Obstetrics and Gynecology Commons^™

Mesonephric-Like Adenocarcinoma Of The Ovary With Co-Existent Endometriosis: A Case Report And Review Of The Literature, K. Seay, T. Akanbi, B. Bustamante, S. Chaudhary, G. L. Goldberg

Journal Articles

© 2020 The Authors Introduction: Mesonephric-like adenocarcinoma (MLA) is a rare malignant gynecologic neoplasm occurring in the uterine corpus and ovary. The morphological and immunohistochemical characteristics of MLA closely resemble that of cervical mesonephric adenocarcinomas, but whether they share a common histogenesis remains unclear. Two main theories for histogenesis of MLAs include the origination of these neoplasms from mesonephric remnants, as is the case for cervical mesonephric adenocarcinoma, versus the differentiation along a mesonephric pathway from Mullerian lesions. Case: A 67-year-old presented after a right salpingo-oophorectomy for a complex ovarian mass revealed a mesonephric-like adenocarcinoma of the ovary and endometriosis. …

Prediction Of Neonatal Birthweight Associated With Maternal Obesity And Diabetes, Laura Gleason, Rebekah Mccurdy, Md, Mph

Phase 1

Introduction: To design a model that will predict neonatal birth weight within obese mothers by diabetic status.

Methods: A secondary data analysis of an RCT (NCT 02909582) was utilized to create a neonatal birth weight prediction model. Women (n=325) with a BMI > 35 kg/m2 from a tertiary academic institution, 2016 – 2019, were included to estimate the risk of large for gestational age (LGA) infants and neonatal birth weight based on maternal prepregnancy BMI and diabetic status. LGA was defined as an infant birth weight > 90th percentile. Analysis included Chi-square, t-test, multivariate logistic and linear regression.

Results: Mean birthweight did …

Prenatal Perception Of Wic Breastfeeding Recommendation Affects First Month Postpartum Breastfeeding Outcomes, Qi Zhang, Lamichhane Rajan, Joanne Guthrie

Community & Environmental Health Faculty Publications

No abstract provided.

Obstetric Training In The Southeast Us: A 2019 Cera Study, Julia Fashner, Christy Cavanagh, Aimee Eden

OB-GYN

Purpose: To describe obstetric training in Southeast family medicine residencies in 2019. To determine factors that contribute to continuity deliveries, vaginal deliveries and residents who continue OB after graduation.

Methods: A survey of family medicine program directors was conducted in 2019. We took the answers from the 32 South Atlantic program directors that completed the survey questions of interest. We used chi-square tests and Kruskal-Wallis rank test to compare variables. STATA 14 was used for analysis.

Results: Half of the programs had graduates with10% of graduates continue OB after graduation. The following factors were significant for graduates who continue OB: …

Does Maternal Methadone Dose Correlate With Severity Of Intrauterine Growth Restriction In Infants With Neonatal Abstinence Syndrome?, D. Friedman, J. Smith, M. Lafferty, Z. H. Aghai

Phase 1

Introduction : Previous studies demonstrate a relationship between maternal opioid use during pregnancy and smaller head circumference of infants with neonatal abstinence syndrome (NAS). The goal of this study is to correlate maternal methadone dose and severity of growth restriction in infants with NAS admitted to the neonatal intensive care unit (NICU).

Methods: This is a retrospective analysis of infants (≥35 weeks gestation) exposed to in utero methadone, born between August 2006 and May 2018, and admitted to a Philadelphia NICU for medical therapy for NAS. Growth parameters (birth weight, birth length, and birth head circumference) were compared between infants …

Evaluating The Utility Of Diagnostic Workups For Biliary Atresia In Neonates With Cholestatic Jaundice Following Prolonged Tpn, Melissa Austin, Zubair H. Aghai

Phase 1

Introduction: Parenteral nutrition associated cholestasis (PNAC) develops in 40-60% of premature infants following TPN for 2-4+ weeks. The incidence of biliary atresia is low and there is a 60-day, post-term window for corrective surgery. There is limited data on both the natural history of PNAC in premature infants following prolonged TPN, as well as the utility of diagnostic tools investigating biliary atresia in these patients.

Methods: A retrospective chart review using EMR data from the Intensive Care Nursey was performed with the following criteria: premature babies diagnosed with cholestasis, born at <1500 grams, and received TPN for 14 days. Ultimately 61 babies met criteria and data was collected and pooled to produce descriptive statistics and graphs describing laboratory trends.

