Medical Specialties Commons^™

Biomarkers For Placental Abnormality, Cathal Mccarthy

Doctoral

Obstetrical complications including recurrent miscarriage, pre-eclampsia and intrauterine growth restriction (IUGR) affect 1%-5% of pregnant women (Younis and Samueloff 2003). Dysfunctional trophoblasts, impaired development of spiral arteries, imbalance in systems controlling the dilation and contraction of spiral arteries, placental fibrin clots and intervillous thrombosis are all possible factors that can result in an insufficient placental circulation. The combination of the hypercoagulable state of pregnancy and presence of genetic thrombophilic markets has the potential to induce placental thrombosis and cause placental insufficiency with subsequent obstetrical complications. The initial part of the research work involved examining the relationship between four common genetic …

Signs And Symptoms Of Urethritis And Cervicitis Among Women With Or Without Mycoplasma Genitalium Or Chlamydia Trachomatis Infection, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Joris Delanghe, Leen Van Simaey, Catharine De Ganck, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme.

Methods: A cross sectional study among female STD clinic attendees in Örebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis.

Results: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% …

Rgs14 Is A Mitotic Spindle Protein Essential From The First Division Of The Mammalian Zygote., Luke Martin-Mccaffrey, Francis S Willard, Antonio J Oliveira-Dos-Santos, David R C Natale, Bryan E Snow, Randall J Kimple, Agnieszka Pajak, Andrew J Watson, Lina Dagnino, Josef M Penninger, David P Siderovski, Sudhir J A D'Souza

Obstetrics & Gynaecology Publications

Heterotrimeric G protein alpha subunits, RGS proteins, and GoLoco motif proteins have been recently implicated in the control of mitotic spindle dynamics in C. elegans and D. melanogaster. Here we show that "regulator of G protein signaling-14" (RGS14) is expressed by the mouse embryonic genome immediately prior to the first mitosis, where it colocalizes with the anastral mitotic apparatus of the mouse zygote. Loss of Rgs14 expression in the mouse zygote results in cytofragmentation and failure to progress to the 2-cell stage. RGS14 is found in all tissues and segregates to the nucleus in interphase and to the mitotic spindle …

Effectiveness Of Early Pregnancy Ultrasound In Diagnosing Fetal Abnormalities In High Risk Women, S Munim, N Khowaja

Department of Obstetrics & Gynaecology

Objective: To assess the efficacy of 11-14 weeks ultrasound in the diagnosis of fetal abnormalities in high risk women.
Methods: Prospective study conducted at a teaching hospital in Karachi, Pakistan. One hundred ultrasound (mini-anomaly) scans were performed on 97 high-risk women, between 11-14 weeks of gestation.
Results: The most common indication for the ultrasound scan in the study, was previous history of structural or chromosomal abnormalities (40%) followed by advanced maternal age (22%). Out of 100 ultrasounds performed, two were found to have structural abnormalities at the time of mini-anomaly scan performed at 11-14 weeks. None of the ultrasound scans …

Knowledge And Awareness Of Pregnant Women About Ultrasounsd Scanning And Prenatal Diagnosis, S Munim, N A. Khawaja, R Qureshi

Department of Obstetrics & Gynaecology

Objective: Antenatal screening and ultrasound scan has become an integral part of the antenatal care in the present time. The aim of this study is to accurately describe the background knowledge and awareness of pregnant women about ultrasound scan and prenatal diagnosis.
Methods: It is a clinic based cross sectional study. Four hundred women, attending the antenatal clinics, were asked to fill in a pre tested structured questionnaire. Different variables of interest were collected. Statistical Program for the social sciences (SPSS) was used for the data management.
Results: Over 93.5% of the women were aware that ultrasound examination is an …

Maternal Anaemia And Its Impact On Perinatal Outcome In A Tertiary Care Hospital In Pakistan, F W. Lone, R N. Qureshi, F Emmanuel

Department of Obstetrics & Gynaecology

Maternal anaemia is a common problem in pregnancy, particularly in developing countries. We investigated the relationship between maternal anaemia and perinatal outcome in a cohort of 629 pregnant women from October 2001 to 2002. Of these, 313 were anaemic (haemoglobin < 11 g/L). Perinatal outcomes included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low Apgar scores and intrauterine fetal death. Univariate and multivariate analyses were performed. The risk of preterm delivery and low birth weight among the anaemic women was 4 and 1.9 times more respectively than the non-anaemic women. The neonates of anaemic women also had 1.8 times increased risk having low Apgar scores at 1 minute and there was a 3.7 greater risk of intrauterine fetal death among the anaemic women than the non-anaemic women.

