Medicine and Health Sciences Commons^™

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 …

Exercise During Pregnancy, Sue Merkel

Physical Therapy Scholarly Projects

Physical fitness and sports participation has increased in popularity over the years. This raises concerns as to whether exercising while pregnant is beneficial or harmful to the mother and her unborn child. Research has determined the maternal and fetal responses during various forms of exercise. This research has been used to help establish guidelines and recommendations for pregnant women. However, there continues to be controversy as to the exercise guidelines pregnant females need to follow. Women experience physical changes throughout their pregnancy which can lead to low back pain, abdominal or pelvic floor dysfunctions. These complications can be prevented or …

Labour And Birth Information Needs Of First Time Mothers In Malawi And Satisfaction With Information Received, Address M. Malata

Theses: Doctorates and Masters

Giving labour and birth information to first time mothers is one of the challenges facing the midwives in Malawi. There are many underlying health and soeioeconomic problems facing the people of Malawi particularly mothers in the child bearing age because of inadequate human and material resources in the health sector. This thesis presents findings of a study carried out in Malawi to explore labour and birth information given to first time mothers at hospitals and in the communities. Maternal satisfaction with the information received was determined. In addition labour and birth information needs of first time mothers in Malawi were …

Book Review Of Michael D. Green, Bendectin And Birth Defects: The Challenges Of Mass Toxic Substance Litigation, Stefan Oglevee

RISK: Health, Safety & Environment (1990-2002)

Review of Michael D. Green, Bendectin and Birth Defects: The Challenges of Mass Toxic Substances Litigation (University of Pennsylvania Press 1996). Acknowledgements, index, preface, selected bibliography. LC 95-42306; ISBN 0-8122-3257-7 [368 pp. $29.95 Cloth. 1300 Blockley Hall, 418 Service Drive, Philadelphia PA 19104-6097.]

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 …

A Correlative Study Of An At-Risk Population And Low Birth Weight/Infant Mortality In A Northeast Oklahoma City Community, Estacia D. Thrower

McCabe Thesis Collection

Studies show that numerous and complex variables influence pregnancy outcomes and infant mortality rates. These variables include demographic, medical, physical, environmental, behavioral, and attitudinal factors and prenatal care. Improving the health of mothers and infants is a national challenge. In 1987, more than 3.8 million infants were born in the United States. Of these, 38,408 died before their first birthday. Although the infant mortality rate is at an all-time low, the pace of progress has slowed. According to Dr. Robert Deppen of the Oklahoma State Health Department, "In 1992, Oklahoma ranked 29th in the United States for infant mortality and …

Disruption Of The Cbfa2 Gene Causes Necrosis And Hemorrhaging In The Central Nervous System And Blocks Definitive Hematopoiesis., Qing Wang, Terryl Stacy, Michael M Binder, Miguel Marin-Padilla, Arlene H. Sharpe, Nancy A. Speck

Dartmouth Scholarship

The CBFA2 (AML1) gene encodes a DNA-binding subunit of the heterodimeric core-binding factor. The CBFA2 gene is disrupted by the (8;21), (3;21), and (12;21) chromosomal translocations associated with leukemias and myelodysplasias in humans. Mice lacking a CBF alpha 2 protein capable of binding DNA die between embryonic days 11.5 and 12.5 due to hemorrhaging in the central nervous system (CNS), at the nerve/CNS interfaces of cranial and spinal nerves, and in somitic/intersomitic regions along the presumptive spinal cord. Hemorrhaging is preceded by symmetric, bilateral necrosis in these regions. Definitive erythropoiesis and myelopoiesis do not occur in Cbfa2-deficient embryos, and disruption …

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. …

Survey Of Omega-3 Fatty Acids In Diets Of Midwest Low-Income Pregnant Women, Nancy M. Lewis, Anne C. Widga, Janet S. Buck, Andrea M. Frederick

Department of Nutrition and Health Sciences: Faculty Publications

The objectives of this project were to detennine the omega-3 fatty acid (ω-3 FA) consumption of low-income pregnant women, and to identify food sources of ω-3 FA in their diets. Thirty women provided three days of dietary intake that were analyzed using the Food Processor Plus computer program. Mean daily consumption of ω-3 FA was 1.060 ± 0.030 g/day. The major form of the ω-3 FA was α-linolenic acid (α-LNA; 93%), with less from eicosapentanoic acid (EPA; 2%), and docosahexanoic acid (DHA; 5%). Foods that provided the most α-LNA were fats, oils, salad dressings, and milk products. EPA …

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.

