Obstetrics and Gynecology Commons^™

Pilot Study To Evaluate Effectiveness Of Concurrent Hpv Vaccination At Time Of Treatment For Vin 2+, Cin 2+, Vain 2+ In Immunocompromised Individuals, Sara Lever Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Effects Of Race And Socioeconomic Factors On Detection Of Gynecological Cancer: State-Wide Analysis, Caitlin Witt Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Enhancing Obgyn Residency Training Through Pudendal Nerve Block Simulation, Allison Lazenby Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Corrigendum: Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Rachel Craik, Alex Mugo, Marleen Temmerman

Pathology, East Africa

Background: Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.

Methods: We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, …

Content And Design Of Respectful Maternity Care Training Packages For Health Workers In Sub-Saharan Africa: Scoping Review, Judith Yargawa, Marina Daniele, Kelly Pickerill, Marianne Vidler, Angela Koech, Hawanatu Jah, Grace Mwashigadi, Mukaindo Mwaniki, Peter Von Dadelszen, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear.

Objective To explore the content and design of RMC training packages for health workers in sub-Saharan Africa.

Search Strategy MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022.

Selection Criteria There were no restrictions on study designs, language, or health-worker cadre. Two reviewers independently screened results.

Data Collection and …

Beyond The Mirage: Confronting Historic Inequities In Maternal Care Deserts., Chynna Smith

Women’s Health Articles

No abstract provided.

Polycaprolactone-Based Shape Memory Foams As Self-Fitting Vaginal Stents, Ashley J Hicks, Courteney Roberts, Andrew Robinson, Kailey Wilson, Varsha Kotamreddy, Trace Larue, Arian Veyssi, Felipe Beltran, Julie Hakim, Manuel K Rausch, Melissa Grunlan, Elizabeth Cosgriff-Hernandez

Faculty, Staff and Students Publications

There is an urgent critical need for a patient-forward vaginal stent that can prevent debilitating vaginal stenosis that occurs after pelvic radiation treatments and vaginal reconstruction. To this end, we developed a self-fitting vaginal stent based on a shape-memory polymer (SMP) foam that can assume a secondary, compressed shape for ease of deployment. Upon insertion, the change in temperature and hydration initiates foam expansion to shape fit to the individual patient and restore the lumen of the stent to allow egress of vaginal secretions. To achieve rapid actuation at physiological temperature, we investigated the effect of architecture of two photocurable, …

A Mouse Model For Conditional Expression Of Activated Β-Catenin In Epidermal Keratinocytes, Vineet K Maurya, Yan Ying, John P Lydon

Faculty, Staff and Students Publications

We report the generation and characterization of the K5: CAT bigenic mouse in which the constitutively activated form of β-catenin (ΔN89 β-catenin) is conditionally expressed in cytokeratin-5 (K5) positive epidermal keratinocytes. Following short-term doxycycline intake during the telogen resting phase, the adult K5: CAT bigenic develops enlarged pilosebaceous units that expand deep into the dermis, an expansion usually observed during the anagen growth phase. Prolonged doxycycline treatment results in significant thickening and folding of the K5: CAT epidermis. During this persistent induction period, there is clear evidence of increased keratinocyte proliferation, particularly in the epidermal basal cell layer and the …

Blood Pressure During Hospital Stay For Delivery And Risk For Postpartum Readmission For Hypertension, Kaitlyn Taylor, Sai S. Pochana, Andrew Chapple, Maureen Dempsey, Elizabeth F. Sutton

School of Medicine Faculty Publications

OBJECTIVE: To evaluate the association of changes in peripartum blood pressure (BP) with risk for postpartum readmission for hypertension. METHODS: We conducted a retrospective cohort study of birthing individuals delivering from January 1, 2017, to March 1, 2020, in Louisiana. We identified patients with postpartum readmission for hypertension (readmission within 30 days of delivery) and compared BP and clinical and sociodemographic characteristics with those of patients who were not readmitted for hypertension. Patients were also grouped by their BP at both admission for delivery and 36 hours postpartum: systolic below 130 mm Hg and diastolic below 80 mm Hg, systolic …

Management Strategies Of Cesarean Section Ectopic Pregnancy: A Case Report, Hannah E. Daley, Ava R. Hansen, Priyanka Raju Md, Jonathan Buerger Md

Transformative Medicine

Introduction:

Cesarean scar ectopic pregnancy is a rare form of pregnancy with potential life-threatening complications such as severe hemorrhage, uterine rupture, and emergency hysterectomy Currently, there is no consensus regarding a standardized treatment algorithm for this specific variant of ectopic pregnancies.

