Obstetrics and Gynecology Commons^™

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

Psychology Theses & Dissertations

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 …

El Rol Del Parto Mapuche En El Mundo De La Medicina Moderna / The Role Of Mapuche Birth In A World Of Modern Medicine, Nita Chai

Independent Study Project (ISP) Collection

Research Question: Is there existing demand for Mapuche birth practices and what are the barriers to incorporating them in the Chilean healthcare system? Objective: Analyze the current role of Mapuche birth practicesby determining what is the demand from the Mapuche for their use, describing the quality of communication between Mapuche women andmodern professionals, and identifying the perspectives of modern professionals on Mapuche birth practices. Background: Childbirth is an integral process for the human race. For many indigenous communities, the arrival of a new life holds cultural significance that is recognized through ceremonies during or after childbirth. Chile has implemented health …

Preliminary Analysis Of In Utero Low-Level Arsenic Exposure And Fetal Growth Using Biometric Measurements Extracted From Fetal Ultrasound Reports, Matthew A. Davis, John Higgins, Zhigang Li, Diane Gilbert-Diamond, Emily R. Baker, Amar Das, Margaret R. Karagas

Dartmouth Scholarship

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero.

Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth …

Metformin Prevents Aggressive Ovarian Cancer Growth Driven By High-Energy Diet: Similarity With Calorie Restriction, Zaid Al-Wahab, Ismail Mert, Calvin Tebbe, Jasdeep Chhina, Miriana Hijaz, Robert T. Morris, Rouba Ali-Fehmi, Shailendra Giri, Adnan Munkarah, Ramandeep Rattan

Department of Obstetrics and Gynecology Research Publications

Caloric restriction (CR) was recently demonstrated by us to restrict ovarian cancer growth in vivo. CR resulted in activation of energy regulating enzymes adenosine monophosphate activated kinase (AMPK) and sirtuin 1 (SIRT1) followed by downstream inhibition of Akt-mTOR. In the present study, we investigated the effects of metformin on ovarian cancer growth in mice fed a high energy diet (HED) and regular diet (RD) and compared them to those seen with CR in an immunocompetent isogeneic mouse model of ovarian cancer. Mice either on RD or HED diet bearing ovarian tumors were treated with 200 mg/kg metformin in drinking …

Comparing Effectiveness Of Two Client Follow-Up Approaches In Sustaining The Use Of Long Acting Reversible Contraceptives (Larc) Among The Underserved In Rural Punjab, Pakistan: A Study Protocol And Participants' Profile, Syed Khurram Azmat, Waqas Hameed, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Erik Munroe

Community Health Sciences

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of …

Mdr1 Sirna Loaded Hyaluronic Acid-Based Cd44 Targeted Nanoparticle Systems Circumvent Paclitaxel Resistance In Ovarian Cancer, Xiaoqian Yang, Arun K. Iyer, Amit Singh, Edwin Choy, Francis J. Hornicek, Mansoor M. Amiji, Zhenfeng Duan

Pharmaceutical Sciences Faculty Publications

Development of multidrug resistance (MDR) is an almost universal phenomenon in patients with ovarian cancer, and this severely limits the ultimate success of chemotherapy in the clinic. Overexpression of the MDR1 gene and corresponding P-glycoprotein (Pgp) is one of the best known MDR mechanisms. MDR1 siRNA based strategies were proposed to circumvent MDR, however, systemic, safe, and effective targeted delivery is still a major challenge. Cluster of differentiation 44 (CD44) targeted hyaluronic acid (HA) based nanoparticle has been shown to successfully deliver chemotherapy agents or siRNAs into tumor cells. The goal of this study is to evaluate the ability of …

Intravenous Estrogen Is Not Proven Effective For Abnormal Uterine Bleeding: Guidelines Are Based On Flawed Evidence, Stephen Simmer

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of: DeVore GR, Owens O, Kase N. Use of intravenous Premarin in the treatment of dysfunctional uterine bleeding--a double-blind randomized control study. Obstet Gynecol. 1982 Mar;59(3):285-91.

This appraisal identifies significant statistical irregularities in the study. A reworking of the study's statistics leads to a conclusion different from that put forth by the authors of this paper: intravenous estrogen therapy is not, in fact, significantly more effective compared to placebo therapy for the cessation of acute abnormal uterine bleeding.

