Medical Specialties Commons^™

A Comparison Of Severe Pre-Eclampsia/Eclampsia In Patients With And Without Hellp Syndrome, N F. Zuberi, K Arif, F M. Khan, J A. Pal

Department of Obstetrics & Gynaecology

Background: The relationship of Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome with maternal and perinatal health and its presentation in Pakistani population is not known.
Purpose: To determine the mode of presentation along with maternal and perinatal outcome of patients with HELLP syndrome.
Methods: Case records of patients with severe hypertension in pregnancy who delivered between January 1, 1989 and December 31, 1994 at The Aga Khan University Hospital, Karachi. Out of 120 cases of severe pre-eclampsia/eclampsia, there were 36 cases of HELLP syndrome (Group-A). These were then compared with cases without HELLP syndrome (Group B) for their …

Effects Of First And Second Trimester Vaginal Bleeding On Pregnancy Outcome, S A. Karim, I Bakhtawar, A T. Butta, M Jalil

Department of Obstetrics & Gynaecology

The effects of vaginal bleeding during first and second trimester on pregnancy outcomes was assessed in a hospital-based population of 268 non-diabetic women. The group of non-bleeders comprised 173 females whereas, there were 71 females with first and 24 with second trimester bleeding. Fetal loss (abortion) occurred in 34% of first trimester and 25% of second trimester bleeders. Low birth weight and preterm delivery were significantly associated with second trimester haemorrhage. The results suggest that first and second trimester vaginal bleeding correlates with adverse infant outcomes.

Effects Of Metformin On Spontaneous And Clomiphene-Induced Ovulation In The Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D., William S. Evans , M.D., Renato Pasquali , M.D.

Obstetrics and Gynecology Publications

ABSTRACT

Background Obese women with the polycystic ovary syndrome are relatively unresponsive to the induction of ovulation by clomiphene. We hypothesized that reducing insulin secretion by administering metformin would increase the ovulatory response to clomiphene.

Methods We performed oral glucose-tolerance tests before and after the administration of 500 mg of metformin or placebo three times daily for 35 days in 61 obese women with the polycystic ovary syndrome. Women who did not ovulate spontaneously were then given 50 mg of clomiphene daily for five days while continuing to take metformin or placebo. Serum progesterone was measured on days 14, 28, …

Experiencing Physical Violence During Pregnancy: Prevalence And Correlates, Vilma E. Cokkinides, Ann L. Coker

CRVAW Faculty Journal Articles

Violence during pregnancy directly impacts the mental and physical health of pregnant women. We assessed the prevalence and correlates of physical violence around the time of pregnancy in a representative sample of 6,718 women in South Carolina. Physical violence, defined as "being physically hurt by husband or partner" or "being involved in a physical fight" was reported by 10.9% of recently pregnant women. These were correlates of violence: experiencing increased numbers of stressful life events, being unmarried, having increased parity, being on Medicaid, and having an unwanted pregnancy. Screening to identify violence in pregnancy in health care settings is vital …

Rapport Du Seminaire National [Au Mali] Pour La Definition D'Une Strategie D'Eradication De L'Excision, Population Council

Reproductive Health

This is a report on a workshop for the eradication of female genital mutilation (FGM) held in Bamako, Mali. The workshop presented the results of a literature review on FGM and the actions taken to counter the practice in Mali; provided updates on the activities of six national NGOs working on issues surrounding FGM; and developed a Plan of Action for activities aimed at reducing the practice. The workshop brought together 85 participants, including policy- and decisionmakers from the government, NGOs, and religious groups. The workshop led to the finalization of a national Plan of Action to the Year 2000 …

Diagnostic Evaluation Of Fine Needle Aspiration Cytology In The Management Of Palpable Breast Lesions, S. H. Shah, Naila Kayani, S. H. Hasan, I. N. Soomro, Shahid Pervez, A. S. Hussainy

Department of Pathology and Laboratory Medicine

A total of 113 fine needle aspirates of the breast masses were evaluated in which the subsequent biopsy or mastectomy specimen were also available for histological examination. The age ranged from 16 to 80 years with a mean of 42 years. In benign conditions the mean age was 34.7 years while in malignant cases it was 48 years. The cytological diagnoses were compared with the histological results which revealed that the specificity and sensitivity of fine needle aspiration cytology in the palpable breast lesions was 86.1% and 89.2% respectively with a positive predictive value of 93% and efficiency of 88.2%. …

Initial Multicenter Experience With Double Nucleoside Therapy For Human Immunodeficiency Virus Infection During Pregnancy., N S Silverman, D H Watts, J Hitti, D M Money, E Livingston, J Axelrod, J M Ernest, D Robbins, M M Divito

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications.

METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV …

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 …

Comparison Of Beta-Adrenoceptor Coupled Camp Production In Cultured Human Mononuclear Leukocytes And Myometrial Cells, Yu-Li Liu

Electronic Theses and Dissertations

$\beta\sb2$-Adrenoceptor ($\beta\sb2$-AR) agonists, such as terbutaline, are used as tocolytic agents in the treatment of preterm labor. $\beta$-Adrenoceptor stimulation relaxes myometrium through specific receptors coupled through Gs to adenylyl cyclase (AC) that catalyzes the conversion of ATP to cAMP. The purpose of this study was to compare $\beta$-adrenoceptors and cAMP production in cultured human leukocytes and myometrial cells, and to determine the importance of $\beta$-adrenoceptors and cAMP production in isoproterenol-induced myometrial relaxation. $\sp{125}$I-iodopindolol was used to assess $\beta$-adrenoceptor affinity and number cAMP levels were analyzed before and after stimulation by isoproterenol, AlF$\sb4\sp-$, forskolin, and PGE$\sb1$. Isometric recording was used to …

Prevalence And Severity Of Viral Hepatitis In Pakistani Pregnant Women: A Five Year Hospital Based Study, A B. Aziz, S Hamid, S Iqbal, W Islam, S A. Karim

Department of Obstetrics & Gynaecology

A hospital based observational study was carried out on pregnant women presenting with either acute hepatitis or fulminant hepatic failure (FHF), during the past years. Of 53 patients, 20 (38%) developed FHF.Non-A, Non-B was the commonest cause (62%) followed by hepatitis B in 17% and hepatitis A in 4% cases. Eight women expired (case fatality rate 15%) with a high maternal mortality (62%) caused by NANB hepatitis. Perinatal mortality was 30%. Poor prognostic factors identified were lack of antenatal care, severity of jaundice, history of somnolence, gastrointestinal bleeding and a high grade of encephalopathy.

Fluorescence In Situ Hybridization Analysis Of Human Embryos Derived From In Vitro And In Vivo Matured Oocytes, Constance Descisciolo

Theses and Dissertations in Biomedical Sciences

Despite adequate hormonal stimulation, oocytes collected for the purpose of in vitro fertilization and embryo transfer display several levels of nuclear maturity. Preovulatory or mature oocytes, technically those that are Metaphase I or II, are inseminated shortly after aspiration and assessed for fertilization the following day. Prophase I oocytes, also called germinal vesicle-bearing or immature oocytes, require a 24-36 hour period in culture before being exposed to spermatozoa. During this time, the majority of Prophase I oocytes complete nuclear maturation in vitro, progressing from germinal vesicle breakdown through first polar body extrusion. If inseminated, many in vitro matured oocytes fertilize …

Bovine Oviductal And Embryonic Insulin-Like Growth Factor Binding Proteins: Possible Regulators Of "Embryotrophic" Insulin-Like Growth Factor Circuits., Q A Winger, P De Los Rios, V K Han, D T Armstrong, D J Hill, A J Watson

Obstetrics & Gynaecology Publications

Bovine oviductal monolayer and vesicle primary cultures express insulin-like growth factor (IGF)-I and -II mRNAs and polypeptides. Early bovine embryos also express IGF-I, IGF-II, IGF-I receptor, IGF-II receptor, and insulin receptor mRNAs. This study reports the expression of IGF binding protein (IGFBP) mRNAs and polypeptides in bovine oviduct primary cultures and IGFBP mRNAs in preattachment embryos. Release of immunoreactive IGF-I and IGF-II by oviduct cultures and bovine blastocysts was also determined. IGFBP-2, -3, -4, and -5 transcripts were observed in oviduct primary cultures throughout an 8-day interval. IGFBP-1 and -6 mRNAs were consistently not detected in the oviduct. Messenger RNAs …

