Obstetrics and Gynecology Commons^™

Is Repeat Abortion A Public Health Problem Among Chinese Adolescents? A Cross-Sectional Survey In 30 Provinces, Jinlin Liu, Shangchun Wu, Jialin Xu, Marleen Temmerman, Wei-Hong Zhang, The Inpac Group

Obstetrics and Gynaecology, East Africa

The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all women seeking abortions within 12 weeks of pregnancy during a period of 2 months in 297 participating hospitals randomly selected across 30 provinces of China in 2013. Only the adolescents (younger than the minimum legal married age of 20 years) were included in this study. Of the 2370 adolescents who were receiving abortions, 927 (39%) were undergoing …

Serum Anti Mullerian Hormone And Renalase Levels In Predicting The Risk Of Preeclampsia, Zehra Jamil, Sana Shahid, Erum Baig, Rida Ahmad, Faryal Subhani, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

Objective: The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia.
Materials and Methods: This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured …

National Policies And Care Provision In Pregnancy And Childbirth For Twins In Eastern And Southern Africa: A Mixed-Methods Multi-Country Study, Claudia Hanson, Stephen Munjanja, Agnes Binagwaho, Bellington Vwalika, Andrea B. Pembe, Elsa Jacinto, George K. Chilinda, Kateri B. Donahoe, Sikolia Wanyonyi, Peter Waiswa, Muchabayiwa F. Gidiri, Lenka Benova

Obstetrics and Gynaecology, East Africa

Background: High-risk pregnancies, such as twin pregnancies, deserve particular attention as mortality is very high in this group. With a view to inform policy and national guidelines development for the Sustainable Development Goals, we reviewed national training materials, guidelines, and policies underpinning the provision of care in relation to twin pregnancies and assessed care provided to twins in 8 Eastern and Southern African countries: Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

Methods and findings: We located policies and guidelines by reviewing national repositories and by contacting experts to systematically map country-level maternal and newborn training materials, guidelines, and …

Association Between Hypertensive Disorders And Fetal Growth Abnormalities In Class Ii And Iii Obese Women, Mary Ferrante, Bs, Rebekah Mccurdy, Md, Mph

Phase 1

Introduction: Studies have shown that hypertension in pregnancy can lead to small for gestational age newborns while obesity can lead to large for gestational age newborns. However, little research has been done to study the influence of both disorders on birthweight.

Objective: To assess the effect of both maternal obesity and a hypertensive disorder on neonatal birthweight and to identify the specific growth abnormality(s) present if a discrepancy exists. We hypothesize that obese women diagnosed with hypertensive disorders are more likely to deliver neonates with growth abnormalities compared to obese women without hypertensive disorders.

Methods: This is a …

17-Hydroxyprogesterone Caproate Does Not Prevent Preterm Birth In Women With A Twin Pregnancy And A Prior Singleton Spontaneous Preterm Birth, Breanna Valcarcel, Bs, Andrew Ward, Md, Huda Al-Kouatly, Md, Vincenzo Berghella, Md, Victoria Greenberg, Md

Phase 1

INTRODUCTION: Prior spontaneous preterm birth (sPTB) is a risk factor for recurrent sPTB. Weekly 17-hydroxyprogesterone caproate (17P) is used to prevent sPTB in singletons, but there is insufficient evidence on its benefit in twin pregnancies.

OBJECTIVE: We hypothesized that 17P weekly injections would reduce the likelihood of sPTB in women carrying a twin pregnancy with a history of singleton sPTB.

METHODS: We performed a retrospective case control study of women with a twin gestation and prior singleton sPTB between 2005 and 2016. The study group consisted of women with a twin gestation that received weekly 17P starting at 16 to …

Impact Of Patient Safety Bundle For Management Of Morbidly Adherent Placenta On Estimated Blood Loss, Aislinn Crank, Johanna Quist-Nelson, Md, Arbor Quist, Msph

Phase 1

Introduction: Establishment of centers of excellence for care of patients with morbidly adherent placentas (MAP) has been described to improve patient outcomes. We compared maternal estimated blood loss (EBL) for patients with MAP delivered before and after the implementation of a protocol for management of MAP.

Objective: To assess the impact of a new protocol for management of MAP.

Methods: This is a retrospective cohort of patients at TJUH who had a MAP between 2007 and 2018. In 2015 our center developed a protocol as a patient safety bundle for the management of MAP. Pre-protocol and post-protocol groups were compared. …

Long Term Effects Of Ovum Donation On Donors, Danielle Garfunkel, Andrea Braverman

Phase 1

Introduction: As infertility affects 17% of couples, IVF has become a key, increasingly prevalent option for couples with oocyte donors providing eggs to infertile women in ~13.7% of IVF cycles. Despite the growing prevalence of donation, there are no long-term follow up studies on the emotional and health effects of donation. We cannot appropriately counsel patients regarding the risks of the donation procedure without understanding its effects.

