Obstetrics and Gynecology Commons^™

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses and Capstone Projects

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin ...

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 ...

The Effect Of Regular Daily Walking On Adverse Pregnancy Outcomes Among Overweight Primigravidas: A Prospective Cohort Study, Nahla W. Shady, Hany F. Sallam, Shymaa S. Ali, Ahmed M. Abbas

POG In Press

Objective: The study aims to evaluate the effect of regular daily walking on the occurrence of adverse pregnancy outcomes among overweight primigravidas.

Materials and Methods: A prospective cohort study conducted at Aswan University Hospital from March 2015 to December 2016. The study included 360 overweight primigravidas, with singleton pregnancies, who were divided into two groups: Group I (control group) and Group II (study group) under supervised regular walking 5 times per week for 30 minutes, starting from 10-12 weeks of gestational age to 38-39 weeks of gestational age. The primary outcome of the study was the rate of gestational weight ...

Hospital Infant Formula Discharge Packagesdo They Affect The Duration Of Breast-Feeding?, Claibourne I. Dungy, Mary E. Losch, Daniel W. Rusell, Paul Romitti, Lois B. Dusdieker

Daniel W. Russell

Objective: To determine whether the duration of breastfeeding is affected by the contents of the hospital discharge package. Design: A randomized clinical trial with 2 experimental interventions (a discharge package containing a manual breast pump only and a discharge package containing a commercially prepared infant formula and a manual breast pump) and a control group who received a commercially prepared infant formula discharge package only. Sociodemographic characteristics and information concerning prior births (including feeding methods) were obtained from each mother within 48 hours of her infant's birth. Sources of influence on the mother's feeding decision, maternal attitudes concerning ...

The Impact Of Neonatal Abstinence Syndrome: The View From A Rural Kentucky Hospital, Sydni Fazenbaker Crowell, Allison M. Crump-Rogers, William Crump, Leann Langston

Marshall Journal of Medicine

Abstract

Introduction

Cases of neonatal abstinence syndrome (NAS) increased 3-fold in the United States from 2000 to 2009, with some indication that the problem may be worse in rural areas. The purpose of our study was to report the incidence of NAS in a small rural community with a regional referral hospital and describe aspects of these infants’ NICU stay.

Methods

Using maternal prenatal positive urine drug screens (UDS) as our initial focus, deliveries at 35 weeks or beyond between March 2015 and May 2016 were included. NAS severity score, length of NICU stay, and hospital charges for each infant ...

Case Report: An Undiagnosed Bladder Diverticulum Resulting In Foley Catheter Perforation During Cesarean Section, A. Allison Roy, Nadim Bou Zgheib, Joseph Assaley

Marshall Journal of Medicine

A bladder diverticulum is diagnosed when herniated bladder mucosa forms an outpouching from the bladder. Bladder diverticula are uncommon and are significantly more common in males. The following case presents a patient with an undiagnosed bladder diverticulum which was incidentally perforated during foley catheter placement for a repeat cesarean section. The diagnosis can be difficult in those who are asymptomatic and lack risk factors, such as the following patient.

Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women: Preliminary Results From A Pilot Randomized Controlled Trial, Ling Shi, Vidya Iyer, Errol Norwitz, Tiffany A. Moore Simas, Nirupa R. Matthan, Alice H. Lichtenstein, Laura L. Hayman

Tiffany A. Moore Simas

Background: Previous evidence suggests that soy containing foods may have beneficial effects on lipid and glycemic metabolism. Pregnancy is associated with a progressive deterioration in glucose and lipid metabolism, partially attributable to elevated estrogen concentrations. Little is known about the effects of soy intake on cardiometabolic risk factors in pregnant women. Methods: A pilot RCT was conducted in 30 pregnant women who were randomized to receive counseling to consume a high-soy or low-soy foods containing diet. Assessments (physical measurements, food frequency questionnaires, fasting blood samples) were conducted at 14 and 28 weeks of pregnancy, and 6 weeks’ postpartum. Monthly follow-up ...

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Heather Z Sankey MD

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8 ...

Spontaneous Triplet Pregnancy With Twin Fetuses Papyraeci: A Rare Case Report And Review Of The Literature, Ahmed M. Abbas, Mohamed Khalf, Mahmoud S. Zakherah

Proceedings in Obstetrics and Gynecology

A fetal death in a multiple pregnancy with one or more normally surviving fetus is unusual. Fetus papyraceous (FP) is a rare obstetric complication in multiple gestations. It is defined as retention of a mummified parchment like remains of a dead fetus in multiple pregnancy associated with a viable twin. It is important to reassure the patient of the normal outcome expected in most of the cases. Herein, we report a rare case of twin FP in a spontaneous triplet pregnancy with a literature review of maternal and neonatal outcomes and management of similar cases.

