Medical Specialties Commons^™

Effect Of Covid On Postpartum Depression (Ppd), Reshma Thomas, Karen Krieg, Joanna Petrides

Rowan-Virtua Research Day

Purpose:

1. To determine if the rates of postpartum depression have changed during COVID
2. To identify differences in characteristics of women with postpartum depression during COVID

Factors Influencing The Need For And Access To Ivf Treatment, Catherine Alapatt, Yoona Choe, Anthony Knepp, Shika Veera, Shawna M Rotoli

Rowan-Virtua Research Day

Infertility is defined as the inability for a couple to become pregnant after 12 months of regular unprotected sexual intercourse. Infertility can stem from an issue with the female reproductive tract, the male reproductive tract, or both. Individuals struggling with infertility seek medical assistance for a successful reproductive course. However, there are many aspects outside of pathology that may encourage or deter an individual to elect for medical assistance such as in vitro fertilization (IVF). In vitro fertilization is defined as a medical procedure in which an egg is fertilized outside the body. The increased usage of IVF demonstrates the …

Opioid Usage In Pregnant Women, Sheron Mehak, Karen Krieg

Rowan-Virtua Research Day

Women have a heightened sense of health during pregnancy, especially first pregnancies. They often pay closer attention to taking medications (both over the counter and prescribed). Some discontinue smoking and choose healthier diet choices. The question or hypothesis of this research is to examine if this heightened sense of health during pregnancy has any effect on the choice to use recreational drugs during pregnancy.

Foci Of Idc In Phyllodes Tumors: Should We Be Worried?: A Systematic Review Of The Literature, Kathryn Eckert, Victoria Tiedemann, Linda Szczurek

Rowan-Virtua Research Day

Phyllodes tumors are rare, fast growing fibroepithelial tumors of the breast that account for less than 1% of all breast tumors globally. They were first characterized by Johannes Muller in 1838 and most often present in the 5th decade of life. Phyllodes tumors are histologically composed of a stromal component and an epithelial component. The stromal component has a widely accepted malignant potential in up to 30% of cases. Grading of the stromal malignant potential of phyllodes tumors has been defined by the World Health Organization (WHO) as benign, borderline, or malignant based on the presence and degree of stromal …

Intraovarian, Isoform-Specific Transcriptional Roles Of Progesterone Receptor In Ovulation, Kirsten M Smith, Doan T Dinh, Lisa K Akison, Matilda Nicholls, Kylie R Dunning, Atsushi Morimoto, John P Lydon, Darryl L Russell, Rebecca L Robker

Faculty, Staff and Students Publications

Progesterone receptor (PGR) activity is obligatory for mammalian ovulation; however, there is no established direct functional pathway explaining how progesterone receptor completely and specifically regulates oocyte release. This study examined the overarching cell- and isoform-specific effects of the PGR within each cellular compartment of the ovary, using mice null for the PGR (PRKO), as well as isoform-specific null mice. The PGR was expressed in ovarian granulosa and stromal cells and although PRKO ovaries showed no visible histological changes in preovulatory ovarian morphology, follicle rupture did not occur. Reciprocal ovarian transplant experiments established the necessity of ovarian PGR expression for ovulation. …

Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …

Effectiveness Of Prenatal Screening Tests On Predicting Cardiac Anomalies, Stephanie Y. Wong, Zeynep Alpay Savasan

Posters

INTRODUCTION
Congenital heart disease (CHD) is the leading cause of birth defect-associated infant death. With 1 in 111 newborns born with CHD and an elevated infant mortality rate of 30-50%, early detection is imperative. Current prenatal screening mainly focuses on detecting chromosomal anomalies. However, the accuracy of these exams on detecting fetal cardiac abnormalities is not well researched. The primary goal of this study is to compare three prenatal screening tests’ potential, i.e anatomy ultrasound, nuchal translucency (NT), and cell-free DNA (cfDNA), in identifying risk for fetal cardiac anomalies.

Descriptive Causes For Decreased Breast And Cervical Screenings In Sikh Populations, Varneet Kaur Brar

Posters

INTRODUCTION
Prior evaluations of breast and cervical cancer screens have found that immigrant South Asian women have lower compliance rates when compared to non-immigrant, white, or African American women (Shoemaker, 2016). It is widely accepted that early detection of cancers can improve outcomes for patients, and that screenings like mammography and pap smear tests are critical in this process. The aim of this study was to evaluate compliance rates for breast cervical cancer screens in Sikh women in Michigan, as well as to investigate attitudes which may be contributing to any disparities which may exist.

