Obstetrics and Gynecology Commons^™

Pessary Use In Urology Clinics, Kathy Z. Lu Bs, Emily Brodowsky Md, Alex Stephens Ms, Samantha Raffee Md, Humphrey Atiemo Md

Medical Student Research Symposium

Introduction: Pessaries are a non-invasive treatment option for patients with pelvic organ prolapse (POP) or stress urinary incontinence (SUI). There is currently limited data regarding pessary usage among urology patients. The aim of this study is to determine the patient characteristics that predict long term pessary usage versus surgical intervention.

Methods: A 10-year retrospective review of pessary usage in women with either SUI or POP was performed. Patients were stratified into pessary longevity of less than or greater than one year. Quality of life measures before and after pessary use included pads per day, incontinence symptom index (ISI) scores, and …

Evaluating The Effect Of Maternal Non-Communicable Disease On Adverse Pregnancy Outcomes And Birthweight In Pakistan, A Facility Based Retrospective Cohort Study, Esther Wainwright, Sheikh Irfan Ahmed, Rahat Qureshi, Sana Yousuf, Raheela Khan, Matthew Elmes

Department of Obstetrics & Gynaecology

Non-communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle-income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre-existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 …

A Case Report And Evaluation Of Intrauterine Gas Of Unknown Origin, Chrystal Stallworth, Diane Gilbertson, Timothy Kremer

North Texas Research Forum 2024

Introduction: Most reports of intrauterine or endometrial gas have been reported in the setting of underlying gynecologic malignancy or infection. The significance of this case report is to give a presentation of a patient presenting with intrauterine gas who subsequently was found to have neither infectious nor malignant cause for such finding. Case Presentation: Patient is a 56 year old postmenopausal female who presenting with “hip pain” and was found to have incidental intrauterine gas on pelvic CT. She underwent in office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign and …

Four Cesarean Scar Pregnancies Managed At Accreta Center Of Excellence At Medical City Dallas Hospital: A Case Series, Ana Adams, Nicole Tenzel, Monica Rodriguez, Robert Cohen

North Texas Research Forum 2024

Cesarean Scar Pregnancy results from pathologic implantation of a gestational sac into a hysterotomy scar. This rare disease continues to increase in incidence due to the rise of Cesarean delivery in the United States. Current management recommendations by the Society of Maternal Fetal Medicine (SMFM) include termination of pregnancy, or in rare instances, hysterectomy. This case series examines four patients diagnosed with Cesarean Scar Pregnancies that either declined termination or were unable to receive abortion services in the first trimester, and who were managed at the Accreta Center of Excellence at Medical City Dallas Hospital. This novel management strategy included …

The Silence Of Mitotic Figures, Hope K. Haefner Md

Patient Experience Journal

A career in medicine is guided by the patients you treat and those who have taught you to treat these individuals. Communication is of utmost importance in all aspects of healthcare. However, there are times when communication can be difficult. This story takes you through a physician’s experience that led to a career in women’s healthcare, reflecting on the silence that prevailed as her journey began.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/).

• Access other PXJ articles related to this lens.
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Educational Case: Endometrial Ectopia In Endometriosis And Adenomyosis, Carolyn G. Chen, Joanna S.Y. Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Association Of Maternal Biomarkers With Gestational Weight Gain And Pre-Eclampsia, Matthew Green, Xinhua Chen

Rowan-Virtua Research Day

Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.

Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational …

Pregnancy Outcome With In Vitro Fertilization-Embryo Transfer According To Age In Women With Diminished Oocyte Reserve (Dor) Using A Follicle Stimulating Hormone Receptor Up-Regulation Technique, Brooke Neumann, Jerome Check, Carrie Wilson, Michael Sobel, Jung Choe

Rowan-Virtua Research Day

Objective: About 18 years ago, one of the top IVF centers published a study and found that women with DOR did not have any live deliveries at any age in women with a day 3 serum FSH exceeding 18 mIU/mL. The failure to achieve a live delivery may have been related to the ovarian hyperstimulation regimen with possible down regulation of the FSH receptor needed to produce a key enzyme needed for successful implantation. The purpose of this 25-year retrospective review was to evaluate the efficacy of a specific type of mild stimulation referred to as the FSH receptor up-take …

