Female Urogenital Diseases and Pregnancy Complications Commons^™

Maternal Mortality In Six Low And Lower-Middle Income Countries From 2010 To 2018: Risk Factors And Trends, Melissa Bauserman, Vanessa R. Thorsten, Tracy L. Nolen, Jackie Patterson, Adrien Lokangaka, Antoinette Tshefu, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Saleem Jessani

Community Health Sciences

Background: Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time.
Methods: We analyzed data from women enrolled in the NICHD Global Network for Women's and Children's Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative …

Why Are The Pakistani Maternal, Fetal And Newborn Outcomes So Poor Compared To Other Low And Middle-Income Countries?, Aleha Aziz, Sarah Saleem, Tracy L. Nolen, Nousheen Akber Pradhan, Elizabeth M. Mcclure, Saleem Jessani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Sameen Siddiqi

Community Health Sciences

Background: Pakistan has among the poorest pregnancy outcomes worldwide, significantly worse than many other low-resource countries. The reasons for these differences are not clear. In this study, we compared pregnancy outcomes in Pakistan to other low-resource countries and explored factors that might help explain these differences.
Methods: The Global Network (GN) Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya, Zambia). Study staff enroll women in early pregnancy and follow-up soon after …

Institutional Deliveries And Stillbirth And Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Shivaprasad S. Goudar, Norman Goco, Manjunath S. Somannavar, Avinash Kavi, Sunil S. Vernekar, Antoinette Tshefu, Elwyn Chomba, Ana L. Garces, Sarah Saleem, Farnaz Naqvi

Community Health Sciences

Background: Few studies have shown how the move toward institutional delivery in low and middle-income countries (LMIC) impacts stillbirth and newborn mortality.
Objectives: The study evaluated trends in institutional delivery in research sites in Belagavi and Nagpur India, Guatemala, Kenya, Pakistan, and Zambia from 2010 to 2018 and compared them to changes in the rates of neonatal mortality and stillbirth.
Methods: We analyzed data from a nine-year interval captured in the Global Network (GN) Maternal Newborn Health Registry (MNHR). Mortality rates were estimated from generalized estimating equations controlling for within-cluster correlation. Cluster-level analyses were performed to assess the association between …

Association Of Parity With Birthweight And Neonatal Death In Five Sites: The Global Network's Maternal Newborn Health Registry Study, Ana Garces, Wilton Perez, Margo S. Harrison, Kay S. Hwang, Tracy L. Nolen, Robert L. Goldenberg, Archana B. Patel, Patricia L. Hibberd, Adrien Lokangaka, Sarah Saleem

Community Health Sciences

Background: Nulliparity has been associated with lower birth weight (BW) and other adverse pregnancy outcomes, with most of the data coming from high-income countries. In this study, we examined birth weight for gestational age z-scores and neonatal (28-day) mortality in a large prospective cohort of women dated by first trimester ultrasound from multiple sites in low and middle-income countries.
Methods: Pregnant women were recruited during the first trimester of pregnancy and followed through 6 weeks postpartum from Maternal Newborn Health Registry (MNHR) sites in the Democratic Republic of Congo (DRC), Guatemala, Belagavi and Nagpur, India, and Pakistan from 2017 and …

Gender Variations In Neonatal And Early Infant Mortality In India And Pakistan: A Secondary Analysis From The Global Network Maternal Newborn Health Registry, Zubair H. Aghai, Shivaprasad S. Goudar, Archana Patel, Sarah Saleem, Sangappa M. Dhaded, Avinash Kavi, Parth Lalakia, Farnaz Naqvi, Patricia L. Hibberd, Elizabeth M. Mcclure

Community Health Sciences

Background: To determine the gender differences in neonatal mortality, stillbirths, and perinatal mortality in south Asia using the Global Network data from the Maternal Newborn Health Registry.
Methods: This study is a secondary analysis of prospectively collected data from the three south Asian sites of the Global Network. The maternal and neonatal demographic, clinical characteristics, rates of stillbirths, early neonatal mortality (1-7 days), late neonatal mortality (8-28 days), mortality between 29-42 days and the number of infants hospitalized after birth were compared between the male and female infants.
Results: Between 2010 and 2018, 297,509 births [154,790 males (52.03%) and 142,719 …

