Medical Specialties Commons^™

Hematologic Autoimmune And Oncology In Pregnancy, Frederick U Eruo

Conference Presentation Abstracts

No abstract provided.

Obstetric Emergencies, Frederick U Eruo

Conference Presentation Abstracts

No abstract provided.

Prenatal Diagnosis, Frederick U Eruo

Conference Presentation Abstracts

No abstract provided.

A Novel In Vitro Method For Pelvic Floor Dysfunction In Pcos Women, Ruben Vila

University Honors Theses

Background:

Poly Cystic Ovary Syndrome and Pelvic Floor Dysfunction are reproductive diseases with comorbidities whose novel relationship deserves further investigation.

Methods:

Levator Ani Muscle/Paravaginal Attachment was dissected from female Rhesus Macaque and subjected to tissue dissociation. Cells were treated with serum level hormones E2, T, and DHT. PCR, ICC, and IHC were used, followed by statistical analysis.

Results:

RNA analysis show differences in relative expression for endpoints ER, PR, AR, Ki-67, Col1A, and Vimentin. IHC along with ICC showed expression and localization in vivo.

Conclusions:

A novel in vitro model was created from macaque Levator Ani Muscle/Paravaginal Attachment for Pelvic …

Uterine Artery Embolization Combined With Methotrexate For Broad Ligament Ectopic Pregnancy In A 30-Year Old Primigravida, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Shaista Riaz, Samreen Aslam, Zouina Ameena

Department of Paediatrics and Child Health

We present the case of 30-year old primigravida female at 11 weeks' gestation who was diagnosed to have ectopic pregnancy on obstetric ultrasound. An MRI pelvis was ordered to assess invasion into the posterior myometrium which confirmed a single right-sided broad ligament-extra uterine pelvic ectopic pregnancy with extrinsic mass effect on the right lower uterine segment without frank myometrial invasion. On an urgent basis, a uterine artery embolization (UAE) was performed by targeting the right femoral artery. Selective catheterization was performed of both uterine arteries and the right side showed a major feeder of the gestational sac. Supplied dose of …

The Ways In Which Women’S Suffrage Affected Healthcare, Madison M. Weber

The Review: A Journal of Undergraduate Student Research

The 19th Amendment had and continues to have a major impact on women’s healthcare in the United States. Prior to suffrage, women had little to no ability to voice their thoughts on and change policies that regarded their own health. This essay addresses the way in which the vote both directly and indirectly impacted healthcare; including workplace conditions, maternal and reproductive rights, racial disparities, political advocacy and healthcare, the different waves of feminism, and how this has all affected modern healthcare for women. From progressive articles being published in women's magazines, to the establishment of marital rape, to the availability …

Improving Outcomes For Pregnant Women With Severe Hypertension, Danette Schloeder

2021 Providence Nurse Research Conference

Background: In 2019, a large hospital in Alaska joined the Alaska Perinatal Quality Collaborative (PQC). The first project was the AIM Hypertension Project. The goals of the project were to reduce severe maternal morbidity among preeclampsia cases by 20% and Increase the timely treatment of hypertension to 80%. Other process and structure measures included education, simulation, clinical debriefs, and follow-up visits.

Methods/Approach: The PQC used monthly educational sessions, data collection and review of every case with severe hypertension, and Plan-Do-Study-Act cycles. Data collection occurred over an 18-month period. Cases were identified by the Washington State Hospital Association database and reviewed …

Water-Fat Magnetic Resonance Imaging Of Adipose Tissue Compartments In The Normal Third Trimester Fetus, Stephanie A Giza, Tianna L Koreman, Simran Sethi, Michael R Miller, Debbie A Penava, Genevieve D Eastabrook, Charles A Mckenzie, Barbra De Vrijer

Obstetrics & Gynaecology Publications

BACKGROUND: Assessment of fetal adipose tissue gives information about the future metabolic health of an individual, with evidence that the development of this tissue has regional heterogeneity.

