Medicine and Health Sciences Commons^™

Anticipation, Accompaniment, And A Good Death In Perinatal Care., Bryanna S. Moore, Brian S. Carter, Bryan Beaven, Katie House, Joel House

Manuscripts, Articles, Book Chapters and Other Papers

The ethics of perinatal care, and the experiences of families who receive such care, remains a nascent area of inquiry. It can be hard to see how existing "good death" constructs apply to the experiences of fetal patients and their families. In this paper, we explore two themes raised by a case at our fetal health center: anticipation and accompaniment. In this case, a mother presented to our fetal health center; her unborn son, our fetal patient, was diagnosed with life-threatening hypoplastic left heart syndrome and endocardial fibroelastosis. The parents were told that their son's life expectancy, upon birth, was …

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Publications

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …

Postpartum Pains, Lakea Youngblood

Capstones

The Academy once again came under fire. This time for banning a commercial that advertised a postpartum support. People all over the country became enraged. The Academy seemed more friendly to movies about murder than postpartum, in alignment with the sexist ideas that have been pervasive in this country since its foundations. This short documentary pushes back against this narrative and the silence around postpartum by showing the realities of it through a woman’s journey.

The film is a personal documentary about myself. After having my first child, I found myself traumatized and scarred by the pains of postpartum. Because …

Exploration Of Naturopathic Medicine For Pregnant And Laboring Women, Megan Latreille

Honors Projects

Exploration of natural medicine has become increasingly common among individuals. With proper use, natural medicine can help treat many common ailments experienced during pregnancy, delivery, and postpartum. This paper serves to shed light on naturopathic medicinal techniques for expectant mothers and families, so that they may implement such in their own lives throughout pregnancy, during labor, and after birth. Yoga can be adapted and utilized during antenatal and postpartum periods to help with stress levels, depression, and physical health. Hypnosis, meditation, and hypnobirthing provide similar effects such as decreased stress and increased contentment; promoting a smoother and more effective labor …

Ricketts, Hunter Christian, B. 1997 (Fa 1382), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 1382. Project completed by Hunter Ricketts in fall 2019 regarding Mennonite health practices as part of a WKU folk studies class on Field Methods in Ethnography.

Las Dos Cosas Versus Exclusive Breastfeeding: A Culturally And Linguistically Exploratory Intervention Study In Hispanic Mothers Living In Kentucky, Ana Maria Linares, Diana Cartagena, Mary Kay Rayens

Nursing Faculty Publications

INTRODUCTION: Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months.

METHODS: A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth.

RESULTS: After the study, women assigned to …

Prenatal Yoga In Pregnancy, Ashleigh Clingenpeel

Senior Honors Theses

Prenatal yoga has emerged as an advisable, beneficial, and supportive addition to birth preparation. Many studies have linked participation in prenatal yoga with both maternal and infant benefits. Physical benefits for the mother include decreased labor time, decreased labor pain, and improved comfort during pregnancy. Significant emotional and mental effects have also been correlated, such as lowered rates of depression and anxiety, increased self-efficacy in labor, and easier transitions into the postpartum period. Finally, prenatal yoga has demonstrated benefits to the neonate, with a greater number of vaginal deliveries, which are less traumatic for the infant, an increase in gestational …

Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore

Journal of Patient-Centered Research and Reviews

Purpose: Smoking during pregnancy can have dire consequences for both the baby and mother. Low-income pregnant women smoke at particularly high rates. Among women who quit during pregnancy, postpartum relapse is high. This randomized control trial tested the effect of adding postpartum assistance to an existing smoking cessation program (First Breath) designed for low-income women.

Methods: Of 185 study participants, 94 women were randomly assigned to the standard First Breath program (control) and 91 to an enhanced program. First Breath consisted of evidence-based smoking cessation counseling provided at every prenatal visit. The enhanced program included all First Breath services plus …

Methodology For Sampling Women At High Maternal Risk In Administrative Data, Jennifer Vanderlaan, Anne Dunlop, Roger Rochat, Bryan Williams, Susan E. Shapiro

Nursing Faculty Publications

Background: In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to consider and inability to distinguish between maternal and fetal risks. High maternal risk sample selection may be improved by using the Obstetric Comorbidity Index (OCI), a system of risk scoring based on weighting comorbidities associated with maternal end organ damage. The purpose of this study was to compare the net benefit of using OCI risk scoring vs …

Neonatal Abstinence Syndrome From Selective Serotonin Reuptake Inhibitor Use During Pregnancy, Elizabeth Kramer, Maria Patnella, Rachel Bulko, Allie Harrison, Hannah Lamb, Manoranjan D'Souza

