Obstetrics and Gynecology Commons^™

Universal Screening For Measles Immunity During Pregnancy: A Cost-Effectiveness Analysis, Anuradha Devabhaktuni, Sarah Boudova, Elias Kassir, Sohum Shah, Neil S. Silverman, Christina S. Han

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Measles is a highly contagious illness capable of causing significant morbidity and mortality, including adverse pregnancy outcomes. Routine screening for measles immunity is not currently recommended during pregnancy. Given the increasing frequency of measles outbreaks nationally and globally, awareness of measles immunity status can influence management of pregnant individuals who incur measles exposures and offer an opportunity for postpartum or preconception vaccination.

OBJECTIVE: We sought to evaluate the cost-effectiveness of universal screening for measles immunity during pregnancy in the United States.

STUDY DESIGN: A decision-analytic model was constructed to evaluate the cost-effectiveness of universal screening for measles immunity during …

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

Marshall Journal of Medicine

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

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

Healthcare Experiences And Needs Of Patients With Pregnancy Of Unknown Location: A Qualitative Study, Kavita Vinekar, Zahava Shimshi, Amanda Doty, Samantha Kolowrat, Rebecca Mercier, Agatha Berger, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Patients presenting with bleeding or pelvic pain in early pregnancy are commonly found to have pregnancies of unknown location (PUL), with no sonographic findings of intrauterine nor ectopic pregnancy. We aimed to explore healthcare experiences and needs of patients presenting with PUL.

METHODS: This was a qualitative study using semi-structured interviews to explore healthcare experiences among patients with PUL. Patients were eligible if they presented with bleeding or abdominopelvic pain to the OB/GYN office or emergency department and were found to have a PUL followed in an electronic health record tracking list; had an initial human chorionic gonadotropin (hCG) …

Text Messaging Support For Patients Diagnosed With Impaired Glucose Tolerance During Pregnancy: Nonrandomized Pre-Post Implementation Study Assessing Impact On Postpartum Transitions Of Care, Natasha R. Kumar, Whitney Bender, Celeste Durnwald

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Patients with impaired glucose tolerance (IGT) identified during pregnancy who do not develop gestational diabetes mellitus (GDM) often do not receive additional interventions for their long-term metabolic risks.

OBJECTIVE: This nonrandomized pre-post implementation study reports the design process and initial program evaluation for Better Follow-up of Impaired Glucose Tolerance (BRIDGE), a 12-week text-based postpartum support program promoting hemoglobin A1c (HbA1c) completion and primary care provider (PCP) visit scheduling for patients diagnosed with IGT during pregnancy, assessing improvement in desired postpartum transition milestones. The 19-month program was divided into 2 arms lasting 9.5 months each, BRIDGE- (SMS text messaging support …

Complement Activation In Maternal And Placental Pathology Of Preeclampsia, Manu T Banadakoppa, Madhulatha S Chauhan, Moises J Tacam, Allyson W Nevins, Antonio H Ruano, Simone H Ruano, Jon A Fuson, Chandra Yallampalli

Faculty, Staff and Students Publications

Background: Preeclampsia is a multifactorial, pregnancy-related disorder characterized by new-onset hypertension and proteinuria, with distinct early- and late-onset forms. Although complement dysregulation has been implicated in the pathogenesis of preeclampsia, its causal role remains unclear. In mice, Crry (complement receptor 1-related protein Y) functions as a critical complement regulator at the fetal-maternal interface. Because complete Crry deficiency is embryonically lethal, direct in vivo investigation of complement activation in pregnancy has been challenging.

Methods: We generated a placenta-specific, doxycycline-inducible short hairpin RNA mouse model in which Crry expression can be downregulated in a dose-dependent manner. This system employs Cyp19-driven Cre recombinase …

Hematologic Markers And Machine Learning In Predicting Placenta Accreta: A Case-Control Study, Michael D Jochum, Kelly D Albrecht, Yamely Mendez Martinez, Victoria Zhang, Sanmay Sarada, Brian Burnett, Christina C Reed, Karin A Fox, Amir A Shamshirsaz, Michael A Belfort, Jessian L Munoz, Hennie A Lombaard

Faculty, Staff and Students Publications

Objective: This study aims to enhance antenatal detection of placenta accreta spectrum (PAS) and predict severe hemorrhage at delivery using machine learning by evaluating the association between antenatal hematologic index trends across trimesters, imaging markers, and patient history.

