Female Urogenital Diseases and Pregnancy Complications Commons^™

Something Has Fallen: Pelvic Organ Prolapse Or Vaginal Cuff Dehiscence And Evisceration? A Case Report., Alexandra Nutaitis, Laurie Kane

Rowan-Virtua Research Day

="/">Learning Objectives: 1) Recognize late presenting complications of hysterectomy. 2) Include vaginal cuff dehiscence with evisceration (VCDE) in the differential diagnosis of women suspected of having acute pelvic organ prolapse (POP).3) Appreciate the relative rarity of VCDE in younger women.
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/="/">Case Summary: A 36 year old G0P0 female presented to the ED with a chief complaint of sudden onset excruciating epigastric pain, followed by diarrhea and visible vaginal bulge. Pertinent past medical and surgical history includes breast cancer diagnosed 15 months prior, status post bilateral mastectomy, radiation, chemotherapy, and robotic-assisted prophylactic hysterectomy and BSO 6 months prior. …

Successful Extracorporeal Membrane Oxygenation In The Management Of Acute Respiratory Distress Syndrome And Cardiopulmonary Collapse Secondary To Amniotic Fluid Embolism, Sumon Roy, Nishit A. Biniwale, Venkata S. Pendela, Patricia Oates, Katrina Wojciechowski, Scott C. Feitell

The VAD Journal

Amniotic fluid embolism (AFE) is one of the most devastating complications of pregnancy that typically manifests as acute cardiopulmonary collapse during delivery or in the postpartum period. The potential role of extracorporeal membrane oxygenation (ECMO) as a management technique in severe cases of AFE remains largely unknown given the limited literature available. In this report, we present the first case, to our knowledge, of successful implementation of ECMO as a life-saving measure in a case of hemorrhagic shock due to postpartum bleeding complicated by severe AFE leading to acute respiratory distress syndrome (ARDS) ultimately requiring tracheostomy. Hemodynamic decompensation is often …

Comparing Rates Of Macrosomia And Neonatal Hypoglycemia Of Differing Treatment Modalities Of Gestational Diabetes Mellitus, Ashleigh Milbrath

Physician Assistant Scholarly Project Posters

Gestational diabetes mellitus (GDM) is a known potential complication that can occur during pregnancy. Unmanaged GDM can result in maternal hyperglycemia, which can cause increased neonatal complications, two of which are macrosomia and neonatal hypoglycemia. To prevent maternal hyperglycemia, treatment of GDM typically begins with dietary changes, home glucose monitoring, increased exercise patterns and other lifestyle modifications. However, if maternal hyperglycemia persists after two weeks of maternal lifestyle modifications, there are not current best practice guidelines established for the treatment of GDM. Historically, subcutaneous multiple daily dosed insulin (MDI) has been the gold standard for treatment after lifestyle modification. However, …

Aspirin Use Following Preeclampsia To Prevent Future Adverse Cardiovascular Outcomes, Kristi Bohlig

Physician Assistant Scholarly Project Posters

• Introduction: Preeclampsia during pregnancy warrants therapy with low dose aspirin. The purpose of this review is to investigate if these women are at increased future risk for cardiovascular morbidity and mortality, and if aspirin therapy prevents future cardiovascular events.

• Research Questions: Do women who had preeclampsia during pregnancy have increased future cardiovascular morbidity and mortality? • Does continued aspirin use in postpartum women, who had preeclampsia during pregnancy; decrease future cardiovascular morbidity and mortality?

• Research Methods: Literature review was conducted utilizing CINAHL, Dynamed plus and PubMed databases.

• Discussion: Many studies have found that preeclampsia does increase …

A Population-Based Analysis Of Patient Age And Other Disparities In The Treatment Of Ovarian Cancer In Central Appalachia And Kentucky, Robert Ore

Theses and Dissertations--Clinical Research Design

Objectives: Adherence to National Comprehensive Cancer Network (NCCN) guidelines for ovarian cancer treatment improves patient outcomes. The aim of this study was to assess disparities associated with ovarian cancer treatment in the state of Kentucky and central Appalachia.

