University of Iowa Carver College of Medicine, Iowa City, Iowa
Thomas Jefferson University Hospital
Vanderbilt University Medical Center
Walden University
SIT Graduate Institute - Study Abroad
Aga Khan University
Scripps College
Stepwise Implementation Of Vaginal Cleansing And Azithromycin At Cesarean Delivery To Decrease Postoperative Infections; A Quality Improvement Study,
2020
Thomas Jefferson University
Stepwise Implementation Of Vaginal Cleansing And Azithromycin At Cesarean Delivery To Decrease Postoperative Infections; A Quality Improvement Study, Julie Gomez, Ms, Johanna Quist-Nelson, Md, Laura Felder, Md, Daniele Dimascio, Md, Rebecca Eckler, Md, Amanda Paternostro, Md, Michael Posencheg, Md, Jason Baxter, Md, Vincenzo Berghella, Md
House Staff Quality Improvement and Patient Safety Conference (2020-)
Aims for Improvement
We aimed to decrease our SSI rate by 30% by sequential implementation of vaginal cleaning1,2 and azithromycin3 for women who underwent a CD after having labored or experienced rupture of membranes.
Jefferson Postpartum Oxytocin Protocol Standardization,
2020
Thomas Jefferson University
Jefferson Postpartum Oxytocin Protocol Standardization, Julie Gomez, Ms, Farnaz Farhi, Md, Sara Hinton, Pharmd, Tara Biedrzycki, Pharmd, Deborah Cruz, Msn, Crnp, Jason Baxter, Md
House Staff Quality Improvement and Patient Safety Conference (2020-)
Aims for Improvement
We aimed to reduce the variation and subsequent waste of postpartum oxytocin by standardizing the concentration available across the three maternity hospitals within the hospital enterprise system.
Clinical Characteristics Of 46 Pregnant Women With A Sars-Cov-2 Infection In Washington State.,
2020
Swedish Maternal Fetal Specialty Center, Swedish Medical Center, Seattle, Washington
Clinical Characteristics Of 46 Pregnant Women With A Sars-Cov-2 Infection In Washington State., Erica M Lokken, Christie L Walker, Shani Delaney, Alisa Kachikis, Nicole M Kretzer, Anne Erickson, Rebecca Resnick, Jeroen Vanderhoeven, Joseph K Hwang, Nena Barnhart, Jasmine Rah, Stephen A Mccartney, Kimberly K Ma, Emily M Huebner, Chad Thomas, Jessica S Sheng, Bettina W Paek, Kristin Retzlaff, Carolyn R Kline, Jeff Munson, Michela Blain, Sylvia M Lacourse, Gail Deutsch, Kristina Adams Waldorf
Articles, Abstracts, and Reports
BACKGROUND: The impact of the coronavirus disease 2019 (Covid-19) on pregnant women is incompletely understood, but early data from case series suggest a variable course of illness from asymptomatic or mild disease to maternal death. It is unclear whether pregnant women manifest enhanced disease similar to influenza viral infection or whether specific risk factors might predispose to severe disease.
OBJECTIVE: To describe maternal disease and obstetrical outcomes associated with Covid-19 disease in pregnancy to rapidly inform clinical care.
STUDY DESIGN: Retrospective study of pregnant patients with a laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection from six hospital systems in ...
Adverse Childhood Experiences And Changing Levels Of Psychosocial Distress Scores Across Pregnancy In Kenyan Women,
2020
Aga Khan University
Adverse Childhood Experiences And Changing Levels Of Psychosocial Distress Scores Across Pregnancy In Kenyan Women, Pauline Samia, Shahirose Premji, Farideh Tavangar, Ilona S. Yim, Sikolia Wanyonyi, Mohamoud Merali, Wangira Musana, Geoffrey Omuse, Ntonghanwah Forcheh, Aliyah Dosani, Nicole Letourneau, The Maternal Infant Global Health Team (Might) Collaborators In Research
Paediatrics and Child Health, East Africa
Background: Adverse childhood experiences (ACEs) have been associated with deleterious effects on mental health in pregnancy.
