Obstetrics and Gynecology Commons^™

Improving Awareness Of Physician Ergonomics In Gynecologic Surgery, Priyanka Raju Md, Annika Eveland Md, Tamara Lalovic Do, Dominic Cammarano Do

Transformative Medicine

Introduction:
Surgeons experience disproportionately high rates of work-related musculoskeletal (MSK) disorders due to prolonged static postures, repetitive motions, and suboptimal instrument design. Gynecologic surgery, in particular, involves sustained non-neutral positioning and physical strain, yet formal ergonomic education is lacking. This study aimed to evaluate gynecologic surgeons’ awareness of ergonomic principles and determine whether targeted education improves knowledge and recognition of ergonomic risk factors during surgery.

Methods: A quality improvement intervention was implemented at a large teaching hospital. Eighty-three recorded gynecologic surgeries (open, laparoscopic, and vaginal) were analyzed for common postural deviations based on ergonomic guidelines. The most frequent errors were …

The Aftermath Of Overturning Roe V. Wade: A Review Of Legal, Social, And Health Implications, Eden Parks M.D.

Transformative Medicine

Roe versus Wade occurred in 1973 and was a landmark case in the United States. It guaranteed the right to abortion until 2022, when the Dobbs versus Jackson case was decided and the U.S. Supreme Court overturned Roe. This abolished the right to abortion and left it up to the states. The Dobbs decision has reshaped the framework for reproductive rights in the United States. This paper focuses on the multifaceted outcomes of the Dobbs decision, highlighting the legal, social and health implications. Through a study of recent research, legal analyses, and public health reports, this article assesses the …

Impact Of Early Term Induction Of Labor On Cesarean Delivery And Maternal-Fetal Outcomes In Patients With Obesity: A Retrospective Cohort Study, Nathanael N. Hoskins, Priya Patel, Thomas Wasser, Xuezhi Jiang

Transformative Medicine

Introduction: Obesity (body mass index [BMI] ≥ 30 kg/m²) is increasingly prevalent in pregnancy and is associated with numerous complications, including gestational diabetes, hypertension, and higher cesarean delivery (CD) rate. There are many risks for patients with obesity during pregnancy; however, there is little evidence supporting early-term (37 0/7 to 38 6/7 weeks of gestation) induction of labor (IOL) to reduce complications. This study aimed to evaluate whether IOL in patients with obesity is associated with a decreased CD rate.

Methods: This retrospective cohort study included pregnancies that underwent IOL between 37 0/7 and 41 6/7 weeks of gestation from …

Opportunity For Increasing Applicant Diversity In Gynecologic Oncology Fellowships, Priyanka Raju Md, Tamara Lalovic Do, Alexandar Lalovic

Transformative Medicine

Introduction: The term healthcare disparity describes differences in access to medical care between population groups. Minimizing the care gap and improving access to care for historically minoritized populations will require a multifaceted approach. Increasing diversity in the healthcare workforce has the potential to lead to significant improvements aimed at minimizing inequity. Fellowship training programs in Gynecologic Oncology serve as the gatekeeper for the workforce of Gynecologic Oncologists. Efforts at improving diversity at the fellowship level are necessary to increase the diversity of practicing physicians. The objective of this study is to assess Gynecologic Oncology fellowship websites for information emphasizing a …

Successful Management Of High-Risk Gestational Choriocarcinoma With Choriocarcinoma Syndrome: A Case Report, Ava R. Hansen, Hannah Daley, Priyanka Raju, Jonathan Buerger

Transformative Medicine

Introduction: Choriocarcinoma is a rare and highly malignant gestational trophoblastic neoplasia that is treatable with timely and appropriate intervention. However, choriocarcinoma may lead to life-threatening complications, such as choriocarcinoma syndrome (CCS), a rare type of tumor lysis manifesting as hemorrhage at metastatic sites of advanced tumors.

Case Description: This case involves a 30-year-old woman, gravida 3 para 0, with high-risk choriocarcinoma and a WHO score of 11, indicating high risk. Initial management comprised Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide and Vincristine (EMA/CO) chemotherapy until multisystem complications arose, including the development of CCS which resulted in an abdominal compartment syndrome. An exploratory …

Impact Of Early Term Labor Induction On Maternal And Fetal Outcomes In Patients With Obesity, Nathanael N. Hoskins, Xuezhi Jiang

Tower Health Research Day

No abstract provided.

