Vani Dandolu - Academia.edu (original) (raw)

Papers by Vani Dandolu

Research paper thumbnail of Resident education regarding technical aspects of cesarean section

The Journal of reproductive medicine

To survey obstetric/gynecologic residents around the country regarding different technical aspect... more To survey obstetric/gynecologic residents around the country regarding different technical aspects of and indications for cesarean section, trends in vaginal birth after cesarean (VBAC) and patient choice of cesarean. A questionnaire was designed to address the above issues and selected demographic information. The questionnaire was sent by e-mail to all the residency programs in the country. The first 400 responses were analyzed. Although a midline vertical incision is considered faster for entry into the abdomen, 77% of residents use a Pfannenstiel incision for urgent/emergency cesarean sections. Fifty-five percent of respondents use single-layer closure of the uterine incision, 37% use double-layer closure, while 11% use single-layer closure only in patients undergoing concomitant sterilization. When questioned regarding a trial of labor, one-third of respondents stated that they would not induce labor in patients with a prior cesarean if the patients did not go into labor spontaneously but offer repeat cesarean for fear of a uterine rupture. Further, 42% said that they would never offer VBAC for an undocumented scar, 12% would and 45% would depending on the history. Regarding the issue of cesarean section by patient request, 94% would not offer an elective cesarean section for uncomplicated primigravidas, while 6% would. However, if a well-informed patient desired an elective cesarean delivery, the majority of residents would respect the patient's request. There is wide variation in the way residents are trained regarding different technical aspects of and indications for cesarean section, choice of repeat cesarean versus VBAC and patient choice of cesarean. Recent trends in the literature are not always reflected in reported practice patterns.

Research paper thumbnail of Medical vs. surgical management of early pregnancy failure

New England Journal of Medicine

The article by Zhang et al.(Aug. 25 issue) 1 demonstrated the usefulness of treatment of early pr... more The article by Zhang et al.(Aug. 25 issue) 1 demonstrated the usefulness of treatment of early pregnancy failure with intravaginal misoprostol but did not describe the serious complications that can arise from such administration of this drug. Although endometritis ...

Research paper thumbnail of Prevalence of urinary symptoms in morbidly obese women and changes after bariatric surgery

The Journal of reproductive medicine

To evaluate the impact of rapid weight loss following bariatric surgery on urinary symptom freque... more To evaluate the impact of rapid weight loss following bariatric surgery on urinary symptom frequency and overall quality of life. Validated questionnaires (Urinary Distress Inventory [UDI-6] and Incontinence Impact Questionnaire [IIQ-7]), were mailed to all women who underwent bariatric surgery at Temple University Hospital between January 2004 and March 2006. McNemar test of paired proportions was used for analysis. Mean body mass index prior to surgery was 47.5 and after surgery was 31.0, with an average weight loss of 49.2 kg. About half the subjects had stress incontinence, 32% had frequency and 24.8% had urgency at baseline. Twenty-six percent of the subjects were frustrated and emotionally distressed by the urinary symptoms at baseline, while one fifth reported interference with performing household chores, travel and other activities. There was a significant improvement in stress incontinence (p < 0.001), frequency and leakage of any degree and overall quality of life subsequent to surgery. Body mass index has a significant effect on urinary symptoms as an independent factor. We report a marked improvement in stress incontinence symptom frequency and symptom bother with rapid weight loss subsequent to bariatric surgery in morbidly obese women.

Research paper thumbnail of Herpes in the peripartum period: a case report

The Journal of reproductive medicine

Despite the tremendous advances made in the management of genital herpes, neonatal herpes has not... more Despite the tremendous advances made in the management of genital herpes, neonatal herpes has not been completely eradicated. In addition, the time from the onset of symptoms in the neonate to the diagnosis of herpes and institution of antiviral medication has remained unchanged in the past 20 years. Neonatal herpes infection resulted from primary, first-episode peripartum genital herpes in the mother. Due to a high index of suspicion, herpes testing was performed on the infant and neonatal herpes diagnosed. Subsequently, the mother developed evidence of primary herpes infection. This case report illustrates the problems with current management strategies for prevention of neonatal herpes.

