Medicine and Health Sciences Commons^™

Buprenorphine/Suboxone Is Safe In Pregnancy: Substance Use And Stigma In The Healthcare Professions, Blake S. Sanford

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Mullins N, Galvin SL, Ramage M, et al. Buprenorphine and Naloxone Versus Buprenorphine for Opioid Use Disorder in Pregnancy: A Cohort Study. J Addict Med. 2020;14(3):185-192. https://doi.org/10.1097/ADM.0000000000000562

for a woman with opioid use disorder during pregnancy.

Examining Gestational Diabetes Mellitus Educational Resources: Patient And Provider Perspectives, Allison F. Peebles, Morgan E. Cooley, Rose A. Maxwell

Student Scholarship

Objective: To analyze the effectiveness of gestational diabetes mellitus (GDM) education as well as patient and provider confidence in education practices. Study

Design: Women with a diagnosis of GDM who delivered at Miami Valley Hospital were included in the study. Patients were asked to complete a questionnaire to evaluate their knowledge and confidence in managing their GDM. Providers were asked to complete a questionnaire to provide their perspective on patient education related to GDM.

Results: Patients correctly identified 66% of the correct ways that GDM affects maternal health, fetal health, and pregnancy complications. Patients felt empowered by their education and …

The Relationship Between Self-Efficacy And Informed Decision-Making On Primiparous Women During The Birthing Process, Morgan R. Fillipo

Nursing | Senior Theses

Childbirth is a very intense and vulnerable experience, especially for first-time mothers. Across the globe, the prevalence of traumatic and unsatisfying births has become an increasingly troublesome issue for women. There is extensive evidence of maltreatment, and a large portion of the problem has to do with the client’s medical team. To combat this dilemma, the best course of action would be to prepare women for this possibility by increasing the client’s self-efficacy and decision-making abilities. Self-efficacy, also known as confidence in one’s skills, is an important trait to have when it comes to patients being able to advocate for …

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

One Man's Pregnancy Story, Yvonne S. Marquez, Paige A. Perez

Capstones

Pregnancy is a challenging time for anyone. For LGBTQ people there are unique obstacles that make it especially difficult to navigate a medical system that was not built for them. Finn Schubert is trans and six months pregnant. He’s loving the experience but stressed by insurance claim denials, concerns for his safety, and medical incompetence.

This capstone project includes a 20-minute documentary, text, and a photo essay.

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Exposure To Family Planning Messages And Teenage Pregnancy: Results From The 2017 Philippine National Demographic And Health Survey, Veincent Christian F. Pepito, Arianna Maever L. Amit, Clinton S. Tang, Luis Miguel B. Co, Neil Andrew K. Aliazas, Sarah J. De Los Reyes, Raymundo S. Baquiran, Lourdes Bernadette S. Tanchanco

Ateneo School of Medicine and Public Health Publications

Background

Teenage pregnancy is known to have physical, emotional, and psychosocial effects. Because of these risks, family planning and contraception messages have been disseminated in various forms of media, but their association with teenage pregnancy has not been studied previously in the Philippines. This study aims to examine the association between exposure to various family planning and contraception messages disseminated in various media channels and pregnancy among Filipino women aged 15–19. The study also intended to examine interactions between the different media channels where these family planning and contraception messages are being disseminated on their effect on teenage pregnancy.

Methods …

Circumcision For The Male Infant: Patient Education And Cultural Humility, Grace E. Eisenbiegler

Family Medicine Clerkship Student Projects

Male circumcision is a religious and cultural decision that has become increasingly medicalized. Many families make decisions about circumcision based on culture and family without true informed consent. There is a need for unbiased information, prior to delivery, about circumcision, so that families may make an informed decision that is right for them. A one page document was created as an addition to the clinic's pregnancy guide with information on risks and benefits of circumcision, complications associated with the uncircumcised penis, cultural significance, and care of the uncircumcised penis.

