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Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim 2017 Aga Khan University

Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim

Department of Obstetrics & Gynaecology

Objective: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins.

Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to December 2012. . Cases of both monochorionic diamniotic and dichorionic diamniotic twin pregnancies were included. SPSS 19 was used for data analysis.

Results: Of the 394 cases, 84(21.3%) were monochorionic diamniotic twins and 310(78.7%) were dichorionic diamniotic twins. There were no cases of stillbirth beyond 30 and 34 weeks in monochorionic and dichorionic twins, respectively. Neonatal mortality stood ...


First Trimester Spontaneous Rupture Of An Unscarred Uterus In A Multiparous Woman: A Case Report, Ahmed M. Abbas, Amera M. Sheha, Mohamed Abdallah, Sara Abdullah, Mohamed Bahaa 2017 Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

First Trimester Spontaneous Rupture Of An Unscarred Uterus In A Multiparous Woman: A Case Report, Ahmed M. Abbas, Amera M. Sheha, Mohamed Abdallah, Sara Abdullah, Mohamed Bahaa

Proceedings in Obstetrics and Gynecology

The rupture of an unscarred uterine is a rare life-threatening event that usually occurs late in pregnancy or during labor. Spontaneous uterine rupture, as in our case, is extremely uncommon and rarely diagnosed before laparotomy. Herein, we present a case of spontaneous uterine rupture in a 32 year old multiparous woman with no previous uterine surgery. The patient presented with acute abdomen at 11 weeks of gestation. Preoperative diagnosis based on clinical and ultra-sonographic findings was ruptured ectopic pregnancy. However, emergency laparotomy showed uterine rupture with extrusion of a dead fetus within intact amniotic sac in the abdomen. The defect ...


Experimental Pain Sensitivity In Women With Vestibulodynia: A Pilot Study, Laura Frey Law, Avery M. Whitis, Colleen K. Stockdale 2017 Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa

Experimental Pain Sensitivity In Women With Vestibulodynia: A Pilot Study, Laura Frey Law, Avery M. Whitis, Colleen K. Stockdale

Proceedings in Obstetrics and Gynecology

Objective: Investigate pain sensitivity in women with vestibulodynia using two experimental pain assessments outside the vulvar region: intramuscular infusion of an acidic phosphate buffer and pressure pain thresholds (PPTs) of the lower limb.

Methods: Three women with a history of vestibulodynia (all 24 years old) participated after providing written informed consent. PPTs of the lower limb were assessed using a hand-held Somedic digital algometer (30 kilopascal (kPa)/sec) at baseline (pre-infusion) and during the intramuscular infusion. The acidic phosphate buffer (pH 5.2) was infused into the anterior tibialis muscle at a rate of 40 ml/hr for 15 min ...


Effects Of Oral Ginkgo Biloba Extract On Pregnancy Complicated By Asymmetrically Intrauterine Growth Restriction: A Double-Blinded Randomized Placebo-Controlled Trial, Diaa Eldeen M. Abd El Aal, Mohammed Khairy Ali, Ahmed Y. Shahin, Mahmoud S. Zakherah, Mohamad S. Abdellah, Ahmed F. Abdel-Kawi, Mohamed S. Fahmy 2017 Department of Obstetrics & Gynecology, Women’s Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt

Effects Of Oral Ginkgo Biloba Extract On Pregnancy Complicated By Asymmetrically Intrauterine Growth Restriction: A Double-Blinded Randomized Placebo-Controlled Trial, Diaa Eldeen M. Abd El Aal, Mohammed Khairy Ali, Ahmed Y. Shahin, Mahmoud S. Zakherah, Mohamad S. Abdellah, Ahmed F. Abdel-Kawi, Mohamed S. Fahmy

Proceedings in Obstetrics and Gynecology

Objectives: to evaluate the effect of oral ginkgo biloba extract (GB)) on asymmetrical intrauterine growth restriction (IUGR).

Study Design: A randomized trial conducted at Assiut Women Health on 226 pregnant women with asymmetrical IUGR. The patients randomly received GB extract or placebo for 6 weeks. The main outcome measures were improvement in fetal weight and feto-maternal blood flow. The data were analyzed by Student’s t- test and chi-squared tests.

Result: There was a significant increase in the estimated fetal weight in the GB group (3047+ 127 gm) when compared to the placebo group (2734+ 127 gm) (p=

Conclusions: GB ...


