Obstetrics and Gynecology Commons^™

The Correlation Between Histopathological And Ultrasound Findings Regarding Cesarean Section Scars – A Three-Year Survey Study, Oana D. Bălălău, Nicolae Bacalbașa, Cristian Bălălău, Carolina Negrei, Bianca Gălățeanu, Octav Ghinghină, Cristina Răduță, Liana Pleș, Anca D. Stănescu, Vasile A. Dumitru

Journal of Mind and Medical Sciences

The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery.

Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy.

Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar.

The study was performed on a batch of 123 patients with previous C-sections, …

Postpartum Depression And Thyroid Dysfunction– Should Pregnant Women Be Screened For Thyroid Disorders?, Anca A. Simionescu, Erika Marin

Journal of Mind and Medical Sciences

The relationship between thyroid dysfunction and postpartum depression has been investigated for quite some time now, but no consensus has been reached regarding the need for screening for thyroid function during pregnancy. This paper aims to investigate whether thyroid hormone screening in pregnancy might contribute to the diagnosis of postpartum depression.

Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) - one of the most widely used measures in detecting postpartum depression and anxiety. Thyroid function was measured using the commonly recommended thyroid laboratory tests.

A structured questionnaire was given to 61 patients closely monitored during their pregnancy and …

Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, Michelle Lipton-Carroll

Evidence-Based Practice Project Reports

Intrauterine device (IUD) insertions and endometrial biopsies (EMB) can be painful in office gynecological procedures. In the clinical setting used for this evidence-based project (EBP) it was noted there was no consistent pain management being used for these procedures. For this EBP project a protocol for pain management during IUD insertions and EMBs was developed and implemented into this clinical setting. The protocol was created from an exhaustive literature search, which yielded six pieces of high-level evidence of good quality. The evidence supported the use of a 1% lidocaine paracervical block prior to IUD insertion and a 2% lidocaine intrauterine …

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Senior Honors Theses

Women's health care professionals, such as general physicians, obstetricians and gynecologists, midwives, nurses, and doulas, in the US need to be aware of cultural issues and disparities. Minorities and migrant women experience cultural challenges and disparities when receiving health care in the US. Without cultural sensitivity, patient care is compromised. Pregnancy and childbirth practices vary widely by culture, and potential differences in perspectives, beliefs, and treatment of these are critical issues for women’s health care professionals to study. Female genital cutting (FGC), obstetric fistulas (OF), and female cancer are also discussed in this paper.

Accuracy Of Self-Collected Vaginal Swabs In The Diagnosis Of Bacterial Vaginosis, Vaginal Candidiasis, And Trichomoniasis, Anna Chase

Thinking Matters Symposium Archive

Vaginitis is the most common gynecological problem seen in primary care. It is estimated to account for 10 million primary care visits each year. The most common causes of vaginitis - responsible for up to 90% of cases - are bacterial vaginosis (BV), vaginal candidiasis (“yeast infections”), and trichomoniasis. The purpose of this evidence-based project was to evaluate whether self-collected vaginal swabs are as accurate as those collected by a provider during a speculum exam in the diagnosis of BV, yeast infections, and trichomoniasis.

In order to appropriately diagnose and treat vaginitis, samples from a vaginal swab are often required. …

Measuring Birth Trauma Rates In Maine Using Public Data, Mike Lapika

Thinking Matters Symposium Archive

An increasing number of states are creating databases that collect and organize health insurance claims from public and private health care payers. Since December 2016, at least 18 states have these “all-payer claims databases” (APCDs), including Maine. APCDs are intended to inform cost containment and quality improvement by increasing transparency and informing consumer choice. For this project, we assessed how Maine’s APCD data might be used to produce standardized quality measures across facilities in the state. Specifically, we tested a birth outcome quality measure developed by the Agency for Healthcare Research and Quality (AHRQ), Birth Trauma – Injury to Neonate …

Metabolism During Pregnancy And Postpartum: How Does It Change And What Factors Influence It?, Kristin Yoho

Masters Theses & Specialist Projects

PURPOSE: Pregnancy is a physically impactful process in a woman’s life. During this time, a woman will gain weight and research has shown that many women will retain some extra weight after delivery. Because of this, recovery in the postpartum period is pivotal to avoiding the implications of weight retention. The postpartum period is vastly understudied in both the research and medical communities and this gap between pregnancy and postpartum research needs to be bridged. Therefore, the purpose of this study was to investigate metabolic changes from pregnancy to postpartum and to study how factors such as sleep and breastfeeding …