Research paper thumbnail of SUTURE RETENTION STRENGTH OF THREE TYPES OF DECELLULARIZED OVINE VAGINAL PATCHES FOR SURGICAL APPLICATIONS

Neurourology and Urodynamics

Research paper thumbnail of ORAL POSTER 9: Long-term Functional and Anatomical Outcome Following Sacrospinous Fixation

Journal of Pelvic Medicine and Surgery, 2006

Research paper thumbnail of Oxidized regenerated cellulose presenting as a postoperative cyst: a case report

The Journal of reproductive medicine

Barriers placed intraabdominally may aid in hemostasis and help prevent adhesion formation. A 17-... more Barriers placed intraabdominally may aid in hemostasis and help prevent adhesion formation. A 17-year-old woman presented with acute pelvic pain and a complex pelvic mass. A laparotomy was performed. To ensure hemostasis, Surgicel (Johnson & Johnson Medical, Arlington, Texas) was placed, and Seprafilm (Genzyme Corp., Cambridge, Massachusetts) was used for adhesion prevention. Within the first postoperative day the patient's status deteriorated, with increasing pain and significant pyrexia. Computed tomography was highly suspicious for a bowel injury. Repeat laparotomy found no injury. The Surgicel was removed and the abdomen irrigated. The remaining postoperative course was uneventful. Seprafilm has been associated with acute reactions, and Surgicel has mimicked many radiologic abnormalities. It is imperative to inform the radiologist of the intraoperative use of these agents to allow use of a proper imaging modality in the postoperative period and to avoid unnecessary repeat su...

Research paper thumbnail of NON-ORAL POSTER 36: Gynecologist??s Gender and Opinion Regarding Hysterectomy

Journal of Pelvic Medicine and Surgery, 2005

Research paper thumbnail of Non-Oral Poster 89: The Risk Factors for Failed Vaginal Hysterectomies

Journal of Pelvic Medicine and Surgery, 2004

Research paper thumbnail of Correlating virtual reality and box trainer tasks in the assessment of laparoscopic surgical skills

American journal of obstetrics and gynecology

The purpose of this study was to examine the correlation in the assessment of laparoscopic surgic... more The purpose of this study was to examine the correlation in the assessment of laparoscopic surgical skills in medical students with the use of a virtual reality laparoscopic trainer and a low-fidelity video box trainer with comparative tasks. Third-year medical students were asked to perform 3 basic skills set modules on LapSim (Surgical Science, Gothenburg, Sweden): coordination, grasping and lifting, and handling the intestines. Each task was set at the easiest level, and each student was allowed a maximum of 10 attempts to complete each task. Similar-appearing tasks were chosen for comparison with the use of a standard video box trainer: pegboard, cup drop and rope pass, respectively. Laparoscopic skills were evaluated with the use of both trainers during 1 session. Pearson's correlation coefficients were used to compare paired data on each student using statistical software. Forty-seven of 65 medical students were assigned to clinical clerkships on-campus at Temple Universit...

Research paper thumbnail of Resident Education in Principles and Technique of Bowel Surgery Using an Ex-Vivo Porcine Model

Obstetrics and Gynecology International

Objective. improve competency of residents with lysis of adhesion (LOA) and bowel surgery using a... more Objective. improve competency of residents with lysis of adhesion (LOA) and bowel surgery using a porcine model. Study Design. Pig bowel was removed at time of an anatomy laboratory, cleansed, and used to demonstrate surgical techniques and principles of LOA, repair of enterotomy, bowel resection, and anastomosis. Participants were surveyed pre- and posttraining session using 10 point Likert scale. Results. Thirty one residents at varying levels of training participated. After the training session, there was a significant improvement noted in mean scores for comfort level with LOA (6.3 versus 7.7, P = .007), comfort level with enterotomy repair (2.8 versus 6.4, P < .0001), understanding principles of LOA (5.0 versus 7.7, P < .0001), understanding principles of enterotomy repair (3.5 versus 7.0, P < .0001), and familiarity with instruments used (5.8 versus 7.3, P = .01). Conclusion. Training sessions using ex-vivo porcine model improve resident perception of knowledge and co...

