Obstetrics and Gynecology Commons^™

Epidural Anesthesia For Cesarean Section For Parturient With Recently Diagnosed Asymptomatic Chiari Malformation Type I: A Case Report, Ashie Kapoor, Jon Halling

HCA Healthcare Journal of Medicine

Chiari malformations (CMs) are congenital defects of the brain and skull that result in inferior displacement of the cerebellum. There are four types of CMs distinguished by the severity of the anatomic defects and parts of the brain that protrude beyond the foramen magnum. Of these types, CM Type I (CMI) is the least severe. It is characterized by the downward displacement of the cerebellar tonsils beyond the foramen magnum by more than 5 millimeters and goes into the cervical spinal canal. CMI is the most common type with an incidence of 0.1-0.5% in the general population and a predominance …

An Investigation Into The Prevalence Of Use And Availability Of Information On Contraception For Female Third Level Students Aged 18-24, Barbara Dymet, Jane Hyde, Chloe Madden, Ciara Walsh

International Undergraduate Journal of Health Sciences

Introduction:

The purpose of this investigation was to find out the amount of female students in third level institutions who use contraception as well as their attitude towards the availability of information about female birth control options in these institutions.

Materials and methods:

An online survey was created using Google Docs which was then sent out to undergraduate third level female students over the age of 18. All gathered data was analysed using Microsoft Excel.

Results:

The vast majority of the surveyed population was sexually active and used contraception with the most common form being a combination of the contraceptive …

Intra-Tumoral Nerve-Tracing In A Novel Syngeneic Model Of High-Grade Serous Ovarian Carcinoma, Jeffrey L Barr, Allison Kruse, Anthony C Restaino, Natalia Tulina, Sarah Stuckelberger, Samuel J Vermeer, Caitlin S Williamson, Daniel W Vermeer, Marianna Madeo, Jillian Stamp, Maria Bell, Mark Morgan, Ju-Yoon Yoon, Marilyn A Mitchell, Anna Budina, Dalia K Omran, Lauren E Schwartz, Ronny Drapkin, Paola D Vermeer

Faculty, Staff and Student Publications

Dense tumor innervation is associated with enhanced cancer progression and poor prognosis. We observed innervation in breast, prostate, pancreatic, lung, liver, ovarian, and colon cancers. Defining innervation in high-grade serous ovarian carcinoma (HGSOC) was a focus since sensory innervation was observed whereas the normal tissue contains predominantly sympathetic input. The origin, specific nerve type, and the mechanisms promoting innervation and driving nerve-cancer cell communications in ovarian cancer remain largely unknown. The technique of neuro-tracing enhances the study of tumor innervation by offering a means for identification and mapping of nerve sources that may directly and indirectly affect the tumor microenvironment. …

Exploring Occupational Therapy’S Role In Supporting Health And Wellness In The Transition To Motherhood, Katelynn A. Lillibridge, Karen Park, Susan Macdermott

Fall 2021 Virtual OTD Capstone Symposium

The transition to motherhood [matrescence] is a time of major life changes. All aspects of a new mother’s life are impacted during matrescence as she assumes her new role, identity, responsibilities, and learns the occupational skills of mothering. During this time, health, wellness, and occupational balance may all be impacted. This is a sensitive time for mothers with potential implications for both short and long-term health. Using an occupation-based approach can be a way to provide comprehensive support and care to mothers during this period to promote health and wellness, enhance occupational engagement, and support meaningful co-occupations. Currently …

The Fatigue Paradox: Team Perceptions Of Physician Fatigue, Emily Field, Lorelei Lingard, Richard Cherry, Julie Ann Van Koughnett, Sandra Deluca, Taryn Taylor

Obstetrics & Gynaecology Publications

OBJECTIVES: Ongoing calls to implement fatigue risk management in residency education assume a shared understanding of physician fatigue as a workplace hazard, yet we lack empirical evidence that all health care team members maintain this assumption. Thus, this study seeks to explore how health care team members understand the role of physician fatigue in an effort to inform the implementation of fatigue risk management in residency training and medical practice.

