Medical Specialties Commons^™

Prenatal Dietary Education, Using The Midwifery Model, In Ireland Vs The United States, Allison Erby

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Prenatal dietary education is a very important component of care in healthy pregnancies, but more than that, dietary education can be an indicator of the value a healthcare provider places on holistic care or preventive medicine. The United States and Ireland are compared in this study because they represent high intervention vs. low intervention approaches, respectively, to obstetric care. Healthcare professionals from the United States and Ireland perceive the most important nutrients and method of receiving those differently. Maybe the most telling contrast, healthcare professionals in Ireland perceive food as the way pregnant women should receive vital nutrients, but healthcare …

The Impact Of Menstrual Hygiene Management Interventions On Adolescent Female’S School Attendance In Middle- And Low- Income Countries: A Systematic Review Of The Literature, Mckenzie Canon

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Menstruation is an ongoing biological process that affects a large portion of the population and requires consistent health and medical care. However, menstruation does not affect women and girls equally in resource-poor communities and girl-unfriendly schools, particularly in low- and middle-income countries. Without proper menstrual hygiene management (MHM) and menstrual health and hygiene (MHH), girl’s attendance at school is reported to decline or cease altogether. Providing the proper resources to fulfill women’s and girl’s menstrual hygiene needs may impact female’s attendance rates at school, and furthering women’s education is fundamental in advancing female’s equality world-wide.

Purpose: The purpose of …

Efficacy Of Nerve Blocks On Immediate Post Caesarean Delivery Functionality, Dorothy Makena

Master of Medicine in Obstetrics and Gynecology

Introduction; Caesarean section is becoming increasingly common and is one of the most performed procedures globally. It is a major surgery accompanied by moderate to severe pain. Pain impacts negatively on functionality of the mother in terms of daily activities like self-care, newborn care and mobility. A post caesarean section mother therefore requires effective and safe pain relief to improve functionality, for effective breastfeeding and to reduce the risk of venous thromboembolism. Abdominal plane nerve blocks have been studied widely in the recent past and have been shown to be effective as part of multimodal post caesarean analgesia. This study …

A Clinical Audit Of Management Of Third And Fourth Degree Perineal Tears, Saida Abrar, Raheela Mohsin Rizvi, Urooj Kashif

Department of Obstetrics & Gynaecology

Objective: To perform a clinical audit of the practices related to the management of third and fourth degree perineal tears.
Methods: The retrorspective study was conducted in 2019 at the Aga Khan University Hospital, Karachi, and comprised medical records from January 2008 to December 2018 of women having singleton term vaginal delivery and sustaining obstetric anal sphincter injuries. The change in practices regarding tear management was compared with a previous audit done at the same institution in 2008. Data was analysed using SPSS 20.
Results: Of the 25,370 deliveries, 142(0.56%) sustained obstetric anal sphincter injuries. There was a significant increase …

Genetic Testing In Pregnancies With Ultrasound Anomalies: Exploration Of Factors That Influence Uptake, Lukas D. Kruidenier

Dissertations and Theses (Open Access)

Prenatal genetic diagnostic and screening tests have been rapidly evolving over the past decade with the introduction and expansion of cell free DNA screening (cfDNA) and the use of chromosomal microarray (CMA) as a first-line test for evaluation of fetal anomalies. Understanding patient motivations for or against expanded genetic testing options is paramount, therefore this study aimed to ascertain the patient perspective. Ninety-nine patients with an ultrasound anomaly participated in an anonymous, cross-sectional, research survey assessing coping strategies, factors influencing the genetic testing decision, and demographic variables. After multivariable analysis, the desire for directive counseling regarding testing was correlated with …

Differences In Obstetric Care Between Japan And The Us: A Qualitative Analysis Of Blogs, Rei Yamada, Maki Kano-Lueckerath, Walter K. Kraft

Student Papers, Posters & Projects

Aim

To investigate patient-reported differences in obstetric care between Japan and the US by characterizing the information Japanese immigrants and expatriates share online.

