Female Urogenital Diseases and Pregnancy Complications Commons^™

Abnormal Placentation With Placenta Accreta In A Post Ablation Pregnancy, Amanda Mirmanesh, Raechel Fockler, Woojin Chong

Rowan-Virtua Research Day

Placenta accreta spectrum (PAS) is a rare complication of pregnancy in which the placenta abnormally implants into, and in rarer cases, through the uterine wall which leads to increased maternal morbidity with risk of maternal mortality. PAS diagnosed at the time of delivery is associated with severe maternal morbidity largely due to elevated blood loss which can result in complications such as DIC and even maternal death. We present a case of a woman with PAS to reiterate the importance of close antepartum monitoring along with having a high suspicion for placenta accreta in a patient with risk factors, specifically …

Global Comparison Of Health Policies Focused On Gestational Diabetes: Recognizing Pertinent Gaps, Muskanjot Kaur, Isvita Marfatia, Samarth Gupta, Swetha Sundaram, Anudeep Deevi, Venkat Venkataraman

Rowan-Virtua Research Day

Introduction: Gestational diabetes mellitus (GDM) is a condition that affects 14.7% of women globally and occurs when a mother develops diabetes during the course of her pregnancy.1 Increased insulin resistance in pregnant mothers can lead to further complications, such as a larger baby, increased risk of the baby developing Type II diabetes, having low blood sugar, and even premature birth, which can lead to respiratory issues. The lack of policies in place to address GDM in various countries worldwide highlights the need for this literature. It is necessary to compile policies that are currently in place and to further discuss …

Ovarian Hemorrhagic Cyst In A 42-Year-Old Female Receiving Ivf, Aloysius Ibe, Francesca Dileonardo, Robin Lahr, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 42-year-old female who presented with lower abdominal/pelvic pain and diagnosed with an active hemorrhagic ovarian cyst after undergoing egg retrieval as part of in-vitro fertilization (IVF) treatment. The differential for abdominal pain in women is vast, but for this patient receiving IVF we had to consider ovarian hyperstimulation syndrome and ectopic pregnancy just to name a few examples. It is predictable that most women will suffer from a ruptured ovarian cyst at some point in their lifetime so long as they continue to menstruate.

Is There An Association Between Preeclampsia/Eclampsia And Congenital Heart Disease Among The Neurodivergent Population?, Jasmine Emanuel, Venkateswar Venkataraman, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart …

The Possible Relationship Of Adiponectin And Gestational Weight Gain During Different Stages Of Pregnancy Amongst Different Ethnic Groups, Jayshree Chauhan, Xinhua Chen

Rowan-Virtua Research Day

Introduction: Gestational Weight Gain (GWG) is defined as weight gain between conception and birth. Adiponectin, a fat derived hormone, has an inverse relationship with weight gain. We investigated the relationship of maternal adiponectin concentration and GWG during different pregnancy stages among ethnic groups. Method: Serum adiponectin levels were measured at entry (week 16) and trimester three (week 28) in pregnant women (n = 1634, age 22.0±5.3, pre-pregnancy BMI 25.7±6.3) which included Hispanic (47%), African American (37%) and Caucasian (16%) women. GWG was measured at week 24, 28, 32, and delivery and was divided into inadequate, adequate, and excessive according to …

Association Of Maternal Biomarkers With Gestational Weight Gain And Pre-Eclampsia, Matthew Green, Xinhua Chen

Rowan-Virtua Research Day

Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.

Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational …

Platelets In Preeclamptic Pregnancies Fail To Exhibit The Decrease In Mitochondrial Oxygen Consumption Rate Seen In Normal Pregnancies, Joseph Kim, Andrew Malinow, Rosemary Schuh

North Texas GME Research Forum 2023

Cellular oxygen consumption and lactate production rates have been measured in both placental and myometrial cells to study obstetrics-related disease states such as preeclampsia. Platelet metabolic alterations indicate systemic bioenergetic changes that can be useful as disease biomarkers. We tested the hypothesis that platelet mitochondria display functional alterations in preeclampsia. Platelets were harvested from women in the third trimester of either a healthy, non-preeclamptic or preeclamptic pregnancy, and from healthy, non-pregnant women. Using Seahorse respirometry, we analyzed platelets for oxygen consumption (OCR) and extracellular acidification (ECAR) rates, indicators of mitochondrial electron transport and glucose metabolism, respectively. There was a 37% …

Intraoperative Management Of Vasa Previa During Cesarean Delivery, Nicholas Sheets

South Atlantic Division GME Research Day 2023

No abstract provided.

