Obstetrics and Gynecology Commons^™

Leveraging Machine Learning To Study How Temperature Scores Predict Pre-Term Birth Status, Erich Seamon, Jennifer A. Mattera, Sarah A. Keim, Esther M. Leerkes, Jennifer L. Rennels, Andrea J. Kayl, Kristy M. Kulhanek, Darcia Narvaez, Sarah M. Sanborn, Jennifer B. Grandits, Christine Dunkel Schetter, Mary Coussons-Read, Amanda R. Tarullo, Sarah J. Schoppe-Sullivan, Mariah E. Thomason, Julie M. Braungart-Rieker, Julie C. Lumeng, Shannon N. Lenze, Lisa M. Christian, Darby E. Saxbe, Laura R. Stroud, Christina M. Rodriguez, Stephanie Anzaman-Frasca

Psychology Faculty Publications

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Background

Preterm birth (birth at <37 completed weeks gestation) is a significant public heatlh concern worldwide. Important health, and developmental consequences of preterm birth include altered temperament development, with greater dysregulation and distress proneness.

Aims

The present study leveraged advanced quantitative techniques, namely machine learning approaches, to discern the contribution of narrowly defined and broadband temperament dimensions to birth status classification (full-term vs. preterm). Along with contributing to the literature addressing temperament of infants born preterm, the present study serves as a methodological demonstration of these innovative statistical techniques.

Study design

This study represents a metanalysis conducted with multiple samples (N = 19) including preterm (n = 201) children and (n = 402) born at term, with data combined across investigations to perform classification analyses.

Subjects …

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Successful Management Of Spontaneous Unilateral Twin Ectopic Pregnancy With Two-Step Dose Of Methotrexate, Lauren A. Forbes, Navya Nuthivana, Renee Morales

Department of Obstetrics & Gynecology Faculty Publications

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The incidence of unilateral tubal twin pregnancy is 1/20,000–1/250,000 with about 100 reported cases. Four of the six cases that were medically managed were successful. A 24-year-old female presented to the emergency department (ED) with vaginal bleeding and abdominal cramping. She was hemodynamically stable without signs of an acute abdomen. Laboratory evaluation revealed she was pregnant with a serum beta-human chorionic gonadotropin (b-hCG) of 798 mIU/mL. Transvaginal ultrasound (TVUS) revealed a single left tubal pregnancy with a yolk sac. The patient elected medical management with body surface area (BSA)–based intramuscular (IM) methotrexate (MTX). On Day 4, the patient returned to …

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Opensim-Based Musculoskeletal Modeling: Foundation For Interactive Obstetric Simulator, Bahador Dodge

Electrical & Computer Engineering Theses & Dissertations

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The use of mathematical and computational models to understand complex biological systems, such as the human birth process, is a rapidly growing field in medicine. These models can be used to optimize and personalize medical treatments for individual patients, enhance training, and aid in educational efforts. While recent advancements in healthcare, particularly in obstetrics, have improved care for mothers and babies, studies and government reports indicate a rising rate of maternal mortality in the United States.

Despite this rising trend, there is a lack of detailed studies concerning the use of modeling and simulation to develop an interactive obstetrics simulator …

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The Ethical Dilemma Of Whether Or Not To Withhold Life Sustaining Treatments For Newborns, Chloe G. Payne

OUR Journal: ODU Undergraduate Research Journal

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Deeply complex ethical questions can arise when deciding whether to continue or stop life-sustaining treatments for critically ill newborns. Various factors that can influence these decisions are explored, such as the expected quality of life for the newborn, the resources that the family and hospital have at their disposal, and the role of religious beliefs. Emphasis is placed on the importance of striking a balance between the child's best interest, the autonomy of the parents, and the medical facts. The potential psychological and physical consequences for parents who decide to stop treatment, which often results in the loss of their …

