Obstetrics and Gynecology Commons^™

Spontaneous Uterine Rupture Secondary To Morbidly Adherent Placenta In An Unscarred Uterus, Nida Sajjad, Kumail Khandwala, Wasim Memon, Jehanzeb Shahid, Burhan Zafar

Department of Radiology

We report a case of spontaneous uterine rupture in a primigravida with an unscarred uterus, which was secondary to morbidly adherent placenta proven on surgery and histology. Although rare, uterine rupture should be considered as a differential diagnosis of acute abdominal pain in pregnancies, especially when associated with free fluid, even with the absence of vaginal bleeding. Abnormal placentation is associated with spontaneous antepartum uterine rupture even in early pregnancy. Most cases in the literature have advocated emergency hysterectomy to arrest life-threatening hemorrhage.

Flavonoids And Other Polyphenols Act As Epigenetic Modifiers In Breast Cancer., Priyanga Selvakumar, Aja Badgeley, Paige Murphy, Hina Anwar, Urvashi Sharma, Katharine Lawrence, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Breast cancer is a common cancer that occurs due to different epigenetic alterations and genetic mutations. Various epidemiological studies have demonstrated an inverse correlation between breast cancer incidence and flavonoid intake. The anti-cancer action of flavonoids, a class of polyphenolic compounds that are present in plants, as secondary metabolites has been a major topic of research for many years. Our review analysis demonstrates that flavonoids exhibit anti-cancer activity against breast cancer occurring in different ethnic populations. Breast cancer subtype and menopausal status are the key factors in inducing the flavonoid's anti-cancer action in breast cancer. The dose is another key …

Abortion Case May Not Overturn Roe, But Could Effectively Nullify It, A. Benjamin Spencer

Popular Media

No abstract provided.

Labour Progression In Obese Women: Are Women With Increased Body Mass Index Having Unnecessary Cesarean Sections?, Caroline Shenouda, Aloka Wijesooriya, Amanda Toufeili, Michael R Miller, Debbie Penava, Barbra De Vrijer

Obstetrics & Gynaecology Publications

OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes.

METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m

RESULTS: Obese class II and III primiparous women required an additional 1.62 and 2.67 hours (P = 0.012), respectively, to reach a dilation of 10 cm compared with their normal weight counterparts; obese class II and III multiparous women required an …

Artificial Intelligence: A New Paradigm In Obstetrics And Gynecology Research And Clinical Practice, Pulwasha Iftikhar, Marcela V. Kuijpers, Azadeh Khayyat, Aqsa Iftikhar, Maribel Degouvia De Sa

Publications and Research

Artificial intelligence (AI) is growing exponentially in various fields, including medicine. This paper reviews the pertinent aspects of AI in obstetrics and gynecology (OB/GYN) and how these can be applied to improve patient outcomes and reduce the healthcare costs and workload for clinicians.

Herein, we will address current AI uses in OB/GYN, and the use of AI as a tool to interpret fetal heart rate (FHR) and cardiotocography (CTG) to aid in the detection of preterm labor, pregnancy complications, and review discrepancies in its interpretation between clinicians to reduce maternal and infant morbidity and mortality. AI systems can be used …

Characterization Of Urinary Concentrations Of Heavy Metals Among Socioeconomically Disadvantaged Black Pregnant Women, Inkyu Han, Kristina W Whitworth, Xueying Zhang, Masoud Afshar, Pamela D Berens, Elaine Symanski

Faculty, Staff and Student Publications

The objective of this study was to characterize exposures to metals using biological samples collected on socioeconomically disadvantaged black pregnant women. We obtained 131 anonymous urine samples provided by black pregnant women visiting a Medicaid-serving prenatal clinic in Houston, TX, from March 27, 2017 to April 11, 2017. We analyzed urine samples for 15 metals including cadmium (Cd), arsenic (As), lead (Pb), and nickel (Ni) and for creatinine and cotinine. We found that median concentrations of zinc (Zn), selenium (Se), and aluminum (Al) among black pregnant women in this study were 1.5 to 3 times higher than levels reported among …

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman

Michigan Journal of Public Health

Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.

Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …

Development Of An Abbreviated Symptom Score For The Neonatal Abstinence Syndrome., I. Chervoneva, S. C. Adeniyi-Jones, F. Blanco, W. K. Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVE: We sought a shortened MOTHER neonatal abstinence syndrome (NAS) and Finnegan score that would retain comparable performance characteristics of the full instrument.

