Medical Specialties Commons^™

Effects Of American Ginseng On Preimplantation Development And Pregnancy In Mice., Danyka Belanger, Michele D Calder, Alessandra Gianetto-Berruti, Edmund M Lui, Andrew J Watson, Valter Feyles

Obstetrics & Gynaecology Publications

In North America, a high proportion of pregnant women use herbal medications including North American ginseng. This medicinal plant contains high amounts of triterpene saponins (ginsenosides), which are the main bioactive compounds. It is important to assess ginseng's impact on all reproductive functions to ensure the safety of pregnant women and fetuses. In this study, we defined the concentration-responsive effects of North American alcoholic and aqueous ginseng extracts on preimplantation development in vitro and on pregnancy and post-partum development in the mouse. Two-cell mouse embryos were cultured with 5 different concentrations of whole ginseng root extracts, or ginsenosides Rb1, Rg1 …

Tricurin, A Novel Formulation Of Curcumin, Epicatechin Gallate, And Resveratrol, Inhibits The Tumorigenicity Of Human Papillomaviruspositive Head And Neck Squamous Cell Carcinoma, Longzhu Piao, Sumit Mukherjee, Qing Chang, Xiujie Xie, Hong Li, Mario R. Castellanos, Probal Banerjee, Hassan Iqbal, Ryan Ivancic, Xueqian Wang, Theodoros N. Teknos, Quintin Pan

Publications and Research

Head and neck squamous cell carcinoma (HNSCC) is the sixth most prevalent cancer worldwide with about 600,000 new cases diagnosed in the last year. The incidence of human papillomavirus-positive head and neck squamous cell carcinoma (HPV-positive HNSCC) has rapidly increased over the past 30 years prompting the suggestion that an epidemic may be on the horizon. Therefore, there is a clinical need to develop alternate therapeutic strategies to manage the growing number of HPV-positive HNSCC patients. TriCurin is a composition of three food-derived polyphenols in unique stoichiometric proportions consisting of curcumin from the spice turmeric, resveratrol from red grapes, and …

Gestational Hormone Profiles Predict Human Maternal Behavior At 1-Year Postpartum, Laura M. Glynn, Elyssia Poggi Davis, Curt A. Sandman, Wendy A. Goldberg

Psychology Faculty Articles and Research

In many non-human species, including primates, gestational reproductive hormones play an essential role in the onset of maternal motivation and behaviors. We investigated the associations between prepartum estradiol and progesterone and maternal behavior at 1-year postpartum in 177 women. Blood was obtained at five gestational time points and an index of quality of maternal care was determined using a well-validated mother-child interaction protocol. Women who exhibited higher quality maternal care at 1-year postpartum were characterized by unique gestational profiles of estradiol, progesterone and the estrogen to progesterone ratio; specifically by slower accelerations and levels of these hormone trajectories beginning in …

P66shc, A Key Regulator Of Metabolism And Mitochondrial Ros Production, Is Dysregulated By Mouse Embryo Culture., Nicole A Edwards, Andrew J Watson, Dean H Betts

Obstetrics & Gynaecology Publications

STUDY QUESTION: Do high oxygen tension and high glucose concentrations dysregulate p66Shc (Src homologous-collagen homologue adaptor protein) expression during mouse preimplantation embryo culture?

SUMMARY ANSWER: Compared with mouse blastocysts in vivo, P66Shc mRNA and protein levels in blastocysts maintained in vitro increased under high oxygen tension (21%), but not high glucose concentration.

WHAT IS KNOWN ALREADY: Growth in culture adversely impacts preimplantation embryo development and alters the expression levels of the oxidative stress adaptor protein p66Shc, but it is not known if p66Shc expression is linked to metabolic changes observed in cultured embryos.

STUDY DESIGN, SAMPLES/MATERIALS, METHODS: We used a …

Caesarean Section Surgical Techniques: All Equally Safe, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Since 1985, a caesarean section rate of 10–15% has been deemed optimum by the international health-care community.1 When caesarean section rates rise towards 10% across a population, maternal and newborn deaths decrease; when they are higher than 15%, there is no evidence of reduced mortality.1 Complications of caesarean sections can be substantial and sometimes permanent for both mothers and babies, and can result in disability or death, especially in settings with inadequate facilities or capacity to undertake safe surgery and treat surgical complications.

