Obstetrics and Gynecology Commons^™

The Association Of Maternal Sociodemographic Factors With Stress In Pregnancy, Maheshwari Andhavarapu

Master of Medicine in Obstetrics and Gynecology

Introduction: Antenatal stress has been linked to maternal morbidity and preterm birth (PTB). One of the pathophysiological processes leading to PTB is thought to be via activation of the hypothalamus-pituitary-adrenal axis resulting in cortisol production. Hair cortisol has recently been shown to be a stress marker in the pregnant and non-pregnant population. Some determinants of hair cortisol have also been studied but more research is needed in this area, especially in pregnancy. Understanding the risk factors of antenatal stress may guide institution of preventative or screening measures to reduce the risk of adverse birth outcomes. As the effect of stress …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Ilana Porges, Vaishali Mehta, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: Delays in management of high risk pregnancies can result in significant morbidity for women seeking obstetric care. A trend of high incidence of pregnancy complications has been observed among women with non-communicable diseases (NCDs) receiving care at the University Teaching Hospital of Kigali (CHUK), which may suggest the need for more consistent screening of NCDs among pregnant women, and more streamlined care for those identified to be at highest risk for complications.

Methods: This study utilized a mixed method design to assess the need for screening of NCDs among pregnant women (n=255) who received obstetric care at CHUK between …

Diabetes Risk Status And Physical Activity In Pregnant Women: U.S. Brfss 2011, 2013, 2015, 2017, Bethany Rand

UNF Graduate Theses and Dissertations

Objective: We sought to examine differences in aerobic activity (AA) and muscle-strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.

Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations.

Methods: The sample (n=9,597) included pregnant women ages 18-44, who participated in 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS were: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or …

Use Of The Progestin Challenge Test In Diagnosing Amenorrhea: The Time Has Come To Say Goodbye., William D. Schlaff, Charles C. Coddington

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Electronic Fetal Monitoring Credentialing Examination: The First 4000., Mark Tomlinson, Sara A Brumbaugh, Marin O'Keeffe, Richard L Berkowitz, Mary D'Alton, Michael Nageotte

Articles, Abstracts, and Reports

No abstract provided.

Neonatal Abstinence Syndrome: Effectiveness Of Targeted Umbilical Cord Drug Screening In Determining Risk Of Withdrawal, Alecia Karr

DNP Projects

Neonatal Abstinence Syndrome (NAS) is a condition in which an infant experiences withdrawal from uterine exposure to various substances such as caffeine, nicotine, amphetamines, THC, opioids, benzodiazepines, and other types of substances. Depending on the severity of the symptoms, these infants may experience a longer hospital stay and may need treatment and monitoring in the neonatal intensive care unit (NICU), resulting in an increase in healthcare costs. The objective of this project was to determine if targeted drug screening of newborns was effective in determining infants at risk of NAS based on a positive screening result. This study utilized a …

Obstetric Training In The Southeast Us: A 2019 Cera Study, Julia Fashner, Christy Cavanagh, Aimee Eden

OB-GYN

Purpose: To describe obstetric training in Southeast family medicine residencies in 2019. To determine factors that contribute to continuity deliveries, vaginal deliveries and residents who continue OB after graduation.

Methods: A survey of family medicine program directors was conducted in 2019. We took the answers from the 32 South Atlantic program directors that completed the survey questions of interest. We used chi-square tests and Kruskal-Wallis rank test to compare variables. STATA 14 was used for analysis.

Results: Half of the programs had graduates with10% of graduates continue OB after graduation. The following factors were significant for graduates who continue OB: …

Evaluation Of A Technology-Based Survivor Care Plan For Breast Cancer Survivors: Pre-Post Pilot Study., Talya Laufer, Bryan Lerner, Anett Petrich, Anna Quinn, Leah Ernst, Alicin Roop, Janet Knoblauch, Nick C. Leasure, Rebecca J. Jaslow, Sarah Hegarty, Amy Leader, Andrea Barsevick

Department of Medical Oncology Faculty Papers

BACKGROUND: As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors.

OBJECTIVE: This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. …

Occupational Therapy's Role In Maternal Mental Health Within Transition From Nicu To Home, Victoria Briltz, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

The purpose of this capstone project is to identify OT’s role in maternal mental health following the transition home from a NICU setting. This capstone project focused on mothers’ roles, routines, and environment during the transition from the NICU to home. Mothers may feel unprepared for the discharge home when their babies are ready to leave the NICU (Boykova, 2016). Occupational therapists address occupational performance through skilled interventions for women during the perinatal period; however, there is a lack of evidence guiding occupational therapy for providing services for maternal wellness (Slootjes, 2016). This capstone project will help share information, ideas, …

Increase Postpartum Gestational Diabetes Screening, Kari Ayala, Angela Bonin, Rachael Baker, Susan Chin, Brian Drake, Joseph Kaempf, Christina Malango, Judy Marvin, Shelly Johnson

Articles, Abstracts, and Reports

Introduction:

Diabetic women did not get follow up screening after delivery. Nurses are finding a way to screen more women.

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan

Department of Paediatrics and Child Health

Abstract are not provided by the author/publisher

Polycystic Ovarian Syndrome And Hyperinsulinemia: Overview And Treatment, Amanda M. Meyer, Lauren D. Bajbus, Sarah E. Drake, Kristen M. Quertinmont, Ashley Overy, Anne Gentry

Pharmacy and Wellness Review

Polycystic ovary syndrome is a prevalent issue in women's health that is associated with hyperinsulinemia and insulin resistance and can lead to long-term health problems. The most highly recommended treatments are diet and lifestyle changes. If these changes alone are not enough, pharmacologic treatments may be employed which include metformin, spironolactone or thiazolidinediones, although more research is needed to fully realize their role. The role of the pharmacist in this disease state includes counseling patients on healthy lifestyle changes, consulting with the physician about prescribing the best medication for each patient, and monitoring therapy adherence in the patient.

