Medicine and Health Sciences Commons^™

Exposure To Phthalates And Replacements During Pregnancy In Association With Gestational Blood Pressure And Hypertensive Disorders Of Pregnancy, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Emma M. Rosenthal, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Exposure to endocrine-disrupting chemicals such as phthalates may increase risk of hypertensive disorders of pregnancy (HDP). Prior studies lack investigation of chemical mixtures, phthalate replacements, or key periods of susceptibility including early pregnancy. In the present study, we used a longitudinal approach to evaluate gestational exposure to phthalates and replacements, as both single-pollutants and mixtures, in association with blood pressure and diagnosis of preeclampsia or any HDP. The Human Placenta and Phthalates prospective pregnancy cohort includes 291 participants recruited from two U.S. clinics. Urinary metabolites of ten phthalates and replacements were quantified at up to 8 time points per individual …

Association Between Adverse Pregnancy Outcomes And Awareness Of Cardiovascular Risk Factors: A Numom2b-Hhs Secondary Analysis, Elizabeth M. Wendl, Amanda A. Allshouse, Ashley Goodwin, Bri Hobbs, Philip Greenland, Lisa Levine, William Grobman, George R. Saade, Natalie Cameron, C. Noel Bairey Merz, Caroline Rouse, Sarah Rogan, Judith H. Chung, Lauren H. Theilen, National Heart, Lung, And Blood Institute Numom2b Heart Health Study Network

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) affect 10%-20% of pregnancies and are associated with increased risk of cardiovascular disease.

Objective

To determine whether the history of APO is associated with a person's awareness of their cardiovascular risk factors (CRF) 2-7 years postpartum.

Methods

This is a secondary analysis of a multicenter cohort study in which nulliparous pregnant people were enrolled in the first trimester and followed prospectively. Participants with a CRF (hypertension, dyslipidemia, and/or prediabetes/diabetes) at follow-up were included. We excluded participants with: pre-gestational diabetes, chronic hypertension, dyslipidemia during the index pregnancy or subsequent pregnancy, and non-fasting blood draws. The exposure …

Magnetic And Ph-Sensitive Dual Actuation Of Biohybrid Microswimmer Of Targeted Drug Release Suitable For Cancer Cell Microenvironment, Richa Chaturvedi, Yumin Kang, Yunji Eom, Sri Ramulu Torati, Cheolgi Kim

Center for Bioelectronics Publications

The chemotherapeutic agents most frequently used in cancer treatment often have limited effectiveness because of their low specificity for tumors and poor therapeutic performance. In addition to the aforementioned therapeutic challenges the drug delivery carriers conjugated with the drug encounter early detection and elimination from the immune system before arriving at the affected area continues to be a significant research focus among researchers. To address this prevalent issue, an effective approach has been developed that leverages the physiological differences between normal and tumor tissue to enhance the efficacy of anticancer drugs. This drug delivery system is designed based on pH-sensitive …

Cost-Effective Hierarchical Cobalt Nanostructured Laser-Induced Graphene For Enhanced Uric Acid Detection, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

This study presents an innovative, cost-effective strategy to develop a flexible, enzyme-free biosensor for the sensitive detection of uric acid (UA). Utilizing electrochemically modified cobalt nanostructured on laser-induced graphene electrodes (CoNCs/LIG), this approach surpasses traditional noble metal-based electrocatalysts in sensitivity and affordability. The one-step electrochemical modification method is efficient and straightforward, enabling the uniform deposition of hierarchical flower-like cobalt nanostructures. These structures synergistically enhance the performance of the LIG, resulting in a broad detection range of 5 to 700 µM with a sensitivity of 6.75 µA µM^-¹ cm^-² and a low detection limit of 3.66 µM for UA. …

Electrochemical And Nanomaterial Based Strategies For Nonenzymatic Glucose Detection: A Review, Reagan Aviha, Gymama Slaughter

Center for Bioelectronics Publications

Electrochemical glucose sensing technologies have undergone significant evolution, with continual advancements aimed at improving sensitivity, selectivity, and user convenience. This review systematically explores the development of emerging nonenzymatic glucose sensor designs. Nonenzymatic sensors are critically evaluated for their ability to overcome enzymatic limitations, leveraging novel materials and catalytic mechanisms. Additionally, the emergence of smartphone-integrated glucose monitoring systems is highlighted as the fifth generation, representing a paradigm shift toward personalized, real-time healthcare management. Emphasis is placed on the strategies employed to reduce the working electrode potential and enhance analytical performance. Key analytical metrics and real-sample applicability are evaluated, and persistent challenges …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

