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An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study., José M. Belizán, Nicole Minckas, Elizabeth M. McClure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces, Fernando Althabe, Margo S. Harrison, Nancy F. Krebs, Richard Derman, Waldemar A. Carlo, Edward A. Liechty, Patricia L. Hibberd, Pierre M. Buekens, Robert L. Goldenberg 2018 Institute for Clinical Effectiveness

An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study., José M. Belizán, Nicole Minckas, Elizabeth M. Mcclure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces, Fernando Althabe, Margo S. Harrison, Nancy F. Krebs, Richard Derman, Waldemar A. Carlo, Edward A. Liechty, Patricia L. Hibberd, Pierre M. Buekens, Robert L. Goldenberg

Global Health Articles

BACKGROUND: Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevalence between 9% and 19% has been associated with better maternal and perinatal outcomes, such as reduced maternal land fetal mortality. However, the specific prevalence of obstetric and medical complications that require caesarean section have not been established, especially in low-income and middle-income countries (LMICs). We sought to provide information to inform the approach to the ...


An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study, José M. Belizán, Nicole Minckas, Elizabeth M. McClure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces 2018 Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina

An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study, José M. Belizán, Nicole Minckas, Elizabeth M. Mcclure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces

Community Health Sciences

Background: Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevalence between 9% and 19% has been associated with better maternal and perinatal outcomes, such as reduced maternal land fetal mortality. However, the specific prevalence of obstetric and medical complications that require caesarean section have not been established, especially in low-income and middle-income countries (LMICs). We sought to provide information to inform the approach to ...


Influence Of Body Mass Index And Polycystic Ovarian Syndrome On Icsi/Ivf Treatment Outcomes: A Study Conducted In Pakistani Women, Rehana Rehman, Rozina Mustafa, Rabiya Ali, Saeeda Shaharyar, Faiza Alam 2018 Aga Khan University

Influence Of Body Mass Index And Polycystic Ovarian Syndrome On Icsi/Ivf Treatment Outcomes: A Study Conducted In Pakistani Women, Rehana Rehman, Rozina Mustafa, Rabiya Ali, Saeeda Shaharyar, Faiza Alam

Department of Biological & Biomedical Sciences

Background: Obesity may establish a crucial barrier for effective fertility treatment in polycystic ovary syndrome (PCOS) females.
Objective: To compare results of intra-cytoplasmic sperm injection (ICSI) in females with and without polycystic ovarian syndrome and further appraise the effect of obesity in PCOS females.
Materials and methods: A cross-sectional study from June 2015 to July 2016 included non-PCOS and PCOS (recognized by Rotterdam criteria) females who underwent ICSI. The PCOS were further stratified into non-obese and Obese according to the South Asian criteria for body mass index. Results were categorized on the basis of beta-human chorionic gonadotropin (β-hCG) and transvaginal ...


Combination Of Myasthenia Gravis And Hellp Syndrome In Pregnancy: Case Report And Literature Review, Pinar Yalcin Bahat, Gokce Turan, Nadiye Koroglu, Berna Aslan Cetin, Elif Goknur Topcu 2018 Kanuni Sultan Suleyman Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey

Combination Of Myasthenia Gravis And Hellp Syndrome In Pregnancy: Case Report And Literature Review, Pinar Yalcin Bahat, Gokce Turan, Nadiye Koroglu, Berna Aslan Cetin, Elif Goknur Topcu

Proceedings in Obstetrics and Gynecology

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. Preeclampsia/HELLP Syndrome is a potentially life-threatening pregnancy complication. The combination of HELLP Syndrome and MG is challenging because the preferred treatment regimens for both conditions generally contradict each other. Our aim is to describe the management options when these two diseases occur simultaneously. We present a case in which a woman with an established diagnosis of MG developed HELLP Syndrome at 31 weeks gestation. Magnesium sulfate prophylaxis was not utilized because of the patient’s MG diagnosis. A cesarean delivery was performed. Reported cases with combined diagnoses of ...


