Obstetrics and Gynecology Commons^™

Spontaneous Uterine Rupture In The Second Trimester: Risk Factors And Clinical Instincts, Lauren Wells, Shea Mcgrinder, Amanda Royek, Bethany Bowling, Anthony B. Royek

South Atlantic Division GME Research Day 2025

No abstract provided.

Use Of Indocyanine Green Angiography To Reduce Postoperative Complications In Post-Mastectomy Breast Reconstruction: An Umbrella Review, William R. Clifton, Phil Moon, Emily V. Clifton, Julia C. Stager, Spencer R. Anderson

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of Twin Gestation In A Rudimentary Uterine Horn Resulting In Rupture: The Importance Of Education And Imaging, Shelby Freeberg, Taylor Penny, Joa Allen

South Atlantic Division GME Research Day 2025

No abstract provided.

Nutritional Management Of Low Birth Weight And Preterm Infants In Low- And Low Middle-Income Countries, Maha Azhar, Rahima Yasin, Sawera Hanif, Sharib Afzal Bughio, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Introduction: Preterm and low birth weight (LBW) infants are at an increased risk of morbidity and mortality compared with their term counterparts, with more than 20 million LBW infants born each year, the majority in lower middle-income countries (LMICs). Given the increased vulnerability and higher nutritional needs of these infants, optimizing feeding strategies may play a crucial role in improving their health outcomes.
Methods: We updated evidence of Every Newborn Series published in The Lancet 2014 by identifying relevant systematic reviews, extracting low-income country (LIC) and LMIC data, and conducting revised meta-analysis for these contexts.
Results: We found 15 reviews; …

Effectiveness And Safety Of Intravenous Iron Therapy In Outpatient Obstetrical Clinic For Treatment Of Iron-Deficiency Anemia During Pregnancy, Ellen M. Murrin, Olivia S. Lebeau, Lillian Singer, Mark A. Kassab, Peyton Kalan, Julie Costanzo, Scott A. Sullivan, George L. Maxwell, George R. Saade, Antonio F. Saad

Department of Obstetrics & Gynecology Faculty Publications

Background

Iron-deficiency anemia (IDA) affects over one-third of pregnant patients globally, contributing to severe maternal morbidity and adverse neonatal outcomes. Oral iron supplementation, while cost-effective, is limited by poor absorption, significant gastrointestinal side effects, and poor adherence. The use of intravenous (IV) iron addresses many of these concerns, including eliminating GI side effects and the need for daily therapy. However, administration of IV iron in pregnant patients is typically restricted to specialized infusion centers or hospitals due to concerns about acute side effects, cost, resource utilization, the need for fetal heart rate monitoring, and extended infusion times.

Methods

This descriptive …

Prenatal Alcohol Exposure Inhibits Transient Expression Of Autophagy And Synaptic Proteins In Developing Brain, Monica Hampe, Nune Darbinian, Nana Merabova, Armine Darbinyan, Jamal Hamze, Uday Bharai, Yuri Persidsky, Mary F Morrison, Shohreh Amini, Laura Goetzl, Michael E Selzer

Faculty, Staff and Student Publications

Introduction: Neuronal apoptosis and consequent inhibition of autophagy, with loss of synaptic connections are central events in the genesis of fetal alcohol spectrum disorders (FASD). However, studies of molecular mechanisms of autophagy in human fetal brain are limited. Recently, prenatal exposure to EtOH was associated with reduced miRNA-9 levels in fetal brain-derived exosomes (FB- Es) isolated from maternal plasma, which correlated with small eyes, an anatomical hallmark of fetal alcohol syndrome (FAS). Since miR-9 targets several genes that regulate synaptic plasticity, EtOH-induced inhibition of miR-9 could potentially result in dysregulation of genes involved in synaptogenesis/plasticity.