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Toward An Interactive, Patient-Specific, Vr-Based Obstetrics Simulator, Michel A. Audette, Marco Parente, Dulce Oliveira, Sreekanth Arikatla, Alfred Abuhamad, Rumit Singh Kakar, Mark Scerbo, Lucia Tabacu, John Conery, Christopher Macgowan, Renato Natal Jorge

Electrical & Computer Engineering Faculty Publications

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This paper presents a nascent collaborative effort to achieve a Virtual Reality (VR)-based, real-time, haptics-driven patient-specific obstetrics simulator. The high-level architecture and preliminary results are presented here; the latter are based on offline birthing simulation developed by team in conjunction with open-source visualization tools. The cornerstones of this simulator will be high-fidelity generic offline birthing simulation, an anatomy-to-image nonrigid registration pipeline exploiting fetal MRI, the open-source interactive medical simulation toolkit IMSTK augmented by high-throughput deep learning-based soft tissue deformation, open-source musculoskeletal dynamics simulation platform SimTk for representing fetal motion. The initial emphasis will be on shoulder dystocia. The two main …

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Prenatal Perception Of Wic Breastfeeding Recommendation Affects First Month Postpartum Breastfeeding Outcomes, Qi Zhang, Lamichhane Rajan, Joanne Guthrie

Community & Environmental Health Faculty Publications

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No abstract provided.

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Fetal Myocardial Performance Index In The Third Trimester Of Pregnancy: Feasibility And Reproducibility Of Conventional Spectral Doppler Versus Spectral Tissue Doppler Technique, Lea M. Porche, Elena Sinkovskaya, Rachel D. Seaman, Hadiza I. Galadima, Letty Romary, Jennifer Philips, Alfred Abuhamad,

Community & Environmental Health Faculty Publications

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Objective: This study aims to compare completion rates and reproducibility of myocardial performance index (MPI) using conventional spectral Doppler versus tissue Doppler in an unselected high-risk third trimester population.

Study Design: This was a prospective cross-sectional study of high-risk pregnancies at ≥28 + 0 weeks’ gestation. Conventional spectral and tissue Doppler MPI of the left ventricle (LV) and right ventricle (RV) was attempted on all patients.

Results: Seventy-nine pregnancies were evaluated. LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (63/79, 79.7% vs. 45/79, 55.7%), p-value

Conclusion: Tissue Doppler had statistically higher completion rates than …

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Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

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Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

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Categorizing Fetal Heart Rate Variability With And Without Visual Aids, Amanda Jane Ashdown

Psychology Theses & Dissertations

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This present study examined the ability of clinicians and novices to correctly categorize fetal heart rate (FHR) variability with and without the use of exemplars. Clinicians and undergraduate students were asked to inspect FHR images and determine into which of four categories they belonged. Each participant took part in three conditions: one in which they were provided exemplars of prototypical FHR variability to use during their categorization task, another in which they were provided exemplars of nonprototypical FHR variability to use in their task, and a control condition in which no exemplars were available. The results showed that experts were …

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Hot Yoga Establishments In Local Communities Serving Pregnant Women: A Pilot Study On The Health Implications Of Its Practice And Environmental Conditions, Viann N. Nguyen-Feng, Steven L. Feng, Shilpa Babbar, Nicole Calloway Rankins, James D. Blando

Community & Environmental Health Faculty Publications

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Hot yoga establishments have been increasing in popularity in local communities. Studios may support participation among pregnant women though no clinical studies currently exist that examine prenatal hot yoga effects. The pilot study described in this article aimed to assess the spread of prenatal hot yoga and to provide information on the environmental conditions and practices of those who engage in hot yoga within a local community. A thermal environment meter was used to measure ambient air conditions during three 90-minute hot yoga classes. Mothers who practiced prenatal hot yoga were more likely than non-hot yoga practitioners to have someone …

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Socioeconomic Disparity In Healthcare-Seeking Behavior Among Chinese Women With Genitourinary Symptoms, Qi Zhang, Diane Lauderdale, Shanshan Mou, William I. Parish, Edward O. Laumann, John Schneider

Community & Environmental Health Faculty Publications

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Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES.

Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured …

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Increased Strength And Physical Performance With Eccentric Training In Women With Impaired Glucose Tolerance: A Pilot Study, Robin L. Marcus, Paul C. Lastayo, Leland E. Dibble, Laura Hill, Donald A. Mcclain

Human Movement Studies & Special Education Faculty Publications

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Background: Menopause is associated with both a loss of muscle mass and a worsening of insulin sensitivity (IS). Although eccentric resistance exercise (ECC) can effectively improve muscle mass over time, a single bout of ECC can worsen IS. This study assessed the effect of repeated ECC on IS, muscle mass, and function in postmenopausal women with impaired glucose tolerance (IGT).

Methods: Sixteen PM women (aged 56 years +/- 6.4) with IGT were randomly assigned to a 12-week, knee extensor ECC program (n = 10) or a nonexercise control group (CON) (n = 6). Participants underwent hyperinsulinemic-euglycemic clamps, dual-energy …

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Simulation To Augment Standardized Patients In Obstetric Ultrasound Training, Scott Richard Guirlinger

Computational Modeling & Simulation Engineering Theses & Dissertations

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Standardized patients are actors used in medical training to teach and eval11atc clinical skills of students prior to their using these skills on an actual patient. Augmented Reality is a relatively new technology that can be used to augment standardized patients with abnonnalitie8 and pathologies that they cannot portray themselves as normal healthy human beings. In our project, we sought to augment standardized patients with a 12-week- old fetus in order to train and possibly evaluate medical students and professionals in performing obstetric ultrasound procedures and interpreting the corresponding ultrasound image results.

The software library ARToolkit provided the framework for …

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Embryo And Gamete Development Upon Exposure To Cca Components: Cro3, Cuo, And As2o5, Nerbana Talaat-Elsebaei Mahmoud

Theses and Dissertations in Biomedical Sciences

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Production of functional gametes and healthy embryos is essential for proliferation of all vertebrates, especially humans. Many compounds have toxic effects on developing gametes and embryos among which are chromium trioxide (CrO₃), cupric oxide (CuO) and arsenic pentaoxide (As₂O₅) as a mixture (CCA) or individually. Controversy surrounding the safety of CCA-treated wood centers primarily on the toxicity of its components and the potential for these metals to be released from the wood.

The aim of this research is to test the hypothesis that CCA components have deleterious effects on embryo development, oocyte maturation and …

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Estrogen Regulation Of The Pregnant Baboon Placental 11Β-Hydroxysteroid Dehydrogenase (11Β-Hsd)-Catalyzed Metabolism Of Cortisol And Cortisone And Its Effect On The Development Of The Fetal Hypothalamic-Pituitary-Adrenal Axis, William Adair Davies

Theses and Dissertations in Biomedical Sciences

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Pepe and Albrecht previously demonstrated that the estrogen-regulated change in transuteroplacental metabolism of cortisol (F) and cortisone (E) from preferential reduction (E to F) at midgestation to oxidation (F to E) near term results in a decline of bioactive cortisol crossing the placenta and reaching the fetus culminating in activation of the hypothalamic-pituitary adrenal axis of the baboon and the ontogenesis of rate-limiting steroidogenic enzymes culminating in de novo F secretion. Protein kinase A (PK-A) activity in the baboon fetal adrenal gland cytosolic fraction was increased 2-fold both at term [day 165 of gestation (term = 184 days)] and following …

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Effects Of Hormonal Changes Throughout The Menstrual Cycle On Joint Laxity In Females, John C. Roberts

Human Movement Studies & Special Education Theses & Dissertations

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The objective of this study was to examine the levels of estrogens, progesterone, LH, FSH, estradiol and testosterone and their relation to ACL laxity throughout the menstrual cycle. Subjects were tested at the onset of menses, the first day of ovulation (days 8–17) and day 23 at the mid-luteal phase. A Pearson Product Moment Correlation Coefficient revealed that there were no statistically significant relationships between laxity measurements, of the KT-2000 or radiographic comparisons, and elevated concentrations of any of the hormones. LH was observed in the follicular phase, at the onset of menses, to have a negative correlation with only …

