Obstetrics and Gynecology Commons^™

Ambient Temperature During Pregnancy And Risk Of Maternal Hypertensive Disorders: A Time-To-Event Study In Johannesburg, South Africa, Chérie Part, Jean Le Roux, Matthew Chersichb, Shobna Sawry, Véronique Filippi, Nathalie Roos, Lee Fairlie, Britt Nakstad, Jeroen De Bont, Stanley Luchters

Institute for Human Development

Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal mortality and morbidity. We evaluate the effects of ambient temperature on risk of maternal hypertensive disorders throughout pregnancy. We used birth register data for all singleton births (22–43 weeks' gestation) recorded at a tertiary-level hospital in Johannesburg, South Africa, between July 2017–June 2018. Time-to-event analysis was combined with distributed lag non-linear models to examine the effects of mean weekly temperature, from conception to birth, on risk of (i) high blood pressure, hypertension, or gestational hypertension, and (ii) pre-eclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, low ...

The Impact Of Therapeutic Neonatal Positioning In The Nicu, Amanda Blaise

2022 Southern California Nursing Research Conference

No abstract provided.

Perceptions And Roles Of Genetic Counselors In Perinatal Palliative Care: Where Are We Now?, Amanda Chamberlain

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

After the identification of a life-limiting fetal diagnosis, a perinatal palliative care (PPC) team can provide specialized medical care and emotional support for the family throughout the pregnancy and after delivery. Although the growth of the field of PPC over the last ten years is well-documented, there is only one study to date that explores the experiences of genetic counselors with regards to PPC. This study seeks to further the understanding of genetic counselors’ current perceptions of, experiences with, and roles in the delivery of PPC.

An edited version of the Perinatal Palliative Care Perceptions and Barriers Scale was used ...

Birth Length Is The Strongest Predictor Of Linear Growth Status And Stunting In The First 2 Years Of Life After A Preconception Maternal Nutrition Intervention: The Children Of The Women First Trial, Nancy F Krebs, K Michael Hambidge, Jamie L Westcott, Ana L Garcés, Lester Figueroa, Antoinette K Tshefu, Adrien L Lokangaka, Shivaprasad S Goudar, Sangappa M Dhaded, Sarah Saleem, Sumera Aziz Ali, Melissa S Bauserman, Richard J Derman, Robert L Goldenberg, Abhik Das, Dhuly Chowdhury

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: The multicountry Women First trial demonstrated that nutritional supplementation initiated prior to conception (arm 1) or early pregnancy (arm 2) and continued until delivery resulted in significantly greater length at birth and 6 mo compared with infants in the control arm (arm 3).

OBJECTIVES: We evaluated intervention effects on infants' longitudinal growth trajectory from birth through 24 mo and identified predictors of length status and stunting at 24 mo.

METHODS: Infants' anthropometry was obtained at 6, 12, 18, and 24 mo after the Women First trial (registered at clinicaltrials.gov as NCT01883193), which was conducted in low-resource settings: Democratic ...

A Comparison Of American Women's Experiences With Both Gestational Surrogate Pregnancies And Spontaneous Pregnancies, Jennifer Lahl, Kallie Fell, Kate Bassett, Frances H. Broghammer, William M. Briggs

Dignity: A Journal of Analysis of Exploitation and Violence

This article evaluates the pregnancy experiences of American women by comparing their spontaneous or non-surrogate pregnancies with their gestational surrogate pregnancies. Data were collected through structured interviews using an online video platform. In total, 96 interviews were conducted. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than during a non-surrogate pregnancy, independent of maternal age or gravidity (OR 11.4, 3.5-36.6; p

Podium Presentation: Racial Inequities And Breastfeeding In A Nicu: A Quality Improvement Project, Emilia C. Garcia

2022 Providence Nurse Research Conference

No abstract provided.

