Obstetrics and Gynecology Commons^™

The Effects Of Body Mass Index On Fertility And In Vitro Fertilization, Morgan R. Kidd

Honors College Theses

In-vitro fertilization (IVF) is the most widely used type of assisted reproductive technology for treating infertility arising from a number of conditions. As obesity rates continue to climb in the United States, infertility has been discovered to have a direct correlation. Individuals that fall below or above the healthy body mass index range are found to have disrupted regulation of the hypothalamic-pituitary-gonadal axis, resulting in diminished reproductive health. Those that are diagnosed as infertile due to conditions caused by the effects of low body mass index or high body mass index may seek assisted reproductive technologies to intervene in achieving …

Co-Designing An Adolescent Perinatal Mental Health Intervention In Kenya And Mozambique: The Inspire Project, Tatiana Salisbury, Fernando Chissale, Margrette Hanselmann, Evaline Langat, Sarah Kinja, Violet Naanyu, Mark Nyalumbe, Mellan Lilumbi, Lucy Nyaga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background Interventions to support adolescent perinatal mental health are limited and largely developed for delivery in high-income countries. This study aimed to co-design an intervention to improve mental health outcomes among pregnant and post-partum adolescent girls in Mozambique and Kenya.

Methods 159 adolescent girls (aged 15–19 years) and young women (aged 20–24 years) with experience of a pregnancy during adolescence, their partners and family members, service providers and community influencers were recruited in Kilifi County, Kenya and Moatize District, Mozambique. Those who consented took part in individual interviews, focus group discussions, observations, and workshops to identify key priorities for supporting …

Comparison Of Levels Of Bmi, Stress, And Depression Of Women During The Prenatal Period Relative To Their Activity Levels, Kalayna King

Honors Theses

This study aimed to analyze the relationships between activity levels, Body Mass Index (BMI), stress levels, and depression symptoms in obese pregnant women in Arkansas. Two separate exercise intervention studies were combined in this analysis to ultimately give a sample size of 293 pregnant women who were randomized into standard of care group (control) and an exercise group (treatment/experimental) (n = 115 and n = 178, respectively). Women in the control groups were instructed to independently continue to follow the physical activity guidelines recommended by their gynecologist, whereas the experimental groups participated in a combination of aerobic and resistance exercise …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

A Comparative Analysis Of Group Care: Trust, Professional Identity, And Health System Structure In The United Kingdom And The Netherlands, Samantha J. Kohlmann

Senior Theses

Group prenatal care (Group Care) has been associated with improved maternal experiences and select clinical outcomes, yet less is understood about how it functions within high-resource health systems and what mechanisms underlie its impact. This study examines how Group Care is implemented in the United Kingdom and the Netherlands, with particular attention to professional roles, relational dynamics, and health system context.

I employed a qualitative, comparative design and conducted four semi-structured interviews with midwife researchers involved in Group Care implementation in both countries. Data were analyzed thematically, with attention to cross-context similarities and differences.

Findings indicate that Group Care operates …

Daily Outdoor Pm2.5 Exposure Characterization And Road Edge Effect During A 2022 - 2023 Monitoring Campaign In Gambia, Kenya And Mozambique, Terence Mushore, Handsome Nyoni, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Anotida Chapunza, Stanley Luchters, Matthew Chersich, Marleen Temmerman, Angela Koech

Centre of Excellence in Women and Child Health

Air pollution is a major contributor to mortality and adverse health outcomes, particularly in pregnant women and children, with vehicular emissions as a key source. This study aimed to characterize long-term exposure to fine particulate matter (PM2.5), evaluate potential health risks, and quantify the contribution of road transport and proximity to roads in The Gambia, Kenya, and Mozambique. Multi-temporal personal exposure data were interpolated into continuous spatial surfaces and aggregated into daily averages, which were then compared with World Health Organization (WHO) guidelines to assess potential health impacts. Multi-distance buffers at 10 m intervals up to 1000m from major roads …

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 …

Maternal Respiratory Syncytial Virus Vaccination And Preterm Birth A Utah Statewide Retrospective Cohort Study, Amy Solsman, Torri Metz, Josh Benton, Shana Godfred-Cato