METHODS: This study uses constructivist grounded theory to explore perceptions of workplace fatigue and its impact on clinical practice. We conducted individual semi-structured interviews with physicians, nurses and senior residents …

The Effects Of Doula Care On Birth Outcomes And Patient Satisfaction In The United States, Lynae Carlson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The visitor policies related to the COVID-19 pandemic limited doula care and called into question the importance of doulas in the birth process. While the Cochrane Systematic Review presents compelling evidence of the benefits of continuous birth support on outcomes ranging from shorter labors to higher 5-minute Apgar scores, there are gaps in literature that exclusively focus on continuous support from doulas. The literature review aims to determine both qualitative and quantitative outcomes of doula care on the mother and baby during the labor and post-partum periods, focusing on specific aggregates, such as adolescents, women with low incomes, and women …

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and …

Nursing Perceptions For Utilizing Essential Oil Application In Labor And The Effect Of Targeted Education, Joni R. Beckham

Electronic Theses and Dissertations

This Doctor of Nursing Practice project was implemented to determine how a nurse’s perception of aromatherapy influences their decision to provide aromatherapy for patients during labor and the effect of targeted education on a nurse’s perception. The purpose of this project was to determine how nurses view the use of aromatherapy resources at their disposal and the likelihood that they would offer the intervention to their patients. This project provided education to increase nurses’ confidence in providing optimal care to patients using a traditional and holistic avenue of aromatherapy while determining if education can positively influence nurses to support essential …

Vte And Anticoagulation In Menstruating Women, Ida Micaily, Bethany T. Samuelson Bannow

Department of Medicine Faculty Papers

Women of childbearing potential have a high prevalence of venous thromboembolism (VTE) due to high estrogen states, such as pregnancy and the use of estrogen-containing contraceptives. Abnormal uterine bleeding (AUB) affects up to two-thirds of menstruating women on anticoagulation (AC), and can severely impair a woman's quality of life. Rates of heavy menstrual bleeding (HMB) and other forms of AUB including inter-menstrual and postmenopausal bleeding are consistently underreported in the original clinical trials utilizing AC. VTE can occur at any time in a woman's life, and the aim of this review article is to discuss the current landscape of literature …

Action Leveraging Evidence To Reduce Perinatal Mortality And Morbidity (Alert): Study Protocol For A Stepped-Wedge Cluster-Randomised Trial In Benin, Malawi, Tanzania And Uganda, Joseph Akuze, Kristi Sidney Annerstedt, Lenka Benova, Effie Chipeta, Jean-Paul Dossou, Mechthild M. Gross, Hussein Kidanto, Bruno Marchal, Helle Mölsted Alvesson, Andrea B. Pembe

Obstetrics and Gynaecology, East Africa

Background: Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions during this period has the potential to avert at least 2.5 million deaths in mothers and their offspring annually. This paper describes a study protocol for implementing and evaluating a multi-faceted health care system intervention to strengthen the implementation of evidence-based interventions and responsive care during this crucial period.

Methods: This is a cluster …

Provider Perception And Office Practices Of The Initial Prenatal Visit Pre – Coronavirus 2019 Pandemic, Arlin Delgado, Emma Hale, Jay Schulkin, Charles Macri, Kimberly Fryer

Florida Public Health Review

Background Prenatal Care is a critical aspect of women’s health and current literature shows adequate care significantly reduces risk of adverse outcomes. With scientific advancement, the initial prenatal visit is increasingly tasked with more objectives that leave providers with barriers to provide appropriate and adequate care.

Purpose The aim of this survey study was to determine clinical practices of the initial prenatal visit – regarding history taking, counseling, lab work and screening prior to the onset of COVID-19 Pandemic.

Methods A one-time anonymous provider survey was distributed electronically to all obstetrics providers in the Tampa Bay Region in Florida. Descriptive …

Comparison Of Pregnancy Complications In Unintended And Intended Pregnancy: A Prospective Follow-Up Study, Mitra Eftekhariyazdi, Malihe Mehrbakhsh, Mahboubeh Neamatshahi, Manijeh Yousefi Moghadam

BioMedicine

Background and Objectives: Unintended pregnancy, as a pregnancy that is mistimed, unplanned or unwanted at the time of conception, is a common experience worldwide that puts mothers at risk for mental stress and its pregnancy complications. The aim of this study was to compare three common pregnancy complications, including preeclampsia, preterm labor, and low birth weight, between unintended and intended pregnancies in Sabzevar, northeast Iran in 2019.

