Obstetrics and Gynecology Commons^™

Elagolix For Heavy Menstrual Bleeding In Women With Uterine Fibroids., William D. Schlaff, Ronald T. Ackerman, Ayman Al-Hendy, David F. Archer, Kurt T. Barnhart, Linda D. Bradley, Bruce R. Carr, Eve C. Feinberg, Sandra M. Hurtado, Jinhee Kim, Ran Liu, R. Garn Mabey, Charlotte D. Owens, Alfred Poindexter, Elizabeth E. Puscheck, Henry Rodriguez-Ginorio, James A. Simon, Ahmed M. Soliman, Elizabeth A. Stewart, Nelson B. Watts, Ozgul Muneyyirci-Delale

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Uterine fibroids are hormone-responsive neoplasms that are associated with heavy menstrual bleeding. Elagolix, an oral gonadotropin-releasing hormone antagonist resulting in rapid, reversible suppression of ovarian sex hormones, may reduce fibroid-associated bleeding.

METHODS: We conducted two identical, double-blind, randomized, placebo-controlled, 6-month phase 3 trials (Elaris Uterine Fibroids 1 and 2 [UF-1 and UF-2]) to evaluate the efficacy and safety of elagolix at a dose of 300 mg twice daily with hormonal "add-back" therapy (to replace reduced levels of endogenous hormones; in this case, estradiol, 1 mg, and norethindrone acetate, 0.5 mg, once daily) in women with fibroid-associated bleeding. An elagolix-alone …

Mentoring Multi-College Bystander Efficacy Evaluation – An Approach To Growing The Next Generation Of Gender-Based Interpersonal Violence Intervention And Prevention (Vip) Researchers, Ann L. Coker, Danielle Davidov, Heather M. Bush, Emily R. Clear

Obstetrics and Gynecology Faculty Publications

The Centers for Disease Control and Prevention provided funding (U01 CE002668) to evaluate bystander program efficacy to reduce gender-based violence on college campuses (Aim 1) and to create a mentoring network (Aim 2) for young campus-based researchers interested in violence intervention or prevention (VIP). While an evaluation of this mentoring program is ongoing, our purpose here was to document the strategies used to create, implement, and begin evaluation of this national multi-college mentoring network. As each public college was recruited into this evaluation named multi-college Bystander Efficacy Evaluation (mcBEE), each college was invited to nominate a researcher interested in receiving …

Prenatal Diagnosis Of Absent Right Superior Vena Cava In Referrals For Fetal Echocardiography, Ruben J. Acherman, William N. Evans, Humberto Restrepo

School of Medicine Faculty Research

A persistent LSVC with an absent right superior vena cava (RSVC) is unusual, encountered in about 10% of patients with persistent LSVC. We present 14 patients with a prenatal diagnosis of single LSVC and situs solitus, including prenatal findings and information on medium-term follow-up. We identified patients with situs solitus and a persistent LSVC born between March 2004 and March 2020, which had been diagnosed prenatally between December 2003 and November 2019. From this cohort, we identified those with absent RSVC. In the population of women undergoing fetal echocardiography, the prevalence of persistent LSVC in situs solitus was 0.43% (84/19,712). …

Why Do Women Deliver Where They Had Not Planned To Go? A Qualitative Study From Peri-Urban Nairobi Kenya., V. Naanyu, V. Mujumdar, C. Ahearn, M. Mcconnell, J. Cohen

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: In urban Kenya, couples face a wide variety of choices for delivery options; however, many women end up delivering in different facilities from those they had intended while pregnant. One potential consequence of this is delivering in facilities that do not meet minimum quality standards and lack the capacity to provide treatment for obstetric and neonatal complications.

METHODS: This study investigated why women in peri-urban Nairobi, Kenya deliver in facilities they had not intended to use. We used 60 in-depth audio-recorded interviews in which mothers shared their experiences 2-6 months after delivery. Descriptive statistics were used to summarize socio-demographic …

Deliver On Your Own: Disrespectful Maternity Care In Rural Kenya, Adelaide Lusambili, Violet Naanyu, Terrance J. Wade, Lindsay Mossman, Michaela Mantel, Rachel Pell, Angela Ng'etich, Kennedy Mulama, Lucy Nyaga, Jerim Obure, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Under the Free Maternity Policy (FMP), Kenya has witnessed an increase in health facility deliveries rather than home deliveries with Traditional Birth Attendants (TBA) resulting in improved maternal and neonatal outcomes. Despite these gains, maternal and infant mortality and morbidity rates in Kenya remain unacceptably high indicating that more needs to be done.

