Obstetrics and Gynecology Commons^™

Umbilical Artery Doppler In Fetal Growth Restriction, Britanie Dollard

Lynchburg Journal of Medical Science

Umbilical artery (UA) Doppler velocimetry is a noninvasive tool used to assess placental vascular resistance and improve risk stratification in pregnancies complicated by suspected fetal growth restriction (FGR). Placental insufficiency remains a leading cause of stillbirth and neonatal morbidity, making early identification critical for optimizing perinatal outcomes. This clinical review synthesizes current evidence regarding the role of UA Doppler in identifying placental insufficiency, outlines key waveform interpretations, and evaluates how Doppler findings guide clinical management and delivery planning. Evidence and major society guidelines support UA Doppler as a targeted surveillance tool in high-risk pregnancies complicated by suspected FGR. Progressive abnormalities, …

The Effect Of Elevated Blood Pressure And Stage One Hypertension On Perinatal Outcomes In Appalachian Gravidas: A Retrospective Cohort Study, Caroline Briggs, Austin L. Loop, Grace E. Montgomery, David G. Chaffin, Jesse Cottrell

Marshall Journal of Medicine

Introduction:  There is literature in the obstetric population that suggests any degree of hypertension (blood pressures greater than or equal to 120 systolic or 80 diastolic) can lead to adverse maternal and fetal outcomes.  We sought to determine if pregnant patients in our Appalachian population with elevated blood pressure or stage 1 hypertension have an increased risk of gestational hypertension and preeclampsia.

Methods:  A retrospective chart review was performed on patients who received obstetric care with the Marshall University OB/GYN department and delivered at Cabell Huntington Hospital.  Delivery outcomes were obtained for 233 deliveries from March 30, 2020 to September …

Kmt2d As An Epigenetic Target In Cervical Cancer: A Literature Review On Polyclonal Antibody Therapeutics And Translational Prospects, Farsya Hidayah Septiananda, Taurisma Aulia Nanda Wibisono, Rajendra Aulya Gilardino, Andreas Budi Wijaya

Preventia: The Indonesian Journal of Public Health

Cervical cancer remains a significant global health burden, particularly in regions with limited access to advanced therapeutics. Beyond viral oncogenesis, accumulating evidence highlights the crucial role of epigenetic dysregulation, particularly KMT2D, in tumor initiation and progression. This literature review aimed to critically synthesize current evidence regarding the biological role of KMT2D in cervical cancer and to explore the opportunities and limitations of antibody-based approaches for future epigenetic intervention. A structured narrative literature review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies published between January 2020 and May 2025. Literature selection was guided by a modified …

Advocating For A Care-Based Ethic: Stories Of Pregnancy And Birth From Caregivers Of Children With Down Syndrome, Lydia Ocasio-Stoutenburg, Nayma Sultana Mim

Developmental Disabilities Network Journal

Down syndrome (DS) impacts about 1 in every 640 childbirths in the United States. While quality of life has improved for people with DS, systemic inequities and deficit-based perceptions have persisted throughout history, with material impacts on people with DS and their caregivers. Researchers have documented how caregivers of children with DS have had negative experiences with healthcare providers and genetic counselors, whose biased views about DS translate into subtle and overt pressures. Few studies explicitly focus on the experiences of Caregivers of Color, multilingual families, as well as families with varying economic experiences who have children with DS. This …

Forced Dependency: The Subjugation Of Women Through Medicine In Ancient Greece And Rome, Evelyn J. Polovich

Binghamton University Undergraduate Journal

In the ancient Mediterranean men were in charge of every facet of life, including women’s medicine. They forced women out of the oversight of gynecology and reformed it into a method of control that they could assert in order to force women into a position of submission. This paper aims to bring the ways in which ancient medicine was influenced by cultural ideas and worked to subjugate women and allow men to gain further control over their autonomy. This research was inspired by the works of ancient physicians like Hippocrates, Soranus, and Galen, as well as contemporary sources that critique …

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 …

Educational Intervention To Improve Awareness Of The Female Athlete Triad Among Division I Athletes, Carly J. Haring, Jonathan Olson Md

Aesculapius Journal (Health Sciences & Medicine)

Introduction: The Female Athlete Triad poses short- and long-term health risks for female athletes through the interrelated components of low energy availability, menstrual dysfunction, and impaired bone health. Despite its prevalence, awareness and education surrounding the Triad remain limited, contributing to delayed recognition and care. The objective of this project was to assess baseline knowledge and comfort discussing Female Athlete Triad–related topics among Division I female athletes and to evaluate the impact of a brief educational intervention on knowledge, attitudes, and help-seeking intentions.

