Obstetrics and Gynecology Commons^™

Professionally Responsible Coronavirus Disease 2019 Vaccination Counseling Of Obstetrical And Gynecologic Patients, F. A. Chervenak, L. B. Mccullough, E. Bornstein, L. Johnson, A. Katz, R. Mcleod-Sordjan, M. Nimaroff, B. L. Rochelson, A. Tekbali, A. Warman, K. Williams, A. Grünebaum

Journal Articles

© 2021 Elsevier Inc. The development of coronavirus disease 2019 vaccines in the current and planned clinical trials is essential for the success of a public health response. This paper focuses on how physicians should implement the results of these clinical trials when counseling patients who are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed about vaccines with government authorization for clinical use. Determining the most effective approach to counsel patients about coronavirus disease 2019 vaccination is challenging. We address the professionally responsible counseling of 3 groups of patients—those who are pregnant, those planning to become pregnant, and …

Effects Of Maternal Obesity And Gestational Diabetes Mellitus On The Placenta: Current Knowledge And Targets For Therapeutic Interventions, Samantha Bedell, Janine Hutson, Barbra De Vrijer, Genevieve Eastabrook

Obstetrics & Gynaecology Publications

Obesity and gestational diabetes mellitus (GDM) are becoming more common among pregnant women worldwide and are individually associated with a number of placenta-mediated obstetric complications, including preeclampsia, macrosomia, intrauterine growth restriction and stillbirth. The placenta serves several functions throughout pregnancy and is the main exchange site for the transfer of nutrients and gas from mother to fetus. In pregnancies complicated by maternal obesity or GDM, the placenta is exposed to environmental changes, such as increased inflammation and oxidative stress, dyslipidemia, and altered hormone levels. These changes can affect placental development and function and lead to abnormal fetal growth and development …

Development Of Maine Ongoing Outreach Simulation Education (Moose), A Novel Telesimulation Program, To Improve Neonatal Resuscitation In A Rural Community Hospital, Allison Zanno, Misty Melendi, Micheline Chipman, Jeffrey Holmes, Alexa Craig, Samantha Piro, Anna Gilbert, Sarah Gabrielson, Leah Mallory, Anya Culter, Mary Ottolini

Costas T. Lambrew Research Retreat 2021

Objective- To implement monthly neonatal resuscitation telesimulation team training sessions in a rural community hospital delivery room that is feasible, sustainable, and replicable at other sites.

Ketamine Infusions For Post-Cesarean Pain In Patients With Opioid Use Disorder, Talitha Budi, Johanna Cobb, Wendy Craig, Heather Turcotte, Janelle Richard, Aurora Quaye

Costas T. Lambrew Research Retreat 2021

Discussion:

• Opioid consumption may be reduced during ketamine infusion without significant side effects

• Further investigation planned with a prospective, randomized, double-blind, placebo-controlled trial.

Exploring Ob/Gyn Provider Knowledge, Practice And Confidence Levels Before And After Aces Training, Nadi Nina Kaonga, Alexandra Turnbull, Paula Vokey, Julia Brock

Costas T. Lambrew Research Retreat 2021

Trauma-informed training on ACEs improves provider confidence on screening and treating their prenatal patients.

A Qualitative Systemic Review On Maternal Health Disparities In Haitian Women, Alexandra Jean-Louis

Honors Undergraduate Theses

Background: It is universally known that pregnancy is a vulnerable time for a woman's health. Women of all backgrounds endure significant physiological and anatomical changes during pregnancy and after childbirth. But the latest research studies have called attention to the unique experience of Black mothers. Compared to other racial and ethnic groups, Black women encounter health disparities at an all-time higher rate. According to research studies conducted in Haiti and the United States, Haitian women are amongst the community of Black women who are experiencing disproportionate maternal outcomes.

Research Aims: The aim of this systematic review is to …

The Impact Of Introducing Ambulance And Delivery Fees In A Rural Hospital In Tanzania, Corinna Vossius, Estomih Mduma, Robert Moshiro, Paschal Mdoe, Jan Terje Kvaløy, Hussein Kidanto, Sara Lyanga, Hege Ersdal

Faculty of Health Sciences, East Africa

Background Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees. …

Modeling Longitudinal Change In Cervical Length Across Pregnancy, Hope M. Wolf, Shawn J. Latendresse, Jerome F. Strauss Iii, Timothy P. York

Graduate Research Posters

Introduction: A short cervix (cervical length < 25 mm) in the mid-trimester (18 to 24 weeks) of pregnancy is a powerful predictor of spontaneous preterm delivery (gestational age at delivery < 37 weeks). Although the biological mechanisms of cervical remodeling have been the subject of extensive investigation, very little is known about the rate of change in cervical length over the course of a pregnancy, or the extent to which rapid cervical shortening increases maternal risk for spontaneous preterm delivery.