Methods: The ACE International Questionnaire (ACE-IQ) was used to measure neglect, abuse, and household dysfunction. Longitudinal mixed effect modelling was used to test the effect of ACEs on pregnancy-related anxiety, depressive symptoms, and perceived stress at two time points (12–19 and 22–29 weeks) during pregnancy.
Results: A total of 215 women who were predominantly married (81%) and had attained tertiary education (96%) were enrolled. Total ACEs were significantly associated with depressive symptoms (r = 0.23, p < 0.05) and perceived stress (r = 0.18, p < 0.05). As depressive symptoms decreased, t (167) = −8.44, p < 0.001, perceived stress increased, t (167) = 4.60, p < 0.001, and pregnancy-related anxiety remained unchanged as pregnancy progressed. Contact sexual abuse (p < 0.01) and parental death or divorce (p = 0.01) were significantly associated with depression over time (p < 0.01). Total ACEs in this study were associated with depressive symptoms early but not late in pregnancy.
Conclusions: Higher total ACEs were positively ...
Socioeconomic Status And Symptoms Of Anxiety And Depression In Pregnant Women,
2020
University of Mississippi
Socioeconomic Status And Symptoms Of Anxiety And Depression In Pregnant Women, Meagan Mandabach
Honors Theses
Pregnancy is a period of great change in a woman’s body as her baby develops. During this period, women commonly experience symptoms of anxiety (Dennis et al., 2017) and depression (Shidhaye & Giri, 2014). Literature has suggested that socioeconomic status (SES) can contribute to the severity at which pregnant women experience anxiety and depression (Arora & Aeri, 2019; Field et al., 2008; Shagufta & Shams, 2019), and women of low socioeconomic status may be more likely to experience symptoms of anxiety and depression during pregnancy (Field et al., 2008). The present study aimed to assess the relationships between household income and experience of anxiety and depression symptoms, in pregnant women in Mississippi. Specifically, it was hypothesized that lower SES would be associated with increased experience of anxiety and depressive symptoms. Participants included 557 pregnant women (77.4% white; Mage = 28.42) recruited at an OBGYN clinic in north Mississippi. Demographics questionnaire and several self-report measures including the Depression Anxiety Stress Scale-21 (DASS-21; Lovibond & Lovibond, 1995) and the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden, Sagovsky, 1987) were completed. Results demonstrated that symptoms of anxiety measured by the DASS-21 were significantly higher in pregnant women earning less than $10,000 per year than all other income brackets (with the exception ...
An Examination Of The Association Between State Medicaid Perinatal Services And Birth Outcomes,
2020
University of Mississippi
An Examination Of The Association Between State Medicaid Perinatal Services And Birth Outcomes, Joy Morgan Myers
Honors Theses
This thesis investigated the connection between socioeconomic status, healthcare coverage, and birth outcomes. The research question that was posed specifically looked at twenty perinatal services that states covered under Medicaid to varying degrees to see their association, if any, with premature birth rates and low birthweight rates. State-level and Mississippi county-level data were compiled regarding preterm birth rates, low birthweight rates, presumptive eligibility adoption, and coverage of twenty different perinatal services. Using these data, the correlation between state Medicaid expansion status and birth outcomes was first calculated in order to determine if variation in birth outcomes was associated with expanded ...
“Disbelieving Black Women To Death”; The “Double Jeopardy”: Racism And Sexism Affects Black Women’S Access To And Quality Of Care During Pregnancy, Birth, And Postpartum,
2020
University of Nebraska at Omaha
“Disbelieving Black Women To Death”; The “Double Jeopardy”: Racism And Sexism Affects Black Women’S Access To And Quality Of Care During Pregnancy, Birth, And Postpartum, Madeline St. Clair
Theses/Capstones/Creative Projects
This paper explores possible reasons why Black women in the United States experience a higher maternal mortality rate than their white counterparts. Using books, articles, journals, documentaries, personal experiences and stories of Black women and mothers, I argue that barriers from the societal to the individual level create health and medical disparities for Black mothers in pregnancy, during delivery, and the postpartum period. The paper concludes with a multifaceted solution and call to action.
