Obstetrics and Gynecology Commons^™

Barriers To Doula Use In New Jersey After 2021 Medicaid Coverage Expansion, June Solow, Aashna Reddy, Natali Sharma, Jonathan Lewis

Rowan-Virtua Research Day

Background: Doulas are trained non-clinical professionals that provide continuous support to a pregnant mother from the prenatal to postpartum period. Presence of a doula has been shown to benefit both mother and newborn health.

Purpose: To determine what prevents doula utilization in New Jersey.

Methods: A review of the current literature about doulas, mothers, clinicians, and legislation in other states was conducted. This included qualitative and quantitative data gathered in the United States.

Results: The most significant barrier from both the mother’s and doula’s perspectives is cost. Besides cost, diversity and number of doulas is low. A major barrier to …

Pregnancy Outcome With In Vitro Fertilization-Embryo Transfer According To Age In Women With Diminished Oocyte Reserve (Dor) Using A Follicle Stimulating Hormone Receptor Up-Regulation Technique, Brooke Neumann, Jerome Check, Carrie Wilson, Michael Sobel, Jung Choe

Rowan-Virtua Research Day

Objective: About 18 years ago, one of the top IVF centers published a study and found that women with DOR did not have any live deliveries at any age in women with a day 3 serum FSH exceeding 18 mIU/mL. The failure to achieve a live delivery may have been related to the ovarian hyperstimulation regimen with possible down regulation of the FSH receptor needed to produce a key enzyme needed for successful implantation. The purpose of this 25-year retrospective review was to evaluate the efficacy of a specific type of mild stimulation referred to as the FSH receptor up-take …

The Vaginal Microbiome Post-Menopause And Urinary Tract Infections, Rifke Anolik, Julia Kiffel, Venkateswar Venkataraman

Rowan-Virtua Research Day

Background: Urinary Tract Infection (UTI) is a condition where pathogens invade the urinary tract and can travel up the urethra and into the bladder. UTIs occur more commonly in females compared to males and in the post-menopausal population this rate increases significantly. While these infections may be asymptomatic, they can also cause severe discomfort and lead to serious and even life threatening complications. Recent investigation into the vaginal microbiome has opened the doors to a possible mechanism behind the increased incidence of UTIs after menopause. Understanding the pathogenesis behind the increased risk of UTIs in the postmenopausal state will allow …

Ovarian Hemorrhagic Cyst In A 42-Year-Old Female Receiving Ivf, Aloysius Ibe, Francesca Dileonardo, Robin Lahr, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 42-year-old female who presented with lower abdominal/pelvic pain and diagnosed with an active hemorrhagic ovarian cyst after undergoing egg retrieval as part of in-vitro fertilization (IVF) treatment. The differential for abdominal pain in women is vast, but for this patient receiving IVF we had to consider ovarian hyperstimulation syndrome and ectopic pregnancy just to name a few examples. It is predictable that most women will suffer from a ruptured ovarian cyst at some point in their lifetime so long as they continue to menstruate.

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Maternal Attitudes, Adjustment, Health Behaviors, And Social Support Among Mothers Of Infants In The Neonatal Intensive Care Unit, Ryanne N. Schaad, Alexa Bonacquisti, Elizabeth Greco, Chloe Hriso

Research Day

Introduction: A growing body of research suggests that an infants’ admission to a neonatal intensive care unit (NICU) is associated with adverse maternal mental health outcomes. Maternal attitudes, adjustment to motherhood, social support, and health behaviors may be important modifiable factors that could improve quality of life and well-being among NICU mothers. The current study examined the relationships among maternal attitudes, adjustment to motherhood, health behaviors, social support, and psychological functioning in NICU mothers.

Methods: One hundred twenty-seven women were recruited from NICUs at three hospitals in the Philadelphia area and completed self-report measures while in the NICU. Descriptive analyses …

The Impact Of Maternal Diabetes On Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For Fetal-Placental Development, Sheryl Choo, Barbra De Vrijer, Timothy R H Regnault, Hilary K Brown, Larry Stitt, Bryan S Richardson

Obstetrics & Gynaecology Publications

Introduction

We determined the impact of gestational diabetes (GDM) and pre-existing diabetes (DM) on birth/placental weight and cord oxygen values with implications for placental efficiency and fetal-placental growth and development.

