Medical Specialties Commons^™

The Utility Of Performing Cervical Length Follow-Up In Lower Risk Singleton, Varsha Kripalu, Rupsa Boelig, Md

Phase 1

Introduction: Short cervical length (<25 mm) during pregnancy is known to be an increased risk factor for preterm birth (<37 weeks). While interventions exist for women who have had prior preterm births, it is important to investigate the cost effectiveness of screening low risk women with an intermediate cervical length (26-29 mm).

Objective: To quantify the association between change in cervical length on follow up and the incidence of preterm birth in otherwise low risk women with an initial intermediate cervical length.

Methods: A retrospective cohort study was conducted, reviewing 108 charts of women who had an initial screening between 26 and 29 mm. Charts were reviewed for whether or not a follow-up ultrasound was recommended, whether or not the follow-up was performed, and the outcome of their deliveries.

Results: 93.5% (N=101) of women were recommended to get a follow-up ultrasound and 84% (N=85) completed their follow-up. …

Electronic Fetal Monitoring Credentialing Examination: The First 4000., Mark Tomlinson, Sara A Brumbaugh, Marin O'Keeffe, Richard L Berkowitz, Mary D'Alton, Michael Nageotte

Articles, Abstracts, and Reports

No abstract provided.

Impact Of Excess Weight Gain On Risk Of Postpartum Infection In Class Iii Obesity, Courtney J. Mitchell, Lamani Adkins, Ann Tucker, Haywood Brown, Anne Siegel, Sarah Dotter-Katz

Obstetrics & Gynecology Faculty Publications

Objective: To assess the impact of gestational weight gain >20 pounds (more than Institute of Medicine [IOM] recommendations) on postpartum infectious morbidity in women with class III obesity.

Methods: This is a retrospective cohort of term, nonanomalous singleton pregnancies with body mass index ≥40 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, and missing weight gain data are excluded. Primary outcome is a composite of postpartum infection (endometritis, urinary tract, respiratory, and wound infection). Secondary outcomes include components of composite, wound complication, readmission, and blood transfusion. Bivariate statistics compared demographics, pregnancy complications, …

Fmic Annual Report 2020 | Pashto (پشتو), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2020 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2020 | Dari (دری), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

The Effect Of Perceived Physician Opinion On Breastfeeding In Women With Opioid Use Disorder Who Are Receiving Medication-Assisted Treatment, Lacey Murray, Meghan Gannon, Phd, Vanessa Short, Phd, Mph

Phase 1

Women who receive medication-assisted treatment (MAT) for opioid use disorder (OUD) are less likely to breastfeed than the general population despite the many possible benefits to the newborn. The ongoing study examines the effect of perceived physician opinion on the outcome of breastfeeding in women receiving MAT for OUD. Women who were receiving MAT for OUD at Thomas Jefferson University’s Family Center were given a survey during their third trimester (n=45), and at 1 month postpartum (n=33) to gather information on the perceived opinion of their physicians on how they should feed their baby and the importance of those opinions. …

Down Regulation With Luteal Gnrh Agonist Therapy In Euploid Embryo Transfers Does Not Impact Pregnancy Rates, Isabelle Levin, Keri Bergin, Md, Dmitry Gounko, Joseph Lee, Alan Copperman, Md

Phase 1

Introduction : Gonadotropin-releasing hormone (GnRH) agonists have been used during assisted reproductive technology (ART) treatment for pituitary suppression and stimulation. Currently, clinical opinion is divided about whether GnRH agonist therapy improves pregnancy rates when used for luteal down-regulation in a frozen euploid embryo transfer (FET). This study evaluated the clinical utility of GnRH agonist down-regulation in single, euploid FET cycles.