The Knowledge and Creativity Expo

We conducted a statewide, retrospective cohort study to evaluate the association between maternal receipt of the respiratory syncytial virus (RSV) vaccine and preterm birth. All individuals who delivered a singleton neonate in Utah and were between 32 0/7 and 36 6/7 weeks of gestation from September 2023 to February 2024 were included and followed up until delivery. Overall, 2,733 of 24,213 individuals (11.3%) received the vaccine. Vaccine receipt was associated with lower odds of preterm birth (5.5% vaccinated group vs 6.8% unvaccinated group, adjusted odds ratio 0.80, 95% CI, 0.67–0.95). Receipt of the RSV vaccine was not associated with any …

Examining The Relationship Between A Positive Obstructive Sleep Apnea Diagnosis And Referring Symptoms Of The Pregnant Patient, Christina Emerson, Beth Tremblay

The Knowledge and Creativity Expo

PROBLEM: Many healthcare providers do not routinely screen pregnant individuals for obstructive sleep apnea (OSA), contributing to its underdiagnosis and potentially leading to various pregnancy-related health issues. Currently used OSA screening tools, such as the Berlin Questionnaire, STOP-BANG Questionnaire, and Epworth Sleepiness Scale, often demonstrate poor predictive value in pregnant women due to the dynamic physiological changes of pregnancy and the differing presentation of OSA in this population.

PURPOSE: To examine the relationships between a positive OSA diagnosis, patient characteristics, and the symptoms among pregnant patients referred for sleep studies.

EBP QUESTIONS: 1) Is there a relationship between certain referring …

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 …

Reducing Surgical Site Infections Post Cesarean Section Through Multi-Modal Standardized Education, Ari Meyers, Fereshteh Pirayesh, Tracie Tolme

Providence Nursing Research Conference 2023 – Present

No abstract provided.

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 …

Patterns Of Recurrent Preterm Birth: An Individual Patient Data Meta-Analysis, Charlotte E. Van Dijk, Annemijn A. De Ruigh, Benjamin Y. Gravesteijn, Brenda M. Kazemier, Vincenzo Berghella, John Owen, Roberto Eduardo Bittar, Rashmi Bagga, Joan M. G. Crane, Andrew H. Shennan, Birgit Arabin, Ben Willem Mol, Eva Pajkrt, C. Emily Kleinrouweler

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Pregnant patients with a previous spontaneous preterm birth are at high risk for recurrent (spontaneous) preterm birth. We investigated whether the number of previous spontaneous preterm births, gestational age of the previous birth and cervical length could stratify patients into different risk groups for recurrence to investigate whether there is a risk group that does not require additional interventions.

DATA SOURCES: A systematic search of MEDLINE and EMBASE was conducted from 1995 until April 2025.

STUDY ELIGIBILITY CRITERIA: Studies that were included were prospective studies with original individual patient data available that reported on asymptomatic pregnant individuals with ≥1 …

Repair Of Uterine Rupture With Placenta Accreta At 22 Weeks, Followed By Cesarean Hysterectomy Delivery Of Healthy Neonate At 32 Weeks, Molly Dickinson, Thomas Jefferson University, Marco Goldberg, Mae Florendo, Andrew Chau, Corrado Minimo, Kate Stampler, Jay Goldberg

Einstein Health Papers

Introduction: Uterine rupture at previable gestational ages is almost always treated with evacuation of the pregnancy, followed by uterine repair or hysterectomy. Case Presentation: A 40-year-old woman with one prior cesarean section presented at 22 weeks of gestation with an acute abdomen. Imaging noted hemoperitoneum with areas of bulging in the anterior uterine wall. Laparoscopy converted to a laparotomy through a midline incision, noted an actively bleeding 2 cm area of uterine rupture with protruding placental tissue. The uterine rupture was surgically closed with sutures. The patient was kept in the hospital for the remainder of her pregnancy. At 32 …

