Obstetrics and Gynecology Commons^™

Sexual And Reproductive Health Of Migrants: Does The Eu Care?, Ines Keygnaert, Aurore Guieu, Gorik Ooms, Nicole Vettenburg, Marleen Temmerman, Kristien Roelens

Obstetrics and Gynaecology, East Africa

The European Union (EU) refers to health as a human right in many internal and external communications, policies and agreements, defending its universality. In parallel, specific health needs of migrants originating from outside the EU have been acknowledged. Yet, their right to health and in particular sexual and reproductive health (SRH) is currently not ensured throughout the EU. This paper reflects on the results of a comprehensive literature review on migrants' SRH in the EU applying the Critical Interpretive Synthesis review method. We highlight the discrepancy between a proclaimed rights-based approach to health and actual obstacles to migrants' attainment of …

A Multi-Center, Two-Arm, Single-Blind Randomized Trial Of Two Different Intravenous Fluids During Labor (Poster)., Lisa M. Dapuzzo-Argiriou Md, John C. Smulian Md, Mph, Meredith Rochon Md, Luisa Galdi Do, Jessika Kissling Md, Peter F. Schnatz Do, George Neubert Md, Angel Gonzalez-Rios Md, James Airoldi Md, Mary Anne Carrillo Md, Jaimie Maines Md, Allen R. Kunselman Ms, John Repke Md, Richard S. Legro Md

Department of Obstetrics & Gynecology

No abstract provided.

Maternal Biomarkers Of Endothelial Dysfunction And Preterm Delivery, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Endothelial dysfunction is key to the development of atherosclerosis. Preterm delivery foreshadows later maternal cardiovascular disease (CVD), but it is not known if endothelial dysfunction also occurs. We prospectively measured circulating biomarkers of endothelial dysfunction in pregnant women with preterm or term delivery.

METHODS: We conducted a case-control study nested within a large prospective epidemiological study of young, generally healthy pregnant women. Women who delivered preterm (gestation, n = 240) and controls who delivered at term (n = 439) were included. Pregnancies complicated by preeclampsia were analyzed separately. Circulating endothelial dysfunction biomarkers included soluble intercellular adhesion molecule-1 (sICAM-1), vascular …

High Levels Of Sox5 Decrease Proliferative Capacity Of Human B Cells, But Permit Plasmablast Differentiation, Mirzokhid Rakhmanov, Heiko Sic, Anne-Kathrin Kienzler, Beate Fischer, Marta Rizzi, Maximillian Seidl, Kerstina Melkaoui, Susanne Unger, Luisa Moehle, Nadine E. Schmit, Sachin D. Deshmukh, Cemil K. Ayata, Wolfgang Schuh, Zhibing Zhang, François-Loic Cosset, Els Verhoeyen, Hans-Hartmut Peter, Reinhard E. Voll, Ulrich Salzer, Hermann Eibel, Klaus Wamatz

Obstetrics and Gynecology Publications

Currently very little is known about the differential expression and function of the transcription factor SOX5 during B cell maturation. We identified two new splice variants of SOX5 in human B cells, encoding the known L-SOX5B isoform and a new shorter isoform L-SOX5F. The SOX5transcripts are highly expressed during late stages of B-cell differentiation, including atypical memory B cells, activated CD21low B cells and germinal center B cells of tonsils. In tonsillar sections SOX5 expression was predominantly polarized to centrocytes within the light zone. After in vitro stimulation, SOX5 expression was down-regulated during proliferation while high expression levels were …

Reassessing The Impact Of Smoking On Preeclampsia/Eclampsia: Are There Age And Racial Differences?, Jen Jen Chang, Jerome F. Strauss, Jonathan P. Deshazo, Fidelma B. Rigby, David P. Chelmow, George A. Macones

Obstetrics and Gynecology Publications

Objective

To investigate the association between cigarette use during pregnancy and pregnancy-induced hypertension/preeclampsia/eclampsia (PIH) by maternal race/ethnicity and age.

