bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essure and Pelvic Pain: Risk Factors for Device Removal and Reintervention [18F]
Authors: Hijaz Miriana , Walton Edward Michael , Tsafrir Ziv , Aoun Joelle , Eisenstein David 
Published: May 2017

INTRODUCTION:
The FDA recently announced actions to provide information about the risks of using the Essure device, requiring a mandatory postmarket study to determine its heightened risks. In this study, we aim to look at our experience with the Essure device and analyze its outcomes and complications, focusing on pelvic pain and the risks associated with re-operation.

METHODS:
We conducted a retrospective cohort study of 319 patient who underwent Essure placement between 2002 and 2016. Patient characteristics included age, race, BMI, parity, history of chronic pelvic pain, prior gynecological surgery or pelvic infections, and documented nickel allergies. Measured outcomes included new or worsening pelvic pain, need for device removal or subsequent pelvic surgery. Logistic regression models were used to test the association between each predictor variable and measured outcomes.

RESULTS:
Out of the total patients, 64 had undergone re-operation and 255 did not. Most common procedure was hysterectomy with bilateral salpingectomy (6.58%) followed by endometrial ablation (5.96%), 3.3% of patients underwent Essure removal. The average time between Essure placement and re-operation was 9 years. Only 4.39% of re-operation were performed due to pelvic pain. There was a significant correlation between incidence of re-operation and illicit drug use (p 0.026), and prior gynecological surgery (p 0.008).

CONCLUSION:
We re-demonstrate the rarity of new onset pelvic pain after Essure placement. However, illicit drug use, especially marijuana, and prior pelvic surgery were significant risk factors in re-operation following Essure placement and should be considered as part of the consent process.
Necessity for Short Interval Intrauterine Device String Check [19F]
Authors: Hylton Jordan , Milton Sarah , Cheang Kai , Sima Adam 
Published: May 2017

INTRODUCTION:
The purpose of the study was to determine the necessity for the short interval IUD string check that is recommended by most IUD manufacturers. The primary objective was to determine if a routine short interval follow up visit after IUD insertion identifies expelled or malpositioned IUDs.

METHODS:
The study is a retrospective chart review of data collected from ICD 9 and 10 codes for “IUD placement” at Virginia Commonwealth University from January 2011 to December 2015. One thousand charts were reviewed. In addition to data on malpositioned or expelled IUDs, information was collected regarding symptoms at time of string check, obstetric and gynecologic history, string check intervals and visits related to IUD complaints. Statistical analysis was accomplished using t-tests and chi square tests.

RESULTS:
There was no difference in identification of malpositioned or expelled intrauterine devices among patients who attended short interval string check visits compared with those who did not, p=0.8269. There were statistically significant differences in breastfeeding status, menstrual bleeding patterns, gravidity and parity between attendees and non-attendees.

CONCLUSION:
There was not a difference in the incidence of IUD malposition or expulsion in patients who attended the short interval string check visit versus those who did not attend. There were, however, statistically significant differences in the two study groups. The CDC’s 2016 U.S. Selected Practice Recommendations for Contraceptive Use sites poor quality and limited data regarding the utility of routine follow up visits following IUD insertion. This study further validates the CDC assertion that routine string check visits are unnecessary.
Male Knowledge of His Partner’s Contraceptive Method and Likelihood of Fathering a Pregnancy [20F]
Authors: Hicks-Courant Katherine , Dubinskaya Alexandra , Baer Samantha 
Published: May 2017

INTRODUCTION:
Many forms of contraception are female-dependent and may not be evident to sexual partners. Less than half of men who are sexually active but do not want to father a child have partners who consistently use contraception. This study examines whether male knowledge of his partner’s birth control method is associated with having impregnated a partner.

METHODS:
We used data from the 2011-2013 National Surveys of Family Growth. Our sample included sexually active men 15-45 years of age who had never been married. Unadjusted t-tests and linear regression assessed whether knowledge of his last partner’s birth control method was associated with having fathered a pregnancy.