Factors Associated With Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study, Katerina A. Furman, Amy Loree Phd, Leah Hecht Phd, Katerina Furman Md Candidate, Lyuba Gavrilova Bs, Hsueh-Han Yeh Phd, Catherine Frank Md, Brian Ahmedani Phd

Medical Student Research Symposium

Purpose: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors among childbearing-aged individuals who were pregnant, postpartum or who experienced pregnancy loss

Methods: Data from nine health care systems in the Mental Health Research Network was included in this sample. A case-control study design was used in which 290 childbearing-age individuals who died by suicide (cases) from 2000-2015 were matched with 10 childbearing-age individuals from the same healthcare system and enrolled during the same time period who did not die by suicide (n=2,900). Conditional logistic regression was used to analyze associations between pregnancy/postpartum/pregnancy loss status and suicide.

Results: …

Multiple Recurrences Of Papillary Urothelial Neoplasia Of Low Malignant Potential (Punlmp) In A Young Adult Female, Justine Bedolla, Aaron Poole, Laura Gutierrez

Central & West Texas GME Research Day 2023

No abstract provided.

Prevalence Of Postpartum Pre-Eclampsia In Pregnancies Affected By Covid-19 Pneumonia, Brittany Sweatman, Rebekah Bongato-Merren, James Baron

West Florida Division GME Research Day 2023

No abstract provided.

Spontaneous Heterotopic Pregnancy: Diagnosis And Management, Katie P. Nguyen, Marlekah Hudspeth, Honey Milestone

Far West Division GME Research Day 2023

No abstract provided.

Factor Vii Deficiency And Second Trimester Abortion: A Case Report, Katie P. Nguyen, Tamara Lynne B. Aqui, Honey Milestone

Far West Division GME Research Day 2023

No abstract provided.

Maternal Mirror Syndrome As A Consequence Of Fetal Sacrococcygeal Teratoma: A Case Report And Literature Review, Ali Farris, Andrew Royek, Kaitlyn Dorsey

South Atlantic Division GME Research Day 2023

No abstract provided.

Areas For Improvement In Pre-Eclampsia Prevention: Aspirin Use In Indicated Pregnancies, Mariah Piazza, Krystal Carmichael, Keisha Reddick, Susan Greene

South Atlantic Division GME Research Day 2023

No abstract provided.

The Impact Of Physical Activity Education During Pregnancy, Lizeth Banuchi

DNP Research Projects

Abstract

Background: Physical Activity (PA) during pregnancy is important to maintain optimal maternal and neonatal health. Gestational Diabetes Mellitus (GDM) requires close monitoring during pregnancy due to the health risk it can cause to mother and fetus. It is evident that PA can help improve maternal health outcomes to positively offer overall wellness throughout the pregnancy.

Objective: The purpose of this Quality Improvement Project (QIP) is to evaluate the impact of PA education on PA implementation during pregnancy and improve clinical practice for healthcare providers to introduce PA education during prenatal care per ACOG and CESP guidelines.

Method: This quality …

Pregnancy And Diabetic Ketoacidosis: Fetal Jeopardy And Windows Of Opportunity, Magda Conradie

Faculty, Staff and Student Publications

BACKGROUND: Diabetic ketoacidosis (DKA) during pregnancy poses significant risks to both the mother and fetus, with an increased risk of fetal demise. Although more prevalent in women with Type I diabetes (T1D); those with Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) can also develop DKA. A lack of information about DKA during pregnancy exists worldwide, including in South Africa.