Methods: We retrospectively analyzed 2017-2023 data from a PAS referral center, including demographics, laboratory results, ultrasounds, and outcomes. Patients with confirmed PAS (cases) were compared to those with antenatal risk but no histopathologic evidence of PAS (controls). Statistical analyses and machine learning models were developed to predict PAS. We also used machine learning to predict severe hemorrhage (>1500 mL) in the …

Fetal Instability And Resuscitative Management During Fetal Intervention: A Retrospective, Descriptive Analysis Of 245 Fetal Cardiac And Spina Bifida Procedures, Claire A Naus, Betul Yilmaz Furtun, Jessian L Munoz, Rebecca M Johnson, Carolyn A Altman, Michael A Belfort, Luc Joyeux, Alice King, David G Mann, Shaine Morris, Athar M Qureshi, Magdalena Sanz Cortes, William E Whitehead, Caitlin D Sutton

Faculty, Staff and Students Publications

Objective: The heterogeneity of fetal surgery has led to variability in the nature and frequency of fetal instability. Understanding these differences is critical for optimizing management.

Methods: We reviewed all fetal atrial septal interventions (FASI) and fetoscopic myelomeningocele (fMMC) repairs with fetal instability performed at our institution between March 2012 and April 2025. We described and compared the frequency, timing, etiology, and management of fetal instability.

Results: During the study period, 28 unique patients underwent 35 FASI procedures, and 210 patients underwent fMMC repair. Fetal instability occurred in 51 of 245 cases (20.8%), with rates varying significantly by procedure type …

Terminal Digit Preference And Threshold Avoidance In Digital Blood Pressure Measurements During Pregnancy: Secondary Analysis Of Data From The Clip And Precise Cohorts, Peter Dadelszen, Akshdeep Sandhu, Jeffrey Bone, Rahat Qureshi, Olukayode Dada, Ashalata Mallapur, Marleen Temmerman, Marie-Laure Volvert, Joseph Waiswa, Moses Mukhanya, Angela Koech

Centre of Excellence in Women and Child Health

Background:Screening for, detecting, and managing pregnancy hypertension is a core function of antenatal care. To reduce both training requirements and the risks of measurement error in blood pressure (BP) values, automated and semiautomated BP devices have been validated in pregnant women with normal BP and pregnant women with hypertension and introduced for serial antenatal measurement of BP.

Objectives:The study aimed to (1) determine whether or not repeated BP measurements reduced the presence of terminal digit preference and (2) discern whether or not there was evidence of threshold avoidance in the Community-Level Interventions for Preeclampsia (CLIP) trials compared with …

Perinatal Mental Health Screening And Care Among Those With Pregnancy Complications, Alison N Goulding, Terri L Fletcher, Emily S Miller

Faculty, Staff and Students Publications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on …

Pregnancy Outcomes After In Utero Exposure To Immune Checkpoint Inhibitors, Morgan Bou Zerdan, Bruna Kfoury, Eliane Aoun, Sarah Diane Hmaidan, Roni Nitecki Wilke, Jeffrey A How, Terri L Woodard, Pamela T Soliman, Laurie J Mckenzie

Faculty, Staff and Students Publications

Importance: Immune checkpoint inhibitors (ICIs) have transformed the management of cancers affecting reproductive-age patients, yet their impact on pregnancy outcomes remains incompletely understood. We describe two cases of maternal and fetal outcomes associated with ICI exposure during pregnancy and present a comprehensive literature review.

Methods: A retrospective chart review was conducted at MD Anderson Cancer Center (1 January 2015 to 31 December 2024) to identify patients exposed to ICIs during pregnancy. Clinical data including cancer type, treatment timing, pregnancy course, and maternal and neonatal outcomes were collected. A narrative literature review was also performed using PubMed to identify reported cases …

The Prevalence And Effects Of Gestational Maternal Allergy: A Narrative Review, Alice Werynski Bs, Kang Chen Phd

Medical Student Research Symposium

Title:

The Prevalence and Effects of Gestational Maternal Allergy: A Narrative Review

Authors:

Alice Werynski B.S, Kang Chen Ph.D

Background:

Maternal allergies are a prevalent yet overlooked category of gestational disease. Pregnancy is characterized by a Th2 dominant immunological environment, and because many allergic diseases also rely on Th2 cytokines and IgE-mediated pathways, allergy during pregnancy may impact symptoms and influence maternal and fetal outcomes.

Methods:

This narrative review summarizes and compares literature on the prevalence of allergic conditions in pregnancy, their immunologic mechanisms, and their effects on maternal health, fetal development, and treatment safety. The search was conducted through …

Prenatal Care, Pregnancy Risk, Birth Outcomes And The Role Of Neighborhood Characteristics, Monica Garcia-Perez Phd, Randy Huard Phd, Christopher Thoms Phd, David Tilstra Md

InnovateHER Meeting 2026

This study links 2024 CentraCare Health birth records with neighborhood census tract conditions from the National Neighborhood Data Archive (NaNDA, 2020/2021) to examine how place, prenatal care, and clinical risks influence birth outcomes in Central Minnesota. Neighborhood factors are standardized and paired with measures of prenatal-care adequacy and pregnancy-risk indicators in a series of multivariate linear models to explore their effect on birth outcomes. Analyses adjust for maternal demographics and clinical risks to identify independent neighborhood effects. A privacy-preserving, tract-linked dataset is also created to help local partners target high-need prevention areas.