Methods

A hospital database was used to obtain birth/placental weight, cord PO₂ and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA >34 weeks (N = 69,854). Oxygen saturation was calculated from the cord PO₂ and pH data, while fetal O₂ extraction was calculated from the oxygen saturation data. The effect of diabetic status on birth/placental weight and cord oxygen values …

Abortion Access And Medically Complex Pregnancies Before And After Texas Senate Bill 8, Whitney Arey, Klaira Lerma, Emma Carpenter, Ghazaleh Moayedi, Lorie Harper, Anitra Beasley, Tony Ogburn, Kari White

School of Medicine Publications

Objective: To evaluate how Texas health care professionals who care for patients experiencing medically complex pregnancies navigate abortion restrictions.

Methods: We conducted qualitative in-depth interviews with health care professionals across Texas who cared for patients with life-limiting fetal diagnoses or who had existing or developed health conditions that adversely affected pregnancy. We conducted the first round of interviews March-June 2021 and the second round of interviews January-May 2022 after the implementation of Texas Senate Bill 8 (SB8), which prohibited most abortions after detection of embryonic cardiac activity. We used inductive and deductive qualitative analysis to identify themes and changes in …

Gestational Weight Gain And The Associated Perinatal Outcomes In Middle Eastern Women, Dana Rector, Zeynep Alpay-Savasan

Posters

Gestational Weight Gain (GWG) can impact perinatal outcomes for mothers and infants, especially if the mother gains inadequate or excessive weight during pregnancy. We hypothesized that Middle Eastern women would be more likely to gain inadequate weight, compared to the general population, resulting in adverse perinatal outcomes.

The Effects Of Bmi On The Development Of Radiation Cystitis Onset: A Pilot Study, Kelsa G. Kazyak, Bernadette Mm Zwaans

Posters

Radiation cystitis (RC) is a debilitating adverse side effect of pelvic radiation therapy. Despite advancements within the field of radiation oncology, the location of the bladder makes it difficult to avoid during radiation and approximately 5-10% of cancer survivors with a history of pelvic radiation are at risk. While RC is not common, the long-term effects can be crippling and we hope to provide more information on the risk factors to help survivors and inform clinicians.

Erac (Enhanced Recovery After Cesarean): A Safer And More Efficient Recovery Protocol, Allison Deluca

Senior Honors Projects

No abstract provided.

Obstetric Outcomes Assessment For New Mainers, Brendan Prast, Christina T. Holt, Amy Haskins, Debra Rothenberg

Costas T. Lambrew Research Retreat 2023

Introduction

• 13% of Portland’s population in 2019 was recent immigrants

• Numbers have increased, with >350 asylum-seeking families (1500 individuals) in 2022 in Portland alone

• Maine Medical Center (MMC) provides obstetrical care for more newly arrived, non-English speaking patients

• Total deliveries in 2020, 2021 (6192) broke records at MMC

• New Mainers at Increased risk for health disparities due to: language barriers, low socioeconomic status and stressors from a history of trauma

Covid-19 Prevalence And Trends Among Pregnant And Postpartum Individuals In Maine By Rurality And Pregnancy Conditions, Charlie Grantham, Christina Ackerman-Banks, Heather Lipkind, Kristin Palmsten, Katherine Ahrens

Costas T. Lambrew Research Retreat 2023

Our study is the first to estimate prevalence of COVID-19 among pregnant and postpartum individuals for Maine, using data that captures both commercial and public insurance and examines differences by rurality, a known modifier of COVID-19 infections in the U.S. individuals.

The Maine Obstetric Medical Simulation (Momsim) Program Identifies And Categorizes Latent Safety Threats Across Rural Hospitals, Jeffrey Holmes, Leah Mallory, Micheline Chipman, Becky Hunt, Sarah Austin, Tracey E. Mcmillan, Emily Watson, Mainehealth

Costas T. Lambrew Research Retreat 2023

Objective: Combine in-situ simulation with an HFMEA framework to identify and categorize common system wide LST and opportunities to improve patient safety

Opensim-Based Musculoskeletal Modeling: Foundation For Interactive Obstetric Simulator, Bahador Dodge

Electrical & Computer Engineering Theses & Dissertations

The use of mathematical and computational models to understand complex biological systems, such as the human birth process, is a rapidly growing field in medicine. These models can be used to optimize and personalize medical treatments for individual patients, enhance training, and aid in educational efforts. While recent advancements in healthcare, particularly in obstetrics, have improved care for mothers and babies, studies and government reports indicate a rising rate of maternal mortality in the United States.

