Obstetrics and Gynecology Commons^™

Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda

Doctor of Nursing Practice Scholarly Projects

Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …

Ectopic Pregnancy Located At Pelvic Wall And Liver: Two Uncommon Case Reports From Vietnam And Mini-Review Literature, Thanh Hai Pham, Van Hoang Bui, Van Hung Nguyen, Phuc Nhon Nguyen

Journal Articles

INTRODUCTION AND IMPORTANCE: Abdominal ectopic pregnancy (AEP) located at hepatic region and pelvic-wall ectopic pregnancy (EP) are rare entities, that provoking a potentially life-threatening condition. Due to insufficient data, a proper management of non-specific types remains a challenge for all gynecologists worldwide.

CASE PRESENTATION: Two child-bearing age women were hospitalized due to delayed menstruation and a urine pregnancy test was positive without a determination of intrauterine pregnancy. The first EP case was located at the pelvic wall which identified incidentally during laparoscopy for a presumed tubal ectopic pregnancy on ultrasonography throughout. The second EP case was found at the hepatic …

Correlation Of Sonographic With Intraoperative Findings In Laparoscopic Managed Ectopic Pregnancies, A 10-Year Synopsis: A Retrospective Observational Study, Steve Mutiso

Obstetrics and Gynaecology, East Africa

Background: Ectopic pregnancies (EP) are a common pregnancy complication that's associated with significant morbidity and rarely mortality if not managed properly. Ultrasound examination forms the cornerstone of diagnosis of EP with some sonographic features occasionally not correlating with intraoperative findings. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the correlation and prediction of sonographic findings to intraoperative findings.

Methods: This study was designed as a Retrospective Observational Study based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of …

Utility Of Bedside Ultrasound In Identifying Undiagnosed Malpresentation Upon Admission To Labor And Delivery: A Quality Improvement Project, Kristen Daugherty, Gloria Wang, Samantha Mclean, Jeffrey Johnson, Kelly Mosher

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Use Of Pulse Oximeter Perfusion Index During Ultrasound Guided Supraclavicular Brachial Plexus Block With Or Without Epinephrine In Upper Extremity Surgery. A Randomized Comparative Study, Gamal Lotfy Gad, Ayman Said Abd El Aziz, Mohamed Abd El Aziz Nasr El Dien Metwalli

Al-Azhar International Medical Journal

Background: Ultrasound (US) guided supraclavicular block (SCB) has the benefit of the widest sensory blocking of all of the brachial plexus techniques, including the single puncture method, due to the concentration of the plexus components at this site. Objectives: to assess the use of pulse oximeter perfusion index (PI) changes in assessment of success SCB in upper extremity surgery and to evaluate impact of adrenaline on pulse oximeter perfusion index changes. Patients and methods: A prospective, randomized, double-blind, comparative research was done on 90 cases between June 2022 to January 2023, at Al- Faculty of Medicine , Al-Al-Azhar University.

Results: …

Acceptability And Feasibility Of A Low-Cost Device For Gestational Age Assessment In A Low-Resource Setting: Qualitative Study, Angela Koech, Peris Muoga Musitia, Grace Mwashigadi, Mai-Lei Woo Kinshella, Marianne Vidler, Marleen Temmerman, Rachel Craik, J. Alison Noble, Peter Dadelszen Von Dadelszen, Aris T . Papageorghiou

Obstetrics and Gynaecology, East Africa

Background: Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with artificial intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated measurements of the fetal transcerebellar diameter and head circumference.

Objective: The aim of this study was to assess the perceptions of pregnant women, their families, and health care workers regarding the feasibility and acceptability of the TraCer device in an appropriate setting.

Methods: A descriptive study using qualitative methods was conducted in …

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 …

Routine Late Trimester Ultrasound For The Detection Ofsmall-For-Gestational-Age And Growth-Restricted Fetus Inlow-Risk Pregnancy: A Randomised Controlled Trial, Sikolia Wanyonyi, Doreen Osoro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To compare the proportion of small-for-gestational-age and fetal growth-restricted fetuses detected in women offered a routine growth ultrasound to those either offered selective or no ultrasound in the third trimester.

Methods: An open-label randomised control trial was conducted at the Aga Khan University Hospital, Nairobi. Eligible women were randomised into either the intervention or control group. Women in the intervention arm had a mandatory third trimester ultrasound for fetal growth performed between 36 weeks 0 days to 37 weeks 6 days. Those in the control group had a selective growth scan done if the clinician suspected abnormal fetal growth. …

The Correlation Between Histopathological And Ultrasound Findings Regarding Cesarean Section Scars – A Three-Year Survey Study, Oana D. Bălălău, Nicolae Bacalbașa, Cristian Bălălău, Carolina Negrei, Bianca Gălățeanu, Octav Ghinghină, Cristina Răduță, Liana Pleș, Anca D. Stănescu, Vasile A. Dumitru

Journal of Mind and Medical Sciences

The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery.

Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy.

Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar.

The study was performed on a batch of 123 patients with previous C-sections, …

Maternal Intuition Of Fetal Gender, Michael Mcfadzen, David P. Dielentheis, Ronda Kasten, Maharaj Singh, Joe Grundle

Journal of Patient-Centered Research and Reviews

Purpose: Fetal gender speculation is a preoccupation of many expecting parents, and pregnant women commonly profess to intuitively know the gender of their unborn babies. This study objectively compared pregnant mothers’ perceptions of fetal gender to sonographically proven gender determinations. Also, success rates from previously published studies, noninvasive prenatal testing and a myriad of gender determination methods were observed and reported for context.