Biological Reasons For The Neurotoxic Effects Of Mdma (‘Ecstasy’) On The Developing Fetus, Leah Schneeweiss

The Science Journal of the Lander College of Arts and Sciences

MDMA (3, 4-methylenedioxymethamphetamine) is an illicit, recreational drug known by many individuals as ‘Ecstasy.’ MDMA has gained popularity over the past decade and has become a drug of choice at dance parties and clubs because of the stimulating and hallucinogenic effects that it has on the central nervous system. Scientists have determined that MDMA causes neurotoxic damage to adults by harming the serotonergic system in the adult brain. Researchers discovered that embryos exposed to MDMA while in utero also suffer neurotoxic deficits, although not due to impairments in the embryos’ serotonergic systems. These deficits arise because of the cortisol increase …

Effect Of Single Embryo Transfer On The Risk Of Preterm Birth Associated With In Vitro Fertilization, A. J. Fechner, K. R. Brown, N. Onwubalili, S. K. Jindal, G. Weiss, L. T. Goldsmith, P. G. Mcgovern

Journal Articles

To determine whether elective single embryo transfer (eSET) reduces the risk of preterm delivery associated with in vitro fertilization (IVF). This is an observational study of 3125 eSET cycles performed from 2008 to 2009 and reported to the Society for Assisted Reproductive Technology (SART) database. Preterm delivery rates were compared to the overall preterm delivery rate among all patients undergoing IVF over the same time period. The 3125 eSET cycles resulted in 1507 live births (live birth rate 48.2 %) Among these deliveries were 27 twins (1.8 %) and one set of triplets (0.07 %). The overall preterm delivery rate …

A Critical Role For The Host Mediator Macrophage Migration Inhibitory Factor In The Pathogenesis Of Malarial Anemia, M. A. Mcdevitt, J. Xie, S. Ganapathy-Kanniappan, J. Griffith, A. Liu, C. Mcdonald, P. Thuma, V. R. Gordeuk, C. N. Metz, R. Mitchell, J. Keefer, J. David, L. Leng, R. Bucala

Journal Articles

No abstract provided.

Improving Anatomical Knowledge Through Interactive Modules On The Ob/Gyn Clinical Clerkship, Artin Galoosian, Jill A. Krapf, Kirsten Brown, Gisela Butera, Ellen F. Goldman, Rosalyn A. Jurjus

Anatomy and Regenerative Biology Faculty Posters and Presentations

The goal of this study is to evaluate the impact of a newly designed interactive method of teaching clinically relevant anatomy to medical students on the OB/GYN clerkship. A 20-question multiple-choice exam was administered to 143 consenting third-year medical students at the beginning and end of each OB/GYN rotation. Students participated in a skills lab with preparatory e-modules that linked anatomy to clinical applications during each rotation. Topics included perineal muscle anatomy (laceration), anterior abdominal wall anatomy (cesarean section), vulvovaginal and uterine anatomy (IUD), and pelvic organ, vasculature, and neural anatomy (hysterectomy). Mean scores improved significantly after the nesting of …

Cervical Varices Presenting As Vaginal Bleeding: A Description Of Two Cases And A Management Plan, Kathy Chyjek, Catherine Hutz, Charles Macri, Jeffrey S. Berger, Anthony C. Venbrux, Nadia Juliet Khati, Dorothy I. Bulas, John W. Larsen

Obstetrics and Gynecology Faculty Publications

Background: Varicose veins are common in pregnancy. However, potentially life-threatening uterine cervical varices have rarely been reported and there are currently no guidelines for their management. Cases: We present two cases of cervical varices found in the setting of second and third trimester bleeding, report on the clinical outcomes and propose a management plan. Both of our patients were delivered between 38-39 weeks gestation and required interdisciplinary meetings between Obstetrics and Gynecology, Anesthesiology, Neonatology and Interventional Radiology to prepare for delivery. Conclusion: For patients in which varices are found inside the cervix, we recommend consideration of second trimester cerclage followed …

Use Of External Cephalic Version And Amnioreduction In The Delivery Of A Fetal Demise With Macrocephaly Secondary To Massive Intracranial Teratoma, M. J. Blitz, E. Greeley, H. T. Tam, B. Rochelson

Journal Articles

Introduction Congenital intracranial tumors are rare and often incidentally diagnosed on routine ultrasound. We report a case of a fetal demise with a massive intracranial teratoma at 25 weeks of gestation and the management of her delivery in the setting of macrocephaly, breech presentation, and polyhydramnios. Case A 31-year-old G3P1011 woman at 25 weeks' gestation presented with a recent fetal demise and a fetal intracranial tumor first identified at 16 weeks' gestational age. The patient had declined termination of pregnancy. Biometry was consistent with 24 weeks' gestation, except for a head circumference of 394.4 mm consistent with 39 weeks' gestation. …