Multiomics Characterization Of Preterm Birth In Low- And Middle-Income Countries, Fyezah Jehan, Muhammad Imran Nisar, Muhammad Ilyas, Usma Mehmood, Aneeta Hotwani, Ambreen Nizar, Sajid Muhammad, Waqasuddin Khan, Javairia Khalid, Furqan Kabir

Department of Paediatrics and Child Health

Importance: Worldwide, preterm birth (PTB) is the single largest cause of deaths in the perinatal and neonatal period and is associated with increased morbidity in young children. The cause of PTB is multifactorial, and the development of generalizable biological models may enable early detection and guide therapeutic studies.
Objective: To investigate the ability of transcriptomics and proteomics profiling of plasma and metabolomics analysis of urine to identify early biological measurements associated with PTB.
Design, setting, and participants: This diagnostic/prognostic study analyzed plasma and urine samples collected from May 2014 to June 2017 from pregnant women in 5 biorepository cohorts in …

Maternal Risk Factors And Short Term Outcome Of Prematurity: A Descriptive Study At A Secondary Care Hospital, Heeramani Lohana, Shakeel Ahmed, Nigar Jabeen, Farida Karim, Sarwat Urooj, Ayesha Ahmed

Department of Paediatrics and Child Health

Background: Approximately 15 million babies are born premature (before 37 weeks of gestation) and 1 million babies die due to prematurity complications every year. Less is known about risk factors of prematurity in middle and low-income countries. The prevalence of prematurity ranges from 5% - 18%.
Objective: To determine the prevalence of premature births and to assess the rate of survival, along with the morbidity, among preterm newborns. Furthermore, to document our experience with different gestational age groups of preterm births; and to analyze the association among these strata and their clinical outcomes.
Study Design: A descriptive study.
Place …

The Effect Of Mtor Inhibitor Rapamycin On A Dietary Drosophila Melanogaster Model Of Calcium Oxalate Nephrolithiasis, Michael T. Pignanelli

Electronic Thesis and Dissertation Repository

Impaired cellular tolerance of reactive oxygen species (ROS) has been suggested as a common mechanistic link associated with aging in both metabolic syndrome and nephrolithiasis. The mechanistic (mammalian) target of rapamycin (mTOR) activity is characteristic of metabolic syndrome. When nutrients are abundant, mTOR is active. Conversely, fasting inhibits mTOR. Metabolic syndrome is correlated with an increased risk of self-reported or imaging findings of nephrolithiasis. At the individual level, patients with a higher BMI have an increased prevalence of recurrent symptomatic nephrolithiasis, 24-hour urinary excretion of oxalate, sodium, uric acid, calcium, and phosphorous as well as lower pH. Calcium oxalate crystals …

Diagnosis Of A Longitudinal Vaginal Septum And Possible Uterus Didelphys Secondary To Coital Injury With An Artificial Phallus, Lauren Sword, Olga Marie Colon-Mercado, James Baron, Mark Sanchez, Tiffany R. Tonismae, Nicole L. Plenty

OB-GYN

See attached document for abstract.

Amniotic Fluid Embolism And The Possible Protective Effects Of Heterozygous Factor V Leiden: A Case Report, Sanela Andelija, Olga M. Colon-Mercado, Kevin Rivera Rodriguez, Jessica A. Young, Greg Den Haese

OB-GYN

Background: Amniotic fluid embolism (AFE) is a rare and commonly fatal obstetric emergency theorized to trigger an inflammatory reaction much like the systemic inflammatory response syndrome (SIRS) of sepsis, leading to vascular constriction and coagulation. This often results in acute respiratory distress syndrome (ARDS), cardiopulmonary arrest, disseminated intravascular coagulation (DIC), and death. With similar theorized mechanisms, we suspect factors that may modify mortality in sepsis may also modify mortality in AFE. Specifically, we ask if alterations in the coagulation cascade of heterozygous Factor V Leiden mutation (FVL+/-) can decrease mortality as seen in studies with severe sepsis. The following case …