‘Essential But Not Always Available When Needed’ – An Interview Study Of Physicians’ Experiences And Views Regarding Use Of Obstetric Ultrasound In Tanzania, Annika Åhman, Hussein Kidanto, Matilda Ngarina, Kristina Edvardsson, Rhonda Small, Ingrid Mogren

Faculty of Health Sciences, East Africa

Background The value of obstetric ultrasound in high-income countries has been extensively explored but evidence is still lacking regarding the role of obstetric ultrasound in low-income countries.

Objective We aimed to explore experiences and views among physicians working in obstetric care in Tanzania, on the role of obstetric ultrasound in relation to clinical management.

Design A qualitative study design was applied. Data were collected in 2015, through 16 individual interviews with physicians practicing in obstetric care at hospitals in an urban setting in Tanzania. Data were analyzed using qualitative content analysis.

Results Use of obstetric ultrasound in the management of …

Important Strategies For Effective Family Planning Counseling, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

No abstract provided.

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Antenatal Glucocorticoid Treatment Is Associated With Diurnal Cortisol Regulation In Term-Born Children, M. N. Edelmann, Curt A. Sandman, Laura M. Glynn, D. A. Wing, Elyssia Poggi Davis

Psychology Faculty Articles and Research

Due to the rapid developmental changes that occur during the fetal period, prenatal influences can affect the developing central nervous system with lifelong consequences for physical and mental health. Glucocorticoids are one of the proposed mechanisms by which fetal programing occurs. Glucocorticoids pass through the blood-brain barrier and target receptors throughout the central nervous system. Unlike endogenous glucocorticoids, synthetic glucocorticoids readily pass through the placental barrier to reach the developing fetus. The synthetic glucocorticoid, betamethasone, is routinely given prenatally to mothers at risk for preterm delivery. Over 25% of the fetuses exposed to betamethasone will be born at term. Few …

Direct Reprogramming To Multipotent Trophoblast Stem Cells, And Is Pluripotency Needed For Regenerative Medicine Either?, Yu Yang, Graham C. Parker, Elizabeth E. Puscheck, Daniel A. Rappolee

Department of Obstetrics and Gynecology Research Publications

No abstract provided.

Urethral Solitary Fibrous Tumor: A Rare Pathologic Diagnosis Of A Periurethral Mass, Gaby N. Moawad, Elias Abi Khalil, Cheryl Silverbrook, Stephanie Barak, Alice Semerjian, Michael Phillips

Obstetrics and Gynecology Faculty Publications

Solitary fibrous tumors (SFTs) may occur at any site in the body. SFTs can only be conclusively diagnosed based on histopathologic and immunohistochemical characteristics of the tumor. The presence of SFTs in the abdomen and pelvis is extremely rare. To our knowledge no cases of urethral solitary fibrous tumor in the literature have been reported so far. We present a case of a solitary fibrous tumor arising from the urethra in a twenty-three-year-old female presenting with vaginal mass.

Flibanserin Approval: Facts Or Feelings?, James A. Simon, Irwin Goldstein, Noel Kim, Murray Freedman, Sharon Parish

Obstetrics and Gynecology Faculty Publications

No abstract provided.

Probability Of Fallopian Tube And Ovarian Detection With Transvaginal Ultrasonography In Normal Women, Jason R. Lefringhouse, Erin Neward, Frederick R. Ueland, Lauren A. Baldwin, Rachel W. Miller, Christopher P. Desimone, Richard J. Kryscio, John R. Van Nagell, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

Objective: Some ovarian malignancies may originate in the fallopian tube. The feasibility of ultrasonographically visualizing the fallopian tube is presented. Methods: In total, 549 normal women participated in the fallopian tube visualization trial, while ovarian visualization was studied in 43,521. Chi-square analysis, t-tests and multivariate analysis determined significance and interactions. Results: Ovaries were observed in 82.7% while fallopian tubes were detected in 77.2% of women and 85.2% of the time when an ovary was detected. Age, BMI or parity was not significantly different when one or both fallopian tubes were visualized. Elevated BMI had slightly greater influence …

Factors Associated With Uptake Of Visual Inspection With Acetic Acid (Via) For Cervical Cancer Screening In Western Kenya, Elkanah Omenge, Juddy Wachira, Fredrick Chite Asirwa, Naftali Busakhala, Violet Naanyu, Job Kisuya, Grieven Otieno, Alfred Keter, Ann Mwangi, Thomas Inui

Obstetrics and Gynaecology, East Africa

Purpose: Cervical cancer screening has been successful in reducing the rates of cervical cancer in developed countries, but this disease remains the leading cause of cancer deaths among women in sub-Saharan Africa. We sought to understand factors associated with limited uptake of screening services in our cervical cancer-screening program in Western Kenya.

