Obstetrics and Gynecology Commons^™

Transformative Experiences, Anticipatory Regret, And Informed Consent, Elizabeth Lanphier, Shannon Fyfe

Scholarly Articles

Regret risk is not consistently part of information sharing within informed consent. Yet two kinds of decisions that often invoke concerns about future regret, abortion and sterilization, raise considerations for the role of regret in clinical decision-making and informed consent, particularly regarding decisions about potentially transformative experiences. We distinguish between first-personal and second-personal anticipatory regret and argue that first-personal anticipatory regret can play a productive role, but second-personal anticipatory regret can function in ways that are pernicious. Introducing second-personal anticipatory regret into medical informed consent processes is, we argue, not only not required for informed medical decision-making, but impermissible within …

A Quality Improvement Project To Improve Provider Awareness Of Breastfeeding Resources, Rachel St. Bernard, Allie Vela, Rose A. Maxwell, Kelly Nagy

Obstetrics and Gynecology Faculty Publications

Breastfeeding is widely acknowledged for its significant benefits for mother and child. Despite the many advantages for breastfeeding, disparities in breastfeeding rates persist, particularly among non-Hispanic Black women in Montgomery County, OH. Rates for babies born in 2020 were low for those who were ‘ever’ breastfed (NH-Black 68.8% vs white 76.6% for ‘ever’ breastfed at hospital discharge) and even lower for those who were exclusively breastfed (NH-Black 38.2% vs. NH-white 57.9% exclusively breastfed at hospital discharge).1 Ohio's breastfeeding initiation rate remains among the lowest in the nation ranking 41st out of 50 states and falling short of the Healthy People …

Prophylactic Resuscitative Endovascular Balloon Occlusion In The Management Of Placenta Percreta: A Case Report, Monica Rodriguez, Nicole Tenzel, Rachel Russo, Robert Cohen

North Texas Research Forum 2025

Introduction: Placenta accreta spectrum disorders (PASD) are associated with severe maternal morbidity, including hemorrhage requiring massive transfusion, intensive care unit (ICU) admission, coagulopathy, organ ischemia or failure, and death. The adherent placenta results in continuous mixed arterial and venous bleeding, preventing the uterus from adequately contracting. This can result in a blood loss rate of 600 mL or more per minute, posing a risk of exsanguination in less than five minutes. Few reports exist on the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA) to reduce obstetric hemorrhage and its application for prolonged occlusion times exceeding 60 …

Comparison Of Four Vaginal Antiseptic Preparation To Reduce Bacteria Colony Counts In Patients Undergoing Vaginal Surgery: A Randomized Trial, James R. Saelens, Adam J. Langer, Andrew N. Boeckley, Natalie M. Castillo, Julie A. Desouza, Jennifer L. Drerup, Kelly M. Muterspaw, Hannah M. Stump, Rose A. Maxwell, Geoffrey D. Towers

Obstetrics and Gynecology Faculty Publications

Introduction: Surgical site infections (SSI) remain a prominent complication of gynecologic procedures. The only FDA approved compound for preoperative vaginal preparation is povidone-iodine. Direct comparison of commonly used agents is needed to inform appropriate standards of care. The objective of this study is to compare the effectiveness of 10% povidone-iodine (PI), 4% chlorhexidine gluconate (CHG), baby shampoo (BS), and 3% para-chloro-meta-xylenol (PCMX) preparations for reducing bacterial and fungal colony counts and minimizing postoperative irritation after vaginal surgery. Materials and Methods: This is a single-blind, RCT conducted between 2018 and 2023 in patients 18 years or older who were undergoing surgeries …

Reproductive Autonomy In Immunological Intervention: Ethical Boundaries In Maternal-Fetal Immune Therapy, Marium Z. Rizvi