Pharmacy and Wellness Review

Neonatal abstinence syndrome (NAS) is a concern for infants born to mothers receiving treatment with a selective serotonin reuptake inhibitor (SSRI) throughout the pregnancy. The risk of NAS associated with SSRI use during pregnancy varies with the specific SSRI that is used by the patient during pregnancy. Common symptoms of NAS include premature delivery, gastrointestinal disturbances, irritability, low birth weight, short length and lack of response to various stimuli. Neonates that present with these symptoms can be scored using either the Finnegan or Lipsitz scoring tools. Neonates experiencing NAS can be calmed or treated using nonpharmacologic methods such as swaddling, …

Pharmacists' Role In Preconception Care, Kelsey Weisenburger, Jamie Kellner, Hannah Granger, Natalie A. Dipietro Mager

Pharmacy and Wellness Review

Within the current health care system, preconception care is often a misunderstood topic and, in many cases, a missed opportunity to improve women's health and decrease adverse pregnancy outcomes. It is important that preconception care is delivered to all women of childbearing age, regardless of pregnancy intentions, as the interventions associated with preconception care can help improve a woman's health overall. In 2006, the Centers for Disease Control and Prevention (CDC) released four goals, 10 recommendations, and 14 evidence-based interventions regarding preconception care. Pharmacists can have a significant role in ensuring preconception care for all women through the application of …

Routine Late Trimester Ultrasound For The Detection Ofsmall-For-Gestational-Age And Growth-Restricted Fetus Inlow-Risk Pregnancy: A Randomised Controlled Trial, Sikolia Wanyonyi, Doreen Osoro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To compare the proportion of small-for-gestational-age and fetal growth-restricted fetuses detected in women offered a routine growth ultrasound to those either offered selective or no ultrasound in the third trimester.

Methods: An open-label randomised control trial was conducted at the Aga Khan University Hospital, Nairobi. Eligible women were randomised into either the intervention or control group. Women in the intervention arm had a mandatory third trimester ultrasound for fetal growth performed between 36 weeks 0 days to 37 weeks 6 days. Those in the control group had a selective growth scan done if the clinician suspected abnormal fetal growth. …

Cervical Assessment By Ultrasound For Preventing Preterm Delivery., Vincenzo Berghella, Gabriele Saccone

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Measurement of cervical length by ultrasound is predictive of preterm birth (PTB). There are three methods of ultrasound cervical assessment: transvaginal (TVU), transabdominal (TAU), and transperineal (TPU, also called translabial). Cervical length measured by TVU is a relatively new screening test, and has been associated with better prediction of PTB than previously available tests. It is unclear if cervical length measured by ultrasound is effective for preventing PTB. This is an update of a review last published in 2013.

OBJECTIVES: To assess the effectiveness of antenatal management based on transvaginal, transabdominal, and transperineal (also called translabial) ultrasound screening of …

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.

Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills

Doctoral Dissertations and Projects

Traditional prenatal care has been the stalwart of care in the United States since the 1920s; however, a new model of care is emerging: group-style prenatal care. This model of care has been well-documented within literature as having notable maternal and fetal outcomes, including increased patient satisfaction, decreased preterm birth rates, increased breastfeeding rates, and increased patient compliance, to name only a few. With such remarkable outcomes, it begs the question of why the group prenatal care model is not more widely utilized. This project aimed to determine if increasing the knowledge of healthcare providers in a private obstetrics practice …

Adolescent Pregnancy: A Clinical Guideline For School Nurses In New Mexico, Karin Ludi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this project is to ensure that school nurses and health assistants are knowledgeable and have the resources to care for pregnant adolescents in the public school system. New Mexico has consistently ranked in the top 10 in the United States for teen births to women aged 15-19 years. The New Mexico School Health Manual is currently used to guide school nurses and health assistants in the care of pregnant adolescents, but it is vague and addresses emergencies such as labor and bleeding.