Factors Affecting The Occurrence Of Postpartum Depression Among Puerperal Women In Sohag City, Egypt, Mohammed N. Salem, Mohamed N. Thabet, Howieda Fouly, Ahmed M. Abbas 2017 Department of Obstetrics & Gynecology, Faculty of Medicine, Sohag, Egypt

Factors Affecting The Occurrence Of Postpartum Depression Among Puerperal Women In Sohag City, Egypt, Mohammed N. Salem, Mohamed N. Thabet, Howieda Fouly, Ahmed M. Abbas

Proceedings in Obstetrics and Gynecology

Aim: Postpartum Depression (PPD) is one of the most common complications of the postpartum period. In Egypt, previous studies have reported that the prevalence of PPD ranged from 20-50% depending on location in Lower and Upper Egypt. This study aimed to evaluate the co-factors affecting the occurrence of PPD amongst puerperal women in Sohag city, Egypt.

Methods: The study was carried out at Sohag University Hospital from June 2015 to May 2016. All women within 6 weeks after birth who gave their consent were included. A pretested questionnaire including demographic, psychosocial, maternal and infant variables as well as the Edinburgh ...


Undiagnosed Asymptomatic Second Trimester Broad Ligament Ectopic Pregnancy: A Case Report And Mini-Review, Ayman H. Shamaash, Ahmed M. Abbas 2017 Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

Undiagnosed Asymptomatic Second Trimester Broad Ligament Ectopic Pregnancy: A Case Report And Mini-Review, Ayman H. Shamaash, Ahmed M. Abbas

Proceedings in Obstetrics and Gynecology

Pregnancy in the broad ligament is a retro-peritoneal abdominal pregnancy. It is a rare form in which the gestational tissue gets implanted between the layers of the broad ligament. Due to its rarity, the diagnosis is infrequently established before surgical intervention. A twenty-five year old nulliparous woman presented for routine antenatal care in the second trimester (±17 weeks). Routine ultrasound revealed an empty uterus with a large pelviabdominal mass. This picture suggested and undiagnosed extra-uterine pregnancy. A right broad ligament ectopic pregnancy was diagnosed at exploratory laparotomy, excision of pregnancy and right salpingectomy was performed. Postoperative course was uneventful and ...


Can Evaluation Of The Cervix With Histogram And Bishop Scoring Prior To Birth Induction Forecast The Birth Type For Superannuated Primigravidas?, Aytek Sık,, Murat Bozkurt, Serkan Kumbasar, Eray Çalıskan 2017 Department Of Obstetrics and Gynecology ,Istanbul Aydin University, Istanbul, Turkey

Can Evaluation Of The Cervix With Histogram And Bishop Scoring Prior To Birth Induction Forecast The Birth Type For Superannuated Primigravidas?, Aytek Sık,, Murat Bozkurt, Serkan Kumbasar, Eray Çalıskan

Proceedings in Obstetrics and Gynecology

Purpose: We conducted this study to research both the forecasting efficiency of the cervical histogram and Bishop scoring for birth type (vaginal birth/cesarean) for the superannuated primigravida prior to birth induction.

Methods: Ninety primigravidas in week 41 and beyond were included in the present study. Exclusions for the study included prior labor, ruptured membranes, any major uterine operations, cephalopelvic discord, fetal malpresentations, fetal anomalies, multiple pregnancy, placenta previa, vaginal bleeding, a high sensitivity for oxytocin usage, and an estimated fetal weight greater than 4000 g. Histogram hyperechogenic focus and hypoechogenic focus measurements are conducted in normal spontaneous birth (NSD ...


Role Of Prophylactic Midurethral Sling In Preventing Post-Operative Stress Urinary Incontinence Following Repair Of Anterior Vaginal Wall Prolapse, Nabendu Bhattacharjee, Sneha Tickoo, Apurba Mandal, Nabanita Dasgupta, Krishnendu Goswami, Anubhati Nag, Shibram Chattapadhyay 2017 Malda Medical College, Malda, West Bengal, India

Role Of Prophylactic Midurethral Sling In Preventing Post-Operative Stress Urinary Incontinence Following Repair Of Anterior Vaginal Wall Prolapse, Nabendu Bhattacharjee, Sneha Tickoo, Apurba Mandal, Nabanita Dasgupta, Krishnendu Goswami, Anubhati Nag, Shibram Chattapadhyay

Proceedings in Obstetrics and Gynecology

Objective: This study was conducted to find whether, among women without preoperative stress incontinence who underwent surgery for repair of anterior vaginal wall prolapse, the placement of a prophylactic midurethral mesh along with the prolapse correction surgery helped to reduce the incidence of post-operative stress urinary incontinence (POSUI).

Materials & Methods: 145 women with anterior vaginal compartment prolapse were randomly assigned to receive either suitable corrective surgery for prolapse or corrective surgery along with concurrent placement of a prophylactic midurethral sling by a transobturator Prolene tape. The primary endpoint was urinary incontinence at three months and twelve months post surgery. Secondary ...


