Obstetrics and Gynecology Commons^™

Cycle Syncing: Optimizing Women's Quality Of Life, Megan Francois

Theses and Graduate Projects

A woman’s hormones are in constant fluctuation throughout the menstrual cycle. This 28-day, on average, fluctuation can cause major shifts in mood, cognition, exercise tolerance, and nutrition needs. Because of this, there is potential to optimize quality of life if each phase is synced with diet, exercise, and complementary medicine utilizing holistic methods. Implications for further research include a need for additional longitudinal and prospective studies. Factors that need to be addressed include further analysis of the windows of vulnerability over the menstrual cycle according to female hormone fluctuations, effects of hormonal contraceptives, and effects of pathology on the cycle.

Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano

School of Medicine Faculty Publications

Introduction: Tertiary syphilis, a late form of the disease with neurologic, cutaneous, and cardiovascular manifestations, is rarely seen in the United States in modern times. Also called the “great imitator,” syphilis tends to mimic other disease processes, which can lead to a delay in proper diagnosis and treatment. Case: We present the case of a 59-year-old woman who presented for evaluation of possible squamous cell carcinoma of the vulva. After multiple inconclusive biopsies and extensive workup with multiple providers, she was instead found to have cutaneous and neurologic tertiary syphilis. A correct diagnosis was delayed in this patient due to …

The Use Of Near-Infrared Angiography In Evaluating Bowel Anastomosis During A Gynecologic Oncology Surgery, Lea A. Moukarzel, Sarah Andres, Oliver Zivanovic

Abington Jefferson Health Papers

Reducing anastomotic leak rates after bowel resection is a priority among patients undergoing gynecologic oncology surgery. While near-infrared (NIR) angiography has been investigated in the colorectal literature, more recent work has demonstrated promising results when used in gynecologic cancer surgery. It has been repeatedly shown to be a safe intervention that can offer real time assessment of bowel perfusion, offering the surgeon the opportunity to act on the results in the hopes of decreasing the risk of complications.

Best Quality Vs. Sex Selection - An Analysis Of Embryo Selection Preferences For Patients Undergoing Preimplantation Genetic Testing For Aneuploidy Over A 10-Year Period, Pavan Gill, Christine Whitehead, Marie Werner, Emre Seli

Jefferson Health - New Jersey Papers

PURPOSE: Investigate patient preferences in embryo selection for transfer regarding quality versus sex in IVF/ICSI cycles with PGT-A and assess associated clinical implications.

METHODS: Retrospective cohort study at a university fertility practice from January 2012 to December 2021. Included were patients undergoing single frozen euploid transfers with at least one embryo of each sex available. Primary outcomes were preference for embryo selection (quality vs. sex) and sex preference (male vs. female). Trends over 10 years were evaluated and clinical outcomes, including clinical pregnancy rate (CPR), sustained implantation rate (SIR), and live birth rate (LBR), were compared.

RESULTS: A total of …

The Precise-Dyad Neurodevelopmental Substudy Protocol: Neurodevelopmental Risk In Children Of Mothers With Pregnancy Complications, Dorcas Magai, Jaya Chandna, Marie-Laure Volvert, Rachel Craik, Hawanatu Jah, Agnes Msoka, Amina Abubakar, Angela Koech, Grace Mwashigadi, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Over 250 million children are not reaching their developmental potential globally. The impact of prenatal factors and their interplay with postnatal environmental factors on child neurodevelopment, is still unclear—particularly in low- and middle-income settings. This study aims to understand the impact of pregnancy complications as well as environmental, psychosocial, and biological predictors on neurodevelopmental trajectories. Open Peer Review Approval Status 1 2 version 2 (revision) 05 Aug 2024 view view version 1 09 Nov 2023 view view Kimford Meador, Stanford University School of Medicine, Palo Alto, CA,, USA 1. Page 1 of 21 Wellcome Open Research 2024, 8:508 Last …

Scaling Up, Sustaining, And Enhancing School-Based Sexuality Education Programs In Resource-Constrained And Conservative Contexts: Replicable Lessons From Positive-Deviant Countries, Chandra Mouli, Michielsen Kristien, Gogoi Aparajita, Nair M, Ziauddin Mohammed, Hadi S, Ijaz A, Rubio Auriolesh, Marleen Temmerman

