Obstetrics and Gynecology Commons^™

Changing Prevalence Of Gestational Diabetes Mellitus During Pregnancy Over More Than A Decade, Aisha Sheikh, Lumaan Sheikh

Section of Diabetes, Endocrinology and Metabolism

No abstract provided.

Microrna-16, Programmed Cell Death Protein-4 (Pdcd-4) And Polycystic Ovarian Syndrome, Naseem Zehra, Arfa Azhar, Rehana Rehman

Department of Biological & Biomedical Sciences

No abstract provided.

Concurrent Hysterectomy And Bilateral Salpingo-Oophorectomy During Cytoreductive Surgery And Hyperthermic Intraperitoneal Chemotherapy For Non-Gynecologic Cancers, Mckayla J. Riggs, Miranda Lin, Joseph Kim, Prakash Pandalai, Charles S. Dietrich Iii

Obstetrics and Gynecology Faculty Publications

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a key component of treatment in non-gynecologic peritoneal surface malignancies. As many as 10-15% of patients with a gastrointestinal primary malignancy will present with carcinomatosis. Maximal cytoreductive surgery directly affects the prognosis of patients. The routine inclusion of hysterectomy with bilateral salpingo-oophorectomy during these procedures optimizes cytoreduction despite negative pre-operative imaging and findings at the time of surgery. In this case series, we review twenty non-gynecologic cancer patients who underwent cytoreductive surgery with concurrent hysterectomy and bilateral salpingo-oophorectomy and HIPEC at our institution.

Family Planning And Afghan Refugee Women And Men Living In Melbourne, Australia: New Opportunities And Transcultural Tensions, Alana Russo, Belinda Lewis, Razia Ali, Atiq Abed, Grant Russel, Stanley Luchters

Population Health, East Africa

This research aimed to explore the family planning perspectives and experiences of Afghan women and men living in Melbourne. A total of 57 Afghan women and men participated in six focus groups and 20 semi-structured interviews. The majority of participants indicated a preference for two or three children and were open to using modern contraception. However, many women described experiencing negative side effects when using hormone-based contraception and expressed difficulty negotiating condom use with their husbands as an alternative. Some women described how these difficulties resulted in inconsistent contraceptive practices and, at times, unintended pregnancy. Participants recognised that health professionals …

Role Of Oxidative Stress And Altered Thyroid Hormones In Unexplained Infertility, Rehana Rehman, Hiba Ismail Rajpar, Mussarat Ashraf, Najeeha Talat Iqbal, Salima Lalani, Faiza Alam

Department of Biological & Biomedical Sciences

Objective: To explore the link between altered thyroid profile and oxidative stress marker in females with unexplained infertility.
Methods: The cross-sectional case-control study was carried out at the Islamabad Clinic Serving Infertile Couples, Islamabad, Pakistan, from June 2016 to August 2017, and comprised women aged 18-40 years regardless of ethnic background who were divided into two groups; those with unexplained infertility were the cases, while fertile women acted as the controls. Serum was analysed for triiodothyronine, thyroxine and thyroid stimulating hormone as well as for oxidative stress markers including manganese superoxide dismutase, glutathione reductase and adrenaline using enzymelinked immunosorbent assay. …

A Different Strategy For Management Of A Case Of Adenoid Cystic Carcinoma Of Bartholin Gland, Rozilla Sadia Khan, Huda Saleem Abbasi

Department of Obstetrics & Gynaecology

Adenoid cystic carcinoma of the Bartholin gland is a rare vulval cancer. Available literature suggests an aggressive nature with protracted clinical symptoms and local recurrence despite adequate surgical excision with or without adjuvant radiotherapy. This case demonstrates the role of neoadjuvant chemotherapy and interstitial brachytherapy with less radical surgery, in the treatment of adenoid cystic carcinoma of the Bartholin gland. A 63-year-old woman presented in the clinic four months after the removal of vulvar mass with histopathology report showing adenoid cystic carcinoma of the Bartholin gland with positive margins. Clinical examination and imaging showed local disease extension up to the …

Postpartum Opioid Use Following Vaginal Deliveries With No Or Minor Obstetric Perineal Lacerations, Samantha Richardson, Todd W. Gress, Amanda Pauley, David C. Jude

Marshall Journal of Medicine

Introduction

Recommendations for management of pain following vaginal delivery are not specific and do not differentiate patients based on the degree of perineal trauma. Our objective is to describe patterns of postpartum opioid use in women with no or minor perineal trauma.

Methods

This is a retrospective cohort study describing the characteristics of opioid analgesia usage among women with no or minor perineal lacerations at the time of vaginal delivery in a university affiliated regional hospital.

