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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 ...


Implementing Awhonn’S Evidence Based Guidelines For Managing The Second Stage Of Labor, George S. Knapp 2017 University of San Diego

Implementing Awhonn’S Evidence Based Guidelines For Managing The Second Stage Of Labor, George S. Knapp

Doctor of Nursing Practice Final Manuscripts

Objective: To improve cesarean rates without worsening perineal tissue integrity or neonatal 5 minute Apgar score. Design: Quality improvement project evaluated with descriptive statistics. Setting: A 24-bed perinatal floor at a general acute care hospital in San Diego County California. Patients: Nulliparous term mothers with a vertex singleton pregnancy (NTSV) with or without epidural anesthesia (EA). Intervention/Measurements: To implement the Association of Women’s Health, Obstetrical, and Neonatal Nurses’ (AWHONN) evidence based clinical practice guidelines, Nursing Care and Management of the Second Stage of Labor and Nursing Care of the Woman Receiving Regional Analgesia/Anesthesia in Labor and measure ...


Ethical Concerns For Assisted Reproductive Technologies, Olga Najera 2017 Abilene Christian University

Ethical Concerns For Assisted Reproductive Technologies, Olga Najera

Dialogue & Nexus

The development of assisted reproductive technologies has provided new options for infertile couples in their pursuit of parenthood. As a result of the successful implementation of in vitro fertilization (IVF), gestational surrogacy is now an alternative. Other technology, such as genetic enhancement, could potentially become available for human beings soon; however, numerous ethical concerns have been raised by the fact that it requires germline engineering. The concerns brought about by these new reproductive technologies will be addressed in light of the teachings of the Roman Catholic Church and of the following ethical theories: Kantian, evolutionary, utilitarian, and virtue ethics.


Herniated Gravid Uterus Through An Infra-Umbilical Laparotomy Scar: A Case Report, Ahmed M. Abbas, Armia Michael 2017 Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

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

POG In Press

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 ...


Full Term Delivery Of A Harlequin Ichthyosis Baby: A Case Report, Ahmed M. Abbas, Armia Michael, Ayman A. Askar, Shymaa S. Ali 2017 Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

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

POG In Press

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.


Cervical Ectropion May Be A Cause Of Desquamative Inflammatory Vaginitis., Leia Mitchell, Michelle King, Heather Brillhart, Andrew Goldstein 2017 George Washington University

Cervical Ectropion May Be A Cause Of Desquamative Inflammatory Vaginitis., Leia Mitchell, Michelle King, Heather Brillhart, Andrew Goldstein

Obstetrics and Gynecology Faculty Publications

Desquamative inflammatory vaginitis is a poorly understood chronic vaginitis with an unknown etiology. Symptoms of desquamative inflammatory vaginitis include copious yellowish discharge, vulvovaginal discomfort, and dyspareunia. Cervical ectropion, the presence of glandular columnar cells on the ectocervix, has not been reported as a cause of desquamative inflammatory vaginitis. Although cervical ectropion can be a normal clinical finding, it has been reported to cause leukorrhea, metrorrhagia, dyspareunia, and vulvovaginal irritation. Patients with cervical ectropion and desquamative inflammatory vaginitis are frequently misdiagnosed with candidiasis or bacterial vaginosis and repeatedly treated without resolution of symptoms. We report the case of a 34-year-old woman ...


Hpv Vaccination Among Females With Mental And Physical Limitation, Melissa Rowe, Audra L. Pritt, Amanda J. Stratton, Jennie L. Yoost 2017 Marshall University School of Medicine

Hpv Vaccination Among Females With Mental And Physical Limitation, Melissa Rowe, Audra L. Pritt, Amanda J. Stratton, Jennie L. Yoost

Marshall Journal of Medicine

Introduction

Adolescent HPV vaccination rates lag behind other vaccinations, partly due to missed opportunities for vaccination and lack of provider recommendation. This study evaluated the rates of HPV vaccination among adolescents with physical and mental limitation and controls, and evaluated differences in parental knowledge and reasons for nonvaccination between groups.

Materials and Methods

A retrospective chart review was performed on female patients age 12-18 presenting to pediatric or gynecology clinics in 2012. Those subjects with a diagnosis of mental or physical limitation were classified as “affected”. HPV vaccination rates were compared between affected and control groups. Parents of affected subjects ...