Centre of Excellence in Women and Child Health

Despite considerable efforts, progress in the implementationof sexuality education (SE) has been uneven. This study identi-fied six “positive-deviant” low- and middle-income countries,i.e., countries that had scaled up, sustained and enhancedtheir SE programs when many others—in similar social, cul-tural and economic circumstances—were not able to do so. Inother words, they were significantly and consistently moresuccessful than the norm. Countries were shortlisted using avalidated framework and were analyzed using three other vali-dated frameworks on political priority setting, scaling up, andstakeholder engagement. The study found that India, Pakistan,Nigeria, Senegal, Mexico, and Uruguay had scaled up (eithernationwide or in some states/provinces), sustained andenhanced their …

Preeclampsia In The Context Of Covid-19: Mechanisms, Pathophysiology, And Clinical Outcomes, Guilherme M Nobrega, Brittany R Jones, Indira U Mysorekar, Maria Laura Costa

Center on Aging Staff Publications

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to the global COVID-19 pandemic, significantly impacting the health of pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related to COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on the potential correlation between COVID-19 and preeclampsia (PE), a leading cause of maternal and perinatal morbidity worldwide, emphasizing the significance of exploring the relationship between these two conditions. Here, we review the pathophysiological similarities that PE shares with COVID-19, with a particular focus on severe COVID-19 cases and in PE-like syndrome cases related with …

Enriching The Pcos Lifestyle, Callie Coleman

Electronic Theses and Dissertations

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting approximately 4 – 20% of women worldwide. It is associated with insulin resistance, fertility problems, and an increased susceptibility to chronic conditions through multiple inflammatory pathways. Women with PCOS are also at increased risk for disordered eating. The Mediterranean diet is associated with decreased inflammation and risk of chronic conditions, and intuitive eating principles are associated with decreased disordered eating patterns. The purpose of this study was to determine if a six-week nutrition education workshop incorporating information and skills related to both the Mediterranean lifestyle and intuitive eating principles can improve …

Effect Of Male Partners' Involvement And Support On Reproductive, Maternal And Child Health And Well-Being In East Africa: A Scoping Review, Richard Fletcher, Faye Forbes, Abel Fekadu Dadi, Getachew Mullu Kassa, Casey Regan, Anna Galle, Addisu Beyene, Rebecca Liackman, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background and Aims: East African countries have high rates of maternal and childmortality and morbidity. Studies have shown that the involvement of male partners inreproductive health can benefit maternal and child health (MCH). This scoping reviewaims to provide an overview of the evidence across East Africa that describes malepartner involvement and its effect on maternal, reproductive, and child well‐being.

Methods: Ten databases were searched to identify quantitative data on male'sinvolvement in East Africa. Studies reporting qualitative data, “intention to use” dataor only reporting on male partner's education or economic status were excluded.Studies were organized into five a priori categories: antenatal …

Cord Blood Troponin I Levels: Biomarker Evidence Of Fetal Cardiac Injury In Intrahepatic Cholestasis Of Pregnancy, Itamar Futterman, Hitangee Jain, Rodney Mclaren, Jonathan Mays

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Intrahepatic cholestasis of pregnancy has been linked to sudden stillbirth. The suddenness of the stillbirths in these cases have led clinicians to suspect that the pathogenesis of stillbirth in women with intrahepatic cholestasis of pregnancy is not related to asphyxia but rather to an undefined etiology. One leading hypothesis relates certain bile acid metabolites to myocardial injury. OBJECTIVE: The purpose of this study was to determine whether cord blood troponin I levels are increased in fetuses born to mothers with a diagnosis of intrahepatic cholestasis of pregnancy. STUDY DESIGN: A prospective, case-control study was performed at a single institution …

Enhancing Vaginal Delivery In Greece Through Educational And Behavioral Interventions Among Maternity Care Providers Regarding Labor Management: The Engage Stepped-Wedge Randomized Prospective Trial Protocol, Nikolaos Vrachnis, Nikolaos Antonakopoulos, Peter Von Dadelszen, Marianne Vidler, Georgios Maroudias, Jeffrey Bone, Ash Sandhu, Nikolaos Loukas, Laura Magee, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: There is an emerging need to systematically investigate the causes for the increased cesarean section rates in Greece and undertake interventions so as to substantially reduce its rates. To this end, the ability of the participating Greek obstetricians to follow evidence-based guidelines and respond to other educational and behavioral interventions while managing labor will be explored, along with barriers and enablers. Herein discussed is the protocol of a stepped-wedge designed intervention trial in Greek maternity units with the aforementioned goals in mind, named ENGAGE (ENhancinG vAGinal dElivery in Greece).

