Reproductive and Urinary Physiology Commons^™

Pengaruh Jarak Kelahiran Terhadap Kematian Bayi Di Indonesia, Filipina, Dan Kamboja (Analisis Data Survei Demografi Kesehatan), Adelina Fitri, Asri Adisasmita, Renti Mahkota

Jurnal Epidemiologi Kesehatan Indonesia

Kematian bayi didefinisikan sebagai kematian yang terjadi pada tahun pertama kehidupan. Angka kematian bayi di Indonesia dan Kamboja sendiri masih berada diatas AKB Asia Tenggara, sedangkan Filipina sudah sama dengan AKB Asia Tenggara. Jarak kelahiran merupakan salah satu faktor yang memegang peran penting pada kematian bayi. Tujuan penelitian ini adalah untuk mengetahui pengaruh jarak kelahiran terhadap kematian bayi di Indonesia, Filipina dan Kamboja. Penelitian menggunakan data dari Demographic Health Survey (DHS). Desain penelitian adalah cross sectional dan sampel pada masing-masing negara berjumlah 10.162, 4.741 dan 4.330 bayi. Hasil penelitian memperlihatkan, jarak kelahiran < 18 bulan memiliki risiko paling besar terhadap kematian bayi di Indonesia (OR = 2,43: 95% CI 1,26 - 4,70), Kamboja (OR = 4,39: 95% CI 1,76 - 10,94) dibandingkan jarak kelahiran 18 - 23 bulan, 24 - 35 bulan dan > 36 bulan. Sedangkan di Filipina jarak kelahiran 18 …

Determinant Of Timely First-Shot Hepatitis B Immunization In East Lombok, West Nusa Tenggara, Indonesia, Putri Bungsu Machmud, Dwi Gayatri, Tri Yunis Miko Wahyono

Jurnal Epidemiologi Kesehatan Indonesia

Hepatitis B remains as one of health problems in the world. The results of several studies related to factors in predicting of the timely first-shot hepatitis B immunization were still inconsistent. Aim of this study is to identify determinant factors of the timely first-shot hepatitis B immunization in East Lombok, Indonesia. We used a cross sectional design study, and data derived from immunization coverage survey at six districts/ cities in 2013. A Total of 227 children aged 12 to 23 months who already got immunization of a first-shot hepatitis B vaccineand well documented were included as samples in this study. …

Feeding Problems Sebagai Prediktor Kejadian Obestitas Pada Anak Autis, Qisty Afifah Noviyanti

Jurnal Epidemiologi Kesehatan Indonesia

Latar belakang: Obesitas merupakan masalah yang dapat terjadi pada anak autis. Hal ini disebabkan adanya perubahan perilaku dan pola makan akibat kondisi autisme. Akan tetapi, belum banyak studi yang menjelaskan hubungan perilaku makan bermasalah (feeding problems) dengan kejadian obesitas pada anak autis. Tujuan: Penelitian ini untuk melihat hubungan antara masalah perilaku makan (feeding problem) dengan kejadian obesitas anak autis. Metode: Peninjauan artikel dilakukan dengan kata kunci autism OR autism spectrum disorder AND feeding problem OR food selectivity dan autism AND childhood obesity. Dua studi ditemukan sesuai dengan kriteria inklusi yang dibuat Anak autis memiliki perilaku makan bermasalah yang lebih tinggi …

Hubungan Pengetahuan Hiv/Aids Dengan Stigma Terhadap Orang Dengan Hiv/Aids Di Kalangan Remaja 15-19 Tahun Di Indonesia (Analisis Data Sdki Tahun 2012), Berliana Situmeang, Syahrizal Syarif, Renti Mahkota