Fetal Vascular Malperfusion And Other Placental Lesions In Relation To Maternal Sars-Cov-2 Exposure: A Case–Control Study, Irene Mwandoto, Marleen Temmerman, Ingrid Gichere, Patricia Okiro

Pathology, East Africa

Background:

The morphologic characteristics of placentas associated with coronavirus disease-19 (COVID-19) have been described but with varying findings. Studies conducted at the onset of the pandemic reported frequency of Fetal Vascular Malperfusion (FVM), an umbrella term that describes occlusive vasculopathies that affect fetal circulation and their associated sequelae. Morphologic manifestations include thrombosis, avascular villi and vascular stromal karyorrhexis. Associated outcomes include fetal growth restriction, thromboembolic events such as neonatal stroke and fetal demise. Placental lesions associated with a severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection present a unique picture in histology, especially in the attempt to decipher the …

Aspirin And Preterm Birth Among Pregnant People With Increased Heat Exposure: Secondary Analysis Of A Randomized Clinical Trial, Gabriella Meltzer, Luke Duttweiler, Sarah Saleem, Kartik Shankar, Manolo Mazariegos, Antoinette Tshefu, Jackie Patterson, Elwyn Chomba, Waldemar Carlo, Shivaprasad Goudar, Richard Derman, Archana Patel, Patricia Hibberd, Edward Liechty, Fabian Essamai, Edwin Asturias, Denise Babineau, Janet Moore, Cascade Tuholske, Andrew Zimmer, Brent Coull, Elizabeth Mcclure, Robert Goldenberg, Nancy Krebs, Matthew Hoffman, Blair Wylie

Global Health Articles

IMPORTANCE: Scalable interventions are urgently needed to mitigate the adverse effects of heat on pregnancy and newborn health.

OBJECTIVE: To evaluate whether low-dose aspirin modifies the association between heat exposure and preterm birth.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of the Global Network for Women's and Children's Health Research Aspirin Supplementation for Pregnancy Indicated Risk Reduction in Nulliparas (ASPIRIN) randomized, double-blinded, placebo-controlled clinical trial was conducted from March 2016 to June 2018. Statistical analyses were performed from June 2024 to June 2025. The study settings included the Democratic Republic of Congo, Zambia, Kenya, Guatemala, Pakistan, and Belagavi and Nagpur, …

Prevalence And Determinants Of Fully Vaccinated Status For Covid-19 Among Pregnant Women In Brazil, Ghana, Kenya, And Pakistan, Vaishnavi Mathur, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Caroline Badzi, Emefa Modey, Marleen Temmerman, Ferdinand Okwaro, Renato Souza

Centre of Excellence in Women and Child Health

Maternal immunization provides essential maternal and fetal protection for several infectious diseases. The variability in vaccination guidelines for pregnant women across countries and through the course of the COVID-19 pandemic influenced the perception of both the general public and broader health care systems towards COVID-19 vaccination in pregnancy and moreover shaped the accessibility and decision-making trajectory of pregnant women to become fully vaccinated. As part of a larger multi-country, mixed-methods study, the purpose of this cross-sectional analysis is to assess what factors are associated with pregnant women being fully vaccinated for COVID-19 in Brazil, Ghana, Kenya, and Pakistan. In each …

Response Of Reticulocyte And Red Blood Cell Indices To Single-Dose Intravenous Iron In Pregnant Women With Moderate Iron Deficiency Anemia: Secondary Analysis Of The Rapidiron Trial, Manjunath S. Somannavar, Sudhir Mehta, Dharmesh Kumar Sharma, Seema Mehta, Yogeshkumar S, Umesh Charantimath, Benjamin E. Leiby, Michael K. Georgieff, Zubair H. Aghai, Ashalata Mallapur, Umesh Ramadurg, Radha Sangavi, Praveen Patil, J. P. Akshaykirthan, Rupsa C. Boelig, Mrutyunjaya B. Bellad, Richard J. Derman

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Iron deficiency anemia in pregnancy is a significant health concern. Reticulocyte hemoglobin equivalent (Ret-He) and immature reticulocyte fraction (IRF) are emerging as early markers, yet their response to different iron therapies in pregnancy is underexplored.

OBJECTIVE: To determine whether intravenous single-dose iron administration produces a more favorable effect on reticulocyte indices than oral iron therapy in anemic pregnant women.