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A Study Of The Factors That Impact Female Military Beneficiaries Obtaining Preventive Health Services, Cynthia Andrea Chargois

Health Services Research Dissertations

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The purpose of this study was to determine what factors predict whether female military retirees or the female beneficiary of a military retiree, ages 40 to 64, will obtain preventive health services, specifically, Pap smears, mammograms, and clinical breast examinations. Based on the findings of the study, it is suggested that it may be important for the Department of Defense to broaden their scope of interest to include those areas that are most prominent in affecting female military retirees or the female beneficiary of a military retiree, particularly those 40 to 64, in obtaining preventive health services.

The study comprised …

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Telomerase Activity In Human Preimplantation Embryos, Diane Lynne Wright

Theses and Dissertations in Biomedical Sciences

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Telomerase, a ribonucleoprotein, has been described as an essential component of highly proliferative cells, which stabilizes the telomeres and avoids cellular senescence. Telomerase has been identified in various embryonic cell stages, hematopoietic cells, and in >85% of tumor tissue biopsies analyzed. The ability to measure the potential to proliferate successfully could provide an objective measure of an embryo's quality. The objectives of this study were to modify the telomeric repeat amplification protocol (TRAP) assay system for increased sensitivity to allow detection of telomerase activity in the single cell of an oocyte and embryo, obtain telomerase activity levels for the oocyte …

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Expression, Isolation And Purification Of Human Zona Pellucida Protein 3, Ting-Fung Chi

Theses and Dissertations in Biomedical Sciences

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Mammalian fertilization involves interactions of sperm surface receptors with the ligands of the zona pellucida, an extracellular matrix surrounding the ovulated oocytes. In humans, the zona pellucida is composed of three major glycoproteins. One of them, ZP3, participates in the primary sperm binding and in the subsequent triggering of the spermatozoa's acrosome reaction. Studies on the role of this specific protein in the human fertilization process are hampered by the limited amount of available biologically functional proteins.

By use of a pcDNA 3.1(+) expression vector, a transfecting-vector was constructed containing a 1.3 kb histidine tagged hZP3 cDNA. This histidine tagged …

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Leukemia Inhibitory Factor (Lif): Murine Preimplantation Embryo Development, Implantation Rates, And Skeletal Development, Michael Hayes Mitchell

Theses and Dissertations in Biomedical Sciences

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Leukemia inhibitory factor (LIF) is a pleiotropic cytokine which demonstrates perplexing physiological effects. It has been demonstrated that LIF is essential for implantation in mice. Little is known relating to the manner by which LIF effects pre-implantation and post-implantation development. The objectives of this project were to determine the effects LIF on pre-implantation development, to determine the effects that it may have on implantation rates, successful pregnancy rates, and resorption rates, and to determine the effects that LIF has on the skeletal development of mice. For the embryo transfer experiments, embryos were exposed to test compounds in the transfer medium …

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Mouse Embryo Development In The Presence Of Capsaicin, Carlos Santiago Villar-Gosalvez

Theses and Dissertations in Biomedical Sciences

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Capsaicin is the pungent agent found in hot peppers of the Capsicum genus. It is a potent neurotoxin that stimulates the degranulation and degeneration of C-afferent neurons. Capsaicin is widely used as a food condiment and medicine. Human exposure of capsaicin can exceed levels shown to be neurotoxic in laboratory animals. Additionally, capsaicin can cross the blood/placenta barrier and affect an embryo in utero. In order to assay the potential for toxicity to human embryos, mouse embryos were exposed to capsaicin and the effect of the capsaicin on embryo development was measured. Embryos were co-cultured in Krebs medium with 1% …