Research paper thumbnail of Poster 19: Trends in the Occurrence of Obstetric Anal Sphincter Lacerations Over the Past 3 Decades in the State of Maryland

Journal of Pelvic Medicine and Surgery, 2005

Research paper thumbnail of Baking soda pica: a case of hypokalemic metabolic alkalosis and rhabdomyolysis in pregnancy

Obstetrics and gynecology, 2006

We report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalem... more We report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalemic metabolic alkalosis and rhabdomyolysis. A multigravida at 31 weeks of gestation presented with weakness and muscle pain. She was found to have severe hypokalemic metabolic alkalosis and rhabdomyolysis, with elevation in serum transaminases and hypertension. We initially thought the patient had an atypical presentation of preeclampsia until it was realized that she was ingesting 1 full box of baking soda (454 g sodium bicarbonate) per day. Symptoms and abnormal laboratory findings resolved with discontinuation of the patient's pica practices. Pica is a common but often overlooked practice that can potentially lead to life-threatening disorders. A thorough evaluation of a patient's dietary intake is extremely important, especially in the setting of atypical presentations of disease in pregnancy.

Research paper thumbnail of Obstetric outcomes with a false-positive one-hour glucose challenge test by the Carpenter-Coustan criteria

Journal of Maternal-Fetal and Neonatal Medicine, 2008

Pregnancies complicated by a false-positive one-hour glucose challenge test (GCT), as determined ... more Pregnancies complicated by a false-positive one-hour glucose challenge test (GCT), as determined by the National Diabetes Data Group (NDDG) criteria, have higher rates of adverse maternal and neonatal outcomes. This study was conducted to determine if pregnancies complicated by a false-positive GCT, as determined by the Carpenter-Coustan (CC) criteria, also have higher rates of adverse maternal and neonatal outcomes. In this retrospective case-control study, we compared 165 patients with a false-positive GCT, as determined by the Carpenter-Coustan criteria, to a cohort of 165 pregnant controls with a normal screening GCT. Multiple variables for maternal and neonatal outcomes were compared between the two groups. The racial distribution and gestational age of delivery were similar in both groups. The study group had a higher one-hour GCT (148.2 mg/dl vs. 95.3 mg/dl, p &amp;amp;amp;amp;lt; 0.001), was older (27.4 yrs vs. 23.8 years, p &amp;amp;amp;amp;lt; 0.001), was more likely to be multiparous (71.5% vs. 58.2%, p = 0.011), and had a higher BMI (26.7 kg/m2 vs. 24.6 kg/m2, p = 0.002). There were no differences between the two groups in mode of delivery, birth weight, rates of macrosomia, shoulder dystocia, antenatal death and maternal laceration. There were also no differences between the two groups in rates of preeclampsia, chorioamnionitis, endometritis, ICN admission, neonatal hypoglycemia, Erb&amp;amp;amp;amp;#39;s palsy, clavicular fracture, neonatal sepsis, neonatal death or use of phototherapy. Women with a false-positive one-hour GCT by the Carpenter-Coustan criteria do not have higher rates of adverse perinatal outcomes. Using the Carpenter-Coustan criteria to diagnose GDM appears to be superior to NDDG criteria in terms of avoiding adverse maternal and neonatal outcomes.

Research paper thumbnail of Characteristics of Obstetric ICU Admissions in New Jersey

Research paper thumbnail of Long-term Anatomic and Functional Outcome Following Sacrospinous Fixation Using Comprehensive Pelvic Floor Questionnaires

Journal of Pelvic Medicine and Surgery, 2007

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > ...

