Medicine and Health Sciences Commons^™

Transient Osteoporosis Of The Hip During Pregnancy: A Casereport, Wen-Chuan Pai, Ching-Yang Lin, Mu-Jung Kao, Fong-Cheng Lin

Rehabilitation Practice and Science

Transient osteoporosis, also called ”bone marrow edema syndrome”, is a rare disorder of unknown etiology. It primarily affects women in the third trimester of pregnancy as well as middle-aged, overweight men, and the hip joint is most commonly involved. The main symptom of transient osteoporosis of the hip is a sudden onset of pain at the lateral aspect of the hip. Mild limitation of hip range of motion is often present. A 36-year-old woman presented to our outpatient department 5 weeks after cesarean section with bilateral hip pain, which had begun suddenly during her eighth month of pregnancy. Magnetic resonance …

Intimate Partner Violence And Pregnancy: Data From The Chicago Women's Health Risk Study, Anne Zehner

Theses and Dissertations

Background: Intimate partner violence (IPV) during pregnancy increases the risks of adverse outcomes for both mothers and their unborn children, including maternal and fetal death. However, more research is needed to determine if IPV increases in frequency or severity during pregnancy and to determine what the risk factors are for IPV during pregnancy. Objectives: To use data from the Chicago Women’s Health Risk Study to determine (1) if abuse is more prevalent during the pregnancy period, 2) if abuse during the pregnancy period increases in frequency or severity, 3) if pregnant women who are abused are at increased risk for …

A Critical Appraisal Of Guidelines For Antenatal Care: Components Of Care And Priorities In Prenatal Education, Lisa Hanson, Leona Vandevusse, Joyce Roberts, Amanda Forristal

College of Nursing Faculty Research and Publications

There are a variety of published prenatal care (PNC) guidelines that claim a scientific basis for the information included. Four sets of PNC guidelines published between 2005 and 2009 were examined and critiqued. The recommendations for assessment procedures, laboratory testing, and education/counseling topics were analyzed within and between these guidelines. The PNC components were synthesized to provide an organized, comprehensive appendix that can guide providers of antepartum care. The appendix may be used to locate which guidelines addressed which topics to assist practitioners to identify evidence sources. The suggested timing for introducing and reinforcing specific topics is also presented in …

Chromosomal Anomalies Influence Parental Treatment Decisions In Relation To Prenatally Diagnosed Congenital Heart Disease., Sinai C. Zyblewski, Elizabeth G. Hill, Girish S. Shirali, Andrew Atz, Geoffrey Forbus, Javier Gonzalez, Anthony Hlavacek

Manuscripts, Articles, Book Chapters and Other Papers

This study aimed to identify the variables that influence parental treatment decisions after a prenatal diagnosis of congenital heart disease (CHD). The authors reviewed all cases of prenatally diagnosed structural CHD from August 1998 to December 2006 at their center. The following variables were studied as potential predictors of parental intent to treat: maternal age, race, insurance status, obstetric history, fetal gender, univentricular versus biventricular cardiac physiology, and fetal chromosomal abnormality. Uni- and multivariable logistic regression analyses were performed. In the review, 252 consecutive cases of prenatally diagnosed CHD were identified. Of these, 204 women pursued full medical treatment, whereas …

Hiv/Aids And Pregnancy-Related Deaths In Blantyre, Malawi, V. M. Lema, C. Kanyighe, J. Changole, E. V. Malunga

Obstetrics and Gynaecology, East Africa

Background: HIV/AIDS epidemic is one of the major factors affecting women’s health and impeding national efforts to improve it especially in sub-Saharan Africa. Current evidence indicates that HIV/ AIDS is increasingly becoming a major cause or contributing factor to pregnancy-related deaths, almost overtaking the “traditional” causes and factors.

Objectives: To survey the contribution of HIV infection and AIDS to pregnancy-related deaths in Blantyre, Malawi.

Design: A retrospective, descriptive, facility-based survey.

Setting: The Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi.

Subjects: All women recorded to have had pregnancy-related deaths between January 1, 1999 and December 31, 2000.

Results: There were …

Transverse Myelitis In Pregnancy: A Case Report, Brian P. Mcdonald, Do, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Faculty Papers

Objective: Describe the clinical course and treatment of a patient with paraplegia secondary to transverse myelitis during her pregnancy.

Setting: Acute Inpatient Rehabilitation Unit, University Hospital.

Participant: 36 year old Caucasian woman at 18 weeks gestation.

