Obstetrics and Gynecology Commons^™

Home, Sweet Home: An Evaluation Of The Relationship Between Food Environment And Diabetes In Pregnancy, Symone Mcclain, Tiffany Clinton, Alicia Speak, Jessica Flint, Allison Fly, Tylar Louise Marie Dickson, Briana Marin, Miranda Goodson, Sun Kwon Kim, Raminder Khangura, D'Angela S. Pitts

Conference Presentation Abstracts

Objective: Access to healthy and nutritious food is a basic human right, although it has become a critical social determinant of health. Lack of healthy food access has been linked to poorer health outcomes and chronic preventable health conditions, especially in our most vulnerable populations. Previous research has suggested mixed results with food insecurity and type 2 diabetes (T2DM) and gestational diabetes (GDM). This study’s objective is to explore the impact of living in a low food access environment (LAFE) on the incidence of T2DM and GDM in pregnant patients Study Design: This study was a retrospective chart review from …

Ai Significantly Improves Detection Of Prenatal Ultrasounds Suspicious For Major Congenital Heart Defects By Obgyn/Mfms, Jennifer Lam-Rachlin, Rajesh Punn, Sarina K. Behera, Miwa Geiger, Matthias Lachaoud, Nadine David, Sara Garmel, Matthew K. Janssen, Kendra Sylvestser, John Kennedy

Conference Presentation Abstracts

Objective: Congenital heart defects (CHDs) are a leading cause of infant morbidity and mortality partly due to low prenatal detection rates. We evaluated whether an artificial intelligence (AI) system can improve the detection of CHDs on fetal ultrasound exams among both general OBGYNs and MFM specialists. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of an exam and detects 8 morphological findings associated with severe CHDs. The presence of any such finding should justify patient referral for further examination. The AI system identifies each finding as present, absent or inconclusive, and highlights frames where findings can be …

Cerebroplacental Doppler Ratio For The Prediction Of Adverse Perinatal Outcomes In Late-Onset Fetal Growth Restriction, Sonia Sajja, Onur Turkoglu, Torey Asao, Perry Friedman, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late-onset fetal growth restriction (LO-FGR), defined as onset 3 32 weeks gestation, is the more common subgroup of FGR. The umbilical artery Doppler is usually unaffected. There are no subgroup-specific guidelines for monitoring pregnancies affected by LO-FGR. We compared the utility of the cerebroplacental Doppler ratio (CPR) to the Biophysical Profile (BPP), a widely endorsed FGR monitoring tool, for the prediction of adverse perinatal outcomes (APO). Study Design: This is a retrospective cohort study of LO-FGR, defined as estimated fetal weight < 10th%, from 2013-2018. Using logistic regression analysis, we determined whether low CPR < 5th% and BPP score £ 6 significantly independently predicted the composite APO defined as one or more complications: cord pH < 7.20, 5-minute Apgar score of < 5, operative or cesarean delivery secondary to non-reassuring fetal heart tracing, assisted respiration at birth, NICU admission, and/ or perinatal death. Secondarily, we also evaluated prediction of severe neonatal morbidity (SNM) defined in Table 1 (legend). Results: There were 233 cases of LO-FGR of which 76 (34%) had a low CPR percentile and 28 (13%) had a low BPP score. There were 22 (9.9%) cases with SNM of which 5 (2.1%) had a low CPR percentile and 4 (1.8%) had a low BPP score. A low CPR was associated with a significantly higher rate of individual and composite APO than cases with normal CPR percentile (p < 0.001) [Table 1]. Both a low CPR percentile and a low BPP score significantly predicted APO overall. CPR appeared to be a better predictor of the APO, controlling for gestational age at testing [Table 2]. Only BPP significantly predicted SNM: CPR (OR = 4.64, p = 0.13) and BPP (OR = 4.11, p = 0.038). Conclusion: A low CPR percentile was a significant independent predictor of perinatal complications in LO-FGR, including abnormal fetal heart rate tracing, smaller birthweight percentile, and NICU admission. CPR appeared superior to BPP overall. CPR should be considered as a fetal surveillance tool in LO-FGR.