Identifying Discrepancies In Diagnosis Of Pcos With Use Of Different Diagnostic Criteria, Naveena Daram, Sangeeeta Kaur

Posters

INTRODUCTION
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Two main diagnostic criteria are used for PCOS: the Rotterdam and Androgen Excess Society (AES) criteria. Depending on which criteria is used, the diagnosis of PCOS may change. Therefore, our study investigates the discrepancies in the diagnosis of PCOS when using the Rotterdam versus the AES scale in the Beaumont Health System. This is clinically significant because a PCOS diagnosis should not be made lightly as it can come with many lifelong social, emotional, and medical implications.

Vbac Success In Women With Diabetes Mellitus Types I + Ii: A Pilot Study, Emma Randall, Rachel Taylor, Sarah Becker, Zeynep Alpay-Savasan

Posters

Due to a rise in cesarean sections since the 1970s, the American College of Gynecology has acted to reduce unnecessary cesarean deliveries. In 2017, ACOG released clinical management guidelines for vaginal birth after cesarean delivery (VBAC), including a nomogram to predict VBAC success. This nomogram, developed by Grobman et al. (2007), explored factors impacting VBAC success for delivery at term for a singleton pregnancy. While the presence of diabetes was evaluated in the study, it was not found to be a significant factor in predicting outcome. This study will take a more detailed look at if pre-existing diabetes impacts a …

Effects Of Increased Levels Of Relaxin Hormone In Women During Pregnancy In Relation To Spondylolisthesis: A Literature Review, Joselin R. Guerrero Rapalo

Honors Theses

No abstract provided.

A Community-Based Approach To Cervical Cancer Prevention In Western Kenya: An Ampath Feasibility Project, Elkanah Omenge, Philip Tonui, Kapten Muthoka, Stephen Kiptoo, Titus Maina, Mercy Agosa, Aaron Ermel, Yan Tong, Darron Brown

Obstetrics and Gynaecology, East Africa

Objectives: Centralized programs have been ineffective in reducing the burden of cervical cancer among Kenyan women. A community-based pilot study was initiated to screen Kenyan women for cervical cancer and to vaccinate their children against human papillomavirus (HPV).

Methods: Women were educated about cervical cancer prevention at community meetings. Women then provided self-collected vaginal swabs for oncogenic HPV testing using the Roche Cobas Assay. All women were then referred to the local clinic for Visual Inspection with Acetic Acid (VIA). Women were offered the quadrivalent HPV vaccine for their children if and when it became available for the …

Determinants Of The Uptake Of Prenatal Aneuploidy Screening Among Pregnant Women At The Aga Khan University Hospital, Nairobi, Kenya, Duncan Ndegwa

Master of Medicine in Obstetrics and Gynecology

INTRODUCTION: Aneuploidies present with an abnormal copy number of chromosomes. Majority are lethal with only a handful carrying on to term and beyond in pregnancy. Its currently recommended that all pregnant women be offered screening for aneuploidies. This is to facilitate pregnant women make informed choices regarding their pregnancies. At present the current uptake rate of aneuploidy screening in Kenya is unknown. The purpose of this study this study was to determine whether pregnant women are aware of aneuploidy screening, the uptake rate of screening and the determinants of screening at a tertiary private healthcare facility in Nairobi, Kenya. METHODS: …

Association Between Third Trimester Cerebro-Placental Ratio And Adverse Outcomes In Appropriate For Gestational Age Foetuses, Morris Wabacha Kimani

Master of Medicine in Obstetrics and Gynecology

Background: Small for gestational age (SGA) fetuses are at increased risk of adverse outcomes and appropriate vigilance is put in place in terms of antenatal and intrapartum surveillance. Appropriate for gestational age (AGA) fetuses have a lower incidence of adverse outcomes, although majority of these outcomes occur in this cohort. AGA fetuses can fail to reach their genetic growth potential due to placental insufficiency and 25 % have actually been found to have placental histological features of chronic hypoxia. Therefore, there is need to use other methods of screening for adverse perinatal outcomes apart from estimated fetal weight (EFW), with …

Increasing Patient Satisfaction Of Post-Cesarean Mothers: An Evidence-Based Practice Quality Improvement Project, Amanda Jones

DNP Projects

Introduction: The first hour after delivery, referred to as the “Golden Hour” or “Sacred Hour,” is when the mom, baby, and the support person get 1-hour of uninterrupted bonding time together. This time is critical because it promotes neonatal thermoregulation, decreases newborn stress levels, improves mother–newborn attachment, and encourages breastfeeding. Unfortunately, most cesarean births do not receive the Golden Hour and instead experience delayed bonding time.

