UTMB Health Obstetrics & Gynecology

While there are a variety of reasons for hysterectomy and techniques to perform the procedure, vNOTES is a novel approach that complements traditional surgical techniques.

Once considered a major abdominal surgery with a long recovery period, modern approaches to hysterectomy aim to complete the procedure with minimal pain, recovery time, and cosmetic effects.

“When performing a hysterectomy, our goal is to use the least invasive approach possible to achieve a quicker recovery,” says Truong Nguyen, MD, of UTMB’s Department of Obstetrics and Gynecology.

This means evaluating every patient to determine the safest, most effective approach.

A Novel Approach to Minimally Invasive Hysterectomy at UTMB With patient safety and quicker recovery in mind, UTMB has recently introduced a novel approach to hysterectomy, called vNOTES.

Congrats are in order for Dr. Mostafa Eyada! His oral abstract presentation received the American Society for Clinical Oncology Annual Meeting Conquer Cancer Merit Award!

Dr. Eyada’s oral presentation was on oral cyclophosphamide plus Bevacizumab in recurrent ovarian cancer. This is the abstract for which he received the ASCO conquer cancer Merit award.

His poster presentation was Gemcitabine plus cisplatin for recurrent ovarian cancer.

Congrats!

GYN simulation day for the ObGyn residents!

EMIGS training
Vaginal manipulator placement
Use of Ally uterine manipulator surgical arm
Fetal pillow placement
MyoSure extended tissue removal
Endometrial ablation
Cooseal vessel sealer

Vanessa Abacan, a clinical nurse specialist and Souby George, a nurse clinician have both seen the effects of maternal female clinician in white coat with stethoscopemental health not being recognized as a serious issue. Currently, the United States reports that one in five women experience postpartum depression, or perinatal mood and anxiety disorder, and that su***de is the third leading cause of maternal mortality.

Mothers can often experience this up until a year after giving birth, even though most postpartum checkups occur three weeks postpartum.
Some symptoms for postpartum women to watch out for include:
feeling sad or depressed
feeling more irritable or angry at those around you
having difficulty bonding with your baby
feeling anxious or panicky
having problems with sleeping or eating
having upsetting thoughts
feeling out of control
worried you might hurt your baby or yourself

Despite misconceptions about what motherhood should look or feel like, these symptoms are very normal things to feel after giving birth. However, these symptoms do need to be addressed to get new moms back to feeling like themselves.

Abacan and George are both working to combat the stigma new mothers might feel about reaching out for help when they start to experience the symptoms of postpartum depression.

Abacan and George recommend resources such as:
text MOM UTMBGA to 321-517-4278
individuals texting this message to the number listed above will be directed to a mental health screening that will help inform patient support measures
call 911 for immediate help
call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262)
visit here to take a brief emotional screening

Both nurses also advocate for normalizing talking about mental health to help remove stigma around it. By talking to new moms about postpartum depression before they leave the hospital, this can make reaching out for help feel less scary.



https://www.utmbhealth.com/health-blog/article/health-blog/2024/05/20/nurses-take-action-against-rising-maternal-mortality-rates-by-advocating-for-mental-health-awareness?fbclid=IwZXh0bgNhZW0CMTEAAR0ukWL5LX3qyiQly8sqJurk1-sgTxXjGkc37REZqbDFYd-qPx4NxdVJw6U_aem_AcfhtkE2VrdWRZkzsExLynYowKkY593ZLpnRyqPokieSZXzXEv7yoFLco8eQdAJSMp1-RD2AEm3pqUmgf-2IuZJz

Nurses take action by advocating for maternal mental health awareness Clinicians at UTMB Health are working to shine light on perinatal mood and anxiety disorder, to help moms understand the feelings they may encounter throughout pregnancy and the postpartum period.

Research from MFM Fellow Dr. Ana Collins-Smith!

Ana Collins-Smith, MD, of the University of Texas Medical Branch in Galveston, reported that among 34,099 healthcare workers, there was an increased incidence of:

•Diet-controlled gestational diabetes mellitus (GDM): 12.88% for healthcare workers vs 9.95% for nonhealthcare workers (n=about 1.5 million), RR 1.2587 (P

Healthcare Workers at Increased Risk of Some Adverse Maternal Outcomes Higher incidence of GDM, hypertension, and more may require more screening, researcher says

Congrats, Dr. Menon!

