Female Urogenital Diseases and Pregnancy Complications Commons^™

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

The Impact Of An Iron-Rich Diet On Fatigue In Menstruating Women With Non-Anemic Iron Deficiency, Meagan Seraydar, Lauren Latimer, Sam Miragliatto

Department of Nutrition Student Projects

Fatigue without diagnosed anemia is prevalent in menstruating women, with iron deficiency being a potential contributor. While iron supplementation is a standard intervention, dietary sources of iron may offer a sustainable alternative. This study aims to assess the impact of an iron-rich diet on fatigue levels in menstruating women. A 12-week randomized controlled trial (RCT) will be conducted, assigning participants to either an iron-rich diet group or a control group following their usual diet without specific iron recommendations. Fatigue will be measured using the Fatigue Severity Scale (FSS) at baseline, six weeks, and twelve weeks, alongside iron status biomarkers, including …

Maternal Carbohydrate-Controlled Diets And The Impact On Neonatal Hypoglycemia Rates, Jenna L. Klopping

Student Scholarly Projects

Practice Problem: Neonatal hypoglycemia has a profound impact on the diabetic maternal infant dyad and their families. The practice problem negatively affects the quality of care offered by healthcare providers, while also imposing a financial burden on the healthcare system that extends well beyond the perinatal period.

PICOT: In term infants born to diabetic mothers (P), does a regular carbohydrate-controlled diet given at least 8 hours prior to birth (I) in comparison to a clear liquid carbohydrate-controlled diet (C) reduce the incidence of neonatal hypoglycemia at two hours of life(O) across an 8-week period(T)?

Evidence: A medical nutrition diet, such …

Building Bridges: A Community Health Worker Training Course, Taylor A. Ramsey, Lesley Khan-Farooqi, Phd, Otd, Otr, Dr. Sharita Ambrose, Dhed., Mph, Ches, Chwi

Spring 2025 OTD Capstone Symposium

Building Bridges: A Community Health Worker Training Course is a comprehensive 20-hour continuing education course designed for community health workers (CHWS) who work with Black pregnant women. This training course was developed for and in collaboration with Allure Alliance Incorporated, a non-profit organization whose mission is to improve the lives of Black women through community programming, education, and advocacy. This training course reflects an interprofessional collaborative approach to addressing the racial disparities in the Black maternal health population in the U.S. The course includes evidence-based strategies and health management interventions derived from the Occupational Therapy Practice Framework, 4th Edition (OTPF-4), …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection (STI) rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase are gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local STI statistics, in addition to when to and not to test for sexually transmitted STI infections. Education was provided to three Advance Practice Nurse Practitioners about disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior …

Molecular Subtyping Of Hypertensive Disorders Of Pregnancy, Michal Elovitz, Elaine Gee, Nathaniel Delaney-Busch, Alison Moe, Mitsu Reddy, Arkady Khodursky, Johnny La, Ilma Abbas, Kay Mekaru, Hunter Collins, Farooq Siddiqui, Rory Nolan, Rupsa Boelig, Daniel Kiefer, Pamela Simmons, George Saade, Antonio Saad, Ebony Carter, Thomas Mcelrath, Stephen Quake, Mark Depristo, Carrie Haverty, Manfred Lee, Eugeni Namsaraev, Vincenzo Berghella, Ai-Ris Collier, Antonia Frolova, Esther Park-Hwang, Luis Pacheco, Elizabeth Sutton, Maneesh Jain, Kara Rood, William A Grobman, Joseph Biggio, Cynthia Gyamfi-Bannerman, Arun Jeyabalan, Morten Rasmussen

Department of Obstetrics and Gynecology Faculty Papers

Hypertensive disorders of pregnancy (HDP), including preeclampsia, affect 1 in 6 pregnancies, are major contributors to maternal morbidity and mortality, yet lack precision medicine strategies. Analyzing transcriptomic data from a prospectively-collected diverse cohort (n = 9102), this study reveals distinct RNA subtypes in maternal blood, reclassifying clinical HDP phenotypes like early/late-onset preeclampsia. The placental gene PAPPA2 strongly predicts the most severe forms of preeclampsia in individuals without pre-existing high risk factors, months before symptoms, and its overexpression correlates with earlier delivery in a dose-dependent manner. Further, molecular subtypes characterized by immune genes are upregulated in less severe forms of HDP. …

Supporting Maternal Mental Health In The Postpartum Period With The Use Of Home Resource Kit, Nicole Craig

Theses and Graduate Projects

Postpartum mental health disorders, including postpartum depression and anxiety, can affect a significant proportion of new mothers for centuries. This paper explores the development, implementation, and evaluation of an at-home mental health resource kit designed to support maternal mental health while navigating the stresses of new motherhood. Utilizing Jean Watson's Theory of Human Caring as a theoretical framework, the study assesses the effectiveness of integrative therapies such as aromatherapy, mindful meditation, and educational resources in managing postpartum stress. Data collected through pre- and post-surveys and roundtable discussions provide insights into the benefits and limitations of these interventions. The findings indicate …

