Obstetrics and Gynecology Commons^™

Management Strategies For Traumatic Injuries In Pregnant Women: A Comprehensive Literature Review, Jaylyn D. Thompson, Jenna Zappetti, Clarence Julian Clark Ii

Rowan-Virtua Research Day

Introduction: Traumatic injuries in pregnant women are the leading cause of non-obstetric death and affect 6% to 8% of all pregnancies. Therefore, it is imperative to maintain updated guidelines to construct a framework for the optimal management strategies for traumatic injuries in pregnant women, considering the perspectives of obstetrics/gynecology, emergency medicine, and orthopedics.

Methods: To conduct this study, research was done via a database search through the Rowan-Virtua School of Osteopathic Medicine’s research library. PubMed was the sole database used to review 8 peer-reviewed sources. Articles that were published within the last 10 years were chosen.

Results: Every woman with …

A Review Of Risk Factors, Adverse Outcomes, And Counseling Strategies Among Pregnant Individuals With Eating Disorders, Alexandra Fontaine, Emily Meale

Rowan-Virtua Research Day

Background: Eating disorders (EDs) among women of childbearing age have become more prevalent on the global level. Identifying at-risk populations of women having EDs before, during, or after pregnancy is essential for clinicians to improve treatment and decrease the likelihood of negative maternal and/or fetal outcomes. Purpose: The purpose is to determine risk factors for women who have EDs throughout pregnancy, to identify negative pregnancy outcomes of women suffering from EDs, and to explore treatment and counseling options through the postpartum period. Methods: This literature review mainly utilizes sources from PubMed and the National Institute of Health databases. An expansive …

Investigating The Link Between Preeclampsia/Eclampsia In Mothers And Cardiovascular Risk Among Their Neurodivergent Children, Jasmine Emanuel, Andrea Iannuzzelli, Venkateswar Venkataraman

Rowan-Virtua Research Day

Preeclampsia/Eclampsia are common gestational conditions among pregnant women. These individuals have hypertension after 20 weeks of gestation, proteinuria/end-stage organ disease, and may have seizures. These conditions can put the mother and fetus at risk.^1,2 A review of literature investigates whether an association exists between congenital heart defects (CHD), and maternal preeclampsia/eclampsia in the neurotypical and neurodivergent population. The Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population was used to investigate whether maternal preeclampsia/eclampsia is indicative of higher congenital heart disease (CHD) in their neurodivergent children to achieve better quality of care. As a first step towards exploring the …

Investigating The Efficacy Of Myo-Inositol In Adolescents With Polycystic Ovary Syndrome: A Scoping Review, Mariam Sharobeem

Rowan-Virtua Research Day

Polycystic ovary syndrome (PCOS) affects approximately 6 to 13% of adolescent girls in the United States.6 PCOS poses difficulty with diagnosing and treatment with adolescents as its symptoms are heterogenous and are often rationalized with other diagnoses. Key diagnostic features of PCOS include irregular menstruation, infertility, obesity, hirsutism, increased risk of diabetes mellitus, hypertension, lipid abnormalities and metabolic syndrome.12 Currently, there are no pharmacological therapies approved by the FDA to treat PCOS.5 Alternatives include pharmacological management of symptoms with medications like combined oral contraceptive pills, metformin and anti-obesity agents.6 Recently, more discussion about the lack of PCOS treatment has been …

Insurance Status And Its Effect On Mothers With Postpartum Depression In The United States, Sanjana Davuluri, Lillian J. Alonzo, Nikita Paranjape, Akshad Thirugnanam, Alexander Youssef

Rowan-Virtua Research Day

Postpartum depression (PPD) is a significant health issue in the US today: 1 in 8 new mothers experience symptoms of PPD. Understanding how social determinants of health impact the short and long-term health outcomes of patients with PPD is key to providing interventions that are effective, efficient, equitable, and patient-centered. In this literature review, we aimed to shed light on the association between discrepancies in health outcomes of mothers with PPD and their insurance status. A search was conducted across PubMed and ProQuest Central databases focusing on literature from 2014 onwards. Studies that explored factors contributing to PPD, the impact …

Between Nsaids, Local Anesthetics, And Non-Medicinal Analgesics, Which Method Is The Most Effective At Providing Pain Relief During Iud Insertions For Nulliparous And Multiparous Women?, Natali Sharma

Rowan-Virtua Research Day

Objective: One major barrier for usage of intrauterine devices (IUD) includes a widespread sense of fear regarding pain during insertion of this contraception. By researching the most effective IUD insertion analgesics available and standardizing these pain management methods, women may be less fearful of obtaining IUDs.

Methods: A comprehensive literature review was conducted using Scopus, PubMed, Web of Science, EMBASE and Cochrane Library to compare methods of pain relief during IUD insertions. Outcomes measured include the pain management method used, the dosage administered, the pain experienced by patients evaluated using a Visual Analog Scale (VAS) prior to insertion …

A Rare Intervention: Perimortem Hysterotomy In An Obstetric Emergency In A 32-Year-Old Female, Alex Mirchandani

Rowan-Virtua Research Day

In the realm of obstetric emergencies, perimortem hysterotomy stands as a rare but crucial intervention, employed in dire circumstances to salvage both maternal and fetal lives. This procedure, involving the surgical delivery of a fetus from a mother in cardiac arrest, presents a unique set of challenges and ethical considerations for healthcare providers. This case report delves into the intricate details surrounding a perimortem hysterotomy performed under emergent conditions, exploring the clinical decision-making process, procedural intricacies, and outcomes. Through this narrative, we aim to shed light on the complexities of managing obstetric emergencies, emphasizing the critical role of timely intervention …

Case Report: An Emergency Department Presentation Of An Ovarian Teratoma, David Marconi, Zamron Masih

