Medicine and Health Sciences Commons^™

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..

The Gamma-Subunit Of The Na-K-Atpase As A Potential Regulator Of Apical And Basolateral Na+-Pump Isozymes During Development Of Bovine Pre-Attachment Embryos., L C Barcroft, S E Gill, A J Watson

Obstetrics & Gynaecology Publications

Expression and activity of the Na-K-ATPase within the basolateral membrane domains of the trophectoderm epithelium provide the driving force for accumulation of Na(+) and Cl(-) across the nascent epithelium, mediating fluid movement into the forming blastocoel. Within the trophectoderm of the bovine blastocyst, multiple isozymes of the Na-K-ATPase are expressed. Immunolocalization has demonstrated that the alpha1-isozyme localizes within the basolateral membrane, whereas the alpha 3-isozyme localizes to the apical cell margins. Gene-specific RT-PCR and wholemount indirect immunofluorescence confocal laser scanning microscopy were used to examine expression of the Na-K-ATPase gamma-subunit (a regulatory subunit of the Na-K-ATPase) throughout development of bovine …

Comparative Study--Efficacy, Safety And Compliance Of Intravenous Iron Sucrose And Intramuscular Iron Sorbitol In Iron Deficiency Anemia Of Pregnancy, A Wali, A Mushtaq, Nilofer

Department of Obstetrics & Gynaecology

Objective: (1) To determine an alternative iron supplementation with better efficacy, compliance & safety in treatment of iron deficiency anemia during pregnancy, (2) to reduce blood transfusion during pregnancy, labor and puerperium.
Material and Method: A prospective comparative study. A total number of 60 pregnant women with the gestational age of 12 - 34 weeks were included in the study who were suffering from iron deficiency anemia. They were divided in 3 groups (A, B and C). Group A (n15) received intravenous iron sucrose according to recommended dose containing 500 mg of iron sucrose for storage, in group B (n=20) …

Improved Continuation Rate Of Depot-Medroxyprogesterone Acetate In Adolescent Mothers, Hatim A. Omar, Amy Fowler, Sandy D'Angelo

Pediatrics Faculty Publications

Poor compliance and high discontinuation rates of Depot-Medroxyprogesterone Acetate (DMPA) and other contraceptive methods are major factors in the continuing problem of adolescent pregnancy. In this study we attempted to determine if providing comprehensive health care for teen mothers and their babies would improve continuation rates of DMPA. Patients who started DMPA between 1/1/96 and 1/1/99 were included. Teen mothers and their babies received all their health care in this clinic, supported by State funding. Key elements regarding DMPA in this clinic were continuity of care, phone and mail reminders of appointments, free DMPA for patients without insurance, counseling at …

Impact Of Life Events, Trauma, Interpersonal Conflict And Substance Abuse On Pregnancy Outcomes Of Inner City Women, Barabara A. Caldwell

Seton Hall University Dissertations and Theses (ETDs)

.

Mrnas Encoding Aquaporins Are Present During Murine Preimplantation Development., H Offenberg, L C Barcroft, A Caveney, D Viuff, P D Thomsen, A J Watson

Obstetrics & Gynaecology Publications

The present study was conducted to investigate the mechanisms underlying fluid movement across the trophectoderm during blastocyst formation by determining whether aquaporins (AQPs) are expressed during early mammalian development. AQPs belong to a family of major intrinsic membrane proteins and function as molecular water channels that allow water to flow rapidly across plasma membranes in the direction of osmotic gradients. Ten different AQPs have been identified to date. Murine preimplantation stage embryos were flushed from the oviducts and uteri of superovulated CD1 mice. Reverse transcription-polymerase chain reaction (RT-PCR) methods employing primer sets designed to amplify conserved sequences of AQPs (1-9) …

The Effect Of Grandmultiparity On Pregnancy Related Complications: The Aga Khan University Experience, S Munim, M H. Rahbar, M Rizvi, N Mushtaq