OBJECTIVE: This study examined the characteristics and outcomes associated with DKA during pregnancy.

METHODS: The study took place between 1 April 2020 and 1 October 2022. Pregnant women with DKA, admitted to Tygerberg Hospital's Obstetric Critical Care Unit (OCCU) …

Possible Gender Differences In The Level Of Perceived Social Support In Couples Who Are Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Objective The purpose of this study is to examine whether there are gender differences in the level of perceived social support in couples experiencing issues with fertility. Methods A total of 938 participants aged 18-47 years, with self-reported issues of infertility, were evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS) which comprises three subscales which correspond with distinct sources of social support: significant other (SO), family, and friends. Differences between sexes for total score and for all subscale scores were subsequently analyzed using SPSS Statistics (IBM Corp, Armonk, USA). Results Mean total scores and scores on all subscales …

Placental Pathology In Spontaneous And Iatrogenic Preterm Birth: Different Entities With Unique Pathologic Features, Pawel T Schubert

Faculty, Staff and Student Publications

INTRODUCTION: Placental pathology is an important contributor to the understanding of preterm birth and reveals major differences between spontaneous preterm birth (SPTB) and iatrogenic preterm birth (IPTB). The aim of this study was to investigate these relationships.

METHODS: Research midwives collected placentas from 1101 women with singleton pregnancies who were enrolled in the Safe Passage Study. Trained pathology technologists prepared and processed placenta specimens for macroscopic and microscopic examination by designated pathologists. Statistical analyses were done with STATISTICA version 13.

RESULTS: In SPTB we found more cases of accelerated villous maturation; however, the other features of maternal vascular malperfusion (MVM) …

Identifying Predictors For Inflammation-Induced Preterm Birth: A Murine Study, Tzu Ning Liu Bs, Jose Galaz Md, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. A large proportion of preterm deliveries is affected by intra-amniotic inflammation, which can occur in the presence (intra-amniotic infection) or absence (sterile intra-amniotic inflammation) of microbes. Studies have shown an association between intra-amniotic inflammation, cervical shortening, and changes in the cervicovaginal microbiome. However, their causal relationships are unknown. This study aims to determine the causality of intra-amniotic inflammation, cervical shortening, and cervicovaginal microbiome alterations.

Methods: Pregnant C57BL/6 dams received an ultrasound-guided intra-amniotic injection of an endotoxin lipopolysaccharide (LPS) or the alarmin interleukin-1 alpha (IL-1 alpha) on 16.5 …

Wernicke’S Encephalopathy Secondary To Hyperemesis Gravidarum, Mohammad Rattu, Alexander Norinsky, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Wernicke’s encephalopathy (WE) is a neurological disorder secondary to thiamine deficiency that is precipitated by administration of glucose-containing fluids prior to thiamine supplementation. Though WE is typically diagnosed among alcoholics (12.5%), the prevalence among nonalcoholics can vary from 0.04-0.13%. Around 30-40% of patients with underlying thiamine deficiency will only experience one of the symptoms from the typical triad, with the complete triad (encephalopathy, oculomotor dysfunction/nystagmus, and ataxia) only evident among 5-16% of the population. Among the non-alcoholic patient population presenting with WE, a history of vomiting is more frequent. While nausea affects around 80% of pregnant women, an extreme form …

Bilateral Teratomas In Pediatric Patient With Unilateral Ovarian Torsion, David Ho, Maya Borowczak, Archana Verma

Rowan-Virtua Research Day

Ovarian torsion is a surgical emergency found in both pediatric and adult populations. It involves the full or partial rotation of the vessels that supply the ovary, resulting in ischemia. In this report, we present the case of a pediatric patient arriving to the Pediatric Emergency Department (PED) for evaluation of right lower quadrant (RLQ) abdominal pain, who was found to have an ovarian torsion. In this particular case, the patient’s ovarian torsion was due to a teratoma, and imaging would later identify an additional smaller teratoma on the contralateral side. This case shows the importance of considering ovarian pathologies …

Hyperammonemia Of Unknown Cause In A Young Postpartum Woman: A Case Report, Sadaf Hanif, Sher Muhammad Sethi