Methods: A community-based educational initiative was conducted in November 2025 among Division I female athletes …

Conjoined Twins And Abortion Restrictions: Navigating 'Ban State' Challenges, A Case Report, Beau Morgan Nrp

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This case report highlights an unusual scenario of a conjoined twin pregnancy resulting from intrauterine insemination in a state with restrictive abortion laws. Despite a diagnosis deemed not compatible with life, the patient faced legal barriers preventing termination within their home state. Forced to seek care out-of-state, the patient underwent a successful termination at ten weeks and three days after lengthy and expensive travel. This case stresses the complex challenges posed by restrictive abortion laws, impacting patient access to essential medical interventions. The case demonstrates the critical intersections between medical care, medical ethics, legal constraints, and patient outcomes in managing …

Policy, Misinformation, And Mortality: The Effects Of Abortion Restrictions On Maternal Outcomes, Gabrielle Samiratedu Dmsc, Mcms, Pa-C

Lynchburg Journal of Medical Science

The objective of this review is to evaluate the effects of restrictive abortion laws on maternal mortality and morbidity in the United States. Even before the landmark reversal of Roe v. Wade, the US had one of the highest maternal mortality rates among other high-income countries, and rates are expected to continue to rise in states with restrictive abortion policies. Electronic databases and public health data were analyzed to assess clinical outcomes, access to care, and disparities associated with abortion restrictions nationally and internationally. The findings suggest that states with highly restrictive abortion policies experience higher rates of maternal morbidity …

Association Of Short Interpregnancy Interval Among Multigravid “Pregnant Youth” In A Tertiary Hospital, Eileen Feliz Cortes-Garcia

The Lasallian Journal of Health

Introduction: Pregnancy among the youth is in creasing not only in the Philippines but worldwide. Studies have shown that a short interpregnancy inter val of 18 months or less is associated with an in creased risk of fetal and maternal complications. However, limited data are available regarding fetal and maternal outcomes among pregnant youth with short interpregnancy intervals, particularly in the Philippines. Objectives: The objective of the study was to deter mine the association between a short interpregnancy interval of <18 months and adverse fetomaternal out comes among pregnant youth aged 15 to 24 years who had their first pregnancy at De La Salle Univer sity Medical Center (DLSUMC) from 2017 to 2019. Methods: This was a retrospective cohort study in volving 130 participants who delivered at DLSUMC from 2017 to 2019 either by vaginal spontaneous delivery, assisted vaginal delivery, or cesarean sec tion. Results: Of these, 84 (66.15%) were 22 to 24 years old and the majority had their first pregnancy at the age of 18 to 21 years (59 [45.38%]). This study demonstrated that preterm delivery, postpartum hem orrhage, and hypertension were significantly associ ated with a short interpregnancy interval. Conclusions: Short interpregnancy interval is associ ated with an increased risk of preterm delivery, hy pertension, and postpartum hemorrhage among mul tiparous pregnant youth. Counseling and proper edu cation, including family planning, are important for both maternal and fetal health. The use of different family planning methods should be discussed and made accessible to young women.

A New Application For Bolt Cutters In Urogynecology: Challenging Removal Of An Impacted Pessary, Carolyn M. Payne, Courtney B. Ritchie, Tanaz R. Ferzandi

HCA Healthcare Journal of Medicine

Background

Pessaries are commonly used to treat pelvic organ prolapse. While these devices generally pose negligible risk, serious morbidity can be associated with neglected use.