Materials and Methods: This prospective follow-up study was conducted on 200 pregnant women (100 intended and 100 unintended pregnancies) who were between 18 and 35 years old and were referred for …

Large-Scale Dna Demethylation Occurs In Proliferating Ovarian Granulosa Cells During Mouse Follicular Development, Tomoko Kawai, Joanne S Richards, Masayuki Shimada

Faculty, Staff and Students Publications

During ovarian follicular development, granulosa cells proliferate and progressively differentiate to support oocyte maturation and ovulation. To determine the underlying links between proliferation and differentiation in granulosa cells, we determined changes in 1) the expression of genes regulating DNA methylation and 2) DNA methylation patterns, histone acetylation levels and genomic DNA structure. In response to equine chorionic gonadotropin (eCG), granulosa cell proliferation increased, DNA methyltransferase (DNMT1) significantly decreased and Tet methylcytosine dioxygenase 2 (TET2) significantly increased in S-phase granulosa cells. Comprehensive MeDIP-seq analyses documented that eCG treatment decreased methylation of promoter regions in approximately 40% of the genes in granulosa …

Is Living In A Region With High Groundwater Arsenic Contamination Associated With Adverse Reproductive Health Outcomes? An Analysis Using Nationally Representative Data From India, Jessie Pinchoff, Brent Monseur, Sapna Desai, Katelyn Koons, Ruben Alvero, Michelle J Hindin

Department of Medicine Faculty Papers

Background: Exposure to groundwater arsenic via drinking water is common in certain geographies, such as parts of India, and causes a range of negative health effects, potentially including adverse reproductive health outcomes.

Methods: We conducted an ecological analysis of self-reported rates of stillbirth, recurrent pregnancy loss, and infertility in relation to groundwater arsenic levels in India. We used a gridded, modeled dataset of the probability of groundwater arsenic exceeding 10 μg/L (World Health Organization drinking water limit) to calculate mean probabilities at the district level (n = 599 districts). A spatial integration approach was used to merge these estimates with …

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

Conference Presentation Abstracts

No abstract provided.

The Efficacy Of A Personalized Mhealth Coaching Program During Pregnancy On Maternal Diet, Supplement Use, And Physical Activity: Protocol For A Parallel-Group Randomized Controlled Trial, Rozina Nuruddin, Khadija Vadsaria, Nuruddin Badruddin Mohammed, Saleem Sayani

Community Health Sciences

Background: Adequate intake of macro- and micronutrients and adoption of an active lifestyle during pregnancy are essential for optimum maternal and fetal health and offspring development. Dietary counseling and advice regarding adequate physical activity are integral components of antenatal care. Personalized coaching through the use of mobile health (mHealth) that supports behavior modification is an innovative approach that needs exploration.
Objective: Our primary aim is to assess the efficacy of an mHealth program in improving diet, supplement use, and physical activity during pregnancy. Secondary objectives include evaluation of the program's effect on maternal and offspring health outcomes and assessment of …

Black Infertility And Social Media Engagement: A Mixed Methodology Analysis, Melody Rasouli, Benette Krizel Sagun, Kajal Verma, Cindy M. Duke

Department of Obstetrics & Gynecology Faculty Research

Objective: To study social media engagement on black infertility to better understand why there is lower utilization of in vitro fertilization by black women despite higher infertility rates. Design: The online analytics module BuzzSumo was used to quantify total engagements with the search term “black infertility” across the commonly used social media platforms. The 10 article links with the highest engagement were selected from periods in 2020 and 2021. Sources cited in each article were reviewed to identify those that had citations of scientific peer-reviewed journals or national medical organizations. The contents of each article were reviewed for accuracy by …

Infant Outcomes Following Maternal Infection With Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2): First Report From The Pregnancy Coronavirus Outcomes Registry (Priority) Study., Valerie J. Flaherman, Yalda Afshar, W. John Boscardin, Roberta L. Keller, Anne H. Mardy, Mary K. Prahl, Carolyn T. Phillips, Ifeyinwa V. Asiodu, Vincenzo Berghella, Brittany D. Chambers, Joia Crear-Perry, Denise J. Jamieson, Vanessa L. Jacoby, Stephanie L. Gaw

Department of Obstetrics and Gynecology Faculty Papers

Infant outcomes after maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well described. In a prospective US registry of 263 infants, maternal SARS-CoV-2 status was not associated with birth weight, difficulty breathing, apnea, or upper or lower respiratory infection through 8 weeks of age.