Interventions: Provided education and training on basic childcare tasks at a wheelchair level, and on how to obtain wheelchair accessible baby furniture. Provided availability of a peer who sustained a spinal cord injury prior to pregnancy. Maintained a close working relationship with maternal fetal health department regarding management of nausea and pain management, and educated team members about the possibility of autonomic …

Effects Of Nicotine Patch Or Nasal Spray On Nicotine And Cotinine Concentrations In Pregnant Smokers, Cheryl A. Oncken, Winston A. Campbell, Grace Chan, Henry R. Kranzler

UCHC Articles - Research

Objective To examine the short-term effects of the nicotine patch or nasal spray on measures of nicotine exposure, withdrawal symptoms, and on maternal and fetal heart rates in pregnant smokers. Methods We measured nicotine/cotinine concentrations and maternal and fetal heart rates during an 8-hour monitoring session while smoking and again after 4 days of nicotine patch (15 mg/16 hours), nasal spray (recommended regimen of 24 doses per day), or placebo treatment. Nicotine withdrawal symptoms were assessed daily. Results Twenty-one subjects, who smoked an average of 17 cigarettes per day, completed both monitoring sessions. Nicotine concentrations decreased from baseline smoking concentrations …

Intrauterine Growth Restriction Increases Fetal Hepatic Gluconeogenic Capacity And Reduces Messenger Ribonucleic Acid Translation Initiation And Nutrient Sensing In Fetal Liver And Skeletal Muscle., Stephanie R Thorn, Timothy Regnault, Laura D Brown, Paul J Rozance, Jane Keng, Michael Roper, Randall B Wilkening, William W Hay, Jacob E Friedman

Paediatrics Publications

Expression of key metabolic genes and proteins involved in mRNA translation, energy sensing, and glucose metabolism in liver and skeletal muscle were investigated in a late-gestation fetal sheep model of placental insufficiency intrauterine growth restriction (PI-IUGR). PI-IUGR fetuses weighed 55% less; had reduced oxygen, glucose, isoleucine, insulin, and IGF-I levels; and had 40% reduction in net branched chain amino acid uptake. In PI-IUGR skeletal muscle, levels of insulin receptor were increased 80%, whereas phosphoinositide-3 kinase (p85) and protein kinase B (AKT2) were reduced by 40%. Expression of eukaryotic initiation factor-4e was reduced 45% in liver, suggesting a unique mechanism limiting …

Mitogen-Activated Protein Kinase (Mapk) Pathways Mediate Embryonic Responses To Culture Medium Osmolarity By Regulating Aquaporin 3 And 9 Expression And Localization, As Well As Embryonic Apoptosis., Christine E Bell, Nathalie M K Larivière, Patricia H Watson, Andrew J Watson

Obstetrics & Gynaecology Publications

BACKGROUND: In order to advance the development of culture conditions and increase the potential for supporting normal preimplantation embryo development in vitro, it is critical to define the mechanisms that early embryos utilize to survive in culture. We investigated the mechanisms that embryos employ in response to culture medium osmolarity. We hypothesized that mitogen-activated protein kinase (MAPK) pathways mediate responses to hyperosmotic stress by regulating Aquaporin (AQP) 3 and 9 expression as well as embryonic apoptosis.

METHODS: Real-time reverse transcription and polymerase chain reaction and whole-mount immunofluorescence were used to determine the relative mRNA levels and protein localization patterns of …

Reducing Stillbirths: Behavioural And Nutritional Interventions Before And During Pregnancy., Mohammad Yawar Yakoob, Esme V Menezes, Tanya Soomro, Rachel A Haws, Gary L Darmstadt, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:The vast majority of global stillbirths occur in low- and middle-income countries, and in many settings, the majority of stillbirths occur antenatally, prior to the onset of labour. Poor nutritional status, lack of antenatal care and a number of behaviours increase women's risk of stillbirth in many resource-poor settings. Interventions to reduce these risks could reduce the resulting burden of stillbirths, but the evidence for the impact of such interventions has not yet been comprehensively evaluated.

Methods:

This second paper of a systematic review of interventions that could plausibly impact stillbirth rates covers 12 different interventions relating to behavioural …

Modifiable Risk Factors For Hypertensive Disorders Of Pregnancy Among Latina Women, Shannon Renee Turzanski Fortner

Open Access Dissertations

Hypertensive disorders of pregnancy affect approximately 8% of pregnancies, and can lead to serious complications for both mother and child. While Latinas are at two-fold increased risk of preeclampsia relative to non-Latina white women, little research on hypertension in pregnancy has been conducted in this population. Furthermore, there are few modifiable risk factors for hypertensive pregnancy. Therefore, we examined associations between psychosocial stress, physical activity, and pre-pregnancy BMI and gestational weight gain and hypertensive disorders of pregnancy using data from the Latina GDM Study, a prospective cohort study of 1,231 women. The first study evaluated the association between perceived stress …

State Infant Mortality: An Ecologic Study To Determine Modifiable Risks And Adjusted Infant Mortality Rates., David A. Paul. Md, Amy Mackley, Rnc, Robert G. Locke, Do, John L. Stefano, Md, Charlan Kroelinger, Phd

