Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and ...

A Novel In Vitro Method For Pelvic Floor Dysfunction In Pcos Women, Ruben Vila

University Honors Theses

Background:

Poly Cystic Ovary Syndrome and Pelvic Floor Dysfunction are reproductive diseases with comorbidities whose novel relationship deserves further investigation.

Methods:

Levator Ani Muscle/Paravaginal Attachment was dissected from female Rhesus Macaque and subjected to tissue dissociation. Cells were treated with serum level hormones E2, T, and DHT. PCR, ICC, and IHC were used, followed by statistical analysis.

Results:

RNA analysis show differences in relative expression for endpoints ER, PR, AR, Ki-67, Col1A, and Vimentin. IHC along with ICC showed expression and localization in vivo.

Conclusions:

A novel in vitro model was created from macaque Levator Ani Muscle/Paravaginal Attachment ...

The Ways In Which Women’S Suffrage Affected Healthcare, Madison M. Weber

The Review: A Journal of Undergraduate Student Research

The 19th Amendment had and continues to have a major impact on women’s healthcare in the United States. Prior to suffrage, women had little to no ability to voice their thoughts on and change policies that regarded their own health. This essay addresses the way in which the vote both directly and indirectly impacted healthcare; including workplace conditions, maternal and reproductive rights, racial disparities, political advocacy and healthcare, the different waves of feminism, and how this has all affected modern healthcare for women. From progressive articles being published in women's magazines, to the establishment of marital rape, to ...

The Challenge Of Maternal Mortality

Proceedings in Obstetrics and Gynecology

The Challenge of Maternal Mortality, University of Iowa Obstetrics and Gynecology Postgraduate Virtual Conference, November 20, 2020.

Poster presentations.

Thin Endometrial Lining During Frozen Embryo Cycles: A Case-Control Study Of Risk Factors And Natural History, Emily A. Jacobs, Karen M. Summers, Amy E. Sparks, Bradley J. Van Voorhis

Proceedings in Obstetrics and Gynecology

Objective: To identify predictors of thin endometrial lining in the first frozen embryo transfer cycles and to characterize the natural history of this condition over subsequent cycles.

Design: Retrospective case-control study

Conclusions: This study shows that prognosis after a diagnosis of thin endometrial lining is favorable. Lower weight and thinner fresh cycle lining are predictors of thin endometrial lining in FET cycles. Most importantly, women with a diagnosis of thin endometrial lining have similar live birth rates as those with adequate endometrial lining, although their time to achieve live birth is slightly longer.

Quantitative Blood Loss: A Validation Study, Keely K. Ulmer, Stephanie Radke, Kelli Ryckman

Proceedings in Obstetrics and Gynecology

Objective: To determine if quantitative blood loss would correlate to predicted blood loss based on change in blood concentration of hemoglobin.

Conclusion: The correlation between calculated blood using modified Brecher’s formula showed poor overall correlation to quantitative blood loss. There was a higher correlation at blood loss greater than 1500 cc which is where estimated blood loss has been shown to be most poor. Possible reasons for this poor correlation include maternal factors influencing hemoglobin levels, gestational age, error in blood loss calculation, inaccuracy of Brecher’s formula in pregnancy.

Upstream Oncology: Identifying Social Determinants Of Health In A Gynecologic Oncology Population, Anne E. Nora, Megan E. Mcdonald, Craig H. Syrop, Michael L. Haugsdal

Proceedings in Obstetrics and Gynecology

Introduction: Social determinants of health (SDoH) are the factors that affect a patient’s health quality and outcomes and contribute to health disparities. Evidence suggests that clinical care contributes only 20% to patients’ health outcomes, while the remainder is under the influence of upstream factors. The upstream approach to healthcare aims to address SDoH before they contribute to less ideal outcomes downstream. Several SDoH may contribute to outcomes for cancer patients. This Upstream Gynecologic Oncology Initiative seeks to identify which SDoH affect a population of patients with gynecologic malignancies.

Hypothesis: This study hypothesizes that women receiving care for gynecologic malignancies ...

Covid-19 Related Complete Blood Count Changes Among Asymptomatic Pregnant Women, Waleed F. Gharib, Hesham Nasser, Ahmed M.A. Sobh, Rasha E. Khamees

Proceedings in Obstetrics and Gynecology

Objective: To evaluate complete blood count (CBC) changes that suggest coronavirus disease-2019 (COVID-19) among asymptomatic pregnant women attending routine antenatal care

Methods: A cross-sectional study included 187 healthy pregnant women who were attending the antenatal care clinic of a tertiary University hospital between March and June 2020. After a thorough history and examinations, a venous blood sample was taken from each participant for complete and differential blood counts. Those who showed CBC findings suggestive of COVID-19 were further scheduled for a nasopharyngeal swab for detection of SARS-CoV-2 specific antigens through polymerase chain reaction (PCR).

