Obstetrics and Gynecology Commons^™

Comparison Of Pre And Post Foley Catheter Bishop’S Score: A Retrospective Record Review At Aga Khan University Hospital Karachi, Pakistan, Ayesha Malik, Sheikh Irfan Ahmed, Farheen Yousuf, Azra Amerjee, Sumaira Naz, Safna Naozer Virji Safna Naozer Virji

Department of Obstetrics & Gynaecology

Objective: To compare pre and post Foley's catheter Bishop Score during labour induction.
Methods: This study was a retrospective study conducted at the Aga Khan University Hospital Karachi, Pakistan after approval from ethical review board. All women who underwent induction of labour with Foley's Catheter at gestation of 37 weeks or more from September 2014-October 2015 were included. Data was entered and analyzed in Statistical Package for Social Sciences (SPSS) version 19.0. The comparison between pre and post Foley's catheter Bishop Score during labour induction will be calculated by Wilcoxon sign test.
Results: There were 981 cases of inductions of …

Evaluating The Effect Of Maternal Non-Communicable Disease On Adverse Pregnancy Outcomes And Birthweight In Pakistan, A Facility Based Retrospective Cohort Study, Esther Wainwright, Sheikh Irfan Ahmed, Rahat Qureshi, Sana Yousuf, Raheela Khan, Matthew Elmes

Department of Obstetrics & Gynaecology

Non-communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle-income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre-existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 …

Identifying Opportunities For Prevention Of Adverse Outcomes Following Female Genital Fistula Repair: Protocol For A Mixed-Methods Study In Uganda, Alison El Ayadi, Susan Obore, Fred Kirya, Suellen Miller, Abner Korn, Hadija Nalubwama, John Neuhaus, Monica Getahun, Patrick Eyul, Robert Twine, Erin Andrew, Justus Barageine

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Female genital fistula is a traumatic debilitating injury, frequently caused by prolonged obstructed labor, affecting between 500,000-2 million women in lower-resource settings. Vesicovaginal fistula causes urinary incontinence, and other morbidity may occur during fistula development. Women with fistula are stigmatized, limit social and economic engagement, and experience psychiatric morbidity. Improved surgical access has reduced fistula consequences yet post-repair risks impacting quality of life and well-being include fistula repair breakdown or recurrence and ongoing or changing urine leakage or incontinence. Limited evidence on risk factors contributing to adverse outcomes hinders interventions to mitigate adverse events. This study aims to quantify …

Infant Growth And Body Composition From Birth To 24 Months: Are Infants Developing The Same?, Shane A. Norris, Lukhanyo H. Nyati, Alexia Murphy Alford, Nishani Lucas, Ina S. Santos, Caroline S. Costa, Rebecca Kuriyan, V Pujitha Wickranasinghe, Shabina Ariff, Andrew P. Hills

Department of Paediatrics and Child Health

Background: Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries.
Methods: We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3-24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length …

Mastitis And Mammary Abscess Management Audit (Mamma) In The Uk And Ireland, Ruth Brown, Hiba Fatayer, Rachel Gallimore, Ashu Gandhi, Matthew Gardiner, Victoria Harmer, Lyndsey Hookway, Gareth Irwin, Charlotte Ives, Helen Mathers, Juliette Murray, D Peter O'Leary, Neill Patani, Sophie Paterson, Shelley Potter, Ruth Prichard, Giovanni Satta, T G Teoh, Paul Ziprin, Stuart Mcintosh, Michael R Boland, Daniel Richard Leff, Mamma Research Collaborative

Faculty, Staff and Student Publications

BACKGROUND: The aim of this multicentre prospective audit was to describe the current practice in the management of mastitis and breast abscesses in the UK and Ireland, with a specific focus on rates of surgical intervention.

METHODS: This audit was conducted in two phases from August 2020 to August 2021; a phase 1 practice survey and a phase 2 prospective audit. Primary outcome measurements for phase 2 included patient management pathway characteristics and treatment type (medical/radiological/surgical).