Politics In Public Health: Growing Partisan Divides In Covid-19 Vaccine Attitudes And Uptake Post-2021 Presidential Inauguration, Hongbin Fan, Zhongliang Zhou, Guanping Liu, Chi Shen, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: To investigate whether the 2021 U.S. presidential inauguration contributed to a widening of partisan divides in COVID-19 vaccine attitudes and uptake. Methods: We leverage the presidential inauguration as a natural experiment and analyze data from the Household Pulse Survey and CDC vaccination records. Using a difference-in-differences framework with continuous treatment, we examine how the transition differentially affected state-level vaccine refusal rates and county-level vaccination rates, based on varying levels of partisanship as measured by the Trump-Biden vote gap. Results: Following Biden's inauguration, vaccine refusal declined more in pro-Biden states. Distrust in government and vaccines accounted for approximately 80% of …

Machine Learning Models For Pancreatic Cancer Survival Prediction: A Multi-Model Analysis Across Stages And Treatments Using The Surveillance, Epidemiology, And End Results (Seer) Database, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pancreatic cancer is among the most lethal malignancies, with poor prognosis and limited survival despite treatment advances. Accurate survival modeling is critical for prognostication and clinical decision-making. This study had three primary aims: (1) to determine the best-fitting survival distribution among patients diagnosed and deceased from pancreatic cancer across stages and treatment types; (2) to construct and compare predictive risk classification models; and (3) to evaluate survival probabilities using parametric, semi-parametric, non-parametric, machine learning, and deep learning methods for Stage IV patients receiving both chemotherapy and radiation. Methods: Using data from the SEER database, parametric models (Generalized Extreme Value, …

A Rare Case Of Metastatic Myxofibrosarcoma To The Right Colon, Timothy K. Farrell, Matthew A. Carnell, Vincent J. Obias

Department Surgery Faculty Publications

Myxofibrosarcoma (MFS) is a common soft tissue sarcoma typically arising in the extremities of older adults. Metastatic spread usually involves the lungs, lymph nodes, or bone. We describe a rare case of metastatic MFS to the colon in a 76-year-old man, three years after surgical excision and radiation treatment for a left flank primary tumor. The patient presented with symptoms of obstipation and was found to have a 4 cm cecal mass confirmed by imaging and colonoscopy. Biopsy and surgical pathology confirmed metastatic MFS. A right colectomy was performed without complication. This case highlights an uncommon site of MFS metastasis …

Reliability Of Popliteal Artery Flow-Mediated Dilation In The Seated Position, Taskina Akhter, Patrick B. Wilson, J. David Branch, Leryn J. Reynolds

Exercise Science Faculty Publications

Flow-mediated dilation (FMD), a noninvasive measure of endothelial function, is commonly measured in the popliteal artery in the supine and upright body positions. However, reliability studies of the measurement in these positions are not well studied. This study aimed to examine the trial-retrial and visit-to-visit reliability of popliteal artery FMD in the seated position. Popliteal artery FMD was measured in 20 healthy adults across two visits in the seated and prone positions to assess visit-to-visit reliability. Two measurements were taken for each body position at each visit to assess trial-retrial reliability. %FMD was calculated as the percent change from baseline …

Impacts Of Physical Inactivity Models On Endothelial Function: A Systematic Review, Joel E. Harden, J. David Branch, Leryn J. Reynolds

Exercise Science Faculty Publications

Background

Endothelial dysfunction is associated with cardiovascular disease and cardiac events. Numerous studies demonstrate that a reduction in physical activity/exercise levels are associated with poor endothelial function. Yet, these studies use a plethora of models to mimic reduced activity levels which may have widely different results on endothelial function. It is pertinent to collectively review these articles to provide a comprehensive understanding of the impact of reduced activity on vascular health, as endothelial function is one of many factors that influences vascular tone.