Participants and Methods: Using items from a previously validated cancer awareness questionnaire repurposed for use in cervical cancer and culturally adapted for use in Kenya, we interviewed 2,505 women aged 18–55 years receiving care in gynecology clinics or seeking other services in 4 health facilities in Western Kenya …

Partner Interfering Behaviors Affecting Cancer Quality Of Life, Ann L. Coker, Diane R. Follingstad, Lisandra S. Garcia, Heather M. Bush

Obstetrics and Gynecology Faculty Publications

Objective: Because partners are an important and unpaid resource in cancer care, understanding how destructive, controlling or interfering partner behaviors influence women's cancer care may be particularly relevant for health care providers seeking to provide cancer care and enhance recovery. Using a new measure of partner interfering behaviors in cancer care (PIB-C), we investigated whether women with a recent cancer diagnosis who additionally endorsed any PIB-C would report (a) more symptoms of depression and stress, and (b) lower Functional Assessment of Cancer Therapy (FACT-G) and lower Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale scores indicating poorer quality of …

Modern Contraceptive Use Among Migrant And Non-Migrant Women In Kenya, Rhoune Ochako, Ian Askew, Jerry Okal, John Oucho, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Manifest socio-economic differences are a trigger for internal migration in many sub-Saharan settings including Kenya. An interplay of the social, political and economic factors often lead to internal migration. Internal migration potentially has significant consequences on an individual’s economic growth and on access to health services, however, there has been little research on these dynamics. In Kenya, where regional differentials in population growth and poverty reduction continue to be priorities in the post MDG development agenda, understanding the relationships between contraceptive use and internal migration is highly relevant.

Methods: Using data from the 2008–09 Kenya Demographic and Health Survey …

A Novel Point-Of-Care Testing Strategy For Sexually Transmitted Infections Among Pregnant Women In High-Burden Settings: Results Of A Feasibility Study In Papua New Guinea, Steven G. Badman, Lisa M. Vallely, Pamela Toliman, Grace Kariwiga, Bomesina Lote, William Pomat, Caroline Holmer, Rebecca Guy, Stanley Luchters, Chris Morgan

Population Health, East Africa

Background: Sexually transmitted and genital infections in pregnancy are associated with an increased risk of adverse maternal and neonatal health outcomes. High prevalences of sexually transmitted infections have been identified among antenatal attenders in Papua New Guinea. Papua New Guinea has amongst the highest neonatal mortality rates worldwide, with preterm birth and low birth weight major contributors to neonatal mortality. The overall aim of our study was to determine if a novel point-of-care testing and treatment strategy for the sexually transmitted and genital infections Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) in pregnancy is …

Maternal Inflammatory Markers In The Diagnosis Of Chorioamnionitis And Prediction Of Neonatal Sepsis In Preterm Pre-Labour Rupture Of Membranes: A Systematic Review, Angela Koech Etyang

Master of Medicine in Obstetrics and Gynecology

Background: There is no consensus on the potential role of inflammatory markers in identifying chorioamnionitis in women with Preterm Pre-labour Rupture of Membranes (PPROM) or in predicting Early Onset Neonatal Sepsis (EONS) in their neonates. Objectives: To perform a quantitative review on the accuracy of maternal C reactive protein (CRP), Procalcitonin (PCT) and Interleukin 6 (IL6) in the diagnosis of Histological Chorioamnionitis and/or Funisitis (HCA/Funisitis) and their role in the prediction of EONS in PPROM. Methods: MEDLINE, EMBASE and The Cochrane Library databases were searched from inception to October 2015, for studies where these markers were assessed against a reference …

Severity And Clustering Of Menopausal Symptoms Among Obese And Nonobese Postmenopausal Women In India, E. S. Sharanya Shre, Kate Trout, Sonia Pant Singh, Awnish Kumar Singh, Surapaneni Krishna Mohan, Ashish Joshi

Publications and Research

Background: The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India.