Section of Internal Medicine

Background: Hyperammonemia is a medical condition described as increased or elevated serum ammonia levels. High serum levels of ammonia can cause neurotoxicity. Sudden onset severe hyperammonemia may cause severe encephalopathy with brain damage. It can result in cerebral edema, emesis, seizures, hypotonia, and death. We report a young postpartum woman who had a sudden rise in serum ammonia levels after vaginal delivery.
Case presentation: A 24-year-old, married, postpartum Pakistani woman was admitted to the intensive care unit through the emergency department, with complaints of fever, severe abdominal pain with distension, and altered levels of consciousness. The patient had a medical …

Understanding The Needs Of A Mobile Phone-Based Telemonitoring Program For Pregnant Women At High Risk For Pre-Eclampsia: Interpretive Qualitative Description Study, Anam Shahil Feroz, Kristina De Vera, Nadia D. Bragagnolo, Sarah Saleem, Zulfiqar Ahmed Bhutta, Emily Seto

Community Health Sciences

Background: Lack of early risk detection, diagnosis, and treatment of pregnant women at high risk for pre-eclampsia can result in high maternal mortality and morbidity not only in Pakistan but also in other low- to middle-income countries (LMICs). A potential tool for supporting pregnant women at high risk for pre-eclampsia for early detection is telemonitoring (TM). However, there is a limited body of evidence on end-user needs and preferences to inform the design of the TM programs for pregnant women at high risk for pre-eclampsia, specifically in LMICs such as Pakistan.
Objective: This study aims to explore the needs of …

The Unspoken Grief Of Multiple Stillbirths In Rural Pakistan: An Interpretative Phenomenological Study, Muhammad Asim, Sehrish Karim, Hajra Khwaja, Waqas Hameed, Sarah Saleem

Community Health Sciences

Background: Pakistan has the highest rate of stillbirth (30.6 stillbirths per 1000 total births) as compared to other South Asian countries. The psychological impact of stillbirths on bereaved women is well documented; however, there is a dearth of literature on lived experiences of women with multiple stillbirths in Pakistan.
Objective: The purpose of this research is to understand the lived experiences of women who had multiple stillbirths in Thatta, Pakistan.
Methods: An interpretative phenomenological study was conducted in district Thatta with eight women who experienced more than one stillbirth. A semi-structured in-depth interview guide was used for data collection. The …

Do Empowered Women Receive Better Quality Antenatal Care In Pakistan? An Analysis Of Demographic And Health Survey Data, Muhammad Asim, Waqas Hameed, Sarah Saleem

Community Health Sciences

Introduction: Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women's empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan.
Methods: We used Pakistan Demographic and Health Survey 2017-18 (PDHS) data which comprises of 6,602 …

A Newfound Breach In Repeat Vaginal Delivery: Unscarred Uterine Rupture, Merritt Mcgowan, Amethyst Wilder, Ashley Hawes

South Atlantic Division GME Research Day 2022

No abstract provided.

Postnatal Venous Thrombembolism (Vte) Risk Assessment In Cesarean Section Patients, Mai-Tram Phan, Michelle Ozcan

North Florida Division GME Research Day 2022

No abstract available.

Pneumomediastinum Associated With Hyperemesis Gravidarum, Henna Ahsan, Donna Boucher

North Florida Division GME Research Day 2022

No abstract available.

Non-Pharmacological Management Of Idiopathic/Persistent Dyspareunia, Iveshia Ford

Capstone Showcase

Painful sexual intercourse, or dyspareunia, is a condition numerous women experience. An unknown, but still important, number of those affected find no relief with medication or surgery. Yet, it can be difficult for patients to discuss concerns with their provider. In addition, many providers do not have an adequate comfort level to discuss such topics. This paper aims to equip providers with non-pharmacological treatment options which include pelvic floor physical therapy, sex therapy and lifestyle changes. With the cultural shifts and changing ideas of sexuality in today’s age, it is important that clinicians remain versed in sexual health and patient …