Maternal Health Care Professionals’ Experiences And Views On The Use Of Obstetric Ultrasound In Rwanda: A Cross-Sectional Study, Ingrid Mogren, Joseph Ntaganira, Jean Paul Semasaka Sengoma, Sophia Holmlund, Rhonda Small, Lan Pham Thi, Hussein Lesio Kidanto, Matilda Ngarina, Cecilia Bergström, Kristina Edvardsson

Faculty of Health Sciences, East Africa

Background This study, undertaken in Rwanda, aimed to investigate health professionals’ experiences and views on the following topics: current clinical guidelines for ultrasound from second trimester at the clinic, regional and national levels, and adherence to clinical guidelines; medically indicated ultrasound examinations; non-medical use of ultrasound including ultrasounds on maternal request; commercialisation of ultrasound; the value of ultrasound in relation to other clinical examinations in pregnancy; and ultrasound and medicalisation of pregnancy.

Methods A cross-sectional design was adopted. Health professionals providing antenatal care and delivery services to pregnant women in 108 health facilities were invited to complete a survey, which …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Barriers To Healthy Births At Nigerian Hospitals, Caroline Johnston

Senior Theses

Maternal mortality is a problem everywhere, but it is especially dangerous in Nigeria where the average woman experiences pregnancy six times during her lifetime (Population Reference Bureau, 2001). Many researchers focus on the medical complications associated with labor, such as hemorrhage, eclampsia, or infection. Although these birth complications are the direct sources of maternal death, it is also important to recognize how maternal mortality is a multifaceted issue influenced by local cultural groups, religions, politics, poverty level and the absence of basic infrastructures. Although maternal mortality is interconnected with social and geographical elements, my paper concentrates on Nigerian hospitals and …

Community Resources Addressing Peripartum Depression, Tiffany L. Lao

Family Medicine Clerkship Student Projects

Peripartum mood disorders affect a large proportion of new mothers as well as their families, partners, and support systems. This project aims to provide patients with information about peripartum mood disorders as part of their initial prenatal packet. Also included are a list of local community resources specifically addressing peripartum mood disorders for patients seeking additional support outside of their primary care office.

Factors Associated With Influenza & Tdap Vaccine Uptake In Pregnant Patients At The Ut Family Medicine Clinic In Memphis, Rachel Woods, Alison Zhong, Madelyn Vincent

Longitudinal Scholar's Project

INTRODUCTION: Given the increased risk for infections among pregnant patients and newborns, vaccination against influenza (>50,000,000 annual US cases affecting all ages) and pertussis (>15,000 annual US cases disproportionately affecting newborns) are recommended among pregnant patients in order to protect them and their babies via passive immunity to cover a newborn’s window of vaccine ineligibility. Though flu and Tdap vaccination rates among pregnant patients have been trending upwards nationally, there is still room for improvement to achieve optimal rates.

OBJECTIVES: The primary objectives were to study factors that affect the vaccination rates at the University of Tennessee Family …

Prevalence Of Illicit Tobacco Use And Tobacco Tax Avoidance In Pregnancy, Brendan P. Mcdonnell, Robert Mccausland, Sheila Keogan, Luke Clancy, Carmen Regan

Articles

Background Smoking during pregnancy is associated with adverse maternal and fetal outcomes. Tobacco tax avoidance and tax evasion undermine the effectiveness of tobacco tax policies, resulting in cheaper prices for smokers and increased tobacco usage. Aims The purpose of this study was to explore the purchasing habits of pregnant smokers with regard to tobacco expenditure and
use of illicit tobacco. Methods Prospective cohort study. Face to face interviews were conducted with 90 attendees (age range 18–42 years; mean age
28 years) of a smoking cessation antenatal clinic in a large Irish tertiary level maternity hospital. Information regarding smoking habits, quantity …

Resource To Address Pandemic-Related Anxiety And Depression For Pregnant Patients In Vermont, Mohammed Wali

Family Medicine Clerkship Student Projects

The 2019 novel coronavirus (COVID-19) has led to patient deaths, strained health care systems, and economic uncertainty. Distress during pregnancy can lead to adverse outcomes for both parent and baby. A patient-friendly handout was created for pregnant patients to offer reassurance, incorporate mind-body recommendations to address stress, and offer screening tools to empower them to address mood concerns with their obstetric providers in the COVID-era.

