Obstetrics and Gynecology Commons^™

Mammographic Density Mediates The Protective Effect Of Early-Life Body Size On Breast Cancer Risk, Marina Vabistsevits, George Davey Smith, Tom G Richardson, Rebecca C Richmond, Weiva Sieh, Joseph H Rothstein, Laurel A Habel, Stacey E Alexeeff, Bethan Lloyd-Lewis, Eleanor Sanderson

Faculty, Staff and Student Publications

The unexplained protective effect of childhood adiposity on breast cancer risk may be mediated via mammographic density (MD). Here, we investigate a complex relationship between adiposity in childhood and adulthood, puberty onset, MD phenotypes (dense area (DA), non-dense area (NDA), percent density (PD)), and their effects on breast cancer. We use Mendelian randomization (MR) and multivariable MR to estimate the total and direct effects of adiposity and age at menarche on MD phenotypes. Childhood adiposity has a decreasing effect on DA, while adulthood adiposity increases NDA. Later menarche increases DA/PD, but when accounting for childhood adiposity, this effect is attenuated. …

Surgical Approach To Urethral Diverticulum And Urethrovaginal Fistula With Mesh Erosion, Alicia Smith, Lauren Burton, Saifuddin Mama

Einstein Health Papers

INTRODUCTION AND HYPOTHESIS: This video illustrates a rare surgical case involving a urethral diverticulum, urethrovaginal fistula, and mesh erosion.

METHODS: We present a 58-year-old patient attending a tertiary care center with a suspected urethrovaginal fistula. Her concerns included stress urinary incontinence (SUI), recurrent urinary tract infection, and vaginal pain. The surgical history was notable for the placement of two different mesh slings during the same procedure to treat SUI. Preoperative evaluation and findings are illustrated in detail. The video uses a high-definition surgical camera to emphasize the initial intraoperative evaluation with localization of the fistula and diverticulum. We then demonstrate …

An Analysis Of Professional Education For Future Physicians To Address Implicit Racial Bias In Black Maternal Health, Jasmine Butler

Honors Theses

The history of medicine in the United States is littered with incidences of racism and exploitation of Black Americans. The extensive history of medical racism has continued to be perpetuated in healthcare today. Within the field of maternal health, the dark history of medicine shows its face with the treatment of black mothers. Black maternal health is a current public health crisis currently being exacerbated through discrimination in the form of implicit bias. Implicit bias is a current issue in our healthcare system that needs to be addressed through adequate training of both medical students and physicians. This qualitative research …

Long Acting Reversible Contraceptive Removal After Immediate Postpartum Insertion, Andrea Dousdebes Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Postoperative Telemedicine Use: Safety And Satisfaction After Benign Gynecologic Surgery, Chloe Smith Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Use Of Clomiphene Citrate As An Inhibitor Of Ovulation In An Oocyte Cryopreservation Cycle, Shelby Howard Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Genetic Testing After Abnormal Prenatal Ultrasound, Eleanor Germano Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Effect Of Residential Geographic Location On Adverse Pregnancy Outcomes In South-Central Louisiana, Aaliyah Keels Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Trends In Postpartum Birth Control Uptake Following Dobbs Decision, Deanna Dawson Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Program (Pdf), Department Of Obstetrics & Gynecology

Dept. of Obstetrics & Gynecology Resident Research Day

Agenda for the 36th Annual Dept. of Obstetrics & Gynecology Residents Research Day held Friday, May 10, 2024.

Sexual Function After Gender Affirming Surgery, Alicia R. Castellanos, Rachel Pope

Faculty Scholarship

Purpose of Review: Sexual function and satisfaction in the transgender community is a nascent field with a paucity of data due to the fast paced nature of improving upon surgical technique and variety of patient experiences. The authors aim to review the current literature for areas of success as well as areas of improvement in order to better the sexual health of the transgender community. Recent Findings: Gender dysphoria is a feeling of distress experienced by those whose gender assigned at birth is not in line with their gender identity. While social transition to the desired gender can suffice for …

Case Report: Diagnosing & Treating Triple Negative Breast Cancer During Pregnancy, Sydney Mefford, Chloe Page

Posters

Pregnancy associated breast cancer (PABC) is rare and can be seen in every 1 in 3000 pregnant patients. It is associated with a high morbidity rate, especially in cases of Triple Negative Breast Cancer (TNBC).