Dynamic Reciprocity Between Cells And Their Microenvironment In Reproduction, J. T. Thorne, T. R. Segal, S. Chang, S. Jorge, J. H. Segars, P. C. Leppert

Journal Articles

Dynamic reciprocity (DR) refers to the ongoing, bidirectional interaction between cells and their microenvironment, specifically the extracellular matrix (ECM). The continuous remodeling of the ECM exerts mechanical force on cells and modifies biochemical mediators near the cell membrane, thereby initiating cell-signaling cascades that produce changes in gene expression and cell behavior. Cellular changes, in turn, affect the composition and organization of ECM components. These continuous interactions are the fundamental principle behind DR, and its critical role throughout development and adult tissue homeostasis has been extensively investigated. While DR in the mammary gland has been well described, we provide direct evidence …

A Preliminary Study Of Three-Dimensional Sonographic Measurements Of The Fetus, U. Ergaz, I. Goldstein, M. Divon, Z. Weiner

Journal Articles

OBJECTIVES: This study was aimed at establishing an ideal method for performing three-dimensional measurements of the fetus in order to improve the estimation of fetal weight. METHODS: The study consisted of two phases. Phase I was a prospective cross-sectional study performed between 28 and 40 weeks' gestation. The study population (n=110) comprised low-risk singleton pregnancies who underwent a routine third-trimester sonographic estimation of fetal weight. The purpose of this phase was to establish normal values for the fetal abdominal and head volumes throughout the third trimester. Phase II was a prospective study that included patients admitted for an elective cesarean …

Adolescent Experiences With Intrauterine Devices: A Qualitative Study, E. O. Schmidt, A. James, K. M. Curran, J. F. Peipert, T. Madden

Journal Articles

PURPOSE: The purpose of this study was to improve understanding of adolescents' reasons for choosing an intrauterine device (IUD) and to explore experiences that led to continuation or discontinuation of the levonorgestrel intrauterine system (LNG-IUS) and the copper IUD (copper IUD). METHODS: We conducted focus groups (FGs) with adolescents and young women who were current or former IUD users stratified by IUD type and 12-month IUD continuation or discontinuation. All subjects were participants from the Contraceptive CHOICE Project. FG data were supplemented with in-depth interviews (IDIs). Data collection was continued until thematic saturation was reached. Transcripts were independently coded by …

A Quantitative Proteomics-Based Signature Of Platinum Sensitivity In Ovarian Cancer Cell Lines, G. Fan, K. O. Wrzeszczynski, C. Fu, G. Su, D. J. Pappin, R. Lucito, N. K. Tonks

Journal Articles

Although DNA encodes the molecular instructions that underlie the control of cell function, it is the proteins that are primarily responsible for implementing those instructions. Therefore quantitative analyses of the proteome would be expected to yield insights into important candidates for the detection and treatment of disease. We present an iTRAQ (isobaric tag for relative and absolute quantification)-based proteomic analysis of ten ovarian cancer cell lines and two normal ovarian surface epithelial cell lines. We profiled the abundance of 2659 cellular proteins of which 1273 were common to all 12 cell lines. Of the 1273, 75 proteins exhibited elevated expression …

Spag17 Deficiency Results In Skeletal Malformations And Bone Abnormalities, Maria Eugenia Teves, Gobalakrishnan Sundaresan, David J. Cohen, Sharon L. Hyzy, Illya Kajan, Melissa Maczis, Zhibing Zhang, Richard M. Costanzo, Jamal Zweit, Zvi Schwartz, Barbara` D. Boyan, Jerome F. Strauss Iii

Obstetrics and Gynecology Publications

Height is the result of many growth and development processes. Most of the genes associated with height are known to play a role in skeletal development. Single-nucleotide polymorphisms in the SPAG17 gene have been associated with human height. However, it is not clear how this gene influences linear growth. Here we show that a targeted mutation in Spag17 leads to skeletal malformations. Hind limb length in mutants was significantly shorter than in wild-type mice. Studies revealed differences in maturation of femur and tibia suggesting alterations in limb patterning. Morphometric studies showed increased bone formation evidenced by increased trabecular bone area …

Sperm Associated Antigen 6 (Spag6) Regulates Fibroblast Cell Growth, Morphology, Migration And Ciliogenesis, Wei Li, Abir Mukherjee, Jinhua Wu, Ling Zhang, Maria E. Teves, Hongfei Li, Shanti Nambiar, Scott C. Henderson, Alan R. Horwitz, Jerome F. Strauss Iii, Xianjun Fang, Zhibing Zhang