Artificial Intelligence System Accurately Detects Fetal Ultrasound Findings Suspicious For Major Congenital Heart Defects, Carolyn M. Zelop, Jennifer Lam-Rachlin, Alisa Arunamata, Rajesh Punn, Sarina K. Behera, Matthias Lachaud, Nadine David, Greggory R. Devore, Andrei Rebarber, Sara Garmel

Conference Presentation Abstracts

Objective: Prenatal detection of congenital heart defects (CHD) improves patient outcomes. Despite advances in imaging techniques and equipment, prenatal diagnosis remains low. We evaluated the accuracy of an artificial intelligence (AI) system to detect 2nd trimester (2T) ultrasound studies suspicious for CHD. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of a study and detects 8 morphological findings suspicious for CHD. The findings were selected such that most major forms of CHD would feature at least one such finding, and the presence of any of these would flag the study for referral for further examination. We retrospectively …

Maternal Lipidomics For The Accurate Prediction Of Fetal Cyanotic Congenital Heart Defects, Onur Turkoglu, Nadia Ashrafi, Ali Yilmaz, Romana Ashrafi Mimi, Abdullah Khan, Perry Friedman, Ciara Talbot, Stewart Graham, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late diagnosis of cyanotic congenital heart defects (CCHD) significantly increases newborn morbidity and mortality. However, a significant percentage of CCHD cases remain undetected prenatally. Our objectives were therefore to evaluate the accuracy of maternal serum lipidomic markers for the prenatal detection of CCHD and also to elucidate the pathogenesis of these disorders. Study Design: This prospective case-control study included 40 cases of CHD (22 cyanotic, 18 acyanotic) and 39 unaffected controls. Maternal serum samples were profiled via a combination of Ultra-High-Performance Liquid Chromatography coupled with Mass Spectrometry and Nuclear Magnetic Resonance. The mean of each lipid specie was compared …

Evaluation Of Current Redating Guidelines For Pregnancies ≤9 6/7 Weeks' Gestation, Grace Chen, Clara Choi, Allyson Nguyen, Mark Brunk-Grady, Tuan Nguyen

Conference Presentation Abstracts

Objectives: The aim was to evaluate the validity of the current redating guidelines for pregnancies ≤9 6/7 weeks’ gestation. We postulated that visually apparent discrepancies between crown-rump length (CRL) measured by ultrasound (US) and CRL by last menstrual period (LMP) were statistically significant. Methods: This is a retrospective, cross-sectional study conducted between January 2019 and June 2023 at a tertiary referral center. Individuals who had singleton gestations between ≥6 0/7 and ≤9 6/7 weeks by known LMP were reviewed. For estimated gestational age (EGA) by LMP ≥6 0/7 and ≤8 6/7 weeks, a 3–5 day discrepancy between EGA by LMP …

Moonlighting: A Pilot Project To Assess Impact Of Extracurricular Activities On Career Satisfaction And Quality-Of-Life In Graduate Medical Education, Charlotte O'Sullivan, David Lee, Karen Childers, Justine Nasr

Conference Presentation Abstracts

Background: Moonlighting is the delivery of healthcare outside of training programs in exchange for compensation. The Accreditation Council on Graduate Medical Education allows individual training programs to permit or restrict moonlighting, which leads to variation in prevalence and practice. Guidelines and regulations for moonlighting vary greatly across graduate medical education programs. Yet, limited research has been done to determine resident and fellow physician attitudes towards moonlighting and its impact on quality-of-life. Objective: This pilot study investigates how participating in moonlighting and extracurricular activities may impact resident and fellow physicians’ self-perceptions of quality-of-life and career satisfaction. Methods: 442 residents and fellow …

Integrative Analysis Of Metabolome And Methylome Identifies The Correlation Of Aminoacyl-Trna Biosynthesis Metabolitesand Sepsecs Gene Methylation In Huntington’S Disease Brain Tissue, Sangeetha Vishweswaraiah, Ali Yilmaz, Nadia Ashrafi, Nazia Saiyed, Abdulla Khalid, Purvesh R. Koladiya, Xiaobei Pan, Shirin Macias, Uppala Radhakrishna, Stewart F. Graham

Conference Presentation Abstracts

No abstract provided.

An Epi-Metabolomics Approach For Studying Epigenetic And Metabolic Changes In Alzheimer’S Disease Brain, Nadia Ashrafi, Sangeetha Vishweswaraiah, Ali Yilmaz, Sumeyya Akyol, Juozas Gordevicius, Stewart Graham

Conference Presentation Abstracts

No abstract provided.

Mild And Severe Traumatic Brain Injury Longitudinally Profiled Using High-Resolution Metabolomics, Ali Yilmaz, Sigal Liraz Zaltsman, Esther Shohami, Juozas Gordevicius, Jack E. Sherman, Ray Bahado-Singh, Stewart F. Graham

Conference Presentation Abstracts

No abstract provided.

Interlaboratory Comparison Of Metabolomics Analyses Of Human And Rodent Blood Using Biocrates Mxp Quant 500 Kit, Nadia Ashrafi, Ali Yilmaz, Stewart F. Graham, Thomas O'Connell, Sumeyya Akyol

Conference Presentation Abstracts

No abstract provided.