From Rights To Risks: Mental Health Implications For Pregnant Patients Following The Reversal Of Roe V. Wade, Andrew Murdock, Angelica Arshoun, Eduardo Espiridion

Tower Health Research Day

No abstract provided.

Management Strategies Of Cesarean Section Ectopic Pregnancy: A Case Report, Hannah E. Daley, Ava R. Hansen, Priyanka Raju Md, Jonathan Buerger Md

Transformative Medicine

Introduction:

Cesarean scar ectopic pregnancy is a rare form of pregnancy with potential life-threatening complications such as severe hemorrhage, uterine rupture, and emergency hysterectomy Currently, there is no consensus regarding a standardized treatment algorithm for this specific variant of ectopic pregnancies.

Case Description:

This case describes a 28-year-old female with history of two prior cesarean sections who was diagnosed with cesarean section scar ectopic pregnancy. Initial management with intramuscular methotrexate was unsuccessful in the setting of inadequate decrease in β-hCG level. The patient ultimately underwent surgical management with dilation and suction evacuation under ultrasound guidance for removal of the ectopic …

Catastrophic Spontaneous Uterine And Bladder Rupture In An Unscarred Uterus, Nathanael N. Hoskins Do, Kathryn Brandt Do, Tory Peterson Md

Transformative Medicine

Introduction:

Uterine rupture during pregnancy is a rare event which can be life-threatening for both the patient and the fetus. This case report describes a rare complication of uterine rupture which ultimately required a hysterectomy and extensive urologic reconstruction.

Case Description:

A 36-year-old patient presented to the hospital after term pre-labor rupture of membranes. The patient underwent induction of labor which ultimately resulted in a uterine rupture in an unscarred uterus. The rupture extended into the posterior bladder wall, right ureter, urethra, and anterior vaginal wall, resulting in a vesicovaginal fistula. The patient required a cesarean hysterectomy due to the …

Same Or Different? Resolution Of Diagnostic Difficulty Of Two Mixed Cell-Type Tumors In Ovarian Pathology., Sarah Ingram, Priyanka Raju Md, Wei Shaw Do, Steve Sowers Pa, Kelly Brenan-Rothschild Md

Transformative Medicine

Introduction: When confronted by two disease processes, physicians in all disciplines are faced with the question: Are they manifestations of a common etiology, or distinct entities co-occurring? Inherent in this dilemma is whether an aberration from normal is even a disease process at all. Tissue pathology plays a key role in resolving this conundrum. Although diagnoses can be challenging, there are various methodologies used in the field of pathology to ascertain whether two tumors are of the same or different origins.

Case Description: This case report reviews two patients with large ovarian neoplasms and surgical pathology revealing histopathological features of …

Guardians Of The Genitals: The Dermatogynecologic Duo, Alexis Arza, Erin Stitzlein

Transformative Medicine

No abstract provided.

A Brief Review Of Zuranolone, Aubrey A. Jackson

Transformative Medicine

Zuranolone, a novel analog of allopregnanolone, has been approved by the U.S. Food and Drug Administration (FDA) as the first oral medication approved for the treatment of postpartum depression in adults. Developed by Sage Therapeutics under the brand name Zurzuvae, zuranolone was approved by the FDA on August 4^th, 2023.¹ Zuranolone is a modified version of brexanolone (sold under the brand name Zulpresso), an intravenously administered allopregnanolone formulation that was previously the only FDA-approved medication for postpartum depression. Zuranolone offers a more accessible treatment option for patients with efficacy established in clinical trials. Its approval expands the …

Same Or Different? Resolution Of Diagnostic Difficulty Of Two Mixed Cell-Type Tumors In Ovarian Pathology., Sarah Ingram, Kelly Brenan, Priyanka Raju Md, Wei Shaw Do, Stever Sowers Pa

Tower Health Research Day

No abstract provided.

Improving Awareness Of Surgical Ergonomics In Gynecologic Surgery, Priyanka Raju Md, Annika Eveland Md, Dominic Cammarano Do

Tower Health Research Day

No abstract provided.

