Obstetrics and Gynecology Commons^™

Assessment Of Intrapartum Nurses' Beliefs Related To Birth Practices, Janice Scaggs

Doctoral Projects

Intrapartum nurses’ beliefs influence nursing behavior and nursing interventions during labor and birth. Assessing these beliefs in a regional hospital in the Southeastern United States was the focus of the doctoral project. Before the project, there was no objective data that assessed individual nurse’s beliefs and birth practices in the labor and delivery unit, or among the nursing staff as a whole. A knowledge gap existed in understanding if the nursing culture valued, promoted, and supported intended vaginal birth. Nursing leadership recognized that the overall cesarean birth rate and primary cesarean birth rate in the hospital were similar to State …

Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, Parker Miller

Undergraduate Honors Theses

Neonatal Abstinence Syndrome (NAS) remains an ever-growing public health issue and a continued avenue for future research. The research question for this retrospective study was whether polysubstance exposure is related to the dose of medication the infant received or to the number of opioid-medications required to treat the infants’ withdrawal symptoms? The hypothesis for the retrospective study was there will be a significant relationship between polysubstance exposure and the dose of medication the infant received as well as the number of opioid-medications required to treat the infants’ withdrawal symptoms. A bivariate correlational indicated that there was not a significant association …

Cervical Cancer Recurrence In The Colon, Samantha A. Erb, Shreyash Pandya, Johnny Johnson

West Florida Division GME Research Day 2020

Cervical cancer is the fourth leading cancer worldwide in women, ranking only after breast cancer, colorectal cancer, and lung cancer. Because it is typically diagnosed at a younger age compared to other major cancer types, it leads to a proportionally greater loss in life-years. Most cancers occur in squamo-columnar junction, the transition point between squamous and columnar cells; squamous cell carcinoma accounts for approximately 70% of cervical cancer cases. Treatment options vary depending on the stage at diagnosis and include surgery (conization or hysterectomy), radiation, chemotherapy, targeted therapy, and immunotherapy. Prognosis is affected by stage, tumor volume, age and performance …

Reflections On North Texas Ob-Gyn Internship, Catherine Beachner

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This thesis provides a personal reflection on a nurse internship with North Texas Ob-Gyn Associations located in Lewisville, Texas. An evaluation of the internship was conducted by providing a description of the position, analyzing the internship, and outlining a pertinent patient case study. The responsibilities for this position mainly included assisting the doctor during appointments. An extensive range of skills were gained through the experience, including developing confidence in interactions with patients and learning physical tasks. The focus of the honors project was overall learning, which occurred through completion of learning goals, and the goals of the internship were fully …

Mass Matters: Increasing Mammography Rates To Underserved Women, Ingrid N. Cooper

Evidence-Based Practice Project Reports

Breast cancer is the most frequently diagnosed cancer among women in Indiana and the United States (Indiana Cancer Organization, 2019). An estimated 268,000 new cases of invasive breast cancer were diagnosed and 41,760 women died due to breast cancer in 2019 (ACS, 2019). Substantial breast cancer-related morbidity and mortality disparities persist among the underserved. Disparities in breast cancer outcomes are due to lower mammography screening rates, lack of timely follow-up of abnormal results, and lack of timely treatment initiation among women with breast cancer (Highfield et al., 2015). The purpose of this evidence-based practice project was to address low mammography …

Assessment Of Activity Levels And Perceived Barriers Or Facilitators To Physical Activity In Pregnancy At Aga Khan University Hospital, Nairobi, Kenya, Zoya Virji Lalani

Master of Medicine in Obstetrics and Gynecology

Introduction: Physical activity (PA) during pregnancy significantly reduces the risk of pregnancy related complications and positively influences maternal health and wellbeing. The American College of Obstetricians and Gynaecologists (ACOG) recommends that pregnant women can exercise moderately for 30 minutes on most days of the week, however no study has ever examined the extent to which Kenyan women are meeting these recommendations. Furthermore, attitudes and perceptions of pregnant women towards PA shape their eventual behaviour. Whilst these influencing factors have not been explored, understanding them is essential for implementing effective interventions to improve exercise participation antenatally. Objectives: This study examined the …

Delivery Mode For Prolonged, Obstructed Labour Resulting In Obstetric Fistula: A Retrospective Review Of 4396 Women In East And Central Africa, C. J. Ngongo, T. J. Raassen, L. Lombard, J Van Roosmalen, S. Weyers, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: To evaluate the mode of delivery and stillbirth rates over time among women with obstetric fistula.

Design: Retrospective record review.

Setting: Tanzania, Uganda, Kenya, Malawi, Rwanda, Somalia, South Sudan, Zambia and Ethiopia.

Population: A total of 4396 women presenting with obstetric fistulas for repair who delivered previously in facilities between 1990 and 2014.

Methods: Retrospective review of trends and associations between mode of delivery and stillbirth, focusing on caesarean section (CS), assisted vaginal deliveries and spontaneous vaginal deliveries.

Main outcome measures: Mode of delivery, stillbirth.