Maternal Characteristics And Outcomes Affected By Hypothyroidism During Pregnancy (Maternal Hypothyroidism On Pregnancy Outcomes, Mhpo-1), Zareen Kiran, Aisha Sheikh, Sarwar Malik, Areeba Meraj, Maha Masood, Safana Ismail, Owais Rashid, Quratulain Shaikh, Numan Majeed, Lumaan Sheikh, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Therefore, we aim to report the clinical features and maternal outcomes of hypothyroid pregnancies and compare the maternal outcomes between uncontrolled and controlled TSH levels in the preconception as well as the gestational period.
Methods: We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital after ethical approval. We collected information …

Perseverance, Faith And Stoicism: A Qualitative Study Of Medical Student Perspectives On Managing Fatigue, Taryn S Taylor, Alexandra L Raynard, Lorelei Lingard

Obstetrics & Gynaecology Publications

CONTEXT: Fatigue risk management (FRM) strategies offer a potential solution to the widespread problem of fatigued trainees in the clinical workplace. These strategies assume a shared perception that fatigue is hazardous. Despite the growing body of evidence suggesting that fatigue leads to burnout and medical errors, previous research suggests that residents perceive fatigue as a personal, surmountable burden rather than an occupational hazard. Before we can implement FRM, we need a better understanding of when and how such problematic notions of fatigue are adopted by medical trainees. Thus, we sought to explore how third-year medical students understand and manage the …

A Cross-Sectional Analysis Of Factors Associated With Detection Of Oncogenic Human Papillomavirus In Human Immunodeficiency Virus-Infected And Uninfected Kenyan Women, Aaron Ermel, P. Tonui, M. Titus, Y. Tong, N. Wong, J. Ong’Echa, Kapten Muthoka, Stephen Kiptoo, A. Moormann, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Background: Cervical cancer is caused by oncogenic human papillomaviruses (HPV) and is one of the most common malignancies in women living in sub-Saharan Africa. Women infected with the human immunodeficiency virus (HIV) have a higher incidence of cervical cancer, but the full impact on HPV detection is not well understood, and associations of biological and behavioral factors with oncogenic HPV detection have not been fully examined. Therefore, a study was initiated to investigate factors that are associated with oncogenic HPV detection in Kenyan women.

Methods: Women without cervical dysplasia were enrolled in a longitudinal study. Data from enrollment are presented …

Addressing Barriers To Maternal Healthcare For Marshallese Islanders In Northwest Arkansas: An Internship Experience, Victoria Richardson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The Marshallese community is a rapidly growing population in Northwest Arkansas. Approximately 12,000 people migrated from the Marshall Islands and settled in the state of Arkansas due to the signing of the Compact of Free Association (COFA) in 1986. Although the population in Northwest Arkansas is experiencing rapid growth, there are significant health disparities that coincide with it. Due to vast cultural differences, language barriers, low economic status, and political barriers, the Marshallese community suffers from prenatal health inequalities and poor maternal and fetal outcomes, including low birth-weight infants, premature births, and increased infant mortality. During my internship, I provided …

Factors Related To Congenital Heart Disease In Offspring From Women With Rheumatic Heart Disease: Case Reports From Moi Teaching And Referral Hospital, Eldoret, Kenya, Philippe P. A, Elkanah Omenge, Barasa F. A

Obstetrics and Gynaecology, East Africa

Maternal exposure to environmental factors has been reported to be associated with birth defects. Congenital heart defects are the most common and are associated with high morbidity and mortality in offspring. However, the relation of maternal rheumatic heart disease to congenital heart defects in the offspring is a rare event not yet reported. The authors report 2 cases of infants with congenital heart defects born from mothers with rheumatic heart disease. This study highlights factors related to congenital heart defects in both newborns.

Is There Value To Sub-Specialty Training In Sub-Saharan Africa?, Elkanah Omenge, S. E. Sinasac, Peter Itsura, Philip Tonui, B. Rosen, A. Covens

Obstetrics and Gynaecology, East Africa

Over the past three decades, Africa has focused on combatting infectious diseases, such as tuberculosis, malaria, and HIV/ AIDS. As treatment strategies for infectious diseases have improved over time, life expectancy has increased, shifting the burden to chronic diseases, such as cancer. The WHO has now identified non-communicable diseases, including cancer, as the new epidemic in sub-Saharan Africa1. Cancer incidence and mortality are increasing rapidly in low and middle-income countries (LMIC) as compared to high-income countries. By 2020, it is predicted that 70% of all new cancers worldwide will occur in LMIC2. In 2012 850 000 new cancers were diagnosed …

Association Of Female Sexual Dysfunction And Fertility: A Cross Sectional Study, Felix Oindi, Alfred Murage, Valentino Manase Lema, Abraham Mukaindo

Obstetrics and Gynaecology, East Africa

Background: Sexual function plays an essential role in the bio-psychosocial wellbeing and quality of life of women and disturbances in sexual functioning often result in significant distress. Female sexual dysfunction (FSD) and subfertility are common problems affecting approximately 43 and 20% of women respectively. However, despite the high prevalence of both conditions, little has been studied on the effects of subfertility on sexual functioning especially in sub-Saharan Africa. We set out to compare the prevalence of female sexual dysfunction in patients on assessment for sub-fertility and those either seeking or already on fertility control services at a private tertiary teaching …