Dual Trigger Protocol Is An Effective Ivf Strategy In Both Normal And High Responders Without Compromising Pregnancy Outcomes,
2020
Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA
Dual Trigger Protocol Is An Effective Ivf Strategy In Both Normal And High Responders Without Compromising Pregnancy Outcomes, Rebecca K. Chung, Abigail Mancuso, Karen Summers, Amy E.T. Sparks, E. Hakan Duran, Rachel A. Mejia
Proceedings in Obstetrics and Gynecology
To compare pregnancy outcomes between normal versus high responders after dual trigger of final oocyte maturation with gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) in fresh in-vitro fertilization (IVF) cycles, where ovarian stimulation was achieved by a flexible GnRH antagonist protocol.
Successful Non-Surgical Management Of Acute, Uncomplicated Appendicitis In Pregnancy: A Case Report,
2020
University of Iowa Carver College of Medicine, Iowa City, Iowa
Successful Non-Surgical Management Of Acute, Uncomplicated Appendicitis In Pregnancy: A Case Report, Avanthi Ajjarapu, Nina N. Moreira
Proceedings in Obstetrics and Gynecology
Acute appendicitis during pregnancy is one of the most common non-obstetric indications for surgery during pregnancy. Prompt surgical intervention for appendicitis is considered the standard of care. However, data on the utility of surgical management of uncomplicated cases of appendicitis is inconclusive and effectiveness of non-surgical management is currently understudied. We present a case that provides evidence for successful, antibiotic management of uncomplicated appendicitis as a means to reduce the burden of surgical complications on the pregnant population. This article also offers a critical analysis of current standard of care and assesses feasibility of nonsurgical management of acute, uncomplicated appendicitis ...
The Effect Of Gonadotropin-Releasing Hormone Analogues On The Preservation Of Ovarian Function Against Cyclophosphamide-Induced Damage In Adult Mice,
2020
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Egypt
The Effect Of Gonadotropin-Releasing Hormone Analogues On The Preservation Of Ovarian Function Against Cyclophosphamide-Induced Damage In Adult Mice, Eman Kishk, Wael Hassan, Mohammed Shaaban, Ahmed Mohamed Abbas
Proceedings in Obstetrics and Gynecology
Objective:
To assess the effect of gonadotropin-releasing hormone analogue (GnRHa) on the preservation of ovarian function against cyclophosphamide-induced gonadal toxicity.
Materials and Methods:
In a controlled, experimental study, 64 female mice were divided into four groups: control (C), triptorelin acetate (T), cyclophosphamide (CY), and triptorelin plus cyclophosphamide (T+CY) groups. Mice in the group (T) were subcutaneously injected with GnRHa (triptorelin acetate) in a dose of 0.5 mg/kg daily for 21 days. In contrast, mice in the (CY) group and (T+CY) group were injected intraperitoneally with 75 mg/kg of CY on day 15. After 21 days ...
Obstetric Care Among Refugee Populations: Reinforcing Cultural Humility In Residency Training—Preliminary Report,
2020
Carver College of Medicine, University of Iowa, Iowa City, Iowa
Obstetric Care Among Refugee Populations: Reinforcing Cultural Humility In Residency Training—Preliminary Report, Avanthi Ajjarapu, Michael L. Haugsdal, William T. Story
Proceedings in Obstetrics and Gynecology
The burden of increasing obstetric morbidity and mortality in the United States disproportionately impacts certain populations more than others, one such group being refugees. Poor obstetric outcomes among refugee communities historically have been attributed to delayed initiation of prenatal care, failure to detect co-morbidities, as well as higher rates of Cesarean sections (C-sections), stillbirths, pre-term births, and low birth weight infants in comparison to host-country mothers. Therefore, understanding the contextual nuances that play a role in these poor outcomes among refugee populations is very important.
