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A Common Pain In Pregnancy With An Uncommon Cause, Jennifer Baima, Amrit V. Vinod, Mathew J. Most 2018 University of Massachusetts Medical School

A Common Pain In Pregnancy With An Uncommon Cause, Jennifer Baima, Amrit V. Vinod, Mathew J. Most

Orthopedics and Physical Rehabilitation Publications and Presentations

Case Diagnosis: We present a case of a patient with hip pain during pregnancy determined to be pigmented villonodular synovitis (PVNS).

Case Description: A 41-year-old woman presented with 9-months of persistent atraumatic left hip pain localized to the groin that had started in her second trimester of pregnancy. Five months after delivery at presentation to clinic, her symptoms had progressively worsened to require a cane for ambulation.

On exam, hip range of motion was limited: flexion to 90o, external rotation to 20o, and internal rotation to 10o. She had groin pain with internal and external rotation. She ...


Z-Can: Prevention Of Unintended Pregnancy In An Emergency Setting, Marleen Temmerman, Cora Nally 2018 Aga Khan University

Z-Can: Prevention Of Unintended Pregnancy In An Emergency Setting, Marleen Temmerman, Cora Nally

Obstetrics and Gynaecology, East Africa

Prevention of unintended pregnancy is a primary strategy to reduce adverse pregnancy and birth outcomes related to Zika virus infection. Infection during pregnancy, either through a mosquito bite or sex with an infected partner, increases the risk of the child developing congenital microcephaly and other fetal brain abnormalities, resulting in the birth of a child with severe disabilities that will necessitate lifelong care.1,2


Pattern And Determinants Of Contraceptive Usage Among Women Of Reproductive Age From The Digo Community Residing In Kwale, Kenya: Results From A Cross-Sectional Household Survey, Vernon Mochache, Amyn Lakhani, Hajara El-Busaidy, Marleen Temmerman, Peter Gichangi 2018 International Centre for Reproductive Health, Mombasa, Kenya

Pattern And Determinants Of Contraceptive Usage Among Women Of Reproductive Age From The Digo Community Residing In Kwale, Kenya: Results From A Cross-Sectional Household Survey, Vernon Mochache, Amyn Lakhani, Hajara El-Busaidy, Marleen Temmerman, Peter Gichangi

Family Medicine, East Africa

Background: Contraceptive usage has been associated with improved maternal and child health (MCH) outcomes. Despite significant resources being allocated to programs, there has been sub-optimal uptake of contraception, especially in the developing world. It is important therefore, to granulate factors that determine uptake and utilization of contraceptive services so as to inform effective programming.

Methods: Between March and December 2015, we conducted a cross-sectional survey among women of reproductive age (WRA) from the Digo community residing in Kwale County, Kenya. The study aimed to describe the pattern and determinants of contraceptive usage in this population. Respondents were selected using stratified ...


The Use Of Scorecards To Improve Documentation Of Obstetrical Blood Loss, Marilyn Cejka Steinberg 2018 Walden University

The Use Of Scorecards To Improve Documentation Of Obstetrical Blood Loss, Marilyn Cejka Steinberg

Walden Dissertations and Doctoral Studies

Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality. The measurement of quantitative blood loss (QBL) at delivery prevents clinicians from failing to recognize hemorrhage in healthy obstetric patients who initially compensate for excessive blood loss. The purpose of this project was to improve the compliance of labor and delivery nurses in a community hospital with consistent QBL measurement. Key theories that formed the basis for the project were Lewin's theory of planned change and homeostasis. The project question addressed was: Is the use of weekly scorecards to provide feedback to nurses with both ...


Provision Of Medical Supply Kits To Improve Quality Of Antenatal Care In Mozambique: A Stepped-Wedge Cluster Randomised Trial, Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu 2018 World Health Organization, Geneva, Switzerland

Provision Of Medical Supply Kits To Improve Quality Of Antenatal Care In Mozambique: A Stepped-Wedge Cluster Randomised Trial, Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu

Obstetrics and Gynaecology, East Africa

Background: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many lowincome countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care.

Methods: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served ...


Cesarean Births Rates After Implementation Of Labor Management Guidelines, Margie Allyn Bridges 2018 Walden University

Cesarean Births Rates After Implementation Of Labor Management Guidelines, Margie Allyn Bridges

Walden Dissertations and Doctoral Studies

Cesarean birth rates are associated with increased maternal morbidity. This project evaluated a quality improvement (QI) initiative implemented to reduce cesarean births among Nulliparous Term Singleton Vertex (NTSV) obstetric populations, the largest contributor to cesarean births. Variations in labor management practice contribute to cesarean birth rate; implementation of labor management bundles have been endorsed to influence practice- and system-level changes in the promotion of vaginal births. The problem addressed in this project was an organizational NTSV cesarean section rate of 30%. The purpose of the project was to use secondary data to evaluate a previously implemented labor management bundle at ...


