Obstetrics and Gynecology Commons^™

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. …

Identification Of Potent Pan-Ephrin Receptor Kinase Inhibitors Using Dna-Encoded Chemistry Technology, Chandrashekhar Madasu, Zian Liao, Sydney E Parks, Kiran L Sharma, Kurt M Bohren, Qiuji Ye, Feng Li, Murugesan Palaniappan, Zhi Tan, Fei Yuan, Chad J Creighton, Suni Tang, Ramya P Masand, Xiaoming Guan, Damian W Young, Diana Monsivais, Martin M Matzuk

Faculty, Staff and Students Publications

EPH receptors (EPHs) are highly sought-after drug targets owing to their essential roles in maintaining appropriate cellular functions in both physiological and disease conditions. However, limited potency and specificity pose significant obstacles to the development of small-molecule inhibitors for EPHs. Here, using high-throughput DNA-encoded chemical library screenings, we developed potent and selective inhibitors of the EPH receptor kinase family. Our results also emphasize the therapeutic potential of our EPH inhibitors in cancer and endometriosis, a global health concern that causes chronic pain and often leads to infertility in women. This study showcases the robust pipeline of using DNA-encoded chemistry technology …

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 …

Minimally Invasive Tissue Extraction: Continued Growth Through Simulation For Obgyn Residents, Angela Frankel, Md, Mph, Melanie Hotz, Md, Patrick Teefey, Md

Department of Obstetrics and Gynecology Posters

Background

• Minimally invasive surgery often requires tissue morcellation for extraction of large surgical specimens.¹
• Surgeon comfort with tissue morcellation in gynecologic surgery is vital in providing a minimally invasive (MIS) approach.
• However, OBGYN residents often feel underprepared to perform this skill independently.²
• While practicing tissue morcellation in the OR is ideal, simulation has been shown to improve resident technical skill without risking increased operative time or associated morbidity.³
• This intervention seeks to build upon a prior simulation exercise, with the ultimate goal of improving OB-GYN resident self-reported comfort with minimally invasive tissue extraction.

Addressing Intimate Partner Violence (Ipv) Amongst Pregnant And Postpartum Individuals, Charlette E. Williams, Md, Elizabeth S. Hood, Bs, Julia F. Switzer, Md

Department of Obstetrics and Gynecology Posters

Goals of Project

1. Better recognition of Intimate Partner Violence (IPV) as it relates to our poor maternal morbidity and mortality statistics/outcomes
2. Better trauma-informed education surrounding recognition of red flag signs/symptoms for House Staff/Ob-Gyn rotation students
3. Better paring of patients with resources both in the clinic setting & postpartum

Sages Guidelines For The Use Of Laparoscopy During Pregnancy, Sunjay S. Kumar, Amelia T. Collings, Claire Wunker, Dimitrios I. Athanasiadis, Colin G. Delong, Julie S. Hong, Mohammed T. Ansari, Ahmed Abou-Setta, Emily Oliver, Vincenzo Berghella, Vamsi Alli, Imran Hassan, Celeste Hollands, Patricia Sylla, Bethany J. Slater, Francesco Palazzo

Department of Surgery Faculty Papers

BACKGROUND: When pregnant patients present with nonobstetric pathology, the physicians caring for them may be uncertain about the optimal management strategy. The aim of this guideline is to develop evidence-based recommendations for pregnant patients presenting with common surgical pathologies including appendicitis, biliary disease, and inflammatory bowel disease (IBD).

