Obstetrics and Gynecology Commons^™

The Effect Of Transvaginal Ultrasound, Vaginal Examination, Or Coitus On Fetal Fibronectin Results: A Systematic Review, Ariel Levy, Md, Johanna Quist-Nelson, Md, Vincenzo Berghella, Md

Department of Obstetrics and Gynecology Posters

Cervical manipulation via transvaginal ultrasound or sterile vaginal examination does not significantly affect fetal fibronectin results; therefore its use after these exposures is clinically acceptable. Conversely, fFN use in the setting of recent coitus should continue to be discouraged.

Impact Of A Multidisciplinary Program On Pregnancy Outcomes In The Setting Of Placenta Accreta Spectrum, Joanne Quiñones Md, Msce, Chelsea Giagni Md, Jose Lazaro Md, Meredith Rochon Md, John C. Smulian Md, Mph, William E. Scorza Md

Department of Obstetrics & Gynecology

No abstract provided.

Point-Of-Care Hpv Molecular Diagnostics For A Test-And-Treat Model In High-Risk Hiv Populations, Shahin Sayed, Michael Chung, Marleen Temmerman

Pathology, East Africa

Strategies for cervical cancer prevention and control in low-income and middle-income countries (LMICs) require concerted efforts to improve screening and access to treatment, especially in high-risk HIV populations. LMICs bear the largest burden of HIV infection, human papillomavirus (HPV) infection is common among HIV-infected women, risk of cervical cancer is increased in women with HIV/AIDS, and HIV clinics provide opportunities to screen and treat for cervical cancer in this population.

Preconception Nutrition Intervention Improved Birth Length And Reduced Stunting And Wasting In Newborns In South Asia: The Women First Randomized Controlled Trial., Sangappa M Dhaded, K. Michael Hambidge, Sumera Aziz Ali, Manjunath Somannavar, Sarah Saleem, Omrana Pasha, Umber Khan, Veena Herekar, Sunil Vernekar, S. Yogesh Kumar, Jamie E. Westcott, Vanessa R. Thorsten, Amaanti Sridhar, Abhik Das, Elizabeth Mcclure, Richard J. Derman, Robert L. Goldenberg, Marion Koso-Thomas, Shivaprasad S. Goudar, Nancy F. Krebs

Global Health Articles

South Asia has >50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing ≥3 months prior to conception (Arm 1), …

Development Of A Graduate Medical Education Program In Obstetrics And Gynecology In A Community-Based Hospital: Building Blocks And Rate Of Progress, Parker B. Long, Katherine M. Choi Md, Rachael Postlethwait Md, Mohamed Foda Md, Karen Harris Md

OB-GYN

Synopsis

The need for trained obstetricians and gynecologists continues to increase. The ongoing advances in women’s health care requires well trained physicians that can only be achieved by a well-structured residency program that provides a reliable training infrastructure while maintaining a patient centered care model according AGCME standards. This residency program started July 2018 with 4 PGY1 and one PGY2 residents.

Objective

To prospectively look at the rate of growth needed to begin an OBGYN residency program in a community-based hospital.

Methods

For this particular residency program, we started a new OBGYN medical practice and all residents were involved in …

Ivf Errors - Is This Only The Tip Of The Iceberg?, Jody L. Madeira, Steven R. Lindheim Md, Mark P. Trolice

Articles by Maurer Faculty

ART errors are fortunately a rare occurrence. but humans are fallible and mistakes are inevitable. As social media sensationalizes these events, we, as infertility specialists, must be vigilant in reviewing existing risk management systems and consider other options to minimize/eliminate these events. ART programs should work to emphasize honesty and transparency to improve quality of care.

Low-Dose Aspirin For The Prevention Of Preterm Delivery In Nulliparous Women With A Singleton Pregnancy (Aspirin): A Randomised, Double-Blind, Placebo-Controlled Trial., Matthew K. Hoffman, Shivaprasad S. Goudar, Bhalachandra S. Kodkany, Mrityunjay Metgud, Manjunath Somannavar, Jean Okitawutshu, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Abigail Mwapule, Musaku Mwenechanya, Elwyn Chomba, Waldemar A. Carlo, Javier Chicuy, Lester Figueroa, Ana Garces, Nancy F. Krebs, Saleem Jessani, Farnaz Zehra, Sarah Saleem, Robert L. Goldenberg, Kunal Kurhe, Prabir Das, Archana Patel, Patricia L. Hibberd, Emmah Achieng, Paul Nyongesa, Fabian Esamai, Edward A. Liechty, Norman Goco, Jennifer Hemingway-Foday, Janet Moore, Tracy L. Nolen, Elizabeth M. Mcclure, Marion Koso-Thomas, Menachem Miodovnik, R. Silver, Richard J. Derman, Aspirin Study Group

Global Health Articles

BACKGROUND: Preterm birth remains a common cause of neonatal mortality, with a disproportionately high burden in low-income and middle-income countries. Meta-analyses of low-dose aspirin to prevent pre-eclampsia suggest that the incidence of preterm birth might also be decreased, particularly if initiated before 16 weeks of gestation.