Purpose: The purpose of this Evidence-Based Practice (EBP) project was to incorporate the Golden Hour for post-cesarean section mothers in a mid-sized community-based hospital in XXX, CT in order to increase patient satisfaction post-c-section; …

The Effects Of Hormonal Contraceptive Use On Perceptions Of Social Stress In Women, Ashton Jones

Biological Sciences Undergraduate Honors Theses

Hormonal contraceptives are widely used due to their efficiency in preventing pregnancy. Although women are often informed of the physical effects of hormonal contraceptives, there is little emphasis on mental effects, such as increased rates of depression and changes in social perception. The current study examined perceptions of social stress among women before beginning hormonal contraceptives, and two months after using hormonal contraceptives. I hypothesized that women would experience increased social stress after beginning hormonal contraceptives, compared to a control group of women who were also assessed twice. Results did not support this hypothesis; there was no difference in interpersonal …

Early Neonatal Mortality Is Modulated By Gestational Age, Birthweight And Fetal Heart Rate Abnormalities In The Low Resource Setting In Tanzania – A Five Year Review 2015–2019, Aisa Shayo, Pendo Mlay, Emily Ahn, Hussein Kidanto, Michael Espiritu, Jeffrey Perlman

Obstetrics and Gynaecology, East Africa

Background: Early Neonatal mortality (ENM) (<7days) remains a signifcant problem in low resource settings. Birth asphyxia (BA), prematurity and presumed infection contribute signifcantly to ENM. The study objectives were to determine: frst, the overall ENM rate as well as yearly ENM rate (ENMR) from 2015 to 2019; second, the infuence of decreasing GA (<37weeks) and BW (<2500g) on ENM; third, the contribution of intrapartum and delivery room factors and in particular fetal heart rate abnormalities (FHRT) to ENM; and fourth, the Fresh Still Birth Rates (FSB) rates over the same time period.

Methods: Retrospective cohort study undertaken in a zonal referral teaching hospital located in Northern Tanzania. Labor and delivery room data were obtained from 2015 to 2019 and included BW, GA, fetal heart rate (FHRT) abnormalities, bag mask ventilation (BMV) during resuscitation, initial temperature, and antenatal steroids use. Abnormal outcome was ENM<7days. Analysis included t tests, odds ratios (OR), and multivariate regression analysis.

Results: The overall early neonatal mortality rate (ENMR) was 18/1000 livebirths over the 5 years and did not change signifcantly comparing 2015 to 2019. Comparing year 2018 to 2019, the overall ENMR decreased signifcantly (OR 0.62; 95% confdence interval (CI) …

Prenatal Testing Decisions And Motivations In Pregnancies Conceived Via In Vitro Fertilization, Michelle Appel

Dissertations and Theses (Open Access)

Currently, there is limited information about how conceiving through in vitro fertilization (IVF) and preimplantation genetic testing for aneuploidy (PGT-A) impact the decisions individuals make about prenatal genetic testing. This quantitative study aimed to examine the prenatal testing decisions made by pregnant individuals who conceived via IVF as well as to compare the prenatal testing decisions and motivations between those who had PGT-A and those who did not. An anonymous survey was distributed through online support forums and in clinical settings to eligible individuals. Overall, 230 complete responses were collected with 203 participants far enough along in pregnancy to make …

Impact Of Homologous Recombination Status And Responses With Veliparib Combined With First-Line Chemotherapy In Ovarian Cancer In The Phase 3 Velia/Gog-3005 Study, Elizabeth M Swisher, Carol Aghajanian, David M O'Malley, Gini F Fleming, Scott H Kaufmann, Douglas A Levine, Michael J Birrer, Kathleen N Moore, Nick M Spirtos, Mark S Shahin, Thomas J Reid, Michael Friedlander, Karina Dahl Steffensen, Aikou Okamoto, Vasudha Sehgal, Peter J Ansell, Minh H Dinh, Michael A Bookman, Robert L Coleman