From this author’s experience as a school nurse in the public school system, it …

Preeclampsia, Melissa Mcguire

Nursing Student Class Projects (Formerly MSN)

Abstract

Preeclampsia is a complication of pregnancy that if left untreated could result in maternal and/or fetal death. Preeclampsia is a pregnancy specific disorder that can affect many different body systems. That pathophysiology of preeclampsia is not completely known, but alterations in placentation are thought to cause the disorder. Signs and symptoms of preeclampsia include: elevated blood pressure, blurred or double vision, epigastric pain, severe headache, proteinuria, thrombocytopenia, kidney failure, and liver failure. Preeclampsia with severe features can lead to the development of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), disseminated intravascular coagulation, and eclampsia. The only cure for …

Fetal Fibronectin Testing For Reducing The Risk Of Preterm Birth., Vincenzo Berghella, Gabriele Saccone

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Fetal fibronectin (FFN) is an extracellular matrix glycoprotein localized at the maternal-fetal interface of the amniotic membranes, between chorion and decidua, where it is concentrated in this area between decidua and trophoblast. In normal conditions, FFN is found at very low levels in cervicovaginal secretions. Levels greater than or equal to 50 ng/mL at or after 22 weeks have been associated with an increased risk of spontaneous preterm birth. In fact, FFN is one of the best predictors of preterm birth in all populations studied so far, and can help in selecting which women are at significant risk for …

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

Assessment Of Post-Discharge Health Care Utilization In Infants With Neonatal Opioid Withdrawal Syndrome, Shikhar Shrestha

Pharmaceutical Sciences ETDs

Background/Objectives: Children born to mothers with opioid use disorder often show withdrawal effects characterized by increased stress, hyperirritability, tremors, tachycardia, sleep deprivation, and gastrointestinal discomfort, commonly known as “neonatal opioid withdrawal syndrome” (NOWS). Studies have shown that the effect of NOWS can lead to several health-related disorders later in life leading to increased health care utilization. However, detailed study of post-discharge health care utilization, specifically focusing on encounters with the health care system is currently lacking in the literature. Our objective was to evaluate health care utilization in infants who were diagnosed with NOWS during a one-year follow-up period after …

Improving Maternal Outcomes Through Labetalol Algorithm Utilization For Hypertensive Disorders Of Pregnancy, Hailee B. Taylor

Dissertations

Hypertensive disorders of pregnancy can have negative effects on both mothers and neonates and are a major contributor to the increasing morbidity and mortality affecting women pregnant women in the United States. Treatment algorithms are available for treatment of hypertensive disorders of pregnancy when treatment criteria are met. With proper use of these algorithms, healthcare personnel can decrease the mortality and morbidity rates, which will increase patient safety and decrease healthcare spending. This research project focused on implementing The American College of Obstetricians and Gynecologists’ (ACOG) Labetalol treatment algorithm to treat patients diagnosed with severe preeclampsia. Prior to implementation, data …

The Association Between Maternal Obesity And Fetal Size For Gestational Age In Singletons And Twins, Shohi Prajapati

Electronic Thesis and Dissertation Repository

Maternal obesity and multiple births have adverse effects on fetal growth; prevalence of both are increasing in Canada. We explored associations between maternal obesity and infant size for gestational age using data from a London perinatal database. Birthweight for gestational age was assessed using standards published by Robertson (2002) to classify Small for Gestational Age (SGA) and Large for Gestational Age (LGA) in 30396 singletons and 1346 twins. Associations were estimated using logistic regression for singletons and the GEE extension of logistic regression for twins. Increased maternal pre-pregnancy BMI was statistically significantly associated with decreased odds of SGA in singletons …

Spousal Factors Associated With Antenatal Psychosocial Stress: A Case Control Study, Asha K. V Ms

Manipal Journal of Nursing and Health Sciences

Stress during pregnancy affects both mother and foetus resulting in unfavourable pregnancy outcomes. Studies regarding the factors linked with increased stress during pregnancy aids to improve the mental status of the mother during gestation and can lead to a reduction in negative pregnancy outcomes. The objective of the study was to identify spousal factors associated with antenatal psychosocial stress among pregnant women seeking prenatal care from a teaching hospital at the Thiruvananthapuram district of Kerala. Methods: Case control design was used for the study. The tools used for data collection were the Antenatal Psychosocial Stress scale (APSS) and a semi-structured …

Effect Of Pregnancy On Growth Of Intracranial Meningiomas, Ayesha Quddusi, Muhammad Shahzad Shamim, Quratulain Virani

Section of Neurosurgery

Meningiomas are the most common benign primary intracranial tumours in adults. Their rapid growth during pregnancy has been well reported. Moreover, the relationship of increased progesterone expression during pregnancy and extensive tumour growth has been debated. In this review, we discuss not only the effect of progesterone on meningiomal growth but also other mechanisms involved in gestational meningiomas.