METHODS: ASPIRIN was a randomised, multicountry, double-masked, placebo-controlled trial of low-dose aspirin (81 mg daily) initiated between 6 weeks and 0 days of pregnancy, and 13 weeks and 6 days of pregnancy, in nulliparous women with an ultrasound confirming gestational age and a singleton viable pregnancy. Participants were enrolled at seven community sites in …

Elagolix For Heavy Menstrual Bleeding In Women With Uterine Fibroids., William D. Schlaff, Ronald T. Ackerman, Ayman Al-Hendy, David F. Archer, Kurt T. Barnhart, Linda D. Bradley, Bruce R. Carr, Eve C. Feinberg, Sandra M. Hurtado, Jinhee Kim, Ran Liu, R. Garn Mabey, Charlotte D. Owens, Alfred Poindexter, Elizabeth E. Puscheck, Henry Rodriguez-Ginorio, James A. Simon, Ahmed M. Soliman, Elizabeth A. Stewart, Nelson B. Watts, Ozgul Muneyyirci-Delale

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Uterine fibroids are hormone-responsive neoplasms that are associated with heavy menstrual bleeding. Elagolix, an oral gonadotropin-releasing hormone antagonist resulting in rapid, reversible suppression of ovarian sex hormones, may reduce fibroid-associated bleeding.

METHODS: We conducted two identical, double-blind, randomized, placebo-controlled, 6-month phase 3 trials (Elaris Uterine Fibroids 1 and 2 [UF-1 and UF-2]) to evaluate the efficacy and safety of elagolix at a dose of 300 mg twice daily with hormonal "add-back" therapy (to replace reduced levels of endogenous hormones; in this case, estradiol, 1 mg, and norethindrone acetate, 0.5 mg, once daily) in women with fibroid-associated bleeding. An elagolix-alone …

Mentoring Multi-College Bystander Efficacy Evaluation – An Approach To Growing The Next Generation Of Gender-Based Interpersonal Violence Intervention And Prevention (Vip) Researchers, Ann L. Coker, Danielle Davidov, Heather M. Bush, Emily R. Clear

Obstetrics and Gynecology Faculty Publications

The Centers for Disease Control and Prevention provided funding (U01 CE002668) to evaluate bystander program efficacy to reduce gender-based violence on college campuses (Aim 1) and to create a mentoring network (Aim 2) for young campus-based researchers interested in violence intervention or prevention (VIP). While an evaluation of this mentoring program is ongoing, our purpose here was to document the strategies used to create, implement, and begin evaluation of this national multi-college mentoring network. As each public college was recruited into this evaluation named multi-college Bystander Efficacy Evaluation (mcBEE), each college was invited to nominate a researcher interested in receiving …

Prenatal Diagnosis Of Absent Right Superior Vena Cava In Referrals For Fetal Echocardiography, Ruben J. Acherman, William N. Evans, Humberto Restrepo

School of Medicine Faculty Research

A persistent LSVC with an absent right superior vena cava (RSVC) is unusual, encountered in about 10% of patients with persistent LSVC. We present 14 patients with a prenatal diagnosis of single LSVC and situs solitus, including prenatal findings and information on medium-term follow-up. We identified patients with situs solitus and a persistent LSVC born between March 2004 and March 2020, which had been diagnosed prenatally between December 2003 and November 2019. From this cohort, we identified those with absent RSVC. In the population of women undergoing fetal echocardiography, the prevalence of persistent LSVC in situs solitus was 0.43% (84/19,712). …

Why Do Women Deliver Where They Had Not Planned To Go? A Qualitative Study From Peri-Urban Nairobi Kenya., V. Naanyu, V. Mujumdar, C. Ahearn, M. Mcconnell, J. Cohen

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: In urban Kenya, couples face a wide variety of choices for delivery options; however, many women end up delivering in different facilities from those they had intended while pregnant. One potential consequence of this is delivering in facilities that do not meet minimum quality standards and lack the capacity to provide treatment for obstetric and neonatal complications.