“Oh Lord, Save Us From Such Monsters:” Maternal Impression And Monstrous Births In The Eighteenth-Century Netherlands, Sara Hollar

Independent Study Project (ISP) Collection

This historical survey focuses on the memoirs of Catharina Schrader, a Frisian midwife in the eighteenth century, as a lens into beliefs about maternal impression and monstrous births during the early modern period. The then popular theory of maternal impression, where pregnant women could impact their gestating fetus’s appearance or characteristics through their behavior, thoughts, and feelings, was used to explain many instances of monstrous births. Monstrosity, now understood as congenital defects or disabilities, was seen as a result and marker of pregnant women’s moral failings. Using examples of monstrous births from Schrader’s memoirs, I analyze the threat of maternal …

Increasing Screening And Education For Human Trafficking In The Obstetric Department, Chibwe Caroline Powell

Doctoral Projects

Background: Human Trafficking, is a human rights violation with global public health implications. HT is associated with multiple health problems. Healthcare providers working in obstetrics departments are in a unique position to interact with trafficked persons. Lack of specific HT screening tools, training and education have been identified as barriers to recognizing HT victims.

Objectives: The purpose of this quality improvement project was to increase victim identification and referrals by improving screening through implementation of an interdisciplinary screening tool into the EHR workflow and providing HT education.

Methods: This project examined the impact of implementing a HT screening tool and …

Where Do We Go From Here?: Two Key Informants' Perspectives On How To Address Conscientious Objection In Top Provision In South Africa, Talia Parker

Independent Study Project (ISP) Collection

This perspectives research endeavor examines the barriers to TOP access that arise from conscientious objection through the conflicting network of rights and legislation in South Africa. While previous research has evidenced the demonstrable barriers to accessing TOP care in South Africa, this project aims to push the existing literature and the field as a whole one step further to interrogate how to move forward within the realities of conscientious objection.

To do so, I conducted interviews with key informants in the field of reproductive healthcare provision, research, and activism in Cape Town on their perspectives about the practice of conscientious …

My Body, Their Choice: Childbearing Attitudes And Practices In Jamkhed, Maharashtra, Sienna Sewell

Independent Study Project (ISP) Collection

Understanding the beliefs and practices of women and their families during pregnancy and childbirth is fundamental to the creation of successful public health interventions that target maternal and infant mortality. This study explores the childbearing practices of women in rural Jamkhed, as well as the social and economic factors that influence family planning, reproductive health-seeking, and delivery. Interviews and quantitative surveys were conducted with women in villages that have partnered with the Comprehensive Rural Health Project (CRHP) to examine how and why women access prenatal care during pregnancy. The influence of CRHP’s “Jamkhed Model” on healthcare access is considered in …

El Rol De Los Agentes Sanitarios Para Mejorar El Acceso A La Salud Sexual Y Reproductiva Para Mujeres En San Carlos, Mendoza. / The Role Of Agentes Sanitarios In Improving Access To Sexual And Reproductive Health For Women In San Carlos, Mendoza., Laura Hult

Independent Study Project (ISP) Collection

Introducción: Es evidente que Argentina tiene un enfoque que atiende a la salud sexual y reproductiva, dado que tiene cobertura universal y la ley de Programa Nacional de Salud Sexual y Procreación Responsable que establece un estándar de cuidado para toda la población. Sin embargo, cobertura universal no implica acceso universal, el cual que está determinado por el transporte, el idioma y la cantidad de recursos de la región. En lugares como San Carlos, Mendoza, donde no hay transporte regular y hay pocos recursos, existe inequidad en la salud, lo que puede aumentar las tasas de embarazos no intencionales y …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

Current Patient Perspectives Of Vulvovaginal Candidiasis: Incidence, Symptoms, Management And Post-Treatment Outcomes., Junko Yano, Jack D. Sobel, Paul Nyirjesy, Ryan Sobel, Valerie L. Williams, Qingzhao Yu, Mairi C. Noverr, Paul L. Fidel

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Vulvovaginal candidiasis (VVC) is a common infection affecting women worldwide. Reports of patterns/risk factors/trends for episodic/recurrent VVC (RVVC) are largely outdated. The purpose of this study was to obtain current patient perspectives of several aspects of VVC/RVVC.

METHODS: Business cards containing on-line survey information were distributed to healthy volunteers and patients seeking standard, elective, or referral gynecologic care in university-affiliated Obstetrics/Gynecology clinics. The internet-based questionnaire was completed by 284 non-pregnant women (78% Caucasian, 14% African American, 8% Asian).