OBJECTIVE: To assess differences in the proton density fat fraction (PDFF) between fetal adipose tissue compartments in the third trimester using water-fat magnetic resonance imaging (MRI).

MATERIALS AND METHODS: Water-fat MRI was performed in a 1.5-T scanner. Fetal adipose tissue was segmented into cheeks, thorax, abdomen, upper arms, forearms, thighs and lower legs. PDFF and R2* values were measured in each compartment.

RESULTS: Twenty-eight women with singleton pregnancies were imaged between 28 and …

Augmented Package Of Palliative Care For Women With Cervical Cancer: Responding To Refractory Suffering, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa

Department of Anaesthesia

The essential package of palliative care for cervical cancer (EPPCCC), described elsewhere, is designed to be safe and effective for preventing and relieving most suffering associated with cervical cancer and universally accessible. However, it appears that women with cervical cancer, more frequently than patients with other cancers, experience various types of suffering that are refractory to basic palliative care such as what can be provided with the EPPCCC. In particular, relief of refractory pain, vomiting because of bowel obstruction, bleeding, and psychosocial suffering may require additional expertise, medicines, or equipment. Therefore, we convened a group of experienced experts in all …

Maternal Sociodemographic Factors And Antenatal Stress, Maheshwari Andhavarapu, James Orwa, Marleen Temmerman, Wangira Musana

Obstetrics and Gynaecology, East Africa

Antenatal stress has been associated with adverse birth outcomes such as fetal growth restriction, low birth weight, and preterm birth. Understanding key determinants of stress in a vulnerable pregnant population has the potential of informing development of targeted cost-effective interventions to mitigate against these adverse birth outcomes. We conducted a secondary analysis of data from 150 pregnant women attending antenatal care services at a rural referral hospital in Kenya. The participants completed a sociodemographic and clinical questionnaire, the Cohen’s Perceived Stress Scale (PSS) and gave a hair sample for cortisol and cortisone analysis. The association between selected sociodemographic predictors (age, …

The Association Of Symptoms Of Overactive Bladder With Pelvic Organ Prolapse And Its Improvement After Pelvic Reconstructive Surgery, Saida Abrar, Raheela Mohsin Rizvi, Nida Zahid

Department of Obstetrics & Gynaecology

Objectives: This study asseses the association of overactive bladder symptoms and pelvic organ prolapse severity and evaluates the effect of pelvic reconstructive surgery on overactive bladder (OAB) symptoms in women with pelvic organ prolapse (POP). It also looks into any pre and post-operative factors responsible for persistent postoperative OAB symptoms.
Methods: This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Karachi between 1st January 2014 and 31st December 2018. In this study women presenting with POP and concommitent OAB who underwent surgery for site specific defects, measured using Pelvic Organ Prolapse Quantification (POP-Q) staging system. OAB …

Inequalities In Early Marriage, Childbearing And Sexual Debut Among Adolescents In Sub-Saharan Africa, Dessalegn Y. Melesse, Réka M. Cane, Aveneni Mangombe, Macellina Y. Ijadunola, Adom Manu, Eniola Bamgboye, Abdu Mohiddin, Rornald M. Kananura, Elsie Akwara, Elsabé Du Plessis

Obstetrics and Gynaecology, East Africa

Background: Adolescent sexual and reproductive health (ASRH) is a major public health concern in sub-Saharan Africa (SSA). However, inequalities in ASRH have received less attention than many other public health priority areas, in part due to limited data. In this study, we examine inequalities in key ASRH indicators.