Identification Of De Novo Variants From Parent-Proband Duos Via Long-Read Sequencing, Leandros Boukas, Emmanuèle C. Délot, Georgia Pitsava, Christine Lambert, Cairbre Fanslow, Primo Baybayan, Sami Belhadj, Bojan Losic, John Harting, Krista Bluske, Jonathan Lotempio, Huda B. Al-Kouatly, Rachid Karam, William J. Rowell, Changrui Xiao, Eric Vilain, Seth I. Berger

Department of Obstetrics and Gynecology Faculty Papers

While de novo variants cause many Mendelian disorders, their detection currently requires sequencing of the proband and both biological parents. This is not feasible when only one parent is available, a limitation for millions of families. Here, we develop duoNovo, which identifies de novo variants from parent-proband duos using long-read sequencing followed by haplotype reconstruction and detection of identical-by-descent haplotype blocks. We sequenced 104 trios with PacBio HiFi sequencing and applied duoNovo to each of the 208 duos constructed by masking one parent, classifying over 55 million variants according to their de novo status. We evaluated duoNovo's performance against classifications …

Benefits, Challenges, And The Way Forward: Medical Specialists' Perception On Family Physician Integration In Healthcare System In Tanzania, Juvenalius Anselm, Roselyter Riang’A, Neelam Ismail, Davis Rubagumya, Jesca Munishi, Sumayyah Saudin, Lynn Moshi, Willbroad Kyejo, Nancy Matillya

Family Medicine, East Africa

Background Family medicine provides comprehensive care by integrating biomedical, behavioral, and social sciences. While established in some sub-Saharan countries, it remains new and unintegrated in Tanzania’s public health system. Its integration is vital for healthcare reform to enhance patient care and system quality.This study aimed to understand the perceptions of medical specialists regarding the integration of family physicians into the Tanzanian healthcare system.

Methods A descriptive qualitative study was conducted through in-depth interviews with ten medical specialists from Aga Khan Hospital and Muhimbili National Hospital in Dar es Salaam. Thematic analysis was employed in this study.

Results Integration of family …

Effect Of Dental Treatments On Reduction Of Preterm Birth: A Systematic Review And Meta-Analysis, Camille Thomas, Shakil Ahmed, Vincenzo Berghella, Romina Brignardello-Petersen, Mohamed El-Rabbany, Catherine Devion, Stefania Ronzoni

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Periodontal disease is associated with increased risk of preterm birth. Effective management during pregnancy may reduce preterm birth, though clinical trial evidence has been inconsistent. This study aimed to assess whether treating dental disease during pregnancy reduces preterm birth.

DATA SOURCES: A systematic search was performed of EMBASE, MEDLINE, PubMed, Cochrane Library, and trial registries up to December 2023 and re-run in January 2025.

STUDY ELIGIBILITY CRITERIA: Randomized controlled trials (RCTs) enrolling pregnant persons with any dental disease randomized to receive dental treatment vs no treatment were included. No language restriction was applied.

STUDY APPRAISAL AND SYNTHESIS METHODS: Data …

A Physician Survey On Research And Implementation Priorities For Caffeine Citrate Use In Newborn Care In Sub-Saharan Africa, Olufunke Bolaji, Osayame Ekhaguere, Franck Houndjahoue, Nicholas Embleton, Helen Nabwera

Centre of Excellence in Women and Child Health

Background:Evidence on caffeine citrate (CC) for apnoeaof prematurity (AOP) originate from high-income countries. This study aimed to develop consensus on research design for evidence in sub-Saharan Africa (SSA).

Methods:We surveyed physicians in newborn units across SSA to assess their opinions on CC research and their preferred study designs.

Participants rated four study designs:a) an observational before-and-after study; a randomized controlled trial (RCT) of b) caffeine versus placebo; c) caffeine versus aminophylline; d) a traditional or stepped wedge cluster trial.  They  assessed  each  design  using  a  Likert  scale  for  evidence, feasibility, and ethics considerations.