Management Of Preeclampsia After Heart Transplant, Emily R. Malling, Heather Anaya Do, R. Erik Edens Md, Phd

Proceedings in Obstetrics and Gynecology

We present a 20-year-old primiparous patient status post heart transplant at 6 months with long-standing hypertension progressing to super-imposed preeclampsia. Pregnancy and delivery after thoracic transplantation is no longer a rare occurrence, however, these women are at a greater risk of gestational hypertension and preeclampsia.1 Current literature does not provide treatment guidelines for treatment of hypertensive disorders in patients with a transplanted heart. In this case report, we explore the different treatments for maintaining blood pressures in the transplanted neurovascular system, effects of eclampsia prevention on blood pressure, and how fluctuations in blood pressure in a long-standing hypertensive can ...

Herniated Gravid Uterus Through An Infra-Umbilical Laparotomy Scar: A Case Report, Ahmed M. Abbas, Armia Michael

Proceedings in Obstetrics and Gynecology

Herniation of a gravid uterus through the abdominal wall is a rare and potentially serious condition due to its antecedent complications. Management is determined by gestational age. Simultaneous hernioplasty with cesarean section is considered safe. Clinical awareness of this complication will prevent delay in its diagnosis and treatment. Delay in recognition of this condition can lead to incarceration and subsequent strangulation of the gravid uterus. Strangulation at or near term appears to be a genuine indication for early hospitalization and elective cesarean section, possibly combined with hernia repair. Here we report the case of a middle aged woman who presented ...

Tubal Splenosis: Unusual Location Of The Spleen, Sema Baki, Alper Basbug, Burcu Yılmaz Hanege, Nazan Özsan

Proceedings in Obstetrics and Gynecology

İntroduction: Splenosis is defined as the autotransplantation of splenic tissue to abnormal locations after splenic injury. Heterotopic spleen can be found within the abdominal and pelvic cavities. We report a tubal splenosis case in a 48 year old woman who underwent splenectomy following a blunt trauma 41 years prior to presentation.

Case report: A 48 years old gravida 3, para 3, was admitted to our gynecology clinic for pelvic pain, menstrual irregularities and abnormal bleeding. The patient had a six months history of sonographically detected 40 x 20 mm pelvic mass. She also had a blunt trauma and splenectomy history ...

Demographic Profile And Treatment Outcomes Of 100 Women With Obstetric Fistula In Niger, Alison A. Heller

Proceedings in Obstetrics and Gynecology

Introduction: Due to high fertility rates, low access to emergency obstetric care, and the poor quality of that care, obstetric fistula is relatively widespread in Niger.

Methods: Mixed-methods research was carried out over a total of eighteen months with 100 women with fistula at four fistula centers in Niger, three in the capital of Niamey and outside the city of Maradi.

Results: The one hundred women who made up the research sample reflect marked diversity in ethnicity, age, marital situation, parity, length of time living with fistula, and surgical history and outcomes. At the time of initial interviews women ranged ...

A Late-Onset Hematoma Developed After Sexual Intercourse Following Sacrospinous Hysteropexy And Mid-Urethral Sling Surgery: Case Report, Ozan Doğan, Çiğdem Pulatoğlu, Alper Başbuğ, Deniz Yüceer

Proceedings in Obstetrics and Gynecology

Introduction: Sacrospinous hysteropexy is a minimally invasive surgical procedure option for apical prolapse repair. Despite a significant number of postoperative hemorrhage and hematoma cases reported in the literature, life-threatening hemorrhage as a complication after sacrospinous hysteropexy is rare. In this case, in addition to sacrospinous hysteropexy, midurethral sling surgery was performed via the needleless technique for stress urinary incontinence. The case presented here is of a hematoma that developed following sexual intercourse on the 10th postoperative day after sacrospinous hysteropexy and its successful management and treatment without re-operation. A review of the literature did not reveal any cases similar to ...

Full Term Delivery Of A Harlequin Ichthyosis Baby: A Case Report, Ahmed M. Abbas, Armia Michael, Ayman A. Askar, Shymaa S. Ali

Proceedings in Obstetrics and Gynecology

Harlequin ichthyosis (HI) is one of the most severe and rare autosomal recessive congenital ichthyosis (ARCI), characterized by severe hyperkeratosis, extensive fissuring and a variable degree of cutaneous malformations. Here we report a case of 22 years old female patient in her first pregnancy. The baby was born at 39 weeks of gestation from non-consanguineous parents. At birth the baby had thick skin with deep fissures. The baby was admitted to the neonatal intensive care unit and survived for 11 days.