Adnexal Torsion In A Patient With Müllerian Agenesis Undergoing Ovarian Stimulation: A Case Report, Erika P. New, Adrianne R. Mallen, Abigail C. Mancuso, Bradley J. Van Voorhis 2018 Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL

Adnexal Torsion In A Patient With Müllerian Agenesis Undergoing Ovarian Stimulation: A Case Report, Erika P. New, Adrianne R. Mallen, Abigail C. Mancuso, Bradley J. Van Voorhis

Proceedings in Obstetrics and Gynecology

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments.

Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary.

Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort ...


Pregnancy Outcome According To Body Mass Index In Primigravidas: A Prospective Cohort Study, Nahla W. Shady, Hany F. Sallam, Shymaa S. Ali, Ahmed M. Abbas 2018 Department of Obstetrics & Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt

Pregnancy Outcome According To Body Mass Index In Primigravidas: A Prospective Cohort Study, Nahla W. Shady, Hany F. Sallam, Shymaa S. Ali, Ahmed M. Abbas

Proceedings in Obstetrics and Gynecology

Objective: The study aims to evaluate the association between Body Mass Index (BMI), gestational weight gain (GWG) and adverse obstetric outcomes among primigravidas.

Material and methods: This was a prospective cohort study conducted at a tertiary University Hospital between June 2015 and May 2017. The study included 480 primigravidas, with singleton pregnancies, who were divided into three groups: women with a healthy weight (BMI: 18.5–24.9 kg/m2) overweight (BMI: 25 – 29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). The primary outcome of the study was the rate of GWG in the participants ...


Comparison Of Neonatal Outcomes Between Category-1 And Non-Category-1 Primary Emergency Cesarean Section: A Retrospective Record Review In A Tertiary Care Hospital, Dureshahwar Kanwar, Iffat Ahmed, Azra Amerjee, Zahra Hoodbhoy 2018 Aga Khan University

Comparison Of Neonatal Outcomes Between Category-1 And Non-Category-1 Primary Emergency Cesarean Section: A Retrospective Record Review In A Tertiary Care Hospital, Dureshahwar Kanwar, Iffat Ahmed, Azra Amerjee, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Objective: To compare neonatal outcomes between Category-1 and Non-Category-1 Primary Emergency Cesarean Section.
Methods: This was a retrospective analysis, conducted at Aga Khan University Hospital Karachi from January 1st 2016 till December 31st 2016. Non-probability purposive sampling technique was used. A sample size of 375 patients who had primary Emergency Caesarean Section (Em-CS) was identified by keeping CS rate of 41.5% and 5% bond on error. Data was collected from labor ward, operating theatre and neonatal ward records by using structured questionnaire.
Results: In the current study, out of 375 participants who underwent primary Em-CS; majority (89.3%) were ...


Review Of Outside Pathology Prior To Treatment Of Cervical Intraepithelial Neoplasia: A Cost Analysis, Heather R. Williams, Alison C. Agner, Colleen Stockdale 2018 Medical College of Georgia at Augusta University, Department of Obstetrics and Gynecology, Augusta, GA

Review Of Outside Pathology Prior To Treatment Of Cervical Intraepithelial Neoplasia: A Cost Analysis, Heather R. Williams, Alison C. Agner, Colleen Stockdale

Proceedings in Obstetrics and Gynecology

Objectives: Academic institutions routinely require in-house review of pathology prior to treatment. However, it is unclear if pathology review is beneficial for the management of patients referred for cervical intraepithelial neoplasia (CIN). This study aims to determine if review of outside pathology for CIN at an academic medical center resulted in a change in the treatment plan and the associated cost for pathology review.

Methods: A retrospective chart review of patients referred for treatment of CIN, including review of outside cytology and histology was performed from January 1 to December 31, 2007 after obtaining IRB approval. Data was analyzed to ...