First Trimester Diagnosis Of Meckel Gruber Syndrome In Pregnancy, S Munim, S Nadeem, R Sikandar

Department of Obstetrics & Gynaecology

No abstract provided.

Deletion Of The Na/K-Atpase Alpha1-Subunit Gene (Atp1a1) Does Not Prevent Cavitation Of The Preimplantation Mouse Embryo., L C Barcroft, A E Moseley, J B Lingrel, A J Watson

Obstetrics & Gynaecology Publications

Increases in Na/K-ATPase activity occur concurrently with the onset of cavitation and are associated with increases in Na(+)-pump subunit mRNA and protein expression. We have hypothesized that the alpha1-isozyme of the Na/K-ATPase is required to mediate blastocyst formation. We have tested this hypothesis by characterizing preimplantation development in mice with a targeted disruption of the Na/K-ATPase alpha1-subunit (Atp1a1) using embryos acquired from matings between Atp1a1 heterozygous mice. Mouse embryos homozygous for a null mutation in the Na/K-ATPase alpha1-subunit gene are able to undergo compaction and cavitation. These findings demonstrate that trophectoderm transport mechanisms are maintained in the absence of the …

P38 Mapk Signaling During Murine Preimplantation Development., David R Natale, Andrew J M Paliga, Frank Beier, S J A D'Souza, Andrew J Watson

Obstetrics & Gynaecology Publications

Mitogen-activated protein kinase (MAPK) pathways mediate some important cellular processes and are likely to also regulate preimplantation development. The role of p38 MAP kinase signaling during murine preimplantation development was investigated in the present study. p38 MAPK, p38-regulated or -activated kinase (PRAK; MK5), map kinase-activated protein kinase 2 (MK2), and heat shock protein 25 (hsp25) mRNAs and proteins were detected throughout preimplantation development. Two-cell stage embryos cultured in the presence of SB220025 and SB203580 (specific inhibitors of p38 MAPK alpha/beta), progressed to the eight-cell stage with the same frequency as controls; however, treated embryos halted their development at the 8- …

Serine-Threonine Kinases And Transcription Factors Active In Signal Transduction Are Detected At High Levels Of Phosphorylation During Mitosis In Preimplantation Embryos And Trophoblast Stem Cells, Jian Liu, Elizabeth E. Puscheck, Fangfei Wang, Anna Trostinskaia, Dusan Barisic, Gordon Maniere, Dana Wygle, W Zhong, Edmond Hhm Rings, Daniel A. Rappolee

Department of Obstetrics and Gynecology Research Publications

Serine-threonine kinases and transcription factors play important roles in the G1-S phase progression of the cell cycle. Assays that use quantitative fluorescence by immunocytochemical means, or that measure band strength during Western blot analysis, may have confused interpretations if the intention is to measure G1-S phase commitment of a small subpopulation of phosphorylated proteins, when a larger conversion of the same population of proteins can occur during late G2 and M phases. In mouse trophoblast stem cells (TSC), a human placental cell line (HTR), and/or mouse preimplantation embryos, 8/19 ser- ine-threonine and tyrosine kinases, 3/8 transcription factors, and 8/14 phospho …

Uwomj Volume 73, No. 1, 2004, Western University

University of Western Ontario Medical Journal

Schulich School of Medicine & Dentistry

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Human Chorionic Gonadotropin Administration Is Associated With High Pregnancy Rates During Ovarian Stimulation And Timed Intercourse Or Intrauterine Insemination, Mohamed F. Mitwally, Sonya Abdel-Razeq, Robert F. Casper

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods

Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and …

Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan

Reproductive Health

CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.

Experience From A Community-Based Education Program In Burkina Faso: The Tostan Program, Djingri Ouoba, Zakari Congo, Nafissatou J. Diop, Molly Melching, Baya Banza, Georges Guiella, Inge Baumgarten

Reproductive Health

This study describes a project that tested the feasibility and effectiveness of replicating the village empowerment program (VEP) developed by the Senegalese NGO, TOSTAN, in Burkina Faso. Although originally developed for empowering women, the program implemented in Burkina Faso also involved men because of their key role in such decisions. Frontiers in Reproductive Health, with funding from USAID and the GTZ Supra Regional Project for the Elimination of FGC, supported the adaptation, implementation, and evaluation of the VEP model in 23 villages in the province of Bazega/Zoundwéogo. In the existing social climate among the Burkinabé, where there is widespread awareness …

Medicalization Of Female Genital Cutting Among The Abagusii In Nyanza Province, Kenya, Carolyne Njue, Ian Askew