Patient Perspectives On Quality Family Planning Services In Underserved Areas, Debora Goldberg, Bhakthi Sahgal, Tishra Beeson, Susan F. Wood, Holly Mead, Aliyah Abdul-Wakil, Hallie Stevens, Pinyao Rui, Sara Rosenbaum 2017 George Mason University

Patient Perspectives On Quality Family Planning Services In Underserved Areas, Debora Goldberg, Bhakthi Sahgal, Tishra Beeson, Susan F. Wood, Holly Mead, Aliyah Abdul-Wakil, Hallie Stevens, Pinyao Rui, Sara Rosenbaum

Patient Experience Journal

Ongoing challenges impede efforts to improve the quality of family planning services in underserved communities, which by definition lack sufficient numbers of physicians and other health professionals. Challenges to improving the quality of family planning services include financing difficulties, lack of standards, training deficiencies, as well as little understanding and attention to patient preferences. The objectives of this study were to explore female patients’ preferences for family planning services in underserved areas and to develop a framework to help providers improve patient-centered care. The methodology for this paper included mixed methods research including a survey of women between the ages ...


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

Scholarly & Creative Works Conference 2017

Type 1 Diabetes Mellitus accounts for approximately 5% of the diabetic population (CDC, 2015). Numerous complications must be avoided when a diabetic is insulin dependent. Women who are diabetic who are planning to conceive a family have special considerations. Little research has been focused into how to best manage Type 1 diabetics during pregnancy. Since Type 1 diabetes is predominantly diagnosed between birth and 30 years of age, many Type 1 diabetics have potential to become pregnant without knowing how to best manage their diabetes. Poor glycemic control in diabetics has been related to miscarriages, stillbirths, malformations, and macrosomia (Lapolla ...


Incidence, Characteristics, And Outcomes Of Acute Kidney Injury Treated With Dialysis During Pregnancy And The Postpartum Period, Ainslie M. Hildebrand 2017 The University of Western Ontario

Incidence, Characteristics, And Outcomes Of Acute Kidney Injury Treated With Dialysis During Pregnancy And The Postpartum Period, Ainslie M. Hildebrand

Electronic Thesis and Dissertation Repository

Pregnancy-related acute kidney injury (AKI) may be associated with significant morbidity and mortality in young and often otherwise healthy women. We conducted a retrospective cohort study of all consecutive pregnancies between 1997 and 2011 in Ontario and describe the incidence, characteristics, and outcomes of AKI treated with dialysis (AKI-D) during pregnancy or within 12 weeks postpartum. Of 1,918,789 pregnancies, 188 were complicated by AKI-D (incidence proportion: 1 per 10,000, 95% confidence interval 0.8 to 1.1). Eight women died (4.3% versus 0.01% in the general population) and seven (3.9%) survivors remained dialysis-dependent four ...


The Rejoice Trial: A Phase 3 Randomized, Controlled Trial Evaluating The Safety And Efficacy Of A Novel Vaginal Estradiol Soft-Gel Capsule For Symptomatic Vulvar And Vaginal Atrophy., Ginger D Constantine, James A Simon, James H Pickar, David F Archer, Harvey Kushner, Brian Bernick, Gina Gasper, Shelli Graham, Sebastian Mirkin 2017 George Washington University

The Rejoice Trial: A Phase 3 Randomized, Controlled Trial Evaluating The Safety And Efficacy Of A Novel Vaginal Estradiol Soft-Gel Capsule For Symptomatic Vulvar And Vaginal Atrophy., Ginger D Constantine, James A Simon, James H Pickar, David F Archer, Harvey Kushner, Brian Bernick, Gina Gasper, Shelli Graham, Sebastian Mirkin

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: To evaluate the safety and efficacy of TX-004HR vaginal estradiol soft-gel capsules for moderate-to-severe dyspareunia associated with postmenopausal vulvar and vaginal atrophy.

METHODS: In this randomized, double-blind, placebo-controlled, phase 3 study, postmenopausal women with a self-identified most bothersome symptom of dyspareunia received 4, 10, or 25 μg TX-004HR or placebo for 12 weeks. Four co-primary efficacy endpoints were change from baseline to week 12 in percentages of superficial and parabasal cells, vaginal pH, and severity of dyspareunia. Secondary endpoints included severity of vaginal dryness and vulvar and/or vaginal itching or irritation. Endometrial histology and adverse events (AEs) were ...


Recurrent Spontaneous Third-Trimester Uterine Rupture After Hysteroscopic Resection Of Myoma: A Case Report, Ahmed M. Abbas, Mohammed K. Ali, Armia Michael, Fatma Abdel-Reheem, Mohamed A. Shahat 2017 1Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

Recurrent Spontaneous Third-Trimester Uterine Rupture After Hysteroscopic Resection Of Myoma: A Case Report, Ahmed M. Abbas, Mohammed K. Ali, Armia Michael, Fatma Abdel-Reheem, Mohamed A. Shahat

POG In Press

Uterine rupture is a catastrophic obstetrical emergency with serious effects on both women and fetuses. Operative hysteroscopic procedures can add more risk factor for occurrence of this tragedy. Here, we report a case of spontaneous recurrent rupture uterus at 33 weeks of gestation in a 32 years old woman with previous history of hysteroscopic resection of submucous myoma after development of acute abdomen. Uterine repair of fundal rupture was performed through emergency exploratory laparotomy. Surgeons should explain to their patients the hazards of probable risk of recurrent and multiple uterine rupture in the future pregnancy and to document this discussion ...