Nsaid Use Increases Risk Of Miscarriage In Early Pregnancy, Leigh Durudogan

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Li D, Ferber J, Odouli R, Quesenberry C. Use of nonsteroidal anti-inflammatory drugs during pregnancy and the risk of miscarriage. Am J Ob Gyn. 2018; 219(3): 275.e1–275.e8. doi: 10.1016/j.ajog.2018.06.002.

Nadolol In Pregnancy: A Medical Student’S Reflection On Her Pregnancy, Rebecca King-Mallory, Shawndra Barker, Kaitlin Mcgrogan, Adam M. Franks

Adam M. Franks, MD

Hypertension is a common concern during pregnancy. Beta-blockers are one potential treatment, but third trimester exposure has correlated with an increased risk of perinatal events. Nadolol, a nonselective beta blocker, has properties that differ from those of its selective counterparts, including longer half-life, decreased protein binding, and renal excretion in the unchanged form. There is very limited data on the use of nadolol during pregnancy, and its safety has not been completely evaluated. This case study documents the perinatal outcomes of nadolol use throughout a medical student’s pregnancy and explores the experience in obtaining and undergoing medical care.

Nadolol In Pregnancy: A Medical Student’S Reflection On Her Pregnancy, Rebecca King-Mallory, Shawndra Barker, Kaitlin Mcgrogan, Adam M. Franks

Marshall Journal of Medicine

Hypertension is a common concern during pregnancy. Beta-blockers are one potential treatment, but third trimester exposure has correlated with an increased risk of perinatal events. Nadolol, a nonselective beta blocker, has properties that differ from those of its selective counterparts, including longer half-life, decreased protein binding, and renal excretion in the unchanged form. There is very limited data on the use of nadolol during pregnancy, and its safety has not been completely evaluated. This case study documents the perinatal outcomes of nadolol use throughout a medical student’s pregnancy and explores the experience in obtaining and undergoing medical care.

Regular Exercise Throughout Pregnancy And Maternal Recovery Postpartum, Rachel Jenkins

Graduate Theses & Dissertations

Abstract

Introduction: The American College of Obstetricians and Gynecologists recommends that “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”1 Many pregnant mothers seek guidance regarding exercise regimens’ safety and efficacy. This paper is a systematic review of the current literature on the topic of exercise regimens performed throughout pregnancy and maternal postpartum recovery.

Purpose: To determine if following the American College of Obstetricians and Gynecologists recommendation to engage in regular aerobic and strength-conditioning exercises throughout pregnancy contributes to easier deliveries as measured by the number of caesarean sections, time …

Needs Assessment For Creating A Patient-Centered, Community-Engaged Health Program For Homeless Pregnant Women, Tegan Ake, Sabina Diehr, Leslie Ruffalo, Emily Farias, Ashton Fitzgerald, Samuel D. Good, Lindsay B. Howard, Stefan P. Kostelyna, Linda N. Meurer

Journal of Patient-Centered Research and Reviews

Purpose: Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs.

Methods: Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as …

Establishing A Pediatric Prenatal Visit At The Health Center (Thc) In Plainfield, Vt, Katherine Price

Family Medicine Clerkship Student Projects

The AAP has long recommended a prenatal visit as part of the continuum of well-child care. However, this visit is underutilized by new families. Most prenatal education focuses on labor and childbirth with little to no information about parenting and the postpartum period. The PRAMS VT Survey 2012-2014 identified “a class for new parents (parenting, not childbirth)” as a requested resource by respondents. The pediatric prenatal visit provides infant care guidance and can connect families with community organizations that provide postpartum education. The Health Center (THC) does not currently have an established pediatric prenatal visit for expecting parents.

