Obstetrics and Gynecology Commons^™

An Evaluation Of The Effectiveness Of An Updated Pre-Service Midwifery Curriculum Integrated With Emergency Obstetric And Newborn Care In Kenya: A Cluster Randomised Controlled Trial, Duncan N. Shikuku, Catherine Mwaura, Peter Nandikove, Alphonce Uyara, Helen Allott, Lucy Waweru, Lucy Nyaga, Edna Tallam, Issak Bashir, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufciently prepared for their teaching role and defcient curriculum compared to international standards afect the quality of healthcare provided by the midwifery graduates. This study assessed the efectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya.

Methods A cluster randomised controlled trial in 20 midwifery colleges (12 intervention, 8 control colleges). Educators in both arms received training in teaching/EmONC skills to deliver the …

Pregnancy Outcomes After Covid-19 Infection, Angela M. Blanco Guertin, Arvinder Singh, Arianna Tapia, Emily Dickinson

Nursing & Health Sciences Research Journal

Background: Since the onset of the Coronavirus 19 (COVID-19) pandemic in 2020, the medical community has raced to keep up with the continued healthcare sequelae of the virus. During this time, pregnant women and newborns have been of particular concern. A higher incidence of pregnancy-related complications was seen among women during the pandemic. This study aimed to assess the relationship between COVID-19 and pregnancy complications among women. Methods: This retrospective study analyzed records of pregnant women with active COVID-19 or a history of COVID-19 during pregnancy, admitted to a South Florida hospital between March 2020 and December 2021. Patients’ charts …

What Is The Evidence? Updates In The Use Of Antenatal Corticosteroids For Patients At Risk Of Preterm Birth, Moti Gulersen, Cynthia Gyamfi-Bannerman

Department of Obstetrics and Gynecology Faculty Papers

Antenatal corticosteroids have long been considered one of the most important antenatal therapies available for pregnant patients at risk of preterm birth based on the associated reduction of neonatal morbidity and mortality following their administration. However, despite decades of research since their incorporation into routine clinical practice, a number of key questions related to antenatal corticosteroid use remain. These include evaluating the impact of antenatal corticosteroids at gestational ages outside of the previously recommended window of 24 0/7–33 6/7 weeks of gestation, determining factors associated with optimal steroid timing in order to reduce unnecessary exposure, alterations in its dosing regimen, …

Invited Perspective: Climate Change And Maternal Mental Health-Looking Beyond High-Income Countries, Andrea G Buchwald, Sarah Boudova

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

The Effectiveness Of Ultrasound-Indicated Cerclage For The Reduction Of Extreme Preterm Birth In Twin Pregnancies With A Short Cervix: A Systematic Review And Meta-Analysis, Lissa Van Gils, Renske Dutilh, Nerissa Denswil, Amanda Roman, Marjon A De Boer, Eva Pajkrt, Martijn A Oudijk

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: This study aimed to evaluate the effectiveness of cervical cerclage in women with a twin pregnancy and a midpregnancy asymptomatic short cervix (≤25 mm), in preventing preterm birth and improving neonatal outcomes.

DATA SOURCES: Systematic searches were conducted in MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library up to April 17, 2023, updated in September and February 2024.

STUDY ELIGIBILITY CRITERIA: Included were randomized controlled trials, cohort studies, and case-control studies comparing cerclage with expectant management in twin pregnancies and an asymptomatic short cervix (≤25 mm).

METHODS: Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale …

Maternal Morbidity Associated With Early Preterm Birth In Low-Risk Singleton Pregnancies, Moti Gulersen, Erez Lenchner, Alisha Goyal, Amos Grunebaum, Frank A. Chervenak, Eran Bornstein

Department of Obstetrics and Gynecology Faculty Papers

Background/Objectives: While neonatal morbidities associated with early preterm birth are known, the risks of maternal morbidities in these births remain unclear. Thus, we set out to assess the risk of maternal morbidities associated with early preterm births. Methods: Retrospective cohort study utilizing the United States (US) Natality Live Birth database from the Centers for Disease Control and Prevention (2016–2021). Low-risk singleton pregnancies were included. High-risk conditions such as out-of-hospital births, fetal anomalies, pregestational and gestational diabetes, and hypertensive disorders of pregnancy were excluded. The rates of several maternal morbidities were compared among three gestational age at birth groups: 23 0/7–27 …

To Develop/Implement An Evidence Based Order Set For Maternity Patients With Potential Opioid Use Disorder (Oud), Katrina Munoz

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Enhancing Prenatal Breastfeeding Education To Improve Breastfeeding Rates, Angela Maietta

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Breastfeeding Education Knowledge, Danielle Sees

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Improving Treatment Outcomes For Bacterial Vaginosis By Affecting The Vaginal Microbiome, Aleya Devries, Jyotsna Chawla Assistant Professor, Microbiology, Jackeline Moljo Assistant Professor, Family Medicine