Reproductive Health

This study sought to understand the role that health providers play in the medicalization of female genital cutting (FGC) among the Abagusii community in western Kenya, among whom the practice continues to be almost universal. Interviews with service providers and their clients revealed an overwhelming belief that FGC fulfills a traditional cultural obligation among the Abagusii, and that it limits a woman’s sexual desire and confers respect on girls. New approaches are needed within this community to present FGC as violating human rights and national laws, as well as threatening girls’ and women’s health. The study recommends measures such as …

Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Social programs need to balance volume (coverage) and income (sustainability). The law of supply and demand states that we can not obtain coverage and support at the same time, because when prices rise, demand decreases. This manual presents willingness-to-pay (WTP) surveys that allow program managers to simulate changes in demand related to price, without actually changing prices. The Population Council, with The Futures Group International, developed these surveys that can be used for existing and new products and services, collect responses from clients with no formal education with sensitivity to their individual characteristics, and provide conservative estimates that accurately predict …

Female Circumcision In Indonesia. Extent, Implications And Possible Interventions To Uphold Women's Health Rights, Meiwita P. Budiharsana, Lila Amaliah, Budi Utomo

Reproductive Health

In Indonesia, the practice of female circumcision (FC) has long existed, but information concerning where and how it is carried out has been limited. The specific aims of the study conducted by the Population Council Jakarta were to provide research-based information on FC customary practices and their socio-cultural determinants, and if possible, to assess any long-term physical and psychological consequences. Study findings indicate that in general Muslim communities support the continuation of FC practice, because they perceive it as both a societal custom and a religious duty. The report strongly recommends that key donor agencies pressure the Ministry of Health …

Congenital Duodenal Diaphragm In Eight Children, Akhtar Nawaz, Hilal Matta, Alic Jacobsz, Omar Trad, Ahmed H. Al Salem

Department of Obstetrics & Gynaecology

Background: Congenital duodenal obstruction (CDO) is a common and usually easy to diagnose cause of intestinal obstruction in the newborn, except when the cause of the obstruction is a duodenal diaphragm. We describe our experience with eight children who had intrinsic duodenal obstruction secondary to a duodenal diaphragm.
Methods: The medical records of 22 children with the diagnosis of congenital intrinsic duodenal obstruction were reviewed for age at diagnosis, sex, gestation, birth weight, clinical features, associated anomalies, method of diagnosis, treatment and outcome. Operative findings and procedures were obtained from the operative notes.
Results: Eight of the 22 children (36.4%) …

Analysis Of Cervical Smears In A Muslim Population, Shahnaz Wasti, Waleed Ahmed, Abbas Jafri, Behram Khan, Rizwan Sohail, Sheema Hassan

Department of Obstetrics & Gynaecology

Background: Screening for cancer of the cervix remains a neglected health care issue in Pakistan. To provide baseline data for future efforts to improve screening, we conducted a retrospective analysis of cervical smears taken in the obstetrics and gynaecological clinics of the Aga Khan University Hospital, Karachi, Pakistan.
Method: We collected data on cervical smear cytology for cervical smears taken from January 1, 1990 to December 31,1996. We assessed risk factors for dysplasia, including age, age at first marriage, and number of pregnancies.
Results: The overall prevalence of abnormal smears in our study was 0.5%. Of 20,995 cervical smears, 12,451 …

A Null Mutation For Tissue Inhibitor Of Metalloproteinases-3 (Timp-3) Impairs Murine Bronchiole Branching Morphogenesis., Sean E Gill, M Cynthia Pape, Rama Khokha, Andrew J Watson, Kevin J Leco

Obstetrics & Gynaecology Publications

Tissue inhibitors of metalloproteinases (TIMPs) regulate extracellular matrix (ECM) degradation by matrix metalloproteinases (MMPs). We have examined the role of TIMP-3 on ECM homeostasis and bronchiole branching morphogenesis during murine embryogenesis. Employing an in vitro organ culture system, we found decreased bronchiolar branching in null lungs when compared with wild type (WT) counterparts after 2 days in culture. When a synthetic inhibitor of MMPs at low dose was added to the culture system, branching was augmented regardless of genotype. Gelatin and in situ zymography revealed that null lungs exhibited enhanced activation of MMPs throughout lung development. We analysed the impact …

What Is Wrong With Medical Audit?, J H. Rizvi

Department of Obstetrics & Gynaecology

No abstract provided.

Psychosocial Stress And Cervical Neoplasia Risk, Ann L. Coker, Sharon M. Bond, Margaret M. Madeleine, Kathryn J. Luchok, Lucia Pirisi

CRVAW Faculty Journal Articles

OBJECTIVE: We assessed the association between psychosocial stress and preinvasive cervical neoplasia development controlling for HR-HPV infection.