Research paper thumbnail of NON-ORAL POSTER 48: Does Obesity Affect Vaginal Hysterectomy Outcomes?

Journal of Pelvic Medicine and Surgery, 2006

Research paper thumbnail of Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome: A historical perspective

Gene

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital defect of the Müllerian ducts char... more Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital defect of the Müllerian ducts characterized by uterovaginal agenesis and underdeveloped female genital organs. This paper is a tribute to the contributors of this condition - August Franz Joseph Karl Mayer, Karl Freiherr von Rokitansky, Hermann Küster and Georges André Hauser. In addition to their contributions, we have discussed findings and reports of similar defects from other important scientists (Hippocrates, Albucasis, etc.) dating as far back as 460B.C. We have also discussed the disease types and different classification systems including VCUAM and AFS/ASRM among others. Even with several surgical and non-surgical treatment options, there are still many questions that remain unanswered and very little is known about the etiology or genetic predisposition of this condition.

Research paper thumbnail of Douching With Water Works Device for Perceived Vaginal Odor With or Without Complaints of Discharge in Women With No Infectious Cause of Vaginitis: A Pilot Study

Infectious Diseases in Obstetrics & Gynecology, 2006

Objective. To determine if douching with Water Works device for 1 month can (1) lower or eliminat... more Objective. To determine if douching with Water Works device for 1 month can (1) lower or eliminate perceived vaginal odor by subject; (2) have any effects on vaginal ecosystem. Methods. Ten women with perceived vaginal odor with or without discharge, douched every day for 4 weeks in an open-label, nonrandomized pilot study. Primary outcome measures included perceived vaginal odor by subject, lactobacilli score from Nugent slide, and acceptance of the Water Works douching system. Secondary outcome included the safety of using this douching device. Results. At week 4, there was improvement in vaginal odor (P = .0006) and there was no significant change in lactobacilli score. Conclusion. Douching with Water Works device is associated with reduction or elimination of vaginal odor without adversely affecting the vaginal ecosystem.

Research paper thumbnail of Is severe perineal damage increased in women with prior anal sphincter injury?

Journal of Maternal-Fetal and Neonatal Medicine, 2006

There is conflicting data in the literature regarding the risk of obstetric anal sphincter lacera... more There is conflicting data in the literature regarding the risk of obstetric anal sphincter laceration in patients with a prior laceration. This retrospective chart review seeks to examine the risk of recurrence of obstetric anal sphincter lacerations. Patients who sustained anal sphincter laceration at delivery during a 13-year time period from January 1991 to December 2003 were identified from the medical records database at Temple University Hospital. All subsequent deliveries in this group of patients were extracted from the database. Chart review was performed on all subsequent deliveries with specific attention to demographic factors such as age, race, parity, etc., maternal weight, fetal weight, presence of maternal diabetes, and labor characteristics such as induction or augmentation of labor, instrumentation at delivery (vacuum or forceps), use of episiotomy, and degree of perineal laceration. There were 23 451 vaginal deliveries at Temple University Hospital between January 1, 1991 and December 31, 2003. Anal sphincter laceration was noted in 778 subjects. Subsequent deliveries among the group of patients with prior sphincter tears numbered 271. Six (2.4%) patients had recurrence of anal sphincter lacerations, and five of them were third degree lacerations. The rate of recurrent lacerations was not significantly different from the rate of initial lacerations (2.4% vs. 3.3%; odds ratio 0.72, 95% confidence interval 0.33-1.59; p = 0.4). Women who sustained recurrent lacerations were older, more obese (mean weight 92 kg vs. 82 kg), had larger babies (3506 g vs. 3227 g), and were more likely to have episiotomies (66.7% vs. 7%) or instrumental deliveries (33.3 vs. 6.5%). Prior anal sphincter laceration does not result in an increased rate of recurrence. Operative vaginal delivery particularly with episiotomy is a risk factor for both initial and recurrent laceration.