Jurnal Epidemiologi Kesehatan Indonesia

Stigma terhadap ODHA menjadi salah satu hambatan paling besar dalam pencegahan, perawatan, pengobatan, dan dukungan HIV/AIDS. Pengetahuan tentang HIV/AIDS mempengaruhi terjadinya stigma terhadap ODHA. Tujuan penelitian ini untuk mengetahui hubungan pengetahuan tentang HIV/AIDS dengan stigma terhadap ODHA di kalangan remaja usia 15-19 tahun di Indonesia. Penelitian ini menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) Tahun 2012 dengan disain cross-sectional. Sampel penelitian sebanyak 8.316 orang. Hasil studi menunjukkan 71,63% remaja mempunyai stigma terhadap ODHA, 49,10% remaja mempunyai pengetahuan yang kurang tentang HIV. Pengetahuan yang kurang tentang HIV/AIDS berhubungan dengan stigma terhadap ODHA (PR= 1,210 95% CI: 1,149-1,273) setelah dikontrol oleh …

Maternal Nicotine Exposure Leads To Decreased Cardiac Protein Disulfide Isomerase And Impaired Mitochondrial Function In Male Rat Offspring., Nicole G Barra, Maria Lisyansky, Taylor A Vanduzer, Sandeep Raha, Alison C Holloway, Daniel B Hardy

Physiology and Pharmacology Publications

Smoking throughout pregnancy can lead to complications during gestation, parturition and neonatal development. Thus, nicotine replacement therapies are a popular alternative thought to be safer than cigarettes. However, recent studies in rodents suggest that fetal and neonatal nicotine exposure alone results in cardiac dysfunction and high blood pressure. While it is well known that perinatal nicotine exposure causes increased congenital abnormalities, the mechanisms underlying longer-term deficits in cardiac function are not completely understood. Recently, our laboratory demonstrated that nicotine impairs placental protein disulfide isomerase (PDI) triggering an increase in endoplasmic reticulum stress, leading us to hypothesize that this may also …

Increased Incidence Of Non-Alcoholic Fatty Liver Disease In Male Rat Offspring Exposed To Fluoxetine During Fetal And Neonatal Life Involves The Nlrp3 Inflammasome And Augmented De Novo Hepatic Lipogenesis., Nicole E De Long, Daniel B Hardy, Noelle Ma, Alison C Holloway

Physiology and Pharmacology Publications

Up to 10% of women take selective serotonin reuptake inhibitors (SSRI) during pregnancy. Children exposed to SSRIs in utero have an increased risk of being overweight suggesting that fetal exposure to SSRIs can cause permanent metabolic changes. We have previously shown in rats that fetal and neonatal exposure to the SSRI antidepressant fluoxetine results in metabolic perturbations including increased hepatic triglyceride content; a hallmark of non-alcoholic fatty liver disease (NAFLD). Therefore, the aim of this study was to identify the mechanism(s) underlying the fluoxetine-induced increase in intrahepatic triglyceride content. Female nulliparous Wistar rats were given vehicle or fluoxetine (10 mg/kg/day) …

Maternal Undernutrition And Long-Term Effects On Hepatic Function, Daniel B. Hardy

Physiology and Pharmacology Publications

Undernutrition in utero, regardless of the source, can impair proper liver development leading to long-term metabolic dysfunction. Understanding the molecular mechanisms underlying how nutritional deficits during perinatal life lead to permanent alterations in hepatic gene expression will provide better therapeutic strategies to alleviate the undernourished liver in postnatal life. This chapter addresses the different experimental models of undernutrition in utero, and highlights the direct and indirect mechanisms involved leading to metabolic diseases in the liver. These include hypoxia, oxidative stress, epigenetic alterations, and endoplasmic reticulum (ER) stress. In addition, promising perinatal nutritional and pharmaceutical interventions are highlighted which …

Effects Of Protein Deficiency On Perinatal And Postnatal Health Outcomes, Shelby L. Oke, Daniel B. Hardy

Physiology and Pharmacology Publications

There are a variety of environmental insults that can occur during pregnancy which cause low birth weight and poor fetal health outcomes. One such insult is maternal malnutrition, which can be further narrowed down to a low protein diet during gestation. Studies show that perinatal protein deficiencies can impair proper organ growth and development, leading to long-term metabolic dysfunction. Understanding the molecular mechanisms that underlie how this deficiency leads to adverse developmental outcomes is essential for establishing better therapeuticstrategies that may alleviate or prevent diseases in later life. This chapter reviews how perinatal protein restriction in humans and animals leads …