RESULTS: A total of 69 hospitals participated in phase 2 (1312 patients). The key findings were a high overall rate of incision and drainage …

Cell State Of Origin Impacts Development Of Distinct Endometriosis-Related Ovarian Carcinoma Histotypes, Ian Beddows, Huihui Fan, Karolin Heinze, Benjamin K Johnson, Anna Leonova, Svetlana Djirackor, Celeste Leigh Pearce, David G Huntsman, Michael S Anglesio, Hui Shen

Faculty, Staff and Student Publications

Clear cell ovarian carcinoma (CCOC) and endometrioid ovarian carcinoma (ENOC) are ovarian carcinoma histotypes, which are both thought to arise from ectopic endometrial (or endometrial-like) cells through an endometriosis intermediate. How the same cell type of origin gives rise to two morphologically and biologically different histotypes has been perplexing, particularly given that recurrent genetic mutations are common to both and present in nonmalignant precursors. We used RNA transcription analysis to show that the expression profiles of CCOC and ENOC resemble those of normal endometrium at secretory and proliferative phases of the menstrual cycle, respectively. DNA methylation at the promoter of …

A Randomized Trial Of Vaginal Antiseptic Preparation Solutions To Reduce Bacteria Colony Counts In Patients Undergoing Vaginal Surgery, James R. Saelens, Adam J. Langer, Andrew N. Boeckley, Natalie M. Castillo, Julie A. Desouza, Jennifer L. Drerup, Kelly M. Muterspaw, Hannah M. Stump, Rose A. Maxwell, Geoffrey Towers

Obstetrics and Gynecology Faculty Publications

Antiseptic preparation of surgical sites is known to reduce the rate of infective complications. However, surgical site infections (SSI) remain a leading cause of post-operative hospitalizations, increasing patient stress and cost for the healthcare system.1-7 In gynecologic surgery, preparation of the vagina is performed to reduce bacterial load prior to surgery, though it is known to remain contaminated.3 In the US, only solutions containing povidone-iodine (PI) are FDA approved for vaginal preparation; though, a 2018 ACOG Practice Bulletin lists chlorhexidine gluconate (CHG) with low (<4%) alcohol concentrations as a reasonable option for off-label use.3 Other preparations for vaginal surgery have been reported including baby shampoo (BS) and a commercially available preparation, containing PCMX (para-chloro-meta-xylenol, Techni-care®, chloroxylenol), that is marketed specifically for use with mucous membranes.8-12 There is a growing need to establish evidence-based alternatives to iodine for vaginal preparation for patients with allergies or sensitivity to iodine-containing products while minimizing postoperative irritation. One retrospective study comparing BS to PI in gynecologic surgeries showed a non-significant lower rate of surgical site infection with BS.9 One major challenge for determining effectiveness of surgical scrubs for reducing SSI is the relatively rare occurrence of postoperative infection. As an alternative proxy for infection colony counts of bacteria/fungi, before and after preparation, have been used.12,13 BS has been shown to reduce bacterial loads in non-gynecologic surgery, but there is limited data regarding its use in vaginal surgery, even though surgeons have been using BS in cases of iodine allergy or intolerance to other antiseptics.9-12CHG use in vaginal surgery has been debated due to concerns about vaginal irritation, however studies have demonstrated that alteration of the solution to 2-4% chlorhexidine with low (4%) alcohol concentration was associated with mild to no vaginal irritation. CHG showed similar reduction in post-incision bacterial counts and wound infections in cesarean delivery, and reduced colony counts during hysterectomy (when compared to PI).14-20 PCMX and CHG were shown to significantly reduce bacterial colonization of extracted root canals, and PCMX has been marketed specifically for vaginal antiseptic preparation.21 While some information on the effectiveness of these four antiseptic preparations has been documented in the literature, at this time there are no randomized controlled trials comparing these solutions in the context of vaginal surgery. Further evaluation and research of antiseptic solutions is warranted to provide evidence for best practices in minimizing infection and irritation. The purpose of this study was to compare the effectiveness of three antiseptic solutions with the standard, PI, for reducing bacterial colonies as a proxy for SSI, and to assess postoperative irritation and infection symptoms.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Incidence Of Peripartum Hysterectomy In Al-Galaa Teaching Hospital, Marwa R. Shahine, Sherif M. Safwat