Research paper thumbnail of Resident education regarding technical aspects of cesarean section

The Journal of reproductive medicine

To survey obstetric/gynecologic residents around the country regarding different technical aspect... more To survey obstetric/gynecologic residents around the country regarding different technical aspects of and indications for cesarean section, trends in vaginal birth after cesarean (VBAC) and patient choice of cesarean. A questionnaire was designed to address the above issues and selected demographic information. The questionnaire was sent by e-mail to all the residency programs in the country. The first 400 responses were analyzed. Although a midline vertical incision is considered faster for entry into the abdomen, 77% of residents use a Pfannenstiel incision for urgent/emergency cesarean sections. Fifty-five percent of respondents use single-layer closure of the uterine incision, 37% use double-layer closure, while 11% use single-layer closure only in patients undergoing concomitant sterilization. When questioned regarding a trial of labor, one-third of respondents stated that they would not induce labor in patients with a prior cesarean if the patients did not go into labor spontaneously but offer repeat cesarean for fear of a uterine rupture. Further, 42% said that they would never offer VBAC for an undocumented scar, 12% would and 45% would depending on the history. Regarding the issue of cesarean section by patient request, 94% would not offer an elective cesarean section for uncomplicated primigravidas, while 6% would. However, if a well-informed patient desired an elective cesarean delivery, the majority of residents would respect the patient&amp;amp;amp;amp;amp;amp;#39;s request. There is wide variation in the way residents are trained regarding different technical aspects of and indications for cesarean section, choice of repeat cesarean versus VBAC and patient choice of cesarean. Recent trends in the literature are not always reflected in reported practice patterns.

Research paper thumbnail of Medical vs. surgical management of early pregnancy failure

New England Journal of Medicine

The article by Zhang et al.(Aug. 25 issue) 1 demonstrated the usefulness of treatment of early pr... more The article by Zhang et al.(Aug. 25 issue) 1 demonstrated the usefulness of treatment of early pregnancy failure with intravaginal misoprostol but did not describe the serious complications that can arise from such administration of this drug. Although endometritis ...

Research paper thumbnail of Prevalence of urinary symptoms in morbidly obese women and changes after bariatric surgery

The Journal of reproductive medicine

To evaluate the impact of rapid weight loss following bariatric surgery on urinary symptom freque... more To evaluate the impact of rapid weight loss following bariatric surgery on urinary symptom frequency and overall quality of life. Validated questionnaires (Urinary Distress Inventory [UDI-6] and Incontinence Impact Questionnaire [IIQ-7]), were mailed to all women who underwent bariatric surgery at Temple University Hospital between January 2004 and March 2006. McNemar test of paired proportions was used for analysis. Mean body mass index prior to surgery was 47.5 and after surgery was 31.0, with an average weight loss of 49.2 kg. About half the subjects had stress incontinence, 32% had frequency and 24.8% had urgency at baseline. Twenty-six percent of the subjects were frustrated and emotionally distressed by the urinary symptoms at baseline, while one fifth reported interference with performing household chores, travel and other activities. There was a significant improvement in stress incontinence (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), frequency and leakage of any degree and overall quality of life subsequent to surgery. Body mass index has a significant effect on urinary symptoms as an independent factor. We report a marked improvement in stress incontinence symptom frequency and symptom bother with rapid weight loss subsequent to bariatric surgery in morbidly obese women.

Research paper thumbnail of Herpes in the peripartum period: a case report

The Journal of reproductive medicine

Despite the tremendous advances made in the management of genital herpes, neonatal herpes has not... more Despite the tremendous advances made in the management of genital herpes, neonatal herpes has not been completely eradicated. In addition, the time from the onset of symptoms in the neonate to the diagnosis of herpes and institution of antiviral medication has remained unchanged in the past 20 years. Neonatal herpes infection resulted from primary, first-episode peripartum genital herpes in the mother. Due to a high index of suspicion, herpes testing was performed on the infant and neonatal herpes diagnosed. Subsequently, the mother developed evidence of primary herpes infection. This case report illustrates the problems with current management strategies for prevention of neonatal herpes.

