Female Urogenital Diseases and Pregnancy Complications Commons^™

Automation And Autonomy In The Ivf Laboratory: Concepts And Implications For Embryologists, Jacques Cohen, Gerardo Mendizabal-Ruiz, Giles Anthony Palmer, Giuseppe Silvestri, Mina Alikani

EVMS School of Health Professions Faculty Publications

Automation is regarded as the next phase in the evolution of laboratory IVF. Despite technological advances, most laboratory procedures remain operator-dependent, contributing to variability in performance and outcomes. While automation has improved reproducibility and efficiency in many areas of medicine, its adoption in IVF has been slow. This review examines how automation may be integrated into IVF laboratories through a set of conceptual distinctions. Automation refers to the execution of procedural steps by machine-controlled systems, whereas autonomy describes the degree to which such systems can operate without human intervention. This review distinguishes between static automation, which maintains or monitors the …

Sleepiness In Pregnancy And Adverse Perinatal Outcomes, Rachel Friedlander, Xiaoning Huang, Phyllis Zee, Sadiya S. Khan, Philip Greenland, Francesca L. Facco, Judith Chung, William A. Grobman, Shalini Manchanda, Uma M. Reddy, George R. Saade, Robert M. Silver, Lynn M. Yee

Department of Obstetrics & Gynecology Faculty Publications

Background

Sleep disorders in pregnancy have been associated with adverse pregnancy outcomes including hypertensive disorders of pregnancy, preterm birth, and gestational diabetes mellitus, yet these findings are largely from retrospective studies. Using data from a prospective study that used validated tools to assess sleepiness in pregnancy, we aimed to assess the association of sleepiness in pregnancy with adverse pregnancy outcomes.

Methods

In this secondary analysis of data from a large, diverse prospective cohort of nulliparous individuals conducted at eight United States medical centers, those with self-reported sleep data were included. Sleepiness was evaluated in early (6-13 weeks) and mid-pregnancy (22-29 …

The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam

Department of Obstetrics & Gynecology Faculty Publications

Objective

Maternal anemia in pregnancy is associated with many adverse maternal, fetal, and neonatal outcomes. The role of social determinants of health (SDOH) in the development of maternal anemia and other adverse outcomes is continually evolving. One such newer tool, the Social Vulnerability Index (SVI), measures an individual's community-level SDOH, with higher SVI denoting higher vulnerability. Our objective was to evaluate the association between SVI, maternal anemia, and other adverse perinatal outcomes.

Methods

Retrospective cohort study of pregnant individuals delivering singletons at a gestational age ≥23 weeks at a single center from 2014 to 2018. Patients with sickle cell disease, …

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …

Frequent Emergency Department Utilization And Syphilis Case Profiles In The Sentara Healthcare System: A Retrospective Cross-Sectional Analysis In Hampton Roads, Martina Zamponi, Grace M. Tillotson, Chandler F. Knox, Mackenzie Tardif-Kunk, Thomas R. Campbell, Peter A. Mollica

Department of Medicine Faculty Publications

Background

Syphilis rates have increased substantially nationwide, disproportionately affecting marginalized populations and individuals with differing patterns of healthcare utilization. The Hampton Roads region of Virginia and North Carolina includes multiple jurisdictions with syphilis rates above the CDC screening threshold, with 7 of its 9 independent cities meeting this criterion. However, no prior study has examined the relationship between emergency department (ED) utilization patterns and documented syphilis diagnoses in this region.

Methods

A retrospective cross-sectional analysis of the Sentara Healthcare network was conducted using aggregate data from the TriNetX platform. Patients diagnosed with syphilis between 2023 and 2024 were stratified by …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

3d Bioprinting Technology Innovation In Female Reproductive System, Siyao Chen, Tongxin Wang, Jiaqi Chen, Mingxing Sui, Luyao Wang, Xueyu Zhao, Jianqiao Sun, Yingli Lu

Department of Obstetrics & Gynecology Faculty Publications

Several diseases affect the female reproductive system, and both disease factors and treatments impact its integrity and function. Consequently, understanding the mechanisms of disease occurrence and exploring treatment methods are key research focuses in obstetrics and gynecology. However, constructing accurate disease models requires a microenvironment closely resembling the human body, and current animal models and 2D in vitro cell models fall short in this regard. Thus, innovative in vitro female reproductive system models are urgently needed. Additionally, female reproductive system diseases often cause tissue loss, yet effective tissue repair and regeneration have long been a bottleneck in the medical field. …