Methods: We analyzed national household surveys from 37 countries in SSA, conducted during 1990–2018, to exam- ine trends and inequalities in adolescent behaviors related to early marriage, childbearing and sexual debut among adolescents using data from respondents 15–24 years. Survival analyses were conducted on each survey to obtain estimates for …

Intimate Partner Violence Against Adolescents And Young Women In Sub-Saharan Africa: Who Is Most Vulnerable?, Yohannes Dibaba Wado, Martin K. Mutua, Abdu Mohiddin, Macellina Y. Ijadunola, Cheikh Faye, Carolina V. N. Coll, Aluisio J. D. Barros, Caroline W. Kabiru

Obstetrics and Gynaecology, East Africa

Background: Intimate partner violence (IPV) is a global public health and human rights issue that affects millions of women and girls. While disaggregated national statistics are crucial to assess inequalities, little evidence exists on inequalities in exposure to violence against adolescents and young women (AYW). The aim of this study was to deter- mine inequalities in physical or sexual IPV against AYW and beliefs about gender based violence (GBV) in sub-Saharan Africa (SSA).

Methods: We used data from the most recent Demographic and Health Surveys (DHS) conducted in 27 countries in SSA. Only data from surveys conducted after …

Ferumoxytol For The Treatment Of Iron Deficiency And Iron-Deficiency Anemia Of Pregnancy., Jesse Gerb, William Strauss, Richard Derman, Vanessa Short, Phd, Mph, Ben Mendelson, Huzefa Bahrain, Michael Auerbach

Department of Obstetrics and Gynecology Faculty Papers

Introduction: A litany of recent evidence supports the morbidity of intra-natal iron-deficiency anemia and its prodrome, iron deficiency. Oral iron administered during second and third trimesters does not get to the developing fetus if the mother is iron deficient. This is especially concerning as the rapidly developing fetal brain is in particular need of iron sufficiency. Intra-natal iron deficiency is associated with autism, schizophrenia and abnormal brain structure. The obstetrical literature reports an unacceptably high incidence of gastrointestinal adverse events with oral iron. The time iron honored standard in the United States for intravenous iron replenishment in gravidas is iron …

Unique Evaluation And Management Considerations For Adolescents With Late Gynecologic And Colorectal Issues In The Setting Of Anorectal Malformations, Wendy Jo Svetanoff

Research Days

Background: Females born with anorectal malformations (ARMs) and bladder exstrophy have a greater incidence of Mullerian and genital anomalies requiring early gynecologic assessment and frequent surgical intervention. However, there is little guidance for management considerations of pubertally identified Mullerian anomalies in these patients

Objectives/Goal: We sought to assess the unique colorectal, gynecologic, and psychological issues present during the adolescent years.

Methods/Design: A retrospective review was performed of 10-25 year old female patients born with an ARM, cloaca, or exstrophy that presented to our multidisciplinary clinic between 2009 and 2019. Data abstracted included the presenting problem, history, imaging studies, psychological evaluation, …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …

Do Males With 45,X/46,Xy Mosaicism Have Turner Syndrome, Michelle Knoll

Research Days

Background: Patients with 45,X/46,XY mosaicism can have genitalia spanning the range from typical female to typical male, and the sex assigned at birth is often based on the appearance of the genitalia. According to current nomenclature, only the subgroup assigned female are diagnosed with Turner syndrome (TS) (Gravholt et al, 2017). Clinical practice guidelines recommend that girls with TS be screened for several comorbidities, including short stature, cardiac and renal anomalies, and autoimmune conditions, but there are no recommendations for screening of boys with 45,X/46,XY mosaicism.

Objectives/Goal: We sought to determine if boys with 45,X/46,XY mosaicism exhibited a similar rate …

Polycystic Ovarian Syndrome For The Pcp, Madeline Taskier, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Define PCOS
• Outline varying diagnostic criteria
• Briefly review pathophysiology and diagnostic approach
• Review primary care management of PCOS symptoms
• Summarize role of PCP for clinical monitoring
• Explore influence of PCOS on fertility and pregnancy

Education Combined With Reminder Strategies To Improve Cervical Cancer Screening Rates, Christina E. Mclean