Methods

This retrospective cohort study was based on the U.S. 2010 natality data. Our study sample included U.S. women who delivered singleton pregnancies between 20 and 44 weeks of gestation without major fetal anomalies in 2010 (n = 3,113,164). Multivariate logistic regression models were fit to estimate crude and adjusted odds ratios and the corresponding 95% confidence intervals.

Results

We observed that the association between maternal smoking and PIH varied by maternal race/ethnicity and age. Compared with non-smokers, reduced odds of …

Sperm-Associated Antigen 6 (Spag6) Deficiency And Defects In Ciliogenesis And Cilia Function: Polarity, Density, And Beat, Maria E. Teves, Patrick R. Sears, Wei Li, Zhengang Zhang, Waixing Tang, Lauren Van Reesema, Richard M. Costanzo, C. William Davis, Michael R. Knowles, Jerome F. Strauss Iii, Zhibing Zhang

Obstetrics and Gynecology Publications

SPAG6, an axoneme central apparatus protein, is essential for function of ependymal cell cilia and sperm flagella. A significant number of Spag6-deficient mice die with hydrocephalus, and surviving males are sterile because of sperm motility defects. In further exploring the ciliary dysfunction in Spag6-null mice, we discovered that cilia beat frequency was significantly reduced in tracheal epithelial cells, and that the beat was not synchronized. There was also a significant reduction in cilia density in both brain ependymal and trachea epithelial cells, and cilia arrays were disorganized. The orientation of basal feet, which determines the direction of axoneme …

Minor Gynecologic Surgery: A Review Of The Training Experience And Skill Building Opportunities For Providers In Low And Middle Income Countries, Rachel Marie Clark, Leslie Siriya Bradford, Jessica Opoku-Anane, Joseph Ngonzi, Ferdous Islam, Mithila Faruque, Annekathryn Goodman

Obstetrics and Gynecology Faculty Publications

Purpose: Minor gynecologic surgery is the cornerstone of gynecologic evaluation and intervention in countries with a well-established medical infrastructure. Surgical training and exposure to minor procedures are not available in low and middle-income countries due to the complex challenges of patient delay and lack of access to healthcare, physician shortages, and the lack of ancillary services such as pathology and radiology. This paper reviews current training statistics, the international literature on minor gynecologic surgery and training strategies.

Methods: PubMed searches using MESH terms cone biopsy, dilation and curettage, and loop electrosurgical excision procedure were performed. Statistics of minor …

Maternal Magnesium Deficiency In Mice Leads To Maternal Metabolic Dysfunction And Altered Lipid Metabolism With Fetal Growth Restriction, M. Gupta, M. H. Solanki, P. K. Chatterjee, X. Y. Xue, A. Roman, N. Desai, B. Rochelson, C. N. Metz

Journal Articles

Inadequate magnesium (Mg) intake is a widespread problem, with over 50% of women of reproductive age consuming less than the Recommended Dietary Allowance (RDA). Because pregnancy increases the requirement for Mg and the beneficial effects of magnesium sulfate for preeclampsia/eclampsia and fetal neuroprotection are well described, we examined the outcomes of Mg deficiency during pregnancy. Briefly, pregnant Swiss Webster mice were fed either control or Mg-deficient diets starting on gestational day (GD) 6 through euthanasia on GD17. Mg-deficient dams had significantly reduced weight gain and higher plasma adipokines, in the absence of inflammation. Livers of Mg-deficient dams had significantly higher …

Pregnancy Associated Plasma Protein-A2: A Novel Biomarker For Down Syndrome, S. Munnangi, S. J. Gross, R. Madankumar, G. Salcedo, S. E. Reznik