UTMB Professor Receives Prestigious NIH Prize Dr. Ramkumar Menon, professor in the Department of Obstetrics and Gynecology at the University of Texas Medical Branch, was recently awarded a prestigious prize of $50,000 from the National Institutes of Health.

Congrats to Dr. Lena Younes, OBGYN PGY 4, on her latest publication!

OBJECTIVE:
To investigate the effects of applying tension to a transcervical Foley balloon on delivery time in term nulliparous patients undergoing labor induction.

METHODS:
This cluster randomized clinical trial included 279 term nulliparous women presenting for labor induction with a plan for cervical ripening through transcervical Foley balloon placement. Participants were assigned to either the tension group (n=138) or the no-tension group (n=141) on the basis of randomized, weekly clusters (26 total clusters). The primary outcome measured was the time from initial Foley balloon insertion to delivery. Secondary outcomes included cesarean delivery rates, peripartum infection, and neonatal intensive care unit (NICU) admission. Our prior data suggested that delivery time in the tension group would be about 1,053 minutes. We estimated a sample size of 260 (130 per group, 26 clusters) on the basis of a 25% difference, power of 80%, and two-sided α of 0.05.

RESULTS:
A total of 279 term nulliparous patients were included in the analysis. The median time from Foley placement to delivery was 1,596 minutes (range 430–3,438 minutes) for the tension group and 1,621 minutes (range 488–3,323 minutes) for the no-tension group (P=.8); similar results were noted for time to vaginal delivery. No significant differences were observed in the secondary outcomes, including the rates of cesarean delivery (34.1% vs 29.8%, P=.7), peripartum infection, and NICU admission, between the two groups.

CONCLUSION:
Applying tension to a transcervical Foley balloon in term nulliparous women undergoing labor induction did not significantly reduce delivery time or improve secondary outcomes.

Applying Tension to the Transcervical Foley Balloon and... : Obstetrics & Gynecology an for cervical ripening through transcervical Foley balloon placement. Participants were assigned to either the tension group (n=138) or the no-tension group (n=141) on the basis of randomized, weekly clusters (26 total clusters). The primary outcome measured was the time from initial Foley balloon...

Thanks to Myra Guerra, Elana Lloyd and Dr. Dawn Short, for providing valuable insights into the programs and demonstrating passion and dedication to their work. Thanks for all you do!

APP Leadership Guides Longstanding Regional Women's Services and Pediatrics Program With APP leaders at the helm, UTMB’s Regional Women’s Services and Pediatrics Program provides women’s health and pediatric care to vulnerable populations across southeast Texas and McAllen.

Latest publication from the Dept. Of ObGyn!

Temporal Trends in Treatment and Outcomes of Endometrial Carcinoma in the United States, 2005-2020 - PubMed Endometrial cancer has continued to see a rising incidence in the US over the years. The main aim of this study was to assess current trends in patients' characteristics and outcomes of treatment for endometrial carcinoma over 16 years. A dataset from the National Cancer Database (NCDB) for patients...

Congrats to Dr. ​Luke Jenusaitis for being chosen as one of the five resident recipients of the Thayer Award for Excellence in Teaching this semester!

Dr. Jenusaitis has accepted this award on behalf of McGovern Academy of Oslerian Medicine.

The Thayer Award is given to a resident or fellow who demonstrates sound scientific knowledge, compassion towards patients, and dedication to learning and teaching. Candidates can be nominated by any medical student or faculty by contacting an Osler Student Scholar.

Traditionally, nine (9) residents/fellows are selected per annum by the Osler Student Scholars. The recipient’s Residency Director and Chair will be notified of their achievement. He or she will be congratulated and presented with an award check during their respective Departmental Grand Rounds.

Please join me in congratulating Drs. Luke Jenusaitis and Xue Zhang for their new role as 2024-2025 Admin Chiefs of our OB/GYN residency program beginning May 1, 2024. We look forward to each of them serving as leaders, being role models to their colleagues, and be catalyst for success and achievements to all of our residents.

CPRIT awarded Dr. Berenson $2,494,865 grant
PP240022
The University of Texas Medical Branch at Galveston (Galveston)

Expansion of a multi-pronged intervention to increase HPV vaccination rates among adolescents from rural and medically underserved areas in Texas

According to the U.S Advisory Committee on Immunization Practices, three doses of the 9-valent HPV vaccine are recommended. The vaccine will be given to those ages 15-26 years old to protect them from HPV-related cancers. “No prospective studies have been conducted in the U.S. to show that two doses of 9vHPV vaccine are non-inferior to three doses among individuals in this age range,” said lead researcher Dr. Abbey Berenson, a UTMB professor within the department of OB/GYN and director of the UTMB Center for Interdisciplinary Research in Women’s Health. “This study was designed to fill that gap of knowledge.”

