Female Urogenital Diseases and Pregnancy Complications Commons^™

A Qualitative Analysis Of The Lived Experience Of Active-Duty Servicewomen Receiving Perinatal Care Within The Military Health System., Caitlin Russell, Emily Balog, Anne Teitelman, Rosemary Polomano

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.

STUDY DESIGN: Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.

RESULTS: Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications …

Updates In Contemporary Management Of Singleton Pregnancies Complicated By A Short Cervix, Moti Gulersen, Vincenzo Berghella, Eran Bornstein

Department of Obstetrics and Gynecology Faculty Papers

Singleton pregnancies complicated by a short cervical length (≤25 mm) are at significantly increased risk for spontaneous preterm birth. Several treatment strategies aimed at reducing this risk and improving perinatal outcomes have been evaluated, including vaginal progesterone, cervical cerclage, and cervical pessary. This review summarizes the latest evidence regarding the efficacy of these interventions. Vaginal progesterone and/or cervical cerclage have been identified as proven evidence-based practices for preterm birth prevention and improve neonatal outcomes. Vaginal progesterone reduces the risk of preterm birth < 35 weeks by 27% (relative risk 0.73, 95% confidence interval 0.58-0.90). Cervical cerclage has been shown to reduce the risk of preterm birth < 35 weeks by 30% (relative risk 0.70, 95% confidence interval 0.55-0.89) in patients with a short cervical length and prior preterm birth. In contrast, recent data suggest that cervical pessary should no longer be considered a management option for these patients. A continued focus on individualized, evidence-based approaches remains essential to optimizing outcomes in this high-risk population.

The Effect Of Hcv On Methadone Dose During Pregnancy, Sarah Boudova, Neel S. Iyer, Danielle M. Tholey, Jonathan M. Fenkel, Rupsa C. Boelig

Department of Obstetrics and Gynecology Faculty Papers

Pregnancy is a time of high patient motivation to initiate treatment for opioid use disorder (OUD). Hepatic drug metabolism can be altered by pregnancy and hepatitis C virus (HCV) infection. We aimed to examine the impact of HCV during pregnancy on methadone dosing. Retrospective chart review of all pregnant patients with OUD admitted for initiation of methadone from 1/2020-6/2022. Associations were examined using Student's T-tests, chi-squared tests, Fisher's exact tests and univariate and multivariate linear regression. We identified 191 pregnancies initiated on methadone, of which 188 were screened for HCV. 111 (59.0%) were HCV Antibody (Ab)+, of whom 108 were …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

The Impact Of An Iron-Rich Diet On Fatigue In Menstruating Women With Non-Anemic Iron Deficiency, Meagan Seraydar, Lauren Latimer, Sam Miragliatto

Department of Nutrition Student Projects

Fatigue without diagnosed anemia is prevalent in menstruating women, with iron deficiency being a potential contributor. While iron supplementation is a standard intervention, dietary sources of iron may offer a sustainable alternative. This study aims to assess the impact of an iron-rich diet on fatigue levels in menstruating women. A 12-week randomized controlled trial (RCT) will be conducted, assigning participants to either an iron-rich diet group or a control group following their usual diet without specific iron recommendations. Fatigue will be measured using the Fatigue Severity Scale (FSS) at baseline, six weeks, and twelve weeks, alongside iron status biomarkers, including …

Molecular Subtyping Of Hypertensive Disorders Of Pregnancy, Michal Elovitz, Elaine Gee, Nathaniel Delaney-Busch, Alison Moe, Mitsu Reddy, Arkady Khodursky, Johnny La, Ilma Abbas, Kay Mekaru, Hunter Collins, Farooq Siddiqui, Rory Nolan, Rupsa Boelig, Daniel Kiefer, Pamela Simmons, George Saade, Antonio Saad, Ebony Carter, Thomas Mcelrath, Stephen Quake, Mark Depristo, Carrie Haverty, Manfred Lee, Eugeni Namsaraev, Vincenzo Berghella, Ai-Ris Collier, Antonia Frolova, Esther Park-Hwang, Luis Pacheco, Elizabeth Sutton, Maneesh Jain, Kara Rood, William A Grobman, Joseph Biggio, Cynthia Gyamfi-Bannerman, Arun Jeyabalan, Morten Rasmussen

Department of Obstetrics and Gynecology Faculty Papers

Hypertensive disorders of pregnancy (HDP), including preeclampsia, affect 1 in 6 pregnancies, are major contributors to maternal morbidity and mortality, yet lack precision medicine strategies. Analyzing transcriptomic data from a prospectively-collected diverse cohort (n = 9102), this study reveals distinct RNA subtypes in maternal blood, reclassifying clinical HDP phenotypes like early/late-onset preeclampsia. The placental gene PAPPA2 strongly predicts the most severe forms of preeclampsia in individuals without pre-existing high risk factors, months before symptoms, and its overexpression correlates with earlier delivery in a dose-dependent manner. Further, molecular subtypes characterized by immune genes are upregulated in less severe forms of HDP. …

