Medicine and Health Sciences Commons^™

Views Of Reproductive-Aged Female Cancer Patients On Oncofertility Care, Erin Boudoin, Akshay Goswami, Amelia Jernigan

Medical Student Research Poster Symposium

In recent years, there have been many advancements in detection and treatment that have allowed individuals to survive cancer at much higher rates than we have seen in the past. These types of advancements have given patients the opportunity to prioritize issues such as financial burdens and overall quality of life when assessing their options for disease management. Aggressive treatment options have led to higher survival rates but the side effects of said treatments often render female patients infertile due to premature ovarian insufficiency (Northern Children’s Oncology Group, 2017). During the tense period of receiving a diagnosis and treatment/management plan, …

Documentation Of Operative Vaginal Deliveries, Margaret Carey, Stacey Scheib

Medical Student Research Poster Symposium

OBJECTIVE: We aim to identify if physicians are documenting operative vaginal deliveries according to Society for Maternal Fetal Medicine (SMFM) guidelines and to identify the frequency with which each criterion is being documented. BACKGROUND: An operative vaginal delivery is a delivery in which the provider uses forceps, a vacuum, or another device to aid in the extraction of the fetus from the vagina. In some cases, operative vaginal delivery can serve as an alternative to cesarean section when spontaneous vaginal delivery is not possible. Operative vaginal deliveries have a higher mortality than spontaneous vaginal deliveries1; operative vaginal deliveries also have …

Marijuana Use In Pregnancy And The Risk Of Preterm Birth, Benjamin Nelson, Rachel Gilbert, Andrew G. Chapple, Sarah Buzhardt, Elizabeth F. Sutton

Medical Student Research Poster Symposium

INTRODUCTION: As more of the United States opts towards legalizing marijuana, the amount of marijuana users in general has increased – including women of reproductive age. Specifically, this trend has disproportionately affected socioeconomically disadvantaged women, with up to 15% of pregnant patients self-reporting marijuana use at some time during pregnancy. There have been several studies, both recent and older, that have linked pre-natal marijuana use with small for gestational age, increased perinatal infection rate, and preterm birth. The published literature does not come to a consensus on the effects of THC, the psychoactive substance in marijuana, on birthing outcomes and, …

Systematic Review And Meta-Analysis Of Perioperative Administration Of Acetazolamidefor Management Of Postoperative Pain After Laparoscopy, Gabrielle Stone, Kaitlin Mcgrail, Andrew G. Chapple, Elizabeth F. Sutton, Neill R. Chappell

Medical Student Research Poster Symposium

Laparoscopy (LSC) for abdominal surgery has become the standard approach for many surgical interventions to date. While there are numerous benefits to a minimally invasive technique, LSC can also be associated with postoperative referred pain to the shoulder. While several interventions have been proposed to mitigate this pain, no singular intervention has proven to be superior. Perioperative acetazolamide (ACTZ) administration is a relatively cost effective and safe option, though it is less well recognized and its efficacy is as yet unproven. This study was designed as a systematic review and meta-analysis to evaluate the efficacy of perioperative ACTZ administration with …

Comparison Of Outcomes Of Frozen Embryo Transfer Using Endometrial Preparation With Lupron Versus Standard Hrt, Caroline Babin, Victoria Bone, Neil Chappell

Medical Student Research Poster Symposium

Frozen embryo transfers (FETs) are now the standard of care in in-vitro fertilization. FETs require estrogen administration followed by progesterone (E/P), though there is no best treatment algorithm. A GnRH agonist may be used to decrease the risk of ovulation along with E/P, though benefit has not been proven, and it increases both cost and time. We conducted a retrospective analysis of patients treated with and without a GnRH agonist in programmed FET cycles. All patients undergoing FET from a single private practice facility from January 1, 2018 to December 31st, 2019 were included in this retrospective cohort study. In …

Risks For Complications And Need For Repeat Excisional Procedures Of The Uterine Cervix, K Robichaux, Claire Bise, Amelia Jernigan, Tara Castellano

Medical Student Research Poster Symposium

Cold Knife Conization (CKC) and Loop Electrical Excision Procedure (LEEP) are interventions used to treat pre-malignant and malignant cervical lesions. On occasion, multiple excisional procedures may be required to treat these lesions. This study aims to identify the risk factors associated with needing a re-excisional procedure of the cervix within one year of the first excision and to investigate if re-excisional procedures within one year are at higher risk for complications. A multi-site, retrospective study of patients aged 18 years or older undergoing either CKC or LEEP from 2019-2021. Clinicopathologic and surgical factors were examined to test for risk factors …

Unique Evaluation And Management Considerations For Adolescents With Late Gynecologic And Colorectal Issues In The Setting Of Anorectal Malformations, Wendy Jo Svetanoff

Research Days

Background: Females born with anorectal malformations (ARMs) and bladder exstrophy have a greater incidence of Mullerian and genital anomalies requiring early gynecologic assessment and frequent surgical intervention. However, there is little guidance for management considerations of pubertally identified Mullerian anomalies in these patients

Objectives/Goal: We sought to assess the unique colorectal, gynecologic, and psychological issues present during the adolescent years.