Sexual Preventative Health In Us Sexual Minority Women: A Review, Kaitlyn C. McCune, Katherine L. Imborek, Colleen K. Stockdale 2017 Department of Obstetrics and Gynecology, Wake Forest Baptist Medical Center, Winston-Salem, NC

Sexual Preventative Health In Us Sexual Minority Women: A Review, Kaitlyn C. Mccune, Katherine L. Imborek, Colleen K. Stockdale

Proceedings in Obstetrics and Gynecology

Despite growing interest and research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) health topics over the last 20 years, relatively little is known about sexual minority women. This review seeks to explore sexual practices, use of preventative measures including barrier methods during sexual activity, sexually transmitted infection rates, and use of screening healthcare services by sexual minority women. Additionally, the role healthcare providers can take in filling this knowledge gap and providing appropriate services is reviewed.


Demographic Profile And Treatment Outcomes Of 100 Women With Obstetric Fistula In Niger, Alison Heller 2017 University of Maryland at College Park

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

POG In Press

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 ...


Spontaneous Triplet Pregnancy With Twin Fetuses Papyraeci: A Rare Case Report And Review Of The Literature, Ahmed M. Abbas, Mohamed Khalaf, Mahmoud S. Zakherah 2017 Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

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

POG In Press

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.


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 2017 Department of Obstetrics and Gynecology, Duzce Ataturk Government Hospital, Duzce, Turkey

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

POG In Press

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 ...


Medical Student And Hospital Team Fight Cervical Cancer In Rural China, Haley Newman 2017 University of Massachusetts Medical School

Medical Student And Hospital Team Fight Cervical Cancer In Rural China, Haley Newman

Senior Scholars Program

Blog post for the Gynius company website describing Newman's Senior Scholars project. She is evaluating portable colposcopy for cervical cancer screening in rural China.


A Comparison Of Colorimetric Assessment Of Vaginal Ph With Nugent Score For The Detection Of Bacterial Vaginosis., Matthew K. Hoffman, Mrutyunjaya B. Bellad, Umesh S. Charantimath, Avinash Kavi, Jyoti M. Nagmoti, Mahantesh B. Nagmoti, Ashalata A. Mallapur, Geetanjali M. Katageri, Umesh Y. Ramadurg, Sheshidhar G. Bannale, Amit P. Revankar, M. S. Ganachari, Richard J. Derman, Shivaprasad S. Goudar 2017 Christiana Care Health System

A Comparison Of Colorimetric Assessment Of Vaginal Ph With Nugent Score For The Detection Of Bacterial Vaginosis., Matthew K. Hoffman, Mrutyunjaya B. Bellad, Umesh S. Charantimath, Avinash Kavi, Jyoti M. Nagmoti, Mahantesh B. Nagmoti, Ashalata A. Mallapur, Geetanjali M. Katageri, Umesh Y. Ramadurg, Sheshidhar G. Bannale, Amit P. Revankar, M. S. Ganachari, Richard J. Derman, Shivaprasad S. Goudar

Department of Obstetrics and Gynecology Faculty Papers

Background. A Nugent score > 7 has been defined as the gold standard for the diagnosis for bacterial vaginosis (BV), though it is resource intensive and impractical as point of care testing. We sought to determine if colorimetric assessment of vaginal pH can accurately predict the occurrence of BV. Methods. We performed a planned subanalysis of 1,216 pregnant women between 13 0/7 and 19 6/7 weeks who underwent vaginal examination as part of a randomized controlled trial. Using a standardized technique, specimens were obtained for colorimetric assessment and two separate slides for Gram staining. These slides were subsequently ...


A Pilot Study To Assess The Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women At High Risk For Gestational Diabetes Mellitus, Ling Shi, Vidya Iyer, Emily Jones, Tiffany A. Moore Simas, Alice H. Lichtenstein, Laura L. Hayman 2017 University of Massachusetts Boston

A Pilot Study To Assess The Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women At High Risk For Gestational Diabetes Mellitus, Ling Shi, Vidya Iyer, Emily Jones, Tiffany A. Moore Simas, Alice H. Lichtenstein, Laura L. Hayman

Laura L. Hayman

Background: Diet plays an important role in the prevention and management of gestational diabetes mellitus (GDM). Previous studies suggest that soy protein and isoflavones may have beneficial effects on lipid and glucose metabolism. Little is known regarding the cardiometabolic effects of soy intake during pregnancy. This pilot study assessed the feasibility, safety and acceptability of daily consumption of soy foods during pregnancy in women at high risk for GDM, and participant adherence to their assigned treatment.

Methods: A randomized controlled trial (RCT) was conducted among pregnant women at high risk for GDM. The Soy group were counseled to consume a ...


Group Medical Visits To Provide Gynecologic Care For Women Affected By Breast Cancer, Sally R. Greenwald, Sarah Watson, Mindy Goldman, Tami S. Rowen 2017 University of California, San Francisco

Group Medical Visits To Provide Gynecologic Care For Women Affected By Breast Cancer, Sally R. Greenwald, Sarah Watson, Mindy Goldman, Tami S. Rowen

Journal of Patient-Centered Research and Reviews

Purpose

Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer.