Sexual And Reproductive Healthcare Perceptions Among Arab-American Women: Implications For Gynecological Health Outcomes, Munna Hazime, Kaitlyn Zablock, Whitney Bowyer, Natalie Ahmad Mateju, Andrew Markowitz

Medical Student Research Symposium

This literature review analyzes the sexual and reproductive healthcare perceptions of Arab-American (AA) women living in the United States and how this impacts the prevalence of gynecological diseases. Sexual health is viewed promiscuously within the AA population and is generally reduced to the physical act of intercourse. It is considered either an agent of sexual desire or a means to reproduce. This dichotomy overlooks aspects of gynecological health within a broader framework. This attitude is evident in the minimal utilization of preventative screenings and increased rates of sexually transmitted infections (STIs) and gynecological cancers. Consequently, this narrow view of sexual …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase being gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local statistics, in addition to when to and not to test for sexually transmitted infections. Education was given to three Advance Practice Nurse Practitioners on disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior to an educational …

The Obstetric Experience Among Vascular Surgery Trainees, Ruojia Debbie Li, Eric B. Pillado, Margaret Reilly, Lauren M. Janczewski, Christina Cui, Kathryn Dilosa, Joshua S. Eng, Matthew C. Chia, Malachi G. Sheahan, Karl Y. Bilimoria, Erika L. Rangel, Yue-Yung Hu, Dawn M. Coleman

School of Medicine Faculty Publications

BACKGROUND: Vascular surgery training poses unique risks to pregnancy, including long hours, physically demanding work, and radiation exposure. Our objectives were to (1) understand pregnancy and parenthood experiences among vascular surgery trainees, (2) assess the rate of obstetric complications among vascular trainees, and (3) evaluate factors associated with trainee-parent wellness. METHODS: A survey was administered after the 2021 Vascular Surgery In-Training Examination. Residents and fellows who (or whose partners) experienced pregnancies during their clinical years of training were asked about their perceptions of the learning environment (work hours and mistreatment, including discrimination, bullying, and harassment), obstetric complications (miscarriage, pre-eclampsia, placental …

Chemoid-Guided Therapy Improves Objective Response Rate In Recurrent Platinum-Resistant Ovarian Cancer Randomized Clinical Trial, Thomas J. Herzog, Thomas C. Krivak, Stephen Bush Ii, John P. Diaz, Scott Lentz, Navya Nair, Nadim Bou Zgheib, Camille Gunderson-Jackson, Abhijit Barve, Krista L. Denning, Seth T. Lirette, Candace M. Howard, Jagan Valluri, Pier Paolo Claudio

School of Medicine Faculty Publications

Patients with recurrent platinum-resistant ovarian cancer (PROC) have poor clinical outcomes, owing mainly to the presence of therapy-resistant cancer stem cells (CSCs). The NCT03949283 randomized clinical trial enrolled patients with recurrent PROC to receive ChemoID-guided chemotherapy or the best physician-choice regimen selected from the same list of thirteen mono or combination chemotherapies. The primary outcome was objective response rate (ORR) assessed on CT scans using the RECIST 1.1 criteria at 6 months follow-up. Subjects treated with the ChemoID assay had an ORR of 55% (CI(95) 39% - 73%), compared to 5% (CI(95) 0% - 11%) for those treated with physician’s …

Blood Tnf-Α And Gabra-1 Levels In Individuals With Poor Ovarian Response Underwent In Vitro Fertilization Program, Gadsara Ruangprachum, Paweena Thuwanut, Wisan Sereepapong, Vorasuk Shotelersuk, Siraprapa Tongkobpetch, Porntip Sirayapiwat

Chulalongkorn Medical Journal

Background: Poor ovarian response (POR) to ovarian stimulation during in vitro fertilization (IVF) program remains a critical issue contributing to decreased ovarian reserve and cancellation of IVF cycles. Nevertheless, the complete etiology of PRO condition remains inadequately understood.

Objectives: This research primarily aimed to compare levels of blood pro-inflammatory cytokine (TNF-α) and apoptotic marker (GABRA-1) between those exhibiting normal ovarian response (NOR) and those with poor ovarian response during IVF program.

Methods: A cross-sectional study involving whole blood collection from 25 participants was conducted (15 individuals in NOR group and 10 in POR group). Relative gene expression levels of blood …

A Randomized Phase Ii/Iii Study Of Paclitaxel/Carboplatin/Metformin Versus Paclitaxel/Carboplatin/Placebo As Initial Therapy For Measurable Stage Iii Or Iva, Stage Ivb, Or Recurrent Endometrial Cancer: An Nrg Oncology/Gog Study, Victoria L. Bae-Jump, Michael W. Sill, Paola A. Gehrig, Jason D. Merker, David L. Corcoran, Adam D. Pfefferle, Michele C. Hayward, Joan L. Walker, Andrea R. Hagemann, Steven E. Waggoner, Roisin E. O'Cearbhaill, Megan E. Mcdonald, Mitchell I. Edelson, Paul A. Disilvestro, Amy L. Mcnally, Aimee Fleury, Ramey D. Littell, Frederick R. Ueland, Heather A. Lankes, Carol Aghajanian

Abington Jefferson Health Papers

INTRODUCTION: We evaluated the efficacy of the addition of the anti-diabetic drug metformin to standard-of-care paclitaxel and carboplatin (PC) in patients with advanced and recurrent endometrial cancer (EC).