UTMB research says that fewer vaccine doses are required for HPV protection Based on research from doctors at the University of Texas Medical Branch, fewer doses of the vaccine recommended for HPV protection are now required for HPV-related cancers in young women. Accordin…

Congratulations to the 2024 Thayer Award Recipients!

Dr. Luke Fletcher, Department of Obstetrics and Gynecology
Dr. Arlen Suarez Ares, Department of Obstetrics and Gynecology

The John P. McGovern Academy of Oslerian Medicine has named its newest recipients of the Thayer Award for Excellence in Teaching.

The Thayer Award, named for Dr. William S. Thayer, Sir William Osler’s first resident at Johns Hopkins, is given to a resident or fellow who demonstrates sound scientific knowledge, compassion toward patients, and dedication to learning and teaching.

Candidates are nominated by medical students and faculty members. The McGovern Academy presents the awards twice per year.

Congratulations to our newly matched PGY-1s! We are so excited to have you on the island!

Congrats to Dr. Melody Safarzedeh, MFM fellow, on her latest publication!

305 A multi-organ fetal membrane-placenta-on-chip platform to study the transmission of infection and inflammation during pregnancy Infection and inflammation are risk factors for spontaneous preterm birth. However, the spread of infection and inflammatory mediators at the two feto-maternal interfaces (FMi; placenta and fetal membranes with decidua [Fig 1A]) are difficult to study due to the limitations of animal models and the....

Check out the latest MotherToBaby Podcast episode #65, “Pregnancy After Age 35,” featuring Dr. Shannon M. Clark, MFM.

The discussion covers the risks associated with having children later in life and gives insight into Dr. Clark’s own personal journey having children after age 35.

Go to to listen!

The MotherToBaby Podcast: Pregnancy After Age 35 Host Chris Stallman, CGC, welcomes back Maternal-Fetal Medicine Specialist and social media health educator, Dr. Shannon Clark of  Dr. Clark debunks myths about the risks associated with having children later in life. She also gives the audience insight into her own personal journey having chil...

Congrats to Ricshonda Milburn DNP, APRN, WHNP-BC, RNFA, Urogynecology Clinical Coordinator and FPRMS Fellowship Clinical Program Manager on her award as Academy of Master Clinicians (AMC) Clinician of the Month for January 2024!

The AMC recognizes and promotes distinction in all clinical domains by fostering excellence in patient-centric care, with a commitment to developing future leaders through the tenets of the art of healing, empathy, education, scientific rigor, professionalism, mentorship and collaborative team work.

•Demonstrating and exemplifying the highest levels of ethics and professionalism
•Demonstrating attributes (trust, accountability, and stewardship) of a supportive and collaborative team player
•Providing superior care to all patients (safe, effective, patient-centered, culturally congruent, timely, efficient, and evidence-based) in an equitable manner without favor or prejudice and being a strong patient advocate
•Demonstrating compassion and empathy toward patients and their families
•Elevating the performance of colleagues, coworkers, and trainees through education, role-modeling, and mentoring
•Striving for continuing quality improvement and outcomes as measured by standard benchmarks

A recent publication from the Dept. Of ObGyn!

Studies have suggested the effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 reinfection among those previously infected. However, it is not yet clear if one dose of the vaccine is enough to prevent breakthrough infections compared to two doses. Using data from Optum deidentified COVID-19 Electronic Health Record (EHR) data set, we assessed breakthrough infection risks in individuals previously infected, comparing those with one vaccine dose to those with two doses. Propensity scores were applied to mitigate confounding factors. Follow-up spanned 6 months, beginning 2 weeks postvaccination. Among 213 845 individuals, those receiving one vaccine dose had a significantly higher breakthrough infection risk than the two-dose group (HR 1.69, 95% CI 1.54–1.85). This pattern was observed across genders, racial/ethnic groups, age categories, and vaccine types. This study reveals a substantial disparity in the risk of breakthrough infections between individuals receiving one versus two doses of the COVID-19 vaccine, suggesting that a single dose may not provide adequate protection against reinfection.

One dose versus two doses of COVID‐19 vaccine for the prevention of breakthrough infections among people previously infected with SARS‐Cov‐2 Journal of Medical Virology is a clinical virology journal focused on the diagnosis, epidemiology, immunology and pathogenesis of human viral infections & diseases.