Methods

A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to ...


What Clinical Interventions Have Been Implemented To Prevent Or Reduce Postpartum Hypertension Readmissions? A Clin-Iq, Sara O'Meara, Molly Lepic 2017 Aurora Sinai Medical Center, Aurora Health Care

What Clinical Interventions Have Been Implemented To Prevent Or Reduce Postpartum Hypertension Readmissions? A Clin-Iq, Sara O'Meara, Molly Lepic

Aurora Ob/Gyn Residents

A literature review was conducted to determine what clinical interventions have been studied and implemented to prevent and/or reduce postpartum hypertension readmissions. Appropriate verbal and printed educational materials should be given to the patient prior to discharge with use of the “teach back” method. Patients and health care providers within the multidisciplinary team should be educated on the warning signs and symptoms of worsening hypertensive disease and when to appropriately involve the obstetrician. The use of text messaging may be useful in preventing hospital readmissions by increasing patient follow-up and compliance and appropriately managing patients in the postpartum period ...


Mind And Body Training To Improve Functioning And Coping With Chronic Pain: A Pilot Study, Olga Valieva, Leah M. Welsh, Betty Amuzu, Niraj Nijhawan, Jessica J.F. Kram 2017 Department of Obstetrics and Gynecology, Aurora Sinai Medical Center

Mind And Body Training To Improve Functioning And Coping With Chronic Pain: A Pilot Study, Olga Valieva, Leah M. Welsh, Betty Amuzu, Niraj Nijhawan, Jessica J.F. Kram

Aurora Ob/Gyn Residents

Background: Patients with chronic pain are often crippled by psychological distress, depression and fear. These patients also can develop altered pain perception, with enhanced brain activity in pain-responsive regions and those associated with anxiety/depression. Exercise and meditation can impact pain-reducing brain areas and positively influence pain characteristics.

Purpose: To alter pain center activity by reducing the activation of the higher brain and deactivation of the lower brain with somatocognitive and meditative practices, with secondary aim of reducing anxiety/depression and improve overall quality of life.

Methods: We conducted a pilot study on mentally competent adult women with stable chronic ...


Self-Reported Tobacco Use And Correlation With Umbilical Cord Blood Cotinine Levels At Delivery Among Appalachian Gravidas, Jesse Cottrell, Brenda L. Mitchell, Pooja N. Sangani, D'Andrea S. Thomas, Monica A. Valentovic 2017 Marshall University

Self-Reported Tobacco Use And Correlation With Umbilical Cord Blood Cotinine Levels At Delivery Among Appalachian Gravidas, Jesse Cottrell, Brenda L. Mitchell, Pooja N. Sangani, D'Andrea S. Thomas, Monica A. Valentovic

Marshall Journal of Medicine

The detrimental effects of cigarette use during pregnancy are well documented. Studies have shown that cigarette smoking while pregnant is associated with multiple adverse outcomes including: pre-term birth, placental abruption, placenta previa, fetal growth restriction, stillbirth, increased rate of birth defects, and increased risk of sudden infant death syndrome. Cotinine is the primary metabolite of nicotine and allows for measurement of active as well as passive exposure. Cotinine freely cross the placental barrier and maternal concentrations are closely correlated with newborn plasma levels. The aim of this study was to compare maternally reported rates of tobacco use to fetal umbilical ...


Effect Of Puerperal Infections On Early Neonatal Mortality: A Secondary Analysis Of Six Demographic And Health Surveys, Saverio Bellizzi, Quique Bassat, Howard L. Sobel, Mohamed M. Ali, Marleen Temmerman 2017 World Health Organization

Effect Of Puerperal Infections On Early Neonatal Mortality: A Secondary Analysis Of Six Demographic And Health Surveys, Saverio Bellizzi, Quique Bassat, Howard L. Sobel, Mohamed M. Ali, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Around 1.5 million annual neonatal deaths occur in the first week of life, and infections represent one of the major causes in developing countries. Neonatal sepsis is often strictly connected to infection of the maternal genital tract during labour.

Methods: The association between signs suggestive of puerperal infection and early neonatal mortality (<7 days of life) was performed using Demographic and Health Surveys (DHS) data of six countries, conducted between 2010 and 2013. The population attributable fraction (PAF) was generated using the estimates on early neonatal mortality of a 1990-2013 systematic analysis for the Global Burden of Disease Study.

Results: Signs of puerperal infection ranged from 0.7% in the Philippines to 16.4% in Honduras. Infection was associated with a 2.1 adjusted Risk Ratio (95% CI: 1.4-3.2) of early neonatal mortality. Around five percent of all deaths in the first week ...


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