Department of Obstetrics & Gynaecology

Background: Grandmultiparity has been associated with complications for both mother and the fetus.Objective: To evaluate if grandmultiparity is a risk factor in the presence of adequate antenatal care.
Setting: A tertiary care teaching hospital.
Methods: It was a retrospective study conducted in the department of Obstetrics & Gynecology at The Aga Khan University Hospital in Karachi. During this period 9253 women were delivered, out of these 143 booked grandmultiparas (GMP) served as cases. The outcome of these women was compared with 430 non-grandmultiparas (NGMP). Logistic regression model was used to adjust for potential confounders.
Results: Grandmultiparas had almost three times …

Effects Of Superovulated Heifer Diet Type And Quantity On Relative Mrna Abundances And Pyruvate Metabolism In Recovered Embryos., C Wrenzycki, P De Sousa, E W Overström, R T Duby, D Herrmann, A J Watson, H Niemann, D O'Callaghan, M P Boland

Obstetrics & Gynaecology Publications

This study investigated the effects of quantity and type of diet fed to superovulated donor heifers on molecular and metabolic indices of embryonic development. These effects included the relative abundances of mRNAs for the alpha 1 subunit of Na/K-ATPase and the antioxidant enzyme Cu/Zn-SOD, as well as pyruvate utilization in bovine morulae and blastocysts developed in vivo. Heifers were fed a daily ration of either grass silage and a citrus-beet pulp-based concentrate or grass silage and a barley-based concentrate for 116 days, both at 3 kg per day or ad libitum. In embryos derived from heifers fed the pulp-based diets, …

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

Igf Paracrine And Autocrine Interactions Between Conceptus And Oviduct., A J Watson, M E Westhusin, Q A Winger

Obstetrics & Gynaecology Publications

Development in vitro is influenced by embryo density, serum, somatic cell co-culture and the production of 'embryotrophic' paracrine and autocrine factors. Research in our laboratory has focussed principally on the insulin-like growth factor (IGF) family. We have demonstrated that pre-attachment bovine and ovine embryos express mRNAs encoding a number of growth factor ligand and receptor genes including all members of the IGF ligand and receptor family throughout this developmental interval. In addition, early embryos express mRNAs encoding IGF-binding proteins (IGFBPs) 2-5 from the one-cell to the blastocyst stage and IGFBP5 mRNA at the blastocyst stage. Cultured bovine blastocysts release up …

Transient Expression Of A Translation Initiation Factor Is Conservatively Associated With Embryonic Gene Activation In Murine And Bovine Embryos., P A De Sousa, A J Watson, R M Schultz

Obstetrics & Gynaecology Publications

In the present study the abundance of mRNAs for eukaryotic translation initiation factors eIF-1A (formerly known as eIF-4C), -2alpha, -4A, -4E, and -5 was examined in in vivo-derived mouse embryos throughout preimplantation development using a semiquantitative reverse transcription-polymerase chain reaction assay. Although the mRNA profile for each gene is unique, only mRNA for eIF-1A transiently increases during embryonic gene activation (EGA) at the 2-cell stage, and this was confirmed by an independent hybridization-based assay. In in vitro-developed bovine embryos, mRNA for eIF-1A was transiently detected at the 8-cell stage, when the major activation of the genome occurs in this species. …

Na/K-Atpase-Mediated 86rb+ Uptake And Asymmetrical Trophectoderm Localization Of Alpha1 And Alpha3 Na/K-Atpase Isoforms During Bovine Preattachment Development., D H Betts, L C Barcroft, A J Watson

Obstetrics & Gynaecology Publications

This study evaluated Na/K-ATPase alpha 1- and alpha 3-subunit isoform polypeptide expression and localization during bovine preattachment development. Na/K-ATPase cation transport activity from the one-cell to blastocyst stage was also determined by measuring ouabain-sensitive 86Rb+ uptake. Both alpha1- and alpha 3-subunit polypeptides were detected by immunofluorescence to encircle the entire cell margins of each blastomere of inseminated zygotes, cleavage stage embryos, and morulae. Immunofluorescent localization of alpha1-subunit polypeptide in bovine blastocysts revealed an alpha1 immunofluorescence signal confined to the basolateral membrane margins of the trophectoderm and encircling the cell periphery of each inner cell mass (ICM) cell. In contrast, alpha …

Experiencing Physical Violence During Pregnancy: Prevalence And Correlates, Vilma E. Cokkinides, Ann L. Coker

