Obstetrics and Gynecology Commons^™

Calcium Carbonate As A Potential Intervention To Prevent Labor Dystocia: Narrative Review Of The Literature, Sabahat Raees, Marie Forgie, Rita Mitchell, Emily Malloy

Journal of Patient-Centered Research and Reviews

Anecdotally, there are attestations from clinicians of calcium carbonate being used successfully for laboring people experiencing labor dystocia. The goal of this narrative review was to provide a synopsis of pertinent literature on calcium use in obstetrics to explore the potential benefit of calcium carbonate as a simple and low-cost intervention for prevention or treatment of labor dystocia. To answer how calcium and carbonate physiologically contribute to myometrium contractility, we conducted a literature search of English-language peer-reviewed articles, with no year limitation, consisting of the keywords “calcium,” “calcium carbonate,” “calcium gluconate,” “pregnancy,” “hemorrhage,” and variations of “smooth muscle contractility” and …

Pelvic Actinomycosis: A Case Report, Jacklyn Locklear, Rachel Gilbert, Neelima Sukhavasi, Elizabeth Sutton

Graduate Medical Education Research Journal

Introduction: Actinomycosis is a bacterial infection caused by the gram positive anaerobic bacteria that most commonly infects the cervicofacial region of the body. Rarely, it can infect the pelvis and typically presents in a nonspecific manner.

Case Report: We present a case of a 43 year old female G6P6006 with Paragard® intrauterine device (IUD) who presented with purulent umbilical discharge and pelvic pain. Initial imaging was concerned for gastrointestinal or ovarian malignancy. Patient underwent diagnostic laparoscopy with pelvic washings and hysteroscopy D&C. Operative pathology returned with results for actinomyces (IUD likely source).

Conclusion: While it is established IUDs can be …

Cervical Os Marsupialization In The Initial Management Of A Rare Case Of Obstructive Uterine Didelphys With Ipsilateral Renal Agenesis, Anna K. Roble, Sarah Dreibelbis, Jonathan Buerger, Xuezhi Jiang

Transformative Medicine (T-Med)

Introduction: Uterine didelphys is an uncommon Mullerian anomaly that often is associated with obstructive pathology. Without early intervention, obstruction can progress to potentially fatal complications including pyometra and sepsis. Due to the rarity and variability of this condition, treatment options have not been systematically studied.

Case Description: In this case report, we discuss a 16-year-old female who presented with acute sepsis secondary to pyometra in the setting of chronic dysmenorrhea and purulent vaginal discharge. On imaging, she was found to have uterus didelphys with right renal agenesis and a hypoplastic right cervix along with a pelvic fluid collection. During …

Late-Onset Isolated Myositis Following Transobturator Mid-Urethral Sling: A Case Report, Bruce Lee, Mohamad Mahmoud

Advances in Clinical Medical Research and Healthcare Delivery

Late onset of isolated myositis following a Transobturator (TOT) mid-urethral sling (MUS) is a rare post-operative complication.

A 38-year-old gravida 3 para 3003 with a long standing history of mixed urinary incontinence, Stage 2 anterior prolapse, dysmenorrhea, and abnormal uterine bleeding underwent a hysteroscopy with dilation and curettage, levonorgestrel intrauterine device insertion, anterior colporrhaphy, MUS insertion using the TOT approach and cystoscopy. Eight weeks post-op, she presented to the emergency room with right inguinal and low back pain, difficulty ambulating, and fevers. Magnetic Resonance Imaging (MRI) of the right hip revealed inflammatory fluid collection within the adductor brevis with posterior …

Covid-19 Vaccination Hesitancy In Pregnancy: A Retrospective Cohort Study Of Patients’ Perceptions, Molly Schassberger, Charlotte Kirk, Samantha Fields, Carol Brenner, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

COVID-19 Vaccination Hesitancy in Pregnancy: A Retrospective Cohort Study of Patients’ Perceptions

Schassberger¹, M, MS III, Kirk¹, C, MS III, Fields¹, S, MS III, Brenner¹, C, Ph.D., Bodine², A, M.D.

¹University of New England College of Osteopathic Medicine, Biddeford, Maine

²Berkshire Medical Center, Pittsfield, Massachusetts

Introduction: The COVID-19 vaccination rate of US pregnant individuals of childbearing age was 42.3%, compared to 63.7% of the total population as of 1/15/2022 despite ACOG and CDC recommendations. Our objectives were to determine patients’ perceptions on COVID-19 vaccine safety and efficacy …

The Impact Of Covid-19 Mitigation Measures On Sexual And Reproductive Health In Low- And Middle-Income Countries: A Rapid Review, Elizabeth Ochola, Maheshwari Andhavarapu, Poppy Sun, Abdu Mohiddin, Ferdinand Okwaro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Pandemic mitigation measures can have a negative impact on access and provision of essential healthcare services including sexual and reproductive health (SRH) services. This rapid review looked at the literature on the impact of COVID-19 mitigation measures on SRH and gender-based violence (GBV) on women in low- and middle-income countries (LMIC) using WHO rapid review guidance. We looked at relevant literature published in the English language from January 2020 to October 2021 from LMICs using WHO rapid review methods. A total of 114 articles were obtained from PubMed, Google Scholar and grey literature of which 20 met the eligible criteria. …

Unilateral Agenesis Of Adnexa, Srinidhi Govindarajan, Aishwarya Bhat

Digital Journal of Clinical Medicine

No abstract provided.