Case Presentation

A 91-year-old woman began to experience acute pain related to an impacted pessary. An Exam in the operating room under anesthesia revealed that the pessary was deeply embedded within the vaginal canal and was noted to have a hard metal wire under a rubber exterior. An intraoperative orthopedic consult was obtained to facilitate discussion and selection of tools outside the typical gynecological scope to remove the pessary. A combination of bolt cutters and …

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 …

Use Of Topical Hemostatic Agents In A Gynecologic Patient With Coagulopathy, Alexis O'Connell, Syeda Zainab Shah

HCA Healthcare Journal of Medicine

Introduction

The use of topical hemostatic agents has become common during surgical interventions. There is a wide variety of substances available to augment clotting, ranging from physical agents to topical thrombin combinations. Application of these agents in gynecologic surgery in patients with existing coagulopathies has not been studied.

Case Presentation

A 62-year-old woman with an inferior vena cava filter and a history of multiple deep vein thromboses presented to the clinic with pelvic pain, stress urinary incontinence, and uterovaginal prolapse. She underwent a total vaginal hysterectomy, sacral colpopexy, tension-free vaginal tape sling, and cystourethroscopy. Warfarin was cross titrated to enoxaparin …

Rapid Percutaneous Nephrostomy Stent Encrustation In Pregnancy: Navigating Your Stone Challenge, Victor M. Feldbaum, Roberto Morales, Shawn R. Ramsey, Michael L. Douso

HCA Healthcare Journal of Medicine

Background

Surgical management of kidney stones in pregnancy can be a serious problem for both mother and fetus.

Case Presentation

A 20-year-old woman with a second trimester pregnancy presented to the emergency room with renal calculi. She required surgical intervention and a left nephrostomy tube after consultation with urology. Five weeks later, her tube was solidified in place unbeknownst to her care team. She required several surgeries, dealt with encrustation remnants, infections, radiation exposure, persistent infection requiring antibiotic management, and, ultimately, an early delivery at 37 weeks.

Conclusion

At the time of writing, this was the first case to describe …

Combined Effect Of Letrozole And Dydrogesterone Versus Dydrogesterone Alone For Relieving Pain In Patients With Endometriosis, Mohamed M.H. Elwakeel, Mohamed A.T. Elsharawy, Abdelghaffar S. Dawod, Dina G. Elkhouly

Journal of Medicine in Scientific Research

Background Endometriosis is a medical condition in women caused by the growth of active endometrial tissue outside the uterine cavity. It predominantly affects women of reproductive age and typically manifests as dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. It negatively impacts psychological well-being and health-related quality of life. Aim This study aims to compare the effect of the combination of letrozole and dydrogesterone versus the effect of dydrogesterone alone in pain-associated endometriosis Patients & Methods This randomized controlled study was conducted on 88 women with endometriosisassociated pain in the gynecologic outpatient clinic at Tanta University Hospitals, from October 2023 to …

An Analysis Of Mental Health In Menopause, Christy Thozer

Lynchburg Journal of Medical Science

Menopause is a major life transition and is frequently accompanied by significant symptoms. While many complaints are often addressed by healthcare providers, many others are frequently left out of the discussion. While these symptoms are significantly detrimental to quality of life and effective treatments are available, many symptoms of menopause remain under-addressed. Mental health symptomatology such as depression, cognitive changes, and decline in libido are common and frequently distressing in the menopause transition and are well worth focused attention. Depression in menopause is well treated by selective serotonin reuptake inhibitors (SSRIs) but may also benefit from treatment with menopausal hormone …

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 …

Medical Students’ Perspectives On Dobbs V Jackson Women’S Health Organization, Victoria Lazarov, Cecilia Mastrogiacomo, Mikaela Koch, Kirsten Wohlars, Tova Ablove, Student Perspectives On Reproductive Rights Research Group

Cooper Rowan Medical Journal

Background: In June 2022, the Dobbs v Jackson Women’s Health Organization ruling overturned the previously upheld constitutional right to abortion. The resulting impact on medical training and student decision-making remains uncertain. This study aims to assess the nationwide impact of the Dobbs decision on medical students’ geographic residency preferences, specialty selection, and level of concern regarding civil and criminal charges for physicians providing abortion and fertility care.