Methods/Design: A retrospective review was performed of 10-25 year old female patients born with an ARM, cloaca, or exstrophy that presented to our multidisciplinary clinic between 2009 and 2019. Data abstracted included the presenting problem, history, imaging studies, psychological evaluation, …

Do Males With 45,X/46,Xy Mosaicism Have Turner Syndrome, Michelle Knoll

Research Days

Background: Patients with 45,X/46,XY mosaicism can have genitalia spanning the range from typical female to typical male, and the sex assigned at birth is often based on the appearance of the genitalia. According to current nomenclature, only the subgroup assigned female are diagnosed with Turner syndrome (TS) (Gravholt et al, 2017). Clinical practice guidelines recommend that girls with TS be screened for several comorbidities, including short stature, cardiac and renal anomalies, and autoimmune conditions, but there are no recommendations for screening of boys with 45,X/46,XY mosaicism.

Objectives/Goal: We sought to determine if boys with 45,X/46,XY mosaicism exhibited a similar rate …

Breastfeeding Education Support Tool For Baby (Best4baby): Feasibility, Acceptability, And Preliminary Impact Of An Mhealth Supported Breastfeeding Peer Counselor Intervention In Rural India, Parth D. Lalakia, Vanessa L. Short, Roopa M. Bellad, Patricia J. Kelly, Yukiko Washio, Tony Ma, Katie Chang, Niranjana Majantashetti, Umesh S. Charantimath, Frances J. Jaeger, Shivaprasad S. Goudar, Richard J. Derman

Rowan-Virtua Research Day

Objective: To evaluate the feasibility of an mHealth-supported breastfeeding peer counselor intervention implemented in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including exclusive breastfeeding (EBF).

Methods: In this quasi-experimental pilot study, participants received either the intervention plus usual care (n = 110) or usual care alone (n = 112). The intervention group received nine in-home visits during and after pregnancy from peer counselors who provided education about and support for EBF and other optimal infant feeding practices and were aided with an mHealth tool. The control group received routine prenatal and postnatal health education. …

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Seeking Sustainable Solutions To Period Poverty Amongst Homeless Women In Camden County, Nj, Bilal Khan, Alana Smith, Melisa Ibarra-Zavala

Rowan-Virtua Research Day

Health Careers Opportunity Program (HCOP) – National Ambassadors is an effort for underserved high school, undergraduate, and medical students to collaborate on a research-based community service project to equip future health professionals with tools to heal their communities.

The average woman spends up to 3500 days of their life menstruating. Menstrual health is therefore not just a fundamental human right, but a robust indicator of community well-being. Despite the biological inevitably of menstruation, barriers to practicing adequate menstrual hygiene, or “Period Poverty,” are far common and often ignored in public forums. Period products face a luxury goods sales tax in …

Ethnic Differences In Maternal Cytokines And Adipokines And Their Association With Spontaneous Preterm Delivery, Yelizavet D. Lomakova, Xinhua Chen

Rowan-Virtua Research Day

Spontaneous preterm delivery (SPTD, birth at <37 weeks’ gestation) is a leading cause of infant mortality in the United States [1]. Infants born prematurely are more likely to suffer from both short and long-term complications including neurodevelopmental delay, visual and hearing impairment, and chronic diseases such as heart disease, hypertension and diabetes in later life [2-4]. African American women have a 2-fold increased risk of preterm delivery compared to Caucasian women [5].The reasons for this disparity are poorly understood. This limits the ability to predict and prevent preterm delivery in the most high-risk populations.

Assessment Of Factors Preventing Adequate Decline In Cervical Cancer Rates Amongst Minority Women In New Jersey, Rosie Wenrich, Jillian Baker

Rowan-Virtua Research Day

Background

• Nationally declining cervical cancer rates are still high amongst minority women in NJ, with Hispanic women being affected the most.

• The Human Papilloma Virus (HPV) is the most common sexually transmitted infection and can lead to cervical cancer

• Administration of the 9-valent HPV vaccine can prevent infection and progression to cancer

• Regular cervical cancer screenings allow for better outcomes

• Various barriers prevent people with a cervix receiving the vaccine

• Various barriers prevent people with a cervix aged >/= 30 from receiving regular cervical cancer screenings

Conclusions

• Improved physician recommendation is required for the …

Liposomal Bupivacaine Infiltration And Transversus Abdominis Plane Block Versus Standard Of Care For Post Caesarean Pain Control: A Retrospective Chart Review, Ellie Ganz, Darren Adams, Rose A. Maxwell, Theresa Roby, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Transversus abdominis plane (TAP) block and wound infiltration with local anesthetics are shown to reduce opiate use and pain scores when compared to controls who received narcotic pain medications. With the current opiate epidemic, finding different ways to control pain without opiates is important,-to prevent unnecessary use of these drugs and reduce the potential for addiction in patients having a Cesarean delivery who often times receive opiate medications on schedule regardless of their reported pain.