Barrier Identification Of Home Blood Pressure Monitoring For Hypertensive Pregnant Patients In The Rio Grande Valley, Johanna Mora, Denise De Los Santos

MEDI 8127 Scholarly Activities Pre-Clerkship

Hypertensive disorders of pregnancy (HDPs) are the major contributors to various maternal and fetal complications. Additionally, these lead to 30,000 maternal, and 500,000 perinatal deaths annually. The delayed diagnosis and treatment during a hypertensive episode of HDPs contributes significantly to its complications. Home blood pressure (BP) monitoring is a process that involves patients monitoring their blood pressure outside the clinical setting, and it has been proven to have benefits by having better blood pressure control in chronic hypertensive patients. Home BP monitoring has also been implemented in pregnant patients in high-income countries, and research has shown that this has not …

A Systematic Literature Review Of Telehealth For Health Equity In Pediatric And Women's Health Care: Promise Vs Reality, Sharanya Chandu

Honors Scholar Theses

Background: Telehealth interventions can transform the healthcare system to improve accessibility, quality of care, and outcomes for women’s obstetric health.

Objective: This literature review seeks to summarize current research to understand the effect of telehealth on women’s obstetrics and gynecology outcomes.

Methods: A literature review was conducted following the PRISMA methodology to identify a set of papers containing information related to obstetrics and maternal health. The search terms used identified telehealth or telemedicine interventions used for obstetric, maternal, or prenatal care from the period 2013-2023. 19 articles were identified and reviewed.

Results: The literature review considered three primary aspects from …

An Investigation Of Oral Sex As A Risk Factor For Recurrent Vaginitis: A Case Study, Humza M. Baig, Kate B. Barker, Joy Zarandy

Research Day

Background:

Recurrent Vaginitis is defined as having three or more confirmed episodes within a year. Recurrence rates of vaginitis have been reported in up to 60% of previously infected women. The most common bacterial cause is due to Gardnerella vaginalis, while Candida albicans is the most common fungal cause; both microorganisms can cause opportunistic infections when imbalances occur in the vaginal environment. Commonly known risk factors include multiple sex partners, unprotected sex, douching, recent antibiotic use, and estrogen therapy.

Case Presentation:

A healthy 34-year-old female is complaining of recurrent episodes of vaginitis since the birth of her son two years …

The End Of Roe V. Wade: Implications For Women's Mental Health And Care, Amalia Londoño Tobón, Eileen Mcnicholas, Camille A Clare, Luu D Ireland, Jennifer L Payne, Tiffany A Moore Simas, Rachel K Scott, Madeleine Becker, Nancy Byatt

Marcus Institute of Integrative Health Faculty Papers

The Supreme Court decision in Dobbs v. Jackson in June 2022 reversed precedent which had previously protected abortion prior to fetal viability as a universal right within the United States. This decision almost immediately led to abortion restrictions across 25 states. The resulting lack of access to abortion care for millions of pregnant people will have profound physical and mental health consequences, the full effects of which will not be realized for years to come. Approximately 1 in 5 women access abortions in the U.S. each year. These women are diverse and represent all American groups. The Supreme court decision, …

Impact Of Osteopathic Manipulative Therapy (Omt) On Morbidity In Pregnant Persons Aged 18-39, Jessica-Sophie Chang Horoschak

Stratford Campus Research Day

Background: Rates of maternal morbidity and mortality in the United States continue to rise.1 Pregnant persons are more vulnerable to stress and morbidities associated with the physiological changes of pregnancy. Low back pain and posterior pelvic pain are of high incidence experienced in pregnant persons.2 Prevention strategies are necessary to improve maternal health outcomes in the United States. Some studies have shown that Osteopathic Manipulative Therapy (OMT) can be an effective treatment modality for pregnant patients experiencing somatic pain. These studies, however, are limited and of small sample size.