A Case Of Rheumatic Heart Disease Diagnosed In The Third Trimester,
2020
University of Iowa Carver College of Medicine, Iowa City, Iowa
A Case Of Rheumatic Heart Disease Diagnosed In The Third Trimester, Amanda Manorot, Nina N. Moreira
Proceedings in Obstetrics and Gynecology
Migration from areas with a high incidence of rheumatic heart disease has led to an increase in pregnancy complicated by rheumatic heart disease in high-income countries. We present a case of rheumatic heart disease diagnosed in a 33-year-old G2P0010 French-speaking Congolese woman at 32 weeks gestation. She was initially hospitalized with respiratory syncytial virus (RSV) bronchiolitis at 24 weeks gestation and established care in our clinic. Mitral valve stenosis was identified at 32 weeks gestation after she presented with severe edema and was hospitalized for acute on chronic heart failure complicated by urosepsis and cellulitis. She was managed in the ...
Multimodal Perioperative Pain Protocol For Gynecologic Oncology Laparotomy Is Associated With Reduced Hospital Length Of Stay And Improved Patient Pain Scores,
2020
Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA
Multimodal Perioperative Pain Protocol For Gynecologic Oncology Laparotomy Is Associated With Reduced Hospital Length Of Stay And Improved Patient Pain Scores, Jordan Mattson, Mackenzie Mackenzie, Sarah L. Mott, Yasmin A. Lyons, Abbey J. Hardy-Fairbanks, Emily K. Hill
Proceedings in Obstetrics and Gynecology
The primary objective was to evaluate the impact of a multimodal perioperative pain regimen on length of hospital stay for patients undergoing laparotomy with a gynecologic oncologist.
Primary Radiation As Initial Management In Endometrial Cancer: Investigating Ebrt, Imrt And Hdr Brachytherapy,
2020
Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA
Primary Radiation As Initial Management In Endometrial Cancer: Investigating Ebrt, Imrt And Hdr Brachytherapy, Vincent M. Wagner, Erin A. Salinas, Sarah L. Mott, Wenqing Sun, Michael J. Goodheart
Proceedings in Obstetrics and Gynecology
For patients with endometrial cancer at increased risk of perioperative morbidity, primary radiation therapy is an effective alternative treatment option. However, there has been no consensus on radiation technique and little data on outcomes. Our aim was to identify factors which determine patient selection for primary radiation, investigate treatment efficacy of radiation compared to surgical management of endometrial cancer and to evaluate different radiation modalities including external beam radiation therapy alone or with a boost of either high dose rate brachytherapy or intensity-modulated radiation therapy for differences in toxicities, recurrence-free interval, cancer-specific survival and overall survival.
Factors Associated With Long-Term Pessary Use,
2020
Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA
Factors Associated With Long-Term Pessary Use, Heather M. Winn, Irene Morcuende, Rene R. Genadry, Joseph T. Kowalski, Catherine S. Bradley
Proceedings in Obstetrics and Gynecology
Vaginal pessary is a well-established pelvic organ prolapse (POP) treatment, but little evidence about long-term use is available. Our aim was to report the duration of use and investigate predictors of long-term pessary use for POP. We hypothesized that younger, healthier women and women who experienced complications would have shorter duration of use.
Health Care Disparities: Moving The Needle,
2020
University of Iowa, Iowa City, Iowa
Health Care Disparities: Moving The Needle, Marygrace Elson
Proceedings in Obstetrics and Gynecology
As an obstetrician, I am acutely aware of the United States maternal mortality rate, which is frighteningly worse than any other developed country. Even more alarming is the fact that the rate for black and native women in the USA is 3-4 times higher, regardless of socioeconomic status and education level. In Iowa, our maternal mortality figures are no better than the rest of the nation overall and may be slightly worse for black and native women. How can this be, when Iowa enjoys a reputation for quality health care?