HCA-NSU MD Research Day

Objective: The goal of this review is to educate providers about the importance of maintaining the balance of the vaginal microbiome (VMB) and how modifiable factors may be used to improve treatment outcomes of patients with bacterial vaginosis. Background: Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age and is treated with Metronidazole, which has a high recurrent infection rate. Preliminary studies highlighted the balance of VMB species affects the development of BV and therapeutic outcomes of Metronidazole. Furthermore, previous studies have described how VMB composition can be shaped by various factors. Methods: Here, we …

Effects Of Sex And Estrous Cycle On Extended-Access Oxycodone Self-Administration And Cue-Induced Drug Seeking Behavior, Bhumiben P Patel, Jessica A Loweth

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Increasing evidence indicates that sex is a factor that impacts the abuse liability and relapse vulnerability of prescription opioids like oxycodone. However, while women are more likely than men to be prescribed and to use these drugs, the impact of sex and ovarian hormones on prescription opioid use and relapse vulnerability remains unclear. Accurately assessing these measures is complicated by the fact that chronic opioid exposure can lower ovarian hormone levels and cause cycle irregularities.

METHODS: Adult male and female Sprague-Dawley rats self-administered oxycodone (0.1 mg/kg/infusion) under extended-access conditions (6 h/day, 10 days) followed by forced abstinence. Separate groups …

Preeclampsia As A Risk Factor For Developing Heart Failure, Blessing Akomas, Confidence Nwalor, Tara Li

Master's Projects

Title: Preeclampsia as a Risk Factor for Developing Heart Failure

Introduction: Preeclampsia affects a significant number of pregnancies worldwide. Preeclampsia has been linked with increased cardiovascular risks for women later in life, thus threatening their life. This literature review examines the existing scientific evidence on the relationship between preeclampsia and the long-term risk of heart failure in postpartum women over a 10-year period.

Methods: A literature search was conducted using CINAHL, PubMed, and Google Scholar. The Melnyk Level of Evidence tool was used to evaluate 10 studies. Identified studies were published between 2019 and 2023. Thematic analysis was used to …

Intrapartum And 30-Day Postpartum Complications In Patients With Antenatal Covid-19 Infection: A Retrospective Cohort Study, Sriya Donthi, Jacqueline Kloos, Kelly S. Gibson, David C. Kaelber

Student Scholarship

Objective: The study was aimed at comparing intrapartum and postpartum outcomes between pregnant patients with and without antenatal COVID-19 infection using aggregated, deidentified electronic health record (EHR) data. Design and Setting: This retrospective cohort study included data from over 80 health care organizations within the TriNetX Analytics Research Network. Population: Individuals admitted for delivery from Jan 2020 to May 2023 were studied. Methods: We studied individuals with ICD-10 codes for delivery, COVID-19 diagnosis, and primary outcomes. We compared the incidence of adverse intrapartum and 30-day postpartum outcomes in those with and without antenatal COVID-19. Main Outcome Measures: The main outcomes …

A Time-Stratified, Case–Crossover Study Of Heat Exposure And Perinatal Mortality From 16 Hospitals In Sub-Saharan Africa, Claudia Hanson, Jeroen De Bont, Kristi Sidney Annerstedt, Maria Del Rosario Alsina, Federica Nobile, Nathalie Roos, Peter Waiswa, Andrea Pembe, Jean-Paul Dossou, Claudia Hanson, Hussein Kidanto

Brain and Mind Institute

Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case–crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0–6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.34 (95% confidence interval …

Rectovaginal Fistula Due To Undiagnosed Rectal Tuberculosis In A Nulliparous Young Woman: A Case Report, Daudi Gidion, Brenda Moshi, Gregory Ntiyakunze, James Chapa, Peter Majinge, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction: Rectovaginal fistulas (RVFs) can arise from various etiologies, the most common cause especially in developing countries is obstetric injury. Uncommonly, rectal tuberculosis can present as RVF, posing a diagnostic and treatment challenge especially in a patient without established risk factors. The first case of rectal tuberculosis was reported by Davis et al., in 1957, and a 2022 systematic review identified only 28 cases reported since then.

Presentation of Case: we report the case of a 25-year-old college woman who presented with a 3-month history of lower abdominal pain and fecal passage per vagina. She had undergone a failed …

Trustworthiness Criteria For Meta-Analyses Of Randomized Controlled Studies: Obgyn Journal Guidelines., Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Postnatal Growth Of Etiologically Characterized Preterm Newborns According To Gestational Age At Birth, Paola Roggero, Irina Ryumina, Robert Gunier, Adele Winsey, Stephen Rauch, Irma Alejandra Coronado Zarco, Shabina Ariff, Maria Albertina Rego, Constanza Soto Conti, R. Ochieng

Obstetrics and Gynaecology, East Africa

Objective: To examine the relationship between etiologically-based preterm birth sub-groups and early postnatal growth according to gestational age at birth.