Methods : A retrospective analysis was performed, using data from patients who underwent a single, euploid FET cycle from 2012 to 2019. Patients were segregated into two cohorts: Group A: single, euploid FET with down-regulation using GnRH agonist; Group B: …

Evaluating Historical Paradigms Of Sterility In Perinatal Microbiology And Ramifications For Pregnancy Outcomes, Jonathan Greenberg

Wayne State University Dissertations

Next-generation sequencing technologies, especially 16S rRNA gene and metagenomic sequencing have allowed investigations of low microbial biomass tissues of the human body. While these sequencing methodologies have provided large amounts of reliable data for higher microbial biomass sites, such as the mouth, intestine, and vagina, tissues of low microbial biomass sites are subject to specific caveats that were not appropriately considered in early investigations of these sites. Low microbial biomass sites of particular interest have included those of the reproductive and urinary systems. Utilization of DNA sequencing methodologies have allowed researchers to challenge existing paradigms of sterility around these sites …

Quality Improvement: Patient Education For Management Of Hypertension In Pregnancy, Kriti Goel

Scholarship in Medicine - All Papers

Objective: We introduced maternal hypertension education tools that address illiteracy in underserved populations. Through these tools, we aim to improve patients’ knowledge of their conditions. We also aim to determine if healthcare providers perceive a benefit to the use of the tools. Ultimately, we hope these changes will lead to better short- and long-term health outcomes for mother and child.

Methods: Pregnant women with any form of hypertension at Five Rivers Center for Women’s Health (FRHC) were surveyed during OB visits. The Patient Questionnaire includes objective knowledge questions on their condition and self-reported comprehension questions. Forty-five women were surveyed during …

Assessing Accuracy Of Attending Provider On The Pennsylvania Birth Certificate, Emily C. Mcgahey

Doctor of Midwifery Advances in Midwifery Projects

Introduction: Birth certificate data is a cornerstone of public health reporting, yet numerous studies document that much of the data collected is unreliable. Limited evidence suggests that the attendant at birth item may not be accurately captured on the current birth certificate, therefore not representative of the care provided by midwives in the United States. The primary purpose of this study was to determine whether midwives are accurately represented as attendant at birth on the Pennsylvania birth certificate. A secondary purpose was to assess midwives’ motivation to improve data collections if significant discrepancies were found.

Methods: A cross-sectional survey was …

Burnout Among Medical Residents; Their Impressions Of Its Impact On Patient Care And Coping Mechanisms, Elizabeth Ochola

Master of Medicine in Obstetrics and Gynecology

Introduction: Burnout is a syndrome that occurs as a result of chronic workplace stress that has not been successfully managed. This global definition is given by the International Classification of Diseases; 11th edition. The ICD-11 further characterizes burnout using three dimensions: Emotional exhaustion described as feelings of energy depletion or exhaustion; depersonalization described as; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and low personal accomplishments seen as reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and is not applied to describe experiences in other areas of life. …

Challenges Of Diagnosis And Management Of Postpartum Choriocarcinoma In Resource Limited Settings: A Case Report From A Tertiary Hospital Of Western Kenya, Amubuomombe Philippe, Benjamin Elly, Andrew Cheruiyot, Sahara Shurie, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Choriocarcinoma is a rare occurrence in pregnancy. It is a highly curable malignant tumour that arises from trophoblastic cells within the uterus. However, the timely diagnosis of choriocarcinoma following birth is challenging, especially in low resource settings because most clinicians are not aware about the existence of the disease following uneventful pregnancy and birth. This report discusses the case of a 28 years old patient, para 2, diagnosed with choriocarcinoma two months after uneventful vaginal delivery at term. She underwent a total abdominal hysterectomy, followed by chemotherapy treatment; and succumbed to her disease. It highlights difficulties encountered on diagnosis and …

Low Sensitivity Of The Carehpv™ Assay For Detection Of Oncogenic Human Papillomavirus In Cervical Samples From Hiv-Infected And Hiv-Uninfected Kenyan Women, Titus Maina, Aaron Ermel, A. Moormann, Susan Cu-Uvin, Elkanah Omenge, Philip Tonui, K Chelimo, B Rosen, Peter Itsura, K. Muthoka

Obstetrics and Gynaecology, East Africa

Background: Human papillomavirus (HPV) infection causes cervical cancer (CC), a common malignancy among Kenyan women. New CC screening methods rely on oncogenic HPV (“highrisk”, or HR-HPV) detection, but most have not been evaluated in swabs from Kenyan women.

Methods: HPV typing was performed on 155 cervical swabs from Kenyan women using the Roche Linear Array® (LA) and careHPV™ (careHPV) assays. Detection of 14 oncogenic HPV types in careHPV assay was compared to LA results.