Methods: Rats were fed a …

In Utero Alcohol And Tobacco Exposure, Maternal Depression, And Maternal Obesity Are Associated With Impaired Oligodendrocyte Differentiation In The Developing Brain, Uday Bharai, Jamal Hamze, Benjamin Zhang, Monica Hampe, Emily Sparks, Nana Merabova, Gabriel Tatevosian, Armine Darbinyan, Mary F Morrison, Laura Goetzl, Nune Darbinian, Michael Selzer

Faculty, Staff and Student Publications

Introduction: Fetal alcohol spectrum disorder (FASD) is the leading preventable cause of pediatric cognitive disability and is associated with dysmyelination. We examined possible clinical co-determinants that might interact with EtOH in impairing oligodendrocyte (OL) development. Women who drink, including pregnant women, also disproportionately suffer from depression (mDepression), which we have shown is a risk factor for FASD. Might depression during pregnancy contribute to OL pathology? Maternal obesity (mObesity) also inhibits white matter development in fetal brain. Finally, tobacco exposure inhibits not only OL development, but also the production of structural proteins, such as actin. Our human biobank derived from voluntarily …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Improving Postpartum Outcomes Through Therapeutic Individual And Group Occupational Therapy Sessions In Hospitalized Antepartum Patients, Melissa C. Learish

Graduate Theses, Dissertations, and Problem Reports (ETD)

Extended hospitalization in the postpartum period is occasionally medically indicated due to a variety of diagnoses, but can pose challenges to the psychosocial well-being of pregnant women, such as social isolation, anxiety, alteration of normal life routines, and less preparation for postpartum life. In acute care settings, however, maternal management tends to focus on physical stabilization rather than holistic maternal care, including opportunities for emotional support, occupational engagement, and postpartum planning. This doctoral capstone project was designed to assess the effect of individualized and group-based occupational therapy interventions for antepartum women who have been hospitalized for extended periods of time, …

Inflammatory Mediators And The Rage Pathway In Placental Tissues Of Pregnancies Complicated By Severe Preeclampsia, Neelima Chandra, Thomas D. Kimble, Kathleen R. Heim, Sharon M. Anderson, Andrew P. Wong, Andrea R. Thurman, Gustavo F. Doncel

CONRAD Publications

Introduction: Preeclampsia (PE) is a complex multisystem disorder of pregnancy associated with abnormal placentation, vascular anomalies, and systemic inflammation and hypertension. Previous research assessing inflammatory triggers of the condition used plasma, amniotic fluid, or explant samples. Studies using placental tissue from either vaginal or cesarean deliveries are confined to semiquantitative analysis using subjective scoring methods and generally involve a small sample size.

Methods: In this study, we have quantified the expression of inflammatory mediators by immunohistochemical image analysis of archived placental tissues obtained from cesarean delivery of preeclamptic, chorioamnionitic, and normal pregnancies.

Results: Among the inflammatory mediators, we found a …

A Comparative Analysis Of Hysterectomy Outcomes: Robotic Single-Port Vs Traditional Transvaginal Notes Approaches, Qiannan Yang, Daniel Y Lovell, Juliana Wu, Chunhua Zhang, Xiaoming Guan

Faculty, Staff and Students Publications

Introduction: This study aimed to explore the feasibility and safety of robotic single port vaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) hysterectomy when compared with traditional vaginal natural orifice transluminal endoscopic surgery (T-vNOTES) hysterectomy.

Methods: In this study, the clinical data of 135 patients who underwent RSP-vNOTES or T-vNOTES hysterectomy performed by a single minimally invasive gynecologic surgeon from January 2017 to September 2024 were retrospectively analyzed. Clinical characteristics, surgical outcomes, perioperative complications, and postoperative pain scores were collected and analyzed.

Results: A total of 79 patients underwent T-vNOTES hysterectomy and 56 patients underwent RSP-vNOTES hysterectomy. Compared to the T-vNOTES …

