Obstetrics and Gynecology Commons^™

Evaluating The Utility Of Diagnostic Workups For Biliary Atresia In Neonates With Cholestatic Jaundice Following Prolonged Tpn, Melissa Austin, Zubair H. Aghai

Phase 1

Introduction: Parenteral nutrition associated cholestasis (PNAC) develops in 40-60% of premature infants following TPN for 2-4+ weeks. The incidence of biliary atresia is low and there is a 60-day, post-term window for corrective surgery. There is limited data on both the natural history of PNAC in premature infants following prolonged TPN, as well as the utility of diagnostic tools investigating biliary atresia in these patients.

Methods: A retrospective chart review using EMR data from the Intensive Care Nursey was performed with the following criteria: premature babies diagnosed with cholestasis, born at <1500 grams, and received TPN for 14 days. Ultimately 61 babies met criteria and data was collected and pooled to produce descriptive statistics and graphs describing laboratory trends.

Results: Median gestational age was 26 [IQR 25, …

Does Maternal Methadone Dose Correlate With Severity Of Intrauterine Growth Restriction In Infants With Neonatal Abstinence Syndrome?, D. Friedman, J. Smith, M. Lafferty, Z. H. Aghai

Phase 1

Introduction : Previous studies demonstrate a relationship between maternal opioid use during pregnancy and smaller head circumference of infants with neonatal abstinence syndrome (NAS). The goal of this study is to correlate maternal methadone dose and severity of growth restriction in infants with NAS admitted to the neonatal intensive care unit (NICU).

Methods: This is a retrospective analysis of infants (≥35 weeks gestation) exposed to in utero methadone, born between August 2006 and May 2018, and admitted to a Philadelphia NICU for medical therapy for NAS. Growth parameters (birth weight, birth length, and birth head circumference) were compared between infants …

The Effect Of Perceived Physician Opinion On Breastfeeding In Women With Opioid Use Disorder Who Are Receiving Medication-Assisted Treatment, Lacey Murray, Meghan Gannon, Phd, Vanessa Short, Phd, Mph

Phase 1

Women who receive medication-assisted treatment (MAT) for opioid use disorder (OUD) are less likely to breastfeed than the general population despite the many possible benefits to the newborn. The ongoing study examines the effect of perceived physician opinion on the outcome of breastfeeding in women receiving MAT for OUD. Women who were receiving MAT for OUD at Thomas Jefferson University’s Family Center were given a survey during their third trimester (n=45), and at 1 month postpartum (n=33) to gather information on the perceived opinion of their physicians on how they should feed their baby and the importance of those opinions. …

Down Regulation With Luteal Gnrh Agonist Therapy In Euploid Embryo Transfers Does Not Impact Pregnancy Rates, Isabelle Levin, Keri Bergin, Md, Dmitry Gounko, Joseph Lee, Alan Copperman, Md

Phase 1

Introduction : Gonadotropin-releasing hormone (GnRH) agonists have been used during assisted reproductive technology (ART) treatment for pituitary suppression and stimulation. Currently, clinical opinion is divided about whether GnRH agonist therapy improves pregnancy rates when used for luteal down-regulation in a frozen euploid embryo transfer (FET). This study evaluated the clinical utility of GnRH agonist down-regulation in single, euploid FET cycles.

Methods : A retrospective analysis was performed, using data from patients who underwent a single, euploid FET cycle from 2012 to 2019. Patients were segregated into two cohorts: Group A: single, euploid FET with down-regulation using GnRH agonist; Group B: …

The Utility Of Performing Cervical Length Follow-Up In Lower Risk Singleton, Varsha Kripalu, Rupsa Boelig, Md

Phase 1

Introduction: Short cervical length (<25 mm) during pregnancy is known to be an increased risk factor for preterm birth (<37 weeks). While interventions exist for women who have had prior preterm births, it is important to investigate the cost effectiveness of screening low risk women with an intermediate cervical length (26-29 mm).

Objective: To quantify the association between change in cervical length on follow up and the incidence of preterm birth in otherwise low risk women with an initial intermediate cervical length.

Methods: A retrospective cohort study was conducted, reviewing 108 charts of women who had an initial screening between 26 and 29 mm. Charts were reviewed for whether or not a follow-up ultrasound was recommended, whether or not the follow-up was performed, and the outcome of their deliveries.

Results: 93.5% (N=101) of women were recommended to get a follow-up ultrasound and 84% (N=85) completed their follow-up. …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Ilana Porges, Vaishali Mehta, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: Delays in management of high risk pregnancies can result in significant morbidity for women seeking obstetric care. A trend of high incidence of pregnancy complications has been observed among women with non-communicable diseases (NCDs) receiving care at the University Teaching Hospital of Kigali (CHUK), which may suggest the need for more consistent screening of NCDs among pregnant women, and more streamlined care for those identified to be at highest risk for complications.

Methods: This study utilized a mixed method design to assess the need for screening of NCDs among pregnant women (n=255) who received obstetric care at CHUK between …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

Prediction Of Neonatal Birthweight Associated With Maternal Obesity And Diabetes, Laura Gleason, Rebekah Mccurdy, Md, Mph

Phase 1

Introduction: To design a model that will predict neonatal birth weight within obese mothers by diabetic status.

Methods: A secondary data analysis of an RCT (NCT 02909582) was utilized to create a neonatal birth weight prediction model. Women (n=325) with a BMI > 35 kg/m2 from a tertiary academic institution, 2016 – 2019, were included to estimate the risk of large for gestational age (LGA) infants and neonatal birth weight based on maternal prepregnancy BMI and diabetic status. LGA was defined as an infant birth weight > 90th percentile. Analysis included Chi-square, t-test, multivariate logistic and linear regression.

Results: Mean birthweight did …