The Role Of Art In Teaching Virtual Anatomy During The Covid-19 Pandemic, Shaigan Bhatti, Ashwatha Thenappan, Rose A. Maxwell, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

The purpose of this study is to determine whether drawing anatomical structures and teaching it virtually to others improves student confidence in remembering anatomy and improves student perceptions of OB/GYN anatomy in the obstetrics and gynecology core clerkship. Active recall is a superior method of learning and memory retention because it practices information retrieval. If one draws an anatomic region of the human body after visualization and then teaches it, the learner would be exercising retrieval thus promotion retention of the material. The specific act of writing things down on paper promotes memory retention. This study sets a precedence of …

Identifying Factors Underlying The Decision For Genetic Carrier Screening Among Women In Montgomery County, Sowon Kim, Rose A. Maxwell

Medical Student Research Symposium Abstracts and Posters

Genetic Carrier Screening (GCS) is a genetic test that allows patients to find out if they carry genes for certain genetic disorders. The results of the test enable patients to make changes to their family planning decisions and prenatal care when appropriate and allow them the opportunity to seek further medical and social support. Despite these health benefits and notable clinical utility of GCS, GCS has not been utilized in most nations due to moral and ethical controversy among the public. Previous studies have demonstrated patients’ ethnicity, socio-demographic (age, education) and economic factors were associated with the patient’s intention to …

A Case Of Ruptured Cornual Pregnancy With Delivery Of A Viable Pre-Term Infant, Elana Miller, Elena Fuell-Wysong, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Interstitial and cornual ectopic pregnancies are rare forms of ectopic with high mortality rate. As such, they pose significant challenges in diagnosis, treatment, and follow up.

This patient was a 42 y/o female G2P1001 at 25+3 weeks gestational age who presented from an outside hospital after an episode of sudden onset abdominal pain with syncope. She was noted to have hypotension, tachycardia, lactic acidosis, and peritoneal free fluid. Physical exam was significant for peritoneal signs with abdominal guarding and rebound. Her pregnancy was complicated by advanced maternal age, THC use, and late presentation for prenatal care in the second trimester. …

Placental Hypoxia-Inducible Factor 1 Alpha In Early-Onset Preeclampsia As A Predictor Of Future Risk In Maternal And Fetal Health, Julie Slyby, Bryce Linkous, Sarah Scott, Chandni Chandiramani, Amy Hwang, Danielle Spanbauer, Melissa R. Kaufman, Traci Rackett, Kailey Nolan, Emily Stone, Rose A. Maxwell, David N. Dhanraj, Thomas L. Brown

Medical Student Research Symposium Abstracts and Posters

Preeclampsia is a life-threatening, pregnancy-associated disorder characterized by the rapid development of hypertension with renal dysfunction. While preeclampsia generally occurs later in pregnancy, early-onset preeclampsia (EOPE) can occur much earlier and is usually more devastating. Early-onset preeclampsia is also associated with an increased risk of maternal cardiovascular and metabolic disease in mothers later in life and neurocognitive dysfunction in their offspring. EOPE is strongly associated with abnormal placental development and fetal growth restriction during pregnancy.

Local Wound Infiltration With Liposomal Bupivacaine Decreases Post-Cesarean Pain Scores, Avni Gupta, Justin Williams, Rose A. Maxwell, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Surgical patients are routinely prescribed opioid analgesics that are strongly associated with drug overdose deaths. Liposomal bupivacaine is a long-acting local anesthetic that received FDA approval in 2011 for local surgical site infiltration to promote post-operative analgesia. This anesthetic has demonstrated an improvement in post-operative pain control in various surgical realms, indicating a decreased need for opiates and subsequently decreased risks. However, few studies have investigated its use at the time of cesarean delivery.

Oncofertility Awareness And Attitudes Among Health Care Providers And Breast Cancer Patients In A Chinese Academic Setting1, John P. Zucal, Ewelina Biskup, Xin Zhaochen, Yun Sun, Yao Lu, Leslie C. Appiah, Hongwei Zhang, Steven R. Lindheim

Medical Student Research Symposium Abstracts and Posters

As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country.