Results: Median gestational age was 26 [IQR 25, …

The Utility Of Performing Cervical Length Follow-Up In Lower Risk Singleton, Varsha Kripalu, Rupsa Boelig, Md

Phase 1

Introduction: Short cervical length (<25 mm) during pregnancy is known to be an increased risk factor for preterm birth (<37 weeks). While interventions exist for women who have had prior preterm births, it is important to investigate the cost effectiveness of screening low risk women with an intermediate cervical length (26-29 mm).

Objective: To quantify the association between change in cervical length on follow up and the incidence of preterm birth in otherwise low risk women with an initial intermediate cervical length.

Methods: A retrospective cohort study was conducted, reviewing 108 charts of women who had an initial screening between 26 and 29 mm. Charts were reviewed for whether or not a follow-up ultrasound was recommended, whether or not the follow-up was performed, and the outcome of their deliveries.

Results: 93.5% (N=101) of women were recommended to get a follow-up ultrasound and 84% (N=85) completed their follow-up. …

Electronic Fetal Monitoring Credentialing Examination: The First 4000., Mark Tomlinson, Sara A Brumbaugh, Marin O'Keeffe, Richard L Berkowitz, Mary D'Alton, Michael Nageotte

Articles, Abstracts, and Reports

No abstract provided.

Impact Of Excess Weight Gain On Risk Of Postpartum Infection In Class Iii Obesity, Courtney J. Mitchell, Lamani Adkins, Ann Tucker, Haywood Brown, Anne Siegel, Sarah Dotter-Katz

Obstetrics & Gynecology Faculty Publications

Objective: To assess the impact of gestational weight gain >20 pounds (more than Institute of Medicine [IOM] recommendations) on postpartum infectious morbidity in women with class III obesity.

Methods: This is a retrospective cohort of term, nonanomalous singleton pregnancies with body mass index ≥40 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, and missing weight gain data are excluded. Primary outcome is a composite of postpartum infection (endometritis, urinary tract, respiratory, and wound infection). Secondary outcomes include components of composite, wound complication, readmission, and blood transfusion. Bivariate statistics compared demographics, pregnancy complications, …

Fmic Annual Report 2020 | Pashto (پشتو), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2020 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2020 | Dari (دری), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

The Effect Of Perceived Physician Opinion On Breastfeeding In Women With Opioid Use Disorder Who Are Receiving Medication-Assisted Treatment, Lacey Murray, Meghan Gannon, Phd, Vanessa Short, Phd, Mph

Phase 1

Women who receive medication-assisted treatment (MAT) for opioid use disorder (OUD) are less likely to breastfeed than the general population despite the many possible benefits to the newborn. The ongoing study examines the effect of perceived physician opinion on the outcome of breastfeeding in women receiving MAT for OUD. Women who were receiving MAT for OUD at Thomas Jefferson University’s Family Center were given a survey during their third trimester (n=45), and at 1 month postpartum (n=33) to gather information on the perceived opinion of their physicians on how they should feed their baby and the importance of those opinions. …

Down Regulation With Luteal Gnrh Agonist Therapy In Euploid Embryo Transfers Does Not Impact Pregnancy Rates, Isabelle Levin, Keri Bergin, Md, Dmitry Gounko, Joseph Lee, Alan Copperman, Md

Phase 1

Introduction : Gonadotropin-releasing hormone (GnRH) agonists have been used during assisted reproductive technology (ART) treatment for pituitary suppression and stimulation. Currently, clinical opinion is divided about whether GnRH agonist therapy improves pregnancy rates when used for luteal down-regulation in a frozen euploid embryo transfer (FET). This study evaluated the clinical utility of GnRH agonist down-regulation in single, euploid FET cycles.