Methods: A cohort of 5,160 unique women carrying 5,971 singleton pregnancies provided two or more measurements of cervical length during pregnancy. Cervical length was measured in millimeters using a transvaginal 12-3 MHz ultrasound endocavity probe (SuperSonic Imagine). Maternal characteristics, including relevant medical history and birth outcome data, were collected for each participant. Gestational age at delivery was measured from the first day of each woman’s last menstrual period and confirmed by ultrasound. Repeated measurements of cervical length during pregnancy were modeled as a longitudinal, multilevel growth curve in MPlus. A three-level variance structure was …

Counting Stillbirths And Covid 19-There Has Never Been A More Urgent Time, Caroline S E. Homer, Susannah Hopkins Leisher, Neelam Aggarwa, Joseph Akuze, Delly Babona, Hannah Blencowe, John Bolgna, Richard Chawana, Aliki Christou, Rafat Jan

School of Nursing & Midwifery

No abstract provided.

Pregnancy Outcomes In Women With Epilepsy And Mthfr Mutations Supplemented With Methylated Folate And Methylcobalamin (Methylated B12)., Emma M Lascar, Nicole M Warner, Michael J Doherty

Articles, Abstracts, and Reports

Antiseizure medications (ASM) may contribute to adverse fetal outcomes in pregnant women with epilepsy (WWE). Folate processing (Methylenetetrahydrofolate reductase, MTHFR) gene abnormalities are common in women with epilepsy and depression. L-methylfolate supplements may bypass MTHFR deficiencies, yet their use in WWE during gestation or on fetal development is not well studied. We examine pregnancy histories of three WWE who supplemented with either folate or L-methylfolate and methylcobalamin (methylated B12) during pregnancies. Their pregnancy outcomes improved with L-methylfolate and methylcobalamin supplementation. L-methylfolate and methylcobalamin supplementation merits further study in WWE who have MTHFR mutations, fertility, recurrent miscarriage and or depression histories.

Comparing The Trends Of Postpartum Depression Screening Scores During And Before The Covid-19 Pandemic, Elif S. Duran, Dung Dang, Tony Ogburn

MEDI 9331 Scholarly Activities Clinical Years

Introduction:

Postpartum depression includes major and minor depressive disorders affecting women in the time period after childbirth. The studies reviewed in our literature found that the COVID-19 pandemic has increased the risk of postpartum depression for women. Our study location, the Rio Grande Valley is one of the hardest-hit locations by the COVID-19 pandemic in the United States. Our patient population is also one with the higher risk factors for postpartum depression. As such, we are expecting the psychological impact of the pandemic to be even more magnified, and thus, actions need to be taken to support the vulnerable population …

Learning From Changes Concurrent With Implementing A Complex And Dynamic Intervention To Improve Urban Maternal And Perinatal Health In Dar Es Salaam, Tanzania, 2011-2019, Brenda Sequeira Dmello, Ziada Sellah, Grace Magembe, Natasha Housseine, Nanna Maaløe, Thomas Van Den Akker, Dan W. Meyrowitsch, Timothy Mushi, Mangalu Masweko, Dorcas Jidayi, Jos Van Roosmalen, Hussein Kidanto

Faculty of Health Sciences, East Africa

Introduction Rapid urbanisation in Dar es Salaam, the main commercial hub in Tanzania, has resulted in congested health facilities, poor quality care, and unacceptably high facility-based maternal and perinatal mortality. Using a participatory approach, the Dar es Salaam regional government in partnership with a non-governmental organisation, Comprehensive Community Based Rehabilitation in Tanzania, implemented a complex, dynamic intervention to improve the quality of care and survival during pregnancy and childbirth. The intervention was rolled out in 22 public health facilities, accounting for 60% of the city’s facility births.

Methods Multiple intervention components addressed gaps across the maternal and perinatal continuum of …

Evaluation Of Time-Dependent Camber And Deflections In Bridge Girders, Furkan Cakmak

Wayne State University Theses

A methodology to predict each stage of camber and displacements in composite prestressed concrete and steel bridge superstructures from inception to end of service life including a prediction of rebound in deck replacement projects is presented. The methodology invokes the use of multiple creep curves and allows the proper simulation of various construction activities each of which feature unique loading events. The proposed method captures the influence of several factors, such as creep and shrinkage of beam and deck concrete as well as prestresses losses induced because of these phenomena. Additionally, the prediction methodology offers the capability to quantify the …

Sexual Behaviour Patterns And Sti Risk: Results Of A Cluster Analysis Among Men Who Have Sex With Men In Portugal, Karel Blondeel, Sonia Dias, Martina Furegato, Armando Seuc, Ana Gama, Ricardo Fuertes, Luís Mendão, Marleen Temmerman, Igor Toskin

Obstetrics and Gynaecology, East Africa

Objectives: Portugal has the highest HIV incidence rate in Western Europe. The proportion assigned to sexual contact between men recently increased to more than 30% of all HIV infections. Men who have sex with men (MSM) are vulnerable to the acquisition of other sexually transmitted infections (STIs), increasing the per-contact risk of HIV infection. Building on syndemic theory, the aim of this analysis was to identify patterns of current sexual behaviour in MSM, and explore their relationship with self-reported current, past STI diagnoses and HIV positive serostatus.