Cerebroplacental Doppler Ratio For The Prediction Of Adverse Perinatal Outcomes In Late-Onset Fetal Growth Restriction, Sonia Sajja, Onur Turkoglu, Torey Asao, Perry Friedman, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late-onset fetal growth restriction (LO-FGR), defined as onset 3 32 weeks gestation, is the more common subgroup of FGR. The umbilical artery Doppler is usually unaffected. There are no subgroup-specific guidelines for monitoring pregnancies affected by LO-FGR. We compared the utility of the cerebroplacental Doppler ratio (CPR) to the Biophysical Profile (BPP), a widely endorsed FGR monitoring tool, for the prediction of adverse perinatal outcomes (APO). Study Design: This is a retrospective cohort study of LO-FGR, defined as estimated fetal weight < 10th%, from 2013-2018. Using logistic regression analysis, we determined whether low CPR < 5th% and BPP score £ 6 significantly independently predicted the composite APO defined as one or more complications: cord pH < 7.20, 5-minute Apgar score of < 5, operative or cesarean delivery secondary to non-reassuring fetal heart tracing, assisted respiration at birth, NICU admission, and/ or perinatal death. Secondarily, we also evaluated prediction of severe neonatal morbidity (SNM) defined in Table 1 (legend). Results: There were 233 cases of LO-FGR of which 76 (34%) had a low CPR percentile and 28 (13%) had a low BPP score. There were 22 (9.9%) cases with SNM of which 5 (2.1%) had a low CPR percentile and 4 (1.8%) had a low BPP score. A low CPR was associated with a significantly higher rate of individual and composite APO than cases with normal CPR percentile (p < 0.001) [Table 1]. Both a low CPR percentile and a low BPP score significantly predicted APO overall. CPR appeared to be a better predictor of the APO, controlling for gestational age at testing [Table 2]. Only BPP significantly predicted SNM: CPR (OR = 4.64, p = 0.13) and BPP (OR = 4.11, p = 0.038). Conclusion: A low CPR percentile was a significant independent predictor of perinatal complications in LO-FGR, including abnormal fetal heart rate tracing, smaller birthweight percentile, and NICU admission. CPR appeared superior to BPP overall. CPR should be considered as a fetal surveillance tool in LO-FGR.

Artificial Intelligence System Accurately Detects Fetal Ultrasound Findings Suspicious For Major Congenital Heart Defects, Carolyn M. Zelop, Jennifer Lam-Rachlin, Alisa Arunamata, Rajesh Punn, Sarina K. Behera, Matthias Lachaud, Nadine David, Greggory R. Devore, Andrei Rebarber, Sara Garmel

Conference Presentation Abstracts

Objective: Prenatal detection of congenital heart defects (CHD) improves patient outcomes. Despite advances in imaging techniques and equipment, prenatal diagnosis remains low. We evaluated the accuracy of an artificial intelligence (AI) system to detect 2nd trimester (2T) ultrasound studies suspicious for CHD. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of a study and detects 8 morphological findings suspicious for CHD. The findings were selected such that most major forms of CHD would feature at least one such finding, and the presence of any of these would flag the study for referral for further examination. We retrospectively …

Ai Significantly Improves Detection Of Prenatal Ultrasounds Suspicious For Major Congenital Heart Defects By Obgyn/Mfms, Jennifer Lam-Rachlin, Rajesh Punn, Sarina K. Behera, Miwa Geiger, Matthias Lachaoud, Nadine David, Sara Garmel, Matthew K. Janssen, Kendra Sylvestser, John Kennedy

Conference Presentation Abstracts

Objective: Congenital heart defects (CHDs) are a leading cause of infant morbidity and mortality partly due to low prenatal detection rates. We evaluated whether an artificial intelligence (AI) system can improve the detection of CHDs on fetal ultrasound exams among both general OBGYNs and MFM specialists. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of an exam and detects 8 morphological findings associated with severe CHDs. The presence of any such finding should justify patient referral for further examination. The AI system identifies each finding as present, absent or inconclusive, and highlights frames where findings can be …

Defining Dysphoric Milk Ejection Reflex: Using Premenstrual Dysphoric Disorder As A Framework For Proposing Preliminary Diagnostic Criteria, Megan Howard, Teni Davoudian, Nicole H Cirino

Faculty, Staff and Students Publications

Dysphoric Milk Ejection Reflex (D-MER) is a distinct neurobiological condition characterized by negative alterations in mental state in response to milk letdown during lactation. Symptoms vary by patient and can include feelings of sadness, anxiety or agitation. Importantly, the symptoms are brief, typically lasting no more than 5 minutes. Prevalence has been found between 6 and 27% of lactating women, but studies show heterogeneity, due in part to inconsistent definition. D-MER is not currently classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), which presents a challenge for researchers of the …

A Murine Model Of Gestational Diabetes Reveals Masld Risk And Alterations In Markers Of Hepatic Mitochondrial Metabolism, Grace E Shryack, Alexa A Krause, Simone Hernandez Ruano, Laura C Schulz, Kathleen A Pennington, R Scott Rector

Faculty, Staff and Students Publications

Introduction: Gestational Diabetes Mellitus (GDM) impacts roughly 1 in 7 pregnancies and results in metabolic dysfunction-associated steatotic liver disease (MASLD) in 30% of these women. Nonetheless, there exists a dearth of investigation into the relationship between GDM and MASLD. Here, we sought to investigate the potential role of hepatic mitochondrial function in GDM and MASLD.