Methods: Twenty-two selected maternity units in Greece will participate in …

#Hashtagthis – Everything You Need To Know About Launching Your Gynecologic Oncology Social Media Research Career: A Report From Gynecologic Oncology Reports And Society Of Gynecologic Oncology Education Committee, Megan L Hutchcraft, Eric Rios-Doria, Tiffany Y Sia, Eleonora Teplinsky, Shannon N Westin, Gregg Nelson

Faculty, Staff and Student Publications

On February 6th, 2024, Gynecologic Oncology Reports and the Society of Gynecologic Oncology Education Committee co-hosted a webinar about ways to use social media for career enhancement and for dissemination of research. During the discussion, we reviewed:i.how to identify one's goals, target audience, and select a social media platform.ii.how to navigate the negatives of social media.iii.how to develop one's online academic brand.iv.how to use social media for academic promotion and career advancement.v.how to use social media as a research tool.vi.how to use visual tools to bring attention to one's research.The objective of this report is to review the literature on …

A Randomized Controlled Trial Of The Happy, Healthy, Loved Personalized Text-Message Program For New Parent Couples: Impact On Breastfeeding Self-Efficacy And Mood., Erin Henshaw, Marie Cooper, Teresa Wood, Sanchita Krishna, Marie Lockhart, Stacey Doan

Women’s Health Articles

BACKGROUND: Breastfeeding self-efficacy has been identified as an important influence on breastfeeding outcomes. Among new parent couples, partners are uniquely positioned to be sources of support for developing breastfeeding self-efficacy, yet few breastfeeding programs have attempted to involve partners directly. The purpose of this study was to test the impact of a novel program, Happy, Healthy, Loved, on breastfeeding self-efficacy and maternal mood through emphasizing partner support and actively addressing postpartum-specific stress management in a tailored text message delivery program.

METHODS: A randomized trial was conducted in which primiparous mother-partner dyads intending to exclusively breastfeed were recruited at midwestern hospitals …

Effect Of Esketamine On Hypotension In Women With Preoperative Anxiety Undergoing Elective Cesarean Section: A Randomized, Double-Blind, Controlled Trial, Yu Qi, Meiyan Zhou, Yaqi Dong, Wenting Zheng, Qinyu Jiang, Yanyu Li, Xinghe Wang, Jia Sun, Hai Zhou, Zhengquan Hu, Liwei Wang

Faculty, Staff and Student Publications

To investigate the effect of low-doses esketamine on spinal anesthesia-induced hypotension in women with preoperative anxiety undergoing elective cesarean section, the randomized controlled trial enrolled 120 women aged 18-35 years who preoperative State-Trait Anxiety Inventory State scores > 40, conducted from September 2022 to August 2023 in Xuzhou Central Hospital, China. Women in the esketamine group received a single intravenous injection of 0.2 mg/kg esketamine after sensory block level achieved. The incidence of hypotension in the esketamine group was significantly lower than the control group at T2 (10% [6 of 60]; P < 0.001), T3 (5.0% [3 of 60]; P = 0.007) and T4(5.0% [3 of 60]; P = 0.004). Despite being higher in the esketamine group, the overall rates of hypertension (11.7% [7 of 60]; P = 0.186), tachycardia (23.3% [14 of 60]; P = 0.246), and bradycardia (0.0% [0 of 60]; P = 0.079) were no significantly difference between the two groups. STAI-S scores was significantly lower in the esketamine group (mean [SD] 37.52[7.14]) than in the control group (mean [SD] 41.03[9.66], P = 0.39) in postoperative day 1. Spinal anesthesia combined with intravenous low-doses esketamine infusion can significantly reduce the incidence of hypotension in women with preoperative anxiety undergoing elective cesarean section.

Glucose-6-Phosphate Dehydrogenase Deficiency As A Cause For Nonimmune Hydrops Fetalis And Severe Fetal Anemia: A Systematic Review, Neel S. Iyer, Matthew H. Mossayebi, Tracy J. Gao, Lylach Haizler-Cohen, Daniele Di Mascio, Rodney A. Mclaren, Huda B. Al-Kouatly

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that predisposes individuals to hemolysis due to an inborn error of metabolism. We performed a systematic literature review to evaluate G6PD deficiency as a possible etiology of nonimmune hydrops fetalis (NIHF) and severe fetal anemia.