Results

For the 6-month study period, 433 patients were eligible for inclusion. Of these, 423 (97.69%) were ordered as needed narcotics during their post-partum …

Reducing Overtreatment Of Urinalysis In Obstetric Triage Patients, Emelia Winston, Rachel Marteney, Erin Casey, Kevin Conway

Marshall Journal of Medicine

Introduction

Overtreatment of asymptomatic bacteriuria (ASB) is a major issue that has been coming to the forefront in recent decades. Studies have shown that it can lead to adverse side effects, extra costs, and antimicrobial resistance. The purpose of this study was to determine the number of patients presenting to obstetric triage who were overtreated for a urinalysis (UA) and to see if an educational intervention could reduce the incidence of overtreatment for suspected ASB.

Methods

This was a retrospective chart review analyzing UA results and outcomes of OB triage patients that came through labor and delivery before and after …

Case Report On Leiomyosarcoma Of The Vulva: A Rare Pathology, Samantha A. Smith, Nadim Bou Zgheib, Andrea M. Vallejos, Jonathan D. Cuda

Marshall Journal of Medicine

Leiomyosarcoma (LMS) of the vulva is rare. However it is the most common histologic subtype of vulvar sarcoma, accounting for approximately 1% of all vulvar malignancies. ^[1-8] Whether genetics and epigenetics play a role in pathogenesis is unclear. ^[1] The tumor is slow-growing with non-specific symptoms, has high metastatic potential, and follows a bimodal age distribution. ^[1-8] Diagnosis and prognosis are based upon immunohistochemical expression and criteria from early literature. ^[1,3,5-7] The most common therapeutic approach involves radical vulvectomy with lymph node resection. The value of adjuvant chemotherapy and radiation remains unknown. ^[1,3,5-8] Our case describes a 46-year-old Caucasian G2P2 …

Interactions Between The Physical And Social Environments With Adverse Pregnancy Events Related To Placental Disorders—A Scoping Review, Yolisa Prudence Dube, Newton Nyapwere, Laura A. Magee, Marianne Vidler, Sophie E. Moore, Benjamin Barratt, Rachel Craik, Peter Von Dadelszen, Prestige Tatenda Makanga, Marleen Temmerman, Angela Koech, Patricia Okiro, Geoffrey Omuse, Sikolia Wanyonyi

Obstetrics and Gynaecology, East Africa

Background: Due to different social and physical environments across Africa, understanding how these environments differ in interacting with placental disorders will play an important role in developing effective interventions.

Methods: A scoping review was conducted, to identify current knowledge on interactions between the physical and social environment and the incidence of placental disease in Africa.

Results: Heavy metals were said to be harmful when environmental concentrations are beyond critical limits. Education level, maternal age, attendance of antenatal care and parity were the most investigated social determinants.

Conclusions: More evidence is needed to determine the relationships between the environment and placental …

A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, Rabia Hammad, Sidrah Nausheen, Mumtaz Malik

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is a rare condition, with few cases reported in the literature. Despite being rare, it is a potentially life-threatening condition in women of child-bearing age. It should be considered in the differential diagnosis of prolonged or irregular vaginal bleeding, which, otherwise, can lead to critical complications ending up in severe morbidity and mortality. This case series describes four cases of young Asian women aged between 33 and 38 years who presented with irregular vaginal bleeding. Trans-abdominal ultrasound of the pelvis showed increased vascularity with multi-directional blood flow in the uterus. Magnetic resonance imaging (MRI) confirmed an …

Assessing The Effect Of Interventions For Axial Spondyloarthritis According To The Endorsed Asas/Omeract Core Outcome Set: A Meta-Research Study Of Trials Included In Cochrane Reviews., Rikke A Andreasen, Lars E Kristensen, Xenofon Baraliakos, Vibeke Strand, Philip Mease, Maarten De Wit, Torkell Ellingsen, Inger Marie J Hansen, Jamie Kirkham, George A Wells, Peter Tugwell, Lara Maxwell, Maarten Boers, Kenneth Egstrup, Robin Christensen

Articles, Abstracts, and Reports

The Assessment of SpondyloArthritis international Society (ASAS) has defined core sets for (i) symptom-modifying anti-rheumatic drugs (SM-ARD), (ii) clinical record keeping, and (iii) disease-controlling anti-rheumatic therapy (DC-ART). These include the following domains for all three core sets: "physical function," "pain," "spinal mobility," "spinal stiffness," and "patient's global assessment" (PGA). The core set for clinical record keeping further includes the domains "peripheral joints/entheses" and "acute phase reactants," and the core set for DC-ART further includes the domains "fatigue" and "spine radiographs/hip radiographs." The Outcome Measures in Rheumatology (OMERACT) endorsed the core sets in 1998.Using empirical evidence from axSpA trials, we investigated …

Pregnancy Rates From Intrauterine Insemination Are Equivalent Following 1- Versus 5-Day Letrozole Administration For Ovulation Induction: A Retrospective Study, Kaitlin Mcgrail, Susan Conway, John Storment, Sarah Buzhardt, Neil Chappell