Methods: Data on patients diagnosed as having ovarian cancer from 2007 through 2011 were extracted from administrative claims-linked Kentucky Cancer Registry data. NCCN compliance was defined by stage, grade, surgical procedure, and chemotherapy. Selection criteria were reviewed carefully to ensure data quality and accuracy. Descriptive analysis, logistic regression, and Cox regression analyses were performed to examine factors associated with guidelines compliance and …

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 …

Comparing Screening And Treatment Of Bacterial Vaginosis And Pregnancy Outcomes, Stephanie Severson

Physician Assistant Scholarly Project Posters

• Evidence shows that bacterial vaginosis (BV) can lead to poor perinatal outcomes.

• The goal of this project is to answer the question of which pregnant patients should be screened for BV and does identification and treatment of BV during pregnancy improve perinatal outcomes.

• Due to variability in a multitude of factors, a generalized recommendation is difficult to make. Lack of recommendations are largely due to harm of treatment in those who were misdiagnosed.

• The development of polymerase chain reaction (PCR) has the capability to reduce misdiagnosis.

• Newer studies have shown benefit of early screening and …

The Politics Of Abortion And Maternal Health: A Discussion Paper, Ihsan Ullah, Ayaz Ayub, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

Abortion should be legally allowed for women because it can save mothers from childbirth-related complications and death. Legal abortion is one of the safest methods to terminate a pregnancy when there is a risk to the mother’s health by childbirth or severe deformity of the fetus or it is unwanted. Unfortunately, approximately half of all abortions worldwide mostly in nations where abortion is severely restricted and are performed in dangerous settings. These risky abortions are a significant contributor to maternal morbidity and disability. Limiting a woman's access to an abortion does not stop abortion; rather, it just encourages more risky …

Effect Of Psychological Distress On The Emerging Cause Of Infertility, Faiza Kausar

Journal of Asian Midwives (JAM)

Background: Infertility is a growing issue of the recent era, and it represents significant crises for most couples. Psychological distress has often been suggested as a cause of unexplained infertility. Male infertility accounts for 40% of all infertility problems, while female infertility accounts for 40% of all infertility problems; others are unexplained. Previous studies have indicated that stress and depression negatively impact various infertility parameters in both partners. To determine the relationship between infertility and psychological distress and the level of different types of stress among infertile couples, and to relate the significant stressors responsible for worsening infertility or …

The Role Of Non-Neuronal Acetylcholine In Urogenital Chlamydial Infection, Jessica R. Lockhart

Electronic Theses and Dissertations

Chlamydia trachomatiscauses a bacterial sexually transmitted infection, Chlamydia, that is often chronic and casues reproductive complications in women. We hypothesized that Chlamydia infection increases local acetylcholine (ACh) production, which regulates the host’s inflammatory response to the infection. Female mice infected with C. muridarumwere sacrificed at days 3, 9, 15, and 21 post-infection, genital tract tissues harvested, and immunohistochemistry performed to enumerate ACh-producing cells. Infection increased the number of ACh-producing cells in cervical tissue at days 3,15, and 21 post-infection (pi), uterine tissue at day 3 and 9 pi, and ovarian tissue day 3, 15, and 21 pi. These …

Influence Of Body Mass Index And Polycystic Ovarian Syndrome On Icsi/Ivf Treatment Outcomes: A Study Conducted In Pakistani Women, Rehana Rehman, Rozina Mustafa, Rabiya Ali, Saeeda Shaharyar, Faiza Alam

Department of Biological & Biomedical Sciences

Background: Obesity may establish a crucial barrier for effective fertility treatment in polycystic ovary syndrome (PCOS) females.
Objective: To compare results of intra-cytoplasmic sperm injection (ICSI) in females with and without polycystic ovarian syndrome and further appraise the effect of obesity in PCOS females.
Materials and methods: A cross-sectional study from June 2015 to July 2016 included non-PCOS and PCOS (recognized by Rotterdam criteria) females who underwent ICSI. The PCOS were further stratified into non-obese and Obese according to the South Asian criteria for body mass index. Results were categorized on the basis of beta-human chorionic gonadotropin (β-hCG) and transvaginal …

Atypical Presentation Of Obstructed Hemivagina And Ipsilateral Renal Anomaly, Christopher Grant, Christopher E. Bayne, N. Kern, Craig A. Peters

Urology Faculty Publications

Herlyn-Werner-Wunderlich Syndrome, otherwise known as obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), is a rare Müllerian anomalyconsisting of uterine didelphys, hemivaginal septum, and ipsilateral renal agenesis. Patients often present at the onset of menarche with abdominal pain and a pelvic mass from an obstructed hemivagina. We report a child who presented with a febrile urinary tract infection and upon further workup was found to have OHVIRA.