Differential Endometrial Responses Of Primates Vs Rodents: Screening For Antiproliferative Effects Of Antiprogestins, David Williams Burleigh

Theses and Dissertations in Biomedical Sciences

The antiprogestin, mifepristone, has previously been shown to noncompetitively inhibit estrogen-induced endometrial proliferation in nonhuman primates (van Uem et al., 1989; Wolf et al., 1989b; Neulen et al., 1990; Neulen et al., 1996). For both economical and ethical reasons, we are encouraged to identify comparative laboratory rodent models which can substitute the need to use primate models. In the following study, we compared capabilities of the rat uterine weight bioassay versus a primate uterine bioassay, to identify the noncompetitive antiestrogenic/antiproliferative effects of mifepristone.

Long-term ovariectomized monkeys were exposed to exogenous 17β-estradiol (E2) and mifepristone in doses and regimes already demonstrated …

Basement Membrane And Repair Of Injury To Peripheral Nerve: Defining A Potential Role For Macrophages, Matrix Metalloproteinases, And Tissue Inhibitor Of Metalloproteinases-1, Monique La Fleur, Johnnie L. Underwood, Daniel A. Rappolee, Zena Werb

Department of Obstetrics and Gynecology Research Publications

Injury to a peripheral nerve is followed by a remodeling process consisting of axonal degenera- tion and regeneration. It is not known how Schwann cell–derived basement membrane is pre- served after injury or what role matrix metalloproteinases (MMPs) and their inhibitors play in axonal degeneration and regeneration. We showed that the MMPs gelatinase B (MMP-9), stromelysin-1 (MMP-3), and the tissue inhibitor of MMPs (TIMP)-1 were induced in crush and distal segments of mouse sciatic nerve after injury. TIMP-1 inhibitor activity was present in excess of proteinase activity in extracts of injured nerve. TIMP-1 protected basement mem- brane type IV collagen …

Hereditary Ovarian Cancer Syndromes In Three Pakistani Families, A B. Aziz, M Sabih, I A. Malik

Department of Obstetrics & Gynaecology

No abstract provided.

Risk Of Uterine Rupture After The Partographic 'Alert' Line Is Crossed--An Additional Dimension In The Quest Towards Safe Motherhood In Labour Following Caesarean Section, K S. Khan, A Rizvi, J H. Rizvi

Department of Obstetrics & Gynaecology

To determine if prolonged active phase of labour is associated with increased risk of uterine scar rupture in labour following previous lower segment caesarean section, a retrospective cohort study (1988-91) was done to analyse active phase partographs of 236 patients undergoing trial of labour following caesarean section, 7 (3%) of whom had scar rupture. After onset of active phase (3 cm cervical dilatation), a 1 cm/h line was used to indicate "alert". A zonal partogram was developed by dividing the active phase partographs into 5 time zones: A (area to the left of "alert" line), B (0-1 h after "alert" …

Decreases In Ovarian Cytochrome P450c17 Alpha Activity And Serum Free Testosterone After Reduction Of Insulin Secretion In Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D.

Obstetrics and Gynecology Publications

BACKGROUND

Insulin resistance and increased ovarian cytochrome P450c17α activity are both features of the polycystic ovary syndrome. P450c17α, which is involved in androgen biosynthesis, has both 17α-hydroxylase and 17,20-lyase activities. Increased activity of this enzyme results in exaggerated conversion of progesterone to 17α-hydroxyprogesterone in response to stimulation by gonadotropin. We hypothesized that hyperinsulinemia stimulates ovarian P450c17α activity.