Results: Compared to LA, sensitivity and specifi city of careHPV assay was 53.0% and 80.9%, respectively. The sensitivity and specifi city of careHPV …

Long Term Health Related Quality Of Life Following Uterine Fibroid Embolization At Aga Khan University Hospital, Nairobi, Michael Muthoka Kioko

Master of Medicine in Obstetrics and Gynecology

Background: Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. Most of the studies have demonstrated an improvement in the quality of life over a short to intermediate period. We carried out this study to assess the long-term quality of life following uterine fibroid embolization in a predominantly black population. There are no identified studies locally or in Africa addressing this issue whereas studies done elsewhere indicate a probable increased fibroid disease burden among black women. Objectives: Our objectives in …

Timing And Factors That Contribute To The Decision Making Process On The Mode Of Delivery After One Previous Casearean Section., Sylvia Nyanyu Mruttu

Master of Medicine in Obstetrics and Gynecology

Background: The rates of caesarean sections have continued to rise despite public and professional concern. This has continually increased the proportion of the obstetric population with a history of previous caesarean delivery. These women may be offered either elective repeat caesarean section (ERCS) or planned vaginal birth after caesarean delivery (VBAC). This study aimed to identify the timing, level of knowledge and factors that influence the decision-making. Objectives: The primary objective was to elicit the factors that contribute to women to choose VBAC or ERCS. The secondary objectives were to determine the timing of this decision, measure the level of …

The Burden Of Urinary Incontinence Among African Diabetic And Non-Diabetic Women Seeking Care At The Aga Khan University Hospital, Nairobi, Martin Kimemia Mbuthia

Master of Medicine in Obstetrics and Gynecology

Introduction: Female urinary incontinence is a common and chronic condition with devastating psychosocial effects. It can occur at any age and is specifically more common in older women. It has a prevalence of up to 55% depending on the age-group and the target population studied. About 9% of adults globally have diabetes and a greater number live in LMICs. Diabetes is twice as prevalent in blacks and three to four times higher in South-Asian populations compared to Caucasian populations. In women with Type 2 DM, urinary incontinence is 30% to 70% more common than among women with normal glucose levels. …

The Association Of Maternal Sociodemographic Factors With Stress In Pregnancy, Maheshwari Andhavarapu

Master of Medicine in Obstetrics and Gynecology

Introduction: Antenatal stress has been linked to maternal morbidity and preterm birth (PTB). One of the pathophysiological processes leading to PTB is thought to be via activation of the hypothalamus-pituitary-adrenal axis resulting in cortisol production. Hair cortisol has recently been shown to be a stress marker in the pregnant and non-pregnant population. Some determinants of hair cortisol have also been studied but more research is needed in this area, especially in pregnancy. Understanding the risk factors of antenatal stress may guide institution of preventative or screening measures to reduce the risk of adverse birth outcomes. As the effect of stress …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Ilana Porges, Vaishali Mehta, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: Delays in management of high risk pregnancies can result in significant morbidity for women seeking obstetric care. A trend of high incidence of pregnancy complications has been observed among women with non-communicable diseases (NCDs) receiving care at the University Teaching Hospital of Kigali (CHUK), which may suggest the need for more consistent screening of NCDs among pregnant women, and more streamlined care for those identified to be at highest risk for complications.

Methods: This study utilized a mixed method design to assess the need for screening of NCDs among pregnant women (n=255) who received obstetric care at CHUK between …

Comparing Open And Fetoscopic Fetal Surgical Repairs Of Myelomeningocele, Kyra Isaacs

Capstone Showcase

Introduction: There have been great advances in the treatment of myelomeningocele (MMC) spina bifida in the past 20 years. An open surgical repair in-utero has been shown to reduce mortality and morbidity, specifically decreasing the rate of shunt placement and hindbrain herniation compared to a postnatal surgical approach. However, this surgery introduced risks to the mother that were never a consideration in previous surgical approaches.