Objective: This study sets out to identify the long-term effects of oocyte donation on donors’ mental state and physical health and how the attitudes and concerns of oocyte donors regarding their donation …

Reducing Postoperative Opioids After Minimally Invasive Hysterectomy With Enhanced Recovery, Kevin D. White, Shirin Azadi, Amanda Pauley, Dr. Brenda L Mitchell,, Nadim Bou Zgheib

Marshall Journal of Medicine

I

Introduction:

We evaluated the efficacy of various strategies utilized for the control of postoperative pain after minimally invasive hysterectomy. The primary enhanced recovery after surgery (ERAS) protocol of interest utilized premedication (acetaminophen, celecoxib and pregabalin), then intraoperative subcutaneous liposomal bupivacaine followed by scheduled oral acetaminophen and ibuprofen postoperatively. Patients also had tramadol and oxycodone as needed for moderate or severe breakthrough pain, respectively.

Materials and Methods:

We conducted a retrospective cohort study that included all patients who underwent minimally invasive hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for both benign and oncologic indications over a 2-year period. We …

Failure Of Effective Contraception In Opioid Addicted Mothers: A Disparity In Planned And Actual Usage, Robert C. Bowers, Makenzie Hatfield Kresch, Amy Roy, Danielle Lancaster, Jennie L. Yoost

Marshall Journal of Medicine

The ongoing opioid epidemic in West Virginia has given rise to a unique population of opioid-addicted obstetric patients. Appropriate education, counseling, and implementation of contraception is of extreme importance among this high risk patient population. This study was a retrospective chart review aimed at evaluating contraception choice and initiation rates among patients enrolled in a maternal buprenorphine maintenance program compared to non-opioid addicted patients. Rates of planned contraception initiation were compared between the two groups. Rates of actual contraception initiation were also compared. Contraceptive choices were then placed into one of three tiers based on efficacy, and rates of initiation …

Neurodevelopmental Milestones And Associated Behaviours Are Similar Among Healthy Children Across Diverse Geographical Locations, José Villar, Michelle Fernandes, Manorama Purwar, Eleonora Staines-Urias, Paola Di Nicola, Leila Cheikh Ismail, Roseline Ochieng, Fernando Barros, Maria Carvalho, Elaine Albernaz

Paediatrics and Child Health, East Africa

It is unclear whether early child development is, like skeletal growth, similar across diverse regions with adequate health and nutrition. We prospectively assessed 1307 healthy, well-nourished 2-year-old children of educated mothers, enrolled in early pregnancy from urban areas without major socioeconomic or environmental constraints, in Brazil, India, Italy, Kenya and UK. We used a specially developed psychometric tool, WHO motor milestones and visual tests. Similarities across sites were measured using variance components analysis and standardised site differences (SSD). In 14 of the 16 domains, the percentage of total variance explained by between-site differences ranged from 1.3% (cognitive score) to 9.2% …

Patient Perceptions Of Planned Organ Removal During Hysterectomy, Zeinab Kassem, Chad M. Coleman, Andrew S. Bossick, Wan-Ting Su, Roopina Sangha, Ganesa Wegienka

Journal of Patient-Centered Research and Reviews

Purpose: Previous reports indicate many women may not have a firm grasp on likely outcomes of different hysterectomy procedures. This study aimed to assess women’s self-reported expectations of how they think their anatomy will change after hysterectomy.

Methods: Women scheduled for hysterectomy at a tertiary care hospital, for non-oncological reasons, reported their planned procedure type and the organs they understood would be removed 2 weeks prior to surgery. Patient reports and electronic medical records were reviewed, and kappa statistics (κ) were calculated to assess agreement for all women and within subgroups.

Results: Most of the 456 study participants (mean age: …

A Systematic Review Of Level I Evidence In The Treatment Of Uterine Fibroids, Varun Singh, Geogy Vatakencherry, Md

Student Papers, Posters & Projects

Purpose

To systematically review randomized controlled trial data to compare the efficacy of uterine artery embolization (UAE), highintensity focused ultrasound (HIFU), hysterectomy, and medical therapy in the management of symptomatic uterine fibroids

Factors Associated With A Positive Depression Screen After A Miscarriage, Steve Mutiso, Alfred Murage, Abraham Mukaindo

Obstetrics and Gynaecology, East Africa

Introduction: Miscarriages are a common pregnancy complication and positive depression screen after a miscarriage has been shown to be high in our population. Various factors are associated with an increased risk of developing depression after a miscarriage. However, these factors vary across populations studied with no studies existing in our region. We set out to determine the factors associated with a positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi.