A Randomized Phase Ii/Iii Study Of Paclitaxel/Carboplatin/Metformin Versus Paclitaxel/Carboplatin/Placebo As Initial Therapy For Measurable Stage Iii Or Iva, Stage Ivb, Or Recurrent Endometrial Cancer: An Nrg Oncology/Gog Study, Victoria L. Bae-Jump, Michael W. Sill, Paola A. Gehrig, Jason D. Merker, David L. Corcoran, Adam D. Pfefferle, Michele C. Hayward, Joan L. Walker, Andrea R. Hagemann, Steven E. Waggoner, Roisin E. O'Cearbhaill, Megan E. Mcdonald, Mitchell I. Edelson, Paul A. Disilvestro, Amy L. Mcnally, Aimee Fleury, Ramey D. Littell, Frederick R. Ueland, Heather A. Lankes, Carol Aghajanian

Abington Jefferson Health Papers

INTRODUCTION: We evaluated the efficacy of the addition of the anti-diabetic drug metformin to standard-of-care paclitaxel and carboplatin (PC) in patients with advanced and recurrent endometrial cancer (EC).

METHODS: In this phase II/III trial, EC patients with chemotherapy-naïve stage III/IVA (with measurable disease) and stage IVB or recurrent (with or without measurable disease) disease were randomly assigned to PC/metformin (850 mg BID) versus PC/placebo. Metformin or placebo was continued as maintenance therapy after completion of PC until disease progression. The primary endpoint of phase II was progression-free survival (PFS). The primary endpoint of phase III was overall survival (OS). Secondary …

Sustained Supraventricular Tachycardia While In Active Phase Labor, Austin Gold, Mona Sadek

HCA Healthcare Journal of Medicine

Background

Supraventricular tachycardia (SVT) is one of the most common tachyarrhythmias found in young women, and SVT can be exacerbated by pregnancy. The symptoms associated with SVT frequently overlap with physiologic changes and symptoms of pregnancy which can lead to delayed or missed diagnosis.

Case Presentation

We describe the presentation and the acute management of a patient who had sustained SVT that developed during the active phase of labor. We then detail the varying management approaches of SVT in pregnancy and labor as well as refractory management options. Maternal monitoring will also be discussed as this case shows how an …

Interventions To Prevent And Manage Infections In Pregnancy, Rahima Yasin, Li Jiang, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Background: Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.
Summary: We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and …

Nitroglycerine For Retained Placenta: A Meta-Analysis Of Randomized Controlled Trials, Alessandro Petrecca, Gabriele Saccone, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To evaluate the effect of nitroglycerine on placenta delivery after retained placenta.

DESIGN: Systematic review with meta-analysis.

DATA SOURCES: MEDLINE, PROSPERO, Scopus, ClinicalTrials.gov, EMBASE, Sciencedirect, the Cochrane Library, Scielo were searched from their inception until February 2024.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included all randomized clinical trials comparing use of nitroglycerine (i.e. intervention group) with placebo or with no treatment (i.e. control group) given for retained placenta after vaginal delivery.

DATA SYNTHESIS: The primary outcome was rate of manual removal of the placenta. The summary measures were reported as relative risk (RR) or as mean difference (MD) with …

Prophylactic Resuscitative Endovascular Balloon Occlusion In The Management Of Placenta Percreta: A Case Report, Monica Rodriguez, Nicole Tenzel, Rachel Russo, Robert Cohen

North Texas Research Forum 2025

Introduction: Placenta accreta spectrum disorders (PASD) are associated with severe maternal morbidity, including hemorrhage requiring massive transfusion, intensive care unit (ICU) admission, coagulopathy, organ ischemia or failure, and death. The adherent placenta results in continuous mixed arterial and venous bleeding, preventing the uterus from adequately contracting. This can result in a blood loss rate of 600 mL or more per minute, posing a risk of exsanguination in less than five minutes. Few reports exist on the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA) to reduce obstetric hemorrhage and its application for prolonged occlusion times exceeding 60 …

Reproductive Autonomy In Immunological Intervention: Ethical Boundaries In Maternal-Fetal Immune Therapy, Marium Z. Rizvi

Journal of Health Ethics

Recent advances in immunology have broken barriers in reproductive medicine through immune-modulating therapies that support fertility and pregnancy. Treatments such as intravenous immunoglobulin (IVIG) and intralipid infusions are increasingly offered to patients with Recurrent Implantation Failure (RIF) or Recurrent Pregnancy Loss (RPL), conditions that result in miscarriages and failed IVF treatments (Pillarysetti et al., 2023). Maternal-fetal immunology reveals a delicate interplay between immune tolerance and defense: the maternal system must accept a genetically foreign fetus while preserving immunological protection. Disruptions in this balance are implicated in implantation disorders and pregnancy failure. As a result, immune-based therapies have emerged as promising …

A Look Into Postpartum T2dm Screening In Patients Diagnosed With Gdm, David Vincent Ream, Joshua Ferrell, Ashlee Nichole Tillery

South Atlantic Division GME Research Day 2025

No abstract provided.