Methodology: The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross‑sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal …

Association Of 24-32wk Maternal Triglyceride Levels And Neonatal Birth Weight At The Aga Khan University Hospital, Demetrius Mududa Omondi

Master of Medicine in Obstetrics and Gynecology

Introduction: The association of neonatal birth weight and mid-term maternal lipid levels has been demonstrated in several studies with elevated serum triglyceride levels shown to be a strong predictor of the large for gestational age baby/ fetal macrosomia. Maternal diabetes remains the strongest risk factor for developing a LGA/macrosomic baby explained by the Pederson hypothesis. However non-diabetic macrosomia is still an obstetric dilemma with the attendant fetal and maternal complications. This phenomenon could be explained by altered maternal lipid metabolism as lipids have been shown to be important for normal fetal growth and development. Objective: Our primary objective was to …

Interventions For Treating Hyperemesis Gravidarum., Rupsa Boelig, Samantha J Barton, Gabriele Saccone, Anthony J Kelly, Steve J Edwards, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy affecting 0.3% to 1.0% of pregnancies, and is one of the most common indications for hospitalization during pregnancy. While a previous Cochrane review examined interventions for nausea and vomiting in pregnancy, there has not yet been a review examining the interventions for the more severe condition of hyperemesis gravidarum.

OBJECTIVES: To assess the effectiveness and safety, of all interventions for hyperemesis gravidarum in pregnancy up to 20 weeks' gestation.

SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's …

Characterization And Small Rna Content Of Extracellular Vesicles In Follicular Fluid Of Developing Bovine Antral Follicles., Raphatphorn Navakanitworakul, Wei-Ting Hung, Sumedha Gunewardena, John S. Davis, Wilaiwan Chotigeat, Lane K. Christenson

Journal Articles: Obstetrics & Gynecology

Exosomes and microvesicles (i.e., extracellular vesicles: EVs) have been identified within ovarian follicular fluid and recent evidence suggests that EVs are able to elicit profound effects on ovarian cell function. While existence of miRNA within EVs has been reported, whether EV size and concentration as well as their cargos (i.e., proteins and RNA) change during antral follicle growth remains unknown. Extracellular vesicles isolated from follicular fluid of small, medium and large bovine follicles were similar in size, while concentration of EVs decreased progressively as follicle size increased. Electron microscopy indicated a highly purified population of the lipid bilayer enclosed vesicles …

The Global Strategy For Women's, Children's And Adolescents' Health (2016-2030): A Roadmap Based On Evidence And Country Experience., Shyama Kuruvilla, Flavia Bustreo, Taona Kuo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The Global strategy for women’s, children’s and adolescents’ health (2016–2030) provides a roadmap for ending preventable deaths of women, children and adolescents by 2030 and helping them achieve their potential for and rights to health and well-being in all settings.1 The global strategy has three objectives: survive (end preventable deaths); thrive (ensure health and well-being); and transform (expand enabling environments). These objectives are aligned with 17 targets within nine of the sustainable development goals (SDGs),2 including SDG 3 on health and other SDGs related to the political, social, economic and environmental determinants of health and sustainable development.

Like the SDGs, …

Pessary Versus Cerclage Versus Expectant Management For Cervical Dilation With Visible Membranes In The Second Trimester., Alexis C. Gimovsky, Anju Suhag, Amanda Roman, Burton L. Rochelson, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: We evaluated pessary for dilated cervix and exposed membranes for prolonging pregnancy compared to cerclage or expectant management.

METHODS: Multicenter retrospective cohort study of women, 15-24 weeks, singleton pregnancies, dilated cervix ≥2 cm and exposed membranes. Women received pessary, cerclage or expectant management. Primary outcome was gestational age (GA) at delivery. Secondary outcomes were time until delivery, preterm premature rupture of membranes (PPROM) and neonatal survival.

