Obstetrics and Gynecology Commons^™

Comparison Between Gram Stain And Culture For The Characterization Of Vaginal Microflora: Definition Of A Distinct Grade That Resembles Grade I Microflora And Revised Categorization Of Grade I Microflora, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Leen Van Simaey, Catharine De Ganck, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the …

Antiviral Agents For Pregnant Women With Genital Herpes, Christopher Wenner Md

Articles

Clinical Question

Do antiviral medications prevent perinatal transmission of genital herpes to neonates?

Evidence-Based Answer

There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates. [Strength of recommendation: A, based on multiple systematic reviews] However, treatment with antivirals during the last month of pregnancy does reduce the rate of HSV outbreaks in pregnant women and the resultant need for cesarean delivery. [Strength of recommendation: A, based on multiple systematic reviews]

Roles Of Na,K-Atpase In Early Development And Trophectoderm Differentiation., Gerald M Kidder, Andrew J Watson

Obstetrics & Gynaecology Publications

Before implantation into the uterine wall, the mammalian embryo undergoes a period of cell division, cell shape change, and cell differentiation leading to the formation of an outer epithelium, the trophectoderm. The trophectoderm is the part of the embryo that initiates uterine contact and, after transformation to become the trophoblast, uterine invasion. Similar to the kidney nephron, the trophectoderm is a transporting epithelium with distinct apical and basolateral membrane domains; its function is to facilitate transepithelial Na+ and fluid transport for blastocoel formation. That transport is driven by Na,K-adenosine triphosphatase (ATPase) localized in basolateral membranes of the trophectoderm. Preimplantation embryos …

Increased Risk Of Hiv In Women Experiencing Physical Partner Violence In Nairobi, Kenya, Karoline Fonck, Leye Els, Nancy Kidula, Jeconiah Ndinya-Achola, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence. Women with more risky sexual behavior such as early sexual debut, number of sex partners, history of condom use and of STI, experienced more partner violence. Parity and miscarriage were associated with a history of lifetime violence. We found an inverse association between schooling …

Review Of "Multiple Pregnancy: Epidemiology, Gestation & Perinatal Outcome. Second Edition", Edward J. Hayes

Department of Obstetrics and Gynecology Faculty Papers

Book Review

P38 Mitogen-Activated Protein Kinase (Mapk) First Regulates Filamentous Actin At The 8-16-Cell Stage During Preimplantation Development., Andrew J M Paliga, David R Natale, Andrew J Watson

Obstetrics & Gynaecology Publications

BACKGROUND INFORMATION: The MAPK (mitogen-activated protein kinase) superfamily of proteins consists of four separate signalling cascades: the c-Jun N-terminal kinase or stress-activated protein kinases (JNK/SAPK); the ERKs (extracellular-signal-regulated kinases); the ERK5 or big MAPK1; and the p38 MAPK group of protein kinases, all of which are highly conserved. To date, our studies have focused on defining the role of the p38 MAPK pathway during preimplantation development. p38 MAPK regulates actin filament formation through the downstream kinases MAPKAPK2/3 (MAPK-activated protein kinase 2/3) or MAPKAPK5 [PRAK (p38 regulated/activated kinase)] and subsequently through HSP25/27 (heat-shock protein 25/27). We recently reported that 2-cell-stage murine …

Mitogen-Activated Protein Kinase (Mapk) Blockade Of Bovine Preimplantation Embryogenesis Requires Inhibition Of Both P38 And Extracellular Signal-Regulated Kinase (Erk) Pathways., Pavneesh Madan, Michele D Calder, Andrew J Watson

Obstetrics & Gynaecology Publications

Blastocyst formation, as a critical period during development, is an effective indicator of embryonic health and reproductive efficiency. Out of a number of mechanisms underlying blastocyst formation, highly conserved mitogen-activated protein kinase (MAPK) signaling has emerged as a major mechanism involved in regulating murine preimplantation embryo development. The objective of our study was to ascertain the role of MAPK signaling in regulating bovine development to the blastocyst stage. Using reverse transcriptase PCR and immunohistochemical staining procedures we have demonstrated that mRNA transcripts and polypeptides encoding p38 MAPK pathway constituents are detectable in preimplantation bovine embryos from the one-cell to the …

Comparison Of Pap Smear, Visual Inspection With Acetic Acid, Human Papillomavirus Dna-Pcr Testing And Cervicography, H De Vuyst, Patricia Claeys, S Njiru, L Muchiri, Sophia Steyaert, Petra De Sutter, E Van Marck, J Bwayo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: To assess the test qualities of four screening methods to detect cervical intra-epithelial neoplasia in an urban African setting.

Method: Six hundred fiftythree women, attending a family planning clinic in Nairobi (Kenya), underwent four concurrent screening methods: pap smear, visual inspection with acetic acid (VIA), PCR for high risk human papillomavirus (HR HPV) and cervicography. The presence of cervical intra-epithelial neoplasia (CIN) was verified by colposcopy or biopsy.