METHODS: This case-control study enrolled low-income women receiving family planning services at health department clinics. There were 59 cases with biopsy confirmed HSIL and 163 with low-grade SIL and 160 controls with normal cervical cytology. A modified SLE scale was used to measure stressful events and the perceived impact of the event in the prior 5 years. Unconditional logistic regression was used to assess SIL risk and stressful events scores and by subscales.

RESULTS: After adjusting for age, HR-HPV infection, and lifetime number …

Aquaporin Proteins In Murine Trophectoderm Mediate Transepithelial Water Movements During Cavitation., Lisa C Barcroft, Hanne Offenberg, Preben Thomsen, Andrew J Watson

Obstetrics & Gynaecology Publications

Mammalian blastocyst formation is dependent on establishment of trophectoderm (TE) ion and fluid transport mechanisms. We have examined the expression and function of aquaporin (AQP) water channels during murine preimplantation development. AQP 3, 8, and 9 proteins demonstrated cell margin-associated staining starting at the 8-cell (AQP 9) or compacted morula (AQP 3 and 8) stages. In blastocysts, AQP 3 and 8 were detected in the basolateral membrane domains of the trophectoderm, while AQP3 was also observed in cell margins of all inner cell mass (ICM) cells. In contrast, AQP 9 was predominantly observed within the apical membrane domains of the …

Critical Appraisal Of Endometriosis Management For Pain And Subfertility, N F. Zuberi, J H. Rizvi

Department of Obstetrics & Gynaecology

Objective: To critically appraise current best available management of pain and subfertility ascribable to endometriosis.
Methods: Medline and specialist computer databases were searched along with reference lists of known reviews and primary articles to identify cited articles not captured by electronic searches. We included all studies pertaining to treatment of pain and subfertility ascribable to endometriosis.
Discussion: Medical and surgical management options for pain and subfertility are presented as Evidence-based inquiries for critically appraised topics. Each problem is presented as an answerable question followed by assessment of literature search for level of evidence. This is followed by critical appraisal of …

Breast Diseases: A Histopathological Analysis Of 3279 Cases At A Tertiary Care Center In Pakistan, M. S. Siddiqui, Naila Kayani, Shahid Pervez, S. A. Aziz, S. Muzaffar, Z. Setna, M. Israr, S. H. Hasan, M. S. Gill

Department of Pathology and Laboratory Medicine

Objective: To know the frequency of breast diseases in Pakistani females.

Methods: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1 993-1996) at the department of pathology, the Aga Khan University Hospital.

Results: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of …

Responsiveness Of Bovine Cumulus-Oocyte-Complexes (Coc) To Porcine And Recombinant Human Fsh, And The Effect Of Coc Quality On Gonadotropin Receptor And Cx43 Marker Gene Mrnas During Maturation In Vitro., Michele D Calder, Anita N Caveney, Lawrence C Smith, Andrew J Watson

Obstetrics & Gynaecology Publications

Substantially less development to the blastocyst stage occurs in vitro than in vivo and this may be due to deficiencies in oocyte competence. Although a large proportion of bovine oocytes undergo spontaneous nuclear maturation, less is known about requirements for proper cytoplasmic maturation. Commonly, supraphysiological concentrations of FSH and LH are added to maturation media to improve cumulus expansion, fertilization and embryonic development. Therefore, various concentrations of porcine FSH (pFSH) and recombinant human FSH (rhFSH) were investigated for their effect on bovine cumulus expansion in vitro. Expression of FSHr, LHr and Cx43 mRNAs was determined in cumulus-oocyte complexes to determine …

Clarifying The Lower Incidence Of Birth Defects In The Midwest Of Western Australia : A Study Using Capture Re-Capture Methodology, Donna Baker

Theses: Doctorates and Masters

In April 2000 the Western Australian Birth Defects Registry held its 20th Anniversary Scientific Symposium to signify the first 20 years of the Birth Defects Registry in Western Australia. At the Symposium, significant trends and occurrences in birth defects within Western Australia over the past 20 years were addressed. One factor highlighted in the Registry's 1980-1999 report was that birth defects were reported less frequently in rural regions compared with metropolitan areas. Data collected from the metropolitan area is considered by the Birth Defects Registry to be the most accurate. Therefore, incidence rates of birth defects in this area arc …

All In Due Time: Perspectives On Childbirth From Deaf Parents, Rsa Region V Project

Course Materials

Six Deaf couples discuss their experiences of giving birth. The stories they share represent a variety of factors and complications that occurred before, during, and after the births of their children.