Obstetrics and Gynecology Commons^™

Twin Pregnancies And Incidence Of Spontaneous Preterm Delivery Stratified By Chorionicity, Amanda Roman, Gabriele Saccone, Yury Cruz, Giuseppe Maruotti, Mohamed Satti, Pasquale Martinelli, Vincenzo Berghella

Department of Obstetrics and Gynecology Posters

Objective: To identify the incidence of spontaneous preterm birth (SPTB) and indications for delivery in women with twin pregnancy stratified by chorionicity (monochorionic diamniotic and dichorionic diamniotic pregnancy).

Study Design: Multicenter retrospective cohort of all consecutive twin gestations from 2010 to 2017. They were stratified by chorionicity monochorionic diamniotic and dichorionic diamniotic pregnancy: Primary outcome was SPTB < 37 weeks. Secondary outcome was SPTB at <34, 32, and <28 weeks, gestational age at delivery and indications for delivery: maternal and fetal. Analysis: t-test, Fisher’s exact test and multivariable logistic regression.

Results: 510 women with twin pregnancies were identified. 158 (30.9%) were monochorionic diamniotic pregnancies, and 352 (69.0%) were dichorionic pregnancies. The gestational age at delivery was significantly shorter in the monochorionic compared to the dichorionic group of about 2 weeks (MD -2.20 weeks, …

Impact Of New “Triple I” Classification On The Incidence Of Clinical Chorioamnionitis And Antibiotic Use In Neonates, Amanda Roman, Yury Cruz, Amy J. Sloane, David Carola, Dorothy Mcelewee, Vincenzo Berghella, Zubair H. Aghai

Department of Obstetrics and Gynecology Posters

Objective

To evaluate the impact of the new classification “Triple I” on the incidence of chorioamnionitis during labor, need of antibiotics and diagnosis of neonatal sepsis.

Maternal Activity Level In Patients With Preterm Premature Rupture Of Membranes: A Prospective Observational Cohort Study, Amanda Roman, Nathan Watters, Denise Moses, Jenny Reisner, Andrea French, Alexis Gimovsky, Caroline Pessel, Burton Rochelson, Neil Seligman, Vincenzo Berghella

Department of Obstetrics and Gynecology Posters

Objective: To evaluate the level of maternal physical activity effect on the perinatal outcomes of women with preterm premature rupture of membranes (PPROM)

Study Design: This is a pilot, prospective, observational multicenter cohort study. We approached patients admitted between 23 0/7 weeks to 32 0/7 weeks gestation with confirmed PPROM between January of 2014 and June of 2017 All patients received corticosteroids and latency antibiotics. Enrollment was done on third day of admission. Delivery occurred at 34 weeks per protocol via induction of labor or cesarean section as obstetrically indicated; or sooner if chorioamnionitis was diagnosed or spontaneous preterm labor …

Predictors Of Preterm Birth After Physical Exam Indicated Cerclage In Singleton Pregnancies, Amanda Roman, Gabriele Saccone, Sarah Pachtman, Yury Cruz, Burt Rochelson, Adiel Fleischer, Pasquale Martinelli, Vincenzo Berghella

Department of Obstetrics and Gynecology Posters

Objective

To evaluate the predictors of preterm birth <32 weeks in women that underwent physical exam indicated cerclage (PEIC) in singleton pregnancy.

Targeted Treatment Of Advanced Ovarian Cancer: Spotlight On Rucaparib., Diana C Pearre, Krishnansu S Tewari

Articles, Abstracts, and Reports

The last 2 years have ushered in a new era in ovarian cancer therapy with the US Food and Drug Administration's (FDA) approval of poly-ADP ribose polymerase (PARP) inhibitors (PARPi). One of the deadliest cancers that women experience, ovarian cancer, is most often diagnosed in advanced stages. Although cytoreductive surgery and (platinum/taxane-based) chemotherapy can place the majority of patients into remission, most will experience a relapse of their disease in their lifetime. This has led to studies exploring the benefits and efficacy of maintenance treatment. This review will briefly discuss the history of maintenance therapy as well as focus on …

Root-Cause Analysis Of Persistently High Maternal Mortality In A Rural District Of Indonesia: Role Of Clinical Care Quality And Health Services Organizational Factors, Mohammad Afzal Mahmood, Ismi Mufidah, Steven Scroggs, Amna Rehana Siddiqui, Hafsa Raheel, Koentijo Wibdarminto, Bernardus Dirgantoro, Jorien Vercruyssen, Hayfaa A. Wahabi