Prediction Of Preterm Birth With And Without Preeclampsia Using Mid-Pregnancy Immune And Growth-Related Molecular Factors And Maternal Characteristics, Laura L. Jelliffe-Pawlowski, Larry Rand, Bruce Bedell, Rebecca J Baer, Scott P Oltman, Mary E Norton, Gary M Shaw, David K Stevenson, Jeffrey C Murray, Kelli K. Ryckman 2018 University of Iowa

Prediction Of Preterm Birth With And Without Preeclampsia Using Mid-Pregnancy Immune And Growth-Related Molecular Factors And Maternal Characteristics, Laura L. Jelliffe-Pawlowski, Larry Rand, Bruce Bedell, Rebecca J Baer, Scott P Oltman, Mary E Norton, Gary M Shaw, David K Stevenson, Jeffrey C Murray, Kelli K. Ryckman

Stead Family Department of Pediatrics Publications

OBJECTIVE: To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia.

STUDY DESIGN: Included were 400 women with singleton deliveries in California in 2009-2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15-20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC).

RESULTS: Twenty-five serum biomarkers along with maternal age80% of women with PTB ± preeclampsia with best performance in women with ...


Clear Cell Carcinoma Of The Pelvic Side Wall Arising From Endometriosis., Lisa N Abaid, John S Cupp, Miles Chang, Steven R Beanes, Bram H Goldstein 2018 Gynecologic Oncology Associates, Hoag Memorial Hospital, Newport Beach, CA 926631, United States.

Clear Cell Carcinoma Of The Pelvic Side Wall Arising From Endometriosis., Lisa N Abaid, John S Cupp, Miles Chang, Steven R Beanes, Bram H Goldstein

Articles, Abstracts, and Reports

Endometriosis is a condition wherein an ectopic layer of endometrial tissue arises in an extra-uterine location, often effecting significant pelvic pain and infertility. While very uncommon, there have been reported cases of endometriosis undergoing malignant transformation, frequently involving the ovaries and seldom in extra-gonadal regions. We recount a case depicting a 63 year-old woman who presented with an apparent inguinal hernia in 2017; she was ultimately diagnosed with a pelvic side wall clear cell carcinoma and attendant metastatic disease to the medial groin, which emanated from endometriosis. Malignant transformation of endometriosis identified in the pelvic side wall is a very ...


Improving Postoperative Pain Control After Cesarean Delivery With Enhanced Recovery In Patients On Buprenorphine Therapy, Kevin D. White, Shirin Azadi, Nadim Bou Zgheib, Brenda L. Mitchell 2018 Marshall University

Improving Postoperative Pain Control After Cesarean Delivery With Enhanced Recovery In Patients On Buprenorphine Therapy, Kevin D. White, Shirin Azadi, Nadim Bou Zgheib, Brenda L. Mitchell

Nadim Bou Zgheib

Abstract:

Introduction:

Prescription drug abuse presents a significant challenge to the management of post operative pain.Pain control amongst the opioid addicted patient can be especially challenging. We aimed to improve pain control after caesarian delivery with enhanced recovery in patients who are on buprenorphine medication-assisted therapy for the treatment of opioid addiction.

Materials and Methods:

We conducted a pilot study by implementing a protocol using liposomal bupivacaine injected at the time of cesarean delivery. Patients were then given 500mg acetaminophen every 4 hours, 800mg ibuprofen every 8 hours and 0.3mg IV buprenorphine every 6 hours as needed. The ...


Case Report: An Undiagnosed Bladder Diverticulum Resulting In Foley Catheter Perforation During Cesarean Section, A. Allison Roy, Nadim Bou Zgheib, Joseph Assaley 2018 Joan C. Edwards School of Medicine

Case Report: An Undiagnosed Bladder Diverticulum Resulting In Foley Catheter Perforation During Cesarean Section, A. Allison Roy, Nadim Bou Zgheib, Joseph Assaley

Nadim Bou Zgheib

A bladder diverticulum is diagnosed when herniated bladder mucosa forms an outpouching from the bladder. Bladder diverticula are uncommon and are significantly more common in males. The following case presents a patient with an undiagnosed bladder diverticulum which was incidentally perforated during foley catheter placement for a repeat cesarean section. The diagnosis can be difficult in those who are asymptomatic and lack risk factors, such as the following patient.