RESULTS:
Our sample included 1,845 males. 477 (25.85%) had fathered a pregnancy. At last sexual intercourse, 45.20% (n=834) reported that their partner used female-dependent contraception, defined as a contraceptive method other than male condoms, withdrawal or male sterilization. 49.70% (n=917) reported that their partner did not use female-dependent contraception, and 5.09% (n=94) did not know what contraception, if any, their partner used. There were no significant differences in rates of having fathered a pregnancy in unadjusted comparisons between groups. When adjusting for age, number of sexual partners, use of male-dependent contraception, and knowledge of contraception prior to first sex there remained no statistically significant association between male’s knowledge of his partner’s contraceptive method and having fathered a pregnancy.

CONCLUSION:
Among unmarried men, knowledge of a current partner’s contraceptive method is not significantly associated with having fathered a pregnancy.
IUDs in the Twittersphere: Sentiment Analysis of IUD-Related Tweets [23F]
Authors: Jung Christina , Richter Felix , Lunde Britt , Chen Katherine 
Published: May 2017

INTRODUCTION:
Twitter has allowed for rapid sharing of user-created content. Researchers have begun to study sentiment in Twitter by building a word lexicon scored for valence from negative to positive sentiment, creating a method of validated sentiment analysis. However, few studies have looked at Twitter and health—much less, in relation to contraception and women’s health.

METHODS:
Publicly posted tweets from January 1, 2007 to January 1, 2016 with hashtags referencing IUD and brands Mirena, Skyla, and Liletta were separated into the following sources: 1) “individual”, 2) “medical provider”, 3) “health organization”, and 4) “legal organization” based on username, Twitter handle, and full name. Tweet content was interpreted with a validated sentiment analysis, and compared across source and brand.

RESULTS:
We found that Tweets by individuals were significantly more positive than Tweets by healthcare organizations (p < 0.005). Tweets by law organizations were significantly more negative than all other sources (p < 0.0005) Tweets about IUD brands across all sources spiked in number at the time of each device’s release into the market. Tweets about the newer IUD brands, Skyla and Liletta, were more positive than those about the Mirena (p < 0.0005).

CONCLUSION:
Our study shows how Twitter data can reflect temporal and sentiment patterns in lay perception of and reaction to IUDs over time. Studying how information about contraception is shared on social media platforms like Twitter can help us better understand the context in which patients make decisions about their health.
Is Perceived Discrimination Associated With Contraceptive Method Use in a National Sample of Women? [24F]
Authors: Loder Charisse , Hall Kelli Stidham , Kusunoki Yasamin , Harris Lisa , Dalton Vanessa 
Published: May 2017

INTRODUCTION:
Patient race, class and ethnicity influence physician recommendations for contraception. Moreover, patient’s perceived discrimination has been linked to health outcomes and healthcare utilization. We investigated associations between patients’ perceived discrimination and contraceptive method use in premenopausal, sexually active U.S. women.

METHODS:
We used population-based data from the 2013 Women’s Health Care Experiences and Preferences study of 18-55 year olds. The survey included items measuring health history and social wellbeing, including the Everyday Discrimination Scale (EDS). We focused on one EDS item, “People act as if they think you are not smart,” which we call “perceived discrimination based on intelligence” (PDI). We analyzed relationships between PDI and contraceptive method use (sterilization; highly effective methods [IUC/implant/injectable]; moderately effective methods [pill/patch/ring]; barrier; no method). We conducted multivariable binary logistic regression, controlling for sociodemographic characteristics.

RESULTS:
We surveyed 730 premenopausal, sexually active women. Logistic regression models showed that PDI was positively associated with use of a highly effective contraceptive method compared to all other methods, controlling for race, ethnicity, marital status and education (OR 1.5, 95% CI 1.14-2.07, p=0.005). PDI was not associated with the use of any other category of contraceptive method.

CONCLUSION:
Perceived discrimination based on intelligence is associated with use of highly effective contraceptive method use. Further research is needed to determine the reasons for these associations, and whether patient autonomy and/or provider bias influence this relationship.
Pregnancy Characteristics and Clinical Outcomes for Varying Severity of Morbidly Adherent Placenta [29F]
Authors: Erfani Hadi , Bateni Zhoobin H. , Salmanian Bahram , Belfort Michael A. , Fox Karin A. 
Published: May 2017

INTRODUCTION:
To compare the characteristics and outcomes of morbidly adherent placenta (MAP) in two groups of placenta accreta and placenta increta or percreta.

