Obstetrics and Gynecology Commons^™

Latinas And The Traditional Genetic Counseling Model: A Qualitative Study, Stephanie Thompson

Dissertations and Theses (Open Access)

The traditional genetic counseling model reflects an individualized counseling session that includes the presentation of information about genes, chromosomes, personalized risk assessment, and genetic testing and screening options. Counselors are challenged to balance providing educational information with discussion of implications of this information in an allotted amount of time. The aim of this study was to explore the perceptions of pregnant Latinas on the benefits and limitations of the traditional prenatal genetic counseling model and to determine the specific preferences for receiving prenatal genetic counseling. Data were collected through focus groups and one-on-one, semi-structured interviews of twenty-five Spanish speaking Latinas …

Partner Support During Pregnancy And Its Influence On Maternal Health Behaviors, Sarah Capponi, Msii, Katelyn Cohen, Msii, Mazvita Nyamukapa, Mph, Jason K. Baxter, Md, Brett Worly, Md

Department of Obstetrics and Gynecology Presentations and Grand Rounds

Abstract

Introduction: Paternal support during pregnancy is considered a predictor of positive birth outcomes. Little research has focused on partner involvement and its impact on maternal health habits such as smoking and alcohol consumption during pregnancy.

Methods:

• This was a cross sectional study

• Pregnant women (n=198) between the ages of 18 – 44 and their partners (n=60)

• Women who identified their partner as their main support

• Norbeck Social Support Questionnaire (scale from 5 - 35)

• ANOVA and Student’s t-test were used to evaluate Norbeck scores and smoking/ drinking status

• Study personnel interviewed subjects to assess reliance on a partner

  Results: …

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Prior Ultrasound-Indicated Cerclage: What Should The Management Be In Next Pregnancy?, Anju Suhag, Md, Jordana Reina, Md, Laura Sanapo, Md, Maria Giraldo, Sushma Potti, Md, Vincenzo Berghella, Md

Department of Obstetrics and Gynecology Presentations and Grand Rounds

Abstract

Objective: To evaluate pregnancy outcomes of women with prior history of ultrasound-indicated cerclage (UIC) for short cervix who in subsequent pregnancy either were followed by transvaginal ultrasound cervical length(TVU CL)screening or received a history-indicated cerclage (HIC).

Materials and Methods: Retrospective cohort study was performed from 1993-2012, involving women with an index singleton pregnancy and history of UIC. Prior UIC was defined as cerclage placed for CLinstitution, women with prior history of UIC were managed in their subsequent pregnancy either by TVU CL screening or by HIC, at the physician's discretion(Figure). In the TVU CL group, if CL became24wks, an …

The Effect Of Commercial Tests For Aneuploidy Screening Using Cell-Free Fetal Dna On Rates Of Invasive Testing In Clinical Practice, Adetola Louis-Jacques Md, Courtney R. Burans Ms, Cgc, Sarah Robinson, Elizabeth A. Schofield, Joanne Quiñones Md, Msce, John C. Smulian Md, Mph, Meredith Rochon Md

Department of Obstetrics & Gynecology

No abstract provided.

Use Of Commercial Tests For Aneuploidy Screening Using Cell-Free Fetal Dna In Clinical Practice (Poster), Adetola Louis-Jacques Md, Courtney R. Burans Ms, Cgc, Sarah Robinson, Elizabeth A. Schofield, Joanne Quiñones Md, Msce, John C. Smulian Md, Mph, Meredith Rochon Md

Department of Obstetrics & Gynecology

No abstract provided.

Why 'Down Under' Is A Cut Above: A Comparison Of Rates Of And Reasons For Caesarean Section In England And Australia, Samantha J. Prosser, Yvette D. Miller, Rachel Thompson, Maggie Redshaw

Dartmouth Scholarship

Background: Most studies examining determinants of rising rates of caesarean section have examined patterns in documented reasons for caesarean over time in a single location. Further insights could be gleaned from cross-cultural research that examines practice patterns in locations with disparate rates of caesarean section at a single time point.