Beyond The Skin: A Case Report Of Vaginal Melanoma, Brittany Gilbert, Wm Tanner Gilbert, Ardeshir Hakam, Lynne J. Goebel

Marshall Journal of Medicine

Mucosal melanomas are rare, accounting for only 1.4% of all melanomas. Only 18% of mucosal melanomas are vulvovaginal in origin, making it exceedingly rare. Mucosal melanomas typically carry a worse prognosis than those arising from cutaneous sites with a higher risk of recurrence and disseminated disease. We report a rare case of vaginal melanoma presenting as postmenopausal bleeding and discuss management of this disease.

Validation Of An Endometrial Tumor Diameter Model For Risk Assessment In The Absence Of Lymph Node Mapping, Mckayla J. Riggs, Callie M. Cox Bauer, Caela R. Miller, James K. Aden, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to assess the optimal tumor diameter for predicting lymphatic metastasis and to determine intraoperatively the need for lymph node dissection in patients with endometrioid endometrial cancer.

Methods: Military beneficiaries diagnosed with stage I–III endometrioid endometrial cancer during 2003–2016 who had at least 7 pelvic and/or paraaortic lymph nodes removed during the time of hysterectomy were studied. Tumor diameter was compared against the presence of positive nodes, using the prior models of 20 mm (ie, Mayo model) and 50 mm (ie, Milwaukee model), to determine the false-negative rate of each threshold. A separate analysis was completed to …

Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

Role Of Oxidative Stress And Altered Thyroid Hormones In Unexplained Infertility, Rehana Rehman, Hiba Ismail Rajpar, Mussarat Ashraf, Najeeha Talat Iqbal, Salima Lalani, Faiza Alam

Department of Biological & Biomedical Sciences

Objective: To explore the link between altered thyroid profile and oxidative stress marker in females with unexplained infertility.
Methods: The cross-sectional case-control study was carried out at the Islamabad Clinic Serving Infertile Couples, Islamabad, Pakistan, from June 2016 to August 2017, and comprised women aged 18-40 years regardless of ethnic background who were divided into two groups; those with unexplained infertility were the cases, while fertile women acted as the controls. Serum was analysed for triiodothyronine, thyroxine and thyroid stimulating hormone as well as for oxidative stress markers including manganese superoxide dismutase, glutathione reductase and adrenaline using enzymelinked immunosorbent assay. …

Reducing Overtreatment Of Urinalysis In Obstetric Triage Patients, Emelia Winston, Rachel Marteney, Erin Casey, Kevin Conway

Marshall Journal of Medicine

Introduction

Overtreatment of asymptomatic bacteriuria (ASB) is a major issue that has been coming to the forefront in recent decades. Studies have shown that it can lead to adverse side effects, extra costs, and antimicrobial resistance. The purpose of this study was to determine the number of patients presenting to obstetric triage who were overtreated for a urinalysis (UA) and to see if an educational intervention could reduce the incidence of overtreatment for suspected ASB.

Methods

This was a retrospective chart review analyzing UA results and outcomes of OB triage patients that came through labor and delivery before and after …

Developing A Virus-Like Particle (Vlp)-Based Vaccine For Neisseria Gonorrhoeae, Ashvini Vaidya

Biomedical Sciences ETDs

Neisseria gonorrhoeae (Ng) is a sexually transmitted bacterium that infects human reproductive mucosal surfaces. Due to the risk of complications in untreated cases and evolving antibiotic resistance, a prophylactic vaccine is critical for preventing infection. There are four Ng outer-membrane proteins that contribute to Ng survival and resistance: PorB, BamA, TbpA, and MtrE. Each protein contains surface-exposed loops that are targets of bactericidal antibodies. Vaccines were developed by displaying Ng epitopes on the surface of bacteriophage virus-like particles (VLP). VLPs are immunogenic, multivalent, self-assembling complexes composed of viral structural proteins. Antigenic peptide sequences can be displayed on the surface …

Impact Of Parity On Gait Biomechanics, Bekah P. Stein

Masters Theses

Background: Symptomatic knee osteoarthritis (OA) is an incurable condition that affects nearly 50% of adults, and women are twice as likely as men to develop OA. Throughout pregnancy, women experience large changes in morphology and gait mechanics, as well as changes in joint loading. It is possible these adaptations could cause lasting changes postpartum, which may potentially contribute to initiation of OA, thereby increasing the overall risk of OA for women.