Department of Pediatrics Faculty Papers

OBJECTIVE: To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. DESIGN/METHODS: Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization …

Associations Among Health Literacy Levels And Health Outcomes In Pregnant Women With Pregestational And Gestational Diabetes In An Urban Setting, Rosemary Ann Mclaughlin

Theses and Dissertations (ETD)

Purpose/Objectives: Poor health literacy is a problem for over 45% of American adults and is associated with a variety of adverse health outcomes. Low health literacy has been associated with poor prenatal care utilization and a higher likelihood of poorer glycemic control. Poor glycemic control can lead to poor birth outcomes for both the mother and infant. Health literacy levels of pregnant women with diabetes can influence these outcomes and need to be known early in the pregnancy. Interventions can influence tighter glycemic control and lessen the impact of diabetes for the mother and infant. Therefore, the purpose of this …

Effect Of Administration Of Antihelminthics For Soil Transmitted Helminths During Pregnancy, Rehana Salam, Batool A. Haider, Quratulain Humayun, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Helminthiasis is infestation of the human body with parasitic worms and it is estimated to affect 44 million pregnancies, globally, each year. Intestinal helminthiasis is associated with blood loss and decreased supply of nutrients for erythropoiesis, resulting in iron deficiency anaemia. Over 50% of the pregnant women in low- and middle-income countries suffer from iron deficiency anaemia. Though iron deficiency anaemia is multifactorial, hook worm infestation is a major contributory cause in women of reproductive age in endemic areas. Antihelminthics are highly efficacious in treating hook worm but evidence of their beneficial effect and safety, when given during pregnancy, …

Antenatal Peer Support Workers And Initiation Of Breast Feeding: Cluster Randomised Controlled Trial, Christine Macarthur, Kate Jolly, Lucy Annang Ingram Phd, Nick Freemantle, Cindy-Lee Dennis, Ros Hamburger, Julia Brown, Jackie Chambers, Khalid Khan

Faculty Publications

OBJECTIVE: To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. DESIGN: Cluster randomised controlled trial. SETTING: Community antenatal clinics in one primary care trust in a multiethnic, deprived population. PARTICIPANTS: 66 antenatal clinics with 2511 pregnant women: 33 clinics including 1140 women were randomised to receive the peer support worker service and 33 clinics including 1371 women were randomised to receive standard care. INTERVENTION: An antenatal peer support worker service planned to comprise a minimum of two contacts with women to provide advice, information, and support from approximately 24 …

Weight Gain In Pregnancy And Risk Of Maternal Hyperglycemia, Sharon J. Herring, Emily Oken, Sheryl L. Rifas-Shiman, Janet W. Rich-Edwards, Alison M. Stuebe, Ken P. Kleinman, Matthew W. Gillman

Public Health Department Faculty Publication Series

OBJECTIVE:

The purpose of this study was to examine associations of weight gain from prepregnancy to glycemic screening with glucose tolerance status.

STUDY DESIGN:

Main outcomes were failed glycemic screening (1-hour glucose result >or= 140 mg/dL) with either 1 high value on 3-hour oral glucose tolerance testing (impaired glucose tolerance in pregnancy) or >or= 2 high values on 3-hour oral glucose tolerance testing (gestational diabetes mellitus). We performed multinomial logistic regression to determine the odds of these glucose intolerance outcomes by quartile of gestational weight gain among 1960 women in Project Viva.

RESULTS:

Mean gestational weight gain was 10.2 +/- …

Women's Awareness Of The Importance Of Long-Chain Omega-3 Polyunsaturated Fatty Acid Consumption During Pregnancy: Knowledge Of Risks, Benefits And Information Accessibility, Danka S. Sinikovic, Heather R. Yeatman, Deborah Cameron, Barbara J. Meyer

Faculty of Health and Behavioural Sciences - Papers (Archive)

OBJECTIVE: To evaluate pregnant women's knowledge regarding the importance of long-chain omega-3 polyunsaturated fatty acids (LC n-3 PUFA) consumption during pregnancy and assess their views on current information availability.

DESIGN: A 27-item demographic and food safety/behaviour questionnaire was administered to pregnant women during their antenatal clinic visits. chi2 tests were performed using SPSS.

SETTING: Antenatal clinics at two regional hospitals in New South Wales, Australia.

SUBJECTS: One hundred and ninety (n 190) pregnant women.