Methods: Prospective, multinational, cohort study involving 15 hospitals that monitored preterm newborns to hospital discharge. Measures/exposures: maternal demographics; etiologically-based preterm birth sub-groups; very, moderate and late preterm categories, and feeding. Primary outcomes: serial anthropometric measures expressed as z-scores of the INTERGROWTH-21st preterm postnatal growth standards.

Results: We included 2320 singletons and 1180 twins: very=24.4% (n = 856, including 178 < 28 weeks’ gestation); moderate=16.9% (n = 592) and late preterm=58.6% (n = 2052). The median (interquartile range) postmenstrual age at the last measure was 37 (36–38) weeks. The ‘no main condition’ sub-group percentage increased from early to late preterm; the ‘perinatal sepsis’ sub-group percentage decreased. ‘Perinatal sepsis’, ‘suspected IUGR’ and ‘fetal distress’ very and late preterm infants had lower postnatal growth patterns than the ‘no main condition’ reference sub-group. This pattern persisted in late but not very preterm infants when postnatal growth was corrected for weight z-score at birth.

Conclusion: The proportional contribution of etiologically-based preterm sub-groups and their postnatal growth trajectories vary by preterm category. Postnatal growth is partially …

Infertility As A Possible Multifactorial Condition; The Experience Of A Single Center, Cristina-Diana Popescu, Bashar Haj Hamoud, Romina Marina Sima, Anca Bobirca, Oana Denisa Balalau, Mihaela Amza, Romeo Micu, Gabriel Petre Gorecki, Liana Ples

Journal of Mind and Medical Sciences

Objectives. Infertility is a topic of great interest around the world because it affects many couples at young ages. It can be caused by genetic background, associated with pathologies and/or external factors. The purpose of our study was to identify the causes of infertility of women presented in our clinic with this pathology. Materials and Methods. This retrospective study was performed on women with primary or secondary infertility. The analyzed data were age, weight, hereditary and personal pathological history, medication, menstrual cycle characteristics, standard blood tests, ultrasound, hysterosalpingography and hysteroscopy. Results. The study included 204 women with average age 35 …

Relationship Between Serum Estradiol Level, Ultrasound Follicle Count, Number Of Oocytes Retrieved And Their Influence On Ivf/Icsi Treatment Outcomes: A Retrospective Cross-Sectional Study, Bashar Haj Hamoud, Gilda Schmidt, Chiara Hipp, Meletios Pantelis Nigdelis, Romina Marina Sima, Liana Ples, Oana Denisa Balalau, Simona Lucia Baus, Georg Peter Breitbach, Gudrun Wagenpfeil, Erich Franz Solomayer, Tim Schmidt, Sebastian Findeklee

Journal of Mind and Medical Sciences

This retrospective cross-sectional study investigates determinants on follicular development, oocyte retrieval and pregnancy outcome. It assessed the clinical practicability of monitoring parameters in relation to predict a successful treatment. Analysis of serum-estradiol (E2), sonographic follicle count, number of oocytes and optimizable parameters have therefore been carried out based on patient files from the IVF outpatient clinic at the Department of Gynecology, Obstetrics and Reproductive Medicine, Homburg/Saar, Germany. Equidirectional connection occurred between serum-E2, sonographic follicle count and number of oocytes (p < 0.001). There was no significant difference between sonographic and punctured follicle count (p = 0.428), but between sonographic/punctured follicle count and number of oocytes obtained (p < 0.01). Increasing endometrial thickness was associated with increasing serum-E2 (p = 0.003) and number of oocytes (p < 0.001), but not with the follicle count (p > 0.05). Additionally, age was inversely associated with sonographic follicle count and number of oocytes (p < 0.001) but not with E2 (p > 0.05). BMI, nicotine and stimulation …

Socio-Economic Disparities In Prenatal Prognosis And Intervention Accessibility, Simona Raluca Iacoban, Madalina Piron Dumitrascu, Camil Laurentiu Bohiltea, Ioan Dumitru Suciu, Silviu Cristian Voinea, Nicolae Suciu

Journal of Mind and Medical Sciences

Objectives. This study aimed to assess the impact of socio-economic factors on prenatal care accessibility and outcomes and to evaluate the effectiveness of specialized integrative prenatal care in mitigating these disparities. Materials and Methods. A prospective cohort study was conducted between 2020 and 2023 in Bucharest, Romania, involving 100 pregnant women. Participants were equally divided into two groups that received standard and specialized prenatal care. Data were collected through structured interviews, medical record reviews, and standardized questionnaires at multiple time points during pregnancy and postpartum. Results. Women receiving integrative care had longer gestation periods (37.8 vs. 37.6 weeks), higher average …