Postpartum Contraception Education, Erin E. Hunt

Family Medicine Clerkship Student Projects

The current standard of practice for postpartum contraception in Plattsburgh, NY, as well as much of the United States, is initiation of contraception at the standard 6 week postpartum visit. However, many women may be better suited for immediate postpartum contraception while still hospitalized in labor and delivery. Long acting reversible birth control (LARC), including hormonal IUDs, copper IUDs, and progesterone implants, were the contraception types focused on in this project. Family medicine residents at CVPH reported low confidence in postpartum contraception as a whole. Furthermore, they reported limited knowledge on immediate postpartum contraception. The primary aim of this project …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

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 …

A Guide To Common Skin Disorders While Pregnant, Debra Henline Sullivan, Virginia Sullivan

Walden Faculty and Staff Publications

During pregnancy, mothers strive to maintain good health and to promote the health of their babies. Having a chronic or acute skin condition during pregnancy could cause fear that treating these conditions could cause harm to their unborn child (American Academy of Dermatology [AAD], 2016). Women will need and seek guidance before and during their pregnancies as well as during lactation, when skin disorders affect them. The childbirth educator would benefit from a basic knowledge base to answer questions that may arise regarding various skin problems during the childbirth experience. This article will define and discuss treatment for some of …

Counseling Pregnant Women On Marijuana Use, Theresa B. Flanagan

Family Medicine Clerkship Student Projects

Marijuana is the most commonly used illicit substance for pregnant women nationwide, with rates of use trending upward. Marijuana use in Penobscot County is elevated well above the national average, and is likely to continue to rise with the legalization of recreational marijuana in the state of Maine. Though the American Congress of Obstetricians and Gynecologists (ACOG) discourages marijuana use during pregnancy and breastfeeding, studies have shown that providers do not emphasize counseling pregnant patients on marijuana use. This project looked at provider practices and perceptions regarding marijuana use during pregnancy at the Center for Family Medicine at Eastern Maine …

Marijuana Use Counseling During Pregnancy, Adam Petchers

Family Medicine Clerkship Student Projects

Penobscot County, Maine has among the highest rates of marijuana use in the country, and Maine has recently voted to legalize recreational use of marijuana. Research has shown that pregnant women frequently seek out and are dissatisfied with information regarding the safety of marijuana use during pregnancy. We surveyed Family Medicine providers at the Center for Family Medicine at Eastern Maine Medical Center in Bangor Maine regarding their counseling of pregnant patients on the topic of marijuana use. From the results, we created an information sheet to aid providers in marijuana use counseling with pregnant women.

A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed

Jennifer Y Mak

The purpose of this study is to provide an in-depth understanding of ''What had happened to the urban minority female athletes who became pregnant while playing high school basketball?'' The study wanted to provide a qualitative analysis of rich narrative data collected from questionnaire interviews of two separate groups (one in Pittsburgh, the other in New York City). The findings of this study suggest that in fact urban female African-Americans athletes still received benefits from sports participation.

Resources For Moms: Opiate Use In Pregnancy, Amy Schumer

Family Medicine Clerkship Student Projects

Substance use in pregnancy is not uncommon and the use of substances increases the risk of complications during pregnancy. In Vermont, opiate use in pregnancy is increasing as well as the number of people seeking treatment for opiate misuse. This project was designed to give pregnant mothers using opiates an idea of what to expect during their pregnancy as well as the resources that are available to them in the Springfield, VT area.

Patient Awareness And Understanding Of Intrauterine Devices, Lindsey Marie Eastman

Family Medicine Clerkship Student Projects

Unintended pregnancy rates in the United States are near 50%, but use of safe and effective long-acting reversible contraception methods, such as intrauterine devices, remain low compared to worldwide rates. Common misconceptions about intrauterine devices likely contribute to this stark contrast in use prevalence. This project aimed to assess patient understanding, awareness, and perception of intrauterine devices at a Family Medicine office in Connecticut. A pamphlet that includes a summary of contraception methods was produced and distributed with the goal of increasing knowledge of intrauterine devices as well as other contraception methods for patients in the primary care setting.

Tdap Vaccination In Pregnancy, Melissa N. Rafferty

Family Medicine Clerkship Student Projects

Since Maine's incidence of pertussis is higher than the national average, primary prevention through vaccination is important to protect vulnerable populations such as newborns in the state. Maternal Tdap vaccination between 27 to 36 weeks of pregnancy is recommended by ACIP to boost placental IgG transmission to the fetus and prevent newborn morbidity and mortality. For quality improvement, maternal Tdap vaccination rates were examined at Eastern Maine Medical Center Family Medicine Center and Residency and an educational handout was developed.