CRVAW Faculty Journal Articles

Violence during pregnancy directly impacts the mental and physical health of pregnant women. We assessed the prevalence and correlates of physical violence around the time of pregnancy in a representative sample of 6,718 women in South Carolina. Physical violence, defined as "being physically hurt by husband or partner" or "being involved in a physical fight" was reported by 10.9% of recently pregnant women. These were correlates of violence: experiencing increased numbers of stressful life events, being unmarried, having increased parity, being on Medicaid, and having an unwanted pregnancy. Screening to identify violence in pregnancy in health care settings is vital …

Determinants Of Antepartum Human Immunodeficiency Virus Testing In A Non-Medicaid Obstetric Population., E Cardonick, S Daly, M Dooley, K Elles, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To determine voluntary human immunodeficiency virus (HIV) testing rates and factors influencing testing in a private obstetric practice.

METHODS: Antepartum patients were offered HIV testing after completing a self-assessment questionnaire. Perceived risks and demographics were correlated with testing rates.

RESULTS: Overall, 348/600 (58%) women consented to HIV testing. In a univariate analysis, patients with "any" perceived risk(s) were more likely to be tested. Single women and those with an at-risk partner(s) or a history of sexually transmitted disease (STD) were more likely to desire testing. These factors remained independently associated with voluntary testing in a multivariate regression model. No …

Initial Multicenter Experience With Double Nucleoside Therapy For Human Immunodeficiency Virus Infection During Pregnancy., N S Silverman, D H Watts, J Hitti, D M Money, E Livingston, J Axelrod, J M Ernest, D Robbins, M M Divito

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications.

METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV …

Fulminant Hepatic Failure In Pregnant Women: Acute Fatty Liver Or Acute Viral Hepatitis?, S S. Hamid, S M. Jafri, H Khan, H Shah, Z Abbas, H Fields

Section of Gastroenterology

Background: Hepatitis E virus, which is endemic in our region, can cause severe liver dysfunction in pregnant women and this can be clinically confused with acute fatty liver of pregnancy.

Methods: We studied the clinical and laboratory data as well as the maternal and fetal outcomes of 12 pregnant women presenting with fulminant hepatic failure in order to determine the etiology of the disease. The clinical diagnoses were subsequently correlated with serologic assays for acute HEV infection. All patients were severely ill with deep jaundice, grade 3-4 encephalopathy and abnormal prothrombin times.

Results: A clinical diagnosis of acute viral …

Analysis Of The Effects Of Overexpression Of Metallothionein-I In Transgenic Mice On The Reproductive Toxicology Of Cadmium., T Dalton, Kai Fu, G C Enders, R D Palmiter, G K Andrews

Journal Articles: Pathology and Microbiology

Exposure to low levels of cadmium reduces fertility. In male mice spermatogenesis is highly sensitive to cadmium, whereas in females the peri-implantation period of pregnancy is sensitive. To examine the potential roles of the cadmium-binding protein, metallothionein (MT), in the reproductive toxicology of cadmium, we examined a transgenic mouse strain that overexpresses metallothionein-I (MT-I). These mice had dramatically increased steady-state levels of MT-I mRNA and MT in the testes and in the female reproductive tract during the peri-implantation period of pregnancy, and this overexpression occurred in a cell-specific and temporally regulated manner similar to that of the endogenous MT-I gene. …

A Growth Factor Phenotype Map For Ovine Preimplantation Development., A J Watson, P H Watson, M Arcellana-Panlilio, D Warnes, S K Walker, G A Schultz, D T Armstrong, R F Seamark

Obstetrics & Gynaecology Publications

The reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the patterns of expression for several growth factor ligand and receptor genes during ovine preimplantation development. Transcripts for insulin-like growth factor (IGF)-I, IGF-II, and the receptors for insulin and IGF-I were detected throughout ovine preimplantation development from the 1-cell to the blastocyst stage. Transforming growth factor alpha (TGF alpha) transcripts were also detected throughout ovine preimplantation development. The mRNAs encoding basic fibroblast growth factor (bFGF) were detected in all stages of the ovine preimplantation embryo, although the relative abundance of this transcript consistently decreased from the 1-cell to the blastocyst …