Objective

The purpose of this systematic review is to examine and synthesize the current literature regarding the …

Motion Artifacts (Ma) At-Rest In Measured Arterial Pulse Signals: Time-Varying Amplitude In Each Harmonic And Non-Flat Harmonic-Ma Coupled Baseline, Md Mahfuzur Rahman, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) cause great variability in a measured arterial pulse signal, and treatment of MA solely as a baseline drift (BD) fails to eliminate its effect on the measured signal. This paper presents a study on the effect of MA at rest (< 0.7 Hz) on measured arterial pulse signals using a microfluidic-based tactile sensor. By taking full account of the dynamic behavior of the transmission path from the true pulse signal in an artery to a measured pulse signal at the sensor, the tissue-contact-sensor (TCS) stack, an analytical model of MA in a measured pulse signal is developed. In this model, the TCS stack is treated as a 1DOF system for its dynamic behavior; MA is quantified as the displacement (i.e., BD) and time-varying system parameters (TVSP) of the TCS stack. The mathematical expression of MA in a measured pulse signal reveals that while BD remains as low-frequency additive noise, TVSP causes time-varying harmonics in a measured pulse signal. Further time-frequency analysis (TFA) of measured pulse signals validates the existence of TVSP and, for the first time, reveals its effect on a measured pulse signal: time-varying amplitude in each harmonic and non-flat harmonic-MA-coupled baseline.

Multimodal Wearable Intelligence For Dementia Care In Healthcare 4.0: A Survey, Po Yang, Gaoshan Bi, Jun Qi, Xulong Wang, Yun Yang, Li Da Xu

Information Technology & Decision Sciences Faculty Publications

As a new revolution of Ubiquitous Computing and Internet of Things, multimodal wearable intelligence technique is rapidly becoming a new research topic in both academic and industrial fields. Owning to the rapid spread of wearable and mobile devices, this technique is evolving healthcare from traditional hub-based systems to more personalised healthcare systems. This trend is well-aligned with recent "Healthcare 4.0" which is a continuous process of transforming the entire healthcare value chain to be preventive, precise, predictive and personalised, with significant benefits to elder care. But empowering the utility of multimodal wearable intelligence technique for elderly care like people with …

Laser-Induced Graphene Sensor For The Electrochemical Detection Of Acetaminophen, Abdellatif Ait Lahcen, Mazhar Sher, Sikander Ameer, Gymama Slaughter

Center for Bioelectronics Publications

Here we present a simple and efficient method for fabricating laser-induced graphene (LIG) electrodes for the electrochemical detection of acetaminophen (AAP), a crucial analgesic and antipyretic that can become toxic at elevated concentrations. Unlike conventional sensors that require intricate chemical modifications, the fabricated LIG-based sensor eliminates the need for functionalization, offering a streamlined sensing solution. The LIG electrodes were characterized using scanning electron microscopy, energy-dispersive spectroscopy, and Raman spectroscopy, which confirmed the formation of a highly porous graphene network with excellent purity and conductivity. Cyclic voltammetry analysis with a ferricyanide redox probe revealed a large electroactive surface area of 1.21 …

Electrochemical Detection Of Prostate Cancer—Associated Mirna-141 Using A Low-Cost Disposable Biosensor, Alexander Hunt, Gymama Slaughter

Center for Bioelectronics Publications

Prostate cancer is the second leading cause of cancer-related deaths among men in the United States. The early detection of aggressive forms is critical. Current diagnostic methods, including PSA testing and biopsies, are invasive and often yield false results. MicroRNA-141 (miRNA-141) has emerged as a promising non-invasive biomarker due to its elevated levels in the urine of patients with metastatic prostate cancer. Here, a low-cost, paper-based electrochemical biosensor for the sensitive detection of miRNA-141 in synthetic urine is reported. The device employs inkjet-printed gold electrodes on photopaper, functionalized with thiolated single-stranded DNA-141 capture probes for specific target recognition. The biosensor …

Using Virtual Reality To Assist Students At Academic Risk In Human Anatomy, Michael Foley, Lauren T. Lilley, Lindsay Meyers, Robert Armstrong, Lisa Fore-Arcand, Kelly Mccoy, Chad Eitel, Tod R. Clapp, Natascha Heise

Department of Pathology & Anatomy Faculty Publications

Learning human anatomy presents a significant challenge for health profession students due to the difficulty in visualizing structures in three dimensions. Virtual reality (VR) has been reported to aid in understanding these relationships. In this study, students at academic risk attended VR sessions alongside their gross anatomy course. Data from post-surveys, observations, and examinations indicated VR participants performed similarly to peers, except in head/neck and pelvis/lower limb exams where performance was lower. Students valued VR for enhancing confidence and understanding. VR shows promise in supplementing anatomy education, particularly for less complex regions, and bridging gaps in traditional learning methods.