Journal Articles

Introduction: In an effort to improve prenatal screening for Trisomy 21, we evaluated pregnancy associated plasma protein-A2 (PAPP-A2) as a potential novel second trimester biomarker for Trisomy 21. Methods: Trisomy 21 and normal control mid-trimester placental samples were subjected to quantitative rt PCR analysis of seven genes we had previously found to be differentially expressed in Trisomy 21 placentae. The localization and differential expression of PAPP-A2 in second trimester placentae from normal and Trisomy 21 pregnancies was determined by immunohistochemistry. PAPP-A2 maternal serum protein levels in ten Trisomy 21 and ten diploid pregnancies were compared by Western blotting. Maternal serum …

Circulating Biomarkers For Detection Of Ovarian Cancer And Predicting Cancer Outcomes, I. Shapira, M. Oswald, J. Lovecchio, H. Khalili, A. Menzin, Jill Whyte, L. Dos Santos, S. Liang, T. Bhuiya, M. Keogh, C. Mason, K. Sultan, D. Budman, P. K. Gregersen, A. T. Lee

Journal Articles

Background: Securing a diagnosis of ovarian cancer and establishing means to predict outcomes to therapeutics remain formidable clinical challenges. Early diagnosis is particularly important since survival rates are markedly improved if tumour is detected early. Methods: Comprehensive miRNA profiles were generated on presurgical plasma samples from 42 women with confirmed serous epithelial ovarian cancer, 36 women diagnosed with a benign neoplasm, and 23 comparably age-matched women with no known pelvic mass. Results: Twenty-two miRNAs were differentially expressed between healthy controls and the ovarian cancer group (P

Brain Region-Specific Alterations In The Gene Expression Of Cytokines, Immune Cell Markers And Cholinergic System Components During Peripheral Endotoxin-Induced Inflammation, H. A. Silverman, M. Dancho, A. Regnier-Golanov, M. Nasim, M. Ochani, P. S. Olofsson, M. Ahmed, E. J. Miller, S. S. Chavan, E. Golanov, C. Metz, K. J. Tracey, V. A. Pavlov

Journal Articles

Inflammatory conditions characterized by excessive peripheral immune responses are associated with diverse alterations in brain function, and brain-derived neural pathways regulate peripheral inflammation. Important aspects of this bidirectional peripheral immune - brain communication, including the impact of peripheral inflammation on brain region-specific cytokine responses, and brain cholinergic signaling (which plays a role in controlling peripheral cytokine levels) remain unclear. To provide insight, we studied gene expression of cytokines, immune cell markers and brain cholinergic system components in the cortex, cerebellum, brainstem, hippocampus, hypothalamus, striatum, and thalamus in mice following an intraperitoneal lipopolysaccharide injection. Endotoxemia was accompanied by elevated serum levels …

Spontaneous Live Recurrent Ectopic Pregnancy After Ipsilateral Partial Salpingectomy Leading To Tubal Rupture, C. Abraham, V. Seethappan

Journal Articles

INTRODUCTION: Ectopic pregnancy accounts for 1-2% of all pregnancies in the United States. The most common site of implantation for an ectopic pregnancy is the fallopian tube. We present the first case describing a recurrent ectopic pregnancy with a fetal heartbeat after ipsilateral salpingectomy that led to tubal rupture. PRESENTATION OF CASE: The patient presented with abdominal pain approximately six weeks after her last menstrual period. Seven years prior to presentation, a laparoscopic partial right salpingectomy had been performed for a tubal ectopic pregnancy. Physical exam was significant for diffuse abdominal tenderness and guarding. Ultrasonography revealed a right tubal pregnancy …

Laser-Assisted Zona Pellucida Thinning Does Not Facilitate Hatching And May Disrupt The In Vitro Hatching Process: A Morphokinetic Study In The Mouse, T. Schimmel, J. Cohen, H. Saunders, M. Alikani

Journal Articles

STUDY QUESTION: Does laser-assisted zona thinning of cleavage stage mouse embryos facilitate hatching in vitro? SUMMARY ANSWER: No, unlike laser zona opening, zona thinning does not facilitate embryo hatching. WHAT IS KNOWN ALREADY: Artificial opening of the zona pellucida facilitates hatching of mouse and human embryos. Laser-assisted zona thinning has also been used for the purpose of assisted hatching of human embryos but it has not been properly investigated in an animal model; thinning methods have produced inconsistent clinical results. STUDY DESIGN, SIZE, DURATION: Time-lapse microscopy was used to study the hatching process in the mouse after zona opening and …