Utilizing A Web-Based Program For Educational Material Distribution In An Obgyn Residency Program, Sarah Dreibelbis, Peter F. Schnatz

Transformative Medicine

Background: Online modules and assignments are commonly used for continuing education among residents. Ensuring ease of distribution and access to learning modules, assignments and simulations allows for the efficient completion of these tasks.

Objective: The purpose of this quality improvement project is to propose a new method for distribution of educational material and assignments to improve resident satisfaction and ease of completion as well as tracking completion by the program manager.

Methods: A survey was sent to the 2020-21 academic year OBGYN residents regarding the current in-hospital folder-based distribution of resources. Based on the survey feedback, a checklist was designed …

Cervical Os Marsupialization In The Initial Management Of A Rare Case Of Obstructive Uterine Didelphys With Ipsilateral Renal Agenesis, Anna K. Roble, Sarah Dreibelbis, Jonathan Buerger, Xuezhi Jiang

Transformative Medicine

Introduction: Uterine didelphys is an uncommon Mullerian anomaly that often is associated with obstructive pathology. Without early intervention, obstruction can progress to potentially fatal complications including pyometra and sepsis. Due to the rarity and variability of this condition, treatment options have not been systematically studied.

Case Description: In this case report, we discuss a 16-year-old female who presented with acute sepsis secondary to pyometra in the setting of chronic dysmenorrhea and purulent vaginal discharge. On imaging, she was found to have uterus didelphys with right renal agenesis and a hypoplastic right cervix along with a pelvic fluid collection. During …

Chronic Stress May Disrupt Covariant Fluctuations Of Vitamin D And Cortisol Plasma Levels And Placentome Formation In Pregnant Sheep During The Last Trimester: A Methodological Approach And Preliminary Report, Colin Wakefield

Tower Health Research Day

No abstract provided.

Demographic And Socioeconomic Factors Predict Maternal Postpartum Rehospitalization: A Retrospective Numom2b Dataset Study, Colin Wakefield

Tower Health Research Day

No abstract provided.

Use Of Telemedicine In An Obgyn Residency Clinic During Covid, Sarah Dreibelbis, Anna Grassi, Daniel Jiang, John Dougherty

Transformative Medicine

INTRODUCTION: Telemedicine can address healthcare disparities by improving access to care and eliminating barriers to in-office appointments. The primary goal of this study is to compare the number of completed telemedicine appointments to the number of completed in-office appointments for an OBGYN residency clinic during the early months of the COVID pandemic. The study also aims to evaluate patient demographics and types of visits performed using telemedicine. METHODS: All OBGYN residency clinic visits at a single institution from March 2020 – May 2020 were included and reviewed. Proportions of the visit type were evaluated for completion as well …

Evaluating The Effect Of Neuraxial Analgesia On External Cephalic Version Success, Sarah Dreibelbis, Peter F. Schnatz, Edwin Newton

Transformative Medicine

Abstract

Background: External cephalic version (ECV) can be a helpful procedure in attempts to decrease the overall cesarean section rate. ECV involves the application of external pressure to the pregnant woman’s abdomen in attempts to turn the fetus to a vertex presentation and allow for subsequent vaginal delivery. Tocolytics are routinely used to increase ECV success rates, and neuraxial analgesia has been presented as another adjunct to increase overall success. The purpose of this quality improvement project is to evaluate the effect neuraxial analgesia may have on ECV success rates.

Methods: Patients scheduled for ECV between the dates of January …

Primary Hyperparathyroidism In Pregnancy: Successful Parathyroidectomy During First Trimester., Niranjan Tachamo, Bidhya Timilsina, Rashmi Dhital, Theresa Lynn, Vasudev Magaji, Ilan Gabriely

Reading Hospital Internal Medicine Residency

Primary hyperparathyroidism in pregnancy can result in significant maternal and fetal complications. When indicated, prompt parathyroidectomy in the early second trimester is considered the treatment of choice. Pregnant patients with primary hyperparathyroidism who have an indication for parathyroidectomy during the first trimester represent a therapeutic challenge. We present the case of a 32-year-old primigravida who presented with symptomatic hypercalcemia from her primary hyperparathyroidism. She remained symptomatic despite aggressive conservative management and underwent parathyroidectomy in her first trimester with excellent outcomes.