Research paper thumbnail of SUTURE RETENTION STRENGTH OF THREE TYPES OF DECELLULARIZED OVINE VAGINAL PATCHES FOR SURGICAL APPLICATIONS

Neurourology and Urodynamics

Research paper thumbnail of ORAL POSTER 9: Long-term Functional and Anatomical Outcome Following Sacrospinous Fixation

Journal of Pelvic Medicine and Surgery, 2006

Research paper thumbnail of Oxidized regenerated cellulose presenting as a postoperative cyst: a case report

The Journal of reproductive medicine

Barriers placed intraabdominally may aid in hemostasis and help prevent adhesion formation. A 17-... more Barriers placed intraabdominally may aid in hemostasis and help prevent adhesion formation. A 17-year-old woman presented with acute pelvic pain and a complex pelvic mass. A laparotomy was performed. To ensure hemostasis, Surgicel (Johnson & Johnson Medical, Arlington, Texas) was placed, and Seprafilm (Genzyme Corp., Cambridge, Massachusetts) was used for adhesion prevention. Within the first postoperative day the patient's status deteriorated, with increasing pain and significant pyrexia. Computed tomography was highly suspicious for a bowel injury. Repeat laparotomy found no injury. The Surgicel was removed and the abdomen irrigated. The remaining postoperative course was uneventful. Seprafilm has been associated with acute reactions, and Surgicel has mimicked many radiologic abnormalities. It is imperative to inform the radiologist of the intraoperative use of these agents to allow use of a proper imaging modality in the postoperative period and to avoid unnecessary repeat su...

Research paper thumbnail of NON-ORAL POSTER 36: Gynecologist??s Gender and Opinion Regarding Hysterectomy

Journal of Pelvic Medicine and Surgery, 2005

Research paper thumbnail of Non-Oral Poster 89: The Risk Factors for Failed Vaginal Hysterectomies

Journal of Pelvic Medicine and Surgery, 2004

Research paper thumbnail of Correlating virtual reality and box trainer tasks in the assessment of laparoscopic surgical skills

American journal of obstetrics and gynecology

The purpose of this study was to examine the correlation in the assessment of laparoscopic surgic... more The purpose of this study was to examine the correlation in the assessment of laparoscopic surgical skills in medical students with the use of a virtual reality laparoscopic trainer and a low-fidelity video box trainer with comparative tasks. Third-year medical students were asked to perform 3 basic skills set modules on LapSim (Surgical Science, Gothenburg, Sweden): coordination, grasping and lifting, and handling the intestines. Each task was set at the easiest level, and each student was allowed a maximum of 10 attempts to complete each task. Similar-appearing tasks were chosen for comparison with the use of a standard video box trainer: pegboard, cup drop and rope pass, respectively. Laparoscopic skills were evaluated with the use of both trainers during 1 session. Pearson's correlation coefficients were used to compare paired data on each student using statistical software. Forty-seven of 65 medical students were assigned to clinical clerkships on-campus at Temple Universit...

Research paper thumbnail of Resident Education in Principles and Technique of Bowel Surgery Using an Ex-Vivo Porcine Model

Obstetrics and Gynecology International

Objective. improve competency of residents with lysis of adhesion (LOA) and bowel surgery using a... more Objective. improve competency of residents with lysis of adhesion (LOA) and bowel surgery using a porcine model. Study Design. Pig bowel was removed at time of an anatomy laboratory, cleansed, and used to demonstrate surgical techniques and principles of LOA, repair of enterotomy, bowel resection, and anastomosis. Participants were surveyed pre- and posttraining session using 10 point Likert scale. Results. Thirty one residents at varying levels of training participated. After the training session, there was a significant improvement noted in mean scores for comfort level with LOA (6.3 versus 7.7, P = .007), comfort level with enterotomy repair (2.8 versus 6.4, P < .0001), understanding principles of LOA (5.0 versus 7.7, P < .0001), understanding principles of enterotomy repair (3.5 versus 7.0, P < .0001), and familiarity with instruments used (5.8 versus 7.3, P = .01). Conclusion. Training sessions using ex-vivo porcine model improve resident perception of knowledge and co...