Trends And Determinants Of Stillbirth In Developing Countries: Results From The Global Network’S Population-Based Birth Registry, Sarah Saleem, Shiyam Sunder Tikmani, Elizabeth M. Mcclure, Janet L. Moore, Iqbal Azam Syed, Sangappa M. Dhaded, Shivaprasad S. Goudar, Ana Garces, Sumera Aziz Ali, Farnaz Naqvi

Community Health Sciences

Background: Stillbirth rates remain high, especially in low and middle-income countries, where rates are 25 per 1000, ten-fold higher than in high-income countries. The United Nations' Every Newborn Action Plan has set a goal of 12 stillbirths per 1000 births by 2030 for all countries.
Methods: From a population-based pregnancy outcome registry, including data from 2010 to 2016 from two sites each in Africa (Zambia and Kenya) and India (Nagpur and Belagavi), as well as sites in Pakistan and Guatemala, we evaluated the stillbirth rates and rates of annual decline as well as risk factors for 427,111 births …

Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem

Community Health Sciences

This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It …

Stress Urinary Incontinence In Collegiate Female Athletes: Prevalence And Impact, Marie Bouchard

Master's Projects and Capstones

Abstract

Introduction, definition: Urinary incontinence is the involuntary leaking of urine (a few drops to a few milliliters). It can happen while exercising with no urge to urinate (stress urinary incontinence), with a sudden urge to urinate (overactive bladder or urgency urinary incontinence), or a combination of the two (mixed urinary incontinence). This issue is very common among female athletes. However, because of the reluctance to discuss this problem, it remains underdiagnosed and undertreated.

Methods:An anonymous and confidential survey was distributed to the 90 University of San Francisco female student athletes from seven different varsity sports in December 2017. …

Barriers To Pregnancy Spacing In Women Living With Hiv: A Series Of Informational Interviews, Rachel K. Scott, Piyapa Praditpan, Patricia Tanjutco, Elizabeth Laidlaw, Regina Zopf, Manon M. Schladen

The Qualitative Report

For reproductive-age women living with HIV, birth spacing allows for optimization of maternal health and viral suppression to prevent mother-to-child transmission of HIV. We conducted semi-structured informational interviews to explore use of contraception for birth spacing. Interviews were transcribed and analyzed. Audio files were reviewed to capture non-explicit data. We interviewed 18 multiparous HIV positive women. All described experiences with at least one contraceptive method. Six themes emerged: Burden of contraception, Failure of birth control, Impact of youth and lack of life experience, Community beliefs about birth control, Lack of partner cooperation, and Altruism. Women viewed birth spacing favorably. Young …

A Rare But Life Threatening Case Of Labile Blood Pressures In Pregnancy, Kelsey Carrio, Aarti Aggarwal, Susan Mcgroarty

Rowan-Virtua Research Day

Pheochromocytoma is a rare but life threatening adrenal secreting tumor. The infrequency with which it is encountered makes pheochromocytoma, especially in pregnancy, a formidable diagnostic challenge.

Although a pheochromocytoma is rare, it is good to keep it in differential diagnosis as a possible cause of labile BP with headaches and significant orthostatic BP. It is critical to recognize this condition to institute an appropriate therapy & surgical intervention to prevent mortality.