Check out the latest publication from MFM! Get your CME!

PMID: 38301258

Article includes:
Suggested Criteria for Inpatient Admission for Management of Hyperemesis Gravidarum

Proposed Definitions for Hyperemesis Gravidarum After Excluding Other Causes

Recommendations for inpatient intravenous (IV) electrolyte, vitamins and minerals, and fluid replacement

Recommendations for inpatient antiemetic pharmacotherapy

Side Effects and Potential Drug-Drug Interactions of Pharmacotherapeutic Options for Inpatient Management of Hyperemesis Gravidarum

Additional Pharmacotherapies and Interventions to Consider

Hyperemesis gravidarum has a reported incidence of approximately 0.3–3% of pregnancies. Without treatment, refractory hyperemesis gravidarum can result in dehydration, electrolyte deficiencies, and severe nutritional deficiencies, resulting in significant maternal morbidity. The overall goals of inpatient management of refractory hyperemesis gravidarum are the resumption of oral intake to an adequate level to maintain hydration and nutrition, including the ability to tolerate oral pharmacotherapy. Patients initially are stabilized with rehydration and electrolyte repletion. There are numerous pharmacotherapeutics available that can be administered intravenously to control symptoms when oral intake is not an option. However, despite maximizing typical antiemetics, there will be cases refractory to these medications, and alternative pharmacotherapeutics and nutrition-support modalities must be considered. Mirtazapine, olanzapine, corticosteroids, and gabapentin are examples of alternative pharmacotherapeutics, and enteral and parenteral nutrition are alternative therapies that can be used when oral intake is not tolerated for prolonged time periods with ongoing weight loss. In refractory cases of hyperemesis gravidarum, the risks and benefits of these alternative forms of management must be considered, along with the risks of undertreated hyperemesis gravidarum and the overall effect of hyperemesis gravidarum on patients’ quality of life.

Inpatient Management of Hyperemesis Gravidarum : Obstetrics & Gynecology inpatient management of refractory hyperemesis gravidarum are the resumption of oral intake to an adequate level to maintain hydration and nutrition, including the ability to tolerate oral pharmacotherapy. Patients initially are stabilized with rehydration and electrolyte repletion. There are numero...

Research by doctors at the University of Texas Medical Branch determined recently that fewer doses of a vaccine than currently recommended are needed to protect against HPV-related cancers in young women.

The U.S. Advisory Committee on Immunization Practices currently recommends three doses of the 9-valent HPV vaccine be given to individuals 15 to 26 years old to protect them against HPV-related cancers.

The World Health Organization recently changed its position to state that only two doses are needed in that population, resulting in a disconnect between U.S. and WHO guidelines.

“No prospective studies have been conducted in the U.S. to show that two doses of 9vHPV vaccine are non-inferior to three doses among individuals in this age range,” said lead researcher Dr. Abbey Berenson, a UTMB professor within the department of OB/GYN and director of the UTMB Center for Interdisciplinary Research in Women’s Health. “This study was designed to fill that gap of knowledge.”

The study, “Immunogenicity of 2 or 3 doses of 9vHPV Vaccine in U.S. Female Individuals 15 to 26 Years of Age,” was funded by the Cancer Prevention and Research Institute of Texas and published in NEJM Evidence.

Fewer doses of vaccine needed for HPV protection, UTMB research shows Newly published study suggests two doses of the 9-valent HPV vaccine offer similar protection as three for females 15-26

The University of Texas Medical Branch opened its new Women’s and Children’s Wing on Jan. 17, marking the latest milestone in the John Sealy Hospital Modernization Project.

The new wing, located in John Sealy Hospital at 301 Eighth St. in Galveston, marks a significant leap in patient-centered care with reimagined patient rooms that are more spacious and family friendly while providing the latest in cutting-edge technologies.

Women's and Children's Wing opens at John Sealy The University of Texas Medical Branch opened its new Women’s and Children’s Wing on Jan. 17, marking the latest milestone in the John Sealy Hospital Modernization Project.

Houston Moms has partnered with UTMB Health, our preferred provider for Southeast Houston, the Bay Area and Galveston, to provide vital information and insights to the Houston community. Check out our monthly videos featuring experts from UTMB Health, covering an array of healthcare needs, questions and concerns you may have for yourself and your family!

This month the topic is cervical cancer with Dr. Marisol Carpio-Solis!

