Obstetrics and Gynecology Commons^™

A Randomized Trial Of Vaginal Antiseptic Preparation Solutions To Reduce Bacteria Colony Counts In Patients Undergoing Vaginal Surgery, James R. Saelens, Adam J. Langer, Andrew N. Boeckley, Natalie M. Castillo, Julie A. Desouza, Jennifer L. Drerup, Kelly M. Muterspaw, Hannah M. Stump, Rose A. Maxwell, Geoffrey Towers

Obstetrics and Gynecology Faculty Publications

Antiseptic preparation of surgical sites is known to reduce the rate of infective complications. However, surgical site infections (SSI) remain a leading cause of post-operative hospitalizations, increasing patient stress and cost for the healthcare system.1-7 In gynecologic surgery, preparation of the vagina is performed to reduce bacterial load prior to surgery, though it is known to remain contaminated.3 In the US, only solutions containing povidone-iodine (PI) are FDA approved for vaginal preparation; though, a 2018 ACOG Practice Bulletin lists chlorhexidine gluconate (CHG) with low (<4%) alcohol concentrations as a reasonable option for off-label use.3 Other preparations for vaginal surgery have been reported including baby shampoo (BS) and a commercially available preparation, containing PCMX (para-chloro-meta-xylenol, Techni-care®, chloroxylenol), that is marketed specifically for use with mucous membranes.8-12 There is a growing need to establish evidence-based alternatives to iodine for vaginal preparation for patients with allergies or sensitivity to iodine-containing products while minimizing postoperative irritation. One retrospective study comparing BS to PI in gynecologic surgeries showed a non-significant lower rate of surgical site infection with BS.9 One major challenge for determining effectiveness of surgical scrubs for reducing SSI is the relatively rare occurrence of postoperative infection. As an alternative proxy for infection colony counts of bacteria/fungi, before and after preparation, have been used.12,13 BS has been shown to reduce bacterial loads in non-gynecologic surgery, but there is limited data regarding its use in vaginal surgery, even though surgeons have been using BS in cases of iodine allergy or intolerance to other antiseptics.9-12CHG use in vaginal surgery has been debated due to concerns about vaginal irritation, however studies have demonstrated that alteration of the solution to 2-4% chlorhexidine with low (4%) alcohol concentration was associated with mild to no vaginal irritation. CHG showed similar reduction in post-incision bacterial counts and wound infections in cesarean delivery, and reduced colony counts during hysterectomy (when compared to PI).14-20 PCMX and CHG were shown to significantly reduce bacterial colonization of extracted root canals, and PCMX has been marketed specifically for vaginal antiseptic preparation.21 While some information on the effectiveness of these four antiseptic preparations has been documented in the literature, at this time there are no randomized controlled trials comparing these solutions in the context of vaginal surgery. Further evaluation and research of antiseptic solutions is warranted to provide evidence for best practices in minimizing infection and irritation. The purpose of this study was to compare the effectiveness of three antiseptic solutions with the standard, PI, for reducing bacterial colonies as a proxy for SSI, and to assess postoperative irritation and infection symptoms.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Incidence Of Peripartum Hysterectomy In Al-Galaa Teaching Hospital, Marwa R. Shahine, Sherif M. Safwat

Journal of Medicine in Scientific Research

Introduction: A hysterectomy carried out at the moment of delivery or within a day after it is known as a peripartum hysterectomy. Either a scheduled or emergency procedure can be carried out. It is a dramatic life-saving technique carried out when all other conservative management avenues have failed, made worse by the frequent emergency circumstances in which it is carried out.

Objectives: Studying the causes and patterns of peripartum hysterectomy at Al-Galaa Maternity Teaching Hospital, A tertiary referral hospital, in addition to studying the associated maternal and fetal complications.

Methodology: In order to analyze the emergency peripartum hysterectomy performed at …

Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig

Obstetrics and Gynecology Faculty Publications

Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the …

Improvement For Cerclage Placement In Relation To Cervical Length In Patients Undergoing Cerclage Placement At Memorial Health And Relationship With Preterm Birth, J Elise Abernathy, Anthony Royek, A Tanner Fincher, Sai Nagula, Alyssa Moffitt, Abby Unger, Cullen Smith, Eric K. Shaw

South Atlantic Division GME Research Day 2024

No abstract provided.

Sequestering The Diagnosis Of Extra Lobar Bronchopulmonary Sequestration: A Case Report, Tanner Fincher, Reese M. Groover, Amanda Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Second Trimester Uterine Rupture With Abnormal Vascularity Of The Lower Uterine Segment, Munsa Manandhar, Linda Haddox

Central & West Texas GME Research Day 2024

No abstract provided.

Nas Associated With Antenatal Tianeptine Exposure: A Case Report, Francesca Damus, Kaleb Freeman, Candace Murbach, Palmer Johnston

South Atlantic Division GME Research Day 2024

No abstract provided.

A Rare Case Of Fetal Digynic Triploidy Additionally Complicated By Mid Trimester Superimposed Preeclampsia, Claire Mccarthy, Bailey Brown, Amanda Royek, Cameron Soriano

South Atlantic Division GME Research Day 2024

No abstract provided.