Methods: Patients were recruited at the 2 weeks clinic review after a miscarriage in the gynaecological clinics. They were screened using the Edinburgh postnatal depression scale …

Septin 9 Isoforms Promote Tumorigenesis In Mammary Epithelial Cells By Increasing Migration And Ecm Degradation Through Metalloproteinase Secretion At Focal Adhesions, J. Marcus, M. Bejerano-Sagie, N. Patterson, S. Bagchi, V. V. Verkhusha, D. Connolly, G. L. Goldberg, A. Golden, V. P. Sharma, C. Montagna, +1 Additional Author

Journal Articles

© 2019, The Author(s), under exclusive licence to Springer Nature Limited. The cytoskeletal interacting protein Septin 9 (SEPT9), a member of the septin gene family, has been proposed to have oncogenic functions. It is a known hot spot of retroviral tagging insertion and a fusion partner of both de novo and therapy-induced mixed lineage leukemia (MLL). Of all septins, SEPT9 holds the strongest link to cancer, especially breast cancer. Murine models of breast cancer frequently exhibit SEPT9 amplification in the form of double minute chromosomes, and about 20% of human breast cancer display genomic amplification and protein over expression at …

12-Month Outcomes Of The Us Patient Cohort In The Sonata Pivotal Ide Trial Of Transcervical Ablation Of Uterine Fibroids., Joseph Hudgens, D. Alan Johns, Andrea S. Lukes, David A. Forstein, Dipak Delvadia

Touro College of Osteopathic Medicine (New York) Publications and Research

Objective: The prospective SONATA pivotal Investigational Device Exemption (IDE) trial was performed in the United States (US) and Mexico to examine the safety and effectiveness of transcervical fibroid ablation (TFA) in the treatment of symptomatic uterine fibroids. This is an analysis of 12-month clinical outcomes in the US cohort.

Methods: TFA with the Sonata System was performed on women with symptomatic uterine fibroids. The 12-month co-primary endpoints were reduction in menstrual blood loss and freedom from surgical reintervention. Symptom severity, quality of life, patient satisfaction, safety, and reductions in uterine and fibroid volumes were also evaluated.

Results: One hundred twenty-five …

Pelvic Examinations For Ovarian Cancer Screening In Asymptomatic Adult Women, Riann Collar

Physician Assistant Scholarly Project Posters

There is discrepancy amongst organizations and the medical community whether bimanual pelvic examinations should be performed in asymptomatic women for routine screening. The purpose of this literature review was to determine whether bimanual pelvic examinations are beneficial for screening for ovarian cancer in comparison to no screening. In addition, research was conducted to see if healthcare providers’ professional beliefs align with the evidence and national recommendations, to determine women’s thoughts and beliefs regarding pelvic examinations, and identify other screening methods if bimanual pelvic exams are determined to be an invalid screening tool. Throughout reviewing peer reviewed articles and high-quality evidence, …

Direct Genetics Referral Pathway For High-Grade Serous Ovarian Cancer Patients: The "Opt-Out" Process, Jacob Mcgee, Teresa M. Peart, Norine Foley, Monique Bertrand, Michel Prefontaine, Akira Sugimoto, Helen Ettler, Stephen Welch, Karen Panabaker

Obstetrics & Gynaecology Publications

Purpose. In order to meet a clinical need for better pathways to access genetic testing for ovarian cancer patients, we implemented and reviewed an opt-out referral process for genetic consultation whereby a referral is automatically sent to genetics following a pathological diagnosis of HGSC. Methods. Following implementation of the opt-out referral process, each month a list of new cases of HGSC was generated from the synoptic pathology report and forwarded directly to the Cancer Genetics clinic. Using an advanced directive, patients were automatically referred for genetic counselling two months after surgery. If the patient declined genetic counselling (opted-out) after discussion …

Barriers To Sexual And Reproductive Health Care Access In Central America With A Focus On Modern Contraception, Maria Mccoshen

Theses and Graduate Projects

Reproductive health is an important indicator of overall population health and is a priority of international organizations such as the United Nations (UN) and the World Health Organization (WHO). The UN includes the right to sexual and reproductive health (SRH) in their international covenant on rights stating, “...a woman’s reproductive option is considered a basic human right”. This paper will evaluate whether SRH, specifically modern contraceptive access, is met throughout areas of Central America, with a focus on the country of Costa Rica.

Maternal Health Interventions In Rural, Resource-Limited Countries, Katherine Tilton

Theses and Graduate Projects

Pregnant women are continuing to die at unacceptable rates around the globe. According to the World Health Organization, complications during pregnancy and childbirth are the leading cause of death and disability among reproductive age women in developing countries. Maternal mortality is often a reflection of a combination of causes: medical conditions while giving birth (ie. hemorrhage, eclampsia, and sepsis); other pre-existing medical conditions (ie. malaria, diabetes, HIV/AIDS); and socio-economic factors (ie. access to contraception, religious beliefs, and political agendas) that when combined, largely compromise health care, most often in the poor, rural and marginalized communities. Nearly all maternal deaths (99%) …

Uncommon Misconceptions: Holding Physicians Accountable For Insemination Fraud, Jody L. Madeira

Articles by Maurer Faculty

No abstract provided.