Implementation Of An Enhanced Recovery Protocol In Gynecologic Oncology., Tanvi V. Joshi, Shaina F. Bruce, Rod Grim, Tommy Buchanan, Sudeshna Chatterjee-Paer, Elizabeth R. Burton, Joel I. Sorosky, Mark S. Shahin, Mitchell I. Edelson

Abington Jefferson Health Papers

Enhanced Recovery after Surgery (ERAS) is an evidence-based approach that aims to reduce narcotic use and maintain anabolic balance to enable full functional recovery. Our primary aim was to determine the effect of ERAS on narcotic usage among patients who underwent exploratory laparotomy by gynecologic oncologists. We characterized its effect on length of stay, intraoperative blood transfusions, bowel function, 30-day readmissions, and postoperative complications. A retrospective cohort study was performed at Abington Hospital-Jefferson Health in gynecologic oncology. Women who underwent an exploratory laparotomy from 2011 to 2016 for both benign and malignant etiologies were included before and after implementation of …

The Role Of Art In Teaching Virtual Anatomy During The Covid-19 Pandemic, Shaigan Bhatti, Ashwatha Thenappan, Rose A. Maxwell, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

The purpose of this study is to determine whether drawing anatomical structures and teaching it virtually to others improves student confidence in remembering anatomy and improves student perceptions of OB/GYN anatomy in the obstetrics and gynecology core clerkship. Active recall is a superior method of learning and memory retention because it practices information retrieval. If one draws an anatomic region of the human body after visualization and then teaches it, the learner would be exercising retrieval thus promotion retention of the material. The specific act of writing things down on paper promotes memory retention. This study sets a precedence of …

Identifying Factors Underlying The Decision For Genetic Carrier Screening Among Women In Montgomery County, Sowon Kim, Rose A. Maxwell

Medical Student Research Symposium Abstracts and Posters

Genetic Carrier Screening (GCS) is a genetic test that allows patients to find out if they carry genes for certain genetic disorders. The results of the test enable patients to make changes to their family planning decisions and prenatal care when appropriate and allow them the opportunity to seek further medical and social support. Despite these health benefits and notable clinical utility of GCS, GCS has not been utilized in most nations due to moral and ethical controversy among the public. Previous studies have demonstrated patients’ ethnicity, socio-demographic (age, education) and economic factors were associated with the patient’s intention to …

Liposomal Bupivacaine Infiltration And Transversus Abdominis Plane Block Versus Standard Of Care For Post Caesarean Pain Control: A Retrospective Chart Review, Ellie Ganz, Darren Adams, Rose A. Maxwell, Theresa Roby, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Transversus abdominis plane (TAP) block and wound infiltration with local anesthetics are shown to reduce opiate use and pain scores when compared to controls who received narcotic pain medications. With the current opiate epidemic, finding different ways to control pain without opiates is important,-to prevent unnecessary use of these drugs and reduce the potential for addiction in patients having a Cesarean delivery who often times receive opiate medications on schedule regardless of their reported pain.

A Case Of Ruptured Cornual Pregnancy With Delivery Of A Viable Pre-Term Infant, Elana Miller, Elena Fuell-Wysong, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Interstitial and cornual ectopic pregnancies are rare forms of ectopic with high mortality rate. As such, they pose significant challenges in diagnosis, treatment, and follow up.

This patient was a 42 y/o female G2P1001 at 25+3 weeks gestational age who presented from an outside hospital after an episode of sudden onset abdominal pain with syncope. She was noted to have hypotension, tachycardia, lactic acidosis, and peritoneal free fluid. Physical exam was significant for peritoneal signs with abdominal guarding and rebound. Her pregnancy was complicated by advanced maternal age, THC use, and late presentation for prenatal care in the second trimester. …

Evaluating The Effectiveness Of Early Exposure: Obstetrics And Gynecology Two-Week Virtual Elective, Elisabeth N. Adkins, Marilyn Kindig, Rose A. Maxwell

Medical Student Research Symposium Abstracts and Posters

Clinical clerkships are an integral part of undergraduate medical education. Until now, clerkships have either been offered through simulation labs, didactics or in the healthcare setting dependent upon the pedagogical approach of each institutions’ curricula. Subsequent to coronavirus-2019, medical students had decreased accessibility to the aforementioned educational settings. This has provided an innovative opportunity for clerkship directors to provide the same clinical experience to students in a novel way –virtually.