Aim: Using data from the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project’s qualitative gender assessment, this paper examines women’s experience of disrespectful care during pregnancy, labour, and delivery. The goal is to promote an improved understanding of the actual care conditions …

Pregnancy And Neonatal Outcomes In Sars-Cov-2 Infection: A Systematic Review., R. S. Chamseddine, F. Wahbeh, F. Chervenak, L. J. Salomon, B. Ahmed, A. Rafii

Journal Articles

With the emergence of SARS-CoV-2 and its rapid spread, concerns regarding its effects on pregnancy outcomes have been growing. We reviewed 245 pregnancies complicated by maternal SARS-CoV-2 infection across 48 studies listed on PubMed and MedRxiv. The most common clinical presentations were fever (55.9%), cough (36.3%), fatigue (11.4%), and dyspnea (12.7%). Only 4.1% of patients developed respiratory distress. Of all patients, 89.0% delivered via cesarean section (n = 201), with a 33.3% rate of gestational complications, a 35.3% rate of preterm delivery, and a concerning 2.5% rate of stillbirth delivery or neonatal death. Among those tested, 6.45% of newborns were …

Ectopic Pregnancy In A Woman With T9 Ais A Paraplegia Secondary To High-Grade Spinal Cord Pilocytic Astrocytoma, Elisabeth K. Acker

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Ectopic pregnancy in a woman with T9 AIS A (motor complete, sensory complete) paraplegia secondary to a high-grade spinal cord pilocytic astrocytoma

Background

In the United States, 20,000 women of childbearing age have a spinal cord injury (SCI). While SCI induces transient amenorrhea immediately after injury, women generally have normal reproductive function after SCI, and their fertility is unimpaired. Medications that commonly manage complications of SCI should be avoided or discontinued during pregnancy. Complications inherent to SCI, including urologic issues, are often exacerbated during pregnancy.

Methods

This is a case report on a female Veteran who initially presented to the …

Adherence And Acceptability Of Telehealth Appointments For High-Risk Obstetrical Patients During The Coronavirus Disease 2019 Pandemic., S. Jeganathan, L. Prasannan, M. J. Blitz, N. Vohra, B. Rochelson, N. Meirowitz

Journal Articles

Background: Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high-risk obstetrics and whether the implementation of a telehealth model improves access to care in nonrural settings.

Objective: This study aimed to describe patient and provider attitudes toward telehealth for the delivery of high-risk obstetrical care in a large healthcare system with both urban and suburban settings and to determine whether the implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.

Study Design: Two self-administered surveys were designed. …

Pregnant Vs Nonpregnant Severe Acute Respiratory Syndrome Coronavirus 2 And Coronavirus Disease 2019 Hospital Admissions: The First 4 Weeks In New York, A Tekbali, A Grünebaum, A Saraya, L Mccullough, E Bornstein, Fa Chervenak

Journal Articles

No abstract provided.

Maternal Mortality Among Women With Covid-19 Admitted To The Intensive Care Unit., Mj Blitz, B Rochelson, N Meirowitz, L Prasannan, Tj Rafael, S Chakravarthy, La Bracero, Sw Wasden, Sl Pachtmanshetty, O Santandreu, Fa Chervenak, Bm Schwartz, M Nimaroff, +2 Additional Authors

Journal Articles

No abstract provided.

Intensive Care Unit Admissions For Pregnant And Nonpregnant Women With Coronavirus Disease 2019, M J. Blitz, A Grünebaum, A Tekbali, E Bornstein, B Rochelson, M Nimaroff, Fa Chervenak

Journal Articles

No abstract provided.

Maternal Mortality Among Women With Coronavirus Disease 2019 Admitted To The Intensive Care Unit, Mj Blitz, B Rochelson, H Minkoff, N Meirowitz, L Prasannan, V London, Tj Rafael, S Chakravarthy, La Bracero, Sw Wasden, Sl Pachtman Shetty, O Santandreu, Fa Chervenak, Bm Schwartz, M Nimaroff

Journal Articles

No abstract provided.

Racial And Ethnic Disparity And Spatiotemporal Trends In Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence On Obstetrical Units In New York., M. J. Blitz, B. Rochelson, L. Prasannan, W. Shan, F. A. Chervenak, M. Nimaroff, E. Bornstein

Journal Articles

No abstract provided.