Case Description:

This case describes a 28-year-old female with history of two prior cesarean sections who was diagnosed with cesarean section scar ectopic pregnancy. Initial management with intramuscular methotrexate was unsuccessful in the setting of inadequate decrease in β-hCG level. The patient ultimately underwent surgical management with dilation and suction evacuation under ultrasound guidance for removal of the ectopic …

Catastrophic Spontaneous Uterine And Bladder Rupture In An Unscarred Uterus, Nathanael N. Hoskins Do, Kathryn Brandt Do, Tory Peterson Md

Transformative Medicine

Introduction:

Uterine rupture during pregnancy is a rare event which can be life-threatening for both the patient and the fetus. This case report describes a rare complication of uterine rupture which ultimately required a hysterectomy and extensive urologic reconstruction.

Case Description:

A 36-year-old patient presented to the hospital after term pre-labor rupture of membranes. The patient underwent induction of labor which ultimately resulted in a uterine rupture in an unscarred uterus. The rupture extended into the posterior bladder wall, right ureter, urethra, and anterior vaginal wall, resulting in a vesicovaginal fistula. The patient required a cesarean hysterectomy due to the …

Same Or Different? Resolution Of Diagnostic Difficulty Of Two Mixed Cell-Type Tumors In Ovarian Pathology., Sarah Ingram, Priyanka Raju Md, Wei Shaw Do, Steve Sowers Pa, Kelly Brenan-Rothschild Md

Transformative Medicine

Introduction: When confronted by two disease processes, physicians in all disciplines are faced with the question: Are they manifestations of a common etiology, or distinct entities co-occurring? Inherent in this dilemma is whether an aberration from normal is even a disease process at all. Tissue pathology plays a key role in resolving this conundrum. Although diagnoses can be challenging, there are various methodologies used in the field of pathology to ascertain whether two tumors are of the same or different origins.

Case Description: This case report reviews two patients with large ovarian neoplasms and surgical pathology revealing histopathological features of …

Guardians Of The Genitals: The Dermatogynecologic Duo, Alexis Arza, Erin Stitzlein

Transformative Medicine

No abstract provided.

A Brief Review Of Zuranolone, Aubrey A. Jackson

Transformative Medicine

Zuranolone, a novel analog of allopregnanolone, has been approved by the U.S. Food and Drug Administration (FDA) as the first oral medication approved for the treatment of postpartum depression in adults. Developed by Sage Therapeutics under the brand name Zurzuvae, zuranolone was approved by the FDA on August 4^th, 2023.¹ Zuranolone is a modified version of brexanolone (sold under the brand name Zulpresso), an intravenously administered allopregnanolone formulation that was previously the only FDA-approved medication for postpartum depression. Zuranolone offers a more accessible treatment option for patients with efficacy established in clinical trials. Its approval expands the …

Untargeted Metabolomic Biomarker Discovery For The Detection Of Ectopic Pregnancy, Onur Turkoglu, Ayse Citil, Ceren Katar, Ismail Mert, Robert A Quinn, Ray O Bahado-Singh, Stewart F Graham

Faculty, Staff and Students Publications

Ectopic pregnancy (EP) is the leading cause of maternal morbidity and mortality in the first trimester. Using an untargeted metabolomic approach, we sought to identify putative plasma biomarkers using tandem liquid chromatography-mass spectrometry for the detection of tubal EP. This case-control study included the prospective recruitment of 50 tubal EP cases and 50 early intrauterine pregnancy controls. To avoid over-fitting, logistic regression models were developed in a randomly selected discovery group (30 cases vs. 30 controls) and validated in the test group (20 cases vs. 20 controls). In total, 585 mass spectral features were detected, of which 221 molecular features …

Knowledge And Confidence Of Obstetrics And Gynecology Residents In The Evaluation And Management Of Heavy Menstrual Bleeding Due To Inherited Bleeding Disorders., Patricia S. Huguelet, Irmel A. Ayala, Laurel Beaty, Christina Bemrich-Stolz, Claudia Borzutzky, Tazim Dowlut-Mcelroy, Sweta Gupta, Kendra Hutchens, Corinna L. Schultz, Lakshmi Srivaths, Maria C. Velez, Neeraja Swaminathan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Heavy menstrual bleeding (HMB) is common, and 20-30% of patients presenting with HMB are diagnosed with an inherited bleeding disorder (IBD). Despite the frequent association of HMB with bleeding disorders, specific learning objectives on this topic are lacking for Obstetrics and Gynecology (OBGYN) residents.