RESULTS: About 112 women met study criteria; 9 - pessary, 85 - cerclage and 18 - expectant management. Mean GA at delivery was 22.9 ± 4.5 weeks with pessary, 29.2 ± 7.5 weeks …

A Medical Malpractice Trial Where The Residents And Faculty Are The Judge And The Jury, Kelly A. Rabah

Obstetrics and Gynecology Faculty Publications

At the conclusion of this session, the learner should be able to:

• Name 3- 5 of the most common reasons for a medical malpractice claim

• Describe and compare negligence, types of error, and recklessness

• Explain 3-5 steps that should be taken to minimize risk for a malpractice suit

• Discuss the emotional toll that litigation causes and the personal and professional risks that may result

Characterization Of Bacterial Pathogens Involved In Aerobic Vaginitis: Prevalence, Strain Characterization And Sequelae, Leslie A. Lafferty

Graduate School of Biomedical Sciences Theses and Dissertations

Aerobic vaginitis (AV) is a more recently defined infection that involves aerobic pathogenic bacteria that replace the normal flora of the vaginal tract. It is commonly mistaken for other vaginal infections, such as bacterial vaginosis (BV), because they share many common symptoms. AV leads to complications during pregnancy, such as premature delivery and amnion infection, and is diagnosed by indications that range from vaginal discharge to inflammation. Because this infection is difficult to diagnose differentially from other vaginal infections, it is important to determine what pathogens are involved in AV so that we may have the ability to detect them. …

Intimate Partner Violence In Early Adolescence: The Role Of Gender, Socioeconomic Factors And The School, A. J. Mason-Jones, P De Koker, S. M. Eggers, Marleen Temmerman, E. Leye, P. J De Vries, H De Vries

Obstetrics and Gynaecology, East Africa

Background: Intimate partner violence (IPV) among adolescents is common worldwide, but our understanding of perpetration, gender differences and the role of social-ecological factors remains limited.

Objectives: To explore the prevalence of physical and sexual IPV perpetration and victimisation by gender, and associated risk and protective factors.

Methods: Young adolescents (N=2 839) from 41 randomly selected public high schools in the Western Cape region of South Africa (SA), participating in the PREPARE study, completed a self-administered questionnaire.

Results: The participants’ mean age was 13.65 years (standard deviation 1.01), with 19.1% (541/2 839) reporting being victims/survivors of IPV and 13.0% (370/2 839) …

Effect Of Body Mass Index On Outcome Of Labour Induction, Farheen Yousuf, Tahira Naru, Sana Sheikh

Department of Obstetrics & Gynaecology

The retrospective study to explore the adverse effect of obesity on pregnancy and labour was conducted at Aga Khan University Hospital, Karachi, Pakistan, and comprised data of all patients booked between 12-14 weeks and required induction of labour from January 1 to December 31, 2012. Women were grouped into two body mass index categories: normal weight (23 kg/m2). Obesity increased the risk of development of gestational hypertension and diabetes. Therefore obese women were more likely to be induced due to medical indication whether primiparous or multiparous adjusted odds ratio =2.89(95% confidence interval 1.29-6.48) and 2.77 (95% confidence interval 1.07-7.19) respectively. …

Positive Deviance, Contraceptive Self-Efficacy And Social Desirability In Sexually Active Adolescent Females : A Mixed Methods Approach., Ashley D. Miller

Electronic Theses and Dissertations

Unintended pregnancy is an issue that impacts women of all ages, ethnicities, and socioeconomic statuses. It also impacts the child that results and the society in which they live. In the United States, adolescents experience unintended pregnancy more than adolescents in other countries. The purpose of this dissertation was to explore the factors that contribute to successful contraceptive use among adolescent females (ages 13-18) seeking reproductive health services at a local family planning clinic. The theoretical framework of contraceptive self-efficacy (CSE) was used to frame this understanding. The exploration was conducted in three ways: a critical review of the literature …

Nipt Results Indicative Of Maternal Neoplasms: Genetic Counselors' Preferences And Attitudes, Meagan E. Giles

Dissertations and Theses (Open Access)

Performing non-invasive prenatal testing (NIPT) on a pregnant woman with a chromosomally abnormal neoplasm may incidentally lead to the diagnosis of cancer due to the coexistence of circulating tumor and placental DNA. Published information regarding NIPT’s accuracy for neoplasm screening is limited, and guidance for patient management is currently lacking. This challenges clinicians’ ability to counsel patients regarding the implications of these results, which often is the responsibility of a genetic counselor. Over three hundred board-eligible/certified genetic counselors were surveyed regarding their awareness, preferences, and attitudes towards NIPT’s ability to indicate maternal neoplasms. Despite 95% of this cohort being aware …