Cross Talk Between Serum Kisspeptin-Leptin During Assisted Reproduction Techniques, Rehana Rehman, Zehra Jamil, Aqsa Khalid, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

Background & Objective: Leptin facilitates onset of puberty by impact on hypothalamic Kisspeptin, gonadotropin releasing hormone, follicle stimulating and luteinizing hormone. The link of peripheral Leptin-Kisspeptin in regulating the ovarian and endometrial tissue in relation to adiposity is unknown. Therefore, we wanted to identify Kisspeptin-Leptin association with body mass index (BMI) and success of assisted reproductive treatments (ART) in infertile females.
Methods: A cross sectional study was carried from August 2014 till May 2016 after receiving ethical approval at Australian Concept Infertility Medical Centre, and Aga Khan University. The study group comprised of females with an age range …

Investigating Ampk Signalling Regulation Of Autophagy In A Model Of Ovarian Tumour Dormancy, Jeremi Laski

Western Research Forum

Investigating AMPK signalling regulation of autophagy in a model of ovarian tumour dormancy

Jeremi Laski and Trevor G. Shepherd

Background:

Ovarian cancer is the most deadly gynecologic malignancy in women. A particular subset of this disease, epithelial ovarian cancer (EOC), is responsible for over 70% of all diagnosed ovarian cancer cases, yet the mechanisms governing disease progression are poorly understood. One of the unique hallmarks of EOC metastasis lies in the process of spheroid formation, whereby tumour cells aggregate into larger 3D structures. These EOC spheroids have been shown to be metabolically dormant, while concurrently up-regulating autophagy (cellular waste …

Possible Causes Of Preeclampsia And Potential Treatments, Helene Weinreb

The Science Journal of the Lander College of Arts and Sciences

Preeclampsia is a common complication of pregnancy characterized by hypertension and proteinuria. Its symptoms are well-defined, but the pathophysiology is not fully understood. This paper analyzes several of the most credible causes of this syndrome and attempts to relate these to the known risk factors. Current preeclampsia treatments are examined, and special focus is given to novel experimental treatments which offer hope of ending preeclampsia and eclampsia.

Placental Eicosanoids And Sphingolipids In Preeclampsia, Daniel T. Reep

Theses and Dissertations

Placental dysfunction is implicated in the pathogenesis of preeclampsia. Chemical signals between the placenta and maternal circulation are a suspect cause of endothelial dysfunction and maternal hypertension. This study examined select lipid mediators of inflammation produced by the placenta. Patients were recruited from Virginia Commonwealth University’s pregnancy clinics and placentas were collected at delivery. Forty-eight-hour explant cultures of villous placental tissue were used to model lipid production. Electrospray ionization mass spectrometry was used to quantify concentrations of free lipids in the culture media. Bicinchoninic acid assays were performed to quantify protein in each culture for normalization of lipid data. After …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin …

Responding To Infertility: Lessons From A Growing Body Of Research And Suggested Guidelines For Practice, Karina M. Shreffler, Arthur L. Greil, Julia Mcquillan

Department of Sociology: Faculty Publications

Infertility is a common, yet often misunderstood, experience. Infertility is an important topic for family scientists because of its effects on families; its relevance to research in related areas, such as fertility trends and reproductive health; and its implications for practitioners who work with individuals and couples experiencing infertility. In this review, we focus on common misperceptions in knowledge and treatment of infertility and highlight insights from recent research that includes men, couples, and people with infertility who are not in treatment. The meaning of parenthood, childlessness, awareness of a fertility problem, and access to resources are particularly relevant for …

A Functional Algorithm For Weight Loss And Obesity Practice: Guide For Clinical Decision-Making For Treating Women, Jennifer A. Tice Williams

Dissertations

ABSTRACT

Background

Overweight and obesity have significant impact and consequences on women leading to reduced quality of life, comorbid conditions and premature mortality. Many healthcare providers lack adequate training and the time to properly treat overweight and obesity. Algorithms have been shown to improve clinical knowledge and save time.

Objectives

To develop an algorithm for weight loss assessment and treatment to aid in the clinical decision-making process while improving the quality of care for overweight and obese clients in an efficient manner that can be replicated.

Methods

After an extensive literature review to identify best-practice guidelines for weight loss a …

Chlamydia Screening In Women At A University Student Health Center, Jaime K. Carroll, Karen Macauley

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidenced-based project was to increase chlamydia pre- screening and screening in women under age 25 presenting with urinary symptoms. Interventions included chlamydia pre-screening alerts embedded into the electronic medical record. Three-month evaluation showed a chlamydia pre-screening rate of 100% and an increase in chlamydia screening by 9%.