Methods: All pregnant women presenting for second-trimester screening ultrasound (at 17–23 weeks gestation) in the obstetrics department of a single health center were asked to participate. A medical sonographer described the ultrasound examination, obtained appropriate consent and …

A Perspective On Ovarian Cancer Biomarkers: Past, Present And Yet-To-Come, Frederick R. Ueland

Obstetrics and Gynecology Faculty Publications

The history of biomarkers and ultrasonography dates back over more than 50 years. The present status of biomarkers used in the context of ovarian cancer is addressed. Attention is given to new interpretations of the etiology of ovarian cancer. Cancer antigen 125 (CA125) and multivariate index assays (Ova1, Risk of Ovarian Malignancy Algorithm, Overa) are biomarker-driven considerations that are presented. Integration of biomarkers into ovarian cancer diagnostics and screening are presented in conjunction with ultrasound. Consideration is given to the serial application of both biomarkers and ultrasound, as well as morphology-based indices. Attempts are made to foresee how individualized molecular …

Probability Of Fallopian Tube And Ovarian Detection With Transvaginal Ultrasonography In Normal Women, Jason R. Lefringhouse, Erin Neward, Frederick R. Ueland, Lauren A. Baldwin, Rachel W. Miller, Christopher P. Desimone, Richard J. Kryscio, John R. Van Nagell, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

Objective: Some ovarian malignancies may originate in the fallopian tube. The feasibility of ultrasonographically visualizing the fallopian tube is presented. Methods: In total, 549 normal women participated in the fallopian tube visualization trial, while ovarian visualization was studied in 43,521. Chi-square analysis, t-tests and multivariate analysis determined significance and interactions. Results: Ovaries were observed in 82.7% while fallopian tubes were detected in 77.2% of women and 85.2% of the time when an ovary was detected. Age, BMI or parity was not significantly different when one or both fallopian tubes were visualized. Elevated BMI had slightly greater influence …

Transvaginal Ultrasonography In Ovarian Cancer Screening: Current Perspectives, John R. Van Nagell Jr., John T. Hoff

Obstetrics and Gynecology Faculty Publications

Transvaginal ultrasonography (TVS) is an integral part of all major ovarian cancer screening trials. TVS is accurate in detecting abnormalities in ovarian volume and morphology, but is less reliable in differentiating benign from malignant ovarian tumors. When used as the only screening test, TVS is sensitive, but has a low positive predictive value. Therefore, serum biomarkers and tumor morphology indexing are used together with TVS to identify ovarian tumors at high risk for malignancy. This allows preoperative triage of high-risk cases to major cancer centers for therapy while decreasing unnecessary surgery for benign disease. Ovarian cancer screening has been associated …

Ultrasound Methodology Used To Construct The Fetal Growth Standards In The Intergrowth-21st Project, Papageorghiou A. T, Sarris I, Oannou C I, Todros T, Maria Carvalho, Pilu G, Salomon L. J

Imaging & Diagnostic Radiology, East Africa

A unified protocol is essential to ensure that fetal ultrasound measurements taken in multicentre research studies are accurate and reproducible. This paper describes the methodology used to take two-dimensional, ultrasound measurements in the longitudinal, fetal growth component of the INTERGROWTH-21^st Project. These standardised methods should minimise the systematic errors associated with pooling data from different study sites. They represent a model for carrying out similar research studies in the future.

Massive Retroperitoneal Hematoma Caused By Retroperitoneal Ectopic Pregnancy, Jay Goldberg, Michael Weinstein, Kris Kaulback, Aileen Gariepy, George Bega

Department of Surgery Faculty Papers

A massive retroperitoneal hematoma caused by a retroperitoneal ectopic pregnancy is managed successfully utilizing multidisciplinary cooperation and transfusion of blood products. The authors report an unusual case of a retroperitoneal ectopic pregnancy presenting as a massive retroperitoneal hematoma in a hemodynamically unstable patient.

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Multiple Pregnancies: Determining Chorionicity And Amnionicity, Traci B. Fox

Department of Radiologic Sciences Faculty Papers

The determination of chorionicity and amnionicity in multiple gestations is one that confounds many in the medical field. The importance of diagnosing the type of multiple gestation cannot be overstated. This is intended to be an introductory primer and refresher to chorionicity and amnionicity. We will first examine what determines mono- versus dichorionic twinning including zygosity and cleavage of the zygote.

Pregnancy Diagnosis Using Ultrasound, M A C Johns

Journal of the Department of Agriculture, Western Australia, Series 4

Few Western Australian ewe flocks are diagnosed for pregnancy despite the precence of high numbers of barren ewes. Surveys of farm flocks in the early 1970s recorded that between 14 and 29 per cent of ewes failed to lamb each year.

Techniques for diagnosing pregnant ewes have been available for many years, but ultrasonic devices and computer technology have made it possible for skilled operators to determine whether ewes are pregnant and more importantly, whether they have one, two or more foetuses.

Once the number of pregnant ewes is known farmers can use labour more efficiently. They can minimise the …