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Standardized Surgical Protocol For Placenta Accreta Spectrum Disorder At An Accreta Center Of Excellence, Ana Adams, Monica Rodriguez, Kate Hansen, Aysu Erdemir, Robert Cohen

North Texas Research Forum 2025

Introduction Placenta Accreta Spectrum Disorder (PASD) refers to a spectrum of abnormal invasion of the placenta into the uterus during pregnancy. PASD ranges in severity from involvement through the endometrial layer of the uterus to complete invasion involving other pelvic structures. This abnormal invasion can result in significant postpartum hemorrhage, often requiring large-volume transfusions, about six units of packed red blood cells on average. The maternal mortality rate associated with PASD is approximately 4-7%. The Society for Maternal-Fetal Medicine (SMFM) recommends that pregnancies complicated by PASD be delivered in hospitals with dedicated interdisciplinary teams, referred to as “Accreta Centers of …

Marginal Cord Insertion And Funic Presentation Mimicking Vasa Previa, Fran Franceschini Lopez, Andrew Tucker, Narinta Limtrakul, Manuel Rivera-Alsina

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Massive Fibroid Uterus Leading To Multiple Sequalae: A Case Report Of Fumarate Hydratase Deficiency, Benjamin Duplaga, Tara Feehan, Heather Miller

West Florida Division GME Research Day 2025

No abstract provided.

Implementation Of Screening For Vte Prophylaxis For The Prevention Of Vte In The Antepartum And Postpartum Period, Elizabeth Campos, Michelle Mieles, Aaron Poole

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Postpartum Glucose Testing And Primary Care Follow-Up For Women With Gestational Diabetes Mellitus: A Quality Improvement Project, Madeline Bartram, Anusha Hussain, Timothy Kremer

North Texas Research Forum 2025

BACKGROUND: Patients with gestational diabetes mellitus (GDM) have a 40-70% lifetime risk for developing type 2 diabetes mellitus, which is 9 times the risk of patients without a history of GDM. Joint association guidelines recommend a 75-gram, 2-hour oral glucose tolerance test (GTT) at 4 to 12 weeks postpartum for all patients with GDM, and to follow-up with a primary care physician. Currently, less than half of these patients do not receive the recommended postpartum glucose testing and/or follow-up. METHODS: For each GDM-affected pregnancy, two primary outcome measures were retrospectively collected from the clinic EHR: completion of the 75-gram GTT …

Planned Out Of Hospital Birth Maternal And Neonatal Outcomes In A Single Institution, Priyanka Vuppala, Juhi Singhal, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Incarcerated Gravid Uterus, Adelene Morrow, Aaron Poole

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Management Of Placenta Accreta Spectrum Disorder Diagnosed Prior To Viability, Anjali Patel, Virginia Lowe, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Abnormal Pap Smears In Pregnancy And The Potential For Fulminant Cervical Cancer: A Case Report And Review Of Staging And Contemporary Treatment, Aliya Nurani, Claud Crosby, Ashley Valenzuela, Meenah Dhir, Mikalah Maury, Stephen Salmieri, Anthony Royek

South Atlantic Division GME Research Day 2025

No abstract provided.

A Rare Case Of Vulvar Endometriosis, Taylor Penny, Shelby Freeberg, Brittany Stofko

South Atlantic Division GME Research Day 2025

No abstract provided.

Optimization Of Venous Thromboembolism (Vte) Prophylaxis In Pregnancy And The Postpartum Period, Sereena Jivraj, Isabella Sciacca, Sherrie Dixon, Timothy Kremer

North Texas Research Forum 2025

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolisms (PE) continues to be a leading cause of maternal mortality (MM) in the United States. VTE accounts for roughly 9-10% of all maternal deaths. Other countries have adopted anticoagulation protocols to reduce MM rates, but the US has yet to follow suit. The American College of Obstetricians and Gynecologists (ACOG), the American College of Chest Physicians (CHEST), and the Royal College of Obstetricians and Gynaecologists (RCOG) all vary in their guidelines for thromboembolism prophylaxis. Patients who deliver by Cesarean section (C-section) have higher incidences of MM due …

When Autoimmunity Meets Pregnancy: Investigating Antiphospholipid Syndrome & Preeclampsia, Brianna Mcdonald, Madison Pearson, U Perni, Shiloh Smajstrla, Stephen Zweibach, James Baron

West Florida Division GME Research Day 2025

No abstract provided.