Recently, the Larner College of Medicine at the University of Vermont created a two-week virtual simulated clerkship electiveencompassing the curricula taught throughout the OB/GYN clerkship. Until now, this virtual elective …

Neonatal Health Outcomes Following Water Immersion During Labor And Delivery, Ariel L. Lanier, Samantha L. Wiegand, David Mckenna

Medical Student Research Symposium Abstracts and Posters

Water birth is child delivery that occurs in a tub of water. Water birth delivery has been offered by Miami Valley Hospital in the Family Beginnings Birth Center since 1994. The first water birth delivery that was documented in a medical journal occurred in France in 1805, which reported that the delivery resulted in a healthy baby. Water birth deliveries have been growing in popularity in the United States as mothers are interested in the possible alleged benefits of water birth including shorter labor, less pain, improved maternal experience of childbirth, and more. Although there are many potential benefits, The …

Placental Hypoxia-Inducible Factor 1 Alpha In Early-Onset Preeclampsia As A Predictor Of Future Risk In Maternal And Fetal Health, Julie Slyby, Bryce Linkous, Sarah Scott, Chandni Chandiramani, Amy Hwang, Danielle Spanbauer, Melissa R. Kaufman, Traci Rackett, Kailey Nolan, Emily Stone, Rose A. Maxwell, David N. Dhanraj, Thomas L. Brown

Medical Student Research Symposium Abstracts and Posters

Preeclampsia is a life-threatening, pregnancy-associated disorder characterized by the rapid development of hypertension with renal dysfunction. While preeclampsia generally occurs later in pregnancy, early-onset preeclampsia (EOPE) can occur much earlier and is usually more devastating. Early-onset preeclampsia is also associated with an increased risk of maternal cardiovascular and metabolic disease in mothers later in life and neurocognitive dysfunction in their offspring. EOPE is strongly associated with abnormal placental development and fetal growth restriction during pregnancy.

Oncofertility Awareness And Attitudes Among Health Care Providers And Breast Cancer Patients In A Chinese Academic Setting1, John P. Zucal, Ewelina Biskup, Xin Zhaochen, Yun Sun, Yao Lu, Leslie C. Appiah, Hongwei Zhang, Steven R. Lindheim

Medical Student Research Symposium Abstracts and Posters

As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country.

Local Wound Infiltration With Liposomal Bupivacaine Decreases Post-Cesarean Pain Scores, Avni Gupta, Justin Williams, Rose A. Maxwell, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Surgical patients are routinely prescribed opioid analgesics that are strongly associated with drug overdose deaths. Liposomal bupivacaine is a long-acting local anesthetic that received FDA approval in 2011 for local surgical site infiltration to promote post-operative analgesia. This anesthetic has demonstrated an improvement in post-operative pain control in various surgical realms, indicating a decreased need for opiates and subsequently decreased risks. However, few studies have investigated its use at the time of cesarean delivery.

Disparities In Access To Assisted Reproductive Technology Among Hispanic Women In The United States, Madison Gallagher

Honors Thesis

Infertility is a health problem that affects approximately 7 million women in the United States (Ethics Committee of the American Society for Reproductive Medicine, 2015). Due to the high costs of reproductive medicine and infertility treatment, these services tend to be expensive and have limited accessibility without full insurance coverage. Emerging literature outlines the disparities in access to proper treatment for reproductive complications. These existing studies highlight that many minority populations in the United States experience increased challenges regarding access to reproductive medicine and infertility treatment. Among these minority groups are Hispanic women, who are more likely to require reproductive …

The Experiences Of Rural British Columbians Accessing Surgical And Obstetrical Care, Aria Jazdarehee, Anshu Parajulee, Jude Kornelsen