Preimplantation Development Of In Vitro-Matured And In Vitro-Fertilized Ovine Zygotes: Comparison Between Coculture On Oviduct Epithelial Cell Monolayers And Culture Under Low Oxygen Atmosphere., A J Watson, P H Watson, D Warnes, S K Walker, D T Armstrong, R F Seamark

Obstetrics & Gynaecology Publications

The roles of medium composition, serum source, embryo coculture, and culture under low O2 conditions on the development of in vitro-matured and in vitro-fertilized (IVMF) ovine zygotes were investigated in three separate experiments. In the first experiment, the proportion of cocultured IVMF zygotes developing to the blastocyst stage was significantly higher (38.0% vs. 3.5%; p < 0.05) than that of non-cocultured zygotes treated within three embryo culture media (TCM-199 + 10% fetal bovine serum [FBS]; bicarbonate-buffered, glucose-free synthetic oviduct fluid medium [mod-SOFM] + 10% FBS; and bicarbonate-buffered BSA-free Tyrode's salt solution [mod-TALP] + 10% FBS) under a 5% CO2 atmosphere in air. In a second experiment, a significantly higher (p < 0.05) proportion of cocultured zygotes placed in TCM-199 medium survived to the blastocyst stage (37.4% blastocysts vs. 23.4% in mod-SOFM). No significant effect of serum (FBS vs. human serum [HS]) was observed on embryonic development, but coculture was confirmed to exert a significant influence on development to the blastocyst stage. In the final experiment, survival of the embryo under a reduced oxygen (5% CO2:5% O2:90% N2) atmosphere was investigated. In contrast to results in the initial experiments, embryonic survival was significantly higher (p < 0.05) in the non-cocultured treatment groups (21.9% blastocysts vs. 0.4% for cocultured zygotes). Serum source also had a significant (p < 0.05) influence upon the development of non-cocultured zygotes: 32.3% of zygotes cultured with HS progressed to the blastocyst stage vs. 11.5% of zygotes cultured in FBS-supplemented medium. These results have characterized two distinct culture environments, each capable of supporting the development of high frequencies of unselected IVMF zygotes to the blastocyst stage in vitro.

Possible Roles Of Insulin And Insulin-Like Growth Factors In Rat Preimplantation Development: Investigation Of Gene Expression By Reverse Transcription-Polymerase Chain Reaction., X Zhang, G M Kidder, A J Watson, G A Schultz, D T Armstrong

Obstetrics & Gynaecology Publications

The sensitive mRNA phenotyping technique of reverse transcription-polymerase chain reaction was used to demonstrate that insulin receptor mRNA is present in rat embryos during the preimplantation period. In addition, mRNA encoding insulin-like growth factor (IGF) type I and type II receptors have also been detected in rat preimplantation embryos. IGF-I mRNA was not detected in preimplantation embryos but was found in oviducts and uteri of prepubertal and early pregnant rats. IGF-II mRNA was present in both embryos and in oviducts and uteri during the preimplantation period. These findings suggest that insulin and IGF-I could influence early embryo development in endocrine …

Bacteriuria And Pregnancy Outcome: A Prospective Hospital-Based Study In Pakistani Women, R N. Qureshi, Khalid S. Khan, Omar Darr, Nasir Khattak, Bader J. Farooqui, J H. Rizvi

Department of Obstetrics & Gynaecology

The prevalence of bacteriuria in Pakistani women and its association with complications of pregnancy was studied. Out of 1579 women, 77 had bacteriuria (4.8%). There was no association of age, gravidity, parity, haemoglobin, pre-eclampsia, mode of delivery, gestational age at delivery, preterm delivery and low birth-weight with presence of bacteriuria. With detection and treatment the pregnancy outcome of women with bacteriuria in pregnancy was the same as that of those without.