METHODS

We measured serum steroid concentrations during fasting and the response of serum 17α-hydroxyprogesterone to leuprolide, a gonadotropin-releasing hormone agonist, and performed oral glucose-tolerance tests before and after oral administration of either metformin (500 mg three times daily) or placebo for four to …

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Administration Documents

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Brooks, Lynnette and Cindy Calisi. The Effect of Selenium Supplementation on the Immune Response of Mice with Experimental Chagas' Disease
• Hildreth, John. Teasing the Muse
• Jenkins, Rhonda. Steinbeck's Portraits of Prostitutes: Progression of an Author's Vision
• Kirkham, Michelle. The Prenatal Use of Crack Cocaine: How It Affects Children and How Schools Can Respond
• Gibson, Jeanette and Juli McCay. Circadian Rhythm of Brain GABA Levels in the Cockroach, Leucophaea Maderae
• Patterson, Dana. Home Schooling …

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

School of Public Health Faculty Research

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council

Reproductive Health

This clinic-based study of female genital mutilation (FGM) was designed and carried out by the Egypt Fertility Care Society to gather detailed information on the types of FGM practiced in Egypt. The study involved interviews with clinic clients to elicit information about their experience and attitudes concerning FGM, and gynecological examinations by specially trained OB/GYN physicians. In all, 93% of the women in this study were found to have some type of FGM. The study's findings were incorporated in the final report of the 1995 Egyptian Demographic and Health Survey, with the aim of contributing to the scientific understanding of …

Hepatocyte Growth Factor And Its Receptor Are Expressed In Cardiac Myocytes During Early Cardiogenesis, Daniel A. Rappolee, Anand Iyer, Yogesh Patel

Department of Obstetrics and Gynecology Research Publications

In the mouse, the heart primordium arises when mesodermis set aside during gastrulation, is induced by pharyngeal endoderm, migrates ventrally to the midline of the embryo, forms a tube, and begins beating. Little is known of the molecular mechanisms that mediate the determination, mitosis, differentiation, and migration that lead to the beating heart. Transcripts for hepatocyte growth factor/scatter factor (HGF) and its receptor are coexpressed transiently and dynamically in the premyocardium but not in other heart progenitor cells. Transcripts for HGF ligand and receptor are first detected before cardiac function and looping and persist through the first looping stage, when …

Strategies For Prevention Of Varicella Pneumonia: A Cost-Effectiveness Analysis., G A Macones, S Ewing, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The objective of this study was to compare the cost-effectiveness of 3 strategies of serologic enzyme-linked immunosorbent assay (ELISA) testing and post-exposure varicella zoster immune globulin (VZIG) prophylaxis for the prevention of maternal varicella pneumonia during pregnancy in patients with negative or uncertain histories of varicella infection.

METHODS: A decision tree was constructed to compare the following strategies: 1) routine serologic testing for varicella immunity followed by targeted post-exposure VZIG prophylaxis, 2) post-exposure serologic testing followed by targeted VZIG prophylaxis, and 3) untargeted post-exposure VZIG administration. The probabilities for the model were obtained from the medical literature and supplemented …

Perceived Barriers And Perceived Motivators To Receiving Prenatal Care, Christine M. Davis

Masters Theses

The Health Belief Model served as the conceptual framework for this retrospective descriptive study that identified women's perceived barriers and perceived motivators to obtaining prenatal care. A 50 item questionnaire, including both forced-choice and open-ended questions, was administered to 29 women who had delivered a healthy infant within the previous 6 to 8 weeks. The sample was predominantly white (82.2%), {dollar}>{dollar}19 years of age (62.1%), single (62.1%), unemployed (51.7%), and receiving Medicaid insurance (69%). Univariate statistics were calculated for each item. Each item was then compared to the timing of the start of prenatal care. The most important motivators …

Knowledge, Sources Used And Factors Considered In The Surgical Treatment Decisions Of Women With Breast Cancer, Debra J. Bisel

Masters Theses

The purpose of this replication study was to examine how women with breast cancer reached their decision for surgical treatment (Ward, Heidrich and Wolberg 1989). Twenty-one women who met the surgical criteria, i.e. option for Breast Conserving surgery or Modified Radical Mastectomy, completed four surveys 1 to 7 days post operatively. The women were divided into two groups, 13 who had Breast Conserving surgery and 8 who had Modified Radical Mastectomy. The surveys assessed demographic characteristics of the groups, the level of knowledge regarding breast cancer, factors considered important in reaching the decision for surgery and the sources of information …

Numerical Chromosome Abnormalities In Sperm From Oligoasthenoteratozoospermic Patients And Fertile Males, Myung-Geol Pang

Theses and Dissertations in Biomedical Sciences

Artificial fertilization protocols have been developed which bypass natural barriers for reproduction. One aspect of infertility which has received little attention is the potential importance of aneuploidy in sperm. To more clearly understand the cytogenetic make-up of sperm from OAT patients, multi-probe, multi-color FISH was performed to determine aneuploidy.