Methods: An anonymous IRB-approved REDCap survey was distributed to American accredited medical schools across the United States and Israel between December 2022 and May 2023. Participants indicated specialty interests and geographic preferences for …

Multi-Center Survey Of Medicine Residents And Self-Assessment On Cardiac Complications In Obstetric Patients, Kevyn Niu, Christie A. Tran, Robert J. Subbiondo Md, Olubenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Internal medicine (IM) residents receive significant cardiology training, and previous surveys have evaluated IM resident competency on obstetric (OB)-related subjects. However, there is minimal literature on self-reported competence of cardiac-specific complications in OB patients. Our study assessed self-reported comfort and competency regarding cardiovascular complications in OB patients with medical residents across several specialties.

Methods

We surveyed 207 residents across 3 specialties and 3 teaching hospitals on 10 questions regarding their self-reported confidence in managing cardiovascular complications in OB patients, including practice setting, specific cardiac issues, and stages of labor. We received 42 responses. Results were obtained using Google Sheets …

Ovarian Dysgerminoma With Tubo-Ovarian Torsion In An 11-Year-Old Child: A Rare Occurrence But A Significant Differential Diagnosis In Acute Abdomen, Charu Chandra, Keeranmayee Mishra, Rahul Mangal, Chirag Doshi, Apurba Anshuman Mishra

HCA Healthcare Journal of Medicine

Background

Ovarian tumors are quite uncommon in the premenarchal age group, with the majority being functional cysts. Malignant tumors are unusual in this age group, making the diagnosis of ovarian malignancy in children quite challenging. Dysgerminoma is the most common malignant ovarian germ cell tumor in females. The clinical symptoms often include abdominal pain, distension, a palpable mass, reduced appetite, nausea, and vomiting.

Case Presentation

We discuss the case of an 11-year-old premenarchal girl who was brought to the emergency department with abdominal pain persisting for 3-4 days, which had intensified over the 24 hours before she arrived at the …

Brown Umbilical Nodule: A Case Of Primary Cutaneous Endometriosis, Richard G. Bindernagel Jr., Aleia Boccardi, Taylor C. Jindia, Parth Patel, Jaimie Bryan, Addie Walker, Summer Moon, Richard Miller

HCA Healthcare Journal of Medicine

Background

Endometriosis is a common condition in which endometrial glands and stroma are implanted outside the uterine cavity. Rarely, the skin can be involved.

Case Presentation

We describe a case of a 41-year-old woman who presented to the dermatology clinic complaining of a brown umbilical nodule with slight erythema. It was occasionally painful and hemorrhagic. She denied a history of endometriosis and abdominal surgeries. A shave biopsy of the nodule was consistent with a diagnosis of cutaneous endometriosis. The patient was referred to her gynecologist for further evaluation and treatment.

Conclusion

This unique case demonstrates primary cutaneous endometriosis in the …

A Complex Case Of A Large Fibroid Uterus Compressing The Inferior Vena Cava Causing Recurrent Deep Vein Thrombosis And Pulmonary Embolisms, Jessica Gil, Jessica Klingensmith, Lauren Hendrix, Patrick J. Stocker, Olugbenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Uterine fibroids have been found to increase the risk for venous thromboembolism. There have been other case reports linking large uterine fibroids, pulmonary embolisms, and deep vein thrombosis (DVT) together due to compression of blood vessels and increased venous stasis. This case report will discuss a case of a large fibroid uterus compressing the inferior vena cava causing a patient with few risk factors to have recurrent DVTs and pulmonary embolisms.

Case Presentation

The patient was a 35-year-old woman who presented with repeated unprovoked thrombosis episodes. The patient had a full workup after the first episode of DVT and …

A Case Report And Evaluation Of Intrauterine Gas Of Unknown Origin, Chrystal Stallworth, Diane Gilbertson, Michele L. Mccarroll, Timothy Kremer

HCA Healthcare Journal of Medicine

Introduction

Most reports of intrauterine or endometrial gas have been reported in the setting of underlying gynecologic malignancy or infection. The significance of this case report is to give a presentation of a patient presenting with intrauterine gas who subsequently was identified as having neither an infectious nor malignant cause for such a finding.