Purpose: To examine the current literature on the impact of OMT …

Pregnancy Outcome With In Vitro Fertilization-Embryo Transfer According To Age In Women With Diminished Oocyte Reserve (Dor) Using A Follicle Stimulating Hormone Receptor Up-Regulation Technique, Brooke Neumann, Jerome Check, Carrie Wilson, Michael Sobel, Jung Choe

Stratford Campus Research Day

Objective: About 18 years ago, one of the top IVF centers published a study and found that women with DOR did not have any live deliveries at any age in women with a day 3 serum FSH exceeding 18 mIU/mL. The failure to achieve a live delivery may have been related to the ovarian hyperstimulation regimen with possible down regulation of the FSH receptor needed to produce a key enzyme needed for successful implantation. The purpose of this 25-year retrospective review was to evaluate the efficacy of a specific type of mild stimulation referred to as the FSH receptor up-take …

Evaluation Of Outcome Following Oocyte Retrieval In Women With Marked Diminished Oocyte Reserve (Dor) Where The Only Oocyte Retrieved Was In A Metaphase I State, Brooke Neumann, Jerome Check, Carrie Wilson, Donna Summers, Kathleen Hollahan

Stratford Campus Research Day

OBJECTIVE: To determine if there is value in culturing a metaphase I oocyte to metaphase II followed by intracytoplasmic sperm injection (ICSI), fertilization, then embryo transfer (ET) in women with marked DOR. MATERIALS AND METHODS: A follicle stimulating hormone (FSH) receptor up-regulation technique was used in women whose day 3 serum FSH levels were >12 mIU/mL and/or the serum anti-mullerian (AMH) level was <1ng/mL to mature antral follicle(s) to the dominant follicle stage (average diameter >18) and serum estradiol (E2) >200pg/mL when 10,000 IU human chorionic gonadotropin (hCG) would be given followed by oocyte retrieval 32 hours later. The basic tenet of this follicle maturation technique is to 1) use very little …

Case Report: Uterine Torsion – A Rare Cause Of Right Lower Quadrant Pain, David Ho, James Jung Lee, James Espinosa

Stratford Campus Research Day

Uterine torsions are very rare. In an article by Matsumoto et al published in 2021, only 25 cases have been documented on PubMed in non-gravid females in the past 20 years. Uterine torsion is defined as rotation of the uterus greater than 45 degrees in the long axis. Rotation can occur anywhere between 45 degrees to 180 degrees. The torsion can be due to a congenital anomaly or an obstetrics emergency such as with an ovarian torsion. Uterine torsions presenting as an obstetrics emergency carries the potential for irreversible ischemic damage to the uterus, and just as in ovarian torsion, …

The Vaginal Microbiome Post-Menopause And Urinary Tract Infections, Rifke Anolik, Julia Kiffel, Venkateswar Venkataman

Stratford Campus Research Day

Background: Urinary Tract Infection (UTI) is a condition where pathogens invade the urinary tract and can travel up the urethra and into the bladder. UTIs occur more commonly in females compared to males and in the post-menopausal population this rate increases significantly. While these infections may be asymptomatic, they can also cause severe discomfort and lead to serious and even life threatening complications. Recent investigation into the vaginal microbiome has opened the doors to a possible mechanism behind the increased incidence of UTIs after menopause. Understanding the pathogenesis behind the increased risk of UTIs in the postmenopausal state will allow …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Stratford Campus Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Ovarian Hemorrhagic Cyst In A 42-Year-Old Female Receiving Ivf, Aloysius Ibe, Francesca Dileonardo, Robin Lahr, James Espinosa, Alan Lucerna

Stratford Campus Research Day

We report a case of a 42-year-old female who presented with lower abdominal/pelvic pain and diagnosed with an active hemorrhagic ovarian cyst after undergoing egg retrieval as part of in-vitro fertilization (IVF) treatment. The differential for abdominal pain in women is vast, but for this patient receiving IVF we had to consider ovarian hyperstimulation syndrome and ectopic pregnancy just to name a few examples. It is predictable that most women will suffer from a ruptured ovarian cyst at some point in their lifetime so long as they continue to menstruate.

Improving Access To Community Resources For Mothers In Southern New Jersey, Ariana Blake, Josalynn Maree, Nayarith Lopez, Vanessa Pizutelli

Stratford Campus Research Day

Maternal mortality rates have skyrocketed across the nation. New Jersey specifically has one of the highest rates across all 50 states. According to the New Jersey Maternal Health Report, southern New Jersey has the highest maternal mortality ratio, with 91% of the maternal deaths throughout New Jersey between 2016-2018 being preventable. It is crucial that families are receiving support during pregnancy and postpartum from the health care system and their community in order to reduce this trend. Acenda Integrated Health’s Connecting NJ aims to provide community support by connecting expectant mothers and families with children under the age of 3 …

The Effects Of Prenatal Buprenorphine Exposure On The Neurobehavioral Development Of The Child, Zaineb Zubair, Maryam Zubair, Juan Alonso, Abdullah Zubair

Stratford Campus Research Day

Background: Current guidelines for pregnant women with substance use disorder advise prenatal maintenance of opioid agonist therapy with either buprenorphine or methadone. Despite this rise in prenatal opioid agonist therapy, little is known about the effect of prenatal buprenorphine on the neurobehavioral development of the child. This poses the question: does buprenorphine have a long-lasting effect on the central and peripheral nervous system development and behavior of children who were exposed prenatally?

Methods: A comprehensive literature review identified articles relating to prenatal buprenorphine and neurobehavioral outcomes. Article searches were conducted on PubMed and Dynamed. Publications from 2002 through November 2021 …