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 …

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, 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

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

Prevalence Of Asymptomatic Chlamydia In Pregnancy, Cynthia Mcalpin

MSN Research Projects

Chlamydia has become the most prevalent sexually transmitted disease in the United States. Most infected women are asymptomatic carriers of the infection. Chlamydia is not a reportable disease in the State of Mississippi. Therefore, no data are available regarding the magnitude of infection in Northeast Mississippi. The purpose of this study was to identify asymptomatic chlamydial infections in pregnant women attending a midwifery clinic in Northeast Mississippi. The Neuman Systems Model identifying levels of prevention was utilized as the theoretical framework. The research questions guiding the study were what percentage of pregnant women are asymptomatic and what are the clinical, …

The Legal Significance Of Gestation, Larry I. Palmer

Faculty Publications

No abstract provided.

Book Review, Ann Marie Wheatcraft

RISK: Health, Safety & Environment (1990-2002)

Review of: ROBERT H. BLANK, MOTHER AND FETUS: CHANGING NOTIONS OF MATERNAL RESPONSIBILITY. (Greenwood Press 1992) [207 pp.], Appendix, bibliography, figures, index, preface, tables. LC-91- 38029; ISBN 0-313-27639-0. [$45.00 cloth. 88 Post Road West, Box 5007, Westport CT 06881.]

Being Pregnant And Using Drugs: A Retrospective Phenomenological Inquiry, Merry A. Armstrong Dnsc, Msn

Dissertations

Qualitative methodology was employed to conduct a phenomenological inquiry describing the structure of the experience of being pregnant and using drugs. The purpose of the study was to explore the nature of women's experience and perception of the interaction, relationship, and intersection of contextual phenomena of lifestyle, pregnancy, and substance abuse. Data gathering and analysis was accomplished using guidelines provided by Spiegelberg and Van Manen. Eleven mothers voluntarily participating in a recovery program described their prior experience of being addicted and pregnant during 2 conversations with the researcher. Through transcript analysis of the first audio-taped interview, major and minor themes …

Risk Assessment For Developmental Toxicity: Airborne Occupational Exposure To Ethanol And Iodine, Donald R. Mattison

RISK: Health, Safety & Environment (1990-2002)

Dean Mattison explains hazard identification, hazard characterization and exposure characterization as furnishing a foundation for Risk assessment generally. He then illustrates their application in assessing the fetal Risk posed by two common substances. Ultimately, he argues that only after Risks have been so examined can women of child bearing age (or anyone) decide what if any measures are appropriate to avoid them.

Fertile Women May Now Apply: Fetal Protection Policies After Johnson Controls, Barbara Ruhe Grumet

RISK: Health, Safety & Environment (1990-2002)

In its recent interpretation of Title VII of the Civil Rights Act, the U.S. Supreme Court leaves little room for permissible occupational sex discrimination. However, its decision has wider implications. Here, Professor Grumet takes a look at some of them from both a legal and a social perspective, including matters such as employees' reproductive freedom and employers' potential liability for a variety of possible injuries to employees' offspring.