Research paper thumbnail of Poster 19: Trends in the Occurrence of Obstetric Anal Sphincter Lacerations Over the Past 3 Decades in the State of Maryland

Journal of Pelvic Medicine and Surgery, 2005

Research paper thumbnail of Baking soda pica: a case of hypokalemic metabolic alkalosis and rhabdomyolysis in pregnancy

Obstetrics and gynecology, 2006

We report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalem... more We report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalemic metabolic alkalosis and rhabdomyolysis. A multigravida at 31 weeks of gestation presented with weakness and muscle pain. She was found to have severe hypokalemic metabolic alkalosis and rhabdomyolysis, with elevation in serum transaminases and hypertension. We initially thought the patient had an atypical presentation of preeclampsia until it was realized that she was ingesting 1 full box of baking soda (454 g sodium bicarbonate) per day. Symptoms and abnormal laboratory findings resolved with discontinuation of the patient's pica practices. Pica is a common but often overlooked practice that can potentially lead to life-threatening disorders. A thorough evaluation of a patient's dietary intake is extremely important, especially in the setting of atypical presentations of disease in pregnancy.

Research paper thumbnail of Obstetric outcomes with a false-positive one-hour glucose challenge test by the Carpenter-Coustan criteria

Journal of Maternal-Fetal and Neonatal Medicine, 2008

Pregnancies complicated by a false-positive one-hour glucose challenge test (GCT), as determined ... more Pregnancies complicated by a false-positive one-hour glucose challenge test (GCT), as determined by the National Diabetes Data Group (NDDG) criteria, have higher rates of adverse maternal and neonatal outcomes. This study was conducted to determine if pregnancies complicated by a false-positive GCT, as determined by the Carpenter-Coustan (CC) criteria, also have higher rates of adverse maternal and neonatal outcomes. In this retrospective case-control study, we compared 165 patients with a false-positive GCT, as determined by the Carpenter-Coustan criteria, to a cohort of 165 pregnant controls with a normal screening GCT. Multiple variables for maternal and neonatal outcomes were compared between the two groups. The racial distribution and gestational age of delivery were similar in both groups. The study group had a higher one-hour GCT (148.2 mg/dl vs. 95.3 mg/dl, p &amp;amp;amp;amp;lt; 0.001), was older (27.4 yrs vs. 23.8 years, p &amp;amp;amp;amp;lt; 0.001), was more likely to be multiparous (71.5% vs. 58.2%, p = 0.011), and had a higher BMI (26.7 kg/m2 vs. 24.6 kg/m2, p = 0.002). There were no differences between the two groups in mode of delivery, birth weight, rates of macrosomia, shoulder dystocia, antenatal death and maternal laceration. There were also no differences between the two groups in rates of preeclampsia, chorioamnionitis, endometritis, ICN admission, neonatal hypoglycemia, Erb&amp;amp;amp;amp;#39;s palsy, clavicular fracture, neonatal sepsis, neonatal death or use of phototherapy. Women with a false-positive one-hour GCT by the Carpenter-Coustan criteria do not have higher rates of adverse perinatal outcomes. Using the Carpenter-Coustan criteria to diagnose GDM appears to be superior to NDDG criteria in terms of avoiding adverse maternal and neonatal outcomes.

Research paper thumbnail of Characteristics of Obstetric ICU Admissions in New Jersey

Research paper thumbnail of Long-term Anatomic and Functional Outcome Following Sacrospinous Fixation Using Comprehensive Pelvic Floor Questionnaires

Journal of Pelvic Medicine and Surgery, 2007

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > ...