Podium Presentation: Identifying Barriers To Quality Mother-Infant Interactions In The Nicu Through Naturalistic Systematic Observations, Christine Neugebauer, Miranda Cox, Melissa Deckert, Ann M. Mastergeorge

2022 Providence Nurse Research Conference

No abstract provided.

Podium Presentation: Continuous Labor Epidural Placement Trends Among Parturients: An Evidence-Based Practice Project, Aleksandr A. Lyakhov, Teresa Bigand, Amanda Affleck, Kenn Daratha, Kris Daratha

2022 Providence Nurse Research Conference

Background:

Childbirth is very painful, and unmanaged pain may reduce patient satisfaction or lead to other complications. Evidence indicates that pain severity is lower among parturient women administered analgesia via a continuous labor epidural (CLE) and that maternal request is sufficient indication for CLE placement to manage labor pain. In some cases, a medical induction of labor may be scheduled, offering an opportunity for proactive pain management from hospital staff. Yet, trends on timing of CLE placement among parturient women with scheduled labor induction versus spontaneous labor in hospitals in Eastern Washington at one health system are unclear.

Purpose:

The ...

The Development Of Maternal Medication Assisted Treatment Learning Modules, Katie Nadalsky, Rebecca Penders

2022 Providence Nurse Research Conference

No abstract provided.

Ultrasound Of The Endometrium, Parts 1 And 2, Robert D. Harris

PEER Liberia Project

This presentation is part of the PEER Liberia Radiology Lecture Series. It provides an overview for clinicians of ultrasound of the endometrium, including histology, accurate endometrial measurements, and endometrial abnormalities.

Identifying Predictors For Inflammation-Induced Preterm Birth: A Murine Study, Tzu Ning Liu Bs, Jose Galaz Md, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. A large proportion of preterm deliveries is affected by intra-amniotic inflammation, which can occur in the presence (intra-amniotic infection) or absence (sterile intra-amniotic inflammation) of microbes. Studies have shown an association between intra-amniotic inflammation, cervical shortening, and changes in the cervicovaginal microbiome. However, their causal relationships are unknown. This study aims to determine the causality of intra-amniotic inflammation, cervical shortening, and cervicovaginal microbiome alterations.

Methods: Pregnant C57BL/6 dams received an ultrasound-guided intra-amniotic injection of an endotoxin lipopolysaccharide (LPS) or the alarmin interleukin-1 alpha (IL-1 alpha) on ...

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm ...

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up ...

The Molecular Mechanisms Of Hepatic Mitochondrial Dysfunction In Growth-Restricted Offspring With Hyperlipidemia, Shelby L. Oke

Electronic Thesis and Dissertation Repository

Intrauterine growth restriction (IUGR) is a pathological condition characterized by low birth weight and poor organ development. Growth of the fetal liver is often compromised at the expense of other vital organs, thereby leading to hepatic dyslipidemia in the affected offspring. As such, epidemiological studies suggest an inverse relationship between birth weight and long-term metabolic health, while the occurrence of postnatal catch-up growth can exacerbate this relationship. Animal studies have shown that IUGR offspring exhibit impaired mitochondrial function, which likely contributes to the later development of metabolic pathologies. That said, the molecular mechanisms by which mitochondria are affected remain unknown ...

Group B Streptococcus Infection During Pregnancy And Infancy: Estimates Of Regional And Global Burden, Bronner P. Gonçalves, Simon R. Procte, Proma Paul, Jaya Chandna, Alexandra Lewin, Farah Seedat, Artemis Koukounari, Ziyaad Dangor, Shannon Leahy, Amina Abubakar

Institute for Human Development

Background: Group B streptococcus (GBS) colonisation during pregnancy can lead to invasive GBS disease (iGBS) in infants, including meningitis or sepsis, with a high mortality risk. Other outcomes include stillbirths, maternal infections, and prematurity. There are data gaps, notably regarding neurodevelopmental impairment (NDI), especially after iGBS sepsis, which have limited previous global estimates. In this study, we aimed to address this gap using newly available multicountry datasets.