Ovarian Cancer Screening: Lessons About Effectiveness, Edward J. Pavlik 2017 University of Kentucky

Ovarian Cancer Screening: Lessons About Effectiveness, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

No abstract provided.


Comparing The Vaginal Wall Sling With Autologous Rectus Fascia And Polypropylene Sling On Outcome And Patient Satisfaction, Mohamed Keheila, Salim Cheriyan, Jim Shen, Catalino J. Bautista, Josianne Bailey, Kevin Kim, Marina Germanos, Isaac Kelly, Matthew Pierce, Andrea Staack 2017 Loma Linda University

Comparing The Vaginal Wall Sling With Autologous Rectus Fascia And Polypropylene Sling On Outcome And Patient Satisfaction, Mohamed Keheila, Salim Cheriyan, Jim Shen, Catalino J. Bautista, Josianne Bailey, Kevin Kim, Marina Germanos, Isaac Kelly, Matthew Pierce, Andrea Staack

Loma Linda University Student Journal

Since 2011 FDA safety update on transvaginal synthetic mesh for treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP), providers are encouraged to counsel patients on risks related to synthetic mesh slings, such as dyspareunia, erosion, and extrusion. As an alternative to synthetic slings patients often choose autologous slings. We aim to compare outcome and patient satisfaction in patients, who received an autologous vaginal wall sling (VWS), rectus fascia sling (RFS), or synthetic suburethral sling (SSS) for treatment of SUI.


Repeat Abortion In Chinese Adolescents: A Cross-Sectional Study In 30 Provinces, Jinlin Liu, Shangchun Wu, Jialin Xu, Marleen Temmerman, Wei-Hong Zhang 2017 Ghent University

Repeat Abortion In Chinese Adolescents: A Cross-Sectional Study In 30 Provinces, Jinlin Liu, Shangchun Wu, Jialin Xu, Marleen Temmerman, Wei-Hong Zhang

Obstetrics and Gynaecology, East Africa

Background: Premarital sex has become more acceptable in China nowadays. The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have little access to information or advice about contraception. Abortion is commonly used to end unintended pregnancies in China. This study aimed to determine risk factors related to repeat abortions in Chinese adolescents.

Methods: This cross-sectional study was one component of an EU-funded project and was conducted between March 20, and Oct 5, 2013 in China. We collected data using a questionnaire filled by abortion service providers for all women seeking abortions within 12 weeks ...


A Rare Case Of Lethal Campomelic Dysplasia, Ahmad El-Sheikhah, Mahy Mohsen, Sief El-Eslam A. Ali, Rasha Taher, Armia Michael, Shymaa S. Ali, Ahmed M. Abbas 2017 Fetal Medicine Unit, Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt

A Rare Case Of Lethal Campomelic Dysplasia, Ahmad El-Sheikhah, Mahy Mohsen, Sief El-Eslam A. Ali, Rasha Taher, Armia Michael, Shymaa S. Ali, Ahmed M. Abbas

POG In Press

Campomelic dysplasia is a rare and mostly lethal congenital malformation. It is known as an autosomal dominant disorder due to mutations in SOX9, a member of the SOX (SRY-related HMG box) gene family. Here we report a case of a 26 years old primigravida married for 3 years with a history of consanguinity. She was impregnated by intracytoplasmic sperm injection (ICSI) due to male factor infertility. This mostly lethal skeletal anomaly was diagnosed by detailed ultrasonography in the late second trimester. She underwent an induction of labor termination due to intrauterine fetal demise.


Management Of Pregnancy In Patients With Exstrophy-Epispadias Sequence: A Case Series And Literature Review, Colette M. Gnade 2017 University of Iowa

Management Of Pregnancy In Patients With Exstrophy-Epispadias Sequence: A Case Series And Literature Review, Colette M. Gnade

POG In Press

Exstrophy-epispadias sequence is an uncommon diagnosis in which surgical reconstruction has increased quality of life for these patients. As they are entering the reproductive phase of their life, consideration must be made for management of their pregnancies in the context of their genitourinary reconstruction. There have been few case reports of patients with cloacal exstrophy conceiving; therefore, information to guide management of their pregnancies is limited. Here we describe a patient with Omphalocele-Exstrophy-Imperforate Anus-Spinal defects (OEIS) and a patient with a history of bladder exstrophy both with spontaneous pregnancy managed by a multidisciplinary approach and primary cesarean delivery.


The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey 2017 Dominican University of California

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 ...