Methods: We compared both rates of and main reason for pre-labour and intrapartum caesarean between England and Queensland, Australia, using data from retrospective cross-sectional surveys of women who had recently given birth in England (n = 5,250) and Queensland (n = 3,467).

Does Cervical Ripening Via Intracervical Balloon Placement Increase The Risk Of Chorioamnionitis In Patients With Premature Rupture Of Membranes At Term?, Irena B. Cabrera Md, Joanne Quiñones Md, Msce, Danielle E. Durie Md, Jacob Rust, John C. Smulian Md, Mph, William E. Scorza Md

Department of Obstetrics & Gynecology

No abstract provided.

Rct Evaluating Safety & Efficacy Of Sodium Hyaluronate/Carboxymethylcellulose At Cesarean Delivery, Daniel G. Kiefer Md, Jolene C. Muscat Md, Jarrett Santorelli Bs, Martin R. Chavez Md, Cande V. Ananth Phd, Mph, John C. Smulian Md, Mph, Anthony M. Vintzileos Md

Department of Obstetrics & Gynecology

No abstract provided.

Amniotic Fluid Index Or Deepest Vertical Pocket?, Joanne Quiñones Md, Msce, R Melody Reynolds Md, Daniel G. Kiefer Md, Meredith Rochon Md, Katie Karabasz-Brown, John C. Smulian Md, Mph

Department of Obstetrics & Gynecology

No abstract provided.

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Spousal Discordance On Fertility Preference And Its Effect On Contraceptive Practice Among Married Couples In Jimma Zone, Ethiopia, Tizta Tilahun, Gily Coene, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Objectives: To assess spousal agreement levels regarding fertility preference and spousal communication, and to look at how it affects contraceptive use by couples. Methods: We conducted a cross-sectional study to collect quantitative data from March to May 2010 in Jimma zone, Ethiopia, using a multistage sampling design covering six districts. In each of the 811 couples included in the survey, both spouses were interviewed. Concordance between the husband and wife was assessed using different statistics and tests including concordance rates, ANOVA, Cohen’s Κ and McNemar’s test for paired samples. Multivariate analysis was computed to ascertain factors associated with contraceptive use. …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

Effects Of Hazardous And Harmful Alcohol Use On Hiv Incidence And Sexual Behaviour: A Cohort Study Of Kenyan Female Sex Workers, Matthew F. Chersich, Wilkister Bosire, Nzioki King’Ola, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Aims: To investigate putative links between alcohol use, and unsafe sex and incident HIV infection in sub-Saharan Africa.

Methods: A cohort of 400 HIV-negative female sex workers was established in Mombasa, Kenya. Associations between categories of the Alcohol Use Disorders Identification Test (AUDIT) and the incidence at one year of unsafe sex, HIV and pregnancy were assessed using Cox proportional hazards models. Violence or STIs other than HIV measured at one year was compared across AUDIT categories using multivariate logistic regression.

Results: Participants had high levels of hazardous (17.3%, 69/399) and harmful drinking (9.5%, 38/399), while 36.1% abstained from alcohol. …

Improving Anatomical Knowledge Retention In Medical Students Entering The Surgery And Obstetrics And Gynecology Clinical Rotations By Nesting Interactive Modules, Samantha Ahle, Jill Krapf, Kirsten Marie Brown, Juliet Lee, Gisela Butera, Ellen Goldman, Myriam Ferzli, Rosalyn A. Jurjus

GW Research Days 2014

Background: It is well documented in the medical education literature that students retain minimal anatomy knowledge when transitioning from pre-clinical didactics to clinical application on the wards. In a previous study at our own institution we were able to quantify this knowledge deficit in students on surgical clerkships, specifically surgery and obstetrics and gynecology (OB/GYN). Using our previous data, we designed an integrated, nested clinical teaching model utilizing e-modules to review clinically relevant surgical anatomy during their clinical rotations.

Objective: The goal of this study is to evaluate the impact of a newly designed method of teaching clinically relevant anatomy …

The Intersection Of Depression, Partner Violence And Poverty During The Perinatal Period, Catherine L. Kothari

Dissertations

Problem: Despite the wealth of research documenting the individual links between maternal depression, partner violence, and poverty, important gaps remain regarding their combined interactions, and their variation related to perinatal timing (pregnancy and postpartum). The current dissertation examined the interplay of these phenomena across perinatality.