Methods: This paper compares research on new minimally invasive fetoscopic surgical techniques to open fetal surgery in the prenatal repair of MMC. Searches in PubMed and Clinical Key were conducted to produce papers published on …

Delayed Umbilical Cord Clamping (Dcc) Compared To Early Cord Clamping (Ecc) In Preterm Infants, Madelynn Fretto

Capstone Showcase

Early cord clamping (ECC) versus delayed cord clamping (DCC) has been studied in preterm infants. The question that was researched is, in pregnant women who are giving birth [P], does delayed umbilical cord clamping (DCC) [I] as compared to early cord clamping [C] improve outcome of preterm infants born before 37 weeks gestation [O]? Results showed preterm infants with DCC had increased hematocrit and hemoglobin, decreasing their risk of anemia. There was not a significant difference in the incidence of jaundice between the two groups. Results suggested DCC has long-term neuroprotective effects. There were no significant differences in intraventricular hemorrhage …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Oxidative Stress Analysis Of Placental Tissue In The Rupp Pregnant Rat, Natalie Ganios

Williams Honors College, Honors Research Projects

Preeclampsia is a disease associated with a vasoconstrictive phenotype due to disrupted signaling in the vascular endothelial growth factor (VEGF) relaxation pathway. The purpose of these studies is to determine the level of oxidative damage that is occurring in the placenta of the reduced uterine perfusion pressure (RUPP) rat, which serves as a common model for preeclampsia. RUPP and SHAM placenta tissue will be examined for oxidative stress as an indicator of tissue damage associated with the pathologically induced ischemia. Oxidative stress in the placental tissue will be measured by performing the following oxidative stress assays: 8-isoprostane test, TBARS assay, …

Neonatal Abstinence Syndrome: Effectiveness Of Targeted Umbilical Cord Drug Screening In Determining Risk Of Withdrawal, Alecia Karr

DNP Projects

Neonatal Abstinence Syndrome (NAS) is a condition in which an infant experiences withdrawal from uterine exposure to various substances such as caffeine, nicotine, amphetamines, THC, opioids, benzodiazepines, and other types of substances. Depending on the severity of the symptoms, these infants may experience a longer hospital stay and may need treatment and monitoring in the neonatal intensive care unit (NICU), resulting in an increase in healthcare costs. The objective of this project was to determine if targeted drug screening of newborns was effective in determining infants at risk of NAS based on a positive screening result. This study utilized a …

Oophorectomy, Ashli A. Lawson, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Oophorectomy is the surgical removal of the ovary and can be unilateral or bilateral. Hysterectomy is the most common major gynecologic surgery, but salpingo-oophorectomy remains a frequent concomitant surgery. Surgery for ovarian pathology alone is still often encountered in females of all ages. While surgical removal of one ovary does not grossly affect the hormonal milieu of a patient, bilateral oophorectomy will render a patient infertile and menopausal with ensuing physiologic changes and risks. Forward-thinking discussions should be held with the patient before undertaking an oophorectomy.

Trend In Male Engagement In Maternal And Newborn Health Services In Ethiopia, Wubite Bekele Bogale

Dissertations and Theses @ UNI

There is a growing recognition among government and local public health systems in Ethiopia that male partners engagement and support during pregnancy and beyond can contribute to improvement in maternal and newborn health (MNH) outcomes and equitable gender roles. Men’s engagement in MNH is associated with the reduction of newborn and maternal mortality. However, in Ethiopia, there is a dearth of evidence on the trend of male engagement in MNH and the differences in male engagement between regional states. This study sought to explore the temporal trend and regional differences in male engagement in MNH in Ethiopia.

Data used for …

Diabetes Risk Status And Physical Activity In Pregnant Women: U.S. Brfss 2011, 2013, 2015, 2017, Bethany Rand

UNF Graduate Theses and Dissertations

Objective: We sought to examine differences in aerobic activity (AA) and muscle-strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.

Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations.

Methods: The sample (n=9,597) included pregnant women ages 18-44, who participated in 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS were: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or …

Use Of The Progestin Challenge Test In Diagnosing Amenorrhea: The Time Has Come To Say Goodbye., William D. Schlaff, Charles C. Coddington

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Evaluation Of A Technology-Based Survivor Care Plan For Breast Cancer Survivors: Pre-Post Pilot Study., Talya Laufer, Bryan Lerner, Anett Petrich, Anna Quinn, Leah Ernst, Alicin Roop, Janet Knoblauch, Nick C. Leasure, Rebecca J. Jaslow, Sarah Hegarty, Amy Leader, Andrea Barsevick

Department of Medical Oncology Faculty Papers

BACKGROUND: As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors.

OBJECTIVE: This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. …