Endometriosis And Pelvic Pain In The Adolescent: Delayed Diagnosis Leading To Long-Term Suffering And The Need For Intervention, Latashia-Lika Lelea

OB-GYN

No abstract available.

Improving Sexually Transmitted Infection Knowledge In Community College Students: A Path To Prevention, Rebecca F. Halford

Electronic Theses and Dissertations

This DNP project was conducted to identify gaps in knowledge focusing on sexually transmitted infections within Texas and Region one. The research study gathered data from first-year nursing students who have chosen to participate in a sexually transmitted infection-focused educational module. Participants were first-year nursing students and understood the research study was strictly voluntary with no forms of compensation. Currently, the curriculum in the nursing program at which the study took place does not focus on sexually transmitted infections and is directed to speak minimally on the subject. This is a contributing factor to why the rise in sexually transmitted …

Determinants Of Preconception Care Among Pregnant Women In An Urban And A Rural Health Facility In Kenya: A Qualitative Study, Joan Okemo, Dorothy Kamya, Mukaindo Mwaniki, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could con- tribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya.

Methods: A qualitative approach was …

A Qualitative Study On The Impact Of Long-Distance Travel For Gynecologic Cancer Care, V. Mujumdar, Timberly R Butler, David I Shalowitz

Department of Obstetrics and Gynecology Faculty Papers

Background: Women with gynecologic malignancies experience improved clinical outcomes when they are treated by gynecologic oncologists and in high-volume cancer centers. However, geography is a major barrier to high-volume care for patients. This qualitative study was undertaken to identify facilitators and barriers to patients traveling long distances for gynecologic cancer care.

Methods: Semi-structured interviews were conducted with 19 women with gynecologic malignancies traveling >50 miles for treatment at Wake Forest Comprehensive Cancer Center. Eight interviews included caregivers. Four interview domains focused on personal challenges and coping strategies related to accessing cancer care.

Results: Mean distance traveled for care was 87 …

A Comparison Of Methods Of Discontinuing Nasal Cpap In Premature Infants <30 Weeks Gestation: A Feasibility Study, Brittany Duyka, Claire Beaullieu, Amir M Khan

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to determine whether abrupt discontinuation vs gradual wean of nasal CPAP (NCPAP) in infantstherapy.

STUDY DESIGN: We performed a single-center, randomized control trial of premature infants born(n = 66), comparing discontinuation of NCPAP from 6 cmH

RESULTS: Duration of NCPAP or mechanical ventilation was longer in the slow wean arm compared to the fast wean arm (17 vs 12 days, p = 0.03). There were no differences observed in secondary outcomes.

CONCLUSION: In weaning NCPAP, abrupt discontinuation may be associated with a shorter duration of positive pressure respiratory support compared to a gradual …

Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem

Community Health Sciences

Objective: Unintended pregnancy has become a substantially growing reproductive health concern in South Asian region. The objective of this survey was to assess the magnitude of unintended pregnancy along with its correlates among currently pregnant women residing in Karachi.
Methods: A community based, multistage, cross-sectional study was carried out among 612 currently pregnant women from squatter settlements of Karachi, inquiring for "unintended pregnancy", outcome of interest. Multivariable logistic analysis was done using SPSS v.19 to determine associated factors.
Results: Of 612 pregnant women interviewed, 168(27.4%) reported their pregnancies as unintended. The multivariable regression identified a high likelihood of unintended pregnancy …

Residency Support During A Natural Disaster: Hurricane Ida, Tiffany Chang, Elizabeth W. Kelly, Chi Dola

HCA Healthcare Journal of Medicine

Natural disasters can have extraordinary impacts on a community and its infrastructure. Disasters can weaken systems that provide crucial resources, such as shelter, food security, water and health care. Recently, southeast Louisiana sustained devastating damage from Hurricane Ida on the 16th anniversary of Hurricane Katrina. Our medical workforce faced challenges caring for patients in a facility without potable water and powered by a generator. With the support of corporate entities and our academic institution, however, these barriers were quickly overcome and thus highlights the importance of collective resilience in the face of a natural disaster.