METHODS: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Guidelines Committee convened a working group to address these issues. The group generated five key questions and completed a systematic review and meta-analysis of the literature. An expert panel then met to form evidence-based recommendations according to the Grading of Recommendations Assessment, …

Moonlighting: A Pilot Project To Assess Impact Of Extracurricular Activities On Career Satisfaction And Quality-Of-Life In Graduate Medical Education, Charlotte O'Sullivan, David Lee, Karen Childers, Justine Nasr

Conference Presentation Abstracts

Background: Moonlighting is the delivery of healthcare outside of training programs in exchange for compensation. The Accreditation Council on Graduate Medical Education allows individual training programs to permit or restrict moonlighting, which leads to variation in prevalence and practice. Guidelines and regulations for moonlighting vary greatly across graduate medical education programs. Yet, limited research has been done to determine resident and fellow physician attitudes towards moonlighting and its impact on quality-of-life. Objective: This pilot study investigates how participating in moonlighting and extracurricular activities may impact resident and fellow physicians’ self-perceptions of quality-of-life and career satisfaction. Methods: 442 residents and fellow …

Unplanned Pregnancy As An Independent Risk Factor For Antepartum Si In A Post Roe Vs. Wade World, Rianna Mcnamee

Rowan-Virtua Research Day

Abstract: The objective of this literature review is to determine whether unplanned pregnancy is an independent risk factor for developing antepartum SI. Background: The Supreme Court of the United States of America recently ruled that the constitution of the United States does not confer a right to abortion to its citizens. As of October 2023, twenty-one states had developed full or partial bans on abortion, resulting in millions of Americans residing in areas where terminating unplanned pregnancy is not a viable option. There is evidence that indicates antepartum suicidal ideation (SI) is higher than that of the general population, however …

Chronic Schizophrenia Presenting With Psychogenic Polydipsia Masking Stage Iv Uterine Adenocarcinoma, Dakota B. Pastore, Kamayel Jaludi, Angelo Sica

Rowan-Virtua Research Day

Background: Psychogenic polydipsia (PPD) is a condition of excessive water intake and seeking behavior with a 6-20% prevalence among patients with psychiatric illnesses, commonly Schizophrenia. It remains unknown how often concomitant disease can mask other, more serious conditions in psychiatric patients.

Case Description: The patient is a 58-year-old Hispanic, white female with chronic schizophrenia complicated by multiple hospitalizations for hyponatremia secondary to PPD. The patient initially presented to the emergency department (ED) in 2016 with abdominal pain, was treated symptomatically and discharged. From 2020 to 2023, the patient was readmitted seven more times, with two suspected aspirin overdoses, an Ambien …

Improving Primary And Gynecological Care In Transmasculine Patients, Alison N. Mautner, Joanna Petrides

Rowan-Virtua Research Day

Introduction: This study aimed to assess the healthcare experiences of transmasculine individuals in primary and gynecological care settings. An online, anonymous survey was conducted to gather insights into positive and adverse encounters, factors influencing care-seeking behaviors, and strategies for improving care delivery in this population.

Methods: A survey was administered between June 1st and July 23rd, 2023, recruiting participants from three LGBTQ+ affirming healthcare offices in South Jersey and via Reddit. Data analysis involved SPSS to gain information from 499 valid responses.

Results: The majority of participants (55%) were aged 18-24, with 51% identifying as transgender men. Over two-thirds (68.5%) …

A Rare Intervention: Perimortem Hysterotomy In An Obstetric Emergency In A 32-Year-Old Female, Alec Mirchandani

Rowan-Virtua Research Day

In the realm of obstetric emergencies, perimortem hysterotomy stands as a rare but crucial intervention, employed in dire circumstances to salvage both maternal and fetal lives. This procedure, involving the surgical delivery of a fetus from a mother in cardiac arrest, presents a unique set of challenges and ethical considerations for healthcare providers. This case report delves into the intricate details surrounding a perimortem hysterotomy performed under emergent conditions, exploring the clinical decision-making process, procedural intricacies, and outcomes. Through this narrative, we aim to shed light on the complexities of managing obstetric emergencies, emphasizing the critical role of timely intervention …

Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy is a rare form of heart failure (HF) that occurs in the late stages of pregnancy or in the early postpartum period. For it to be classified as PPCM, it must occur in the absence of another identifiable cause for HF and have left ventricular (LV) systolic dysfunction with an LV ejection fraction (LVEF) less than 45%. Here we present the case of a 46-year-old female G3P2 presented 5 days postpartum cesarean section delivery in acute respiratory distress where point of care ultrasound was used for assessment of the lungs to visualize …