Journal of Health Ethics

Recent advances in immunology have broken barriers in reproductive medicine through immune-modulating therapies that support fertility and pregnancy. Treatments such as intravenous immunoglobulin (IVIG) and intralipid infusions are increasingly offered to patients with Recurrent Implantation Failure (RIF) or Recurrent Pregnancy Loss (RPL), conditions that result in miscarriages and failed IVF treatments (Pillarysetti et al., 2023). Maternal-fetal immunology reveals a delicate interplay between immune tolerance and defense: the maternal system must accept a genetically foreign fetus while preserving immunological protection. Disruptions in this balance are implicated in implantation disorders and pregnancy failure. As a result, immune-based therapies have emerged as promising …

An Analysis Of Comprehensive Sex Education As A Means Of Reducing Teenage Pregnancy Rates, Ben Hiett, Adriana Parella

Scholarship in Medicine - All Papers

Teenage pregnancy rates have been declining since the 1990s, yet teenage pregnancy remains a pressing public health concern given its associated negative maternal and infant complications. Many experts and advocates have placed an increasing emphasis on school programs that provide teenagers with comprehensive education on healthy sexual functioning, safe sex practices, and effective contraceptive use, pointing to them as a means of reducing unplanned teen pregnancies. However, there is still some debate regarding the effectiveness of comprehensive sex education compared to more limited programs that focus primarily on promoting abstinence. Using data from County Health Rankings and SIECUS, we compared …

Maternal Cardiovascular Risk And Lactation: Disparities And Future Directions, Monica Rodriguez, Michele Mccarroll, Caroline Marrs, Kamala P. Tamirisa

North Texas Research Forum 2025

Pregnancy functions as a cardiopulmonary stress test, unmasking underlying cardiovascular disease (CVD) or heightening the future CVD risk following adverse pregnancy outcomes (APOs). Multiple studies have demonstrated strong associations between APOs, higher mortality rates, and an increased risk of cardiometabolic diseases. Black women, in particular, have a disproportionately higher burden of coronary artery disease related mortality, with an earlier onset compared to women of other racial and ethnic groups. Increasing allostatic load due to both acute and chronic racial discrimination may potentially be a key factor driving poorer pregnancy outcomes. Breastfeeding has a protective effect on allostatic load and is …

Curtain-Like Vision Loss: A Case Report On Semaglutide And Its Effects On Vision, Sereena Jivraj, Jonathan Eledge, Amenda Khoei, Amnah Andrabi

North Texas Research Forum 2025

Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-RA), was introduced and approved by the United States Food and Drug Administration (FDA) for the management of type 2 diabetes in 2017. Since then, the medication has garnered much more attention for its ability to aid with weight loss. Until recently, the most significant side effects of semaglutide noted were mostly gastrointestinal symptoms such as nausea, vomiting, and diarrhea due to the drug’s mechanism of action of delayed gastric emptying. However, a singular cohort study from Harvard Medical School in conjunction with Massachusetts Eye and Ear of 16,827 patients recently suggested a …

A Look Into Postpartum T2dm Screening In Patients Diagnosed With Gdm, David Vincent Ream, Joshua Ferrell, Ashlee Nichole Tillery

South Atlantic Division GME Research Day 2025

No abstract provided.

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Standardized Surgical Protocol For Placenta Accreta Spectrum Disorder At An Accreta Center Of Excellence, Ana Adams, Monica Rodriguez, Kate Hansen, Aysu Erdemir, Robert Cohen

North Texas Research Forum 2025

Introduction Placenta Accreta Spectrum Disorder (PASD) refers to a spectrum of abnormal invasion of the placenta into the uterus during pregnancy. PASD ranges in severity from involvement through the endometrial layer of the uterus to complete invasion involving other pelvic structures. This abnormal invasion can result in significant postpartum hemorrhage, often requiring large-volume transfusions, about six units of packed red blood cells on average. The maternal mortality rate associated with PASD is approximately 4-7%. The Society for Maternal-Fetal Medicine (SMFM) recommends that pregnancies complicated by PASD be delivered in hospitals with dedicated interdisciplinary teams, referred to as “Accreta Centers of …