Methods: One week prior to conception and throughout pregnancy, mice were fed either a low-fat control diet (CD) or a high-fat, high-sucrose (HFHS) diet to induce an established model of GDM. Maternal livers were collected at day 0, 6.5, 13.5 and 17.5 of pregnancy. Hepatic …

Finite Element Modeling In Obstetrics And Gynecology: Advances, Applications, And Challenges, Taylor Moseley, Ashley J Hicks, Elizabeth M Cosgriff-Hernandez, Manuel Karl Rausch, Julie Hakim

Faculty, Staff and Students Publications

Finite element modeling (FEM) is a critical tool in biomechanics and biomedical engineering, offering valuable insights where in vivo or ex vivo investigations are not possible. This review specifically highlights the diverse applications of FEM within obstetrics and gynecology through a comprehensive analysis of the literature. We explore the past use of FEM in analyzing complications affecting pelvic floor structures, urinary continence, and reproduction. The potential contributions of FEM in addressing these challenges are summarized and future directions for its application in obstetrics and gynecology are highlighted.

Maternal Rest Improves Growth In Small-For-Gestational-Age Fetuses (<10th Percentile), Greggory R Devore, Bardo Polanco, Wesley Lee, Jeffrey Brian Fowlkes, Emma E Peek, Manesha Putra, John C Hobbins

Faculty, Staff and Students Publications

BACKGROUND: Optimal management of fetuses diagnosed as small for gestational age based on an estimated fetal weight ofHowever, maternal bed rest has not been recommended based on the results of a randomized clinical trial that showed that maternal rest does not improve fetal growth in small-for-gestational-age fetuses. This study was conducted to revisit this question.

OBJECTIVE: This study aimed to determine whether maternal bed rest was associated with an increase in the fetal biometric parameters that reflect growth after the diagnosis of a small-for-gestational-age fetus.

STUDY DESIGN: A retrospective study was conducted on fetuses who were diagnosed as small for …

Wilson’S Disease Presenting As Acute Hepatitis In Pregnancy With Successful Maternal And Neonatal Outcomes: A Case Report, Paribesh Gyawali, Ranjan Regmi, Shambu Khanal, Rajan Bhandari, Shivani Gupta, Gunjan Arora

Graduate Medical Education Research Journal

Background: Wilson’s disease is a rare genetic disorder characterized by copper accumulation, leading to multi-organ symptoms. It affects between 1 in 30,000 to 1 in 100,000 individuals, with a mean age at diagnosis of 13.2 years. The diagnosis may be overlooked due to its numerous presentations, which can range from non-specific symptoms such as fever, fatigue, and behavioral changes to fulminant hepatic failure. Its clinical manifestations vary widely, making diagnosis during pregnancy particularly challenging. Wilson’s disease complicates pregnancy, as untreated cases can lead to significant morbidity and mortality; excess copper can disrupt metabolic processes and contribute to recurrent miscarriages.

Case: …

Effect Of Social Vulnerability Index On Betamethasone Timing In Patients At Risk Of Preterm Birth, Lizelle Comfort, Gillian Piltch, David Krantz, Frank Ian Jackson, Matthew J. Blitz, Burton Rochelson

Specialty Medicine Faculty Publications

Background/Objectives: Several social vulnerability index (SVI) components have been associated with adverse obstetrical outcomes and provider bias. The objective of this study is to assess whether betamethasone administration timing among patients at risk for preterm birth differs by social vulnerability index. Methods: A multicenter retrospective cohort study of pregnant people at a large academic healthcare system between January 2019 and January 2023. Patients with live singleton gestations at risk for preterm birth who received at least one dose of intramuscular betamethasone for fetal lung maturity from 22 to 34 weeks were included. Patients aged less than 18, who received late-preterm …