OBJECTIVE: We sought to determine the exposure of OBGYN residents to didactics, clinical training, and confidence in evaluation and management of patients with HMB due to IBDs.

METHODS: Prospective survey of OBGYN residents through email solicitation. Residents were invited to complete an anonymous 26-item survey, querying residents' confidence in evaluation and management of HMB in …

Financial Toxicity In Breast Cancer Patients Receiving Regional Nodal Irradiation: Variation By Cancer Subtype, Grace L Smith, Benjamin D Smith, Chi-Fang Wu, Simona F Shaitelman, Mariana Chavez-Macgregor, Rashmi Murthy, Kelsey Kaiser, Kimberly S Ku, Julia J Shi, Sanjay S Shete, Ying-Shiuan Chen, Robert J Volk, Sharon H Giordano, Ya-Chen T Shih, Karen E Hoffman

Faculty, Staff and Student Publications

BACKGROUND: We evaluated sociodemographic and clinical predictors of financial toxicity (FT) among patients with breast cancer with higher risk clinical factors warranting regional nodal irradiation (RNI).

METHODS: Among 183 participants in a clinical trial of conventional vs. hypofractionated treatment with RNI, 125 (68 %) completed a pilot survey of FT measured using the validated Economic Strain and Resilience in Cancer (ENRICh) instrument, scored from 0 (minimal) to 10 (severe) FT. Associations with predictors were evaluated using Pearson correlation coefficients and Kruskal Wallis, Mann-Whitney U, and Jonckheere-Terpstra tests. Predictors of severe FT (ENRICh≥5) were tested using multivariable logistic regression with odds …

Survival Outcomes After Omission Of Surgery For Ductal Carcinoma In Situ, Elizabeth C Poli, Wenli Dong, Simona F Shaitelman, Nina Tamirisa, Yu Shen, Isabelle Bedrosian

Faculty, Staff and Student Publications

Clinical trials of active surveillance (AS) for Ductal Carcinoma in Situ (DCIS) are underway. We sought to understand the historical management of biologically favorable DCIS and to determine the outcomes of patients who did not have immediate surgery. Using data from the NCDB from 2004 to 2017, the selected cohort included women >40 years of age, with low or intermediate grade and hormone receptor (HR) positive DCIS. AS was defined as either no surgery or surgery >12 months from diagnosis. Women in the AS group were compared to women who had immediate surgery. A Cochran-Armitage test was used to assess …

Creb-Binding Protein/P300 Bromodomain Inhibition Reduces Neutrophil Accumulation And Activates Antitumor Immunity In Triple-Negative Breast Cancer, Xueying Yuan, Xiaoxin Hao, Hilda L Chan, Na Zhao, Diego A Pedroza, Fengshuo Liu, Kang Le, Alex J Smith, Sebastian J Calderon, Nadia Lieu, Michael J Soth, Philip Jones, Xiang Hf Zhang, Jeffrey M Rosen

Faculty, Staff and Students Publications

Tumor-associated neutrophils (TANs) have been shown to promote immunosuppression and tumor progression, and a high TAN frequency predicts poor prognosis in triple-negative breast cancer (TNBC). Dysregulation of CREB-binding protein (CBP)/P300 function has been observed with multiple cancer types. The bromodomain (BRD) of CBP/P300 has been shown to regulate its activity. In this study, we found that IACS-70654, a selective CBP/P300 BRD inhibitor, reduced TANs and inhibited the growth of neutrophil-enriched TNBC models. In the bone marrow, CBP/P300 BRD inhibition reduced the tumor-driven abnormal differentiation and proliferation of neutrophil progenitors. Inhibition of CBP/P300 BRD also stimulated the immune response by inducing …

Unique Considerations In The Management Of Healthcare Among Fertile Women A Case Report On Chronic Myeloid Leukemia And Pregnancy, Hermione Yamyo Monie, Taha Al Hassan, Salomon Pardo Roca, Uchechi Ehiemua, Ramiro Leal

Research Colloquium

Background: With the overturning of Roe v. Wade, the management of women who are family planning has become more complex, highlighting the necessity for comprehensive and informed healthcare. This case report underscores the importance of holistic, interdisciplinary care for women with chronic conditions like Chronic Myeloid Leukemia (CML) who are planning for pregnancy. The novelty lies in the interplay between oncological treatment and reproductive health under current legal constraints.

Case Presentation: We present the case of a 32-year-old woman, G2P0010, with a history of CML and a previous spontaneous abortion. Initially believed to be in remission, she was started …