Obstetrics and Gynecology Commons^™

Over-Medicalization And Criminalization Of Birth In The United States: Exploring The Outcomes, Meg Wallace 20

Honor Scholar Theses

This paper will examine the effects that over-medicalization and criminalization have had on the state of giving birth in the United States. It will attempt to offer insight on why the United States ranks near the bottom of countries that are considered “developed” in maternal mortality rates and infant mortality rates, despite spending the highest percentage of gross national product on health care. The paper will analyze: the history behind the medicalization of birth in the United States, different methods of over-medicalization, the impacts of unnecessary medical interventions, different incentives driving medicalization, the history of criminalization of pregnant women, the …

Trace Elements In Maternal Serum And Their Relationships With Preterm Birth And Fetal Growth Restriction, Rima Irwinda, Ali Sungkar, Raymond Surya, Valerie Tiempo Guinto

Makara Journal of Health Research

Background: Preterm birth (PTB) and fetal growth restriction (FGR) contribute to high hospital costs. An imbalance in the concentration of the four trace elements (i.e., copper, zinc, iron, and calcium) was shown to be associated with complications during pregnancy. This study aimed to analyze the role of these trace elements in the occurrence of PTB and FGR.

Methods: A search was conducted in PubMed, Cochrane Library, and Ovid. The articles were filtered based on the inclusion and exclusion criteria, and further screening was based on the association of articles with the clinical question. The risk of bias in …

An Investigation Into Differences In The Infant Intestinal Microbiome Based On Method Of Delivery, Savannah Whitney

Senior Honors Theses

The infant intestinal microbiome is greatly influenced by method of delivery in relation to bacterial composition, diversity, and richness. The intestinal tracts of cesarean delivered infants are more likely to be colonized with skin microbiota like Clostridium, Staphylococcus, Streptococcus, and Corynebacterium, and have less bacterial diversity and richness than their vaginally delivered counterparts, who are more likely to be colonized with Bacteroides, Bifidobacterium, and Lactobacillus, which are common vaginal bacteria. These microbial differences make cesarean delivered infants more likely to develop allergies, asthma, eczema, gastrointestinal conditions, obesity, and diabetes, among other diseases. Though vaginal seeding has been proposed …

Encuentros Intergeneracionales: Continuidades Y Reformulaciones En Las Prácticas Militantes De Las Jóvenes Integrantes De Espacios De Acompañamiento De Aborto En La Amba / Intergenerational Encounters: Continuities And Reformulations In The Activist Practices Of The Young Members Of Abortion Accompaniment Spaces In The Amba, Hannah Robinson

Independent Study Project (ISP) Collection

Debido al acceso restrictivo de los abortos legales, en los últimos diez años los espacios de acompañamiento de personas que quieren interrumpir la gestación se han convertido en un sitio importante de la militancia feminista en Argentina. Estos espacios o colectivos brindan información sobre el uso del medicamento misoprostol para abortar, conectan las personas gestantes con profesionales de salud “amigables” que garantizan el acceso al Interrupción Legal del Embarazo, y proveen apoyo durante el proceso de interrupción. Al mismo tiempo, en los últimos cinco años una marea de jóvenes ha entrado masivamente a la militancia feminista.

A través de la …

The Social Dimensions Of Reproductive Health: Analyzing Disparities In Morocco Through Health Indicators And Social Determinants, Mila Sicorsky

Independent Study Project (ISP) Collection

This paper explores the social dimensions of reproductive health in Morocco through a look at its health indicators and social determinants. Existing literature discusses reproductive health differences that run on economic, social, and cultural lines. In this paper, I shed light on how best to measure and understand these disparities. The research shows that reproductive health in Morocco is most accurately indicated by maternal mortality rates (MMR), access to prenatal and postnatal visits, and access to adequate family planning. It also finds that location of residence, economic status, and women’s status are key social determinants of reproductive health in Morocco. …

Midwives’ And Women’S Perception On Moyo Fetal Heart Rate Monitor For Intrapartum Fetal Heart Rate Monitoring; A Cross-Sectional Study, Paschal Mdoe, Anita Yeconia, Fanuel Buu, Simeon Kusulla, Ladislaus Blacy, Estomih Mduma, Godfrey Guga, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Background: The annual global neonatal mortality stands at 2.5 million deaths, 1 million of them dying within the first day of life. An additional 2.6 million are stillborn globally, the majority of them due to intrapartum events. Optimal fetal heart rate (FHR) monitoring has the potential to timely detect fetuses at risk and, if coupled with timely obstetric responses may save more newborns. Moyo is a new Doppler with nine crystals capable of monitoring FHR both intermittently and continuously.