The Vaginal Microbiome Post-Menopause And Urinary Tract Infections, Rifke Anolik, Julia Kiffel, Venkateswar Venkataman

Rowan-Virtua Research Day

Background: Urinary Tract Infection (UTI) is a condition where pathogens invade the urinary tract and can travel up the urethra and into the bladder. UTIs occur more commonly in females compared to males and in the post-menopausal population this rate increases significantly. While these infections may be asymptomatic, they can also cause severe discomfort and lead to serious and even life threatening complications. Recent investigation into the vaginal microbiome has opened the doors to a possible mechanism behind the increased incidence of UTIs after menopause. Understanding the pathogenesis behind the increased risk of UTIs in the postmenopausal state will allow …

Ovarian Hemorrhagic Cyst In A 42-Year-Old Female Receiving Ivf, Aloysius Ibe, Francesca Dileonardo, Robin Lahr, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 42-year-old female who presented with lower abdominal/pelvic pain and diagnosed with an active hemorrhagic ovarian cyst after undergoing egg retrieval as part of in-vitro fertilization (IVF) treatment. The differential for abdominal pain in women is vast, but for this patient receiving IVF we had to consider ovarian hyperstimulation syndrome and ectopic pregnancy just to name a few examples. It is predictable that most women will suffer from a ruptured ovarian cyst at some point in their lifetime so long as they continue to menstruate.

The Effects Of Prenatal Buprenorphine Exposure On The Neurobehavioral Development Of The Child, Zaineb Zubair, Maryam Zubair, Juan Alonso, Abdullah Zubair

Rowan-Virtua Research Day

Background: Current guidelines for pregnant women with substance use disorder advise prenatal maintenance of opioid agonist therapy with either buprenorphine or methadone. Despite this rise in prenatal opioid agonist therapy, little is known about the effect of prenatal buprenorphine on the neurobehavioral development of the child. This poses the question: does buprenorphine have a long-lasting effect on the central and peripheral nervous system development and behavior of children who were exposed prenatally?

Methods: A comprehensive literature review identified articles relating to prenatal buprenorphine and neurobehavioral outcomes. Article searches were conducted on PubMed and Dynamed. Publications from 2002 through November 2021 …

Abnormal Placentation With Placenta Accreta In A Post Ablation Pregnancy, Amanda Mirmanesh, Raechel Fockler, Woojin Chong

Rowan-Virtua Research Day

Placenta accreta spectrum (PAS) is a rare complication of pregnancy in which the placenta abnormally implants into, and in rarer cases, through the uterine wall which leads to increased maternal morbidity with risk of maternal mortality. PAS diagnosed at the time of delivery is associated with severe maternal morbidity largely due to elevated blood loss which can result in complications such as DIC and even maternal death. We present a case of a woman with PAS to reiterate the importance of close antepartum monitoring along with having a high suspicion for placenta accreta in a patient with risk factors, specifically …

Global Comparison Of Health Policies Focused On Gestational Diabetes: Recognizing Pertinent Gaps, Muskanjot Kaur, Isvita Marfatia, Samarth Gupta, Swetha Sundaram, Anudeep Deevi, Venkat Venkataraman

Rowan-Virtua Research Day

Introduction: Gestational diabetes mellitus (GDM) is a condition that affects 14.7% of women globally and occurs when a mother develops diabetes during the course of her pregnancy.1 Increased insulin resistance in pregnant mothers can lead to further complications, such as a larger baby, increased risk of the baby developing Type II diabetes, having low blood sugar, and even premature birth, which can lead to respiratory issues. The lack of policies in place to address GDM in various countries worldwide highlights the need for this literature. It is necessary to compile policies that are currently in place and to further discuss …