Epigenetics In Ovarian Cancer: Premise, Properties, And Perspectives., Qilian Yang, Yuqing Yang, Nianxin Zhou, Kexin Tang, Wayne Bond Lau, Bonnie Lau, Wei Wang, Lian Xu, Zhengnan Yang, Shuang Huang, Xin Wang, Tao Yi, Xia Zhao, Yuquan Wei, Hongjing Wang, Linjie Zhao, Shengtao Zhou 2018 West China Second University Hospital, Sichuan University and Collaborative Innovation Center

Epigenetics In Ovarian Cancer: Premise, Properties, And Perspectives., Qilian Yang, Yuqing Yang, Nianxin Zhou, Kexin Tang, Wayne Bond Lau, Bonnie Lau, Wei Wang, Lian Xu, Zhengnan Yang, Shuang Huang, Xin Wang, Tao Yi, Xia Zhao, Yuquan Wei, Hongjing Wang, Linjie Zhao, Shengtao Zhou

Department of Emergency Medicine Faculty Papers

Malignant ovarian tumors bear the highest mortality rate among all gynecological cancers. Both late tumor diagnosis and tolerance to available chemical therapy increase patient mortality. Therefore, it is both urgent and important to identify biomarkers facilitating early identification and novel agents preventing recurrence. Accumulating evidence demonstrates that epigenetic aberrations (particularly histone modifications) are crucial in tumor initiation and development. Histone acetylation and methylation are respectively regulated by acetyltransferases-deacetylases and methyltransferases-demethylases, both of which are implicated in ovarian cancer pathogenesis. In this review, we summarize the most recent discoveries pertaining to ovarian cancer development arising from the imbalance of histone acetylation ...


Improving Postoperative Pain Control After Cesarean Delivery With Enhanced Recovery In Patients On Buprenorphine Therapy, Kevin D. White, Shirin Azadi, Nadim Bou Zgheib, Brenda L. Mitchell 2018 Marshall University

Improving Postoperative Pain Control After Cesarean Delivery With Enhanced Recovery In Patients On Buprenorphine Therapy, Kevin D. White, Shirin Azadi, Nadim Bou Zgheib, Brenda L. Mitchell

Marshall Journal of Medicine

Abstract:

Introduction:

Prescription drug abuse presents a significant challenge to the management of post operative pain.Pain control amongst the opioid addicted patient can be especially challenging. We aimed to improve pain control after caesarian delivery with enhanced recovery in patients who are on buprenorphine medication-assisted therapy for the treatment of opioid addiction.

Materials and Methods:

We conducted a pilot study by implementing a protocol using liposomal bupivacaine injected at the time of cesarean delivery. Patients were then given 500mg acetaminophen every 4 hours, 800mg ibuprofen every 8 hours and 0.3mg IV buprenorphine every 6 hours as needed. The ...


Prophylactic Antibiotic Use In Female Patients With Pelvic Floor Reconstructive Surgery: A Retrospective Comparative Effectiveness Study, Courtney E. Turnbough 2018 University of Missouri, St. Louis

Prophylactic Antibiotic Use In Female Patients With Pelvic Floor Reconstructive Surgery: A Retrospective Comparative Effectiveness Study, Courtney E. Turnbough

Dissertations

Problem: The purpose of this project was to determine the most effective prophylactic antibiotic to decrease the number of patients who have urinary tract infections (UTIs) after pelvic floor reconstructive surgery in a gynecological reconstructive surgery practice.