Aim: To assess women’s and midwives’ opinions on the use of Moyo for intrapartum FHR monitoring.

Methods: We conducted a cross-sectional …

Pannus Sign On Ultrasound And Magnetic Resonance Imaging Predicts Placenta Percreta And Is Associated With High Estimated Blood Loss, Karin Fox, Tushar Shetty

Medical Student Research Symposium

Objective: Antenatal identification of the placenta accreta spectrum (PAS) has been estimated to be approximately 50% in multicenter and population based data, with sensitivity and specificity far lower than that reported from referral center cohorts. Easily obtained, objective markers are key to improving antenatal detection. We noted that in many PAS cases, the placenta bulges over the cervical os, like an abdominal pannus over a belt. The depth of the “pannus” can be measured on ultrasound (US) and magnetic resonance imaging (MRI). We predicted that a positive sign can differentiate between percreta and increta/accreta.

Study Design: Retrospective chart review of …

Spontaneous Uterine Rupture Secondary To Morbidly Adherent Placenta In An Unscarred Uterus, Nida Sajjad, Kumail Khandwala, Wasim Memon, Jehanzeb Shahid, Burhan Zafar

Department of Radiology

We report a case of spontaneous uterine rupture in a primigravida with an unscarred uterus, which was secondary to morbidly adherent placenta proven on surgery and histology. Although rare, uterine rupture should be considered as a differential diagnosis of acute abdominal pain in pregnancies, especially when associated with free fluid, even with the absence of vaginal bleeding. Abnormal placentation is associated with spontaneous antepartum uterine rupture even in early pregnancy. Most cases in the literature have advocated emergency hysterectomy to arrest life-threatening hemorrhage.

Flavonoids And Other Polyphenols Act As Epigenetic Modifiers In Breast Cancer., Priyanga Selvakumar, Aja Badgeley, Paige Murphy, Hina Anwar, Urvashi Sharma, Katharine Lawrence, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Breast cancer is a common cancer that occurs due to different epigenetic alterations and genetic mutations. Various epidemiological studies have demonstrated an inverse correlation between breast cancer incidence and flavonoid intake. The anti-cancer action of flavonoids, a class of polyphenolic compounds that are present in plants, as secondary metabolites has been a major topic of research for many years. Our review analysis demonstrates that flavonoids exhibit anti-cancer activity against breast cancer occurring in different ethnic populations. Breast cancer subtype and menopausal status are the key factors in inducing the flavonoid's anti-cancer action in breast cancer. The dose is another key …

Abortion Case May Not Overturn Roe, But Could Effectively Nullify It, A. Benjamin Spencer

Popular Media

No abstract provided.

Labour Progression In Obese Women: Are Women With Increased Body Mass Index Having Unnecessary Cesarean Sections?, Caroline Shenouda, Aloka Wijesooriya, Amanda Toufeili, Michael R Miller, Debbie Penava, Barbra De Vrijer

Obstetrics & Gynaecology Publications

OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes.

METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m

RESULTS: Obese class II and III primiparous women required an additional 1.62 and 2.67 hours (P = 0.012), respectively, to reach a dilation of 10 cm compared with their normal weight counterparts; obese class II and III multiparous women required an …

Artificial Intelligence: A New Paradigm In Obstetrics And Gynecology Research And Clinical Practice, Pulwasha Iftikhar, Marcela V. Kuijpers, Azadeh Khayyat, Aqsa Iftikhar, Maribel Degouvia De Sa

Publications and Research

Artificial intelligence (AI) is growing exponentially in various fields, including medicine. This paper reviews the pertinent aspects of AI in obstetrics and gynecology (OB/GYN) and how these can be applied to improve patient outcomes and reduce the healthcare costs and workload for clinicians.