METHODS: This study investigated why women in peri-urban Nairobi, Kenya deliver in facilities they had not intended to use. We used 60 in-depth audio-recorded interviews in which mothers shared their experiences 2-6 months after delivery. Descriptive statistics were used to summarize socio-demographic …

Deliver On Your Own: Disrespectful Maternity Care In Rural Kenya, Adelaide Lusambili, Violet Naanyu, Terrance J. Wade, Lindsay Mossman, Michaela Mantel, Rachel Pell, Angela Ng'etich, Kennedy Mulama, Lucy Nyaga, Jerim Obure, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Under the Free Maternity Policy (FMP), Kenya has witnessed an increase in health facility deliveries rather than home deliveries with Traditional Birth Attendants (TBA) resulting in improved maternal and neonatal outcomes. Despite these gains, maternal and infant mortality and morbidity rates in Kenya remain unacceptably high indicating that more needs to be done.

Aim: Using data from the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project’s qualitative gender assessment, this paper examines women’s experience of disrespectful care during pregnancy, labour, and delivery. The goal is to promote an improved understanding of the actual care conditions …

Pregnancy And Neonatal Outcomes In Sars-Cov-2 Infection: A Systematic Review., R. S. Chamseddine, F. Wahbeh, F. Chervenak, L. J. Salomon, B. Ahmed, A. Rafii

Journal Articles

With the emergence of SARS-CoV-2 and its rapid spread, concerns regarding its effects on pregnancy outcomes have been growing. We reviewed 245 pregnancies complicated by maternal SARS-CoV-2 infection across 48 studies listed on PubMed and MedRxiv. The most common clinical presentations were fever (55.9%), cough (36.3%), fatigue (11.4%), and dyspnea (12.7%). Only 4.1% of patients developed respiratory distress. Of all patients, 89.0% delivered via cesarean section (n = 201), with a 33.3% rate of gestational complications, a 35.3% rate of preterm delivery, and a concerning 2.5% rate of stillbirth delivery or neonatal death. Among those tested, 6.45% of newborns were …

Ectopic Pregnancy In A Woman With T9 Ais A Paraplegia Secondary To High-Grade Spinal Cord Pilocytic Astrocytoma, Elisabeth K. Acker

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Ectopic pregnancy in a woman with T9 AIS A (motor complete, sensory complete) paraplegia secondary to a high-grade spinal cord pilocytic astrocytoma

Background

In the United States, 20,000 women of childbearing age have a spinal cord injury (SCI). While SCI induces transient amenorrhea immediately after injury, women generally have normal reproductive function after SCI, and their fertility is unimpaired. Medications that commonly manage complications of SCI should be avoided or discontinued during pregnancy. Complications inherent to SCI, including urologic issues, are often exacerbated during pregnancy.

Methods

This is a case report on a female Veteran who initially presented to the …

Adherence And Acceptability Of Telehealth Appointments For High-Risk Obstetrical Patients During The Coronavirus Disease 2019 Pandemic., S. Jeganathan, L. Prasannan, M. J. Blitz, N. Vohra, B. Rochelson, N. Meirowitz

Journal Articles

Background: Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high-risk obstetrics and whether the implementation of a telehealth model improves access to care in nonrural settings.

Objective: This study aimed to describe patient and provider attitudes toward telehealth for the delivery of high-risk obstetrical care in a large healthcare system with both urban and suburban settings and to determine whether the implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.

Study Design: Two self-administered surveys were designed. …

Pregnant Vs Nonpregnant Severe Acute Respiratory Syndrome Coronavirus 2 And Coronavirus Disease 2019 Hospital Admissions: The First 4 Weeks In New York, A Tekbali, A Grünebaum, A Saraya, L Mccullough, E Bornstein, Fa Chervenak

Journal Articles

No abstract provided.

Maternal Mortality Among Women With Covid-19 Admitted To The Intensive Care Unit., Mj Blitz, B Rochelson, N Meirowitz, L Prasannan, Tj Rafael, S Chakravarthy, La Bracero, Sw Wasden, Sl Pachtmanshetty, O Santandreu, Fa Chervenak, Bm Schwartz, M Nimaroff, +2 Additional Authors

Journal Articles

No abstract provided.

Intensive Care Unit Admissions For Pregnant And Nonpregnant Women With Coronavirus Disease 2019, M J. Blitz, A Grünebaum, A Tekbali, E Bornstein, B Rochelson, M Nimaroff, Fa Chervenak

Journal Articles

No abstract provided.

Maternal Mortality Among Women With Coronavirus Disease 2019 Admitted To The Intensive Care Unit, Mj Blitz, B Rochelson, H Minkoff, N Meirowitz, L Prasannan, V London, Tj Rafael, S Chakravarthy, La Bracero, Sw Wasden, Sl Pachtman Shetty, O Santandreu, Fa Chervenak, Bm Schwartz, M Nimaroff

Journal Articles

No abstract provided.

Racial And Ethnic Disparity And Spatiotemporal Trends In Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence On Obstetrical Units In New York., M. J. Blitz, B. Rochelson, L. Prasannan, W. Shan, F. A. Chervenak, M. Nimaroff, E. Bornstein

Journal Articles

No abstract provided.