Journal of Medicine in Scientific Research

Introduction: A hysterectomy carried out at the moment of delivery or within a day after it is known as a peripartum hysterectomy. Either a scheduled or emergency procedure can be carried out. It is a dramatic life-saving technique carried out when all other conservative management avenues have failed, made worse by the frequent emergency circumstances in which it is carried out.

Objectives: Studying the causes and patterns of peripartum hysterectomy at Al-Galaa Maternity Teaching Hospital, A tertiary referral hospital, in addition to studying the associated maternal and fetal complications.

Methodology: In order to analyze the emergency peripartum hysterectomy performed at …

Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig

Obstetrics and Gynecology Faculty Publications

Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the …

Improvement For Cerclage Placement In Relation To Cervical Length In Patients Undergoing Cerclage Placement At Memorial Health And Relationship With Preterm Birth, J Elise Abernathy, Anthony Royek, A Tanner Fincher, Sai Nagula, Alyssa Moffitt, Abby Unger, Cullen Smith, Eric K. Shaw

South Atlantic Division GME Research Day 2024

No abstract provided.

Sequestering The Diagnosis Of Extra Lobar Bronchopulmonary Sequestration: A Case Report, Tanner Fincher, Reese M. Groover, Amanda Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Second Trimester Uterine Rupture With Abnormal Vascularity Of The Lower Uterine Segment, Munsa Manandhar, Linda Haddox

Central & West Texas GME Research Day 2024

No abstract provided.

Nas Associated With Antenatal Tianeptine Exposure: A Case Report, Francesca Damus, Kaleb Freeman, Candace Murbach, Palmer Johnston

South Atlantic Division GME Research Day 2024

No abstract provided.

A Rare Case Of Fetal Digynic Triploidy Additionally Complicated By Mid Trimester Superimposed Preeclampsia, Claire Mccarthy, Bailey Brown, Amanda Royek, Cameron Soriano

South Atlantic Division GME Research Day 2024

No abstract provided.

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

North Texas GME Research Forum 2024

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 found to have neither infectious nor malignant cause for such finding. Case Presentation: Patient is a 56 year old postmenopausal female who presenting with “hip pain” and was found to have incidental intrauterine gas on pelvic CT. She underwent in office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign and …

Bridging The Gap: Evaluating The Impact Of Buprenorphine-Based Prenatal Care On Neonatal Abstinence Syndrome And Maternal Health, Whitney-Lanae Crofcheck-Glenn, Jennifer Nethercutt

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome (NAS), now known as Neonatal Opioid Withdrawal Syndrome (NOWS) by government authorities, is a severe postnatal withdrawal condition caused by opioid exposure during pregnancy. NAS is diagnosed every 25 minutes in the United States. Medication-assisted treatment (MAT) with buprenorphine was used to treat opioid use disorder (OUD) and NAS. The MOTHER trial found that utilizing buprenorphine to treat mother OUD during pregnancy led to significant decreases in LOS and length of therapy.

Purpose of the Study: The purpose of this study is to evaluate the effectiveness of a prenatal care program that integrates buprenorphine-based Medication-Assisted Treatment …

Four Cesarean Scar Pregnancies Managed At Accreta Center Of Excellence At Medical City Dallas Hospital: A Case Series, Ana Adams, Nicole Tenzel, Monica Rodriguez, Robert Cohen