Initiating Hpv Co-Testing For Women Aged 30-65 In An Ob/Gyn Practice Setting, Stephen Cavazos 2017 University of the Incarnate Word

Initiating Hpv Co-Testing For Women Aged 30-65 In An Ob/Gyn Practice Setting, Stephen Cavazos

Doctor of Nursing Practice

The purpose of this project was to improve the rate of successful human papilloma virus (HPV) screening in a small Texas based Women's Health clinic through a co-testing method. The intended goal was to increase the rate of HPV screening, from a 73% baseline, to 95% over a 10-week period for women between the ages of 30-65 years old. Approximately 79 million American women are currently infected with HPV, and 14 million people contract it every year. Seventy percent of cervical cancers today are caused by HPV, leading to approximately 12,820 new diagnoses of invasive cervical cancer predicted ...


A Qualitative Exploration Of Perceptions And Experiences Of Contraceptive Use, Abortion And Post-Abortion Family Planning Services (Pafp) In Three Provinces In China, Yan Che, Esther Dusabe-Richards, Shangchun Wu, Yi Jiang, Xiaojing Dong, Jian Li, Wei-Hong Zhang, Marleen Temmerman, Rachel Tolhurst, INPAC group 2017 Fudan University

A Qualitative Exploration Of Perceptions And Experiences Of Contraceptive Use, Abortion And Post-Abortion Family Planning Services (Pafp) In Three Provinces In China, Yan Che, Esther Dusabe-Richards, Shangchun Wu, Yi Jiang, Xiaojing Dong, Jian Li, Wei-Hong Zhang, Marleen Temmerman, Rachel Tolhurst, Inpac Group

Obstetrics and Gynaecology, East Africa

Background: The INPAC project aims to evaluate the effectiveness of integrated post-abortion family planning (PAFP) services into existing hospital based abortion services in China. A qualitative study was conducted in three provinces to contribute to developing effective PAFP services through understanding influences on contraceptive use, experiences of abortion and existing PAFP, and their effect on future contraceptive practices from the perspective of users, in the context of social and institutional change.

Methods: Twenty-nine in-depth interviews (IDIs) were undertaken with women who had experienced abortion between 1 and 6 months prior to interview, recruited from three urban and two rural facilities ...


Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber 2017 DePaul University

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative ...


Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir 2017 Marshall University Joan C. Edwards School of Medicine

Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir

Ayman Elkadry

Sheehan’s syndrome typically occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and can present with varying degrees of pituitary insufficiency. It is more common in underdeveloped countries, and is frequently diagnosed years after delivery due to its nonspecific signs and symptoms. Failure to lactate is a common initial symptom, while many women also report amenorrhea or oligomenorrhea. This article presents a 26-year-old female with a history of hypertension, who presented to the hospital for diarrhea, vomiting, and dizziness. Her blood pressure was 80/40 mmHg, requiring aggressive fluid resuscitation, after which it remained borderline ...


Reducing Postoperative Opioids After Minimally Invasive Gynecologic Surgery With Multimodal Pain Control, Kevin D. White, William C. Wallace, Nadim Zgheib 2017 Marshall University Joan C. Edwards School of Medicine

Reducing Postoperative Opioids After Minimally Invasive Gynecologic Surgery With Multimodal Pain Control, Kevin D. White, William C. Wallace, Nadim Zgheib

William C. Wallace

Introduction: We evaluated the efficacy of a multimodal pain regimen that approaches pain control by utilizing different mechanisms of action. This novel protocol utilizing liposomal bupivacaine, acetaminophen, tramadol and oxycodone as needed in reducing the overall opioid use by patients after undergoing robotic-assisted total laparoscopic hysterectomy in an obese population that is heavily afflicted by the opioid epidemic. Materials and Methods: We conducted a retrospective study wherein a sample of 100 (50 multimodal group and 50 controls) were taken from 433 eligible cases conducted over a 1 year period. Patient medical records were evaluated for demographics, surgical characteristics, opioid type ...


Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner 2017 Department of Family Medicine, Aurora University of Wisconsin Medical Group

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide ...


Conference Proceedings: Aurora Scientific Day 2017, 2017 Aurora Health Care

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.


Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns 2017 Department of Obstetrics and Gynecology, Aurora Sinai Medical Center

Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Hospital readmission rates are a focus of the Centers for Medicare and Medicaid Services. This was identified as a system opportunity to improve health care quality and patient education in order to reduce preventable readmissions. In 2009, 27% of obstetric readmissions were due to hypertensive disease, and preventable readmissions regarding hypertension are flagged as an area for quality improvement in our health care system. There is limited evidence on specific management of postpartum hypertension.

Purpose: Identify risk factors in our community and reduce postpartum readmissions for hypertension within our hospital.

Methods: We performed a retrospective chart review from November ...


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