Medicine and Health Sciences Commons^™

Pm25 Metal Constituent Exposure And Stillbirth Risk In Harris County, Texas, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Elaine Symanski

Faculty, Staff and Student Publications

There is limited evidence on the role of exposure to chemical constituents of fine particulate matter (PM

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 …

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 …

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.

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 …

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 Departmental Research

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

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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, Amelia K. Boehme, E. Sander Connolly, Alexander M. Friedman, Mitchell S.V. Elkind, Joshua Z. Willey, Eliza C. Miller

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 …

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

A Practical Understanding Of Preeclampsia For A Nurse In A Third World Setting, Anna Lovin

Senior Honors Theses

Preeclampsia is a disease of pregnancy that affects approximately 3-5% of women with child. It is one of the primary causes of mortality in mothers and babies across the globe. The exact cause, pathogenesis, or disease progression is unknown. Therefore, there is no definition of which patients are at risk for developing preeclampsia and what can work as a preventative measure. In high socioeconomic settings where there is good healthcare, standard treatment is established to manage the symptoms and decrease the progression of preeclampsia to eclampsia. However, in more rural, third-world settings of developing countries, caring for patients with preeclampsia …

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Senior Honors Theses

Women's health care professionals, such as general physicians, obstetricians and gynecologists, midwives, nurses, and doulas, in the US need to be aware of cultural issues and disparities. Minorities and migrant women experience cultural challenges and disparities when receiving health care in the US. Without cultural sensitivity, patient care is compromised. Pregnancy and childbirth practices vary widely by culture, and potential differences in perspectives, beliefs, and treatment of these are critical issues for women’s health care professionals to study. Female genital cutting (FGC), obstetric fistulas (OF), and female cancer are also discussed in this paper.

Online Video Instruction On Hand Expression Of Colostrum In Pregnancy Is An Effective Educational Tool, Therese A. O'Sullivan, Joy Cooke, Chris Mccafferty, Roslyn Giglia

Research outputs 2014 to 2021

The use of antenatal colostrum expression in the weeks prior to birth may help improve long-term breastfeeding, but few large-scale studies exist. Typically, antenatal colostrum expression instruction relies on face-to-face education, making large interventions costly. We aimed to determine whether an expert online instructional video can improve knowledge and confidence around antenatal colostrum expressing. Pregnant women were asked to complete a questionnaire pre- and post-watching the instructional video online. Ninety five pregnant women completed both pre- and post-questionnaires. Total antenatal colostrum expression knowledge scores improved after watching the video, from a mean of 3.05 ± 1.70 correct out of a …

Why Doula Services Should Become An Essential Health Benefit In New York State, Jalisha Hanshaw, Amy White

Publications and Research

Doulas are birth workers who assist expecting mothers through pregnancy, birth and postpartum using holistic techniques. Techniques include: prenatal yoga, birth affirmations and induction acupuncture. Doulas are underrated healthcare providers who deserve the same respect as clinical and non-clinical providers. Doulas are well-rounded alternative care providers who focus on mental, emotional, and physical well being of mothers. Also, they know special alternative medical techniques that prevent mothers from maternal mortality among other negative health outcomes. The amount of time and effort doulas perform with expecting mothers are equal or more than the average medical healthcare provider and should be a …

Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd

Journal of Health Disparities Research and Practice

In an exploratory study, a convenience sample of 148 pregnant women was recruited from a WIC clinic in the southeast region of the U.S. to: 1) Examine and compare daily nutrient and food group intakes of WIC pregnant women to national guidelines, and; 2) Determine racial/ethnic differences in nutrient and food group intakes among WIC pregnant women. Women were selected for the study if they were: ≥ 18 y, in 2^nd trimester of pregnancy, and if they spoke English or Spanish as a first language. Upon recruitment, participants were interviewed to collect information on their socio-demographics, including race/ethnicity. Additionally, …

Psychometric Development Of The Patient Engagement In Prenatal Care Scale, Phyllis M. Dyess-Nugent

Nursing Theses and Dissertations

The value of prenatal care in improving maternal and neonatal outcomes has been evident in research for many years, and yet in the U.S. where prenatal care is widely accessible to women, maternal and neonatal morbidity and mortality remain higher than many developing countries (CDC, 2019). Attributes of prenatal care have been studied, such as the number of visits and timing of entry into care. Additional aspects of prenatal care deserve exploration in order to make improvements in this established, valuable intervention. A woman’s engagement in her care during pregnancy has not been previously measured. The focus of this dissertation …

