Proceedings in Obstetrics and Gynecology
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Division of General Obstetrics and Gynecology
Get PDFThe Division of General Obstetrics and Gynecology provides well-woman care for women of all ages and complete care for pregnancy and birth. We evaluate and treat gynecologic disorders. We perform office, outpatient and inpatient gynecologic surgery. We offer minimally invasive hysterectomy including total laparoscopic and robotic surgery. Our division is committed to excellence in caring for women from adolescence to maturity. We regard each patient as an individual with her own history and needs. We are all dedicated to outstanding clinical practice and teaching
The relationship between obesity, pregnancy, and levels of indoleamine 2,3-dioxygenase
Get PDFFor a successful pregnancy to occur, foreign genetic material such as the allogeneic fetus must be tolerated within the maternal host. Indoleamine 2,3-dioxygenase (IDO) is an enzyme induced by pro-inflammatory cytokines that has been shown to be key to this process. Obesity as a pro-inflammatory state is associated with poor obstetric outcomes. The primary objective of this study is to investigate the relationship between obesity and IDO activity
Meckel Gruber Syndrome diagnosed in two consecutive pregnancies
Get PDFMeckel Gruber syndrome is a lethal, autosomal recessive, multisystemic disorder that is associated with a mutation affecting ciliogenesis. In this report, we present two consecutive pregnancies of a woman complicated with MKS. In the first pregnancy with MKS, the amniotic fluid index was under 1 cm with bilateral polycystic fetal kidneys. Post-abortion macroscopic examination of the first fetus revealed multiple congenital anomalies including occipital encephalocele, axial polydactyly and pes equinovarus. Ultrasound examination during the second gestation revealed a singleton pregnancy complicated by MKS. There were multiple congenital anomalies including an occipital encephalocele, polycystic and horseshoe shaped kidneys, axial polydactyly, cleft lip and palate
Ruptured cornual ectopic pregnancy: case report
Get PDFEctopic pregnancy, defined as the placement of an embryonic sac somewhere other than the uterine wall, is the most common life-threatening emergency seen during early pregnancy. Interstitial ectopic pregnancy is defined as the placement of an ectopic pregnancy to the uterine part of the fallopian tubes and makes up about 2-4% of all ectopic pregnancies. Compared to other tubal pregnancies, they rupture later during pregnancy and gross hemorrhage is seen as a result of this rupture. Maternal mortality risk is 2 to 5 times more in interstitial ruptured pregnancy in comparison with other tubal pregnancies. Early diagnosis and treatment of interstitial ectopic pregnancy is therefore very crucial, as they carry a very high risk of morbidity associated with the rupture. In this case report, we present a case presenting with severe abdominal pain and amenorrhea for 3 months to our clinic. After examination, the patient was diagnosed with a cornual ectopic pregnancy which was late for a case like this. We would like to discuss this case with a literature review on this subjec
Leiomyoma: a common benign tumor at an unusual location
Get PDFLeiomyoma in the female genital tract is a common benign tumor of the uterus, followed by cervix, round ligament and inguinal ligament. Vaginal leiomyoma is a rare entity with only about 300 reported cases.Here, we report a case of a vaginal leiomyoma in a 22 year old nullipara who presented with dyspareunia and infertility. Vaginal examination revealed a mass in the anterior vaginal wall. MRI of the pelvis revealed a hypoechogenic and hypointense mass in the anterior vaginal wall. Excision of the tumor was done by the vaginal route. Histopathology revealed a benign leiomyoma
ACOG Iowa Section Report, November 2014
Get PDFThe Iowa Section of (ACOG), The American College/Congress of Obstetricians and Gynecologists, the strengths of our membership are education, research, political advocacy and service to women including internationally
Does leptin predict successful induction of labor?
Get PDFObesity in pregnancy is becoming increasingly common and is associated with many pregnancy-related complications such as failed induction of labor (IOL). Leptin, an adipocytokine important in energy homeostasis, is found in higher levels in obese individuals. Leptin has also been demonstrated to have an inhibitory effect on myometrial contractility in vitro. We hypothesize that leptin may play a part in the mechanism of dysfunctional labor. Thus, we sought to compare the maternal plasma leptin levels in women that had a successful vaginal delivery post-IOL vs. those who had a C-section post-IOL
Pregnant transmen and barriers to high quality healthcare
Get PDFA transman presents for prenatal care with a planned, desired pregnancy and no underlying medical issues. Clinicians caring for him are initially unable to initiate a pregnancy episode in the electronic medical record (EMR) secondary to his legal designation as male, and must change the gender marker in the EMR to female in order to document the pregnancy. This situation illuminates the systemic challenges faced by transmen seeking health care, especially in the area of obstetrics. This article will review language used to define the trans* community, highlight trans* healthcare disparities, review the context in which transmen receive perinatal care, discuss what is known about their experiences, and make recommendations for improvement in healthcare systems to eliminate barriers to safe, effective, and culturally-competent care
Prenatal radiation exposure
Get PDFPregnant women may be exposed to nonionizing, ionizing radiation and contrast media via diagnostic or therapeutic procedures and workplace exposure. When computed tomography or magnetic resonance imaging is performed on a pregnant woman, the effects of exposure to radiation, high magnetic fields and contrast media, which can be risky for a fetus, should be considered. Nonionizing radiation that is not significantly risky for a fetus includes microwave, ultrasound, radio frequency and electromagnetic waves, while ionizing radiation that can be teratogenic, carcinogenic or mutagenic includes particles and electromagnetic radiation. The effects of radiation are associated with the level of exposure and stage of fetal development. Organogenesis (two to seven weeks after conception) and the early fetal period (eight to fifteen weeks after conception) are the most sensitive stages for a fetus. Noncancerous health effects have not been determined at any stage of gestation with less than 50 mGy (5 rad) exposure dose of ionizing radiation. Higher exposure levels may lead to spontaneous abortion, growth restriction, and mental retardation. The risk of cancer is increased regardless of the dose. Although the use of iodinated contrast media is generally thought to be safe during pregnancy, the risk of fetal hypothyroidism should be considered and it should be used only when necessary. The use of gadolinium-based contrast media during pregnancy is controversial because of the lack of clinical data. The purpose of this article is to review the existing literature regarding the prenatal radiation exposure and to discuss fetal risk of radiation
Severe ovarian hyperstimulation syndrome in spontaneous pregnancy treated successfully with cabergoline
Get PDFOvarian hyperstimulation syndrome (OHSS) is a relatively common complication in infertile patients treated with exogenous gonadotropins. Ovarian hyperstimulation in spontaneous pregnancies is a rare but possible. The pathogenesis of spontaneous OHSS is not well known. Risk factors for OHSS are young age, polycystic ovaries, low body mass index, high gonadotropin dose, increased estradiol and human chorionic gonadotropin levels, multiple pregnancy, OHSS history, molar pregnancy and hypothyroidism. In this report we present a case of severe spontaneous OHSS with a brief summary of the literature. She was hospitalized and treated in the clinic with the diagnosis of severe OHSS accompanying spontaneous pregnancy