North Texas GME Research Forum 2024

Cesarean Scar Pregnancy results from pathologic implantation of a gestational sac into a hysterotomy scar. This rare disease continues to increase in incidence due to the rise of Cesarean delivery in the United States. Current management recommendations by the Society of Maternal Fetal Medicine (SMFM) include termination of pregnancy, or in rare instances, hysterectomy. This case series examines four patients diagnosed with Cesarean Scar Pregnancies that either declined termination or were unable to receive abortion services in the first trimester, and who were managed at the Accreta Center of Excellence at Medical City Dallas Hospital. This novel management strategy included …

Improving Rates Of Postpartum Depression Screening: A Quality Improvement Project, Sarah Chason, Keisha Reddick, Alexis Brown, Cassandra Hensel, Hannah Pittman, Jennifer Brown

South Atlantic Division GME Research Day 2024

No abstract provided.

Intertwin Membrane Separation In Monochorionic- Diamniotic Twins, Fran Franceschini Lopez, N Moreno, Henry Garcia, Manuel Rivera-Alsina

Central & West Texas GME Research Day 2024

No abstract provided.

Transcatheter Mitral Valve Replacement In The Second Trimester Of Pregnancy: A Case Report, Ashton Tanner Fincher, Andrew Royek, Reese M. Groover, Abigail Haythorn, Anthony Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Development And Implementation Of An Educational Prenatal Packet To Improve Obstetric Management And Patient Education Within A Family And Community Medicine Residency Program, Jalicia Sturdivant, Julianna Snow, Esther Piervil, Erica Paulos, Kimberly Mathurin

South Atlantic Division GME Research Day 2024

No abstract provided.

Biallelic Inheritance Of Autosomal Dominant Polycystic Kidney Disease Gene Mutations And The Veo Spectrum Of Fetal And Neonatal Phenotypes: A Case Series, Mikalah Maury, Caitlin Turner, Andrew Royek, Eleanor Stark, Leyla Nielsen, Anthony Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Quality Improvement Project: Compliance Of Antenatal Testing In Patients With Class Iii Obesity, Isabella L. Sciacca, Timothy Kremer, Nicole Tenzel

North Texas GME Research Forum 2024

The prevalence of obesity in women of reproductive age (20 to 39) in the US is 39.7%. It has been estimated that one-quarter of pregnancy complications are attributable to maternal obesity. Comprehensive prenatal care is imperative to achieving positive health outcomes. This quality improvement (QI) initiative aimed to improve antenatal fetal surveillance rates in patients with class III obesity. Evidence based interventions to test fetal wellbeing were implemented and examined over a 7 month time period to evaluate physician compliance of the standard of care for antenatal surveillance starting at 34 weeks gestation. Following implementation of this initiative, compliance with …

Post-Operative Infection Following Abdominal Hysterectomy With Or Without Surgical Drains, Dylan Gallegos, Dominique Barnes

Central & West Texas GME Research Day 2024

No abstract provided.

Pregnancy Outcome In Assisted Reproductive Technology Pregnancy Complicated By 46 Day Preterm Prelabor Rupture Of Membranes, Type 2 Diabetes Mellitus And Severe Preeclampsia, A Case Report, Dana Rei Cassab, Alexis O'Connell, Maral Darya

East Florida Division GME Research Day 2024

No abstract provided.

Congenital Syphilis: A Case Report Of Heightened Awareness In Pregnancy, Madison Kaelin, Manasi Patwardhan

South Atlantic Division GME Research Day 2024

No abstract provided.

Type Iv Ehlers-Danlos Syndrome And A Fragile Uterus, Alyssa M. Moffitt, Cullen D. Smith, Alicia Farris, William Osborne, Anthony Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Papillary Thyroid Carcinoma Of The Ovary Presenting As A Dermoid Cyst, Renee Ricci, Alicia Farris, Dina Linfoot, Maclaren Durkee, Kenley Tyler

South Atlantic Division GME Research Day 2024

No abstract provided.

Puerperal Group A Streptococcus Infection Mimicking Gastrointestinal Ileus, Juhi Singhal, Mollie Mcdonnold, Carol Wang, Clarissa Villareal

Central & West Texas GME Research Day 2024

No abstract provided.