Patient Experience Journal

The attrition of small volume surgical and maternity services in rural Canada over the past three decades has made access to these services especially challenging for rural citizens. While many of these closures have occurred as consequences of regionalization, a strategy to regionally centralize healthcare services, many studies investigating outcomes of regionalization have focused on costs and medical endpoints rather than the direct experiences of the rural patients affected. In this study, we aimed to understand and document the experiences of rural residents accessing procedural and maternity care both locally and away from home. This study is part of a …

Determinants Of Short Birth Intervals Among Married Women: A Cross-Sectional Study In Karachi, Pakistan, Sidrah Nausheen, Maria Asif Bhura, Kristy Hackett, Imtiaz Hussain, Zainab Shaikh, Arjumand Rizvi, Uzair Ansari, David Canning, Iqbal Shah, Sajid Bashir Soofi

Department of Obstetrics & Gynaecology

Introduction: Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.
Methods: We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were …

Maternal And Neonatal Morbidity And Mortality Among Pregnant Women With And Without Covid-19 Infection: The Intercovid Multinational Cohort Study, José Villar, Shabina Ariff, Robert B. Gunier, Ramachandran Thiruvengadam, Stephen Rauch, Alexey Kholin, Paola Roggero, Federico Prefumo, Marynéa Silva Do Vale, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Detailed information about the association of COVID-19 with outcomes in pregnant individuals compared with not-infected pregnant individuals is much needed.
Objective: To evaluate the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with not-infected, concomitant pregnant individuals.
Design, setting, and participants: In this cohort study that took place from March to October 2020, involving 43 institutions in 18 countries, 2 unmatched, consecutive, not-infected women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were …

Hispanic Acculturation: Associations With Family Planning Behaviors And Attitudes, Rachel Chamberlain, Mary Fatehi, Joshua Fogel, Jacob Kulyn

Publications and Research

Introduction. The purpose of this study was to investigate the association of Hispanic acculturation in the U.S. with family planning behaviors and attitudes.

Methods. Surveys of 225 Hispanic women were collected that used acculturation measures of number of years lived in the U.S. and the Short Acculturation Scale for Hispanics (SASH), along with questions about family planning behaviors, including birth control use, sterilization, and abortion.

Results. SASH-Language statistically differed (p = 0.03) where those with ‘yes birth control’ had significantly lower English acculturation (M = 6.10, SD = 1.77) than those with ‘no birth control’ (M = 7.00, SD = …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

Are Underprivileged And Less Empowered Women Deprived Of Respectful Maternity Care: Inequities In Childbirth Experiences In Public Health Facilities In Pakistan, Waqas Hameed, Mudassir Uddin, Bilal Iqbal Avan

Community Health Sciences

Background: Attainment of healthcare in respectful and dignified manner is a fundamental right for every woman regardless of the individual status. However, social exclusion, poor psychosocial support, and demeaning care during childbirth at health facilities are common worldwide, particularly in low- and middle-income countries. We concurrently examined how women with varying socio-demographic characteristics are treated during childbirth, the effect of women's empowerment on mistreatment, and health services factors that contribute to mistreatment in secondary-level public health facilities in Pakistan.
Methods: A cross-sectional survey was conducted during August-November 2016 among 783 women who gave birth in six secondary-care public health facilities …

Caesarean Section Versus Vaginal Birth In The Perception Of Woman Who Gave Birth By Both Methods, Octavian Gabriel Olaru, Anca Daniela Stanescu, Cristina Raduta, Liana Ples, Adriana Vasilache, Nicolae Bacalbasa, Andrei Vasilache, Oana Denisa Balalau

Journal of Mind and Medical Sciences

The increase in the number of births by Caesarean section is a phenomenon whose global expansion is generated by numerous factors and especially by the contemporary perceptions of women regarding childbirth meeting the interests of the professionals in the field. However, the opinion of many women towards the benefits of Caesarean delivery is often not based on the experience or information from reliable sources. This study aimed at sharing the experience of women who gave birth both vaginally and by Caesarean section, focusing on their perception of these events. The study included 26 women and the conclusion of the vast …

The Social And The Psychological Impact Of Endometriosis On The Romanian Urban Population, Iulia Baciu, Alecsandra Irimie-Ana, Anca Maria Panaitescu, Gheorghe Peltecu, Corina Gica, Nicolae Gica