METHODS:
All patients with pathology proven morbidly adherent placenta (MAP, including placenta accreta, increta or percreta), who underwent cesarean hysterectomy from January 2000 to June 2016, were included in the study retrospectively. Data were reported using descriptive statistics and appropriate statistical methods were used based on the normality of the data.

RESULTS:
We reviewed total of 189 pathologically proven MAP from January 2000 to June 2016, 157 of which were singletons who underwent cesarean hysterectomy. Twenty-six out of 56 (46.4%) patients with placenta accreta versus 78 out of 101 (77.2%) patients with placenta increta or percreta had antenatal diagnosis for placenta previa (P < 0.001). On the other hand the rate of unsuspected cases who did not have antenatal diagnosis was higher in placenta accreta in comparison to those with increta or percreta (P < 0.001). Moreover, the rate of positive history of previous cesarean delivery was higher in the group of increta or percreta than accreta patients (P < 0.01). Interestingly there were no statistically significant difference between the two groups regarding the blood loss or blood products transfusion.

CONCLUSION:
Our study showed that the prevalence of placenta previa is higher in deeper depth of MAP. The rate of unsuspected cases that are diagnosed at the surgery was higher in placenta accreta probably due to less severe ultrasound features used to render a pre-delivery diagnosis.
Chronic Histiocytic Intervillositis – Clinical, Biochemical and Radiological Associations [30F]
Authors: Koby Lawrence , Keating Sarah , Malinowski Ann , Murphy Kellie , D'Souza Rohan 
Published: May 2017

INTRODUCTION:
To determine the clinical, biochemical and radiological features associated with a histopathologic diagnosis of chronic histiocytic intervillositis (CHI), and propose surveillance strategies for pregnancies at risk for this condition.

METHODS:
A retrospective chart review was conducted to identify cases with a diagnosis of CHI between 2001 and 2014. Adverse pregnancy outcomes included pregnancy loss, preterm birth, small for gestational age (SGA) and preeclampsia. Maternal tests included serum alkaline phosphatase (ALKP) and prenatal screening bioanalytes. Mid-trimester placental ultrasound reported placental dimensions, echotexture, echogenic cystic lesions, infarcts and uterine artery pulsatility indices. Late-trimester ultrasound reported umbilical artery Dopplers and amniotic fluid volume. Outcomes were described as proportions.

RESULTS:
Of the 261 cases of intervillositis identified, 33 were cases of CHI. Fetal demise was noted in 13/33 (39.4%) of which 11 (35.5%) were stillbirths. Of the 18 live births, 16 (88.9%) delivered prematurely; 6 of these (33.3%) before 34 weeks and 12 (66.7%) required neonatal unit admission. All babies born after 22 weeks were SGA, with 15/23 (65.2%) under the 3rd centile. Preeclampsia complicated 9/33 (27.3%) of pregnancies. 12/16 (75.0%) had at least one abnormal prenatal screening bioanalyte and 6/19 (31.57%) ALKP levels 2.5 times above normal. 15/20 (75.0%) had at least one abnormal mid-trimester placental ultrasound marker.

CONCLUSION:
CHI is associated with a cluster of clinical, biochemical or radiological findings. Given the high recurrence rate and no available treatment, individualized care plans based on a combination of clinical, biochemical and radiological tests have been proposed to improve outcomes in subsequent pregnancies.
Pregnancy Outcomes in Gestational Hypertension and Preeclampsia Without Severe Features [32F]
Authors: Rincon Monica P. , Kuo Kelly , Sabol Bethany , Burwick Richard 
Published: May 2017

INTRODUCTION:
Guidelines recommend that women with gestational hypertension (GHTN) be managed similarly to preeclampsia (PE) without severe features (SF). We sought to compare pregnancy outcomes in a cohort of subjects with GHTN or PE without SF.