Results: Out of 4396 women with fistula, 3695 (84.1%) delivered a stillborn baby. Among …

“Disbelieving Black Women To Death”; The “Double Jeopardy”: Racism And Sexism Affects Black Women’S Access To And Quality Of Care During Pregnancy, Birth, And Postpartum, Madeline St. Clair

Theses/Capstones/Creative Projects

This paper explores possible reasons why Black women in the United States experience a higher maternal mortality rate than their white counterparts. Using books, articles, journals, documentaries, personal experiences and stories of Black women and mothers, I argue that barriers from the societal to the individual level create health and medical disparities for Black mothers in pregnancy, during delivery, and the postpartum period. The paper concludes with a multifaceted solution and call to action.

The Effects Of Total Body Proton Irradiation On Mouse Myometrium, Lillith Bulawa

Undergraduate Honors Theses

The boundaries of human space exploration continue to expand with new technology and discoveries making it even more important to investigate the effects of space on biological systems. Although humans have explored space in small increments, reproductive studies must be conducted to determine if stable short- or long-term residences for humans can exist in space. This study explored the effects of whole-body proton radiation on uterine smooth muscle known as the myometrium. Two types of mice utilized in this study were C57BL/6 and B6.129S6Cybbtm1Din/J NOX2 knockout mice. C57BL/6 mice are standard laboratory mice that were used to represent the wildtype …

Prevalence Of Intimate Partner Violence Among The Maternal-Fetal Medicine Population, Sarah K. Larsen

Capstone Experience: Master of Public Health

Intimate partner violence (IPV) is increasingly understood as an important public health issue. It is well understood that intimate partner violence has many negative effects on its survivors ranging from physical to mental health conditions. The population of people who experience intimate partner violence and population of pregnant women are both vulnerable populations. Examining the two populations together demands a trauma-informed approach and an understanding of the intricacies of both pregnancy and intimate partner violence. While IPV has been studied among the pregnant population, intimate partner violence as it relates to the maternal fetal medicine (MFM) or high-risk pregnancy population …

Successful Completion Of Pregnancy After Mustard Procedure For Transposition Of Great Arteries: A Rare Case From The Developing World, Muhammad Kamran Younis Memon, Ayesha Malik, Saleem Akhtar

Department of Paediatrics and Child Health

Surgical repair of transposition of great arteries has undergone various evolutionary changes over the years. The initial of these treatment options was atrial septectomy followed by atrial switch and the current preferred treatment option is arterial switch operation worldwide. Due to various reasons, like lack of medical and surgical expertise atrial switch operation was commonly in practice in developing countries until few years back. Pregnancy in a patient with history of atrial switch operation poses a unique haemodynamic challenge. We report the case of a successful pregnancy in a 26 years old lady who had undergone Mustard repair surgery in …

Precise Pregnancy Cohort: Challenges And Strategies In Setting Up A Biorepository In Sub-Saharan Africa, Rachel Craik, Donna Russell, Rachel M. Tribe, Marleen Temmerman, Angela Koech, Patricia Okiro, Geoffrey Omuse, Sikolia Wanyonyi

Obstetrics and Gynaecology, East Africa

Background and objective: PRECISE is a population-based, prospective pregnancy cohort study designed for deep phenotyping of pregnancies in women with placenta-related disorders, and in healthy controls. The PRECISE Network is recruiting ~ 10,000 pregnant women in three countries (The Gambia, Kenya, and Mozambique) representing sub-Saharan Africa. The principal aim is to improve our understanding of pre-eclampsia, fetal growth restriction and stillbirth. This involves the creation of a highly curated biorepository for state of the art discovery science and a rich database of antenatal variables and maternal and neonatal outcomes. Our overarching aim is to provide large sample numbers with …

The Precise (Pregnancy Care Integrating Translational Science, Everywhere) Database: Open-Access Data Collection In Maternal And Newborn Health, Laura A. Magee, Amber Strang, Larry Li, Domena Tu, Warancha Tumtaweetikul, Rachel Craik, Marina Daniele, Angela Koech, Umberto D’Alessandro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

In less-resourced settings, adverse pregnancy outcome rates are unacceptably high. To effect improvement, we need accurate epidemiological data about rates of death and morbidity, as well as social determinants of health and processes of care, and from each country (or region) to contextualise strategies. The PRECISE database is a unique core infrastructure of a generic, unified data collection platform. It is built on previous work in data harmonisation, outcome and data field standardisation, open-access software (District Health Information System 2 and the Baobab Laboratory Information Management System), and clinical research networks. The database contains globally-recommended indicators included in Health Management …

The Precise (Pregnancy Care Integrating Translational Science, Everywhere) Network’S First Protocol: Deep Phenotyping In Three Sub-Saharan African Countries, Peter Von Dadelszen, Meriel Flint-O’Kane, Lucilla Poston, Rachel Craik, Donna Russell, Rachel M. Tribe, Umberto D’Alessandro, Marleen Temmerman, Angela Koech, Anna Roca

Obstetrics and Gynaecology, East Africa

Background: The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network is a new and broadly-based group of research scientists and health advocates based in the UK, Africa and North America.