Journal of Mind and Medical Sciences

Objectives. Our study assesses the social and psychological impact of the symptoms of endometriosis. Materials and methods. This crosssectional study was conducted from January 2014 to January 2016. The research involved two groups. The study instrument, the EHP-5 questionnaire, was completed by the respondents on the admission date or on the routine gynecological visit day. Results. Endometriosis has a negative social and psychological impact on women’s life, the most affected areas being work, fertility and sexual activity. Moreover, pain and the negative perception of self-image are major sources of distress. Conclusion. The symptoms and effects of endometriosis, especially chronic pelvic …

A Comprehensive Analysis Of Postpartum Depression And Delivery Characteristics: A Cross-Sectional Study, Navdar Dogus Uzun, Mustafa Tekin, Fulya Uzun

Journal of Mind and Medical Sciences

Objective: We attempted to identify risk factors for postpartum depression (PPD) by evaluating individuals in terms of their birth patterns, as well as other characteristics, including income level, smoking habits, number of children, age, and history of antidepressants. Methods and results: Participants completed a questionnaire consisting of three sections: demographic characteristics, delivery characteristics, and Edinburgh Postpartum Depression Scale. Participants with a depression medical history had a higher depression level during the postpartum. There were significant correlations between postpartum depression, the husband’s working status, the desire fo r the pregnancy, and the patient’s depression medical history. PPD levels did not differ …

The Analysis Of Risk Factors Associated With Women's Urinary Incontinence; Literature Review, Denisa Oana Balalau, Octavian Gabriel Olaru, Nicolae Bacalbasa, Stana Paunica, Daniela Gabriela Balan, Anca Daniela Stanescu

Journal of Mind and Medical Sciences

Urinary incontinence (UI) is a common condition among women. Approximately 50% of them had an involuntary loss of urine at least once in their lifetime. It can be present during sexual activity, contributing to sexual dysfunction and often associated with anxiety or even depression, thus having a negative impact on the quality of life. The incidence of UI is related to the existence of predisposing factors. The best known are: age, weight, family history, race/ ethnicity, number of pregnancies and mode of birth, history of genitourinary interventions and factors related to ordinary habits: smoking, caffeine consumption, oral contraceptives. Studies on …

A Mini-Review Regarding The Carcinogenesis And Morphology Of Serous Tumors Of The Ovary, Fallopian Tube And Peritoneum, Tiberiu-Augustin Georgescu, Roxana Bohiltea, Octavian Munteanu, Corina Grigoriu, Ioana Paunica, Maria Sajin

Journal of Mind and Medical Sciences

Similar to the already well-recognized adenoma-carcinoma sequence in colorectal cancer pathogenesis, it has been believed for many decades that the progression of ovarian epithelial tumors occurs from benign serous cystadenomas to borderline tumors, to well-differentiated carcinomas, and ultimately, to poorly differentiated carcinomas. However, it is currently accepted that low-grade serous carcinoma (LGSC) and high-grade serous carcinoma (HGSC) are fundamentally different tumor types and, consequently, different diseases. In fact, whereas the benign-borderline-malignant sequence seems to apply quite well to low-grade serous carcinoma, the sequence of genetic alterations in high-grade serous carcinoma is substantially different. In this mini-review, we included the current …

Periodontitis As A Potential Risk Factor For Premature Delivery, Ana Turcu-Duminică, Anca Silvia Dumitriu, Stana Paunica, Corina Gică, Radu Botezatu, Nicolae Gică, Gheorghe Peltecu, Anca Maria Panaitescu

Journal of Mind and Medical Sciences

Pregnancy is a particular period of time for a woman, so that it is important to accurately determine the impact of adjacent pathologies on the natural evolution of the nine months of pregnancy. Although there is still much to debate on the association between periodontal disease and pregnancy, the conclusion seems to remain the same: untreated periodontal pathology in pregnancy could have adverse consequences such as premature birth or low birth weight fetuses. Periodontopathies are introduced as risk factors, the novelty of the subject being the association between untreated periodontal pathology and the evolution of pregnancy. The affected periodontal tissue …