Evaluation Of A Tennessee Statewide Initiative To Reduce Early Elective Deliveries Using Quasi-Experimental Methods, Michael P. Thompson, Ilana Graetz, Caitlin N. Mckillop, Peter H. Grubb, Teresa M. Waters

Health Management and Policy Faculty Publications

Background: Concerted quality improvement (QI) efforts have been taken to discourage the practice of early elective deliveries (EEDs), but few studies have robustly examined the impact of directed QI interventions in reducing EED practices. Using quasi-experimental methods, we sought to evaluate the impact of a statewide QI intervention to reduce the practice of EEDs.

Methods: Retrospective cohort study of vital records data (2007 to 2013) for all singleton births occurring ≥36 weeks in 66 Tennessee hospitals grouped into three QI cohorts. We used interrupted-time series to estimate the effect of the QI intervention on the likelihood of an EED birth …

Evaluation Of The Drug Utilization Pattern Among Pregnant Women In A Tertiary Care Teaching Hospital, Vijaynarayana Kunhikatta

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Objective of the study was to evaluate the drug utilization pattern in pregnancy. A retrospective study conducted among pregnant women in a tertiary care teaching hospital. Parameters like demography, gravidity, complaints on admission, clinical signs and symptoms, comorbid conditions, drugs prescribed and its utilization details and neonatal outcome were collected. Study included 876 pregnant women. The mean age of the study population was 29.4±4.4 (mean±SD). Majority of them (68.2%) had caesarian section type of delivery. Diabetes mellitus (33.6%) was the most common comorbidity, followed by hypertension (28.3%) and thyroid disorders (18.3%). Folic acid (15.7%) and calcium (15.2%), were the most …

Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

Takotsubo Cardiomyopathy In Pregnancy: A Case Report And Literature Review, Felix Oindi, Evan Sequeira, Herman Ryan Sequeira, Steve Mutiso

Obstetrics and Gynaecology, East Africa

Background: Takotsubo cardiomyopathy is rare in pregnancy and is characterized by left ventricular dysfunction with apical ballooning. This transient cardiac dysfunction may affect women of childbearing age in the antepartum, intrapartum or postpartum period. Most patients respond well to medical management with resolution of cardiac dysfunction within weeks.

Case presentation: A 35-year-old female in her second pregnancy presented with severe preeclampsia at 31 weeks of gestation. She subsequently developed severe substernal chest pain and workup showed a stress induced cardiomyopathy prior to her delivery via caesarean section. She had full recovery of her cardiac function by 12 weeks postpartum after …

Shamshur, Shamshur, Tsos

TSOS Interview Gallery

Shamshur has been in Cox’s Bazaar for 8 months and works in Hope Hospital (the camp hospital) as a traditional birth attendant. In addition, she makes house calls to pregnant women throughout the camp who are fearful of hospitals due to past trauma and sexual torture. Shamshur has nine children and a husband who is in prison.

Nidar, Nidar, Tsos

TSOS Interview Gallery

Nidar has been in Cox’s Bazaar for 8 months and works in Hope Hospital (the camp hospital) as a traditional birth attendant. In addition, she makes house calls to pregnant women throughout the camp who are fearful of hospitals due to past trauma and sexual torture. Nidar has two children and a husband who fell victim to war.

Shobika, Shobika, Tsos

TSOS Interview Gallery

Shobika escaped Myanmar amid widespread chaos. After being separated from her husband and experiencing the kidnap of her two children, she was raped by soldiers and became pregnant. Her husband now rejects this child.

Januka, Januka, Tsos

TSOS Interview Gallery

After being raped by a soldier in Myanmar, Januka fled to Bangladesh with her father and later found out she was pregnant. She fears no one will want to marry her because she has been raped.

Rohima, Rohima, Tsos

TSOS Interview Gallery

Rohima was brutally raped and tortured by soldiers during an attack. After witnessing other women receive the same treatment, she fled Myanmar for Cox’s Bazar, Bangladesh. Once there, she got married while pregnant as a result of the rape.