Letrozole Versus Clomiphene For Infertility In The Polycystic Ovary Syndrome, Richard S. Legro, Robert Bryzki, Michael Diamond, Christos Coutifaris, William D. Schlaff, Peter Casson, Gregory M. Christman, Hao Huang, Qingshang Yan, Ruben Alvero, Daniel J. Haisenleder, Kurt T. Barnhart, G. Wright Bates, Rebecca Usadi, Scott Lucidi, Valerie Baker, J. C. Trussell, Stephen A. Krawetz, Peter Snyder, Dana Ohl, Nanette Santoro, Esther Eisenberg, Heping Zhang

Obstetrics and Gynecology Publications

BACKGROUND

Clomiphene is the current first-line infertility treatment in women with the polycystic ovary syndrome, but aromatase inhibitors, including letrozole, might result in better pregnancy outcomes.

Full Text of Background...

METHODS

In this double-blind, multicenter trial, we randomly assigned 750 women, in a 1:1 ratio, to receive letrozole or clomiphene for up to five treatment cycles, with visits to determine ovulation and pregnancy, followed by tracking of pregnancies. The polycystic ovary syndrome was defined according to modified Rotterdam criteria (anovulation with either hyperandrogenism or polycystic ovaries). Participants were 18 to 40 years of age, had at least one patent fallopian …

Contraceptive Sabotage, Leah A. Plunkett

Law Faculty Scholarship

This Article responds to the alarm recently sounded by the American College of Obstetricians and Gynecologists over “birth control sabotage”—the “active interference [by one partner] with [the other] partner’s contraceptive methods in an attempt to promote pregnancy.” Currently, sabotage is not a crime, and existing categories of criminal offenses fail to capture the essence of the injury it does to victims. This Article argues that sabotage should be a separate crime—but only when perpetrated against those partners who can and do get pregnant as a result of having sabotaged sex. Using the principle of self-possession—understood as a person’s basic right …

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

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 …

Challenges And Considerations In Optimizing Ovarian Stimulation Protocols In Oncofertility Patients, Kathryn Coyne, Makenzie Purdy, Kathleen O'Leary, Jerome L. Yaklic, Steven R. Lindheim, Leslie A. Appiah

Obstetrics and Gynecology Faculty Publications

The scope of cancer treatment in women of childbearing age has changed in the last decade. Fertility preservation is no longer an afterthought but central to multi-disciplinary cancer treatment planning and should be addressed due to the cytotoxic effects of cancer therapy. However, oncology patients present as a unique treatment challenge as the physician must balance the urgency of fertility preservation with the risks of delaying cancer therapy. Controlled ovarian stimulation (COS) is routinely applied in assisted reproductive technology but can be contraindicated in women with estrogen-receptor-positive tumors. This paper reviews some of the challenges to consider when using COS …

Maternal Opioid Drug Use During Pregnancy And Its Impact On Perinatal Morbidity, Mortality, And The Costs Of Medical Care In The United States, Valerie E. Whiteman, Jason L. Salemi, Mulubrhan F. Mogos, Mary Ashley Cain, Muktar H. Aliyu, Hamisu M. Salihu

Obstetrics & Gynecology Faculty Publications

Objective. To identify factors associated with opioid use during pregnancy and to compare perinatal morbidity, mortality, and healthcare costs between opioid users and nonusers. Methods. We conducted a cross-sectional analysis of pregnancy-related discharges from 1998 to 2009 using the largest publicly available all-payer inpatient database in the United States. We scanned ICD-9-CM codes for opioid use and perinatal outcomes. Costs of care were estimated from hospital charges. Survey logistic regression was used to assess the association between maternal opioid use and each outcome; generalized linear modeling was used to compare hospitalization costs by opioid use status. Results. …