Evidence-Based Practice Project Reports

Cervical cancer is the second most common cancer among women worldwide and a leading cause of death in some countries (Jayasekara, 2020). Approximately 13,800 cases of cervical cancer were diagnosed in the U.S. last year, and about 4,290 women died (American Cancer Society [ACS], 2020). Regular cervical cancer screening (CCS) reduces morbidity and mortality, but screening rates are low in the U.S. and at the project site (ACS. 2020). The purpose of this evidence-based practice (EBP) project was to increase CCS at a Federally Qualified Health Center (FQHC) with six clinic locations in Northwest Indiana; the primary project site was …

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

Conference Presentation Abstracts

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 a risk for fetal cardiac anomalies. METHODS A retrospective chart review utilized a convenience sample of …

Seeking Sustainable Solutions To Period Poverty Amongst Homeless Women In Camden County, Nj, Bilal Khan, Alana Smith, Melisa Ibarra-Zavala

Rowan-Virtua Research Day

Health Careers Opportunity Program (HCOP) – National Ambassadors is an effort for underserved high school, undergraduate, and medical students to collaborate on a research-based community service project to equip future health professionals with tools to heal their communities.

The average woman spends up to 3500 days of their life menstruating. Menstrual health is therefore not just a fundamental human right, but a robust indicator of community well-being. Despite the biological inevitably of menstruation, barriers to practicing adequate menstrual hygiene, or “Period Poverty,” are far common and often ignored in public forums. Period products face a luxury goods sales tax in …

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Assessment Of Factors Preventing Adequate Decline In Cervical Cancer Rates Amongst Minority Women In New Jersey, Rosie Wenrich, Jillian Baker

Rowan-Virtua Research Day

Background

• Nationally declining cervical cancer rates are still high amongst minority women in NJ, with Hispanic women being affected the most.

• The Human Papilloma Virus (HPV) is the most common sexually transmitted infection and can lead to cervical cancer

• Administration of the 9-valent HPV vaccine can prevent infection and progression to cancer

• Regular cervical cancer screenings allow for better outcomes

• Various barriers prevent people with a cervix receiving the vaccine

• Various barriers prevent people with a cervix aged >/= 30 from receiving regular cervical cancer screenings

Conclusions

• Improved physician recommendation is required for the …

Breastfeeding Education Support Tool For Baby (Best4baby): Feasibility, Acceptability, And Preliminary Impact Of An Mhealth Supported Breastfeeding Peer Counselor Intervention In Rural India, Parth D. Lalakia, Vanessa L. Short, Roopa M. Bellad, Patricia J. Kelly, Yukiko Washio, Tony Ma, Katie Chang, Niranjana Majantashetti, Umesh S. Charantimath, Frances J. Jaeger, Shivaprasad S. Goudar, Richard J. Derman

Rowan-Virtua Research Day

Objective: To evaluate the feasibility of an mHealth-supported breastfeeding peer counselor intervention implemented in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including exclusive breastfeeding (EBF).

Methods: In this quasi-experimental pilot study, participants received either the intervention plus usual care (n = 110) or usual care alone (n = 112). The intervention group received nine in-home visits during and after pregnancy from peer counselors who provided education about and support for EBF and other optimal infant feeding practices and were aided with an mHealth tool. The control group received routine prenatal and postnatal health education. …

Ethnic Differences In Maternal Cytokines And Adipokines And Their Association With Spontaneous Preterm Delivery, Yelizavet D. Lomakova, Xinhua Chen

Rowan-Virtua Research Day

Spontaneous preterm delivery (SPTD, birth at <37 weeks’ gestation) is a leading cause of infant mortality in the United States [1]. Infants born prematurely are more likely to suffer from both short and long-term complications including neurodevelopmental delay, visual and hearing impairment, and chronic diseases such as heart disease, hypertension and diabetes in later life [2-4]. African American women have a 2-fold increased risk of preterm delivery compared to Caucasian women [5].The reasons for this disparity are poorly understood. This limits the ability to predict and prevent preterm delivery in the most high-risk populations.