Electrical Homeostasis Of The Inner Mitochondrial Membrane Potential, Peyman Fahimi, Lázaro A. M. Castanedo, P. Thomas Vernier, Cherif F. Matta

Bioelectrics Publications

The electric potential across the inner mitochondrial membrane must be maintained within certain bounds for the proper functioning of the cell. A feedback control mechanism for the homeostasis of this membrane potential is proposed whereby an increase in the electric field decreases the rate-limiting steps of the electron transport chain (ETC). An increase in trans-membrane electric field limits the rate of proton pumping to the inter-membrane gap by slowing the ETC reactions and by intrinsically induced electroporation that depolarizes the inner membrane. The proposed feedback mechanism is akin to a Le Chatelier's-type principle of trans-membrane potential feedback control.

The Central Role For Troponin C Amino-Terminal ⍺-Helix In Vertebrate Thin Filiment Ca²⁺-Activation, Yun Shi, Lauren A. Blackwell, Ryan K. Schroy, B. Max Cleland, Cristina M. Risi, Michelle S. Parvatiyar, Jose R. Pinto, Vitold E. Galkin, P. Bryant Chase

Department of Biomedical and Translational Sciences Faculty Publications

Troponin C (TnC) is the Ca²⁺-sensing subunit of troponin that is responsible for activating thin filaments in striated muscle, and, in turn, for regulating the systolic and diastolic contractile function of cardiac muscle. The secondary structure of vertebrate TnC is mainly composed of α-helices, with nine helices named sequentially, starting from the amino terminus, from N to A–H. The N-helix is a 12-residue-long α-helix located at the extreme amino terminus of the protein and is the only helical structure that does not participate in forming Ca²⁺-binding EF-hands. Evolutionarily, the N-helix is found only in TnC from mammalian species and most …

Evaluating The Early Impact Of Ab 617: Air Pollution, Health Disparities, And Environmental Justice In California, Cherry Cheuk Lam Cheung, Adam Eckerd

School of Public Service Faculty Publications

This study evaluates the initial effectiveness of California’s Assembly Bill 617 (AB 617), enacted to address air pollution impacts in communities designated as environmental justice priorities, a policy approach that has recently been touted as a successful start. These claims of initial success stand in contrast to much of the research on remediation of environmental justice, particularly with respect to air pollution. Despite well-documented disparities in air pollution exposure and its health impacts among racial-ethnic minorities, previous policy efforts to mitigate these effects have had, at best, marginal effects. AB 617 mandates local air districts and the California Air Resources …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

Clinical Pharmacology And Medication Safety: A Remote Learning Elective Designed For Senior Medical Students, Elizabeth B. Graham, William T. Wightkin, Curt R. Bay, Uzoma S. Ikonne

Department of Biomedical and Translational Sciences Faculty Publications

In the United States, medical educators have expressed concern that an integrated and condensed pre-clerkship curriculum risks leaving gaps in student pharmacology knowledge. This study evaluates a remote-learning clinical pharmacology elective that integrates fundamental pharmacology concepts and principles of medication safety and explores how the course impacts senior medical students' self-reported readiness for residency. Clinical Pharmacology and Medication Safety is a remote elective course for senior medical students. The course integrates a review of basic pharmacology with clinical pharmacology topics through case-based learning sessions led by clinical pharmacists and physicians. To evaluate the elective's effectiveness, students in the fall and …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

3d Bioprinting Technology Innovation In Female Reproductive System, Siyao Chen, Tongxin Wang, Jiaqi Chen, Mingxing Sui, Luyao Wang, Xueyu Zhao, Jianqiao Sun, Yingli Lu

Department of Obstetrics & Gynecology Faculty Publications

Several diseases affect the female reproductive system, and both disease factors and treatments impact its integrity and function. Consequently, understanding the mechanisms of disease occurrence and exploring treatment methods are key research focuses in obstetrics and gynecology. However, constructing accurate disease models requires a microenvironment closely resembling the human body, and current animal models and 2D in vitro cell models fall short in this regard. Thus, innovative in vitro female reproductive system models are urgently needed. Additionally, female reproductive system diseases often cause tissue loss, yet effective tissue repair and regeneration have long been a bottleneck in the medical field. …

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …

Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …

Predicting Mental Health Disparities Using Machine Learning For African Americans In Southeastern Virginia, Ismail El Moudden, Michael C. Bittner, Matvey V. Karpov, Isaac O. Osunmakinde, Akosua Acheamponmaa, Breshell J. Nevels, Mamadou T. Mbaye, Tonya L. Fields, Karthiga Jordan, Messaoud Bahoura