Fmic Annual Report 2014 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Characterisation Of The Vaginal Microflora Of Human Immunodeficiency Virus (Hiv) Positive And Negative Women In A Sub-Urban Population Of Kenya, Teresa N. Kiama, Rita Verhelst, Paul M. Mbugua, Mario Vaneechoutte, Hans Verstraelen, Benson Estambale, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Lactobacilli predominate normal vaginal microflora and are important in maintenance of vaginal health. The current study set out to identify and compare culture isolates of vaginal microflora of human immunodeficiency virus (HIV) positive (HIV+ ) and HIV negative (HIV- ) women at different phases during menstrual cycle from a sub-urban population of Kenya. Seventy four (74) women, 41 HIV+ and 33 HIV- , followed up two consecutive menstrual cycles, had high vaginal swabs taken to prepare Gram stains for six visits and anaerobic cultures for four. All 751 isolates identified by t-DNA polymerase chain reaction (PCR) belong to 51 species. …

Identifying Factors Associated With The Uptake Of Prevention Of Mother To Child Hiv Transmission Programme In Tigray Region, Ethiopia: A Multilevel Modeling Approach, Wondwossen Lerebo, Steven Callens, Debra Jackson, Christina Zarowsky, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Prevention of mother to child HIV transmission (PMTCT) remains a challenge in low and middle-income countries. Determinants of utilization occur – and often interact - at both individual and community levels, but most studies do not address how determinants interact across levels. Multilevel models allow for the importance of both groups and individuals in understanding health outcomes and provide one way to link the traditionally distinct ecological- and individual-level studies. This study examined individual and community level determinants of mother and child receiving PMTCT services in Tigray region, Ethiopia.

Methods: A multistage probability sampling method was used for this …

A History Of Abuse And Operative Delivery - Results From A European Multi-Country Cohort Study, Berit Schei, Mirjam Lukasse, Elsa Lena Ryding, Jacquelyn Campbell, Helle Karro, Hildur Kristjansdottir, Made Laanpere, Anne-Mette Schroll, Ann Tabor, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult.

Design: The Bidens study, a cohort study in six European countries (Belgium, Iceland, Denmark, Estonia, Norway, and Sweden) recruited 6724 pregnant women attending routine antenatal care. History of abuse was assessed through questionnaire and linked to obstetric information from hospital records. The main outcome measure was operative delivery as …

International Standards For Early Fetal Size And Pregnancy Dating Based On Ultrasound Measurement Of Crown–Rump Length In The First Trimester Of Pregnancy, A. T. Papageorghiou, S. H. Kennedy, L. J. Salomon, E. O. Ohuma, L. Cheikh Ismail, F. C. Barros, A. Lambert, Maria Carvalho, Y. A. Jaffer, E. Bertino, M. G. Gravett, D. G. Altman, M. Purwar, J. A. Noble, R. Pang, C. G. Victora, Z. A. Bhutta, J. Villar

Obstetrics and Gynaecology, East Africa

Objectives: There are no international standards for relating fetal crown–rump length (CRL) to gestational age (GA), and most existing charts have considerable methodological limitations. The INTERGROWTH-21^st Project aimed to produce the first international standards for early fetal size and ultrasound dating of pregnancy based on CRL measurement.

Methods: Urban areas in eight geographically diverse countries that met strict eligibility criteria were selected for the prospective, population-based recruitment, between 9 + 0 and 13 + 6 weeks' gestation, of healthy well-nourished women with singleton pregnancies at low risk of fetal growth impairment. GA was calculated on the basis of a …

Rwandan Young People’S Perceptions On Sexuality And Relationships: Results From A Qualitative Study Using The ‘Mailbox Technique’, Kristien Michielsen, Pieter Remes, John Rugabo, Ronan Van Rossem, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