The Possible Relationship Of Adiponectin And Gestational Weight Gain During Different Stages Of Pregnancy Amongst Different Ethnic Groups, Jayshree Chauhan, Xinhua Chen

Rowan-Virtua Research Day

Introduction: Gestational Weight Gain (GWG) is defined as weight gain between conception and birth. Adiponectin, a fat derived hormone, has an inverse relationship with weight gain. We investigated the relationship of maternal adiponectin concentration and GWG during different pregnancy stages among ethnic groups. Method: Serum adiponectin levels were measured at entry (week 16) and trimester three (week 28) in pregnant women (n = 1634, age 22.0±5.3, pre-pregnancy BMI 25.7±6.3) which included Hispanic (47%), African American (37%) and Caucasian (16%) women. GWG was measured at week 24, 28, 32, and delivery and was divided into inadequate, adequate, and excessive according to …

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 …

Case Report: Uterine Torsion – A Rare Cause Of Right Lower Quadrant Pain, David Ho, James Jung Lee, James Espinosa

Rowan-Virtua Research Day

Uterine torsions are very rare. In an article by Matsumoto et al published in 2021, only 25 cases have been documented on PubMed in non-gravid females in the past 20 years. Uterine torsion is defined as rotation of the uterus greater than 45 degrees in the long axis. Rotation can occur anywhere between 45 degrees to 180 degrees. The torsion can be due to a congenital anomaly or an obstetrics emergency such as with an ovarian torsion. Uterine torsions presenting as an obstetrics emergency carries the potential for irreversible ischemic damage to the uterus, and just as in ovarian torsion, …

Is There An Association Between Preeclampsia/Eclampsia And Congenital Heart Disease Among The Neurodivergent Population?, Jasmine Emanuel, Venkateswar Venkataraman, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart …

Platelets In Preeclamptic Pregnancies Fail To Exhibit The Decrease In Mitochondrial Oxygen Consumption Rate Seen In Normal Pregnancies, Joseph Kim, Andrew Malinow, Rosemary Schuh

North Texas Research Forum 2023

Cellular oxygen consumption and lactate production rates have been measured in both placental and myometrial cells to study obstetrics-related disease states such as preeclampsia. Platelet metabolic alterations indicate systemic bioenergetic changes that can be useful as disease biomarkers. We tested the hypothesis that platelet mitochondria display functional alterations in preeclampsia. Platelets were harvested from women in the third trimester of either a healthy, non-preeclamptic or preeclamptic pregnancy, and from healthy, non-pregnant women. Using Seahorse respirometry, we analyzed platelets for oxygen consumption (OCR) and extracellular acidification (ECAR) rates, indicators of mitochondrial electron transport and glucose metabolism, respectively. There was a 37% …

Intraoperative Management Of Vasa Previa During Cesarean Delivery, Nicholas Sheets

South Atlantic Division Research Day 2023

No abstract provided.

Factors Associated With Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study, Katerina A. Furman, Amy Loree Phd, Leah Hecht Phd, Katerina Furman Md Candidate, Lyuba Gavrilova Bs, Hsueh-Han Yeh Phd, Catherine Frank Md, Brian Ahmedani Phd

Medical Student Research Symposium

Purpose: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors among childbearing-aged individuals who were pregnant, postpartum or who experienced pregnancy loss

Methods: Data from nine health care systems in the Mental Health Research Network was included in this sample. A case-control study design was used in which 290 childbearing-age individuals who died by suicide (cases) from 2000-2015 were matched with 10 childbearing-age individuals from the same healthcare system and enrolled during the same time period who did not die by suicide (n=2,900). Conditional logistic regression was used to analyze associations between pregnancy/postpartum/pregnancy loss status and suicide.

Results: …

Areas For Improvement In Pre-Eclampsia Prevention: Aspirin Use In Indicated Pregnancies, Mariah Piazza, Krystal Carmichael, Keisha Reddick, Susan Greene

South Atlantic Division Research Day 2023

No abstract provided.