METHODS: PubMed, OVID Medline, Scopus, and clinicaltrials.gov were queried from inception until 31 April 2023 for all published cases of NIHF and severe fetal anemia caused by G6PD deficiency. Keywords included "fetal edema," "hydrops fetalis," "glucose 6 phosphate dehydrogenase deficiency," and "fetal anemia." Cases with workup presuming G6PD deficiency as an etiology for NIHF and …

Assessing Association Between Socio-Demographic Variables And Contraceptive Usage In Married Men Residing In Korangi District, Karachi, Pakistan, Fahmida Khawaja, Gloria Noble Khan, Alia Nasir, Kiran Khowaja

Journal of Asian Midwives (JAM)

Background: Population growth remains an alarming concern for Pakistan as it not only exhausts scarce resources but further impedes socioeconomic development. One potential solution is to advance modern Family Planning (FP), which in the Pakistani context requires specific and rigorous attention towards male contraception in conjunction with female family planning usage. This study aims to determine the association between socio demographic factors and contraceptive use in married men of squatter settlement of Korangi Karachi.
Methods and Materials: A cross-sectional study was carried out from March, 2017 to June 2017, using a non-probability convenience sampling technique to select married men …

Multicountry Spread Of Influenza A(H1n1)Pdm09 Viruses With Reduced Oseltamivir Inhibition, May 2023-February 2024, Mira C Patel, Ha T Nguyen, Philippe Noriel Q Pascua, Rongyuan Gao, John Steel, Rebecca J Kondor, Larisa V Gubareva

Faculty, Staff and Student Publications

Since May 2023, a novel combination of neuraminidase mutations, I223V + S247N, has been detected in influenza A(H1N1)pdm09 viruses collected in countries spanning 5 continents, mostly in Europe (67/101). The viruses belong to 2 phylogenetically distinct groups and display ≈13-fold reduced inhibition by oseltamivir while retaining normal susceptibility to other antiviral drugs.

New Labor Curves Of Dilation And Station To Improve The Accuracy Of Predicting Labor Progress., Emily F Hamilton, Tilekbek Zhoroev, Philip A Warrick, Adi L Tarca, Thomas J Garite, Aaron B Caughey, Jason Melillo, Mona Prasad, Duncan Neilson, Peter Singson, Kimberlee Mckay, Roberto Romero

Women’s Health Articles

BACKGROUND: The diagnosis of failure to progress, the most common indication for intrapartum cesarean delivery, is based on the assessment of cervical dilation and station over time. Labor curves serve as references for expected changes in dilation and fetal descent. The labor curves of Friedman, Zhang et al, and others are based on time alone and derived from mothers with spontaneous labor onset. However, labor induction is now common, and clinicians also consider other factors when assessing labor progress. Labor curves that consider the use of labor induction and other factors that influence labor progress have the potential to be …

Evaluation Of Current Redating Guidelines For Pregnancies ≤9 6/7 Weeks' Gestation, Grace Chen, Clara Choi, Allyson Nguyen, Mark Brunk-Grady, Tuan Nguyen

Conference Presentation Abstracts

Objectives: The aim was to evaluate the validity of the current redating guidelines for pregnancies ≤9 6/7 weeks’ gestation. We postulated that visually apparent discrepancies between crown-rump length (CRL) measured by ultrasound (US) and CRL by last menstrual period (LMP) were statistically significant. Methods: This is a retrospective, cross-sectional study conducted between January 2019 and June 2023 at a tertiary referral center. Individuals who had singleton gestations between ≥6 0/7 and ≤9 6/7 weeks by known LMP were reviewed. For estimated gestational age (EGA) by LMP ≥6 0/7 and ≤8 6/7 weeks, a 3–5 day discrepancy between EGA by LMP …

Delivery Of Hereditary Cancer Genetics Services To Patients Newly Diagnosed With Ovarian And Endometrial Cancers At Three Gynecologic Oncology Clinics In The Usa, Brazil, And Mexico, Erica M Bednar, Keiry A Paiz, Karen H Lu, Aline Patricia Soares Dias De Souza, Gabriela Oliveira, Carlos E Eduardo Mattos Da Cunha Andrade, Lenny Gallardo, Jairo Rubio-Cordero, David Cantu-De-León, Jose Alejandro Rauh-Hain

Faculty, Staff and Student Publications

Objective: Three gynecologic oncology clinics located in the USA, Brazil, and Mexico collaborated to evaluate their delivery of hereditary cancer genetics services. This descriptive retrospective review study aimed to establish baseline rates and timeliness of guideline-recommended genetics service delivery to patients with ovarian, fallopian tube, primary peritoneal (ovarian), and endometrial cancers at each clinic.

Methods: Patients who were newly diagnosed with ovarian and endometrial cancers between September 1, 2018 and December 31, 2020 were identified from the medical records of the clinics. Genetics service delivery metrics included the rates of mismatch repair deficiency tumor testing for patients with endometrial cancer …