Perinatal Malnutrition And Epigenetic Regulation Of Long-Term Metabolism In The Liver And Adipose Tissue, Daniel B. Hardy

Physiology and Pharmacology Publications

Maternal malnutrition in perinatal life can have long-lasting adverse effects on glucose and lipid homeostasis in the offspring, culminating in dyslipidemia, insulin resistance and obesity. Understanding the molecular mechanisms underlying how these nutritional deficits during perinatal life lead to permanent changes in hepatic and adipose function will provide efficacious therapeutic strategies to mitigate these metabolic defects short- and long-term. This chapter addresses how epigenetic mechanisms mediate alterations in hepatic and adipose gene expression identified from clinical studies and different experimental models of maternal malnutrition. These include DNA methylation, post-translational histone modifications, and microRNAs.

Connective Tissue, Glial And Neuronal Expressions In Testis Of The African Giant Rat (Cricetomys Gambianus), T. E. Falade, Matthew A. Olude, Oluwaseun A. Mustapha, Ejikeme F. Mbajiorgu, Amadi O. Ihunwo, F. E. Olopade, B. O. Oke

Brain and Mind Institute

Introduction:

This study was carried out to investigate the expression of connective tissue (Collagens I and III), glia and neuronal markers in the testis of the African giant rat using histology and immunohistochemistry techniques.

Materials and Methods:

Eight (8) apparently healthy wild male African giant rats were used for this experiment, divided into 2 groups (juvenile and adult) of 4 animals each. The testes were harvested following intracardial perfusion of the rats and histology was performed using Haematoxylin-Eosin stain and Mallory-Heideinhain rapid one- step staining for connective tissue. Immunohistochemical identification was achieved using the following antibodies: anti-collagen type …

A Functional Algorithm For Weight Loss And Obesity Practice: Guide For Clinical Decision-Making For Treating Women, Jennifer A. Tice Williams

Dissertations

ABSTRACT

Background

Overweight and obesity have significant impact and consequences on women leading to reduced quality of life, comorbid conditions and premature mortality. Many healthcare providers lack adequate training and the time to properly treat overweight and obesity. Algorithms have been shown to improve clinical knowledge and save time.

Objectives

To develop an algorithm for weight loss assessment and treatment to aid in the clinical decision-making process while improving the quality of care for overweight and obese clients in an efficient manner that can be replicated.

Methods

After an extensive literature review to identify best-practice guidelines for weight loss a …

Ethical Concerns For Assisted Reproductive Technologies, Olga Najera

Dialogue & Nexus

The development of assisted reproductive technologies has provided new options for infertile couples in their pursuit of parenthood. As a result of the successful implementation of in vitro fertilization (IVF), gestational surrogacy is now an alternative. Other technology, such as genetic enhancement, could potentially become available for human beings soon; however, numerous ethical concerns have been raised by the fact that it requires germline engineering. The concerns brought about by these new reproductive technologies will be addressed in light of the teachings of the Roman Catholic Church and of the following ethical theories: Kantian, evolutionary, utilitarian, and virtue ethics.

Informational Dichotomy Of The Mind; The Role Of Sexual Neuromodulators, Ion G. Motofei, David L. Rowland

Journal of Mind and Medical Sciences

Many basic physiological mechanisms of sexuality were initially studied on animal subjects and conclusions regarding human subjects extrapolated afterward. These ancestral reflexes are assumed to have ascended during human evolution to the cerebral level, where cognition would intermediate (being an environmental operator) both sexual and mental processes. Accordingly, the study of human sexuality suggests an additional/ particular documentation regarding mental existence and its implication, phenomena that are not characteristic of animals.