Myocardial Injury Associated With Coronavirus Disease 2019 In Pregnancy., S. L. Pachtman Shetty, N. Meirowitz, M. J. Blitz, T. Gadomski, C. R. Weinberg

Journal Articles

OBJECTIVE:Coronavirus disease 2019 (COVID-19) is associated with cardiac injury1-3 and bradycardia4 in the non-pregnant population. The incidence of these complications in pregnancy is unknown. The objective of this study was to determine the rate of abnormal serum cardiac biomarkers or bradycardia among pregnant and immediately postpartum women admitted for treatment of severe or critical COVID-19 in a large integrated health system in New York. STUDY DESIGN:This is a retrospective review of all pregnant and immediately postpartum women hospitalized for COVID-19 at 7 hospitals within Northwell Health, the largest academic health system in New York state, from March 1 to April …

Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies In Pregnant Women Admitted To Labor And Delivery Units., L. Haizler-Cohen, A. Davidov, M. J. Blitz, G. Fruhman

Journal Articles

No abstract provided.

Adherence And Acceptability Of Telehealth Appointments For High Risk Obstetrical Patients During The Covid-19 Pandemic., S. Jeganathan, L. Prasannan, M. J. Blitz, N. Vohra, B. Rochelson, N. Meirowitz

Journal Articles

Background:Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high risk obstetrics and if implementation improves access to care in non-rural settings. Objective:The study aims to: 1) Describe patient and provider attitudes toward telehealth for delivery of high risk obstetrical care in a large health care system with both urban and suburban settings. 2) Determine if implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.Study DesignTwo self-administered surveys were designed. The first survey was sent to all high-risk …

Gog 244-The Lymphedema And Gynecologic Cancer (Leg) Study: Incidence And Risk Factors In Newly Diagnosed Patients, J. W. Carlson, J. Kauderer, A. Hutson, J. Carter, J. Armer, S. Lockwood, S. Nolte, B. R. Stewart, L. Wenzel, R. R. Barakat, +9 Additional Authors

Journal Articles

© 2019 Elsevier Inc. Objectives: To evaluate the incidence and risk factors for lymphedema associated with surgery for gynecologic malignancies on GOG study 244. Methods: Women undergoing a lymph node dissection for endometrial, cervical, or vulvar cancer were eligible for enrollment. Leg volume was calculated from measurements at 10-cm intervals starting 10 cm above the bottom of the heel to the inguinal crease. Measurements were obtained preoperatively and postoperatively at 4–6 weeks, and at 3-, 6-, 9-, 12-, 18-, and 24- months. Lymphedema was defined as a limb volume change (LVC) ≥10% from baseline and categorized as mild: 10–19% LVC; …

Obesity And Sting1 Genotype Associate With 23-Valent Pneumococcal Vaccination Efficacy, M. Sebastian, C. J. Hsiao, H. S. Futch, R. S. Eisinger, L. Dumeny, S. Patel, M. Gobena, D. S. Katikaneni, L. Spiryda, M. L. Brantly, +4 Additional Authors

Journal Articles

© 2020, Sebastian etal. BACKGROUND. Obesity has been associated with attenuated vaccine responses and an increased risk of contracting pneumococcal pneumonia, but no study to our knowledge has assessed the impact of obesity and genetics on 23-valent pneumococcal vaccine (PPSV23) efficacy. We assessed the relationship of obesity (primary analysis) and stimulator of interferon genes (STING1) genotype (secondary analysis) on PPSV23 efficacy. METHODS. Nonobese (BMI 22-25 kg/m2) and obese participants (BMI ≥30 kg/m2) were given a single dose of PPSV23. Blood was drawn immediately prior to and 4-6 weeks after vaccination. Serum samples were used to assess PPSV23-specific antibodies. STING1 genotypes …

The Biomarker He4 (Wfdc2) Promotes A Pro-Angiogenic And Immunosuppressive Tumor Microenvironment Via Regulation Of Stat3 Target Genes, N. E. James, J. B. Emerson, A. D. Borgstadt, L. Beffa, M. T. Oliver, V. Hovanesian, A. Urh, R. K. Singh, R. Rowswell-Turner, J. R. Ribeiro, +3 Additional Authors

Journal Articles

© 2020, The Author(s). Epithelial ovarian cancer (EOC) is a highly lethal gynecologic malignancy arising from the fallopian tubes that has a high rate of chemoresistant recurrence and low five-year survival rate. The ovarian cancer biomarker HE4 is known to promote proliferation, metastasis, chemoresistance, and suppression of cytotoxic lymphocytes. In this study, we sought to examine the effects of HE4 on signaling within diverse cell types that compose the tumor microenvironment. HE4 was found to activate STAT3 signaling and promote upregulation of the pro-angiogenic STAT3 target genes IL8 and HIF1A in immune cells, ovarian cancer cells, and endothelial cells. Moreover, …

Racial Disparity In Pregnancy Risks And Complications In The Us: Temporal Changes During 2007-2018, E. Bornstein, Y. Eliner, F. A. Chervenak, A. Grunebaum

Journal Articles

No abstract provided.