Bacteriuria And Pregnancy Outcome: A Prospective Hospital-Based Study In Pakistani Women, Rahat Qureshi, Khalid S. Khan, Omar Darr, Nasir Khattak, Javaid H. Rizvi, Bader J. Farooqui

Department of Obstetrics & Gynaecology

The prevalence of bacteriuria in Pakistani women and its association with complications of pregnancy was studied. Out of 1579 women, 77 had bacteriuria (4.8%). There was no association of age, gravidity, parity, haemoglobin, pre-eclampsia, mode of delivery, gestational age at delivery, preterm delivery and low birth-weight with presence of bacteriuria. With detection and treatment the pregnancy outcome of women with bacteriuria in pregnancy was the same as that of those without

Oncolog, Volume 36, Issue 02, April-June 1991, Gilbert H. Fletcher M.D., James M. Bowen

OncoLog MD Anderson's Report to Physicians (All issues)

• Redefining the risks of chemotherapy during pregnancy Renewing the assault on pancreatic cancer
• Significance of cancer volume in radiotherapy

Rubella Susceptibility And Continuing Risk Of Infection In Pregnancy, Saadiya Rasul, Mohammad Khurshid, Javaid Rizvi, Shahbanu Rizvi

Section of Haematology/Oncology

Sera of 2000 pregnant women attending the antenatal clinic of the Aga Khan University Hospital were tested for rubella antibodies. Of these 1684(84.2%) were Immune and 316(15.8%) were susceptible to rubella. Majority (99.8%) of the women were Asian in origin. Susceptibility decreased with increasing age and parity. We conclude that apart from vaccination of all young children greater attention should be paid to immunization of women of child-bearing age

Maternal-Neonatal Serum Vitamin A Concentrations., Girish S. Shirali, D G. Oelberg, K P. Mehta

Manuscripts, Articles, Book Chapters and Other Papers

Prevention of neonatal vitamin A deficiency is related to the adequacy of maternal vitamin A stores. In this study we investigated maternal and cord serum vitamin A and retinol-binding protein (RBP) values in an Indian population including, for the first time, clinically vitamin A-deficient mothers. Twenty-eight maternal-neonatal pairs were selected from maternal cohorts of high socioeconomic status without clinical evidence of vitamin A deficiency (group I) and low socioeconomic status with conjunctival xerosis and Bitot's spots (group II). Maternal education, caloric and vitamin A intakes, weight, height, hemoglobin, and birth weight were significantly lower in group II. Serum vitamin A …

Anaemia In Pregnancy: Occurrence In Two Economically Different Clinic Populations Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, Javed H. Rizvi

Section of Haematology/Oncology

According to previous WHO standards, anaemia in pregnancy denoted a haemoglobin level of 11.0 gms/dl or less, but this is now considered to be variable¹ as it differs from country to country depending on local reference ranges and socio-economic conditions. Each country should “lay down minimal acceptable standards” below which an individual is considered to be anaemic, taking into account the available fmancial and manpower resources and other health needs of the country². There is a wide divergence in the quoted prevalence of anaemia in Pakistan and neigh­bouring countries.^3-6 This study was undertaken to determine a …

Serial Cardiovascular Adaptations During Pregnancy, Mark Vincent Hart

Dissertations and Theses

Maternal cardiovascular adaptations appear to be essential in order to supply extra circulation to both the developing fetus and maternal system during a successful pregnancy. Since inadequate cardiovascular adjustments may produce abortions or maternal morbidity, the characterization of maternal cardiovascular changes during pregnancy and the elaboration of the underlying mechanism for these changes are essential to the understanding of how the heart enlarges during pregnancy and what significance this enlargement might have. To provide needed information regarding this time course and extent of maternal cardiac enlargement and the hormonal and hemodynamic changes which may be responsible for these changes, the …

Notes From A Lecture On Midwifery By Dr. William Shippen, Jr. April 7, 1798; And Clinical Notes From The Pennsylvania Hospital, December 1799-February 1800, Uriah Derickson

Medical Student and Faculty Lecture Notes

This notebook was written by student Uriah Derickson at Pennsylvania Hospital. The notebook includes notes from a lecture on Midwifery by Dr. William Shippen, Jr. that were taken on April 7, 1798. Shippen was a professor of Anatomy and Surgery at Pennsylvania Hospital from 1774-1806. He pioneered courses in midwifery despite opposition, and warned against the use of instruments in childbirth (Penn University Archives & Records Center). The notebook also contains clinical notes written at the Pennsylvania Hospital under the direction of Dr. Benjamin Rush and Dr. Philip Syng Physick. The notebook mentions that on February 26, …