School of Medicine Faculty Publications

Objective: To compare the efficacy of single-dose letrozole (25 mg) with a 5-day course (5 mg/day) for ovulation induction (OI). Design: Retrospective cohort study. Setting: Hospital. Patient(s): Patients undergoing first round of OI and intrauterine insemination with letrozole from January 2015 through December 2017. Intervention(s): Patients received letrozole as either a single 25 mg dose for 1 day (1D) versus 5 mg daily for 5 days (5D). A secondary analysis was performed on patients also receiving gonadotropins (GND). Main Outcome Measure(s): Pregnancy rate (PR) determined by positive human chorionic GND. Result(s): There were 847 patients included in the study, 302 …

Barriers To Maternal Retention In Hiv Care In Ghana: Key Differences During Pregnancy And The Postpartum Period., Kwame S. Sakyi, Margaret Y. Lartey, Caitlin E. Kennedy, Julie A. Dension, Luke C. Mullany, Prince G. Owusu, Emma Sacks, Emily A. Hurley, Pamela J. Surkan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Maternal retention in HIV care is lower for women in the postpartum period than during pregnancy, but the reasons are poorly understood. We examined key differences in barriers to retention in HIV care during and after pregnancy.

METHODS: We conducted semi-structured, in-depth interviews with 30 postpartum women living with HIV. Participants were recruited from two tertiary facilities implementing Option B+ for prevention of mother-to-child HIV transmission in Accra, Ghana. We collected data from mothers who had disengaged from HIV care and those who were still engaged in care. The interviews were analyzed using principles adapted from grounded theory.

RESULTS: …

Gynecologic Surgrete, New Horizons Guyana 2019: An Experience Of A Lifetime For Global Health Engagement And Medical Readiness, Bethany L. Charron, Katherine L. Dengler, Bao Tram Nguyen, Ashley Coggins, Jason C. Massengill, Trisha J. Tomkins

Obstetrics and Gynecology Faculty Publications

New Horizons is an annual training exercise designated for military medical professionals and civil engineers to assist partner nations of Southern Command (SOUTHCOM), as well as provide exceptional training to U.S. military members.1 In Spring of 2019, a gynecologic surgery readiness training exercise (SURGRETE) team composed of 16 joint-service military healthcare professionals, specifically including a fellowship-trained female pelvic medicine and reconstructive surgery (FPMRS) surgeon, an FPMRS fellow, an obstetrics and gynecology (OB/GYN) specialist, three OB/GYN residents, and additional anesthesia, nursing, and surgical technician support, traveled to Guyana to participate in the New Horizons global health exercise. The mission of the …

Lessons From An Evidence-Based Medicine Exploration: When Transparency And Sensitivity (Analyses) Can Change The Take-Home Message, Nadi N. Kaonga, Toby Fitzgerald

Journal of Maine Medical Center

No abstract provided.

Strengthening The Evidence Base For Telehealth For Abortion Service Delivery, Nadi Kaonga

Journal of Maine Medical Center

Telehealth – which is the use of information and communication technology to provide clinical services to patients remotely – provides an opportunity to extend safe abortion services to women. A recent review article on telehealth for abortion service delivery found it to be acceptable, feasible and safe when compared to in-person service delivery. Despite the promising findings, the evidence base can and should be strengthened to optimize the impact of such services for women. Areas for improvement include evaluating the efficacy and effectiveness of telehealth implementations in more remote settings and with women across variable levels of technoliteracy, conducting cost-effectiveness …

Evaluation Of Geographic Disparities In Cervical Cancer Survival Across Maine, Kaylee Underkofler, Jason Lachance

Journal of Maine Medical Center

Introduction. National data exists suggesting the existence of geographic disparities in oncology care within the United States. It is unknown whether geographic disparities present a problem for women with gynecologic malignancies locally in Maine.

Methods. Data for each cervical cancer case diagnosed or treated under the MaineHealth system between 2007 and 2011 were acquired from the MaineHealth Network Registry. Average annual incidence and 5-year survival were calculated for each county in Maine and were mapped using geographic information systems (GIS) software. Next, cases were divided into 2 groups: those residing less than or equal to 60 miles from the sole …

A Novel Indication For Oocyte Cryopreservation Prior To Autologous Hematopoietic Cell Transplantation For Refractory Multiple Sclerosis, Neal R. Trulock, Luke Ying, Edward Zbella, Mark Sanchez

West Florida Division GME Research Day 2020

Multiple sclerosis (MS) is an immune mediated inflammatory diseases of the central nervous system characterized by focal ovoid like lesions of demyelination seen on MRI(1,2). The etiology of MS is unknown, however inflammation followed by CNS demyelination and axonal degeneration are known to be part of the pathologic processes that lead to the disease (1). The mean age of onset of MS is 28-31 years old and tends to affect women more often then men with a ratio of 2.3:1 (3,4) . Other risk factors associated with MS include vitamin D deficiency, smoking, and certain viruses (5). The pattern of …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania; A Cross-Sectional Analytic Study, Akampa Mukuve, Mariam Noorani, Ibrahim Sendagire, Miriam Mgonja

Faculty of Health Sciences, East Africa

Background

Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally.

The primary objective was to determine the magnitude of screening for GDM among …