training Of Graduating Ob/Gyn Residents In The United States, Emad Mikhail, Jason L. Salemi, Stuart Hart, Anthony N. Imudia

Obstetrics & Gynecology Faculty Publications

Objective. To assess the impact of a single versus dual console robotic system on the perceptions of program directors (PD) and residents (RES) towards robotic surgical training among graduating obstetrics and gynecology residents. Design. An anonymous survey was developed using Qualtrics, a web-based survey development and administration system, and sent to obstetrics and gynecology program directors and graduating residents. Participants. 39 program directors and 32 graduating residents (PGY4). Results. According to residents perception, dual console is utilized in about 70% of the respondents’ programs. Dual console system programs were more likely to provide a robotics …

Evidence-Based Cesarean Delivery For The Nonobstetrician, Joshua D. Dahlke, Hector Mendez-Figueroa, Jeffrey D. Sperling, Lindsay Maggio, Brendan D. Connealy, Suneet P. Chauhan

Obstetrics & Gynecology Faculty Publications

Cesarean delivery (CD) is one of the most common major surgeries performed in the United States and worldwide. Surgical techniques evaluated in well-designed randomized controlled trials (RCTs) that demonstrate maternal benefit should be incorporated into practice. The objective of this review is to provide a summary of surgical techniques of the procedure and review the evidence basis for them for the nonobstetrician. The following techniques with the strongest evidence should be commonly performed, when feasible: (1) prophylactic antibiotics with a single dose of ampicillin or first-generation cephalosporin prior to skin incision; (2) postpartum hemorrhage prevention with oxytocin infusion of 10 …

Association Between Fellowship Training, Surgical Volume, And Laparoscopic Suturing Techniques Among Members Of The American Association Of Gynecologic Laparoscopists, Emad Mikhail, Lauren Scott, Branko Miladinovic, Anthony N. Imudia, Stuart Hart

Obstetrics & Gynecology Faculty Publications

Study Objective. To compare surgical volume and techniques including laparoscopic suturing among members of the American Association of Gynecologic Laparoscopists (AAGL) according to fellowship training status. Design. A web-based survey was designed using Qualtrics and sent to AAGL members. Results. Minimally invasive gynecologic surgery (FMIGS) trained surgeons were more likely to perform more than 8 major conventional laparoscopic cases per month (63% versus 38%, , OR [95% CI] = 2.78 [1.54–5.06]) and were more likely to perform laparoscopic suturing during these cases (32% versus 16%, , OR [95% CI] = 2.44 [1.25–4.71]). The non-fellowship trained (NFT) surgeons …

Maternal Opioid Drug Use During Pregnancy And Its Impact On Perinatal Morbidity, Mortality, And The Costs Of Medical Care In The United States, Valerie E. Whiteman, Jason L. Salemi, Mulubrhan F. Mogos, Mary Ashley Cain, Muktar H. Aliyu, Hamisu M. Salihu

Obstetrics & Gynecology Faculty Publications

Objective. To identify factors associated with opioid use during pregnancy and to compare perinatal morbidity, mortality, and healthcare costs between opioid users and nonusers. Methods. We conducted a cross-sectional analysis of pregnancy-related discharges from 1998 to 2009 using the largest publicly available all-payer inpatient database in the United States. We scanned ICD-9-CM codes for opioid use and perinatal outcomes. Costs of care were estimated from hospital charges. Survey logistic regression was used to assess the association between maternal opioid use and each outcome; generalized linear modeling was used to compare hospitalization costs by opioid use status. Results. …

Retroperitoneal Lymph Node Dissection With Concomitant Ivc Thrombectomy, Caval Wall Resection, And Grafting For Metastatic Nsgt, Tariq Hakky, Timothy Kim, Alejandro R. Rodriguez, Paul Armstrong, Devanand Mangar, Philippe E. Spiess

Obstetrics & Gynecology Faculty Publications

INTRODUCTION: The management of a post-chemotherapy retroperitoneal mass secondary to testicular cancer can present a surgical challenge when involving adjacent organs or major vascular structures. We present the first video of a retroperitoneal lymph node dissection (RPLND) with IVC (inferior vena cava) thrombectomy, caval wall resection resulting from metastatic non-seminomatous germ cell testis (NSGCT) cancer.

METHODS: In this surgical video, we highlight important surgical considerations in the management of a post-chemotherapy retroperitoneal mass with direct IVC wall invasion and level 2 thrombus in such a patient.

RESULTS: A 34 year old man underwent a right inguinal orchiectomy for a mixed …

Climatic Factors And The Incidence Of Pyelonephritis During Pregnancy, John D. Busowski, Ronald A. Chez

Obstetrics & Gynecology Faculty Publications

Objective: Numerous published reports have linked various disease states and pregnancy-related conditions with meteorologic factors such as weather, humidity, and temperature. The purpose of this study was to determine if temperature and dew point affect the incidence of pyelonephritis during pregnancy.Methods: A retrospective chart review of a 4-year period from 1989 to 1992 was performed. The records of women who were diagnosed with pyelonephritis during pregnancy were abstracted for the dates of admission. The climatic records of the Tampa Bay area of Florida were obtained from the National Weather Service.Results: The average, minimum, or maximum daily temperature or …

Lewis Phenotype In Women With Preterm Labor And Premature Rupture Of The Membranes, William F. O'Brien, German F. Leparc, Jodi Holbrook

Obstetrics & Gynecology Faculty Publications

Objective: The purpose of this study was to evaluate the possible association between Lewis phenotype status in pregnant women and preterm labor (PTL) or preterm rupture of the membranes (PROM).Methods: Red blood cell (RBC) Lewis phenotype was determined in 113 pregnant women admitted for PTL or PROM and in 121 controls. The results were controlled for the influence of race on Lewis phenotype.Results: Pregnancy was associated with a higher frequency in women with the a–b– phenotype. There was no association between RBC Lewis phenotype and the occurrence of PTL or PROM.Conclusions: A susceptibility to PTL or PROM …

Penetration Of Piperacillin/Tazobactam Into Gynecologic Tissues Following A Single Loading Dose Prior To Hysterectomy, William F. O'Brien, Shelley George

Obstetrics & Gynecology Faculty Publications

Objective: This study was undertaken to determine plasma and pelvic tissue concentrations of piperacillin/tazobactam following a single intravenous administration.Methods: Plasma and tissue samples were obtained following administration of 3 g of piperacillin and 0.375 g of tazobactam. Concentrations of these agents were determined by chromatography.Results: Plasma concentrations (mean ±SD) for piperacillin/tazobactam were 208 ± 87/27 ± 8 and 95 ± 53/14 ± 2, respectively, at 30 and 60 min after the start of the infusion. The 8:1 ratio between piperacillin and tazobactam in plasma remained constant for up to 96 min. Tissue concentrations yielded a broader range, but …