METHODS:
Retrospective cohort of singleton pregnancies delivering greater than or equal to 23 weeks gestational age from September 2015 to March 2016 in a single institution. Charts were first screened for hypertension in pregnancy utilizing ICD9 and ICD 10 discharge codes. Individual chart review was utilized to identify sub-groups of women with GHTN or PE without SF, using 2013 American College of Obstetricians and Gynecologists criteria.

RESULTS:
Our cohort included 1,399 total deliveries. GHTN and PE without SF complicated 95 pregnancies (6.71%). Women with GHTN and PE without SF were of similar age, BMI, race, parity, and diabetes status. Delivery occurred slightly later in women with GHTN, but this was not statistically significant (38.6 vs. 37.9 wks., p=0.11). Women with PE without SF had higher peak systolic blood pressure (p=0.024), lower hemoglobin (p=0.007) and lower platelet counts (p=0.036) prior to delivery. While maternal adverse outcomes were no different between groups, women with PE without SF tended to have higher rates of PTB less than 37 wks (p=0.11), SGA neonates (p=0.067), NICU admission (p=0.10), and RDS (p=0.11).

CONCLUSION:
Our results support the concept that women with GHTN and PE without SF are generally similar in nature. However, compared to women with PE without SF, women with GHTN tend to have more modest blood pressure elevations at delivery and better neonatal outcomes.
Pregnancy Outcomes in Women With Neuromuscular Dystrophies: A Retrospective Study [34F]
Authors: AlShehri Eman , Czuzoj-Shulman Nicholas , Spence Andrea , Abenhaim Haim 
Published: May 2017

INTRODUCTION:
Neuromuscular dystrophies (NMD) are a group of rare genetic diseases characterized by weakness and muscular wasting. Data on NMD in pregnancy is limited. Our aim is to determine the prevalence of muscular dystrophies at delivery, and related maternal and newborn outcomes.

METHODS:
Using the United States Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) from 1999 to 2013, we conducted a population-based retrospective cohort study to compare women with and without any form of NMD at delivery. We used multivariate logistic regression analyses to estimate the associated risks of maternal and neonatal outcomes.

RESULTS:
Of the 12,592,178 births in our cohort, 914 deliveries were to women carrying a NMD. Over the 15-year period, there was an increased prevalence rate from 3 to 10 cases per 100 000 deliveries per year (p < 0.001). Births to women with NMD were more likely to be premature (OR 1.60, 95% CI 1.26-2.02), have intrauterine growth restriction (OR 2.08,95% CI 1.50-2.90) and congenital malformation (OR 4.93, 95% CI 3.30-7.38). Compared with controls, women with muscular dystrophies were more likely to deliver by cesarean section (OR 1.87,95% CI 1.62-2.17), have forceps assisted deliveries (OR 1.76, 95% CI 1.01-3.04), were at higher risk of major morbidities including cardiac dysrhythmia (OR 4.97,95% CI 3.02-8.20) and increased requirements for blood transfusion (OR 2.44,95% CI 1.56-3.83).

CONCLUSION:
Pregnancies in NMD patients are associated with an increased risk of maternal and fetal morbidities and, as such, they should be cared for in a tertiary care center.
Investigating Parity as a Risk Factor for Developing Preeclampsia in Gestational Diabetes Mellitus [36F]
Authors: Bernard Kimberly , Gabbur Nagaraj 
Published: May 2017

INTRODUCTION:
It is well established that patients with Gestational Diabetes Mellitus (GDM) are at a greater risk of developing preeclampsia than those not diagnosed with GDM. It has also been shown that nulliparous women are at an increased risk of developing preeclampsia compared to multiparous women. This study investigates the role of parity as a risk factor for preeclampsia in patients already diagnosed with GDM.

METHODS:
A retrospective chart review was conducted at SUNY Downstate Medical Center. Exact Mantel-Haenszel tests of trend were conducted for the outcome of preeclampsia (yes vs. no) from the following predictors: number of full-term deliveries, number of pre-term deliveries, and number of spontaneous/elective abortions. Step-down Bonferroni corrections to p-values were applied to correct for multiple testing.