Department of Obstetrics & Gynecology Faculty Publications

This study examined mental health disparities among African Americans using AI and machine learning for outcome prediction. Analyzing data from African American adults (18–85) in Southeastern Virginia (2016–2020), we found Mood Affective Disorders were most prevalent (41.66%), followed by Schizophrenia Spectrum and Other Psychotic Disorders. Females predominantly experienced mood disorders, with patient ages typically ranging from late thirties to mid-forties. Medicare coverage was notably high among schizophrenia patients, while emergency admissions and comorbidities significantly impacted total healthcare charges. Machine learning models, including gradient boosting, random forest, neural networks, logistic regression, and Naive Bayes, were validated through 100 repeated 5-fold cross-validations. …

Longitudinal Assessment Of Intravillous Arterioles In Normal Pregnancy Using Superb Microvascular Imaging, R. Horgan, E. Sinkovskaya, G. Saade, E. Kalafat, A. Heeze, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

To use superb microvascular imaging (SMI) to longitudinally evaluate blood flow in intravillous arterioles (IVA) in pregnancy, and to develop reference ranges for IVA pulsatility index (PI) and peak systolic velocity (PSV) from 12 to 38 weeks' gestation.

Methods

The data for this study were obtained from the National Institutes of Health-funded Human Placenta Project. Eligible for inclusion were women aged 18-35 years, with a body mass index of <  30 kg/m², without comorbidities, with a singleton pregnancy conceived spontaneously and a gestational age of ≤ 13 + 6 weeks. Exclusion criteria were maternal or neonatal complications, fetal or umbilical cord anomalies, abnormal placental implantation and delivery <  37 weeks. Each participant underwent eight ultrasound examinations during pregnancy. Using SMI technology, the total number of IVA identified was recorded in a sagittal placental section at the level of cord insertion. The PI and PSV were measured in a total of six IVA (two in the central portion of the placenta, two peripherally towards the uterine fundal portion and two peripherally towards the lower uterine segment). Umbilical artery (UA)-PI was also obtained. Multilevel regression models were used to create reference ranges for IVA-PI and IVA-PSV at 12-38 weeks' gestation.

Results

A total of 90 women fulfilled the study criteria. IVA-PI decreased throughout pregnancy from a mean ± SD of 1.04 ± 0.23 in the first trimester (at 12-13 weeks) …

American Heart Association Blood Pressure Classification And Subsequent Risk Of Preeclampsia, Rebecca Horgan, Erkan Kalafat, Elena Sinkovskaya, Alfred Abuhamad, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: In 2017, the American Heart Association (AHA) and American College of Cardiology updated their hypertension guidelines for the nonpregnant population, lowering the diagnostic thresholds to systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. This reclassification has raised important questions regarding whether blood pressure (BP) values previously considered within the normal range in pregnancy may, in fact, confer an increased risk for hypertensive disorders of pregnancy (HDPs).

Objective: To evaluate the association between first-trimester BP classified by AHA thresholds and the subsequent development of HDPs.

Study design: This was a secondary analysis of a prospective, multicenter cohort …

Treatment Effects Of Genital Mycoplasma Species In High-Risk Pregnant Individuals: A Retrospective Cohort Study, Takashi Yoshimasu, Tasuku Inao, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

We aimed to estimate the causal effect of treatment for genital Mycoplasma species on preterm birth (PTB) and spontaneous abortion (SA). We also evaluated treatment effects separately for cases with co-infection of Ureaplasma and Mycoplasma species.

Methods

This was a retrospective observational cohort study at a single center. Singleton mothers with one or more risk factors for PTBs were screened and treated for genital Mycoplasma species. The treatment was repeated based on polymerase chain reaction (PCR) results after each course. We applied inverse probability treatment weighting, and risk differences (RDs) of the treatment effect on pregnancy outcomes were estimated …

A Rare Complication Of Dilation And Evacuation: Unrecognized Extrauterine Retained Products Of Conception, Aviana Terschueren, Lauren Siewertsz Van Reesema, Joseph Hudgens

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Surgical abortions, including dilation and evacuation, are among the safest gynecological procedures, with complication rates ranging from 0.5–4.0%. Uterine perforation, though rare (0.2–0.8%), can result in serious sequela, including translocation of retained products of conception into the abdominal cavity. We present a rare case of abdominal retained products of conception following a second-trimester dilation and evacuation.

Case Report: A 29-year-old G3P1112 underwent an elective surgical abortion at 17 weeks’ gestation, complicated by hemorrhage necessitating transfer to an outside hospital. She was treated with uterotonics and a blood transfusion and was discharged after a 6-day hospitalization. Initial transvaginal ultrasound showed …