Research paper thumbnail of NON-ORAL POSTER 48: Does Obesity Affect Vaginal Hysterectomy Outcomes?

Journal of Pelvic Medicine and Surgery, 2006

Research paper thumbnail of Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome: A historical perspective

Gene

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital defect of the Müllerian ducts char... more Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital defect of the Müllerian ducts characterized by uterovaginal agenesis and underdeveloped female genital organs. This paper is a tribute to the contributors of this condition - August Franz Joseph Karl Mayer, Karl Freiherr von Rokitansky, Hermann Küster and Georges André Hauser. In addition to their contributions, we have discussed findings and reports of similar defects from other important scientists (Hippocrates, Albucasis, etc.) dating as far back as 460B.C. We have also discussed the disease types and different classification systems including VCUAM and AFS/ASRM among others. Even with several surgical and non-surgical treatment options, there are still many questions that remain unanswered and very little is known about the etiology or genetic predisposition of this condition.

Research paper thumbnail of Douching With Water Works Device for Perceived Vaginal Odor With or Without Complaints of Discharge in Women With No Infectious Cause of Vaginitis: A Pilot Study

Infectious Diseases in Obstetrics & Gynecology, 2006

Objective. To determine if douching with Water Works device for 1 month can (1) lower or eliminat... more Objective. To determine if douching with Water Works device for 1 month can (1) lower or eliminate perceived vaginal odor by subject; (2) have any effects on vaginal ecosystem. Methods. Ten women with perceived vaginal odor with or without discharge, douched every day for 4 weeks in an open-label, nonrandomized pilot study. Primary outcome measures included perceived vaginal odor by subject, lactobacilli score from Nugent slide, and acceptance of the Water Works douching system. Secondary outcome included the safety of using this douching device. Results. At week 4, there was improvement in vaginal odor (P = .0006) and there was no significant change in lactobacilli score. Conclusion. Douching with Water Works device is associated with reduction or elimination of vaginal odor without adversely affecting the vaginal ecosystem.

Research paper thumbnail of Is severe perineal damage increased in women with prior anal sphincter injury?

Journal of Maternal-Fetal and Neonatal Medicine, 2006

There is conflicting data in the literature regarding the risk of obstetric anal sphincter lacera... more There is conflicting data in the literature regarding the risk of obstetric anal sphincter laceration in patients with a prior laceration. This retrospective chart review seeks to examine the risk of recurrence of obstetric anal sphincter lacerations. Patients who sustained anal sphincter laceration at delivery during a 13-year time period from January 1991 to December 2003 were identified from the medical records database at Temple University Hospital. All subsequent deliveries in this group of patients were extracted from the database. Chart review was performed on all subsequent deliveries with specific attention to demographic factors such as age, race, parity, etc., maternal weight, fetal weight, presence of maternal diabetes, and labor characteristics such as induction or augmentation of labor, instrumentation at delivery (vacuum or forceps), use of episiotomy, and degree of perineal laceration. There were 23 451 vaginal deliveries at Temple University Hospital between January 1, 1991 and December 31, 2003. Anal sphincter laceration was noted in 778 subjects. Subsequent deliveries among the group of patients with prior sphincter tears numbered 271. Six (2.4%) patients had recurrence of anal sphincter lacerations, and five of them were third degree lacerations. The rate of recurrent lacerations was not significantly different from the rate of initial lacerations (2.4% vs. 3.3%; odds ratio 0.72, 95% confidence interval 0.33-1.59; p = 0.4). Women who sustained recurrent lacerations were older, more obese (mean weight 92 kg vs. 82 kg), had larger babies (3506 g vs. 3227 g), and were more likely to have episiotomies (66.7% vs. 7%) or instrumental deliveries (33.3 vs. 6.5%). Prior anal sphincter laceration does not result in an increased rate of recurrence. Operative vaginal delivery particularly with episiotomy is a risk factor for both initial and recurrent laceration.