Rowan-Virtua Research Day

A teratoma (from the Greek terato for “monster” and onkoma for “mass” or “swelling”) is a type of neoplasm composed of tissues from two or three germ layers. Mature cystic teratomas (MCTs) constitute 70% of all ovarian neoplasms. They typically present with nonspecific symptoms such as pain and nausea. They account for approximately 2% of all primary ovarian malignant cancers and are predominately diagnosed via ultrasound. Computed tomography may be necessary if malignancy is suspected. Larger size warrants a higher suspicion of malignancy. Management is symptom control and ultimately, surgical removal. Prognosis is generally excellent, provided there is no malignant …

Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy is a rare form of heart failure (HF) that occurs in the late stages of pregnancy or in the early postpartum period. For it to be classified as PPCM, it must occur in the absence of another identifiable cause for HF and have left ventricular (LV) systolic dysfunction with an LV ejection fraction (LVEF) less than 45%. Here we present the case of a 46-year-old female G3P2 presented 5 days postpartum cesarean section delivery in acute respiratory distress where point of care ultrasound was used for assessment of the lungs to visualize …

Dermoid Cyst – Presenting With Llq Abdominal Pain, Mohammad A. Rattu, James A. Espinosa

Rowan-Virtua Research Day

Ovarian cysts are fluid-filled structures that may be defined as simple or complex and are often discovered incidentally on imaging. Their etiology can range from physiologically normal (such as follicular or luteal cysts) to ovarian malignancies. They are more common in the reproductive years secondary to endogenous hormonal production however may also occur at any age. Simple cysts more commonly occur among all age groups; mixed cystic and solid and completely solid ovarian lesions however have rates of increased malignancy. The most independent risk factor is age; therefore, post-menopausal women should have proper follow-up secondary to this risk. Some risk …

Ketamine For Postpartum Depression: A Systematic Review, Jaylyn Thompson, David F. Lo, Alexis Foschini, Suvan Sundaresh, Don D. Shamilov

Rowan-Virtua Research Day

The purpose of this review is to explore perinatal ketamine’s potential for reducing postpartum depression after cesarean section. Articles reviewed from Pubmed, Cochrane, and Web of Science using specific search terms. 8 final papers were used for review after excluding duplicates and irrelevant titles and abstracts. Ketamine showed potential in reducing postpartum depression symptoms post C-section, although some studies reported no significant effects. All studies were randomized control trials. Ketamine may help prevent or lessen postpartum depression symptoms post C-section, but more research is needed to understand dosing and its casual relationship with PPD in this context.

Does Esketamine In Cesarean Delivery Increase Postoperative Adversities And Related Diseases?, Cheryce Daniel, Kylon Coombs

Rowan-Virtua Research Day

Esketamine has emerged as a promising treatment option, particularly noted for its effectiveness in reducing postpartum depression, alleviating pain, and promoting faster recovery. Despite its therapeutic benefits, recent research has raised concerns regarding potential adverse effects associated with high doses of esketamine in patients. Specifically, there is growing interest in understanding the potential risks linked to the administration of esketamine during cesarean delivery, given its increasing use in obstetric anesthesia.

This comprehensive review aims to investigate the potential associations between the use of esketamine during cesarean delivery and the subsequent risk of related diseases or physiological disorders. The goal is …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Evaluation Of Outcome Following Oocyte Retrieval In Women With Marked Diminished Oocyte Reserve (Dor) Where The Only Oocyte Retrieved Was In A Metaphase I State, Brooke Neumann, Jerome Check, Carrie Wilson, Donna Summers, Kathleen Hollahan

Rowan-Virtua Research Day

OBJECTIVE: To determine if there is value in culturing a metaphase I oocyte to metaphase II followed by intracytoplasmic sperm injection (ICSI), fertilization, then embryo transfer (ET) in women with marked DOR. MATERIALS AND METHODS: A follicle stimulating hormone (FSH) receptor up-regulation technique was used in women whose day 3 serum FSH levels were >12 mIU/mL and/or the serum anti-mullerian (AMH) level was <1ng/mL to mature antral follicle(s) to the dominant follicle stage (average diameter >18) and serum estradiol (E2) >200pg/mL when 10,000 IU human chorionic gonadotropin (hCG) would be given followed by oocyte retrieval 32 hours later. The basic tenet of this follicle maturation technique is to 1) use very little …

Paradoxical Dat In A Term Newborn With Physiological Jaundice, Abiram Sivanandam, Tomas Rotschild

Rowan-Virtua Research Day

The Direct Antigen Test (DAT) is used to find out if a newborn has maternally-produced antibodies against the newborn’s red blood cells. We discuss the case of a term newborn male with an O+ blood type born to a mother whose blood type is A+. As a part of routine screening, DAT of umbilical cord blood was obtained, which resulted positive. While the neonate had jaundice, the overall clinical picture pointed more toward neonatal physiological jaundice rather than a potential hemolytic anemia expected with a positive DAT. This discrepancy prompted us to review literature to explain our findings.

Characterization Of Bacterial Pathogens Involved In Aerobic Vaginitis: Prevalence, Strain Characterization And Sequelae, Leslie A. Lafferty

Graduate School of Biomedical Sciences Theses and Dissertations

Aerobic vaginitis (AV) is a more recently defined infection that involves aerobic pathogenic bacteria that replace the normal flora of the vaginal tract. It is commonly mistaken for other vaginal infections, such as bacterial vaginosis (BV), because they share many common symptoms. AV leads to complications during pregnancy, such as premature delivery and amnion infection, and is diagnosed by indications that range from vaginal discharge to inflammation. Because this infection is difficult to diagnose differentially from other vaginal infections, it is important to determine what pathogens are involved in AV so that we may have the ability to detect them. …