Metastatic Squamous Cell Carcinoma To The Colon Arising From A Mature Cystic Ovarian Teratoma, Jaimie Maines, Jordan Newell, Elizabeth Frauenhoffer, Justin Juliano, Francesca Ruggiero, Ian Schreibman, Joshua P. Kesterson

Proceedings in Obstetrics and Gynecology

Malignant transformation of a mature cystic teratoma is extremely rare, occurring in 0.17-2% of cases.¹ The most common malignant degeneration is squamous cell carcinoma (SCC) arising from the ectoderm. Approximately half of all cases of SCC of the ovary are confined to the ovary at time diagnosis.^1,2 Secondary to its absolute rarity and the relative infrequency of cases with metastatic spread the optimal treatment of advanced stage disease is unknown. Outcomes for locally advanced and widespread disease have historically been very poor. Ford and Timmons recently reported on a patient with stage IIC SCC arising in ...

Recurrent Second-Trimester Intrauterine Fetal Death Due To Undiagnosed Atrioventricular Block: A Case Report, Ahmed M. Abbas, Sief El-Eslam Ali, Armia Michael

Proceedings in Obstetrics and Gynecology

Fetal cardiac abnormalities are one of the common causes of non-immune fetal hydrops. Early diagnosis and treatment may prevent the late consequences that can occur as heart failure and intrauterine fetal death. Herein we report the case of a 32-year-old patient with a history of recurrent second trimester intrauterine fetal death. She presented with fetal hydrops at 23 weeks. A detailed echocardiography revealed that the fetus had a third degree atrioventricular block and advanced hydropic changes due to heart failure. Corticosteroid therapy was started but the fetus died in utero after 2 weeks.

A Case Report Of Twin Reversed Arterial Perfusion Sequence With Expectant Management, Aşkı Ellibeş Kaya, Alper Basbug, Derya Başbuğ, Çiğdem Pulatoğlu, Ozan Dogan

Proceedings in Obstetrics and Gynecology

Acardiac twin or TRAP (twin reversed arterial perfusion) sequence is a rare complication of monochorionic pregnancies. In these cases, the heart is either absent or non-functional. It’s controversial whether conservative management or therapeutic treatment is better in TRAP-sequence.

In this case, we present a 19-years old, primigravida diagnosed with spontaneous monochorionic monoamniotic twin pregnancy at 7th week of gestation. One of the fetuses had a crown-rump length of 8 mm and fetal heart rate 122/minute while the other one had a crown-rump of 7 mm with no detected fetal heartbeat. At the 11th week of gestation, the acardiac ...

P1: Effect Of Age, Oestradiol Levels And Endometrial Thickness On Determining Success Of Frozen Embryo Transfers, Alfred Murage, Maybeth Jamieson, Robin Yates, Isabel Traynor, Helen Lyall, Scott Nelson

Scott Nelson

Introduction: Frozen-thawed embryo transfer (FET) is a widely used technique, with replacement of embryos during natural menstrual cycles or in cycles constructed by exogenous steroids having similar outcomes in many series. Multiple factors have been proposed to have a positive influence on the success rate of FET, including increased endometrial thickness, younger maternal age and lower circulating oestradiol. The impact of these variables in the context of constructed cycles, using GnRH agonists to facilitate suppression of ovarian function prior to exogenous steroid administration, is not known. The aim of this study was to determine the predictive ability of these indices ...

The Maternal And Neonatal Outcomes Of Teenage Pregnancy In A Tertiary University Hospital In Egypt, Ahmed M. Abbas, Shymaa S. Ali, Mohammed K. Ali, Howieda Fouly, Ahmed Altraigey

POG In Press

Aim: To highlight the grave complications among teenage mothers in Assiut Woman's Health Hospital compared with the adult mothers.

Methods: This study was a prospective case control study, conducted at the Labor Ward of Assiut Woman's Health Hospital from 1st of January 2016 to 30th of June 2016. We included teenage pregnant women (13-19 completed years at delivery) as case and adult mothers (20-29 years) formed the control group. The primary outcome of the study is the rate of pregnancy complications among teenage mothers.

Results: Obstetric complications were higher among the teenage mothers (p=0.0001). The teenage ...