Investigation Of The Relationship Between Gestational Week And Sexuality,
2020
Osmaniye State Hospital, Department of Gynaecology and Obstetrics, Osmaniye. Turkey
Investigation Of The Relationship Between Gestational Week And Sexuality, Yusuf Seyhan, Özer Birge, Aliye Nigar Serin, İlkan Kayar
Proceedings in Obstetrics and Gynecology
Background: The aim of the study was to twofold: to provide sociological data comparing sexuality both before and during pregnancy for women in developing countries as well as to look for differences in correlation between elements of sexuality and gestational age. Its intention is to help improve communication between physicians and patients in and from countries where social mores and traditions make such conversations difficult and uncommon.
Methods: Participants in the study included 1026 pregnant women at different gestational ages that presented to an Antenatal Outpatient Clinic in Istanbul, Turkey between April 2017 and November 2017. The participants were given ...
Efficacy Of Oral Celecoxib And Hyoscine Butyl-Bromide Versus Placebo During Copper Intrauterine Device Placement In Women Delivered Only By Elective Cesarean Section: A Randomized Controlled Study,
2020
Department of Obstetrics & Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Efficacy Of Oral Celecoxib And Hyoscine Butyl-Bromide Versus Placebo During Copper Intrauterine Device Placement In Women Delivered Only By Elective Cesarean Section: A Randomized Controlled Study, Fatma F. Darweesh, Ahmed Samy, Ahmed M. Abbas, Mohamed Hamza, Ahmed Said Ali, Mohamed Hussein
Proceedings in Obstetrics and Gynecology
Objective: To compare the efficacy and tolerability of celecoxib to hyoscine butyl bromide (HBB) and placebo in reducing pain scores during placement of copper intrauterine devices (IUD) in parous women who have undergone elective cesarean section and who have had no previous vaginal deliveries.
Methods: We conducted a randomized, double-blind, placebo-controlled trial at a tertiary University hospital from April 2018 to September 2018. The study included women who had never delivered vaginally and who desired copper IUD insertion. We randomized the study participants in a 1:1:1 ratio to celecoxib, HBB or placebo groups. They took the tablets orally ...
Placental Pouch Closure: A Novel, Safe And Effective Surgical Procedure For Conservative Management Of Placenta Accreta,
2020
Department of Obstetrics and Gynecology, Woman's Health Hospital, Faculty of Medicine, Assiut University, Egypt.
Placental Pouch Closure: A Novel, Safe And Effective Surgical Procedure For Conservative Management Of Placenta Accreta, Kamal M. Zahran, Mostafa M. Elsonbaty, Ahmed M. Abbas, Abdel Ghaffar M. Ahmed, Mohamed F. Mostafa, Mansour A. Khalifa, Ahmed Nasr, Ahmed F. Abdel-Kawi, Alaa Eldin A. Youssef
Proceedings in Obstetrics and Gynecology
Background: Placenta accreta spectrum (PAS) has become a global problem secondary to the high rate of cesarean delivery (CD). The current study presents an effective surgical procedure (placental pouch closure) for uterine preservation in patients with PAS.
Methods: We applied this procedure in sixty cases at a tertiary university hospital between September 2017 and January 2019. We included women who were diagnosed as PAS based on preoperative ultrasound and Doppler evaluation, and who had the desire for uterine preservation.
Results: The procedure was successful in almost all cases; the uterus was conserved 98.33 % of participants, with no associated severe ...
Disparities In Healthcare: A Focus On Native American Women’S Health And The System That Is Failing Them,
2020
Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa
Disparities In Healthcare: A Focus On Native American Women’S Health And The System That Is Failing Them, Keely K. Ulmer
Proceedings in Obstetrics and Gynecology
Women’s health care has always been a hotbed for public attention. The upcoming presidential election and new state-level laws targeting reproductive rights have only brought these issues into greater prominence. While reproductive rights are an important topic on their own, we also need to talk about a subset of the greater issue that is often swept under the rug, to talk about women’s healthcare disparities on Native American reservations. Unless you live close to a reservation, you may have never thought to consider that a disparity even exists. Yet, as a female tribal member who has lived on ...