Community Health Sciences

Background: Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants.
Method: Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays.
Findings: The root causes were found in poor quality of care, which caused …

Association Between Obesity, Surgical Route, And Perioperative Outcomes In Patients With Uterine Cancer, Entidhar Al Sawah, Jason L. Salemi, Mitchel Hoffman, Anthony N. Imudia, Emad Mikhail

Obstetrics & Gynecology Faculty Publications

Objective. To study temporal trends of hysterectomy routes performed for uterine cancer and their associations with body mass index (BMI) and perioperative morbidity. Methods. A retrospective review of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) 2005-2013 databases was conducted. All patients who were 18 years old and older with a diagnosis of uterine cancer and underwent hysterectomy were identified using ICD-9-CM and CPT codes. Surgical route was classified into four groups: total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), laparoscopic assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH) including both conventional and robotically assisted. …

Adnexal Torsion In A Patient With Müllerian Agenesis Undergoing Ovarian Stimulation: A Case Report, Erika P. New, Adrianne R. Mallen, Abigail C. Mancuso, Bradley J. Van Voorhis

Obstetrics & Gynecology Faculty Publications

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments.

Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary.

Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort …

Clinical Utility Of Ca-125 In The Management Of Uterine Carcinosarcoma, Koji Matsuo, Malcolm S. Ross, Mayu Yunokawa, Marian S. Johnson, Hiroko Machida, Kohei Omatsu, Merieme M. Klobocista, Dwight D. Im, Shinya Satoh, Tsukasa Baba, Yuji Ikeda, Stephen H. Bush, Kosei Hasegawa, Erin A. Blake, Munetaka Takekuma, Masako Shida, Masato Nishimura, Sosuke Adachi, Tanja Pejovic, Satoshi Takeuchi, Takuhei Yokoyama, Yutaka Ueda, Keita Iwasaki, Takahito M. Miyake, Shiori Yanai, Tadayoshi Nagano, Tadao Takano, Mian M. Shahzad, Frederick R. Ueland, Joseph L. Kelley, Lynda D. Roman

Obstetrics & Gynecology Faculty Publications

No abstract provided.

Provision Of Medical Supply Kits To Improve Quality Of Antenatal Care In Mozambique: A Stepped-Wedge Cluster Randomised Trial, Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu

Obstetrics and Gynaecology, East Africa

Background: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many lowincome countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care.

Methods: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served …

Female Sex Workers Experiences Of Using Contraceptive Methods: A Qualitative Study In Kenya, Rhoune Ochako, Jerry Okal, Steven Kimetu, Ian Askew, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Female Sex Workers (FSWs) are predisposed to a broad range of social, sexual and reproductive health problems such as sexually transmitted infections (STIs)/HIV, unintended pregnancy, violence, sexual exploitation, stigma and discrimination. Female sex workers have unmet need for contraceptives and require comprehensive Sexual and Reproductive Health (SRH) prevention interventions. Existing programs pay little attention to the broad sexual and reproductive health and rights of these women and often focus on HIV and other STIs prevention, care and treatment while neglecting their reproductive health needs, including access to family planning methods. The aim of this study is, therefore, to explore …

The Satisfactory Growth And Development At 2 Years Of Age Of The Intergrowth-21st Fetal Growth Standards Cohort Support Its Appropriateness For Constructing International Standards., José Villar, Leila Cheikh Ismail, Eleonora Staines Urias, Francesca Giuliani, Sikolia Wanyonyi

Obstetrics and Gynaecology, East Africa

Background: The World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue to monitor fetal growth using numerous local charts or equations that are based on different populations for each body structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21st Project has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards …

Fmic Annual Report 2018 | Dari (دری), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2018 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Prevalence Of Positive Depression Screen Among Post Miscarriage Women- A Cross Sectional Study, Steve Mutiso, Alfred Murage, Abraham Mukaindo

Obstetrics and Gynaecology, East Africa

Background: Miscarriages are a common pregnancy complication affecting about 10–15% of pregnancies. Miscarriages may be associated with a myriad of psychiatric morbidity at various timelines after the event. Depression has been shown to affect about 10–20% of all women following a miscarriage. However, no data exists in the local setting informing on the prevalence of post-miscarriage depression. We set out to determine the prevalence of positive depression screen among women who have experienced a miscarriage at the Aga Khan University hospital, Nairobi.