The Impact Of Physical Activity Education During Pregnancy, Lizeth Banuchi

DNP Research Projects

Abstract

Background: Physical Activity (PA) during pregnancy is important to maintain optimal maternal and neonatal health. Gestational Diabetes Mellitus (GDM) requires close monitoring during pregnancy due to the health risk it can cause to mother and fetus. It is evident that PA can help improve maternal health outcomes to positively offer overall wellness throughout the pregnancy.

Objective: The purpose of this Quality Improvement Project (QIP) is to evaluate the impact of PA education on PA implementation during pregnancy and improve clinical practice for healthcare providers to introduce PA education during prenatal care per ACOG and CESP guidelines.

Method: This quality …

Multiple Recurrences Of Papillary Urothelial Neoplasia Of Low Malignant Potential (Punlmp) In A Young Adult Female, Justine Bedolla, Aaron Poole, Laura Gutierrez

Central & West Texas Research Day 2023

No abstract provided.

Maternal Mirror Syndrome As A Consequence Of Fetal Sacrococcygeal Teratoma: A Case Report And Literature Review, Ali Farris, Andrew Royek, Kaitlyn Dorsey

South Atlantic Division Research Day 2023

No abstract provided.

Factor Vii Deficiency And Second Trimester Abortion: A Case Report, Katie P. Nguyen, Tamara Lynne B. Aqui, Honey Milestone

Far West Division Research Day 2023

No abstract provided.

Spontaneous Heterotopic Pregnancy: Diagnosis And Management, Katie P. Nguyen, Marlekah Hudspeth, Honey Milestone

Far West Division Research Day 2023

No abstract provided.

Prevalence Of Postpartum Pre-Eclampsia In Pregnancies Affected By Covid-19 Pneumonia, Brittany Sweatman, Rebekah Bongato-Merren, James Baron

West Florida Division Research Day 2023

No abstract provided.

Possible Gender Differences In The Level Of Perceived Social Support In Couples Who Are Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Objective The purpose of this study is to examine whether there are gender differences in the level of perceived social support in couples experiencing issues with fertility. Methods A total of 938 participants aged 18-47 years, with self-reported issues of infertility, were evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS) which comprises three subscales which correspond with distinct sources of social support: significant other (SO), family, and friends. Differences between sexes for total score and for all subscale scores were subsequently analyzed using SPSS Statistics (IBM Corp, Armonk, USA). Results Mean total scores and scores on all subscales …

Role Of Decorin At The Fetal-Maternal Interface, Chidambra D. Halari

Electronic Thesis and Dissertation Repository

The human placenta is an invasive tumor-like structure, this invasion being physiological. A subset of placental trophoblast called extra-villous trophoblast invades the uterine decidua and remodels uterine arteries into low-resistance, high-flow tubes to permit adequate flow of maternal blood to nourish the fetus. A poor extra-villous trophoblast invasion and uterine arterial remodeling can lead to fetal growth restriction and a serious pregnancy-associated maternal disease preeclampsia. Decorin, a leucine-rich proteoglycan produced by uterine decidual cells restrains multiple trophoblast functions: self-renewal and differentiation of trophoblast stem cells, migration, invasion, proliferation and endovascular differentiation. Additionally, decidual overproduction of decorin was associated with preeclampsia, …

Identifying Predictors For Inflammation-Induced Preterm Birth: A Murine Study, Tzu Ning Liu Bs, Jose Galaz Md, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. A large proportion of preterm deliveries is affected by intra-amniotic inflammation, which can occur in the presence (intra-amniotic infection) or absence (sterile intra-amniotic inflammation) of microbes. Studies have shown an association between intra-amniotic inflammation, cervical shortening, and changes in the cervicovaginal microbiome. However, their causal relationships are unknown. This study aims to determine the causality of intra-amniotic inflammation, cervical shortening, and cervicovaginal microbiome alterations.

Methods: Pregnant C57BL/6 dams received an ultrasound-guided intra-amniotic injection of an endotoxin lipopolysaccharide (LPS) or the alarmin interleukin-1 alpha (IL-1 alpha) on 16.5 …