RESULTS:
636 patients with GDM and no prior history of diabetes were included. The population was composed of 30.3% nulliparous patients with a median age of 31 y/o and 37 weeks 2 days at delivery. The multipara (69.7%) population was similar with a median age of 32 y/o and 37 weeks 2 days at delivery. The results revealed that the frequency of developing preeclampsia in nulliparous women with GDM was more than twice that of multiparous women (8.81 to 4.06, p=0.086).

CONCLUSION:
As this value was approaching statistical significance, it warrants the necessity of further investigation of nulliparity as a risk factor for preeclampsia in GDM patients. This research was created in the effort to help physicians understand which patients are more at risk for preeclampsia thus aiding in counseling and management.
Six Years Experience With Porcine Extracellular Matrix: A New Paradigm for Pelvic Floor Repair [1G]
Authors: Storey Jean , Yordan-Jovet Raul , Kambiss Scott 
Published: May 2017

INTRODUCTION:
Retrospective case series report on the efficacy and safety of using the porcine extracellular matrix Matristem® (ACell, Columbia, MD) in the surgical management of pelvic organ prolapse (POP).

METHODS:
Charts of patients treated surgically for POP with a porcine bladder graft at our institution between 2010 and 2015 were reviewed. Pre and postoperative POP-Q scores were compared. Surgical complications and adverse events were surveilled.

RESULTS:
84 patients were identified with POP including 93 pelvic reconstructive procedures performed. 61 anterior repairs (AR) including 17 total vaginal hysterectomies with modified McCall's uterosacral ligament cuff suspensions, and 6 concurrent posterior repairs (PR). 27 additional posterior repairs, 2 vaginal para vaginal repairs (VPVR), and 3 bilateral sacrospinous ligament colpopexies (SSLC). Preoperative POP-Q scores measuring level 1 and level 2 support ranged from -2 to +6. POP-Q scores obtained 3 to 72 months (median = 54) postoperatively revealed durable global level 1 and 2 support with most at -3 scores. 2 anatomical failures to anterior or apical -1 scores, but only 1 symptomatic case needed reoperation. No significant surgical or product complications were identified.

CONCLUSION:
Secondary to procurement inconsistencies associated with synthetic and cadaveric products, and the risk of erosion, fibrosis, retraction, or dyspareunia with synthetic materials, our preliminary data shows that Matristem xenografts offers a safe and efficacious alternative in the surgical repair of level 1 and 2 POP.
Identifying and Rating Urogynecology Applications Using the APPLICATIONS Scoring System [4G]
Authors: Wallace Shannon , Mehta Shailja , Farag Sara , Kelley Robert , Chen Katherine 
Published: May 2017

INTRODUCTION:
Thousands of medical applications (apps) are available for mobile devices. Finding accurate, provider-directed apps may be time-consuming and frustrating for urogynecologists. This study’s objective is to identify and rate urogynecology (urogyn) apps using an adapted APPLICATIONS scoring system.

METHODS:
Urogyn apps were identified from the Apple iTunes and Google Play Stores using the following ten MESH terms: urogynecology, incontinence, prolapse, urinary tract infection, pelvic surgery, fecal incontinence, defecation disorder, voiding disorder, urethral diverticulum and fistula. Consumer-based and inaccurate apps were excluded. Remaining apps were rated with the APPLICATIONS scoring system, which uses objective and subjective criteria to evaluate comprehensiveness (the extent of ability to aid in clinical-decision making and to provide informational data). Objective rating components included price, paid subscription, literature used, in-app purchases, Internet connectivity, advertisements, text search field, interplatform compatibility and incorporated images, figures, videos and special features. Subjective rating components were ease of navigation and presentation.

RESULTS:
The urogyn-related MESH terms identified 137 and 238 apps in the Apple iTunes and Google Play stores, respectively. Only 8 apps (5 of which were in both stores) were found to be accurate and useful and were rated using the APPLICATIONS scoring system. The top rated apps were Practical Urology for Gynecologists and Practical Urology.

CONCLUSION:
Few accurate clinical-decision making and informational apps exist for urogynecologists. Apps varied by comprehensiveness and quality. This study highlights the importance of systematically reviewing and rating medical apps. It also emphasizes the need for developing accurate apps for urogynecologists that improve health provider performance and patient outcomes.