A Case Report And Evaluation Of Intrauterine Gas Of Unknown Origin, Chrystal Stallworth, Diane Gilbertson, Timothy Kremer

North Texas GME Research Forum 2024

Introduction: Most reports of intrauterine or endometrial gas have been reported in the setting of underlying gynecologic malignancy or infection. The significance of this case report is to give a presentation of a patient presenting with intrauterine gas who subsequently was found to have neither infectious nor malignant cause for such finding. Case Presentation: Patient is a 56 year old postmenopausal female who presenting with “hip pain” and was found to have incidental intrauterine gas on pelvic CT. She underwent in office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign and …

Bridging The Gap: Evaluating The Impact Of Buprenorphine-Based Prenatal Care On Neonatal Abstinence Syndrome And Maternal Health, Whitney-Lanae Crofcheck-Glenn, Jennifer Nethercutt

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome (NAS), now known as Neonatal Opioid Withdrawal Syndrome (NOWS) by government authorities, is a severe postnatal withdrawal condition caused by opioid exposure during pregnancy. NAS is diagnosed every 25 minutes in the United States. Medication-assisted treatment (MAT) with buprenorphine was used to treat opioid use disorder (OUD) and NAS. The MOTHER trial found that utilizing buprenorphine to treat mother OUD during pregnancy led to significant decreases in LOS and length of therapy.

Purpose of the Study: The purpose of this study is to evaluate the effectiveness of a prenatal care program that integrates buprenorphine-based Medication-Assisted Treatment …

Four Cesarean Scar Pregnancies Managed At Accreta Center Of Excellence At Medical City Dallas Hospital: A Case Series, Ana Adams, Nicole Tenzel, Monica Rodriguez, Robert Cohen

North Texas GME Research Forum 2024

Cesarean Scar Pregnancy results from pathologic implantation of a gestational sac into a hysterotomy scar. This rare disease continues to increase in incidence due to the rise of Cesarean delivery in the United States. Current management recommendations by the Society of Maternal Fetal Medicine (SMFM) include termination of pregnancy, or in rare instances, hysterectomy. This case series examines four patients diagnosed with Cesarean Scar Pregnancies that either declined termination or were unable to receive abortion services in the first trimester, and who were managed at the Accreta Center of Excellence at Medical City Dallas Hospital. This novel management strategy included …

Improving Rates Of Postpartum Depression Screening: A Quality Improvement Project, Sarah Chason, Keisha Reddick, Alexis Brown, Cassandra Hensel, Hannah Pittman, Jennifer Brown

South Atlantic Division GME Research Day 2024

No abstract provided.

Intertwin Membrane Separation In Monochorionic- Diamniotic Twins, Fran Franceschini Lopez, N Moreno, Henry Garcia, Manuel Rivera-Alsina

Central & West Texas GME Research Day 2024

No abstract provided.

Transcatheter Mitral Valve Replacement In The Second Trimester Of Pregnancy: A Case Report, Ashton Tanner Fincher, Andrew Royek, Reese M. Groover, Abigail Haythorn, Anthony Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Development And Implementation Of An Educational Prenatal Packet To Improve Obstetric Management And Patient Education Within A Family And Community Medicine Residency Program, Jalicia Sturdivant, Julianna Snow, Esther Piervil, Erica Paulos, Kimberly Mathurin

South Atlantic Division GME Research Day 2024

No abstract provided.

Biallelic Inheritance Of Autosomal Dominant Polycystic Kidney Disease Gene Mutations And The Veo Spectrum Of Fetal And Neonatal Phenotypes: A Case Series, Mikalah Maury, Caitlin Turner, Andrew Royek, Eleanor Stark, Leyla Nielsen, Anthony Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Quality Improvement Project: Compliance Of Antenatal Testing In Patients With Class Iii Obesity, Isabella L. Sciacca, Timothy Kremer, Nicole Tenzel

North Texas GME Research Forum 2024

The prevalence of obesity in women of reproductive age (20 to 39) in the US is 39.7%. It has been estimated that one-quarter of pregnancy complications are attributable to maternal obesity. Comprehensive prenatal care is imperative to achieving positive health outcomes. This quality improvement (QI) initiative aimed to improve antenatal fetal surveillance rates in patients with class III obesity. Evidence based interventions to test fetal wellbeing were implemented and examined over a 7 month time period to evaluate physician compliance of the standard of care for antenatal surveillance starting at 34 weeks gestation. Following implementation of this initiative, compliance with …

Post-Operative Infection Following Abdominal Hysterectomy With Or Without Surgical Drains, Dylan Gallegos, Dominique Barnes

Central & West Texas GME Research Day 2024

No abstract provided.

Pregnancy Outcome In Assisted Reproductive Technology Pregnancy Complicated By 46 Day Preterm Prelabor Rupture Of Membranes, Type 2 Diabetes Mellitus And Severe Preeclampsia, A Case Report, Dana Rei Cassab, Alexis O'Connell, Maral Darya

East Florida Division GME Research Day 2024

No abstract provided.