Methods : A retrospective analysis was performed, using data from patients who underwent a single, euploid FET cycle from 2012 to 2019. Patients were segregated into two cohorts: Group A: single, euploid FET with down-regulation using GnRH agonist; Group B: …

Evaluating Historical Paradigms Of Sterility In Perinatal Microbiology And Ramifications For Pregnancy Outcomes, Jonathan Greenberg

Wayne State University Dissertations

Next-generation sequencing technologies, especially 16S rRNA gene and metagenomic sequencing have allowed investigations of low microbial biomass tissues of the human body. While these sequencing methodologies have provided large amounts of reliable data for higher microbial biomass sites, such as the mouth, intestine, and vagina, tissues of low microbial biomass sites are subject to specific caveats that were not appropriately considered in early investigations of these sites. Low microbial biomass sites of particular interest have included those of the reproductive and urinary systems. Utilization of DNA sequencing methodologies have allowed researchers to challenge existing paradigms of sterility around these sites …

Quality Improvement: Patient Education For Management Of Hypertension In Pregnancy, Kriti Goel

Scholarship in Medicine - All Papers

Objective: We introduced maternal hypertension education tools that address illiteracy in underserved populations. Through these tools, we aim to improve patients’ knowledge of their conditions. We also aim to determine if healthcare providers perceive a benefit to the use of the tools. Ultimately, we hope these changes will lead to better short- and long-term health outcomes for mother and child.

Methods: Pregnant women with any form of hypertension at Five Rivers Center for Women’s Health (FRHC) were surveyed during OB visits. The Patient Questionnaire includes objective knowledge questions on their condition and self-reported comprehension questions. Forty-five women were surveyed during …

Assessing Accuracy Of Attending Provider On The Pennsylvania Birth Certificate, Emily C. Mcgahey

Doctor of Midwifery Advances in Midwifery Projects

Introduction: Birth certificate data is a cornerstone of public health reporting, yet numerous studies document that much of the data collected is unreliable. Limited evidence suggests that the attendant at birth item may not be accurately captured on the current birth certificate, therefore not representative of the care provided by midwives in the United States. The primary purpose of this study was to determine whether midwives are accurately represented as attendant at birth on the Pennsylvania birth certificate. A secondary purpose was to assess midwives’ motivation to improve data collections if significant discrepancies were found.

Methods: A cross-sectional survey was …

Burnout Among Medical Residents; Their Impressions Of Its Impact On Patient Care And Coping Mechanisms, Elizabeth Ochola

Master of Medicine in Obstetrics and Gynecology

Introduction: Burnout is a syndrome that occurs as a result of chronic workplace stress that has not been successfully managed. This global definition is given by the International Classification of Diseases; 11th edition. The ICD-11 further characterizes burnout using three dimensions: Emotional exhaustion described as feelings of energy depletion or exhaustion; depersonalization described as; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and low personal accomplishments seen as reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and is not applied to describe experiences in other areas of life. …

Challenges Of Diagnosis And Management Of Postpartum Choriocarcinoma In Resource Limited Settings: A Case Report From A Tertiary Hospital Of Western Kenya, Amubuomombe Philippe, Benjamin Elly, Andrew Cheruiyot, Sahara Shurie, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Choriocarcinoma is a rare occurrence in pregnancy. It is a highly curable malignant tumour that arises from trophoblastic cells within the uterus. However, the timely diagnosis of choriocarcinoma following birth is challenging, especially in low resource settings because most clinicians are not aware about the existence of the disease following uneventful pregnancy and birth. This report discusses the case of a 28 years old patient, para 2, diagnosed with choriocarcinoma two months after uneventful vaginal delivery at term. She underwent a total abdominal hysterectomy, followed by chemotherapy treatment; and succumbed to her disease. It highlights difficulties encountered on diagnosis and …

Low Sensitivity Of The Carehpv™ Assay For Detection Of Oncogenic Human Papillomavirus In Cervical Samples From Hiv-Infected And Hiv-Uninfected Kenyan Women, Titus Maina, Aaron Ermel, A. Moormann, Susan Cu-Uvin, Elkanah Omenge, Philip Tonui, K Chelimo, B Rosen, Peter Itsura, K. Muthoka

Obstetrics and Gynaecology, East Africa

Background: Human papillomavirus (HPV) infection causes cervical cancer (CC), a common malignancy among Kenyan women. New CC screening methods rely on oncogenic HPV (“highrisk”, or HR-HPV) detection, but most have not been evaluated in swabs from Kenyan women.

Methods: HPV typing was performed on 155 cervical swabs from Kenyan women using the Roche Linear Array® (LA) and careHPV™ (careHPV) assays. Detection of 14 oncogenic HPV types in careHPV assay was compared to LA results.

Results: Compared to LA, sensitivity and specifi city of careHPV assay was 53.0% and 80.9%, respectively. The sensitivity and specifi city of careHPV …