Methods: This dissertation utilized secondary analysis of telephone survey data from a representative sample of women recruited during their postpartum hospital stay and interviewed four times over the subsequent 18 months. Linear regression was used for predictive modeling of fixed effects, and generalized estimating equation regression was used for multivariate analysis of temporal trends.

Findings: …

Attendance At Cervical Cancer Screening And Use Of Diagnostic And Therapeutic Procedures On The Uterine Cervix Assessed From Individual Health Insurance Data (Belgium, 2002-2006), Marc Arbyn, Valérie Fabri, Marleen Temmerman, Cindy Simoens

Obstetrics and Gynaecology, East Africa

Objective: To assess the coverage for cervical cancer screening as well as the use of cervical cytology, colposcopy and other diagnostic and therapeutic interventions on the uterine cervix in Belgium, using individual health insurance data.

Methods: The Intermutualistic Agency compiled a database containing 14 million records from reimbursement claims for Pap smears, colposcopies, cervical biopsies and surgery, performed between 2002 and 2006. Cervical cancer screening coverage was defined as the proportion of women aged 25-64 that had a Pap smear within the last 3 years.

Results: Cervical cancer screening coverage was 61% at national level, for the target population of …

Complementary And Alternative Medicine Use In Women During Pregnancy: Do Their Healthcare Providers Know?, Lisa Strouss, Amy Mackley, Ursula Guillen, David A Paul, Robert Locke

Student Papers, Posters & Projects

BACKGROUND: The National Institutes of Health reported in 2007 that approximately 38% of United States adults have used at least one type of Complementary and Alternative Medicine (CAM). There are no studies available that assess general CAM use in US pregnant women.The objectives of our study were to determine the prevalence and type of CAM use during pregnancy at one medical center; understand who is using CAM and why they are using it; and assess the state of patients' CAM use disclosure to their obstetrical providers.

METHODS: A cross-sectional survey study of post-partum women was done to assess self-reported CAM …

Long-Term Safety Of Ospemifene (52-Week Extension) In The Treatment Of Vulvar And Vaginal Atrophy In Hysterectomized Postmenopausal Women, James A. Simon, David J. Portman, R. Garn Mabey, The Ospemifene Study Group

Obstetrics and Gynecology Faculty Publications

Objective

To examine the long-term safety of oral ospemifene, a non-estrogen tissue-selective estrogen agonist/antagonist, for the treatment of moderate to severe dyspareunia, a symptom of vulvar and vaginal atrophy (VVA) due to menopause.

Study design

This multicenter, long-term, open-label, safety extension study was conducted in women without a uterus aged 40–80 years (N = 301) who received oral ospemifene 60 mg/day for 52 weeks. Participants either continued their 60-mg/day ospemifene dose from the initial 12-week pivotal efficacy study or switched from blinded placebo or ospemifene 30 mg/day to open-label ospemifene 60 mg/day. The 52-week open-label extension period plus initial …

Effectiveness, Safety And Acceptability Of Sino-Implant (Ii) During The First Year Of Use: Results From Kenya And Pakistan, Anja Lendvay, Rose Otieno-Masaba, Syed Khurram Azmat, Angie Wheeless, Waqas Hameed, Babar Tasneem Shaikh, Shiphrah Kuria, Markus J. Steiner, Mario Chen, Paul J. Feldblum

Community Health Sciences

Background: Sino-implant (II) is a two-rod subcutaneous contraceptive implant used up to 4 years, containing 150 mg of levonorgestrel. We conducted two observational studies of Sino-implant (II) to evaluate its performance in routine service delivery settings.
Methods: We enrolled 1326 women age 18-44 who had Sino-implant (II) inserted at clinics in Pakistan and Kenya. Women were followed-up using either an active or passive follow-up scheme in each study. Study outcomes were: one-year cumulative pregnancy and discontinuation rates; rates of insertion and removal complications; adverse event and side effect rates; reasons for discontinuation; and implant acceptability and satisfaction with clinic services. …

Family Planning Versus Contraception: What's In A Name?, Maria I. Rodríguez, Lale Say, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

No abstract provided.