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The Role Of Glycoconjugates In Mediating Human Fertilization And Induction Of Fetomaternal Tolerance, Manish S. Patankar

Theses and Dissertations in Biomedical Sciences

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Using the hemizona assay (HZA), a in vitro sperm-egg binding assay, we show that specific glycoconjugates known to inhibit immune cell interactions mediated by the selectins, potently block human sperm-egg binding. The selectin ligand sialyl Lewis^x inhibits sperm binding in the HZA by 60% at a concentration of 1 mg/ml. Our data indicates that glycodelin-A, a endometrial glycoprotein known to block sperm-egg binding in the HZA at low concentrations expresses unusual fucosylated lacdiNAc type glycans. The fucosylated lacdiNAc type sugars have been previously shown to be 15-20 fold more potent ligands of E-selectin. Glycodelin-S a seminal plasma glycoform of …

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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

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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 …

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

Theses and Dissertations in Biomedical Sciences

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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 …

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

Theses and Dissertations in Biomedical Sciences

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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. …

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In Vitro Expression Of Human Zona Pellucida Protein 3, Chih-Wei Chen

Theses and Dissertations in Biomedical Sciences

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Human zona pellucida protein 3 (hZP3) is the putative receptor on the zona pellucida of the mature oocyte that recognizes and binds sperm, and therefore plays a critical role in fertilization.

A full length cDNA of hZP3 (1278 bp) was amplified from the human ovary mRNA by reverse transcription-polymerase chain reaction (RT-PCR). The hZP3 cDNA was subcloned into PSK and pREP4 expression vectors. The cDNA of hZP3 was further characterized by restriction mapping, PCR, auto-sequencing and Southern blot analysis by using an internal oligonucleotide probe, and found to be identical to the one reported by J. Dean. Using autosequencing, 289 …

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Immunologic Evaluation Of Ectopic Gestation, Tawfig Amin Nasser

Health Services Research Dissertations

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Ectopic gestation is an error in the implantation site of the blastocyst. Extrauterine implantation presents a unique environment since the protective features of the uterus are absent. This study is an investigation into the immunoregulatory differences that may develop as a result of a change in the feto-maternal junction.

The effects of female plasma on one-way mixed lymphocyte cultures and mitogen-stimulated cultures, anti-paternal lymphocytotoxicity, and lymphocyte phenotypes were determined on normal, ectopic and non-pregnant females. The results indicated that pregnant female plasma enhanced the response of autologous lymphocytes to spouse and male control lymphocytes. Enhancement was not seen in the …

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Development And Characterization Of Monoclonal Antisperm Antibodies: Potential For Contraception, Dilrowshan H. Haque

Theses and Dissertations in Biomedical Sciences

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There is an expressed need to develop a greater variety of safe contraceptive methods which would find acceptance worldwide, particularly in developing countries. Immunization against spermatozoa might be such a method as judged by the accumulated evidence from studies on human females and in a number of female animal species.

Two extraction techniques were used for sperm membrane antigen isolation. The first technique involved NP-40 detergent for antigen extraction from human motile sperm and the second technique employed homogenized human testis for antigen extraction. Using these immunogens, sperm membrane-specific monoclonal antibodies (MAbs) were developed. When these antisperm MAbs were subjected …

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Factors That Influence Prepared Childbirth Couples' Use Of Epidural Anesthesia For Labor And Delivery, Terri S. Chambers

Community & Environmental Health Theses & Dissertations

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The purpose of this study was to identify factors that influence a Prepared Childbirth couple's decision to utilize epidural anesthesia for labor and delivery. Review of the literature indicated a high correlation between epidural use for uncomplicated labors and deliveries and a high incidence of maternal complications and low neonatal neurological and behavioral scores.

A sample of twenty-nine couples was used in this prospective, non-experimental field study for the research. Data were collected utilizing two developed demographic and factual event tools, Rotter's Internal-External Locus of Control Tool and Spanier's Dyadic Marital Adjustment Tool.

Three hypotheses were developed and data were …

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