Methods: We collated and meta-analysed summary data, primarily identified in a series of systematic reviews published in 2017 but also from recent studies on NDI and stillbirths, using Bayesian hierarchical models, and estimated ...

Fetal Movement Trials: Where Is The Evidence In Settings With A High Burden Of Stillbirths?, Natasha Housseine, Joyce Browne, Nanna Maaløe, Brenda Sequeira Dmello, Sam Ali, Muzdalfat Abeid, Tarek Meguid, Marcus J. Rijken, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

No abstract provided.

Urban Family Planning In Sub-Saharan Africa: An Illustration Of The Cross-Sectoral Challenges Of Urban Health, Trudy Harpham, Moses Tetui, Robert Smith, Ferdinand Okwaro, Adriana Biney, Judith Helzner, James Duminy, Susan Parnell, John Ganle

Obstetrics and Gynaecology, East Africa

The multi-sectoral nature of urban health is a particular challenge, which urban family planning in sub-Saharan Africa illustrates well. Rapid urbanisation, mainly due to natural population increase in cities rather than rural–urban migration, coincides with a large unmet urban need for contraception, especially in informal settlements. These two phenomena mean urban family planning merits more attention. To what extent are the family planning and urban development sectors working together on this? Policy document analysis and stakeholder interviews from both the family planning and urban development sectors, across eight sub-Saharan African countries, show how cross-sectoral barriers can stymie efforts but ...

Protocol For A Sequential, Prospective Meta-Analysis To Describe Coronavirus Disease 2019 (Covid-19) In The Pregnancy And Postpartum Periods, Emily R. Smith, Erin Oakley, Siran He, Rebecca Zavala, Kacey Ferguson, Gargi Wable Grandner, Ibukun-Oluwa Omolade Abejirinde, Yalda Afshar, Homa Ahmadzia, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

We urgently need answers to basic epidemiological questions regarding SARS-CoV-2 infection in pregnant and postpartum women and its effect on their newborns. While many national registries, health facilities, and research groups are collecting relevant data, we need a collaborative and methodologically rigorous approach to better combine these data and address knowledge gaps, especially those related to rare outcomes. We propose that using a sequential, prospective meta-analysis (PMA) is the best approach to generate data for policy- and practice-oriented guidelines. As the pandemic evolves, additional studies identified retrospectively by the steering committee or through living systematic reviews will be invited to ...

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused on hand hygiene compliance among staff members involved in the C-section procedure. Staff members were observed entering and exiting the operating room to determine if they performed hand hygiene upon entry or exit. Hand hygiene compliance increased by 8.8% among all staff members. Obstetric (OB) nurse hand hygiene compliance increased by 28.6%. While overall hand hygiene compliance increased, it was not statistically significant; however, the increase in OB nurse compliance is statistically significant. Implementation of educating the OB nurses proved to be successful, and future interventions were recommended to continue to monitor and improve hand hygiene compliance.

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically past the initial measuring in L&D – using the Triton Scale and proper documentation of QBL onto EPIC, the hospital’s electronic patient record system (EPIC). This included creating an instructional video for the Triton Scale, flyers on how to document QBL, emails of changes and implementation, and surveys on nurses’ feedback for QBL implementation. Data collection focused on daily auditing of the nurses’ QBL documentation for the first two voids of a vaginal delivery, QBL for the first four hours of enhanced recovery after surgery (ERAS), and the first eight hours ERAS with ambulation. If a patient hemorrhages, the focus shifts to determine when the nurse notified the Medical Doctor (MD) or Obstetric (OB) rapid response. QBL compliance increased by 96% among all nurses in the PP unit. While QBL compliance increased, it was not statistically significant; however, important steps towards attaining this goal were found. Nurses have demonstrated significant improvements in the ability to use the Triton scale and the ability to properly document their ...