Herein, we will address current AI uses in OB/GYN, and the use of AI as a tool to interpret fetal heart rate (FHR) and cardiotocography (CTG) to aid in the detection of preterm labor, pregnancy complications, and review discrepancies in its interpretation between clinicians to reduce maternal and infant morbidity and mortality. AI systems can be used …

Characterization Of Urinary Concentrations Of Heavy Metals Among Socioeconomically Disadvantaged Black Pregnant Women, Inkyu Han, Kristina W Whitworth, Xueying Zhang, Masoud Afshar, Pamela D Berens, Elaine Symanski

Faculty, Staff and Student Publications

The objective of this study was to characterize exposures to metals using biological samples collected on socioeconomically disadvantaged black pregnant women. We obtained 131 anonymous urine samples provided by black pregnant women visiting a Medicaid-serving prenatal clinic in Houston, TX, from March 27, 2017 to April 11, 2017. We analyzed urine samples for 15 metals including cadmium (Cd), arsenic (As), lead (Pb), and nickel (Ni) and for creatinine and cotinine. We found that median concentrations of zinc (Zn), selenium (Se), and aluminum (Al) among black pregnant women in this study were 1.5 to 3 times higher than levels reported among …

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman

Michigan Journal of Public Health

Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.

Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …

Development Of An Abbreviated Symptom Score For The Neonatal Abstinence Syndrome., I. Chervoneva, S. C. Adeniyi-Jones, F. Blanco, W. K. Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVE: We sought a shortened MOTHER neonatal abstinence syndrome (NAS) and Finnegan score that would retain comparable performance characteristics of the full instrument.

STUDY DESIGN: Retrospective cohort.

RESULTS: In total, 124,170 MOTHER NAS scores between August 2007 and May 2016 from 775 infants (≥36 weeks) were examined. Classification and regression tree model identified the most important subsets of the scored variables. A 9-element shortened scale yielded >90% sensitivity and specificity to predict clinical endpoints based on the full 19-element MOTHER NAS score. Conversion of the data sets to the Finnegan score, and applying the same procedure resulted in a nine-element …

International Standards For Fetal Brain Structures Based On Serial Ultrasound Measurements From The Fetal Growth Longitudinal Study Of The Intergrowth-21 St Project, Raffaele Napolitano, Malid Molloholli, Vera Donadono, Eric O. Ohuma, Sikolia Wanyonyi, Bryn Kemp, Mohammad K. Yaqub, Stephen Ash, Fernando C. Barros, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Objective: To create prescriptive growth standards for five fetal brain structures, measured by ultrasound, from healthy, well-nourished women, at low risk of impaired fetal growth and poor perinatal outcomes, taking part in the Fetal Growth Longitudinal Study (FGLS) of the INTERGROWTH-21st Project.

Methods: This was a complementary analysis of a large, population-based, multicentre, longitudinal study. We measured, in planes reconstructed from 3-dimensional (3D) ultrasound volumes of the fetal head at different time points in pregnancy, the size of the parieto-occipital fissure (POF), Sylvian fissure (SF), anterior horn of the lateral ventricle (AV), atrium of the posterior ventricle (PV) and cisterna …

Robotic Adrenalectomy For Functional Adenoma In Second Trimester Treats Worsening Hypertension, Courtney Capella, Bs, Joseph Godovchik, Bs, May Jean Counsilman, Md, Thenappan Chandrasekar, Md, Costas D. Lallas, Md, Huda B. Al-Kouatly, Md

Department of Obstetrics and Gynecology Posters

Robotic adrenalectomy is a feasible surgical alternative in the second trimester and can reverse the hypertensive disease and its associated maternal-fetal complications

Improving Utilization Of Aspirin For Prevention Of Preeclampsia In A High Risk Urban Cohort, Rupsa C. Boelig, Md, Mariam Wanees, Ba, Vincenzo Berghella, Md, Amanda Roman, Md

Department of Obstetrics and Gynecology Posters

High risk women without a history of preeclampsia were less likely to be recommended aspirin for preeclampsia prevention. A simple screening tool at 1st trimester ultrasound can significantly improve aspirin utilization for preeclampsia prevention

Association Between Abo Blood Type And Postpartum Hemorrhage By Mode Of Delivery: A Retrospective Cohort Study, Julia Burd, Md, Johanna Quist-Nelson, Md, Sara Edwards, Md, Anju Suhag, Md, Vincenzo Berghella, Md, J. Biba Nijjar, Md

Department of Obstetrics and Gynecology Posters

Background

Patients with type O blood have been reported to have more bleeding complication than those of other pooled blood groups (OR 1.33)

Prior studies on postpartum hemorrhage by blood type

• Yielded mixed results
• Did not separate by mode of delivery