Adult Granulosa Cell Tumor In Pregnancy: A New Case And A Review Of The Literature, Sofia Guidi, Vincenzo Berghella, Giovanni Scambia, Anna Fagotti, Annalisa Vidir, Stefano Restaino, Giuseppe Vizzielli, Frediano Inzani, Anna Franca Cavaliere

Department of Obstetrics and Gynecology Faculty Papers

Granulosa cell tumors are rare ovarian tumors that can arise during pregnancy. We present a new case of recurrent adult granulosa cell tumor (AGCT) in pregnancy and a systematic review of the literature. The new case described is a 41-year-old woman G5P1122 with a prior history of AGCT that was referred to our center at 29 weeks because of a symptomatic abdominal mass, compatible with a possible recurrence of AGCT. At 36 + 3 weeks, she underwent a cesarean delivery for preterm labor and a total hysterectomy with a radical surgical staging. A healthy female infant was delivered. The patient …

The Factors Influencing Cesarean-Section Rates-A Narrative Review From Pakistan, Bakhtawar M H. Khowaja, Farida Bibi Mughal, Komal Valliani

Department of Obstetrics & Gynaecology

The significant increase in the rate of cesarean section is a major public health issue. The World Health Organization recommends C-section rates not to be greater than 10% and not lower than 5% as both the indicated limits can adversely affect maternal and newborn health. The rate of C-section deliveries is 22% according to recent Pakistan demographics and Health Survey of 2017-2018. This study contributes to the existing literature by examining the factors influencing high C-section rates in Pakistan. A narrative review of published literature between 2000 to 2020, on “factors influencing C-section rates in Pakistan” was done. The findings …

Allografts For Skin Closure During In Utero Spina Bifida Repair In A Sheep Model, Lovepreet K Mann, Jong Hak Won, Rajan Patel, Eric P Bergh, Jeannine Garnett, Meenakshi B Bhattacharjee, Ponnada A Narayana, Ranu Jain, Stephen A Fletcher, Dejian Lai, Ramesha Papanna

Faculty, Staff and Student Publications

OBJECTIVES: Use of off-label tissue graft materials, such as acellular dermal matrix (ADM), for in utero repair of severe spina bifida (SB), where primary skin layer closure is not possible, is associated with poor neurological outcomes. The cryopreserved human umbilical cord (HUC) patch has regenerative, anti-inflammatory, and anti-scarring properties, and provides watertight SB repair. We tested the hypothesis that the HUC is a superior skin patch to ADM for reducing inflammation at the repair site and preserving spinal cord function.

METHODS: In timed-pregnant ewes with twins, on gestational day (GD) 75, spina bifida was created without a myelotomy (functional model). …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Neuroendocrine Carcinoma Of The Breast: A Case Report, Iulia Gîvan, George Ciulei, Angela Cozma, Mădălina Gabriela Indre, Vlad Țâru, Anca Pop, Adela Sitar Tăut, Simina Țărmure, Vasile Negrean, Olga Hilda Orășan

Journal of Mind and Medical Sciences

Neuroendocrine breast carcinomas represent a rare subtype of breast cancer. Their definition, prevalence and prognosis remain controversial in the literature. Regarding the presentation, there are no differences from other breast carcinomas and clinical syndromes related to hormone production are extremely rare. Refinement of the classification of neuroendocrine neoplasms of the breast is needed in order to improve the reproducibility of their diagnostic criteria and to define their clinical significance.

This article presents the case of a 44-year-old female patient diagnosed with invasive breast carcinoma with neuroendocrine features, according to the 2012 World Health Organization (WHO) definition, with focus on presentation, …