In a previously published paper we presented ideas regarding the structural dichotomy of the mind and its subsequent implications to sexuality. In this paper we present a general perspective …

Cystatin C And Cardiac Measures In Children And Adolescents With Ckd., Tammy M. Brady, Kelly Townsend, Michael F. Schneider, Christopher Cox, Thomas Kimball, Peace Madueme, Bradley A. Warady, Susan Furth, Mark Mitsnefes

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Cardiovascular disease (CVD) is highly prevalent among children with chronic kidney disease (CKD). Cystatin C is an established marker of kidney function and an emerging biomarker for CVD events. We quantified the relationship between cystatin C level and cardiac structure and function over time among children with CKD and assessed whether cystatin C level and diastolic function retained an association after accounting for kidney function.

STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS: 678 children and adolescents with mild to moderate CKD enrolled in the CKD in Children (CKiD) Study with 1,228 echocardiographically obtained cardiac structure and function measurements. …

Breed Quality Scores For Post-Cervical Artificial Insemination And The Effects On Farrowing Rate And Total Born At A Commercial Swine Facility In The Southern United States, Kathryn R. Prus

Murray State Theses and Dissertations

The objective of this experiment was to determine the possible relationship between a sow’s ease of breeding on the first service and the farrowing rate and total born. This study was conducted in a commercial farrowing unit in the Southern United States utilizing pen gestation with stock of 6,000 head. Five hundred ninety-seven sows were bred between the months of April and May 2017 were selected for this study. All animals were inseminated using a post-cervical artificial insemination catheter unless insertion of the inner catheter was impossible. The semen dose fell within the following parameters: concentration of 1.5 x 10 …

Atypical Hemolytic Uremic Syndrome In First Trimester Pregnancy Successfully Treated With Eculizumab, Gabriela Andries, Michael Karass, Srikanth Yandrapalli, M Karass, Delong Liu, John Nelson, R Pawar, Savneek Chugh

NYMC Faculty Publications

BACKGROUND: Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab. CASE PRESENTATION: A 30-year-old woman presented at 10 weeks of gestation with hypertension, hemolytic anemia, thrombocytopenia, and acute kidney injury, …

Role Of Fgf23 In Pediatric Hypercalciuria., Maria Goretti Moreira Guimarães Penido, Marcelo De Sousa Tavares, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Background: This study explored the possible role of FGF23 in pediatric hypercalciuria.

Methods: Plasma FGF23 was measured in 29 controls and 58 children and adolescents with hypercalciuria: 24 before treatment (Pre-Treated) and 34 after 6 months of treatment (Treated). Hypercalciuric patients also measured serum PTH hormone, 25(OH)vitD, phosphate, calcium, creatinine, and 24 h urine calcium, phosphate, and creatinine.

Results: There were no differences in age, gender, ethnicity, or body mass index either between controls and patients, or between Pre-Treated and Treated patients. Median plasma FGF23 in controls was 72 compared with all patients, 58 RU/mL (p = 0.0019). However, …

Efficient Method For Transfer Of Microinjected Eggs To Mouse Ampulla For Generating Transgenic Mice, Guang Wen, Jin Di, Qian Li, Jianling Chen, Ling Jin, Cheng Wang, Sanqing Xu

Publications and Research

Background: The new method described here is highly efficient in transferring microinjected mouse eggs (MEs) through the bursa membrane of a surrogate mother mouse to the ampulla of the oviduct without damaging the blood vessels on the bursa membrane.

Results: This method causes no loss of blood, and it produces newborn pups/founders from approximately 70% of the transferred MEs, because only a small hole is made on the blood vessel–free area of the bursa membrane and ampulla of the surrogate mother mouse. The infundibulum remains intact. The small hole on the bursa membrane/ ampulla may already heal up before the …

Spinal Cord Injury And Autonomic Dysreflexia- A Case Report, Apurva Bhatt, Brit Moore, Talal Asif, Kristy E. Steigerwalt, Rebecca R. Pauly

Marshall Journal of Medicine

Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management.

Vulvodynia; An Under-Recognized Disease, Simona Roxana Georgescu, Cristina I. Mitran, Mădălina I. Mitran, Maria I. Sârbu, Mircea Tampa

Journal of Mind and Medical Sciences

Vulvodynia is a chronic condition which affects an increasing number of women; it presents currently an incidence that is higher than had previously been estimated. Regarding pathogenesis, several (hormonal, infectious, inflammatory and psychological) factors have been proposed, but vulvodynia etiology remains still unclear. This disorder is a multifactorial condition with a significant impact on the patient’s quality of life, yet is difficult to diagnose (an under-estimated/ under-recognized affection). Certain medical investigations are required in order to exclude other diseases (the diagnosis of vulvodynia being one of exclusion), but anamnesis and physical examination are essential steps in the diagnosis.

Although many …

The Current Treatment Of Erectile Dysfunction, Maria Isabela Sarbu, Mircea Tampa, Mădălina I. Mitran, Cristina I. Mitran, Vasile Benea, Simona R. Georgescu

Journal of Mind and Medical Sciences

Erectile dysfunction (ED) is the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. It is the most frequent sexual dysfunction in elderly men and its prevalence increases with age.

Ever since ED was recognized as a real health problem, several treatment options became available and some of them proved to be very efficient. PDE5 inhibitors are the mainstay treatment of ED.

However, other treatment options such as intracorporal injections, surgery, vacuum devices and prosthesis are also available for patients who are unresponsive to PDE5 inhibitors. Since none of the treatment options available so far has proven …

Loss Of Exogenous Androgen Dependence By Prostate Tumor Cells Is Associated With Elevated Glucuronidation Potential, Brenna M. Zimmer, Michelle E. Howell, Qin Wei, Linlin Ma, Trevor Romsdahl, Eileen G. Loughman, Jennifer E. Markham, Javier Seravalli, Joseph J. Barycki, Melanie A. Simpson

Department of Biochemistry: Faculty Publications

Prostate epithelial cells control the potency and availability of androgen hormones in part by inactivation and elimination. UDP-glucose dehydrogenase (UGDH) catalyzes the NAD⁺-dependent oxidation of UDP-glucose to UDP-glucuronate, an essential precursor for androgen inactivation by the prostate glucuronidation enzymes UGT2B15 and UGT2B17. UGDH expression is androgen stimulated, which increases the production of UDP-glucuronate, and fuels UGT-catalyzed glucuronidation. In this study, we compared the glucuronidation potential and its impact on androgen-mediated gene expression in an isogenic LNCaP model for androgen dependent versus castration resistant prostate cancer. Despite significantly lower androgen-glucuronide output, LNCaP 81 castration resistant tumor cells expressed higher …

Ramadan & Pregnancy, Omar Rizvi

Celebration of Learning

Fasting during Ramadan, the ninth month of the Muslim calendar, is one of the five pillars of Islam and is fard (obligatory) for all Muslims physically and mentally capable of doing so. In the Qur’an, it is made abundantly clear that religion and its acts of worship are not meant to pose undue difficulty or hardship (Qur’an 22:78, 5:6, 2:185). My paper explores the Islamic definitions for “unnecessary difficulty” and “physically capable” specifically in regards to pregnant women. At what point does fasting incur significant, if any, damage to the fetus that it should prevent the mother from participating in …

Demonstration Of Follicle Waves Using Delay Differential Equations, Andrew A. Wright

Biology and Medicine Through Mathematics Conference

No abstract provided.

Embryo Adoption As An Ethical Option For Couples Faced With Infertility, Rachel M. Walters

Senior Honors Theses

Embryo adoption takes embryos that are still forming and introduces them into the uterus of a woman with whom they do not share any genetic material. If pregnancy does ensue and continues without complications, the child that will be born will not share any genes with the woman who carried him or her. In addition, if the child is born to parents who already have other children, the children in the adoptive family will share no biological link to the newborn. Essentially, the child will have two families—a biological family and an adoptive family. This thesis will explore and discuss …

Male Psychological Adaptation To Unsuccessful Medically Assisted Reproduction Treatments: A Systematic Review, Mariana Veloso Martins, Miguel Basto-Pereira, Juliana Pedro, Brennan Peterson, Vasco Almeida, Lone Schmidt, Maria Emília Costa

Marriage and Family Therapy Faculty Articles and Research

BACKGROUND Similarly to women, men suffer from engaging in fertility treatments, both physically and psychologically. Although there is a vast body of evidence on the emotional adjustment of women to infertility, there are no systematic reviews focusing on men's psychological adaptation to infertility and related treatments.

OBJECTIVE AND RATIONALE The main research questions addressed in this review were ‘Does male psychological adaptation to unsuccessful medically assisted reproduction (MAR) treatment vary over time?’ and ‘Which psychosocial variables act as protective or risk factors for psychological maladaptation?’

SEARCH METHODS A literature search was conducted from inception to September 2015 on five databases …

A Urinary Metabolic Signature For Multiple Sclerosis And Neuromyelitis Optica, Teklab Gebregiworgis, Helle H. Nielsen, Chandirasegara Massilamany, Arunakumar Gangaplara, Jay Reddy, Zsolt Illes, Robert Powers

Jay Reddy Publications

Urine is a metabolite-rich biofluid that reflects the body’s effort to maintain chemical and osmotic homeostasis. Clinical diagnosis routinely relies on urine samples because the collection process is easy and noninvasive. Despite these advantages, urine is an under-investigated source of biomarkers for multiple sclerosis (MS). Nuclear magnetic resonance spectroscopy (NMR) has become a common approach for analyzing urinary metabolites for disease diagnosis and biomarker discovery. For illustration of the potential of urinary metabolites for diagnosing and treating MS patients, and for differentiating between MS and other illnesses, 38 urine samples were collected from healthy controls, MS patients, and neuromyelitis optica-spectrum …

Pelvic Floor Muscle Training In Management Of Postpartum Pelvic Floor Dysfunctions: A Literature Review, Rebecca S. Tanner

Honors Undergraduate Theses

Women can face a wide range of pelvic floor dysfunctions following pregnancy, ranging from urinary incontinence to pelvic pain. Unfortunately, these problems are not routinely checked for in postpartum check-ups and women do not always bring it to the physician’s attention. Strengthening of the pelvic floor muscles may be able to help women prevent these disorders and improve these women’s lifestyles.

The purpose of this thesis was to review and analyze different trials to determine if different pelvic floor dysfunctions (urinary incontinence, sexual dysfunction, and pelvic girdle pain) can be treated using pelvic floor muscle training in the postpartum. After …

Proceedings Of The Working Group Session On Fertility Preservation For Individuals With Gender And Sex Diversity., Courtney Finlayson, Emilie K. Johnson, Diane Chen, Elizabeth Dabrowski, Yasmin Gosiengfiao, Lisa Campo-Engelstein, Ilina Rosoklija, Jill Jacobson, Margarett Shnorhavorian, Mary Ellen Pavone, Molly B. Moravek, Herbert J. Bonifacio, Lisa Simons, Janella Hudson, Patricia Y. Fechner, Veronica Gomez-Lobo, Rachel Kadakia, Angela Shurba, Erin Rowell, Teresa K. Woodruff

Manuscripts, Articles, Book Chapters and Other Papers

Children and adolescents with gender and sex diversity include (1) gender-nonconforming and transgender individuals for whom gender identity or expression are incongruent with birth-assigned sex (heretofore, transgender) and (2) individuals who have differences in sex development (DSD). Although these are largely disparate groups, there is overlap in the medical expertise necessary to care for individuals with both gender and sex diversity. In addition, both groups face potential infertility or sterility as a result of desired medical and surgical therapies. The Ann & Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) gender and sex development program (GSDP) provides specialized multidisciplinary …

Does Aerobic Exercise During Pregnancy Prevent Cesarean Sections?, Kait Lassen

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aerobic exercise in pregnant women prevents cesarean sections (“C-sections”).

STUDY DESIGN: Review of two English articles and one English/Portuguese article, two of which were randomized control trials (RCTs) and one was a prospective study, all published after 2011.

DATA SOURCES: Two RCTs and one prospective study found via PubMed and Cochrane Database.

OUTCOMES MEASURED: The main clinical outcome in all studies measured the incidence of C-section as compared to vaginal delivery. The outcomes were measured by method of delivery which was categorized as either vaginally or …