Diagnosis Of Hypertensive Disorders In Pregnancy, Rebecca Horgan, Yara Hage Diab, Maged Costantine, George Saade, Baha Sibai

Department of Obstetrics & Gynecology Faculty Publications

Hypertensive disorders of pregnancy, including chronic hypertension, superimposed preeclampsia, gestational hypertension, and preeclampsia, affect 10-20% of pregnancies and are a significant cause of maternal and perinatal mortality. The incidence of these disorders is rising due to factors such as advanced maternal age, obesity, assisted reproductive technology, and increased rates of preexisting comorbidities. Differentiating pregnancy-associated hypertension from pre-existing chronic hypertension is challenging, as the overlap between the two may be broadening due to the changing demographics of the pregnant population. This review critically evaluated the evidence regarding the current time periods recommended to make a diagnosis of a hypertensive disorder of …

Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …

Treatment Effects Of Genital Mycoplasma Species In High-Risk Pregnant Individuals: A Retrospective Cohort Study, Takashi Yoshimasu, Tasuku Inao, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

We aimed to estimate the causal effect of treatment for genital Mycoplasma species on preterm birth (PTB) and spontaneous abortion (SA). We also evaluated treatment effects separately for cases with co-infection of Ureaplasma and Mycoplasma species.

Methods

This was a retrospective observational cohort study at a single center. Singleton mothers with one or more risk factors for PTBs were screened and treated for genital Mycoplasma species. The treatment was repeated based on polymerase chain reaction (PCR) results after each course. We applied inverse probability treatment weighting, and risk differences (RDs) of the treatment effect on pregnancy outcomes were estimated …

Association Between Adverse Pregnancy Outcomes And Awareness Of Cardiovascular Risk Factors: A Numom2b-Hhs Secondary Analysis, Elizabeth M. Wendl, Amanda A. Allshouse, Ashley Goodwin, Bri Hobbs, Philip Greenland, Lisa Levine, William Grobman, George R. Saade, Natalie Cameron, C. Noel Bairey Merz, Caroline Rouse, Sarah Rogan, Judith H. Chung, Lauren H. Theilen, National Heart, Lung, And Blood Institute Numom2b Heart Health Study Network

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) affect 10%-20% of pregnancies and are associated with increased risk of cardiovascular disease.

Objective

To determine whether the history of APO is associated with a person's awareness of their cardiovascular risk factors (CRF) 2-7 years postpartum.

Methods

This is a secondary analysis of a multicenter cohort study in which nulliparous pregnant people were enrolled in the first trimester and followed prospectively. Participants with a CRF (hypertension, dyslipidemia, and/or prediabetes/diabetes) at follow-up were included. We excluded participants with: pre-gestational diabetes, chronic hypertension, dyslipidemia during the index pregnancy or subsequent pregnancy, and non-fasting blood draws. The exposure …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

Successful Management Of Spontaneous Unilateral Twin Ectopic Pregnancy With Two-Step Dose Of Methotrexate, Lauren A. Forbes, Navya Nuthivana, Renee Morales

Department of Obstetrics & Gynecology Faculty Publications

The incidence of unilateral tubal twin pregnancy is 1/20,000–1/250,000 with about 100 reported cases. Four of the six cases that were medically managed were successful. A 24-year-old female presented to the emergency department (ED) with vaginal bleeding and abdominal cramping. She was hemodynamically stable without signs of an acute abdomen. Laboratory evaluation revealed she was pregnant with a serum beta-human chorionic gonadotropin (b-hCG) of 798 mIU/mL. Transvaginal ultrasound (TVUS) revealed a single left tubal pregnancy with a yolk sac. The patient elected medical management with body surface area (BSA)–based intramuscular (IM) methotrexate (MTX). On Day 4, the patient returned to …

Dysmenorrhea Among High-School Students And It's Associated Factors In Kuwait, Sharefah Al-Matouq, Hessah Al-Mutairi, Ohood Al-Mutairi, Fatima Abdulaziz, Dana Al-Basri, Mona Al-Enzi, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background

Although dysmenorrhea is not a life-threatening condition, it can cause a substantial burden on individuals and communities. There is no data on the prevalence of dysmenorrhea in Kuwait. This study aimed to estimate the prevalence of dysmenorrhea among female public high-school students in Kuwait and investigate factors associated with dysmenorrhea.

Methods

A cross-sectional study using multistage cluster sampling with probability proportional to size method was conducted on 763 twelfth grade female public high-school students (aged 16–21 years). We used face-to-face interview with a structured questionnaire to collect data on dysmenorrhea and presumed risk factors. Weight and height of the …