Zika 2016: A 3-Phase Longitudinal Study Of The Media Impact On Public Attitudes And Behavioral Response Characteristics, Karly Kownslar

Electronic Theses & Dissertations

Using the Extended Parallel Processing Model (EPPM) as a theoretical framework, the present 3-phase longitudinal study examines the impact of media exposure to Zika information on public perception of the threat severity, personal susceptibility, and behavioral intentions toward the threat of Zika virus between May and November of 2016. A total of 826 participants took an online survey throughout three phases, roughly one month apart. Participants were recruited using Amazon Mechanical Turk and TurkPrime. Measured EPPM concepts include: perceived severity, susceptibility, self- efficacy, response-efficacy, third-person effects, combined with behavioral intentions. Participants also selected the sources from which they …

Cranberry Juice Vs. Placebo As Prophylaxis For Recurrent Urinary Tract Infection In Adult Women: A Systematic Review, Donald S. Trawick, Hinda Mezaache

Physician Assistant Capstones, 2016 to 2019

Objective: To determine the effectiveness of cranberry juice consumption as prophylaxis for urinary tract infection (UTI) in women with a history of recurrent UTI. Methods: Systematic literature review using Google Scholar with search terms “cranberry juice prophylaxis.” Results: Our search resulted in three randomized-control trials (RCTs), two of which demonstrated no benefit of cranberry juice in preventing recurrent UTI. Conclusion: Because of the significant heterogeneity among published studies, there is no definitive proof that cranberry juice is effective or useless as UTI prophylaxis.

Characterization Of E-Cadherin Regulation In Response To Zeb1 Inhibition In Endometrial Cancer Cell Lines, Chidozie Paul Chukwu

Graduate School of Biomedical Sciences Theses and Dissertations

Epithelial to mesenchymal transition (EMT) is the process in which cells lose their epithelial structure during gastrulation. This process also affects the migration and movement of tumor cells and promotes invasion and metastases of endometrial carcinomas. Down-regulation of E-cadherin (CDH1) by transcription factors is the key target of EMT modulators and is achieved mainly by ZEB1 (zinc finger E-box binding homeobox 1). Current research looking at restoration of E-cadherin expression in vitro involves the use of small molecules such as histone deacetylase (HDAC) inhibitors and DNA methyltransferase inhibitors. Trichostatin A (TSA) and small interfering ribonucleic acid (siRNA) are tools that …

Chat Expression In Chlamydia Muridarum-Infected Female Murine Genital Tract, Hallie Sartain

Undergraduate Honors Theses

Chlamydia trachomatis is the most prevalent agent of bacterial sexually transmitted infections in the world. However, a profuse number of cases are unreported, as the infection is often asymptomatic. Sequelae such as pelvic inflammatory disease, an increased risk of cervical cancer, premature birth, and perinatal infections in pregnant women can occur. Inflammation occurs in the body in response to infection or injury. Although inflammation can lead to some unwanted secondary effects, such as pain, it serves to return the body to homeostasis by restoring injured tissues and eliminating pathogens. One recently identified connection between the central nervous system and the …

Plasma Cross-Gestational Sphingolipidomic Analyses Reveal Potential First Trimester Biomarkers Of Preeclampsia, Aneta Dobierzewska, Sony Soman, Sebastian E Illanes, Andrew J. Morris

Saha Cardiovascular Research Center Faculty Publications

Introduction

Preeclampsia (PE) is a gestational disorder, manifested in the second half of pregnancy by maternal hypertension, proteinuria and generalized edema. PE is a major cause of maternal and fetal morbidity and mortality, accounting for nearly 40% of all premature births worldwide. Bioactive sphingolipids are emerging as key molecules involved in etiopathogenesis of PE, characterized by maternal angiogenic imbalance and symptoms of metabolic syndrome. The aim of this study was to compare the cross-gestational profile of circulating bioactive sphingolipids in maternal plasma from preeclamptic (PE) versus normotensive control (CTL) subjects with the goal of identifying sphingolipids as candidate first trimester …