Utility Of Recommendation Letters And Correlation With Specific Residency Applicant Qualities, Joseph E. Patruno Md, Amanda B. Flicker Md, Craig Koller Med, Amy B. Smith Phd, Hubert K. Huang Ms, Med, Taylor N. Weilnau

Department of Obstetrics & Gynecology

No abstract provided.

Metrics Of The Gynecologic Oncology Literature Focused On Cited Utilization And Costs, Edward J. Pavlik, John Hoff, Dylan Woolum, Yuqing Liang, Christiaan Wijers, Melissa Schwartz, Jason Lefringhouse, Lauren Baldwin

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: The newest findings on literature utilization relevant to gynecologic oncology were published by Thomson Reuters during June 2013 as determinants of journal standing. Our objective was to assess the different metrics reported for relative impact and cost for journals relevant to gynecologic oncology.

METHODS: 55 journals were evaluated for Impact Factor (IF), 5Year IF, Immediacy Index, Cited Half Life, Eigenfactor (EF) Score, Article Influence (AI) scores and subscription costs obtained from publisher information.

RESULTS: CA-A Cancer Journal for Clinicians had the highest IF (101.78) & AI (24.502). The top EF cancer-specific journals were the Journal of Clinical Oncology, Cancer …

A Multi-Center, Two-Arm, Single-Blind Randomized Trial Of Two Different Intravenous Fluids During Labor (Poster)., Lisa M. Dapuzzo-Argiriou Md, John C. Smulian Md, Mph, Meredith Rochon Md, Luisa Galdi Do, Jessika Kissling Md, Peter F. Schnatz Do, George Neubert Md, Angel Gonzalez-Rios Md, James Airoldi Md, Mary Anne Carrillo Md, Jaimie Maines Md, Allen R. Kunselman Ms, John Repke Md, Richard S. Legro Md

Department of Obstetrics & Gynecology

No abstract provided.

It's About Time: Who And Partners Release Programming Strategies For Postpartum Family Planning, Mary Eluned Gaffield, Shannon Egan, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Since 2010, the World Health Organization (WHO) has been receiving an increasing number of requests from country programs for strategies to create or strengthen voluntary family planning programs for women in the first year after childbirth. During this extended postpartum period, 95% of women in low- and middle-income countries want to avoid a pregnancy within the next 2 years, but 70% are not using contraception.

Sexual And Reproductive Health Of Migrants: Does The Eu Care?, Ines Keygnaert, Aurore Guieu, Gorik Ooms, Nicole Vettenburg, Marleen Temmerman, Kristien Roelens

Obstetrics and Gynaecology, East Africa

The European Union (EU) refers to health as a human right in many internal and external communications, policies and agreements, defending its universality. In parallel, specific health needs of migrants originating from outside the EU have been acknowledged. Yet, their right to health and in particular sexual and reproductive health (SRH) is currently not ensured throughout the EU. This paper reflects on the results of a comprehensive literature review on migrants' SRH in the EU applying the Critical Interpretive Synthesis review method. We highlight the discrepancy between a proclaimed rights-based approach to health and actual obstacles to migrants' attainment of …

Maternal Biomarkers Of Endothelial Dysfunction And Preterm Delivery, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Endothelial dysfunction is key to the development of atherosclerosis. Preterm delivery foreshadows later maternal cardiovascular disease (CVD), but it is not known if endothelial dysfunction also occurs. We prospectively measured circulating biomarkers of endothelial dysfunction in pregnant women with preterm or term delivery.