STUDY DESIGN: Retrospective cohort.

RESULTS: In total, 124,170 MOTHER NAS scores between August 2007 and May 2016 from 775 infants (≥36 weeks) were examined. Classification and regression tree model identified the most important subsets of the scored variables. A 9-element shortened scale yielded >90% sensitivity and specificity to predict clinical endpoints based on the full 19-element MOTHER NAS score. Conversion of the data sets to the Finnegan score, and applying the same procedure resulted in a nine-element …

International Standards For Fetal Brain Structures Based On Serial Ultrasound Measurements From The Fetal Growth Longitudinal Study Of The Intergrowth-21 St Project, Raffaele Napolitano, Malid Molloholli, Vera Donadono, Eric O. Ohuma, Sikolia Wanyonyi, Bryn Kemp, Mohammad K. Yaqub, Stephen Ash, Fernando C. Barros, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Objective: To create prescriptive growth standards for five fetal brain structures, measured by ultrasound, from healthy, well-nourished women, at low risk of impaired fetal growth and poor perinatal outcomes, taking part in the Fetal Growth Longitudinal Study (FGLS) of the INTERGROWTH-21st Project.

Methods: This was a complementary analysis of a large, population-based, multicentre, longitudinal study. We measured, in planes reconstructed from 3-dimensional (3D) ultrasound volumes of the fetal head at different time points in pregnancy, the size of the parieto-occipital fissure (POF), Sylvian fissure (SF), anterior horn of the lateral ventricle (AV), atrium of the posterior ventricle (PV) and cisterna …

Robotic Adrenalectomy For Functional Adenoma In Second Trimester Treats Worsening Hypertension, Courtney Capella, Bs, Joseph Godovchik, Bs, May Jean Counsilman, Md, Thenappan Chandrasekar, Md, Costas D. Lallas, Md, Huda B. Al-Kouatly, Md

Department of Obstetrics and Gynecology Posters

Robotic adrenalectomy is a feasible surgical alternative in the second trimester and can reverse the hypertensive disease and its associated maternal-fetal complications

Improving Utilization Of Aspirin For Prevention Of Preeclampsia In A High Risk Urban Cohort, Rupsa C. Boelig, Md, Mariam Wanees, Ba, Vincenzo Berghella, Md, Amanda Roman, Md

Department of Obstetrics and Gynecology Posters

High risk women without a history of preeclampsia were less likely to be recommended aspirin for preeclampsia prevention. A simple screening tool at 1st trimester ultrasound can significantly improve aspirin utilization for preeclampsia prevention

Association Between Abo Blood Type And Postpartum Hemorrhage By Mode Of Delivery: A Retrospective Cohort Study, Julia Burd, Md, Johanna Quist-Nelson, Md, Sara Edwards, Md, Anju Suhag, Md, Vincenzo Berghella, Md, J. Biba Nijjar, Md

Department of Obstetrics and Gynecology Posters

Background

Patients with type O blood have been reported to have more bleeding complication than those of other pooled blood groups (OR 1.33)

Prior studies on postpartum hemorrhage by blood type

• Yielded mixed results
• Did not separate by mode of delivery

The Effect Of Transvaginal Ultrasound, Vaginal Examination, Or Coitus On Fetal Fibronectin Results: A Systematic Review, Ariel Levy, Md, Johanna Quist-Nelson, Md, Vincenzo Berghella, Md

Department of Obstetrics and Gynecology Posters

Cervical manipulation via transvaginal ultrasound or sterile vaginal examination does not significantly affect fetal fibronectin results; therefore its use after these exposures is clinically acceptable. Conversely, fFN use in the setting of recent coitus should continue to be discouraged.

Impact Of A Multidisciplinary Program On Pregnancy Outcomes In The Setting Of Placenta Accreta Spectrum, Joanne Quiñones Md, Msce, Chelsea Giagni Md, Jose Lazaro Md, Meredith Rochon Md, John C. Smulian Md, Mph, William E. Scorza Md

Department of Obstetrics & Gynecology

No abstract provided.