Kimmel Cancer Center Faculty Papers

Objective: In the Phase 3 VELIA trial (NCT02470585), PARP inhibitor (PARPi) veliparib was combined with first-line chemotherapy and continued as maintenance for patients with ovarian carcinoma enrolled regardless of chemotherapy response or biomarker status. Here, we report exploratory analyses of the impact of homologous recombination deficient (HRD) or proficient (HRP) status on progression-free survival (PFS) and objective response rates during chemotherapy.

Methods: Women with Stage III-IV ovarian carcinoma were randomized to veliparib-throughout, veliparib-combination-only, or placebo. Stratification factors included timing of surgery and germline BRCA mutation status. HRD status was dichotomized at genomic instability score 33. During combination therapy, …

Targeting Metabolic Adaptations To Anti-Angiogenic Therapy In Ovarian Cancer, Deanna M. Glassman, Deanna Glassman

Dissertations and Theses (Open Access)

ABSTRACT

Background: Ovarian cancer is the most lethal gynecologic malignancy. Despite modest clinical improvements with anti-VEGF antibody (AVA) therapy, adaptive resistance is nearly ubiquitous and additional therapeutic options are limited. A dependence on glutamine metabolism, via the enzyme glutaminase (GLS), is a known mechanism of adaptive resistance.

Purpose: To assess the efficacy of a glutaminase inhibitor as a means of exploiting the metabolic vulnerability of glutamine dependence that develops as a result of adaptive resistance to AVA therapy.

Experimental Design: We used a glutaminase inhibitor (GLSi) synthesized at MD Anderson Cancer Center for all in vitro and in vivo experiments. …

Physiological Mechanisms Of The Impact Of Heat During Pregnancy And The Clinical Implications: Review Of The Evidence From An Expert Group Meeting, Louisa Samuels, Britt Nakstad, Nathalie Roos, Ana Bonell, Matthew Chersich, George Havenith, Stanley Luchters, Louise-Tina Day, Jane E. Hirst, Tanya Singh

Population Health, East Africa

Many populations experience high seasonal temperatures. Pregnant women are considered vulnerable to extreme heat because ambient heat exposure has been linked to pregnancy complications including preterm birth and low birthweight. The physiological mechanisms that underpin these associations are poorly understood. We reviewed the existing research evidence to clarify the mechanisms that lead to adverse pregnancy outcomes in order to inform public health actions. A multi-disciplinary expert group met to review the existing evidence base and formulate a consensus regarding the physiological mechanisms that mediate the efect of high ambient temperature on pregnancy. A literature search was conducted in advance of …

An Evaluation Of Seasonal Maternal-Neonatal Morbidity Related To Trainee Cycles, Ayamo Oben, Paula Mcgee, William A Grobman, Jennifer L Bailit, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units Network

Faculty, Staff and Student Publications

BACKGROUND:

The existence of the “July phenomenon” (worse outcomes related to the presence of new physician trainees in teaching hospitals) has been debated in the literature and media. Previous studies of the phenomenon in obstetrics are limited by the quality and detail of data.

OBJECTIVE:

To evaluate whether the months of June to August, when transitions in trainees occur, are associated with increased maternal and neonatal morbidity.

STUDY DESIGN:

Secondary analysis of an observational cohort of 115,502 mother–infant pairs that delivered at 25 hospitals from March 2008 to February 2011. Inclusion criteria were an individual who had a singleton, nonanomalous …

Predictive Performance Of Newborn Small For Gestational Age By A Us Intrauterine Versus Birth Weight-Derived Standard For Short-Term Neonatal Morbidity And Mortality, Nathan R Blue, Lisa Mele, William A Grobman, Jennifer L Bailit, Ronald J Wapner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

Objective:

The use of birth weight standards to define small for gestational age (SGA) may fail to identify neonates affected by poor fetal growth since they include births associated with sub-optimal fetal growth. Our objective was to compare intrauterine versus birth weight-derived standards to define newborn SGA to predict neonatal morbidity and mortality.