Results:Ninety-two   newborn   physicians …

Renin-Angiotensin-Aldosterone System In Preeclampsia: Pathophysiological Insights And Links To Vascular Dementia, Robin C. Finch, Jenny Lutshumba, Elizabeth Mirsky, Esther Ndashaala, Kelsey Bullens, Emma Smith

Pediatrics Faculty Publications

Pre-eclampsia, a condition characterized by new-onset hypertension during pregnancy and one or more indices of organ damage, is a major driver of both short and long-term maternal health outcomes. Individuals with a history of pre-eclampsia are at increased risk for cardiovascular, renal, and other chronic diseases. Recent studies have linked pre-eclampsia history with increased risk of dementia later in life, underscoring the importance of new guidelines emphasizing blood pressure control to reduce the risk of cognitive decline. Unfortunately, neither mechanisms underlying causes of pre-eclampsia nor their links with cognitive function are well understood. Vascular contributions to cognitive impairment and dementia …

Osteopathic Manipulative Medicine As An Adjunctive Approach To Improve Pelvic Perfusion And Fertility-Related Physiologic Markers, Ashton Dodd, Yanielisse Bellinger, Marsha Chevalier, Annaliese Taylor, Jacob Warner-Palacio, Aurora Jeanes, Nathan Barnhurst

Annual Research Symposium

No abstract provided.

Molecular Profiling And Tumor Biomarker Analysis Of Gog281/Logs: A Positive Late-Phase Trial Of Trametinib For Recurrent/Persistent Low-Grade Serous Ovarian Carcinoma, Robert L. Hollis, Austin Miller, Heather A. Lankes, Kwong-Kwok Wong, William Rodgers, David Millan, Karen Carty, Robert L. Coleman, Kathleen N. Moore, Angeles Alvarez Secord, David M. O'Malley, John K. Chan, Andrea R. Hagemann, Stephanie Gaillard, Saketh R. Guntupalli, Mitchell I. Edelson, Peter G. Rose, Oliver Dorigo, Susana Banerjee, Ailith Ewing, Michael Churchman, Anil K. Sood, C. Simon Herrington, Charlie Gourley, David M. Gershenson

Abington Jefferson Health Papers

PURPOSE: Low-grade serous ovarian carcinoma (LGSOC) is a distinct form of ovarian cancer characterized by younger patient age and relative chemoresistance. The GOG281/LOGS trial (NCT02101788) investigated the efficacy of the MEK inhibitor trametinib compared with physician's choice standard-of-care (SOC) in patients with LGSOC with persistent/recurrent disease. The study demonstrated significantly improved progression-free survival (PFS) in the trametinib-treated arm.

EXPERIMENTAL DESIGN: Two hundred and sixty patients with recurrent/persistent LGSOC were enrolled and randomly assigned in GOG281. We performed molecular analysis of 170 patients with available tumor specimens, comprising whole-exome sequencing and phospho-ERK (pERK) IHC, to identify biomarkers of clinical benefit from …

Tumor Necrosis Factor Alpha Inhibition Improves Fetal Growth In A Rat Model Of Preeclampsia, Laura E. Coats, Nathan Campbell, Dylan Solise, Gabrielle M. Chamoun, Adam Z. Rawls, Alexandra Demesa, Ty Turner, Baoying Zheng, Barbara T. Alexander, Babbette Lamarca

Physiology & Biophysics

Introduction

Artificial Intelligence In Medical Ethics Education: A Descriptive Study Of Eight Models In Multiple Choice Question Generation, John Obeid, Christopher Bobier, Alex Gillham, Adam Omelianchuk, Daniel Hurst

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Integrating artificial intelligence (AI) into medical education poses barriers and opportunities for medical educators. One of those opportunities is content creation for medical ethics assessment. Assessing the performance of AI in generating multiple choice questions (MCQs) in ethics that aligns with United States Medical Licensing Examination (USMLE) is important. The present study evaluates the performance of eight AI models-GPT-4 Turbo, GPT-3.5 Turbo 0125, o1 Mini, o1 Preview, GPT-4, Claude 3.5 Sonnet, Claude 3 Opus, and Gemini-in regard to the relevance, clarity, and accuracy of generated ethics-based MCQs.