Methods: The study was cross-sectional in design. Patients who had a miscarriage were recruited at the post-miscarriage clinic …

The Effects Of Pre-Pregnancy Tobacco Use On Food Cravings And Weight Gain In Pregnancy, Lauren E. Blau

Legacy Theses & Dissertations (2009 - 2024)

Smoking cessation is associated with greater frequency of food cravings, even when controlling for body mass index. Recent studies have indicated similarities between obese women and women who smoke tobacco in mood states and food craving frequency. This is consistent with the common substrate hypothesis, which postulates that shared neural pathways mediate craving across multiple domains, and could explain why it is common for women attempting to quit smoking to gain weight. Smoking cessation prior to pregnancy is strongly encouraged due to the adverse effects of tobacco use on the developing fetus. Studies have shown that women who quit smoking …

The Effectiveness Of A "Patient Discharge Information" Booklet In Patient Education Programs In Saudi Arabia, Amani Mohammed Al Rebeh

Dissertations and Theses @ UNI

The purpose of this research was to investigate the effectiveness of the Patient Discharge Information (PDI) booklet on the knowledge, attitude, and behaviors of participants who were cesarean patients in local hospitals in Saudi Arabia. This study investigated the following two research questions: (1) does the participant have information, resources, and understand basic personal health information regarding her health conditions including diagnosis, treatment, self-care management, medication instructions, normal expected symptoms, dangerous signs and what to do, as well as lifestyle changes?; and (2) how does patient discharge information provided by the hospital make a difference in participants’ knowledge, attitude, and …

Healthcare Providers’ Perceptions Of Pregnant Women, Allison Goderwis

Theses and Dissertations--Family Sciences

Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Ebonyi, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Ebonyi …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Katsina, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Katsina …

The Effect Of Breastfeeding And Rooming-In Care On Neonatal Abstinence Syndrome, Rachel Boyer, Lindsay Gal, Mahaylie Cline

Williams Honors College, Honors Research Projects

Concurrent with a rise in opioid abuse during pregnancy is an increase in the number of babies born with Neonatal Abstinence Syndrome (NAS). Despite this crisis, no single treatment has been identified for NAS. This paper sought to analyze and synthesize research evaluating the effectiveness of breastfeeding and rooming-in care on the need and length of pharmacologic treatment and length of hospital stay for neonates with NAS. Twenty-six peer reviewed research articles published between 2006 and 2017 were selected from PubMed and CINAHL for analysis. The studies focused on neonates with NAS born to mothers addicted to opioids or undergoing …

"To Conceive With Child Is The Earnest Desire If Not Of All, Yet Of Most Women": The Advancement Of Prenatal Care And Childbirth In Early Modern England: 1500-1770, Victoria E.C. Glover

Theses and Dissertations

This thesis analyzes medical manuals published in England between 1500 and 1770 to trace developing medical understandings and prescriptive approaches to conception, pregnancy, and childbirth. While there have been plenty of books written regarding social and religious changes in the reproductive process during the early modern era, there is a dearth of scholarly work focusing on the medical changes which took place in obstetrics over this period. Early modern England was a time of great change in the field of obstetrics as physicians incorporated newly-discovered knowledge about the male and female body, new fields and tools, and new or revived …

Inequities In Antenatal Care, And Individual And Environmental Determinants Of Utilization At National And Sub-National Level In Pakistan: A Multilevel Analysis, Ambreen Sahito, Zafar Fatmi

Community Health Sciences

Background: Nationally representative surveys are vital for gauging progress in health and planning health services. However, often marred with inadequate analysis to provide any guidance to health policy and planning. Most recent Pakistan Demographic and Health Survey (PDHS) 2012-2013 is an inclusive nationally representative investigation. Nonetheless, its published report offers limited evidence regarding antenatal care (ANC). Furthermore, after 18th constitutional amendment, policies are principally made at provincial level in Pakistan; therefore, it is imperative to have contextual evidence at sub-national level to feed programs and policies.
Methods: We analysed 7142 women with a recent birth, to assess the …

Factors Associated With Maternal Wellbeing At Four Months Post-Partum In Ireland, Annemarie E. Bennett, John Kearney

Articles

This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were measured at 17 weeks post-partum. Binary logistic regression predicted maternal distress and statistical significance was taken at p < 0.05. One hundred and seventy-two women were followed-up in pregnancy, at birth and at 17 weeks post-partum. Three in five (61.6%, n106) initiated breastfeeding. At 17 weeks post-partum, 23.8% (n41) were exclusively or partially breastfeeding and over a third (36.0%, n62) of all mothers were at risk of distress. In multivariate analyses, independent predictors of distress included: low maternal resilience (p < 0.01, odds ratio (OR): 7.22 (95% confidence interval [CI]: 2.49–20.95)); unsatisfactory partner support (p = 0.02, OR: 3.89 (95% CI: 1.20–12.65)); older age (p = 0.02, OR: 1.11 (95% CI: 1.02–1.21)); and breastfeeding (p = 0.01, OR: 2.89 (95% CI: 1.29–6.47)). Routine assessment of emotional wellbeing and targeted interventions are needed to promote a more healthful transition to motherhood among women in Ireland.