Study Design:

This was a secondary analysis of a multi-center observational study of 118,422 births. Liveborn singleton, non-anomalous newborns born at 23–41 weeks were included. Those with missing gestational age estimation or without a 1^st or 2^nd trimester ultrasound to confirm dating, birth weight, or …

Copper Intrauterine Device Is An Appropriate Method Of Contraception For A Patient With A History Of Systemic Lupus Erythematosus, Sydney E. Daviskiba

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Sánchez-Guerrero J, Uribe AG, Jiménez-Santana L, et al. A Trial of Contraceptive Methods in Women with Systemic Lupus Erythematosus. N Engl J Med. 2005;353(24):2539-2588. https:/doi.org/10.1056/nejmoa050817

for a patient with systemic lupus erythematosus choosing a method of contraception.

Assessment Of Obstetric Outcomes Graphs And Figures For New Mainers, Amy Haskins, Brendan Prast, Tina Holt

Costas T. Lambrew Research Retreat 2022

Introduction

• 4% of Maine’s population in 2018 was recent immigrants

• Maine Medical Center provides obstetrical care for more newly arrived, non- English speaking patients

• Increased risk for health disparities due to: language barriers, low socioeconomic status and stressors from a history of trauma.

Cross-Sectional Survey Regarding Marijuana Use In Pregnancy, Kathleen S. Carlson

Costas T. Lambrew Research Retreat 2022

Introduction • There is a paucity of data regarding extent and patterns of marijuana use in pregnancy. • Nausea, sleep problems, anxiety are commonly reported reasons for use (Kaarid, 2021) • Marijuana use in pregnancy is associated with increased risk for neonates of preterm delivery, NICU admission, small for gestational age, and lower 1min APGAR scores (Marchand, 2022) • Knowledge of reasons and patterns of marijuana use is important to properly counsel patients, identify patients at risk for use during pregnancy and to offer alternative therapies that are safer during pregnancy.

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Protecting A Woman’S Right To Abortion During A Public Health Crisis, San Juanita Gonzalez

The Scholar: St. Mary's Law Review on Race and Social Justice

As COVID-19 infected our nation, states were quick to issue executive orders restricting various aspects of daily life under the pretense of public safety. It was clear at the outset that certain civil liberties were going to be tested. Among them, the constitutional right to an abortion.

This comment explores Texas’ response to the COVID-19 pandemic and the limitations it imposed on abortion access. It will attempt to address the legitimacy of the “public health concerns” listed in executive orders issued throughout numerous states and will discuss the pertinent legal framework and judicial scrutiny to apply.

According to the Fifth …

Hyperactivation Is Sufficient To Release Porcine Sperm From Immobilized Oviduct Glycans, Momal Sharif, Vincent Hickl, Gabriel Juarez, Xingjian Di, Karl Kerns, Peter Sutovsky, Nicolai Bovin, David J Miller

Faculty, Staff and Students Publications

Fertilizing sperm are retained by adhesion to specific glycans on the epithelium of the oviduct forming a reservoir before sperm are released from the reservoir so fertilization can ensue. Capacitated sperm lose affinity for the oviduct epithelium but the components of capacitation that are important for sperm release are uncertain. One important correlate of capacitation is the development of hyperactivated motility. Hyperactivation is characterized by asymmetrical flagellar beating with high beat amplitude. We tested whether the development of full-type asymmetrical motility was sufficient to release sperm from immobilized oviduct glycans. Sperm hyperactivation was induced by four different compounds, a cell-permeable …

Surgery In Advanced Ovary Cancer: Primary Versus Interval Cytoreduction, Mackenzie Cummings, Olivia Nicolais, Mark S. Shahin

Department of Obstetrics and Gynecology Faculty Papers

Primary debulking surgery (PDS) has remained the only treatment of ovarian cancer with survival advantage since its development in the 1970s. However, survival advantage is only observed in patients who are optimally resected. Neoadjuvant chemotherapy (NACT) has emerged as an alternative for patients in whom optimal resection is unlikely and/or patients with comorbidities at high risk for perioperative complications. The purpose of this review is to summarize the evidence to date for PDS and NACT in the treatment of stage III/IV ovarian carcinoma. We systematically searched the PubMed database for relevant articles. Prior to 2010, NACT was reserved for non-surgical …