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Obstetrics and Gynecology Commons

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Kimberly K. Leslie

Pregnancy Complications

Discipline

Articles 1 - 9 of 9

Full-Text Articles in Obstetrics and Gynecology

Acute Intrauterine Infection Results In An Imbalance Between Pro- And Anti-Inflammatory Cytokines In The Pregnant Rabbit., Kimberly Leslie, S. Lee, S. Woodcock, J. Davies, R. Mcduffie, E. Hirsch, M. Sherman, J. Eskens, R. Gibbs Feb 2013

Acute Intrauterine Infection Results In An Imbalance Between Pro- And Anti-Inflammatory Cytokines In The Pregnant Rabbit., Kimberly Leslie, S. Lee, S. Woodcock, J. Davies, R. Mcduffie, E. Hirsch, M. Sherman, J. Eskens, R. Gibbs

Kimberly K. Leslie

PROBLEM: Intrauterine infection results in an increase in cytokines. This study compared the time courses for the pro- and anti-inflammatory cytokine responses in 33 pregnant rabbits at 70% gestation. Pro-inflammatory markers were activated nuclear factor-kappa B (NF-kappaB) in placenta and tumor necrosis factor-alpha (TNF-alpha) in amniotic fluid. These were compared to the anti-inflammatory cytokine, interleukin-1 receptor antagonist (IL-1ra), in placenta and uterus. METHOD OF STUDY: Does were endoscopically inoculated with Escherichia coli through their cervices and sacrificed at six intervals between 0 and 30 hr post-inoculation. RESULTS: Activated NF-kappaB, determined by electromobility gel shift assay, increased significantly 16 hr after …


Histologic Inflammation In The Maternal And Fetal Compartments In A Rabbit Model Of Acute Intra-Amniotic Infection., J. Davies, R. Shikes, C. Sze, Kimberly Leslie, R. Mcduffie, R. Romero, R. Gibbs Feb 2013

Histologic Inflammation In The Maternal And Fetal Compartments In A Rabbit Model Of Acute Intra-Amniotic Infection., J. Davies, R. Shikes, C. Sze, Kimberly Leslie, R. Mcduffie, R. Romero, R. Gibbs

Kimberly K. Leslie

OBJECTIVE: This study was undertaken to determine the course of acute inflammation in the maternal and fetal compartments during experimentally induced ascending intra-amniotic infection. STUDY DESIGN: Forty pregnant rabbits at 70% gestation were inoculated endocervically with 10(5) colony-forming units of Escherichia coli. Does were killed at 0, 4, 8, 16, 24, and 30 hours after inoculation. At necropsy, blood, peritoneal fluid, amniotic fluid, and uterine tissue were cultured. Fetal brain, lung, heart, gut, and kidney were collected for histologic examination. Necrosis, infiltrates, congestion, and edema were each assessed semiquantitatively, and mean composite histologic-inflammation scores were compared with analysis of variance. …


Estrogens In Intrahepatic Cholestasis Of Pregnancy., Kimberly Leslie, L. Reznikov, F. Simon, P. Fennessey, H. Reyes, J. Ribalta Feb 2013

Estrogens In Intrahepatic Cholestasis Of Pregnancy., Kimberly Leslie, L. Reznikov, F. Simon, P. Fennessey, H. Reyes, J. Ribalta

Kimberly K. Leslie

OBJECTIVE: To determine whether estrogen production and excretion are impaired in gravidas with intrahepatic cholestasis. METHODS: Plasma and urine samples were collected from 13 women from the United States and Chile at 35-38 weeks' gestation with mild (n = 9) or severe (n = 4) intrahepatic cholestasis of pregnancy. Urinary and plasma steroid levels from women with cholestasis were compared with levels from 27 normal pregnant women within the same gestational age range. Urinary concentrations of dehydroepiandrosterone (DHEA), estrone (E1), estradiol (E2), estriol (E3), estetrol, progesterone, and 16-hydroxy-pregnenolone were measured by gas chromatography mass spectrometry, and plasma concentrations of DHEA …


A Randomized Controlled Trial Of Interleukin-1 Receptor Antagonist In A Rabbit Model Of Ascending Infection In Pregnancy., R. Mcduffie, J. Davies, Kimberly Leslie, S. Lee, M. Sherman, R. Gibbs Feb 2013

A Randomized Controlled Trial Of Interleukin-1 Receptor Antagonist In A Rabbit Model Of Ascending Infection In Pregnancy., R. Mcduffie, J. Davies, Kimberly Leslie, S. Lee, M. Sherman, R. Gibbs

Kimberly K. Leslie

OBJECTIVE: To determine whether treatment with interleukin-1 receptor antagonist (IL1-ra) would affect amniotic fluid concentrations of tumor necrosis factor alpha (TNF-alpha) and prostaglandins or clinical or microbiological outcomes in a model of ascending bacterial infection in pregnancy. METHODS: Timed pregnant New Zealand white rabbits at 70% of gestation underwent endoscopic inoculation of the cervices with 10(6) - 10(7) cfu Escherichia coli. Animals were randomly assigned in a blinded manner to a 5-h intravenous infusion of human IL1-ra (10 mg/kg) or placebo beginning 1-2 h after inoculation. Blood was drawn from the does for assay of serum IL1-ra concentration before inoculation, …