Prevalence has increased as society grows to have pregnancies at later ages. Risk is elevated for 1 year after delivery of baby.

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …

Contraception And Menstrual Management In Transmasculine And Gender-Diverse Individuals, Adrian Chiem, Maria Cristina Marcos, Beth I. Schwartz

Department of Obstetrics and Gynecology Faculty Papers

Purpose of Review This review outlines the current evidence on the contraceptive and menstrual management methods that are used for transmasculine or gender-diverse (TGD) individuals, as well as the gaps in the literature for this population.

Recent Findings Contraception and menstrual management continue to be an understudied area in the care of TGD individuals, with much of existing research extrapolated from cisgender populations. Emerging studies have looked at contraceptive and menstrual management choices and outcomes in adolescents and highlight the 52 mg LNG-IUD as an option that is efficacious for both indications, as well as high-dose progestin-only pills for menstrual …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

Assessment Of Obgyn Department Research Collaboration And Satisfaction, Anne Bocage, Md, Melanie Hotz, Md, Julia Switzer, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• There are many simultaneous and similar research projects ongoing within the OB-GYN department, but with little collaboration. Additionally, it can be difficult to identify faculty, residents, and students with similar research interests.
• Collaboration between residents is shown to improve research productivity (1) and co-residents serve as effective research mentors (2).
• This project is aimed to assess the department's satisfaction with ongoing research and collaboration and to purpose an intervention for improvement.

Knowledge And Receptiveness Of Epidural Labor Analgesia By Parturients At Two Teaching Hospitals In Rwanda: A Cross-Sectional Study, Casey Fishman, Ba, Justin Do, Bs, Richita Bashyal, Mph, Fidele Hakorimana, Md

Health Equity and Quality Improvement (HEQI) Summit

Introduction

• Pain during labor can result in lasting psychological and physiological effects.¹ Although epidural analgesia is a first line pain management treatment and is used to reduce birth complications in many western countries, it is not commonly used in much of the world including Rwanda. The literature shows that African women have some of the lowest rates of pharmacological pain relief usage.
• Barriers to accessibility include; availability of equipment, staff with sufficient skills and monitoring, or myths and controversies surrounding labor.² Studies have found that some women believe that crying is a sign of weakness.³
• The aim …

Interprofessional Pilot Approach To Standardizing Nursing-Provider Driven Postpartum Urinary Retention Protocol, Mymy Nguyen, Mary Van Schaick, Md, Charlette E. Williams, Md, Anne Bocage, Md, Julia Switzer, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement: Postpartum urinary retention is a frequent cause of distress to new mothers, affecting 1 in 500 patients¹. It is imperative that patients receive prompt diagnosis and management to avoid long term sequelae of urogenital tract morbidity, including detrusor damage and bladder rupture². Although hospital protocols for urinary retention in the non-obstetric setting exist, management of urinary retention in the postpartum setting often varies by nursing-provider preference.

Project AIM: In this QI project, we developed a standardized protocol for postpartum urinary retention, and a comprehensive training model for provider and nursing teams. We assessed …

Providing A Latch Key: Increasing Lactation Education For Medical Students, Elizabeth Wagman, Bs, Santosh Coorg, Md, Cheryl Godcharles, Md, Nabblem-C

Health Equity and Quality Improvement (HEQI) Summit

Background

• Problem Statement: Current Healthy People 2030 data suggests that only up to 25% of infants are exclusively breastfed at six months of life, but target rates are upwards of 40%. Though this trend is multifactorial, an actionable solution is to increase lactation education for residents and medical students to better equip them to counsel patients.
• Project AIM: We aim to increase provider comfort in lactation counseling by implementing lactation education, resources, hands-on training, and postpartum follow-up strategies for Thomas Jefferson University pre-clerkship/ rotating medical students and OB/GYN residents.

Promoting Physiologic Birth By Improving Access To Doulas, Karen Schwartz

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Birth in the United States (U.S.) leans towards a medicalized approach, overlooking the advantages of physiologic birth. Physiologic birth is a natural approach to childbirth, without medical interventions. Intrapartum nurses play an integral role in caring for women during labor by providing continuous labor support. Competing nursing tasks, exacerbated nursing shortages and increased nurse to patient ratios have made it increasingly challenging for intrapartum (IP) nurses to provide continuous labor support to their patients. The aim of this DNP project is to gain insight into the beliefs of IP nurses regarding childbirth and how these beliefs impact their approach to …