Purpose: This exploratory study looked to identify differences between lower limb gait mechanics of healthy nulliparous women and healthy parous women.

Methods: 28 healthy female participants (14 parous, 14 …

Nutrient Sensing Pathways Mediating Igfbp1 Phosphorylation In Fgr, Shapnil Bhuiyan

Electronic Thesis and Dissertation Repository

Impairment of fetal oxygen levels and nutrient delivery contributes to fetal growth restriction (FGR), which affects 20% of pregnancies. Such cellular stress induces hepatic Insulin-like Growth Factor Binding Protein 1 (IGFBP1) phosphorylation, which sequesters Insulin-like Growth Factor 1 (IGF-I) and markedly reduces fetal growth signaling. IGFBP1 hyperphosphoryaltion in hypoxia is mediated through the mTOR signaling pathway and through the Amino Acid Response (AAR) pathway during amino acid deprivation. Hypoxia stimulates upstream mTORC1 regulators, AMPK and REDD1 which are well-established upstream regulators of one of the two mTOR complexes, mTORC1. The molecular mechanisms by which upstream mTORC1-driven processes regulate IGFBP1 phosphorylation …

Hpv Vaccination In Females: The Role Of Primary Health Care And Primary Health Care Providers, Brooke Bouza

Graduate Theses and Dissertations

Two reasons for subpar coverage of the Human papillomavirus (HPV) vaccine are missed clinical opportunities and nonacceptance of the vaccine upon recommendation from a medical provider. The purpose of study one was to examine factors associated with access and adherence to physician’s recommendations in association with HPV vaccine uptake. Data were obtained from National Health Interview Survey (2017). Variables theoretically related to clinical opportunities and adherence to physician’s recommendations were examined in association with HPV vaccine uptake. Univariate logistic regressions were run to determine the associations between the aforementioned variables and uptake of the HPV vaccine. Multinomial logistic regressions were …

A School-Based Sexual Health Education Program, Tracy L. Kendall

Electronic Theses and Dissertations

A small rural community has high incidence rates of chlamydia (4,751 per 100,000) and gonorrhea (970 per 100,000) in females 15–24 years old. Data obtained from Texas Health and Human Services showed that incidence rates of chlamydia and gonorrhea in females 15–24 years old were higher in Navarro County, Texas, than the state of Texas. Texas schools do not mandate sex health education. There is a gap in school-based sexual health education available to 18- and 19-year-old females residing in this rural community in Texas. The purpose of this research study was to evaluate the impact of school-based sexual health …

Risk Of Acute Kidney Injury In Patients Receiving Vancomycin And Piperacillin-Tazobactam Compared To Vancomycin And Cefepime, Viktoria Andonova

All Publications

No abstract provided.

Twin Pregnancy Complicated By Intrauterine Death Of One Fetus And Herniated Bowel Loops Over Gravid Uterus, Malika Hameed, Khalid Ahsan

Department of Anaesthesia

No abstract provided.

Change In Sex Of Rearing In Individuals With Disorders Of Sex Development, Michelle Knoll

Research Days

No abstract provided.

“Disbelieving Black Women To Death”; The “Double Jeopardy”: Racism And Sexism Affects Black Women’S Access To And Quality Of Care During Pregnancy, Birth, And Postpartum, Madeline St. Clair

Theses/Capstones/Creative Projects

This paper explores possible reasons why Black women in the United States experience a higher maternal mortality rate than their white counterparts. Using books, articles, journals, documentaries, personal experiences and stories of Black women and mothers, I argue that barriers from the societal to the individual level create health and medical disparities for Black mothers in pregnancy, during delivery, and the postpartum period. The paper concludes with a multifaceted solution and call to action.