Evidence For Attenuation Of Myo-Inositol Uptake, Phosphoinositide Turnover And Inositol Phosphate Production In Aortic Vasculature Of Rats During Pregnancy, Kirk P. Conrad, Susan A. Barrera, Peter A. Friedman, Vicki M. Schmidt

Dartmouth Scholarship

We postulated that vascular phosphoinositide metabolism is attenuated during pregnancy, and thereby could contribute to maternal vasodilation and reduced vascular reactivity. The basal rate of incorporation of [3H]myo-inositol and [3H]glycerol into phosphoinositides of aortae from pregnant rats in vitro was significantly reduced, when compared with vessels from virgin animals. After injection of [3H]myo-inositol intravenously into chronically instrumented conscious pregnant and virgin rats, the incorporation of the label by phosphatidylinositol was 66 +/- 4% less in aortae of gravid versus virgin animals (P less than 0.001), despite comparable plasma concentrations of radioactivity. Fold stimulation of total [3H]inositol phosphates by arginine vasopressin, …

Problems And Coping Styles Of Antepartal Patients Being Treated For Risk Of Preterm Labor, Janet Wiehrs Rogers

Ellmer School of Nursing Theses & Dissertations

The purpose of this study was to identify the range of problems and coping strategies as perceived by antepartal patients experiencing medical treatment to decrease risk of preterm labor. In this qualitative, interpretive study problems and coping strategies were identified through semi-structured interviews with a convenience sample of seven antepartal patients. Using content analysis of interview data, identified problems were categorized, and for each problem, coping strategies were identified and grouped using the categories of the Jalowiec Coping Scale. Major categories of problems were: bedrest, role change, finances, uncomfortable emotions, and reactions of families and friends. Supportant, palliative, and confrontive …

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

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

• 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 …

Pregnancy Outcome In Military And Civilian Women, Karen Messersmith Heroman Dnsc

Dissertations

Low birth weight and prematurity account for much of the morbidity and mortality in the neonatal period as well as for much of the cost in newborn care. The purpose of this investigation was to determine if two groups of pregnant women, military enlisted and civilian dependents, differed in selected risk factors (smoking, alcohol consumption, weight gain, prenatal care, work patterns, life stress, and social support) or in pregnancy outcome (infant birth weight and gestational age). The House (1981) theory of stress, social support, and health served as the framework for this study. Since little has been published on pregnancy …

U.S. Women And Hiv Infection, P. Clay Stephens

New England Journal of Public Policy

Women are inadequately provided with HIV services and education and are differentially denied access to these. Divisions of race, ethnicity, economic class, and religion, among others, are compounded by sexual discrimination within each of these categories.

Review of current data on women with AIDS reveals that the reporting methods used convey a false impression that women are not at significant risk. Moreover, the persons indirectly affected by AIDS are predominantly women — mothers, sisters, partners, family members, teachers, and human service workers. Thus, AIDS is more of a women's issue than the statistics imply.

Women, as a gender-defined class, face …

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 …

Pregravid Weight, Prenatal Weight Gain And Maternal Age As Risk Factors In Pregnancy-Induced Hypertension Development, Maryellen C. Remich

Ellmer School of Nursing Theses & Dissertations

This study examined whether the factors of pregravid weight, total prenatal weight gain at twenty-eight weeks and maternal age correlated with the development of pregnancy-induced hypertension in the third trimester. An ex post facto chart review of low risk primigravidas attending a public health maternity clinic was performed. A multiple regression correlation procedure demonstrated no significant correlation between the variables. Significant results of Chi-sguare tests of independence were demonstrated between low maternal age and pregnancy-induced hypertension development and between the failure of the mean arterial pressure to decrease in the second trimester and the development of pregnancy-induced hypertension in the …

Evidence Against The Hypothesis That Prostaglandins Are The Vasodepressor Agents Of Pregnancy. Serial Studies In Chronically Instrumented, Conscious Rats., Kirk P. Conrad, Mary C. Colpoys

Dartmouth Scholarship

Renal hemodynamics increase dramatically during pregnancy, and pressor responsiveness to exogenous administration of vasoconstrictors is attenuated. We investigated whether or not vasodilatory prostaglandins mediate these phenomena. Trained, chronically instrumented, conscious pregnant rats were used. Control values of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were elevated at midgestation (P less than 0.01 and P = 0.05 from prepregnant means, respectively), and effective renal vascular resistance was decreased (P = 0.05). Indomethacin (4.5-6.5 mg/kg body weight [BW]) failed to decrease renal hemodynamics at this stage of pregnancy; in fact, it raised GFR somewhat further (P less than 0.05). …