Placental Micrornas In Pregnancies With Early Onset Intrauterine Growth Restriction And Preeclampsia: Potential Impact On Gene Expression And Pathophysiology., Zain Awamleh, Gregory B Gloor, Victor K M Han

Paediatrics Publications

BACKGROUND:
A normally developed placenta is integral to a successful pregnancy. Preeclampsia (PE) and intrauterine growth restriction (IUGR) are two common pregnancy related complications that maybe a result of abnormal placental development. Placental microRNAs (miRNAs) have been investigated as potential biomarkers for these complications, as they may play a role in placental development and pathophysiology by influencing gene expression. The purpose of this study is to utilize next-generation sequencing to determine miRNA and gene expression in human placental (chorionic villous) samples from three distinct patient groups with early-onset (EO) PE, IUGR, or PE + IUGR.

METHODS:
Placental tissues were collected …

Marta, Marta, Tsos

TSOS Interview Gallery

Marta is a member of the support community for Central American refugees arriving in the southwest US. In this interview, Marta shares her own story of crossing the border at a young age with her daughter and her life in the US. Marta was self-employed for many years and later went on to serve in the US Army in Iraq. For the last 9 months, she and her husband Israel and son Josue have worked tirelessly to help make sure the current refugees arriving are cared for after they are released from detention centers and begin their lives in the …

“I Am A Runner”: A Qualitative Analysis Of Women-Runners’ Pregnancy Experiences, Jennifer M. Ohlendorf, Anna L. Anklam, Lindsay Gardner

College of Nursing Faculty Research and Publications

Background

Women runners are a group with potential for health maintenance and health promotion in pregnancy. When providers counsel women to discontinue or cut back on running without cause, an opportunity for health benefits to both woman and baby may be lost.

Aim

This study aims to explicate the experience women runners have in pregnancy to further providers’ understanding of this population’s unique needs.

Methods

An online, qualitative inquiry was employed to explore the experiences of an online community of women runners in pregnancy (N = 22). The Doing Pregnancy framework provided guidance for final stages of the analysis.

Findings …

Chemotherapy Is Avoided During The First Trimester Of Pregnancy, When Is The Safest Time To Start Treatment During The Second Or Third Trimester?, Elyce Cardonick, Emily Eicheldinger, John P. Gaughan

Cooper Medical School of Rowan University Faculty Scholarship

ABSTRACT

Background

Cancer occurs in approximately 1:1000 pregnancies. When chemotherapy cannot be delayed until postpartum, beginning chemotherapy is based on presumed safety after organogenesis is completed during the first trimester. The safest gestational age to start chemotherapy after the first trimester is unknown.

Patients and Methods

In an observational cohort of pregnant women diagnosed and treated for cancer at multiple centers, pregnancy outcomes for the mother, and clinical outcomes for the neonate were analyzed according to the gestational age in weeks of pregnancy at first chemotherapy cycle. Outcomes including birth weight, fetal growth restriction, congenital malformations, and perinatal complications for …

Labor Management Protocol For Parturients On Buprenorphine, Erik Sanders

Doctor of Nursing Practice Projects

...

Opioid dependence during pregnancy may lead to negative outcomes for both the parturient and the fetus. Opioid dependent parturients are often prescribed buprenorphine, a form of medication- assisted therapy. The use of buprenorphine within the parturient population is a relatively new practice and anesthesia providers are encountering difficulties in managing this population during the peripartum period. Literature has demonstrated anesthesia providers may best serve this population by utilizing a multimodal approach when providing analgesia (Jones et al., 2008; Meyer et al., 2010; Reddy et al., 2017). A combination of oral, intravenous and neuraxial modalities, in conjunction with the daily …

Maternal Morbidity Outcomes In Idiopathic Moyamoya Syndrome In New York State, Hajere J. Gatollari Mph, Amelia K. Boehme Ph.D., E. Sander Connolly M.D., Alexander M. Friedman M.D., Mitchell S.V. Elkind M.D., Joshua Z. Willey M.D., Eliza C. Miller M.D.

Rowan-Virtua Research Day

Background: Pregnancy is associated with an increased risk of stroke in young women. Idiopathic moyamoya syndrome (IMMS) is a rare condition characterized by progressive narrowing of large cerebral arteries resulting in flimsy collaterals prone to rupture or thrombosis. Data are limited on pregnancy outcomes in women with IMMS. We hypothesized that IMMS would be associated with increased pregnancy morbidity, including stroke.

Conclusion: Pregnancies within 1 year prior or any time after IMMS diagnosis did not have increased maternal morbidity compared to unexposed pregnancies after adjusting for age and clustering of women with multiple pregnancies. Prospective studies are needed to better …