Shanti's "The Recovery Mama Guide To Your Eating Disorder Recovery In Pregnancy And Postpartum" (Book Review), Elizabeth A. Nolan

The Christian Librarian

No abstract provided.

An Investigation Of Treatments For The Prevention Of Metabolic Complications For Women Suffering From Polycystic Ovarian Syndrome: Diet, Exercise, Weight Reduction And Herbal Remedies, Brenda Martinez-Puente

Nursing | Senior Theses

The purpose of this research study is to compare the views of traditional versus alternative treatments available to women with Polycystic Ovarian Syndrome (PCOS) suffering from metabolic complications. Alternative treatments include diet, exercise, herbal remedies, or any combination of the three. Pharmacological interventions for the conditions associated with PCOS such as metformin, used to control glucose levels, and clomiphene, used to treat infertility. Through the literature review, articles show herbs and plant products to have similar mechanisms of actions as the pharmacological interventions, but with less side effects. For example, cinnamon was shown to increase insulin sensitivity and pomegranate juice …

The Evil Twin: The Case Of Heterotopic Pregnancy, Rashmi Jadhav, Vegas Brown, Gabriel Cabrera

West Florida Division Virtual Research Day 2020

• Heterotopic pregnancy occurs in about 1 in 30,000 naturally conceived pregnancies (5). The risk rises 1-3% for pregnancies occurring through assisted reproductive technologies (ART) (1).
• Isolated ectopic pregnancy affects an average of 1 in every 150 live births (1).
• A known pre-existing intrauterine pregnancy (IUP) can be falsely reassuring and delay the diagnosis of a potentially life-threatening concurrent ectopic pregnancy.
• Presentation is vague and 45% of patients have no symptoms (5).
• Differential Diagnoses: endometritis, incomplete miscarriage, ruptured ovarian cyst, non-GYN cause (ie: appendicitis or UTI).
• Risk Factors: Infertility treatment, in vitro fertilization (IVF), prior ectopic, prior tubal surgery, use of …

Can Magnetic Resonance Imaging Predict Pathologic Findings For Endometrioid Endometrial Cancer?, Elizabeth L. Dickson Michelson, Jessica J. F. Kram, Kayla Heslin, David Baugh, Vikram Bamra, Jiahao Hu, Abhishek Shukla, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

This pilot study aimed to assess the feasibility of precisely measuring tumor diameter and myometrial invasion in patients with endometrioid endometrial cancer (EEC) using preoperative contrast-enhanced magnetic resonance imaging (MRI). Adult patients with confirmed diagnosis of complex hyperplasia with atypia or EEC were included. Three radiologists separately measured tumor diameter and myometrial invasion. Basic descriptive statistics were used to describe patient characteristics and to compare radiology- and pathology-measured tumor diameter and myometrial invasion. Using the pathology results for tumor diameter as the gold standard for comparison, at least 1 radiologist was able to predict largest tumor diameter within 5 mm …

Relation Of Flt-1 And Endothelial Function In Women Soon After Delivery: Effect Of Physical Activity And Sedentary Behavior, Chloe W. Caudell

Senior Theses

Adverse pregnancy outcomes (APOs) are believed to be caused by poor placental formation. APOs can be characterized by elevated levels of a circulating Fms-like tyrosine kinase biomarker called Flt-1, produced by the placenta when its blood vessels are shallow or inadequately formed. Flt-1 acts directly on the maternal endothelium to impair vascular function during pregnancy and contributes to maternal features of APOs. This study aimed to evaluate the relation of Flt-1 and endothelial function in women soon after delivery. This study also aimed to evaluate the relation of Flt-1 and physical activity and sedentary behavior in women during and soon …

Case Series Of Anca Vasculitis As Prognostic Marker For Severity Or Relapse Of Glomerulonephritis., Jake N. Cho, Venkat Chitumalla, Izuchukwu Nwakoby

Nephrology

No abstract provided.