Methods: This paper describes the protocol that underpins the clinical research activity of the Network, so that the investigators, and broader global health community, can have access to ‘deep phenotyping’ (social determinants of health, demographic and clinical parameters, placental biology and agnostic discovery biology) of women as they advance through pregnancy to the end of the puerperium, whether those pregnancies have normal outcomes or are complicated by one/more of the …

Harnessing The Precise Network As A Platform To Strengthen Global Capacity For Maternal And Child Health Research In Sub-Saharan Africa, Meriel Flint-O’Kane, Peter Von Dadelszen, Prestige Tatenda Makanga, Esperança Sevene, Anna Roca, Peter Dukes, Saba Hinrichs-Krapels, Rachel Craik, Laura A. Magee, Marleen Temmerman, Angela Koech, The Precise Network

Obstetrics and Gynaecology, East Africa

It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network has been established as a platform to strengthen global capacity for research focused on the improvement of maternal, fetal and newborn health in subSaharan Africa. Best practice principles outlined in an ESSENCE on Health Research report have been considered in relation to the PRECISE Network capacity-building activities …

The Contribution Of Qualitative Research Within The Precise Study In Sub-Saharan Africa, Marina A. S. Daniele, Melisa Martinez-Alvarez, Angela Koech, Marianne Vidler, Tatiana Salisbury, Prestige Tatenda Makanga, Peris Musitia, Meriel Flint-O’Kane, Tanya Wells Brown, Brahima Amara Diallo, Marleen Temmerman, Geoffrey Omuse, Sikolia Wanyonyi, Patricia Okiro

Obstetrics and Gynaecology, East Africa

The PRECISE Network is a cohort study established to investigate hypertension, fetal growth restriction and stillbirth (described as “placental disorders”) in Kenya, Mozambique and The Gambia. Several pregnancy or birth cohorts have been set up in low- and middle-income countries, focussed on maternal and child health. Qualitative research methods are sometimes used alongside quantitative data collection from these cohorts. Researchers affiliated with PRECISE are also planning to use qualitative methods, from the perspective of multiple subject areas. This paper provides an overview of the different ways in which qualitative research methods can contribute to achieving PRECISE’s objectives, and discusses the …

Prevalence Of Pelvic Organ Prolapse In Women, Associated Factors And Impact On Quality Of Life In Rural Pakistan: Population-Based Study, Abdul Hakeem Jokhio, Raheela Mohsin Rizvi, Christine Macarthur

Department of Obstetrics & Gynaecology

Background: Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate "the prevalence of pelvic organ prolapse" associated factors, duration and impact on women's quality of life in rural Pakistan.
Methods: A cross-sectional study was conducted with a three stage random sampling strategy. Three health centers were selected and selected Lady Health Workers from each health center interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health …

Can Magnetic Resonance Imaging Predict Pathologic Findings For Endometrioid Endometrial Cancer?, Elizabeth L. Dickson Michelson, Jessica J. F. Kram, Kayla Heslin, David Baugh, Vikram Bamra, Jiahao Hu, Abhishek Shukla, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

This pilot study aimed to assess the feasibility of precisely measuring tumor diameter and myometrial invasion in patients with endometrioid endometrial cancer (EEC) using preoperative contrast-enhanced magnetic resonance imaging (MRI). Adult patients with confirmed diagnosis of complex hyperplasia with atypia or EEC were included. Three radiologists separately measured tumor diameter and myometrial invasion. Basic descriptive statistics were used to describe patient characteristics and to compare radiology- and pathology-measured tumor diameter and myometrial invasion. Using the pathology results for tumor diameter as the gold standard for comparison, at least 1 radiologist was able to predict largest tumor diameter within 5 mm …

Dancing During Labor: Social Media Trend Or Future Practice?, Caroline P. Toberna, Drew Horter, Kayla Heslin, Marie M. Forgie, Emily Malloy, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Over the past 30 years, medical interventions in pregnancy and childbirth have increased. Some pregnant women seek less invasive and nonpharmacological options to manage discomforts during labor. While exercise during pregnancy is recommended, less is known about exercise, specifically dancing, during labor. While anecdotal evidence is supportive, little is known about the implications of exercise and dance during the first stage of labor for pain reduction and labor progression. Some movements common in dance, such as expanding hip circles that loosen and relax muscles of the pelvic floor, may be beneficial to women during labor. Available evidence suggests that dancing …

Supporting The Role And Transition To Motherhood Through The Occupation Of Feeding, Bethanne N. Vidmar, Becki Cohill, Susan Macdermott

Spring 2020 Virtual OTD Capstone Symposium

The purpose of this project was to assess and explore the occupational needs of mothers who are feeding their infants in a variety of ways to then identify psychosocial and occupational barriers affecting women's’ choices in feeding options for their infant through survey and interviews and opportunities for occupational therapists to become more involved in the occupation of breastfeeding.

Data analysis for this capstone project consisted of running a needs assessment in Santa Barbara County. The needs assessment consisted of written or online surveys and semi-structured in-depth interviews. Of the 95 women who filled out the hard-copy or online survey, …