The introduction of intracytoplasmic sperm injection (ICSI) has revolutionized protocols used in in vitro fertilization centers. The pregnancies resulting from ICSI suggest an increased frequency of sex chromosome aneuploidy in livebirths. Preliminary data by others' suggest that sperm tail swelling patterns following hypo-osmotic swelling (HOST) can be predictive of fertilizing ability. …

Expression Of Genes Encoding Antioxidant Enzymes In Preimplantation Mouse And Cow Embryos And Primary Bovine Oviduct Cultures Employed For Embryo Coculture., M B Harvey, M Y Arcellana-Panlilio, X Zhang, G A Schultz, A J Watson

Obstetrics & Gynaecology Publications

Preimplantation embryos from a variety of mammalian species contrast markedly in their response to culture in vitro. Murine preimplantation embryos display a wider tolerance than other mammalian species to culture environments, and this has contributed to the development of several effective defined culture media. Embryo coculture on somatic cells remains the most effective method of supporting reasonable rates of bovine preimplantation development in vitro. The patterns of gene expression for several antioxidant enzymes during preimplantation murine and bovine development were examined by use of the reverse transcription-polymerase chain reaction technique to determine whether the differential developmental capacity of mammalian preimplantation …

The Health Belief Model As A Predictor Of Gynecological Exams: Does Sexual Orientation Matter?, Lynn Elizabeth Kunkel

Dissertations and Theses

Screening and early detection are essential for the management and control of most diseases. It is important for women to practice routine health care that includes both clinical and self examinations. Today, many women go without health care due to barriers which prevent them from obtaining adequate care. The present study was designed to investigate, using the Health Belief Model, whether there is a difference between heterosexual and lesbian women in obtaining gynecological exams. Responses from 238 participants, 70 heterosexuals and 168 lesbians, indicated that the Health Belief Model was a significant predictor of whether women complied with recommended guidelines …

Audit Changes Clinical Practice! Impact On Rate Of Justification Of Hysterectomy Indication, Khalid S. Khan, J H. Rizvi

Department of Obstetrics & Gynaecology

After performing a baseline audit in 1986-89, an ongoing quality assurance process was initiated in January, 1990 and all hysterectomies performed over the next 2 year period were analyzed. Hysterectomy indications were divided into two groups: one in which the uterine specimen was expected to show pathology and another in which no pathology was expected. The hysterectomy was considered justified in the former if the pathology report verified the indication or showed a significant alternate pathology. In the latter, validation criteria showing documentation of certain prerequisite diagnostic procedures performed before reverting to hysterectomy, were used to ascertain justification. The overall …

Method For Inhibiting Angiogenesis With Aurintricarboxylic Acid, Its Analogues Or Salts, Delwood C. Collins, Antonio Gagliardi, Anjan Bhattacharyya

Obstetrics and Genecology Faculty Patents

Aurintricarboxylic acid has potent anti-angiogenic activity and may be used for new therapeutic approaches for diseases of neovascularization including the treatment of solid tumors, diabetic retinopathy and arthritis, among others.

Are Non-Diabetic Women With Abnormal Glucose Screening Test At Increased Risk Of Pre-Eclampsia, Macrosomia And Caesarian Birth?, Khalid S. Khan, Firasat A. Hashmi, J H. Rizvi

Department of Obstetrics & Gynaecology

To determine, in non-diabetic women, the relationship of abnormal glucose screening test, with the incidence of pre-eclampsia, macrosomia and caesarian delivery, from 1988-92, 5646 consecutive women attending antenatal clinic were screened with a glucose challenge test (GCT) on their first visit (usually at 16-20 weeks); those with risk factors i.e., history of unexplained perinatal loss, macrosomia or family member with diabetes and an initial abnormal screening test were rescreened at 28-32 weeks, In 482 cases the GCT was abnormal (plasma glucose value was >140 mg% 2 hours after 75g glucose challenge). Of these, 292 had one or more abnormal critical …