Despite this rising trend, there is a lack of detailed studies concerning the use of modeling and simulation to develop an interactive obstetrics simulator …

Outcomes Of The "Brca Quality Improvement Dissemination Program": An Initiative To Improve Patient Receipt Of Cancer Genetics Services At Five Health Systems., Erica M Bednar, Minxing Chen, Michael T Walsh, Amanda L Eppolito, Molly H Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Han Gill Chao, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Rebekah Krukenberg, Sandra B Jenkinson, Jennifer J Moore, Cassandra Garcia, Fatimaeliza Gonzalez, Towanna Murray, Linda D Nielsen, Brenda Ho, Megan Haas, Sarah B Greenzweig, Abby Anderson, Christina Johnson, Nichole A Morman, Elizabeth Bowdish, Emaline Wise, Julia N Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F De Gracia, Brooke Levin, Kristin Mattie, Kathryn Zarnawski, Molly Kalasinski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M Kennedy, Rachel A Paul, Michelle Bilbao, Maureen Romero, Rebecca L Carr, Jennifer M Siettmann, Anna K Vercruyssen, Kaycee Leon, Banu K Arun, Andrew V Grainger, David P Warshal, Erin Bowman, Timothy A Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H Lu

Oncology Articles

OBJECTIVE: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

METHODS: QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, …

Prenatal Screening Decision-Making Facilitated Through An Online Patient Education Module, Erin Atkinson

Dissertations and Theses (Open Access)

As recommendations for prenatal genetic screening are expanded to include patients with pregnancies at low risk for aneuploidy, there is a need to develop accessible mechanisms to promote informed decision-making about genetic screening. The use of patient decision aids has been shown to promote informed decision-making. UTHealth Houston has developed and implemented an online module for pre-test triage for genetic counseling and education of low-risk pregnant patients about genetic screening, called the Prenatal Genetic Education Program (PGEP).

Here, through a retrospective chart review, we characterize the use of PGEP to triage previously presumed low-risk patients to genetic counseling, and whether …

Impact Of Recent Abortion Legislation On Patient Trust In Healthcare Providers, Jasmine Tyson Ms

Dissertations and Theses (Open Access)

Trust is a key aspect of any patient-provider relationship as patients must rely on their healthcare providers (HCPs) to provide appropriate care and guidance, maintain confidentiality, and act in their best interests. Studies suggest that recent changes to abortion legislation have resulted in a loss of the patient-physician relationship, with individuals describing feelings of isolation and fear regarding safety and confidentiality, and many seeking information outside of the medical community. An anonymous survey was distributed among members of abortion support groups and advocacy organizations in the United States to assess how recent changes to abortion legislation may impact patient trust …

Perceived Utility Of Genetic Carrier Screening In A Diverse Patient Population, Jack A. Colleran

Dissertations and Theses (Open Access)

Carrier screening assesses whether an individual may carry variants in select genes associated with autosomal recessive and X-linked inheritance. Recent American College of Medical Geneticists (ACMG) guidelines call for utilization of expanded screening that analyzes carrier status for up to hundreds of conditions. In these guidelines, clinical utility is based on alterations to reproductive decision-making. However, clinical utility study cohorts cited by these guidelines were largely white, highly educated, of high income, and were often receiving preconception counseling. There is a lack of research on the perspectives of patients from diverse backgrounds, whose perceptions may be more reflective of those …

Integrating Human Papillomavirus Testing As A Point-Of Care Service Using Genexpert Platforms: Findings And Lessons From A Kenyan Pilot Study (2019–2020), Valerian Mwenda, Joan-Paula Bor, Mary Nyangasi, James Njeru, Sharon Olwande, Patricia Njiri, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Globally, cervical cancer is a major public health problem, with about 604,000 new cases and over 340,000 deaths in 2020. In Kenya, it is the leading cause of cancer deaths, with over 3,000 women dying in 2020 alone. Both the Kenyan cancer screening guidelines and the World Health Organization’s Global Cervical Cancer Elimination Strategy recommend human papillomavirus (HPV) testing as the primary screening test. However, HPV testing is not widely available in the public healthcare system in Kenya. We conducted a pilot study using a point of care (POC) HPV test to inform national roll-out.

Methods: The …