What is cervical cancer
Are there signs/symptoms or is it a more silent disease?
What are the screening guidelines for this disease?
At what age do screenings begin?
How frequently do women need to be screened?
What’s the process?
If someone is diagnosed, are there treatments available?
What are those like?
What about prevention?
Is the HPV vaccine the best/only option?
Who qualifies for that shot?
Any other potentials being explored?

Cervical Cancer Awareness (Houston Moms & UTMB Health)

Congrats to Dr. Arlen Suarez (PGY1) and Dr. Luke Fletcher (PGY 2) for being awarded the Fall 2023 Thayer Award for Excellence in Teaching!

This award is distributed by the McGovern Academy every semester to residents and fellows who demonstrate sound scientific knowledge, compassion towards patients, and dedication to learning and teaching. Candidates can be nominated by any medical student, and the final winners are selected by the Oslerian Student Scholars.

Congrats!

Happy National APP week!

National Advanced Practice Provider (APP) Week honors the contributions of Physician Assistants/Associates, Nurse Practitioners, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, Certified Nurse Midwives, and Certified Anesthesiologist Assistants.

Featured:

Sarah Menotti NP Clear Lake Obgyn
Nickie Milburn NP Clear Lake Urogyn
Caitlyn McDonald NP Clear Lake Obgyn

Congrats to Dr. Emily Calasanz of UTMB Health Women’s HealthCare for being chosen as a Top Doctor for Houstonia Magazine!

Congrats to Dr. Lucy Villarreal on being selected by her peers to be inducted into the Academy of Master Clinician (AMC).

The AMC honors clinicians who are recognized as consistently outstanding in all areas, demonstrating, and exemplifying the highest level of ethics and professionalism.

Congrats!!!

MFM specialist Dr. Shannon M Clark contributed to this piece in .

Link in stories and “pregnancy 3” highlight!

Pseudocyesis is a very rare disorder where a nonpregnant, nonpsychotic person believes they are pregnant and can even have signs and symptoms of pregnancy. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes pseudocyesis under Other Specified Somatic Symptom and Related Disorder.

It affects people from all ethnic, racial, and socioeconomic groups. Although it is more common in those aged 20 to 39, it can occur in premenarchal and postmenopausal persons as well.

Most of these individuals will still insist they are pregnant even after they are shown a negative pregnancy test or empty uterus on ultrasound. They can also have any of the following:
Abdominal enlargement: most common sign
Menstrual irregularities
Sensation of fetal movement
GI symptoms
Weight gain
Breast changes
Abdominal pain
Urinary symptoms

How the patient recovers is related to the psychological factor(s) or social circumstances that precipitated the pseudocyesis. Some patients go on to develop depression, hypomania or psychosis. Some patients even become suicidal.

Because of its rarity and the lack of education on the topic, the medical establishment, even within the field of ObGyn, does not have a good understanding of pseudocyesis. Healthcare professionals may falsely attribute a case of pseudocyesis to the patient being “crazy” or psychotic, when in reality people with the condition are not psychotic at all. This can lead to inappropriate management, the patient feeling unheard or dismissed, or misdiagnosis. This all can lead to the develop of poor outcomes for the patient and even lead to suicidal ideations, su***de attempts or su***de.

It is a real condition and patients truly believe they are pregnant; so much so that when they are told they are not, they feel like they are being lied to. This can be very distressing to the individual and precipitate a significant distrust in the medical system, friends and family. This can all lead to the individual not getting the help they truly need.

What is pseudocyesis? Here’s the science behind phantom pregnancies First highly detailed in Queen Mary back in 1555, the uncommon disorder can cause a woman’s body to mimic signs of pregnancy, from a lack of menstrual periods to a distended stomach.

Congratulations to Dr. Lauren Richardson on being selected as one of only 4 podium speakers at the annual meeting this year. There are 76 BIRCWH scholars in the US so this is a huge honor!

Her research focuses on bridging the gap between bench-to-bedside research by merging advanced engineering and biology concepts. The goal is research is twofold: One, to utilize microfluidic devices to collect underutilized biological fluids for biomarker screening, and two, to develop novel organ-on-chip devices that physiologically recreate in utero organs and organ systems. These devices are primed to replace traditional research approaches, limit animal models for research, and speed up preclinical experiments to get the drugs to clinical trials at a much faster pace.

Congrats!

Thanks to Drs. Nguyen, Kilic, Lewis and Pantoja for arranging the UTMB GYN Technology Day simulation for our ObGyn residents!