Management Of Preeclampsia After Heart Transplant, Emily R. Malling, Heather Anaya, R. Erik Edens 2017 University of Iowa Carver College of Medicine, Iowa City, Iowa

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

POG In Press

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. 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 affect ...


High-Grade Cervical Dysplasia In Pregnancy – Psychological And Medical Challenges, Denisa O. Balalau, Romina M. Sima, Nicolae Bacalbasa, Petrisor Banu, Cristian Bălălău, Liana Ples, Anca D. Stanescu 2017 Bucur Maternity Hospital

High-Grade Cervical Dysplasia In Pregnancy – Psychological And Medical Challenges, Denisa O. Balalau, Romina M. Sima, Nicolae Bacalbasa, Petrisor Banu, Cristian Bălălău, Liana Ples, Anca D. Stanescu

Journal of Mind and Medical Sciences

Despite being rare, the incidence of pregnancy-related cancer is expected to rise as women continue to delay childbearing and give birth later in their reproductive years. In this broad category, tumors like breast cancer, dermatological neoplasia and cervical cancer are most common and tend to arise in women of childbearing age. All pregnant women with clinical and cytologic suspicion of cervical cancer, except for squamous atypia or low-grade squamous intraepithelial lesions, should undergo colposcopy, with or without biopsy, the latter being avoided if possible due to possible complications which, although rare, may involve preterm labor initiation.

Some studies have attempted ...


Maternal Characteristics And Obstetrical Complications Impact Neonatal Outcomes In Indonesia: A Prospective Study., Trisari Anggondowati, Ayman A E El-Mohandes, S Nurul Qomariyah, Michele Kiely, Judith J Ryon, Reginald F Gipson, Benjamin Zinner, Anhari Achadi, Linda L Wright 2017 George Washington University

Maternal Characteristics And Obstetrical Complications Impact Neonatal Outcomes In Indonesia: A Prospective Study., Trisari Anggondowati, Ayman A E El-Mohandes, S Nurul Qomariyah, Michele Kiely, Judith J Ryon, Reginald F Gipson, Benjamin Zinner, Anhari Achadi, Linda L Wright

Medicine Faculty Publications

BACKGROUND: We investigated associations between maternal characteristics, access to care, and obstetrical complications including near miss status on admission or during hospitalization on perinatal outcomes among Indonesian singletons.

METHODS: We prospectively collected data on inborn singletons at two hospitals in East Java. Data included socio-demographics, reproductive, obstetric and neonatal variables. Reduced multivariable models were constructed. Outcomes of interest included low and very low birthweight (LBW/VLBW), asphyxia and death.

RESULTS: Referral from a care facility was associated with a reduced risk of LBW and VLBW [AOR = 0.28, 95% CI = 0.11-0.69, AOR = 0.18, 95% CI = 0.04-0 ...


Galactose And Its Metabolites Deteriorate Metaphase Ii Mouse Oocyte Quality And Subsequent Embryo Development By Disrupting The Spindle Structure, Mili Thakur, Faten Shaeib, Sana N. Khan, Hamid-Reza Kohan-Ghader, Roohi Jeelani, Sarah R. Aldhaheri, Bernard Gonik, Husam M. Abu-Soud 2017 Department of Obstetrics and Gynecology, Wayne State University School of Medicine

Galactose And Its Metabolites Deteriorate Metaphase Ii Mouse Oocyte Quality And Subsequent Embryo Development By Disrupting The Spindle Structure, Mili Thakur, Faten Shaeib, Sana N. Khan, Hamid-Reza Kohan-Ghader, Roohi Jeelani, Sarah R. Aldhaheri, Bernard Gonik, Husam M. Abu-Soud

C.S. Mott Center Research Publications

Premature ovarian insufficiency (POI) is a frequent long-term complication of classic galactosemia. The majority of women with this disorder develop POI, however rare spontaneous pregnancies have been reported. Here, we evaluate the effect of D-galactose and its metabolites, galactitol and galactose 1-phosphate, on oocyte quality as well as embryo development to elucidate the mechanism through which these compounds mediate oocyte deterioration. Metaphase II mouse oocytes (n=240), with and without cumulus cells (CCs), were exposed for 4hours to D-galactose (2μM), galactitol (11μM) and galactose 1-phosphate (0.1mM), (corresponding to plasma concentrations in patients on galactoserestricted diet) and compared to controls ...


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 ...


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 ...


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 ...


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