Case Presentation

The patient is a 56-year-old postmenopausal woman who presented with “hip pain” and was found to have incidental intrauterine gas on a pelvic computed tomography. She underwent in-office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign, …

Thyrotoxicosis In Pregnancy Cured By Total Thyroidectomy, Owen G. Alvine, Daniel Thum Md

Aesculapius Journal (Health Sciences & Medicine)

Thyrotoxicosis during pregnancy is a rare but potentially life-threatening condition that requires prompt recognition and management. This case report describes a 23-year-old pregnant woman with a history of Graves’ disease who presented with symptoms of thyrotoxicosis, including tachycardia, weight loss, and dyspnea. Initial treatment with propylthiouracil and propranolol was insufficient, and her condition progressed to include pericardial effusion with early tamponade physiology and systemic inflammatory response syndrome (SIRS). Despite medical therapy, her symptoms persisted, necessitating a total thyroidectomy during the second trimester. Postoperatively, the patient experienced significant clinical improvement and delivered a healthy infant at term. This case highlights the …

A Tubo-Ovarian Abscess In Aplastic Anemia Presenting As Fever Of Unknown Origin, Rashi Mittal, Saurabh Kumar Gautam, Prasan Kumar Panda, Latika Chawla

Chulalongkorn Medical Journal

This report describes a complex case of a tubo-ovarian abscess (TOA) presenting atypically as fever of unknown origin (FUO) in a young woman initially diagnosed with severe aplastic anemia. The case involved protracted febrile illness, heavy menstrual bleeding, and pancytopenia. Identification of an Escherichia coli tubo-ovarian abscess, rather than tuberculosis, emphasized the need for a thorough evaluation in atypical presentations of TOA. Negative tuberculosis tests highlighted the variety of possible microbial etiologies. The resolution of fever following drainage and tailored antibiotic therapy, along with timely surgical intervention, demonstrated the importance of specific management strategies in such cases. Awareness of the …

A Rare Instance Of Streptococcus Agalactiae Pyomyoma In A Postmenopausal Patient: A Case Report, Mariah Piazza, Sai V. Nagula, Madeleine Salzberg, Darren Preuninger

HCA Healthcare Journal of Medicine

Background

Pyomyoma is a rare, but potentially fatal, complication of uterine leiomyoma. Most cases occur in postpartum or postmenopausal patients with vascular disease and arise due to infarction and infection of existing fibroids. The proposed diagnostic triad for pyomyoma includes 1) sepsis or bacteremia; 2) uterine leiomyomata; and 3) no other apparent source of infection. We present a case of a postmenopausal patient who presented with the aforementioned triad and was found to have a pyomyoma, positive for Streptococcus agalactiae.

Case Presentation

A 67-year-old woman with no known past medical history presented to the emergency department for altered mental …

Vaginismus: Causes, Diagnosis, And Treatment Options, Heather Thomas

Best Integrated Writing

This paper provides a current review of the diagnosis, causes, and treatment outcomes for vaginismus. Of particular interest are predisposing factors, like a lack of sex education and a sexually restrictive upbringing, for the development of this disorder. Controversies surrounding US-based diagnostic criteria for female sexual dysfunction are also reviewed, and up-to-date and novel treatment options, like vaginal Botox injections, are described.

Polycystic Ovarian Syndrome: A Clinical Review, Amanda Nettles

Lynchburg Journal of Medical Science

Polycystic ovarian syndrome (PCOS) is a pervasive condition that affects women all over the world. It presents with a wide variety of symptoms like menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. Although generally considered to be solely a reproductive disorder, PCOS impacts metabolic, psychological, and cardiovascular health, and increases the risk for those diagnosed for other complications. Although PCOS is relatively common, it remains greatly misunderstood, which makes diagnosing the condition even more complex. Risk factors taken into consideration include genetics, environment, and lifestyle. The pathophysiology of PCOS focuses on dysfunction of the hypothalamic-pituitary-ovarian axis, insulin resistance, and inflammation. There …