Design: A cross-sectional behavioural survey was conducted in Portugal among MSM, using a …

Impact Of Smoking And Hpv Status On Cervical Cancer Survival In Women Living In Kentucky, 2004-2005 And 2014-2015, Brittany M. Mckinley

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

BACKGROUND/ OBJECTIVE: Cervical cancer is the fourth most commonly occurring malignancy in women worldwide, with an estimated 530,000 new cases and 270,000 new deaths each year (Small et al, 2017). While the incidence of cervical cancer has decreased by approximately 1.9% per year between 2007 and 2011, the death rate has remained stable (Bernard et al, 2014). Studies have shown that nearly all cervical cancer cases are associated with the Human Papilloma Virus (HPV). Many studies support the association of smoking with increased risk of invasive cervical cancer in women with high-risk HPV (Castle et al, 2002; Fang et al, …

Uptake And Determinants Of Cervical Cancer Screening Among Health Care Workers In Aga Khan University Hospital, Nairobi Kenya., Doreen Moraa Osoro

Master of Medicine in Obstetrics and Gynecology

Background: The cancer burden has been rising globally. The reported incidence of cervical cancer is 13.1 / 100,000 globally and 40 / 100,000 in Kenya. Up to 88% of all cervical cancer deaths have been reported in lower to middle-income countries. In comparison, developed countries had up to two to four times lower rates of cervical cancer incidence and mortality. The burden of cancers attributable to carcinogenic infections has potentially modifiable risk factors, for which prevention tools already exist. There is a gap in the implementation of evidence-based interventions including primary prevention with the HPV vaccine and secondary prevention with …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Utilizing Patient-Derived Epithelial Ovarian Cancer Tumor Organoids To Predict Carboplatin Resistance, Justin W. Gorski

Theses and Dissertations--Clinical and Translational Science

The development of patient-derived tumor organoids (TOs) from epithelial ovarian cancer tumor obtained at the time of primary or interval debulking surgery has the potential to play an important role in precision medicine.

Here, we utilize TOs to test front-line chemotherapy sensitivity and to investigate genomic drivers of carboplatin resistance. We developed six high grade serous epithelial ovarian cancer tumor organoids from tissue obtained during debulking surgery (2 neoadjuvant carboplatin exposed, 4 chemo-naïve). Each organoid line was screened for sensitivity to carboplatin at four different doses (100, 10, 1 and 0.1µM). Cell viability curves and resultant EC50 values were determined …

A Simulation-Based Outreach Program Improves Delivery Room Team Confidence In Neonatal Resuscitation At Rural Community Hospitals, Allison Zanno, Misty Melendi, Micheline Chipman, Jeffrey Holmes, Alexa Craig, Samantha Piro, Anna Gilbert, Sarah Gabrielson, Leah Mallory, Anya Culter, Mary Ottolini

Costas T. Lambrew Research Retreat 2021

Objective- Our goal is to pilot the use of an onsite Neonatal Community Outreach Education Program to improve provider confidence with procedural skills and neonatal resuscitation in the delivery room.

The Injustice Of Unfit Clinical Practice Guidelines In Low-Resource Realities, Nanna Maaløe, Anna Marie Rønne Ørtved, Jane Brandt Sørensen, Brenda Sequeira Dmello, Thomas Van Den Akker, Monica Lauridsen Kujabi, Hussein Kidanto, Tarek Meguid, Ib Christian Bygbjerg

Obstetrics and Gynaecology, East Africa

To end the international crisis of preventable deaths in low-income and middle-income countries, evidence-informed and cost-efficient health care is urgently needed, and contextualised clinical practice guidelines are pivotal. However, as exposed by indirect consequences of poorly adapted COVID-19 guidelines, fundamental gaps continue to be reported between international recommendations and realistic best practice. To address this long-standing injustice of leaving health providers without useful guidance, we draw on examples from maternal health and the COVID-19 pandemic. We propose a framework for how global guideline developers can more effectively stratify recommendations for low-resource settings and account for predictable contextual barriers of implementation …