Marginal Cord Insertion And Funic Presentation Mimicking Vasa Previa, Fran Franceschini Lopez, Andrew Tucker, Narinta Limtrakul, Manuel Rivera-Alsina

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

The Influence Of Senate Bill 8 On Permanent Sterilization In Texas Women: A Retrospective Analysis, Isabella Sciacca, Chrystal Stallworth, Cameron Stokes, Hannah Affleck, Timothy Kremer, Michele Mccarroll

North Texas Research Forum 2025

Introduction Of the 6.1 million pregnancies that occurred in the United States in 2011, 45% were unintended. Of those unintended pregnancies, 42% ended in elective abortion. In the United States, the most common contraceptive method used is permanent female sterilization. Senate Bill 8 (SB8), also known as the Texas Heartbeat Act, was put into effect on September 1st, 2021. This act virtually bans all abortions after six weeks gestation. This study is aimed at evaluating the association between the implementation of SB8 and patients who underwent permanent sterilization procedures. Methods Patients who underwent permanent sterilization in Texas within a multi-institute …

Large Mesenteric Cyst Casting Wide Differential Across Specialties, Jessica Harper, Katherine Kleinberg, Jose S. Saldivar

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Improvement In Prenatal Education And Involvement In Patient Care, Miranda Ibrahim, Christelle Reeves, Timothy Kremer

North Texas Research Forum 2025

BACKGROUND: While the attempt is to educate the patient (and their family members) and empower them in their medical decision making, integration of birth plans and discussion of such plans is not routinely implemented by most obstetrical providers. There is currently no standardized approach to the education and birth plan development/or the obstetrical patients. The goal of this project, therefore, is to develop a standardized approach to discussion of birth plans and, albeit indirectly, allow for an opportunity for education for obstetrical patients. METHODS: On a daily basis, through birth plan discussions with patients during routine obstetrical visits, and via …

Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison

Theses, Dissertations and Capstones

Problem Statement: Cesarean delivery is associated with significant postoperative pain, typically managed with spinal anesthesia using a local anesthetic. While opioids are often added as adjuncts, the addition of dexmedetomidine, an alpha-2 agonist, has emerged as a potential alternative that may enhance the efficacy of the spinal block in terms of pain management, potentially improving block duration and quality compared to local anesthetic alone.

Methodology: A literature review was conducted on the use of dexmedetomidine as an adjunct to spinal anesthesia for patients undergoing cesarean sections. Databases used for the search included PubMed, CINAHL Complete, and MEDLINE. The keywords used …

Implementation Of Screening For Vte Prophylaxis For The Prevention Of Vte In The Antepartum And Postpartum Period, Elizabeth Campos, Michelle Mieles, Aaron Poole

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Postpartum Glucose Testing And Primary Care Follow-Up For Women With Gestational Diabetes Mellitus: A Quality Improvement Project, Madeline Bartram, Anusha Hussain, Timothy Kremer

North Texas Research Forum 2025

BACKGROUND: Patients with gestational diabetes mellitus (GDM) have a 40-70% lifetime risk for developing type 2 diabetes mellitus, which is 9 times the risk of patients without a history of GDM. Joint association guidelines recommend a 75-gram, 2-hour oral glucose tolerance test (GTT) at 4 to 12 weeks postpartum for all patients with GDM, and to follow-up with a primary care physician. Currently, less than half of these patients do not receive the recommended postpartum glucose testing and/or follow-up. METHODS: For each GDM-affected pregnancy, two primary outcome measures were retrospectively collected from the clinic EHR: completion of the 75-gram GTT …

Planned Out Of Hospital Birth Maternal And Neonatal Outcomes In A Single Institution, Priyanka Vuppala, Juhi Singhal, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Fetal Presentation Confirmation On L&D With Ultrasound, Noelle Coen, Aaron Poole

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.