“Just Because A Doctor Says Something, Doesn’T Mean That [It] Will Happen”: Self-Perception As Having A Fertility Problem Among Infertility Patients, Ophra Leyser-Whalen, Arthur L. Greil, Julia Mcquillan, Katherine M. Johnson

Department of Sociology: Faculty Publications

Only some individuals who have the medically defined condition ‘infertility’ adopt a self-definition as having a fertility problem, which has implications for social and behavioral responses, yet there is no clear consensus on why some people and not others adopt a medical label. We use interview data from 28 women and men who sought medical infertility treatment to understand variations in self-identification. Results highlight the importance of identity disruption for understanding the dialectical relationship between medical contact and self-identification, as well as how diagnosis acts both as a category and a process. Simultaneously integrating new medical knowledge from testing and …

Maternal Anaemia And Folate Intake In Early Pregnancy, E.G. O'Malley, Shona Cawley, R.A.K. Kennedy, C.M.E. Reynolds, A. Molloy, M.J. Turner

Articles

The World Health Organization recommends that women take 400 µg of folate supplementation daily throughout pregnancy. We examined the relationship between total folate intake from the diet and supplements at the first prenatal visit and haematological indices at this visit and subsequently.

First Trimester Serum Biomarkers To Predict Gestational Diabetes In A High-Risk Cohort: Striving For Clinically Useful Thresholds, Siobhan M. Corcoran, Natalie Achamallah, John O'Loughlan, Philip Stafford, Pat Dicker, Fergal D. Malone, Fionnuala Breathnach

Articles

Objectives: Screening and diagnosis of gestational diabetes (GDM) has been a source of controversy. The prevalence has increased in line with an obesity epidemic and a trend towards delayed child-bearing. Treatment of even modest glycaemic impairment in pregnancy has been shown to be beneficial in preventing its clinical sequalae. However the cumbersome nature and timing of the oral glucose tolerance test coupled with debate around universal versus risk factor based screening have been problematic. This group aimed to investigate a panel of biomarkers which have shown promise in the literature to predict GDM from the first trimester in a group …

The Use Of Scorecards To Improve Documentation Of Obstetrical Blood Loss, Marilyn Cejka Steinberg

Walden Dissertations and Doctoral Studies

Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality. The measurement of quantitative blood loss (QBL) at delivery prevents clinicians from failing to recognize hemorrhage in healthy obstetric patients who initially compensate for excessive blood loss. The purpose of this project was to improve the compliance of labor and delivery nurses in a community hospital with consistent QBL measurement. Key theories that formed the basis for the project were Lewin's theory of planned change and homeostasis. The project question addressed was: Is the use of weekly scorecards to provide feedback to nurses with both blinded …

Perinatal Residents' Perceptions Of Confidence Gained Through Their Preceptors, Veritta Henderson

Walden Dissertations and Doctoral Studies

The importance of preceptorships, as a mechanism to transfer knowledge of evidence-based nursing practices and developing confidence in nurses, is well-known. However, the effectiveness of preceptorships to develop confidence in perinatal nurses who provide safe care to childbearing women is unknown. Guided by Kolb's model of experiential learning and using a narrative analysis approach, this study examined perinatal nurse residents' perceptions of experiences that enhanced learning and developed confidence during preceptorship. Twenty nurses who completed a perinatal nurse residency of 18 weeks or more in the past 12 months participated in audiotaped, structured interviews. Their answers were transcribed and data …

Cesarean Births Rates After Implementation Of Labor Management Guidelines, Margie Allyn Bridges

Walden Dissertations and Doctoral Studies

Cesarean birth rates are associated with increased maternal morbidity. This project evaluated a quality improvement (QI) initiative implemented to reduce cesarean births among Nulliparous Term Singleton Vertex (NTSV) obstetric populations, the largest contributor to cesarean births. Variations in labor management practice contribute to cesarean birth rate; implementation of labor management bundles have been endorsed to influence practice- and system-level changes in the promotion of vaginal births. The problem addressed in this project was an organizational NTSV cesarean section rate of 30%. The purpose of the project was to use secondary data to evaluate a previously implemented labor management bundle at …