METHODS: This is a secondary analysis of the RAPIDIRON Trial, a multicenter, three-arm randomized controlled trial comparing ferric carboxymaltose (FCM), ferric derisomaltose (FDM) and standard oral ferrous sulfate. Reticulocyte hemoglobin equivalent (Ret-He), Immature Reticulocyte Fraction (IRF) and other red blood …

Carcinoma Of The Bladder Diagnosed Incidentally Following Cesarean Section, Fatima Hussain, Mimi Rogers

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Statin Use In Pregnancy: Pilot Study In El Paso Texas Border Population, Margaret Klausmeyer, Mateo Rivera, Manuel Rivera-Alsina

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

The Case Of A Pain-Ridden Pregnancy In A Woman With Sickle Cell Disease, Katie Riffle, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Factors Associated With Postpartum Readmission For Hypertensive Disorders Of Pregnancy In A United States Border Population, Narinta Limtrakul, Fran Franceschini, Erdemir Aysn, Alondra Sierra, Manuel Rivera-Alsina

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

When A Copper Iud Crosses Boundaries: Colo-Uterine Fistula With Sepsis, Melissa Cullum, Victoria Roberts, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Diagnostic Challenges And Surgical Management Of A Cervical Ectopic Pregnancy Mimicking Cesarean Scar Implantation, Xena Morataya, Laura Reguero, Uti Essien, Stacy Sassaman, Jorge Venegas

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Recurrent Molar Pregnancy – A Case Report, Jayce Jaynes, Sarina Garcia, Dorovenia Hawkins-Koch

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

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 …

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 …

Trans-Broad-Ligament Abdominal Cerclage Versus Blind Needle-Piercing Abdominal Cerclage During Pregnancy: A Comparison Of Surgical Outcomes, Qiannan Yang, Daniel Y Lovell, Joseph Nassif, Lubna Chohan, Jugnu Biba Nijjar, Nurul Farhanah Binte Abdul Latif, Zhenkun Guan, Xiaoming Guan

Faculty, Staff and Students Publications

No abstract provided.

Qualitative Exploration Of Factors Associated With Covid-19 Vaccination Among Pregnant Women In Kenya, Violet Naanyu, Ferdinand Okwaro, Ingrid Gichere, Mandeep Sura, Prachi Singh, Berhaun Fesshaye, Marleen Temmerman

Centre of Excellence in Women and Child Health

The COVID-19 pandemic significantly disrupted societies worldwide, and COVID-19 vaccination has been identified as instrumental in the fight against the pandemic. While studies have examined uptake of COVID-19 vaccination, more research is needed to gain a better understanding of the factors influencing pregnant women’s decisions to get vaccinated. In this study, we used a cross-sectional descriptive qualitative study to explore the attitudes, beliefs, and behaviors related to COVID-19 vaccination during pregnancy in Kenya. A total of 50 in-depth interviews were conducted between October 2023 to March 2024 with a purposively drawn sample of 25 pregnant and 25 postpartum women during …

Severe Maternal Morbidity According To Sickle Cell Disease Genotype, Tetsuya Kawakita, Natsume Furukawa, Sora A. Jones, Salimah Navaz Gangji

Department of Obstetrics & Gynecology Faculty Publications

Background

Sickle cell disease (SCD) is a genetic hemoglobinopathy that disproportionately affects individuals of African descent and is associated with elevated risks of maternal complications. However, the contribution of specific SCD genotypes to severe maternal morbidity (SMM) and postpartum readmission remains poorly characterized at the population level.

Objective

We sought to examine the association between SCD genotypes-hemoglobin SS (HbSS) disease, hemoglobin SC (HbSC) disease, sickle thalassemia, and sickle cell trait-and SMM, hospital readmission, and related adverse maternal outcomes.

Study design

This was a retrospective cohort study using the Nationwide Readmissions Database from 2016 through 2022, representing over 20 million weighted …

Induced Vaginal Delivery In Pregnant Patient With Enlarging Choroidal Hemangioma, Sandra Zhi, Allison Burkes, Monica Saripella, Bhagyashri Pandey, Keith Storts, Kishan Patel, J William Harbour

North Texas GME Research Forum 2026

INTRODUCTION: Sturge Weber Syndrome (SWS) is a rare congenital neurocutaneous disorder affecting capillary formation, classically presenting with a facial port-wine birthmark and seizures. Associated symptoms vary by individual but may include additional brain and eye manifestations such as cognitive impairment, headache, stroke-like episodes, and glaucoma or visual field defects. Because SWS results from a sporadic mutation, it does not carry specific contraindications to pregnancy regarding fetal risk. However, pregnancies in patients with SWS should be managed by an multidisciplinary team and closely monitored for acute neurological and ophthalmologic complications. In childbirth, previous case reports have favored Cesarean section over vaginal …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …