Medical Specialties Commons^™

Fetal Sex Impacts Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For Regulatory Mechanisms, Bryan S. Richardson, Akasham Rajagopaul, Barbra De Vrijer, Genevieve Eastabrook, Timothy R.H. Regnault

Obstetrics & Gynaecology Publications

Background: We determined the effect of fetal sex on birth/placental weight and umbilical vein and artery oxygen values with implications for placental efficiency and regulatory mechanisms underlying fetal–placental growth differences. Methods: A hospital database was used to obtain birth/placental weight, cord PO2 and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA > 34 weeks (N = 69,836). Oxygen saturation was calculated from the cord PO2 and pH data, while fractional O2 extraction was calculated from the oxygen saturation data. The effect of fetal sex on birth/placental weight, cord PO2, O2 saturation, and fractional O2 …

Expression And Localization Of Nrf2/Keap1 Signalling Pathway Genes In Mouse Preimplantation Embryos Exposed To Free Fatty Acids., Grace Dionne, Michele D. Calder, Dean H Betts, Basim Abu Rafea, Andrew J Watson

Obstetrics & Gynaecology Publications

Obese women experience greater incidence of infertility, with reproductive tracts exposing preimplantation embryos to elevated free fatty acids (FFA) such as palmitic acid (PA) and oleic acid (OA). PA treatment impairs mouse preimplantation development in vitro, while OA co-treatment rescues blastocyst development of PA treated embryos. In the present study, we investigated the effects of PA and OA treatment on NRF2/Keap1 localization, and relative antioxidant enzyme (Glutathione peroxidase; Gpx1, Catalase; Cat, Superoxide dismutase; Sod1 and γ-Glutamylcysteine ligase catalytic unit; Gclc) mRNA levels, during in vitro mouse preimplantation embryo development. Female mice were superovulated, mated, and embryos cultured in the presence …

Ecological Interchangeability: Supporting Team Adaptive Expertise In Moments Of Disruption, Sayra Cristancho, Emily Field, Lorelei Lingard, Taryn Taylor, Kathryn Hibbert, Graham Thompson, William Hibbert

Obstetrics & Gynaecology Publications

While undesirable, unexpected disruptions offer unique opportunities to enact adaptive expertise. For adaptive expertise to flourish, individuals and teams must embrace both efficiency and adaptation. While some industries do it readily, others continue to struggle with the tension between efficiency and adaptation, particularly when otherwise stable situations are unexpectedly disrupted. For instance, in healthcare settings, the efficiency mandate for strict compliance with scopes of practice can deter teams from using the adaptive strategy of making their members interchangeable. Yet, interchangeability has been hinted as a key capacity of today’ teams that are required to navigate fluid team structures. Because interchangeability …

Facing Hierarchy: A Qualitative Study Of Residents' Experiences In An Obstetrical Simulation Scenario, Adam B Garber, Glenn Posner, Taylor Roebotham, M Dylan Bould, Taryn Taylor

Obstetrics & Gynaecology Publications

BACKGROUND: Residents in surgical specialties face a steep hierarchy when managing medical crises. Hierarchy can negatively impact patient safety when team members are reluctant to speak up. Yet, simulation has scarcely been previously utilized to qualitatively explore the way residents in surgical specialities navigate this challenge. The study aimed to explore the experiences of residents in one surgical specialty, obstetrics and gynecology (Ob/Gyn), when challenging hierarchy, with the goal of informing future interventions to optimize resident learning and patient safety.

METHODS: Eight 3rd- and 4th-year Ob/Gyn residents participated in a simulation scenario in which their supervising physician made an erroneous …

Highlighting The Mechanistic Relationship Between Perinatal Depression And Preeclampsia: A Scoping Review, Mei Yuan, Samantha Bedell, Barbra De Vrijer, Genevieve Eastabrook, Jefferson C. Frisbee, Stephanie J. Frisbee

Obstetrics & Gynaecology Publications

Background: Although there is scientific literature supporting an association between depression and preeclampsia (PE), little is known about the underlying mechanistic pathways that may explain these observed associations. Thus, this study aimed to outline the relationship between depression and PE, and to highlight the underlying cardiovascular and metabolic risk factors that are common to both. Methods: A scoping review of the literature was conducted in Medline, Scopus, and Web of Science. Results: From 706 articles initially identified, 23 articles met the inclusion criteria and were included in this review. Although some studies reported a positive association between PE and postpartum …

Role Of Decorin At The Fetal-Maternal Interface, Chidambra D. Halari

Electronic Thesis and Dissertation Repository

The human placenta is an invasive tumor-like structure, this invasion being physiological. A subset of placental trophoblast called extra-villous trophoblast invades the uterine decidua and remodels uterine arteries into low-resistance, high-flow tubes to permit adequate flow of maternal blood to nourish the fetus. A poor extra-villous trophoblast invasion and uterine arterial remodeling can lead to fetal growth restriction and a serious pregnancy-associated maternal disease preeclampsia. Decorin, a leucine-rich proteoglycan produced by uterine decidual cells restrains multiple trophoblast functions: self-renewal and differentiation of trophoblast stem cells, migration, invasion, proliferation and endovascular differentiation. Additionally, decidual overproduction of decorin was associated with preeclampsia, …

The Molecular Mechanisms Of Hepatic Mitochondrial Dysfunction In Growth-Restricted Offspring With Hyperlipidemia, Shelby L. Oke

Electronic Thesis and Dissertation Repository

Intrauterine growth restriction (IUGR) is a pathological condition characterized by low birth weight and poor organ development. Growth of the fetal liver is often compromised at the expense of other vital organs, thereby leading to hepatic dyslipidemia in the affected offspring. As such, epidemiological studies suggest an inverse relationship between birth weight and long-term metabolic health, while the occurrence of postnatal catch-up growth can exacerbate this relationship. Animal studies have shown that IUGR offspring exhibit impaired mitochondrial function, which likely contributes to the later development of metabolic pathologies. That said, the molecular mechanisms by which mitochondria are affected remain unknown. …

"Maybe I'M Not That Approachable": Using Simulation To Elicit Team Leaders' Perceptions Of Their Role In Facilitating Speaking Up Behaviors, Rachael Pack, Lauren Columbus, Trevor Hines Duncliffe, Harrison Banner, Priyanka Singh, Natashia Seemann, Taryn Taylor

Obstetrics & Gynaecology Publications

BACKGROUND: Simulation research that seeks to solve the problem of silence among interprofessional teams has focused almost exclusively on training subordinate team members to be more courageous and to speak up to team leaders using direct challenge scripts despite the great interpersonal cost. Consequently, the existing literature overemphasizes the responsibility of subordinate team members for speaking up and fails to consider the role and responsibilities of team leaders in sustaining silence. The purpose of this study is to identify and describe the subtle behaviors and actions of team leaders that both promote and discourage speaking up.

METHODS: This study used …

Gestational Age Impacts Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For The Fetal Oxygen Margin Of Safety, Bryan S Richardson, Barbra De Vrijer, Hilary K Brown, Larry Stitt, Sheryl Choo, Timothy R H Regnault

Obstetrics & Gynaecology Publications

Background: We determined the impact of gestational age (GA) from near term to term to post-term on birth/placental weight ratio and cord oxygen values with implications for placental transport efficiency for oxygen, fetal O2 consumption relative to delivery or fractional O2 extraction, and oxygen margin of safety.

Materials and methods: A hospital database was used to obtain birth/placental weight ratios, cord PO2 and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA > 34 completed weeks (N=69,852). Oxygen saturation was calculated from the cord PO2 and pH data, while fractional O2 extraction was calculated from …