Targeted Treatment Using Monoclonal Antibodies And Tyrosine-Kinase Inhibitors In Pregnancy, A. Robinson, W. Watson, Kimberly Leslie Feb 2013

Targeted Treatment Using Monoclonal Antibodies And Tyrosine-Kinase Inhibitors In Pregnancy, A. Robinson, W. Watson, Kimberly Leslie

Kimberly K. Leslie

An expanding knowledge of the signalling pathways involved in the cell cycle has led to great improvements in the understanding of the molecular events involved in carcinogenesis. The past decade has seen substantial advances with the introduction of several classes of targeted therapeutics for the treatment of various cancers and autoimmune disorders. However, the question arises as to whether pregnant women can take advantage of these new treatments in view of the potential risks to the fetus. Published work suggests that biological agents, like traditional treatments, have the potential to affect the fetus, and should, therefore, be used with caution …


Chronic Intrauterine Infection And Inflammation In The Preterm Rabbit, Despite Antibiotic Therapy, R. Gibbs, J. Davies, R. Mcduffie, Kimberly Leslie, M. Sherman, C. Centretto, D. Wolf Feb 2013

Chronic Intrauterine Infection And Inflammation In The Preterm Rabbit, Despite Antibiotic Therapy, R. Gibbs, J. Davies, R. Mcduffie, Kimberly Leslie, M. Sherman, C. Centretto, D. Wolf

Kimberly K. Leslie

OBJECTIVE: In a pregnant rabbit model using intracervical inoculation of Escherichia coli with delayed antibiotic therapy, we investigated the rate of positive cultures and histologic inflammation of maternal and fetal compartments and the concentration of tumor necrosis factor-alpha in the amniotic fluid for up to 5 days. STUDY DESIGN: New Zealand White rabbits at 70% gestation were inoculated intracervically with 10(3) - 10(4) colony-forming units of E coli per uterine horn. At varying intervals after inoculation (0.5 - 4.0 hours), antibiotic therapy was initiated with ampicillin-sulbactam. Primary outcomes were positive cultures and histologic inflammation score. Tumor necrosis factor-alpha levels in …


Breast Cancer And Pregnancy, Kimberly Leslie, C. Lange Feb 2013

Breast Cancer And Pregnancy, Kimberly Leslie, C. Lange

Kimberly K. Leslie

This article addresses a challenging diagnostic and treatment dilemma encountered in the care of pregnant women-breast cancer. The treatment of a breast cancer is significantly affected by an ongoing pregnancy and may result in an increased risk for a poor outcome in the mother. The definition, incidence, mechanism, diagnosis, and treatment of breast cancer associated with pregnancy and the normal physiologic and endocrine changes in the breast during pregnancy that contribute to the difficulty encountered by practitioners in diagnosing and treating the disorder are reviewed. The risks associated with pregnancy after breast cancer treatment and the effect of pregnancy on …


Chemotherapeutic Drugs In Pregnancy, Kimberly Leslie, C. Koil, W. Rayburn Feb 2013

Chemotherapeutic Drugs In Pregnancy, Kimberly Leslie, C. Koil, W. Rayburn

Kimberly K. Leslie

Chemotherapy may be indicated for the treatment of cancer during pregnancy. The decision to use chemotherapy significantly impacts the pregnancy, and in turn the pregnancy may affect the treatment options available to patients with cancer. This review provides information about the effects of chemotherapeutic agents in pregnancy, taking into account both the mother and the fetus. For convenience, the agents are divided into categories based upon class and mechanism of action. These include alkylating agents, antimetabolites, nucleoside analogs, topoisomerase I inhibitors, topisomerase II inhibitors, vinca alkaloids, taxanes, and biologics such as signaling and growth factor blocking agents.


Chronic Hepatitis C In Pregnancy, E. Berkley, Kimberly Leslie, S. Arora, C. Qualls, J. Dunkelberg Feb 2013

Chronic Hepatitis C In Pregnancy, E. Berkley, Kimberly Leslie, S. Arora, C. Qualls, J. Dunkelberg

Kimberly K. Leslie

OBJECTIVE: To estimate outcomes, to determine whether appropriate follow-up was performed for pregnant patients with hepatitis C virus (HCV), and to show that maternal and neonatal complications would be higher in the HCV-positive group. METHODS: We compared pregnant women from a drug dependence and treatment program who were HCV antibody-positive with those who were HCV antibody-negative using the University of New Mexico Perinatal Database. Maternal and neonatal outcomes were evaluated, including cholestasis of pregnancy, preterm birth, low birth weight, neonatal intensive care unit admissions, and neonatal methadone withdrawal. Variables were compared using Student t, Fisher exact, and chi(2) tests. RESULTS: …