RESULTS: The majority of the participants (78%) indicated a history of VVC with 34% defined as having RVVC. The most common …

Hypertensive Disorders Of Pregnancy (Hdp) And Infertility Treatment: A Population-Based Survey Among U.S. Women, Brent Monseur, Md, Scm, Jerrine Morris, Md, Mph, Heather Hipp, Md, Vincenzo Berghella, Md

Department of Obstetrics and Gynecology Posters

Objective

To explore associations between infertility treatment and hypertensive disorders of pregnancy using a nationally representative sample of women

Progress In Adolescent Health And Wellbeing: Tracking 12 Headline Indicators For 195 Countries And Territories, 1990–2016, Peter S. Azzopardi, Stephen J. C. Hearps, Kate L. Francis, Elissa C. Kennedy, Ali H. Mokdad, Nicholas J. Kassebaum, Stephen Lim, Caleb M. S. Irvine, Theo Vos, Alex D. Brown, Surabhi Dogra, Stuart A. Kinner, Natasha S. Kaoma, Mariam Naguib, Nicola J. Reavley, Jennifer Requejo, John S. Santelli, Susan M. Sawyer, Vegard Skirbekk, Marleen Temmerman, Jordan Tewhaiti-Smith, Joseph L. Ward, Russell M. Viner, George C. Patton

Obstetrics and Gynaecology, East Africa

Background: Rapid demographic, epidemiological, and nutritional transitons have brought a pressing need to track progress in adolescent health. Here, we present country-level estimates of 12 headline indicators from the Lancet Commission on adolescent health and wellbeing, from 1990 to 2016.

Methods: Indicators included those of health outcomes (disability-adjusted life-years [DALYs] due to communicable, maternal, and nutritional diseases; injuries; and non-communicable diseases); health risks (tobacco smoking, binge drinking, overweight, and anaemia); and social determinants of health (adolescent fertility; completion of secondary education; not in education, employment, or training [NEET]; child marriage; and demand for contraception satisfied with modern methods). We drew …

Takotsubo Cardiomyopathy In Pregnancy: A Case Report And Literature Review, Felix Oindi, Evan Sequeira, Herman Ryan Sequeira, Steve Mutiso

Obstetrics and Gynaecology, East Africa

Background: Takotsubo cardiomyopathy is rare in pregnancy and is characterized by left ventricular dysfunction with apical ballooning. This transient cardiac dysfunction may affect women of childbearing age in the antepartum, intrapartum or postpartum period. Most patients respond well to medical management with resolution of cardiac dysfunction within weeks.

Case presentation: A 35-year-old female in her second pregnancy presented with severe preeclampsia at 31 weeks of gestation. She subsequently developed severe substernal chest pain and workup showed a stress induced cardiomyopathy prior to her delivery via caesarean section. She had full recovery of her cardiac function by 12 weeks postpartum after …

Effects Of Free Maternity Service Policy In Kenya: An Interrupted Time Series Analysis, Evaline Lang'at, L. Mwanri, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: In Kenya, more than 6000 maternal deaths, and 35000 stillbirths occur each year. In June, 2013, the Government of Kenya abolished user fees for maternity care in all public health facilities under the Free Maternity Service (FMS) policy, to make maternity services accessible and affordable, and to reduce maternal and perinatal deaths. This study aims to establish whether the FMS policy has influenced use of, access to, and quality of maternity care in Kenya.

Methods: We did an observational retrospective study in three counties in Kenya. We used daily maternity registers in 90 public health facilities to extract monthly …

Empowering Hiv-Infected Women In Lowresource Settings: A Pilot Study Evaluating A Patient-Centered Hiv Prevention Strategy For Reproduction In Kisumu, Kenya, Okeoma Mmeje, Betty Njoroge, Pauline Wekesa, Alfred Murage, Raphael O. Ondondo, Sheryl Van Der Poel, Mary A. Guze, Starley B. Shade, Elizabeth A. Bukusi, Deborah Cohan, Craig R. Cohen

Obstetrics and Gynaecology, East Africa

Background: Female positive/male negative HIV-serodiscordant couples express a desire for children and may engage in condomless sex to become pregnant. Current guidelines recommend antiretroviral treatment in HIV-serodiscordant couples, yet HIV RNA viral suppression may not be routinely assessed or guaranteed and pre-exposure prophylaxis may not be readily available. Therefore, options for becoming pregnant while limiting HIV transmission should be offered and accessible to HIV-affected couples desiring children.

Methods: A prospective pilot study of female positive/male negative HIV-serodiscordant couples desiring children was conducted to evaluate the acceptability, feasibility, and effectiveness of timed vaginal insemination. Eligible women were 18-34 years with regular …