Neonatal Health Outcomes Following Water Immersion During Labor And Delivery, Ariel L. Lanier, Samantha L. Wiegand, David Mckenna

Medical Student Research Symposium Abstracts and Posters

Water birth is child delivery that occurs in a tub of water. Water birth delivery has been offered by Miami Valley Hospital in the Family Beginnings Birth Center since 1994. The first water birth delivery that was documented in a medical journal occurred in France in 1805, which reported that the delivery resulted in a healthy baby. Water birth deliveries have been growing in popularity in the United States as mothers are interested in the possible alleged benefits of water birth including shorter labor, less pain, improved maternal experience of childbirth, and more. Although there are many potential benefits, The …

Evaluating The Effectiveness Of Early Exposure: Obstetrics And Gynecology Two-Week Virtual Elective, Elisabeth N. Adkins, Marilyn Kindig, Rose A. Maxwell

Medical Student Research Symposium Abstracts and Posters

Clinical clerkships are an integral part of undergraduate medical education. Until now, clerkships have either been offered through simulation labs, didactics or in the healthcare setting dependent upon the pedagogical approach of each institutions’ curricula. Subsequent to coronavirus-2019, medical students had decreased accessibility to the aforementioned educational settings. This has provided an innovative opportunity for clerkship directors to provide the same clinical experience to students in a novel way –virtually.

Recently, the Larner College of Medicine at the University of Vermont created a two-week virtual simulated clerkship electiveencompassing the curricula taught throughout the OB/GYN clerkship. Until now, this virtual elective …

Evidence-Based Practice: Delaying Infant Bathing, Gabrielle Wadle, Grace Frankland

Scholars Week

A hospital's policy regarding infant bathing is currently not congruent with best nursing practice. The hospital’s current policy is to bathe an infant once they are stable and their rectal temperature is at or above 98.6 °F. Although the infant may become stable within the first 24-hours of birth, the World Health Organization recommends that, “Bathing should be delayed until 24 hours after birth.” (2013, p. 4). Research has been completed to support delaying infant bathing until 24 hours post-delivery, suggesting potential modifications to current policy.

The Efficacy Of In Vitro Fertilization In Treating Infertility Due To Anovulatory Pcos In Comparison To Ovulation Induction Via Letrozole, Amanda Salay

Capstone Showcase

Abstract:

Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder found in women of reproductive age that often causes infertility. The first-line treatment for infertility in anovulatory PCOS patients is ovulation induction. In vitro fertilization (IVF) is a third line treatment often used as a last resort. PCOS patients have higher failure risks of first- and second-line medications. Therefore, this review analyzes if adverse pregnancy outcomes (O) are reduced more with IVF (I) versus using letrozole for ovulation induction (C) in women aged 20-30 struggling with infertility due to anovulatory PCOS (P).

Methods: A literature search on Pubmed and EBSCOhost …

The Benefits Of Statins As Adjunct Therapy For Non-Pregnant And Non-Lactating Women Diagnosed With Pcos, Claire Barre

Capstone Showcase

Introduction: Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting about 20% of women in reproductive age. PCOS is associated with many health risks, one of which is an increased risk of cardiovascular and metabolic disorders. There is no set treatment plan to help decrease the risk of cardiometabolic diseases, but some standard recommended treatments include lifestyle changes, oral contraceptive pill (OCP), and metformin. The review analyzes the potential benefit of adding statins as an adjunct therapy (I) to decrease the cardiometabolic disease risk (O) in women diagnosed with PCOS (P) compared to the current recommended intervention (C). …

The Effects Of Psychological Intervention On Pregnant Women With Elevated Cortisol Levels And Adverse Birth Events, Megan Mellon

Capstone Showcase

Elevated levels of stress, anxiety, and depression during pregnancy are thought to influence cortisol levels. Dysregulations in cortisol, as a byproduct of the hypothalamic-pituitary axis, have been associated with preterm birth and adverse birth outcomes. Studies have demonstrated poorer long-term effects of antenatal stress on child neurodevelopment, temperament, and cognition. Psychological interventions of cognitive behavioral therapy (CBT), mindfulness, and gratitude have shown to have a positive effect on psychological wellbeing across various populations. The purpose of this literature review was to analyze a collection of randomized-controlled trials to conclude if psychological interventions during pregnancy for women with elevated levels of …

Efficacy Of Myo-Inositol In The Treatment Of Polycystic Ovarian Syndrome (Pcos), Rachel Mathews

Capstone Showcase

Polycystic ovarian syndrome (PCOS) is a disorder that results from insulin resistance. Symptoms include chronic anovulation, polycystic ovaries, acne, hirsutism, and infertility. Although there is currently no cure for PCOS, treatments such as metformin, clomiphene citrate, and reproductive assistive techniques (IVF) have been used to target specific symptoms. Recent research has suggested that myo-inositol may be beneficial in the treatment of PCOS. Therefore, this review analyzes the addition of myo-inositol (I) in adult patients with PCOS (P) compared to current methods such as metformin, clomiphene citrate, and assisted therapies alone (C) in improving ovulation and fertility (O). A literature search …