Results: We found 5.3% (n ...

Sarah A. Shaffer, Do, Mme

Proceedings in Obstetrics and Gynecology

Sarah A. Shaffer, DO, MME.

University of Iowa Hospitals and Clinics. Clinical Associate Professor of Obstetrics and Gynecology-General Obstetrics and Gynecology

Department of Obstetrics and Gynecology Clerkship Director - Obstetrics & Gynecology. University of Iowa Carver College of Medicine, Iowa City, Iowa

The Impact Of Adding Fetal Mri To Sonographically Diagnosed Intrauterine Ventriculomegaly: A Prospective Cohort Study, Mostafa Mahmod, Sara M. Ragaee, Soha T. Hamed, Ahmed Abbas, Mohamed A.F. Mourad

Proceedings in Obstetrics and Gynecology

Objective: Intrauterine fetal ventriculomegaly (IVM) is one of the most commonly detected fetal anomalies. Prenatal diagnosis in IVM is considered a challenge with a significant impact on management. The current study aims to evaluate the added value of performing fetal MRI to sonographically diagnosed IVM.

Methods: A prospective cohort study was conducted at a tertiary University Hospital in the period between January 2017 and March 2019. We included pregnant women with a single fetus sonographically diagnosed IVM (symmetrical or asymmetrical). First, a basic obstetric sonographic examination was done, followed by a detailed (2D/3D) fetal CNS anomaly scan for the ...

Efficacy And Safety Of Elagolix In The Treatment Of Endometriosis Associated Pain: A Systematic Review And Network Meta-Analysis, Omar M. Mattar, Lubaba O. Namous, Mohamed Ros, Mohamed Fathi, Fares A. Elgendy, Shrouk M. Elghazaly, Ahmed H. Ibrahim, Ahmed Gadallah, Esraa Abdelmon'em M Faraag, Omnia Sayed, Ahmed Samy, Ahmed M. Abbas

Proceedings in Obstetrics and Gynecology

Background: Endometriosis commonly presents with dysmenorrhea, non-menstrual pelvic pain, and infertility. Elagolix is an oral, short-acting, gonadotropin-releasing hormone antagonist acting through complete estrogen suppression.

Objective: To evaluate the evidence from published randomized controlled trials (RCTs) about the efficacy and safety of Elagolix in the treatment of endometriosis associated pain.

Search strategy: Electronic databases containing articles published between January 2000 and February 2020 were searched using the MeSH terms (Elagolix OR gonadotropin-releasing hormone antagonist OR GnRH antagonist OR antigonadotropin) AND (endometriosis) AND (pelvic pain).

Selection criteria: All RCTs assessing the efficacy of Elagolix in the treatment of pain associated with endometriosis ...

Effect Of Dexamethasone On Reducing Pain And Gastrointestinal Symptoms Associated With Cesarean Section: A Systematic Review And Meta-Analysis, Mohamed Abdelmonem, Fatma M. Sayed, Omar M. Mohammed, Ahmed K. Abdeltawab, Hanaa Abdelmonem, Manar M. Hosny, Ahmed T. Masoud, Ahmed Samy, Ahmed M. Abbas

Proceedings in Obstetrics and Gynecology

Background: Dexamethasone has analgesic and antiemetic actions that have been documented in the literature. Therefore, we performed a systematic review and meta-analysis to investigate its overall effectiveness in reducing a variety of negative outcomes after cesarean section.

Objectives: To investigate the efficacy and safety of dexamethasone for reducing pain associated with cesarean section, nausea, vomiting, pruritus, postoperative need for analgesia, postoperative antiemetic requests and headache.

Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science for relevant clinical trials. We then performed a systematic review and meta-analysis, including only randomized, placebo-controlled clinical trials. Our main population target was women ...

Ferumoxytol For The Treatment Of Iron Deficiency And Iron-Deficiency Anemia Of Pregnancy., Jesse Gerb, William Strauss, Richard Derman, Vanessa Short, Phd, Mph, Ben Mendelson, Huzefa Bahrain, Michael Auerbach

Department of Obstetrics and Gynecology Faculty Papers

Introduction: A litany of recent evidence supports the morbidity of intra-natal iron-deficiency anemia and its prodrome, iron deficiency. Oral iron administered during second and third trimesters does not get to the developing fetus if the mother is iron deficient. This is especially concerning as the rapidly developing fetal brain is in particular need of iron sufficiency. Intra-natal iron deficiency is associated with autism, schizophrenia and abnormal brain structure. The obstetrical literature reports an unacceptably high incidence of gastrointestinal adverse events with oral iron. The time iron honored standard in the United States for intravenous iron replenishment in gravidas is iron ...