Methods: Each of the eight models was tasked with generating two sets …

Exploring Physician Views On Birth Method And Route Of Delivery, Vivian Nguyen, Vincenzo Berghella, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: In the United States, rates of cesarean deliveries (CD) have been increasing. Despite recommendations from the American College of Obstetrics and Gynecology to prevent increasing rates of CDs, planned CD has been associated with lower rates of perinatal deaths and better maternal outcomes when compared to planned vaginal delivery (VD). However, the data is limited, so it is important that we conduct randomized controlled trials (RCTs) comparing maternal and perinatal outcomes in planned CD vs planned vaginal delivery (VD) for nulliparous, term, single, vertex pregnancies. The purpose of study is to survey obstetricians and gynecologists (ob/gyns) on their …

Normative Growth Trajectories Of Fetal Brain Regions Validated By Satisfactory Maturation Of Neurodevelopmental Domains At 2 Years Of Age, Madeleine Wyburd, Stephen Kennedy, Michelle Fernandes, Nicola Dinsdale, Linde Hesse, Robert Gunier, Leila Ismail, Eric Ohuma, Michael Gravett, Maria Carvalho

Obstetrics and Gynaecology, East Africa

We previously constructed a qualitative, 3D ultrasound derived atlas of the normative spatiotemporal dynamics of fetal brain maturation. Here, using the same healthy multi-national cohort, we applied deep learning methods to 4205 fetal brain scans from 18–27 weeks’ gestation, to produce an extensive, quantitative description of the growth of 16 fetal brain structures associated with satisfactory domain-specific neurodevelopmental scores at 2 years of age. The methodology, which is publicly available, takes less than 10 seconds per scan. We define 28 region-specific, functionally relevant, normative growth trajectories, a ratio between the relative volumes of the insular (rILV) and parietal (rPLV) lobes …

Pregnancy Outcomes Among Women With And Without Hiv Infections Who Underwent Excisional Treatment For High-Grade Cervical Intraepithelial Neoplasia: A Retrospective Cohort Study In Low-Resource Settings, Poli Amubuomombe, Peter Itsura, Philiph Tonui, Elkanah Orang'o, Benjamin Odongo, Patrick Loehrer, Susan Cu-Uvin

Obstetrics and Gynaecology, East Africa

Objective The standard treatment for high-grade squamous intraepithelial lesions is excisional involving the uterine cervix, while surveillance is an acceptable approach for low-grade squamous intraepithelial lesions. There is controversy about excisional treatment on pregnancy outcomes. The objective of this study was to determine pregnancy outcomes in women living with and without HIV who underwent excisional treatment for high-grade cervical intraepithelial lesions.

Design This retrospective cohort study compared the pregnancy outcomes of women with and without HIV who were or were not treated for cervical intraepithelial lesions. A cohort of 488 women with and without HIV infection who did or did …

Prevalence And Risk Factors For Laparoscopic Managed Ectopic Pregnancies At A Tertiary Referral Hospital - A 10-Year Synopsis: A Cross Sectional Study, Steve Mutiso, Eric Mugambi

Obstetrics and Gynaecology, East Africa

Background Ectopic pregnancies (EP) are a common pregnancy associated complication. They are associated with significant morbidity, and rarely mortality, if not managed properly. EP have a myriad of predisposing factors that help identify patients at risk and facilitate early diagnosis and intervention. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the incidence, prevalence and risk factors of their occurrence.

Methods This study was designed as a Retrospective Clinical Audit based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis …

Intraoperative Care And Complications Of Symptomatic Adolescent And Young Adult Patients Undergoing Laparoscopy To Diagnose And/Or To Treat Endometrioses: A Multi-Institutional Review., Jacquelyn R. Evans, Katherine Bergus, Lindsey Asti, Lesley L. Breech, Ruiqi Cen, Yuan Yuan Gong, S Paige Hertweck, Holly R. Hoefgen, Anne H. Horne, Ashli A. Lawson, Seema Menon, Kathleen E. O'Brien, Shashwati Pradhan, Brenna Rachwal, Yolanda R. Smith, Priya Suvarna, Sarah Van Son, Geri Hewitt

Manuscripts, Articles, Book Chapters and Other Papers

STUDY OBJECTIVE: This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.

METHODS: A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.

RESULTS: There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common …