Methods: This was a retrospective chart review from 2015-2017 that included 732 subjects from a single practice. All patients underwent pelvic floor reconstructive surgery, with or without a midurethral sling placed. Patients also had a catheter and vaginal packing postoperatively. Patients who had a culture-proven UTI within the six-week postoperative period were noted.

Results: There were less UTIs (χ2 = 12.119, df = 1 ...


Consensus On Molecular Subtypes Of High-Grade Serous Ovarian Carcinoma, Gregory M. Chen, Lavanya Kannan, Ludwig Geistlinger, Victor Kofia, Zhaleh Safikhani, Deena MA Gendoo, Giovanni Parmigiani, Michael Birrar, Benjamin Haibe-Kains, Levi Waldron 2018 Princess Margaret Cancer Centre

Consensus On Molecular Subtypes Of High-Grade Serous Ovarian Carcinoma, Gregory M. Chen, Lavanya Kannan, Ludwig Geistlinger, Victor Kofia, Zhaleh Safikhani, Deena Ma Gendoo, Giovanni Parmigiani, Michael Birrar, Benjamin Haibe-Kains, Levi Waldron

Publications and Research

Purpose: The majority of ovarian carcinomas are of high-grade serous histology, which is associated with poor prognosis. Surgery and chemotherapy are the mainstay of treatment, and molecular characterization is necessary to lead the way to targeted therapeutic options. To this end, various computational methods for gene expression-based subtyping of high-grade serous ovarian carcinoma (HGSOC) have been proposed, but their overlap and robustness remain unknown.

Experimental Design: We assess three major subtype classifiers by meta-analysis of publicly available expression data, and assess statistical criteria of subtype robustness and classifier concordance. We develop a consensus classifier that represents the subtype classifications of ...


Journey Interrupted: A Phenomenological Exploration Of Miscarriage, Marit A. Watson, Vanessa D. Jewell, Sarah L. Smith 2018 Creighton University

Journey Interrupted: A Phenomenological Exploration Of Miscarriage, Marit A. Watson, Vanessa D. Jewell, Sarah L. Smith

The Open Journal of Occupational Therapy

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping.

Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semi-structured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic analysis ...


Pregnancies Complicated By Maternal Osteogenesis Imperfecta Type Iii: A Case Report And Review Of Literature., Tetsuya Kawakita, Melissa Fries, Jasbir Singh, Huda B. Al-Kouatly 2018 MedStar Washington Hospital Center

Pregnancies Complicated By Maternal Osteogenesis Imperfecta Type Iii: A Case Report And Review Of Literature., Tetsuya Kawakita, Melissa Fries, Jasbir Singh, Huda B. Al-Kouatly

Department of Obstetrics and Gynecology Faculty Papers

The restrictive lung disease can be exacerbated by growing fundus in women with osteogenesis imperfecta type III. Regional anesthesia can be performed in these women. Mode of delivery for women with osteogenesis imperfecta type III is generally cesarean delivery. Neonatal outcomes are complicated due to indicated preterm deliveries.


Placental Pathology In Twin Pregnancies, Etaoin Kent 2018 Royal College of Surgeons in Ireland

Placental Pathology In Twin Pregnancies, Etaoin Kent

MD theses

Twin pregnancies remain a challenge in perinatal medicine, with significantly higher rates of complications and increased perinatal morbidity and mortality when compared to singletons. Abnormal growth in twins is a significant independent contributory factor to this increased morbidity, and knowledge of the underlying pathological processes governing growth disorders in twins is vital to improving our antenatal surveillance and clinical management of these pregnancies.

We performed a comprehensive study of the placental factors governing growth and development of twin pregnancies in a large, prospectively collected cohort of twins. Placental pathology was evaluated in terms of gross placental abnormalities and histopathological variants ...


The Fight For Birth, Jessica E. Brown 2018 University of Nevada, Las Vegas

The Fight For Birth, Jessica E. Brown

Research Briefs

No abstract provided.


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