METHODS: In this phase II/III trial, EC patients with chemotherapy-naïve stage III/IVA (with measurable disease) and stage IVB or recurrent (with or without measurable disease) disease were randomly assigned to PC/metformin (850 mg BID) versus PC/placebo. Metformin or placebo was continued as maintenance therapy after completion of PC until disease progression. The primary endpoint of phase II was progression-free survival (PFS). The primary endpoint of phase III was overall survival (OS). Secondary …

The Impact Of Testosterone Therapy On The Vaginal Microbiota Of Transgender Men And Non-Binary People: A Prospective Study, Olivia T. Van Gerwen, Kristal J. Aaron, Emma Sophia Kay, Krishmita Siwakoti, Angela Pontius, Saralyn Richter, Z Alex Sherman, Keonte J. Graves, Ashutosh Tamhane, Jacob H. Elnaggar, Meng Luo, Evelyn Toh, David E. Nelson, Nicholas J. Van Wagoner, Christopher M. Taylor, Christina A. Muzny

School of Medicine Faculty Publications

BACKGROUND: Understanding the impact of testosterone on the vaginal microbiota of transgender men (TGM) and non-binary people assigned female sex at birth over time is imperative as vaginal dysbiosis and incident bacterial vaginosis (iBV) may cause bothersome genital symptoms and increase HIV/STI acquisition risk. We investigated shifts in the composition of the vaginal microbiota over time in TGM initiating testosterone for gender-affirming hormone therapy, including development of vaginal dysbiosis and iBV.

METHODS: Participants ages ≥18 years, assigned female sex at birth and reporting TGM or non-binary identity, interested in starting injectable testosterone, demonstrating optimal vaginal microbiota, with no current STI(s) …

Plasma Cell-Rich Lymphoid Neoplasm In An Endocervical Polyp Of The Uterine Cervix In A Perimenopausal 52-Year-Old Woman, Anjali Patel, Jacqueline Haas, Angela Kueck

HCA Healthcare Journal of Medicine

Background

The adaptive immune system consists of T and B lymphocytes, with some B lymphocytes further differentiating into plasma cells that secrete antibodies and make up the humoral immune system. Extramedullary plasmacytoma, mucosa-associated lymphoid tissue (MALT) lymphoma, and plasmablastic lymphoma are all plasma cell-rich lymphoid neoplasms that rarely present in the female genital tract. To date, few case reports of these malignancies arising within the uterine cervix exist.

Case Presentation

This case report describes a 52-year-old perimenopausal woman who presented to her primary obstetrician-gynecologist for an annual exam with the complaint of light spotting following an endometrial ablation that occurred …

Sustained Supraventricular Tachycardia While In Active Phase Labor, Austin Gold, Mona Sadek

HCA Healthcare Journal of Medicine

Background

Supraventricular tachycardia (SVT) is one of the most common tachyarrhythmias found in young women, and SVT can be exacerbated by pregnancy. The symptoms associated with SVT frequently overlap with physiologic changes and symptoms of pregnancy which can lead to delayed or missed diagnosis.

Case Presentation

We describe the presentation and the acute management of a patient who had sustained SVT that developed during the active phase of labor. We then detail the varying management approaches of SVT in pregnancy and labor as well as refractory management options. Maternal monitoring will also be discussed as this case shows how an …

Diagnostic Stewardship Cutoffs For Urinalysis Results Prior To Performing A Urine Culture: Analysis Of Data From A Healthcare System, Deborah Kupferwasser, Amy Y. Kang, Liz Chen, Holly K. Huse, Loren G. Miller

Pharmacy Faculty Articles and Research

Background Urinary Tract Infections (UTIs) are commonly overdiagnosed. Some labs conduct urinalysis (UA) as a preliminary screening before proceeding to urine culture to reduce processing unnecessary samples. However, the optimal UA cutoffs for this diagnostic stewardship intervention are not well defined.

UA squamous epithelial cells were not graphed b/c the value crossed the diagonal at multiple points. Methods We performed a retrospective, cross-sectional analysis of urine studies performed from 2/1/21-1/31/23 at the Los Angeles County Department of Health Services (4 medical centers & 20 clinics). We examined patient encounters in which a UA was ordered synchronously with a urine culture. …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Interventions To Prevent And Manage Infections In Pregnancy, Rahima Yasin, Li Jiang, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Background: Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.
Summary: We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and …