This study aimed to gain more insight into young Rwandans’ perceptions on sex and relationships, which is essential for formulating effective sexual and reproductive health (SRH) promotion interventions. Using a ‘mailbox technique’, this paper studies the spontaneous thoughts of Rwandan young people on sexuality. Mailboxes were installed in five secondary schools in the Bugesera district and students were invited to write about their ideas, secrets, wishes, desires and fears on sexuality and relationships. Of the 186 letters collected, 154 addressed SRH topics. The letters were analysed in NVivo 9 using a theoretical model on vulnerability. Two stereotypical sexual interactions co-exist: …

Sexual Violence And Sub-Saharan Migrants In Morocco: A Community-Based Participatory Assessment Using Respondent Driven Sampling, Ines Keygnaert, Abdessamad Dialmy, Altay Manço, Jeroen Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The European Union contracted Morocco to regulate migration from so-called “transit migrants” from Morocco to Europe via the European Neighbourhood Policy. Yet, international organisations signal that human, asylum and refugee rights are not upheld in Morocco and that many sub-Saharan migrants suffer from ill-health and violence. Hence, our study aimed at 1) investigating the nature of violence that sub-Saharan migrants experience around and in Morocco, 2) assessing which determinants they perceive as decisive and 3) formulating prevention recommendations.

Methods: Applying Community-Based Participatory Research, we trained twelve sub-Saharan migrants as Community Researchers to conduct in-depth interviews with peers, using Respondent …

Measuring The Impact Of Contraceptive Use On Unintended Pregnancy And Other Health Outcomes, Step Up Research Programme Consortium

Reproductive Health

This brief describes several statistical models that have been developed to estimate the number of health outcomes that will be averted because of contraceptive use. Concerns have been expressed that this range of approaches—which overlap in the impacts they estimate, but sometimes use different inputs, mathematical algorithms, and assumptions, and may produce different results—may be confusing for policymakers, managers, and donors who want to measure or evaluate these impacts. To address these concerns, the STEP UP consortium convened two expert meetings to review the estimation methods used; come to consensus on methodologies and assumptions, where possible; and provide guidance to …

Eating Disorders: The Hidden Hormonal Effect On Fertility, Esther Tessler-Karfunkel

The Science Journal of the Lander College of Arts and Sciences

Women who have a history of eating disorders, specifically anorexia nervosa, are more prone to suffer from infertility. There are several hormones which are the driving force in this system and are therefore responsible for this. Fortunately, there are treatments which can help women with a history of eating disorders to reproduce. Using information found on Pubmed and Touro College’s database, this paper will discuss why the body cannot reproduce when it is lacking proper nutrition, as well as the various dynamics in the human reproductive system which are compromised when the body is not properly nourished.

Adolescence And Sexuality, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Association Between Parity And Rubella Seropositivity Among Older Reproductive-Age Women, Ibtisam Salim Awadh

Master of Medicine in Obstetrics and Gynecology

Background: Rubella virus when it infects a non-pregnant adult or child usually causes a mild febrile rash illness. However, infection in the first 12 weeks of pregnancy causes miscarriages, stillbirths or foetal anomalies known as congenital rubella syndrome (CRS). Factors associated with rubella immunity include age and parity. No studies have been done to isolate the association of parity independent of age. Objectives: To determine the seroprevalence of rubella IgG antibodies among nulliparous and multiparous women of the same age-group attending various clinics in Aga Khan University Hospital, Nairobi, Design: A cross-sectional study of women attending a tertiary hospital, Nairobi, …

A Mother's Paradox: Choosing A Birthing Method In The 21st Century, Jenae Franklin

Pitzer Senior Theses

Investigating childbirth, one of the biggest moments of a woman’s life, this thesis examines the reasons behind women’s preferred birthing methods. This research explores the fundamental decisions women make during the birthing process: the amount of prenatal care mothers will receive, the type of health care provider they will use, picking the place of delivery, views on technological and medical interventions, and outlooks on natural childbirth. In addition to an extensive literature review, in-depth interviews with mothers, midwives, and obstetricians are used to examine the various controversies of childbirth. This thesis begins with a review of the transition from midwives …