Result: Sensitivity (for CIN2 or higher) and specificity (to exclude any CIN or cancer) were 83.3% (95% CI [73.6, 93.0]) and 94.6% (95% CI [92.6, 96.5]), respectively, for pap smear; 73.3% …

Effect Of Serum And Cumulus Cell Expansion On Marker Gene Transcripts In Bovine Cumulus-Oocyte Complexes During Maturation In Vitro., Michele D Calder, Anita N Caveney, Marc-Andre Sirard, Andrew J Watson

Obstetrics & Gynaecology Publications

OBJECTIVE: To determine the distribution of transcripts encoding the FSH receptor (FSHr), LH receptor (LHr), connexin 43 (Cx43), cyclooxygenase-2 (COX-2), and prostaglandin E(2) receptors 2 and 3 (EP2 and EP3) within bovine cumulus-oocyte complexes (COCs) and denuded oocytes and investigate the influence of gonadotropins, serum, and cumulus cell expansion on the abundance of transcripts encoding these genes.

DESIGN: Prospective controlled animal study.

SETTING: University research laboratory.

PATIENT(S): Animal models for human studies.

INTERVENTION(S): Cumulus-oocyte complexes were treated in culture with serum and gonadotropin-supplemented media to examine the effects to mRNA transcript levels.

MAIN OUTCOME MEASURE(S): Variation in mRNA transcript levels. …

The Role Of Aromatase Inhibitors In Ameliorating Deleterious Effects Of Ovarian Stimulation On Outcome Of Infertility Treatment, Mohamed Fm Mitwally, Robert F. Casper, Michael P. Diamond

Wayne State University Associated BioMed Central Scholarship

Abstract

Clinical utilization of ovulation stimulation to facilitate the ability of a couple to conceive has not only provided a valuable therapeutic approach, but has also yielded extensive information on the physiology of ovarian follicular recruitment, endometrial receptivity and early embryo competency. One of the consequences of the use of fertility enhancing agents for ovarian stimulation has been the creation of a hyperestrogenic state, which may influence each of these parameters. Use of aromatase inhibitors reduces hyperestrogenism inevitably attained during ovarian stimulation. In addition, the adjunct use of aromatase inhibitors during ovarian stimulation reduces amount of gonadotropins required for optimum …

Prenatal Stress And Stress Physiology Influences Human Fetal And Infant Development, Elyssia Poggi Davis, Calvin J. Hobel, Curt A. Sandman, Laura M. Glynn, Pathik D. Wadhwa

Psychology Faculty Books and Book Chapters

"Prenatal stress has been proposed as a risk factor that may have developmental consequences persisting throughout the lifespan. Exposing rodents to stress during pregnancy has consequences for brain development, stress regulation, learning, emotionality (increased anxiety), and social behavior (increased withdrawal) of the offspring (Weinstock, 2001; Chapillon et al., 2002). Additionally, non-human primates who experience stress during pregnancy have offspring with enhanced behavioral reactivity to stressors later in life (Clarke et al., 1994), lowered levels of motor behavior (Schneider, 1992), compromised neuromotor responses (Schneider and Coe, 1993), irritable temperament (Schneider et al., 1992), and attentional problems (Schneider et …

Deference, Denial, And Exclusion: Men Talk About Contraception And Unintended Pregnancy, Scott D. Johnson, Lindy B. Williams

Rhetoric and Communication Studies Faculty Publications

Individual in-depth interviews were conducted with 20 men, ages 21-48, who have fathered at least one unintended pregnancy. The goal of the interviews was to explore the experiences of these men with unintended pregnancy, their communication with partners and others, contraceptive beliefs and practices, their relationships with their partners, and the outcomes and consequences of the unintended pregnancies. This essay describes results derived from their comments regarding their contraceptive practices and the pregnancy-outcome decisions, with thematic analysis used to identify prominent themes from participant comments. Two strong themes, "deference" and "denial," and one lesser theme, "exclusion," emerged from participant responses. …

Biomarkers For Placental Abnormality, Cathal Mccarthy

Doctoral

Obstetrical complications including recurrent miscarriage, pre-eclampsia and intrauterine growth restriction (IUGR) affect 1%-5% of pregnant women (Younis and Samueloff 2003). Dysfunctional trophoblasts, impaired development of spiral arteries, imbalance in systems controlling the dilation and contraction of spiral arteries, placental fibrin clots and intervillous thrombosis are all possible factors that can result in an insufficient placental circulation. The combination of the hypercoagulable state of pregnancy and presence of genetic thrombophilic markets has the potential to induce placental thrombosis and cause placental insufficiency with subsequent obstetrical complications. The initial part of the research work involved examining the relationship between four common genetic …

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Privatization And Punishment In The New Era Of Reprogenetics, Dorothy E. Roberts

All Faculty Scholarship

No abstract provided.