Unique Evaluation And Management Considerations For Adolescents With Late Gynecologic And Colorectal Issues In The Setting Of Anorectal Malformations, Wendy Jo Svetanoff

Research Days

Background: Females born with anorectal malformations (ARMs) and bladder exstrophy have a greater incidence of Mullerian and genital anomalies requiring early gynecologic assessment and frequent surgical intervention. However, there is little guidance for management considerations of pubertally identified Mullerian anomalies in these patients

Objectives/Goal: We sought to assess the unique colorectal, gynecologic, and psychological issues present during the adolescent years.

Methods/Design: A retrospective review was performed of 10-25 year old female patients born with an ARM, cloaca, or exstrophy that presented to our multidisciplinary clinic between 2009 and 2019. Data abstracted included the presenting problem, history, imaging studies ...

Do Males With 45,X/46,Xy Mosaicism Have Turner Syndrome, Michelle Knoll

Research Days

Background: Patients with 45,X/46,XY mosaicism can have genitalia spanning the range from typical female to typical male, and the sex assigned at birth is often based on the appearance of the genitalia. According to current nomenclature, only the subgroup assigned female are diagnosed with Turner syndrome (TS) (Gravholt et al, 2017). Clinical practice guidelines recommend that girls with TS be screened for several comorbidities, including short stature, cardiac and renal anomalies, and autoimmune conditions, but there are no recommendations for screening of boys with 45,X/46,XY mosaicism.

Objectives/Goal: We sought to determine if boys ...

Polycystic Ovarian Syndrome For The Pcp, Madeline Taskier, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Define PCOS
• Outline varying diagnostic criteria
• Briefly review pathophysiology and diagnostic approach
• Review primary care management of PCOS symptoms
• Summarize role of PCP for clinical monitoring
• Explore influence of PCOS on fertility and pregnancy

Education Combined With Reminder Strategies To Improve Cervical Cancer Screening Rates, Christina E. Mclean

Evidence-Based Practice Project Reports

Cervical cancer is the second most common cancer among women worldwide and a leading cause of death in some countries (Jayasekara, 2020). Approximately 13,800 cases of cervical cancer were diagnosed in the U.S. last year, and about 4,290 women died (American Cancer Society [ACS], 2020). Regular cervical cancer screening (CCS) reduces morbidity and mortality, but screening rates are low in the U.S. and at the project site (ACS. 2020). The purpose of this evidence-based practice (EBP) project was to increase CCS at a Federally Qualified Health Center (FQHC) with six clinic locations in Northwest Indiana; the ...

Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk

Evidence-Based Practice Project Reports

The standard of care in the treatment for women diagnosed with breast cancer includes identification and biopsy of the sentinel lymph nodes (SLN) of the breast (Chaterjee et al., 2017; Kneece, 2017). The process of identifying the SLNs involves radioisotope injections into or near the areola. Because this area is highly sensitive, women report this procedure to be considerably painful. The purpose of this evidence-based practice (EBP) project was to determine if the provision of a 5-minute session of guided imagery (GI), as a complementary alternative medicine, prior to SLN injections was effective in mitigating reports of procedural pain. A ...

Perceived Stress May Mediate The Relationship Between Antenatal Depressive Symptoms And Preterm Birth: A Pilot Observational Cohort Study, Sharifa Bashir Lalani, Aliyah Dosani, Ntonghanwah Forcheh, Shahirose Sadrudin Premji, Sana Siddiqui, Kiran Shaikh, Ayesha Mian, Ilona S Yim Ilona S Yim, Maternal-Infant Global Health Team (Might) Collaborators In Research

School of Nursing & Midwifery

Background: Screening for changes in pregnancy-related anxiety and depressive symptoms during pregnancy may further our understanding of the relationship between these two variables and preterm birth.
Objectives: To determine whether changes in pregnancy-related anxiety and depressive symptoms during pregnancy influence the risk of preterm birth among Pakistani women; explore whether perceived stress moderates or mediates this relationship, and examine the relationship between the various components of pregnancy-related anxiety and preterm birth.
Methods: A prospective cohort study design was used to recruit a diverse sample of 300 low-risk pregnant women from four centers of Aga Khan Hospital for Women and Children ...

Loss Of Obstetric Services In Rural Appalachia: A Qualitative Study Of Community Perceptions, Caroline R. Efird, David Dry, Rachel F. Seidman

Journal of Appalachian Health

Background: As rural hospitals across the United States increasingly downsize or close, the availability of inpatient obstetric services continues to decline in rural areas. In rural Appalachia, the termination of obstetric services threatens to exacerbate the existing risk of adverse birth outcomes for women and infants, yet less is known about how the cessation of these services affects the broader community.

Purpose: The purpose of this paper is to explain how the loss of local obstetric services affects perceptions of healthcare among multi-generational residents of a remote, rural Appalachian community in western North Carolina.

Methods: An interdisciplinary team of researchers ...