Perceived Stress May Mediate The Relationship Between Antenatal Depressive Symptoms And Preterm Birth: A Pilot Observational Cohort Study, Sharifa Bashir Lalani, Aliyah Dosani, Ntonghanwah Forcheh, Shahirose Sadrudin Premji, Sana Siddiqui, Kiran Shaikh, Ayesha Mian, Ilona S Yim Ilona S Yim, Maternal-Infant Global Health Team (Might) Collaborators In Research

School of Nursing & Midwifery

Background: Screening for changes in pregnancy-related anxiety and depressive symptoms during pregnancy may further our understanding of the relationship between these two variables and preterm birth.
Objectives: To determine whether changes in pregnancy-related anxiety and depressive symptoms during pregnancy influence the risk of preterm birth among Pakistani women; explore whether perceived stress moderates or mediates this relationship, and examine the relationship between the various components of pregnancy-related anxiety and preterm birth.
Methods: A prospective cohort study design was used to recruit a diverse sample of 300 low-risk pregnant women from four centers of Aga Khan Hospital for Women and Children …

Characteristics Associated With Downward Residential Mobility Among Birthing Persons In California., Samantha Gailey, Rebekah Israel Cross, Lynne C. Messer, Tim A. Bruckner

OHSU-PSU School of Public Health Faculty Publications and Presentations

Substantial research documents health consequences of neighborhood disadvantage. Patterns of residential mobility that differ by race/ethnicity and socioeconomic status (SES) may sort non-Hispanic (NH) Black and low-SES families into disadvantaged neighborhoods. In this study, we leverage a sibling-linked dataset to track residential mobility among birthing persons between pregnancies and investigate baseline characteristics associated with downward mobility, including race/ethnicity, SES, and pre-existing health conditions.

Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk

Evidence-Based Practice Project Reports

The standard of care in the treatment for women diagnosed with breast cancer includes identification and biopsy of the sentinel lymph nodes (SLN) of the breast (Chaterjee et al., 2017; Kneece, 2017). The process of identifying the SLNs involves radioisotope injections into or near the areola. Because this area is highly sensitive, women report this procedure to be considerably painful. The purpose of this evidence-based practice (EBP) project was to determine if the provision of a 5-minute session of guided imagery (GI), as a complementary alternative medicine, prior to SLN injections was effective in mitigating reports of procedural pain. A …

Loss Of Obstetric Services In Rural Appalachia: A Qualitative Study Of Community Perceptions, Caroline R. Efird, David Dry, Rachel F. Seidman

Journal of Appalachian Health

Background: As rural hospitals across the United States increasingly downsize or close, the availability of inpatient obstetric services continues to decline in rural areas. In rural Appalachia, the termination of obstetric services threatens to exacerbate the existing risk of adverse birth outcomes for women and infants, yet less is known about how the cessation of these services affects the broader community.

Purpose: The purpose of this paper is to explain how the loss of local obstetric services affects perceptions of healthcare among multi-generational residents of a remote, rural Appalachian community in western North Carolina.

Methods: An interdisciplinary team of researchers …

Economic And Cost-Effectiveness Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials In India, Pakistan And Mozambique, Jeffrey N. Bone, Asif R. Khowaja, Marianne Vidler, Beth A. Payne, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Ashalata A. Mallapur, Khatia Munguambe, Rahat Qureshi, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: The Community-Level Interventions for Pre-eclampsia (CLIP) trials (NCT01911494) in India, Pakistan and Mozambique (February 2014-2017) involved community engagement and task sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the incremental costs and cost-effectiveness of the CLIP intervention overall in comparison to standard of care, and by PIERS (Pre-eclampsia Integrated Estimate of RiSk) On the Move (POM) mobile health application visit frequency.
Methods: Included were all women enrolled in the three …