METHODS: We conducted a case-control study nested within a large prospective epidemiological study of young, generally healthy pregnant women. Women who delivered preterm (gestation, n = 240) and controls who delivered at term (n = 439) were included. Pregnancies complicated by preeclampsia were analyzed separately. Circulating endothelial dysfunction biomarkers included soluble intercellular adhesion molecule-1 (sICAM-1), vascular …

High Levels Of Sox5 Decrease Proliferative Capacity Of Human B Cells, But Permit Plasmablast Differentiation, Mirzokhid Rakhmanov, Heiko Sic, Anne-Kathrin Kienzler, Beate Fischer, Marta Rizzi, Maximillian Seidl, Kerstina Melkaoui, Susanne Unger, Luisa Moehle, Nadine E. Schmit, Sachin D. Deshmukh, Cemil K. Ayata, Wolfgang Schuh, Zhibing Zhang, François-Loic Cosset, Els Verhoeyen, Hans-Hartmut Peter, Reinhard E. Voll, Ulrich Salzer, Hermann Eibel, Klaus Wamatz

Obstetrics and Gynecology Publications

Currently very little is known about the differential expression and function of the transcription factor SOX5 during B cell maturation. We identified two new splice variants of SOX5 in human B cells, encoding the known L-SOX5B isoform and a new shorter isoform L-SOX5F. The SOX5transcripts are highly expressed during late stages of B-cell differentiation, including atypical memory B cells, activated CD21low B cells and germinal center B cells of tonsils. In tonsillar sections SOX5 expression was predominantly polarized to centrocytes within the light zone. After in vitro stimulation, SOX5 expression was down-regulated during proliferation while high expression levels were …

Reassessing The Impact Of Smoking On Preeclampsia/Eclampsia: Are There Age And Racial Differences?, Jen Jen Chang, Jerome F. Strauss, Jonathan P. Deshazo, Fidelma B. Rigby, David P. Chelmow, George A. Macones

Obstetrics and Gynecology Publications

Objective

To investigate the association between cigarette use during pregnancy and pregnancy-induced hypertension/preeclampsia/eclampsia (PIH) by maternal race/ethnicity and age.

Methods

This retrospective cohort study was based on the U.S. 2010 natality data. Our study sample included U.S. women who delivered singleton pregnancies between 20 and 44 weeks of gestation without major fetal anomalies in 2010 (n = 3,113,164). Multivariate logistic regression models were fit to estimate crude and adjusted odds ratios and the corresponding 95% confidence intervals.

Results

We observed that the association between maternal smoking and PIH varied by maternal race/ethnicity and age. Compared with non-smokers, reduced odds of …

Sperm-Associated Antigen 6 (Spag6) Deficiency And Defects In Ciliogenesis And Cilia Function: Polarity, Density, And Beat, Maria E. Teves, Patrick R. Sears, Wei Li, Zhengang Zhang, Waixing Tang, Lauren Van Reesema, Richard M. Costanzo, C. William Davis, Michael R. Knowles, Jerome F. Strauss Iii, Zhibing Zhang

Obstetrics and Gynecology Publications

SPAG6, an axoneme central apparatus protein, is essential for function of ependymal cell cilia and sperm flagella. A significant number of Spag6-deficient mice die with hydrocephalus, and surviving males are sterile because of sperm motility defects. In further exploring the ciliary dysfunction in Spag6-null mice, we discovered that cilia beat frequency was significantly reduced in tracheal epithelial cells, and that the beat was not synchronized. There was also a significant reduction in cilia density in both brain ependymal and trachea epithelial cells, and cilia arrays were disorganized. The orientation of basal feet, which determines the direction of axoneme …

Minor Gynecologic Surgery: A Review Of The Training Experience And Skill Building Opportunities For Providers In Low And Middle Income Countries, Rachel Marie Clark, Leslie Siriya Bradford, Jessica Opoku-Anane, Joseph Ngonzi, Ferdous Islam, Mithila Faruque, Annekathryn Goodman

Obstetrics and Gynecology Faculty Publications

Purpose: Minor gynecologic surgery is the cornerstone of gynecologic evaluation and intervention in countries with a well-established medical infrastructure. Surgical training and exposure to minor procedures are not available in low and middle-income countries due to the complex challenges of patient delay and lack of access to healthcare, physician shortages, and the lack of ancillary services such as pathology and radiology. This paper reviews current training statistics, the international literature on minor gynecologic surgery and training strategies.

Methods: PubMed searches using MESH terms cone biopsy, dilation and curettage, and loop electrosurgical excision procedure were performed. Statistics of minor …