RESULTS: Three quarters of the women had not received information regarding LC n-3 PUFA. Approximately half of the women were aware …

Using Motivational Interviewing In Public Health Practice To Prevent Fetal Alcohol Syndrome, Lisa J. Ficker, Cheryl Lauber, Sandra L. King, Jewell Akins, Dranoel Knox, William Ridella

Michigan Journal of Public Health

Background: Surveys of women in prenatal care at busy clinics in Detroit, Michigan have reported 12.5% continue to drink during pregnancy (Flynn et al, 2003) and women in substance abuse treatment programs in Wayne County, MI have an incidence rate for Fetal Alcohol Syndrome (FAS) of 4 in 1,000 births, double the national prevalence rate of FAS. The goal of the current study was to intervene with women at high risk for an alcohol-exposed pregnancy using techniques of Brief Motivational Interviewing (BMI) in a verbal and written format. Methods: One third (33%) of 1,784 women screened at Detroit Department of …

Hematologic Effects Of Placental Pathology On Very Low Birthweight Infants Born To Mothers With Preeclampsia., Kelly J. Zook, Md, Amy B. Mackley, Rnc, Jennifer Kern, David A. Paul. Md

Department of Pediatrics Faculty Papers

OBJECTIVE: To investigate the effect of placental pathology on neonatal neutrophils, platelets, hematocrit and nucleated red blood cells in very low birthweight (VLBW) infants born to mothers with preeclampsia. STUDY DESIGN: Retrospective cohort study of infants with birthweight < 1500 g born to mothers with preeclampsia from july, 2002 to july, 2006 at a single level III neonatal intensive care unit. Placental pathology was reviewed for the presence of placental infarction and vasculopathy. Hematologic parameters from day of life 0, 1 and 2 were obtained. Statistical analysis included repeated-measures analysis of variance and multivariable analysis using logistic regression. RESULT: The study sample included 203 infants with estimated gestational age of 28+/-3 weeks; 45% had placental infarctions and 26% placental vasculopathy. Infants with neutropenia and thrombocytopenia did not have an increased occurrence of placental infarction or maternal vasculopathy but were more likely to be of small gestational age (SGA) and of lower gestational age compared with infants without neutropenia or thrombocytopenia. After multivariable analysis, gestational age and SGA remained associated with both neutropenia and thrombocytopenia whereas placental infarction and vasculopathy did not remain in the models. CONCLUSION: In our population of VLBW infants born to mothers with preeclampsia, placental pathology was common. There was no association of placental infarction or vasculopathy with neonatal neutropenia and thrombocytopenia. The data suggest that neonatal hematologic effects of maternal preeclampsia, if related to the placenta, are associated with factors other than placental histology.

Developing Tta Transgenic Rats For Inducible And Reversible Gene Expression., Hongxia Zhou, Cao Huang, Min Yang, Carlisle P Landel, Pedro Yuxing Xia, Yong-Jian Liu, Xu Gang Xia

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

To develop transgenic lines for conditional expression of desired genes in rats, we generated several lines of the transgenic rats carrying the tetracycline-controlled transactivator (tTA) gene. Using a vigorous, ubiquitous promoter to drive the tTA transgene, we obtained widespread expression of tTA in various tissues. Expression of tTA was sufficient to strongly activate its reporter gene, but was below the toxicity threshold. We examined the dynamics of Doxycycline (Dox)-regulated gene expression in transgenic rats. In the two transmittable lines, tTA-mediated activation of the reporter gene was fully subject to regulation by Dox. Dox dose-dependently suppressed tTA-activated gene expression. The washout …

A Patient With Addison's Disease Whose Sixth Pregnancy Resulted In A Healthy Baby, Yusuf Aydin, Merve Yilmaz, Di̇lek Berker, İhsan Üstün, Tuncay Deli̇başi, Serdar Güler

Turkish Journal of Medical Sciences

No abstract provided.

Comparison Of Semen Parameters Between Pregnant And Nonpregnant Couples With Male Factor Infertility During Intrauterine Insemination*, Candan İltemi̇r Duvan, Bülent Berker, Ömer Bayrak, Kaan Aydos, Ni̇lgün Turhan Öztürk, Hakan Şatiroğlu

Turkish Journal of Medical Sciences

Aim: To compare the semen parameters between pregnant and nonpregnant couples with male factor infertility during intrauterine insemination (IUI). Materials and Methods: The study included a total of 156 IUI cycles performed in our center from January 2005 to December 2006 with the indication of male infertility. IUI cycles were divided into 2 groups: group 1 pregnancy (24 cycles) and group 2 (132 cycles) nonpregnancy cycles. Results: In both groups, progressive motility of neither initial nor processed sperm specimens was significantly different (P > 0.05). When comparisons of semen parameters in groups were performed in the initial specimen, sperm concentration and …

Elevated Corticotropin-Releasing Hormone In Human Pregnancy Increases The Risk Of Postpartum Depressive Symptoms, Ilona S. Yim, Laura M. Glynn, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Curt A. Sandman

Psychology Faculty Articles and Research

Postpartum depression (PPD) is common and has serious implications for the mother and her newborn. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been discussed, but there is a lack of empirical evidence.