Untargeted Metabolomic Identification Of Diagnostic Biomarkers In Ectopic Pregnancy, Onur Turkoglu, Robert Quinn, Stewart F. Graham, Ray Bahado-Singh

Conference Presentation Abstracts

Introduction: Ectopic pregnancy (EP) is a potentially life-threatening condition and early diagnosis still remains a challenge, causing a delay in management leading to tubal rupture. Targeted metabolomics has been shown to identify novel biomarkers for the detection of ectopic pregnancy. Using untargeted metabolomics approach, we sought to identify putative plasma biomarkers for the detection of tubal EP compared to intrauterine pregnancies. Methods: This case-control study included prospective recruitment of 50 tubal EP cases and 50 early intrauterine pregnancy controls. Plasma samples were biochemically profiled using tandem liquid chromatographymass (MS/MS) spectrometry with untargeted metabolomics approach. To avoid over-fitting, datasets were randomly …

Does Maternal Sars-Cov-2 Infection Or Sars-Cov-2 Vaccination Trigger An Inflammatory Response In The Fetus?, Ali Alhousseini, Sonia Sajja, Onur Turkoglu, Kurt Wharton, Kirsten Gage, Jaber Saad, Jay Idler, Ray Bahado-Singh

Conference Presentation Abstracts

Objective SARS-CoV-2 infection triggers a significant maternal inflammatory response. There is a dearth of data regarding whether maternal SARS-CoV-2 infection or SARS-CoV-2 vaccination triggers an inflammatory response in the fetus. Fetal Inflammatory Response Syndrome (FIRS) has been described in other clinical conditions such as intraamniotic infection and has been defined as a cord blood Interleukin-6 (IL-6) level > 11 pg/ml. The objective of the study is to evaluate Il-6 levels in the cord blood of three delivering women: SARS-CoV-2 infection group, SARS-CoV-2 vaccinated group, and a control group.

Study Design A prospective case control study of a total of 61 pregnant …

Prediction Of Small For Gestational Age Neonates By Combining Maternal Risk Factors With Biophysical Markers, Anthony O. Odibo, Umit Kayisli, Richard Bronsteen, Charles Lockwood

Conference Presentation Abstracts

OBJECTIVE: Studies have suggested a role for biophysical markers (BPM) including uterine artery Doppler (UAD) and maternal mean arterial pressure (MAP) in prediction of neonatal SGA. We sought to determine if the addition of flow velocities in spiral artery (SA), UAD, MAP and maternal risk factors could improve prediction of neonatal SGA, compared with using maternal risk factors alone. STUDY DESIGN: This is a prospective longitudinal study over a 5-year period. We measured SA UAD and MAP at: 11 to 13 + 6, 18 to 22 + 6/7 and 28 to 34+ 6/7 weeks of gestation. Prediction models for SGA …

Non-Contraceptive Uses And Benefits Of Intrauterine Contraceptive Devices, Frederick Eruo

Conference Presentation Abstracts

No abstract provided.

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.

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 …

510 Contemporary Trends In Cesarean Delivery Rates And Indications, Sara Jaber, Christina Blanchard, Michelle Y. Lu

Conference Presentation Abstracts

Objective

The American College of Obstetrics and Gynecology (ACOG) introduced updated guidelines for labor management (2014) and fetal heart rate interpretation in an attempt to reduce cesarean delivery (CD) rates – especially the primary CD. We sought to describe CD rates and indications at a single center in order to assess the impact of these guidelines on trends in clinical practice.

Study Design

Retrospective cohort study of women ≥ 23 weeks gestation delivering at a single tertiary care referral center from 2013 - 2018. Demographic characteristics, mode of delivery, and main CD indication were ascertained by individual chart review. Main …

Ultrasound Guided Laparoscopic Radiofrequency Ablation For Very Large Multi-Fibroid Uterus, Alia A. Shah, Jay E. Fisher

Conference Presentation Abstracts

Study Objective

This video describes the technique and advantages of laparoscopic radiofrequency ablation with ultrasound guidance for the treatment of very large multi-fibroid uteri.

Design

N/A

Setting

Large tertiary care hospital.

Patients or Participants

45-year-old gravida 2 para 0 female with menorrhagia, dysmenorrhea, and bulk symptoms secondary to a very large multi-fibroid uterus. She desired a minimally invasive and uterine conserving method to treat her symptoms.

Interventions

We performed laparoscopic radiofrequency ablation under ultrasound guidance for the patients’ multiple fibroids. The uterus was mapped ultrasonographically using the laparoscopic ultrasound transducer. Next, under laparoscopic visualization, the needle handpiece was inserted into …