Point-Of-Care Hpv Molecular Diagnostics For A Test-And-Treat Model In High-Risk Hiv Populations, Shahin Sayed, Michael Chung, Marleen Temmerman

Pathology, East Africa

Strategies for cervical cancer prevention and control in low-income and middle-income countries (LMICs) require concerted efforts to improve screening and access to treatment, especially in high-risk HIV populations. LMICs bear the largest burden of HIV infection, human papillomavirus (HPV) infection is common among HIV-infected women, risk of cervical cancer is increased in women with HIV/AIDS, and HIV clinics provide opportunities to screen and treat for cervical cancer in this population.

Preconception Nutrition Intervention Improved Birth Length And Reduced Stunting And Wasting In Newborns In South Asia: The Women First Randomized Controlled Trial., Sangappa M Dhaded, K. Michael Hambidge, Sumera Aziz Ali, Manjunath Somannavar, Sarah Saleem, Omrana Pasha, Umber Khan, Veena Herekar, Sunil Vernekar, S. Yogesh Kumar, Jamie E. Westcott, Vanessa R. Thorsten, Amaanti Sridhar, Abhik Das, Elizabeth Mcclure, Richard J. Derman, Robert L. Goldenberg, Marion Koso-Thomas, Shivaprasad S. Goudar, Nancy F. Krebs

Global Health Articles

South Asia has >50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing ≥3 months prior to conception (Arm 1), …

Low-Dose Aspirin For The Prevention Of Preterm Delivery In Nulliparous Women With A Singleton Pregnancy (Aspirin): A Randomised, Double-Blind, Placebo-Controlled Trial., Matthew K. Hoffman, Shivaprasad S. Goudar, Bhalachandra S. Kodkany, Mrityunjay Metgud, Manjunath Somannavar, Jean Okitawutshu, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Abigail Mwapule, Musaku Mwenechanya, Elwyn Chomba, Waldemar A. Carlo, Javier Chicuy, Lester Figueroa, Ana Garces, Nancy F. Krebs, Saleem Jessani, Farnaz Zehra, Sarah Saleem, Robert L. Goldenberg, Kunal Kurhe, Prabir Das, Archana Patel, Patricia L. Hibberd, Emmah Achieng, Paul Nyongesa, Fabian Esamai, Edward A. Liechty, Norman Goco, Jennifer Hemingway-Foday, Janet Moore, Tracy L. Nolen, Elizabeth M. Mcclure, Marion Koso-Thomas, Menachem Miodovnik, R. Silver, Richard J. Derman, Aspirin Study Group

Global Health Articles

BACKGROUND: Preterm birth remains a common cause of neonatal mortality, with a disproportionately high burden in low-income and middle-income countries. Meta-analyses of low-dose aspirin to prevent pre-eclampsia suggest that the incidence of preterm birth might also be decreased, particularly if initiated before 16 weeks of gestation.

METHODS: ASPIRIN was a randomised, multicountry, double-masked, placebo-controlled trial of low-dose aspirin (81 mg daily) initiated between 6 weeks and 0 days of pregnancy, and 13 weeks and 6 days of pregnancy, in nulliparous women with an ultrasound confirming gestational age and a singleton viable pregnancy. Participants were enrolled at seven community sites in …

Ivf Errors - Is This Only The Tip Of The Iceberg?, Jody L. Madeira, Steven R. Lindheim Md, Mark P. Trolice

Articles by Maurer Faculty

ART errors are fortunately a rare occurrence. but humans are fallible and mistakes are inevitable. As social media sensationalizes these events, we, as infertility specialists, must be vigilant in reviewing existing risk management systems and consider other options to minimize/eliminate these events. ART programs should work to emphasize honesty and transparency to improve quality of care.

Development Of A Graduate Medical Education Program In Obstetrics And Gynecology In A Community-Based Hospital: Building Blocks And Rate Of Progress, Parker B. Long, Katherine M. Choi Md, Rachael Postlethwait Md, Mohamed Foda Md, Karen Harris Md

OB-GYN

Synopsis

The need for trained obstetricians and gynecologists continues to increase. The ongoing advances in women’s health care requires well trained physicians that can only be achieved by a well-structured residency program that provides a reliable training infrastructure while maintaining a patient centered care model according AGCME standards. This residency program started July 2018 with 4 PGY1 and one PGY2 residents.

Objective

To prospectively look at the rate of growth needed to begin an OBGYN residency program in a community-based hospital.

Methods

For this particular residency program, we started a new OBGYN medical practice and all residents were involved in …