Obstetrics and Gynecology Publications

Mammalian Spag6 is the orthologue of Chlamydomonas PF16, which encodes a protein localized in the axoneme central apparatus, and regulates flagella/cilia motility. Most Spag6-deficient mice are smaller in size than their littermates. Because SPAG6 decorates microtubules, we hypothesized that SPAG6 has other roles related to microtubule function besides regulating flagellar/cilia motility. Mouse embryonic fibroblasts (MEFs) were isolated from Spag6-deficient and wild-type embryos for these studies. Both primary and immortalizedSpag6-deficient MEFs proliferated at a much slower rate than the wild-type MEFs, and they had a larger surface area. Re-expression of SPAG6 in the Spag6-deficient MEFs …

Characterizing The Propagation Of Uterine Electrophysiological Signals Recorded With A Multi-Sensor Abdominal Array In Term Pregnancies., Diana Escalona-Vargas, Rathinaswamy B. Govindan, Adrian Furdea, Pam Murphy, Curtis L Lowery, Hari Eswaran

Pediatrics Faculty Publications

The objective of this study was to quantify the number of segments that have contractile activity and determine the propagation speed from uterine electrophysiological signals recorded over the abdomen. The uterine magnetomyographic (MMG) signals were recorded with a 151 channel SARA (SQUID Array for Reproductive Assessment) system from 36 pregnant women between 37 and 40 weeks of gestational age. The MMG signals were scored and segments were classified based on presence of uterine contractile burst activity. The sensor space was then split into four quadrants and in each quadrant signal strength at each sample was calculated using center-of-gravity (COG). To …

The Impact Of Centeringpregnancy Implementation, Carole Ann Moleti

2010-2016 Archived Posters

Evaluation of 6 Centering Pregnancy Group Prenatal Care cycles showed the logic models supported implementation and expansion of Centering Groups at 2 federally qualified health centers. There was adequate progress toward site approval with favorable method fidelity scores in addition to patient and staff satisfaction ratings using the Centering Counts data collection system. Outcomes in 33 participants demonstrated beneficial effects on key indicators.

Meeting The Challenge Of Abortion As A Topic In Medical Education, Julia B. Frank, Seema Kakar, Gisela Butera, Maria Jarkowiec, Suzanne Gouda

Medicine Faculty Posters and Presentations

Abortions typically occur outside of academic medical centers, in a highly politicized context. As adult learners. students may have well formed beliefs about abortion. Few schools address the subject in the clinical years and even fewer in the pre-clinical years. Fulfilling the APGO mandate to provide abortion education requires the development of innovative approaches.

Financing Early Childhood Education: An Investment Into The Future, Shelina Bhamani

Department of Obstetrics & Gynaecology

No abstract provided.

Psychobiobehavioral Model For Preterm Birth In Pregnant Women In Low- And Middle-Income Countries, Shahirose S. Premji, Ilona S. Yim, Aliyah Dosani (Mawji), Zeenatkhanu Kanji, Salima Sulaiman, Wangira Musana, Pauline Samia, Kiran Shaikh, Nicole Letourneau

School of Nursing & Midwifery, East Africa

Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in …

Fmic Annual Report 2015 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Sexual Onset And Contraceptive Use Among Adolescents From Poor Neighbourhoods In Managua, Nicaragua, Peter Decat, Sara De Meyer, Lina Jaruseviciene, Miguel Orozco, Marcia Ibarra, Zoyla Segura, Bernardo Vega, Kristien Michielsen, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Background and objectives: The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned.

Methods: From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use.

Results: Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption …

Intravenous Tranexamic Acid As An Adjunct Haemostat To Ornipressin During Open Myomectomy. A Randomized Double Blind Placebo Controlled Trial, Sammy Ngichabe, Timona Obura, William Stones

Obstetrics and Gynaecology, East Africa

Background: Myomectomy is a surgical technique used for removal of uterine fibroids and historically hysterectomy has represented the mainstay of treatment. The options of conservative surgical approaches mainly aim at retention of fertility but have to be balanced against potential risks such as haemorrhage; blood loss at myomectomy still remains troublesome with use of various pharmacologic agents yielding inconclusive results. This trial aimed to explore the benefit of combining ornipressin and tranexamic acid during open myomectomy.

Study design: A randomized double blind placebo controlled trial.

Methods: Women who satisfied eligibility criteria were enrolled into the study and randomized into one …

A Review Of Factors Associated With The Utilization Of Healthcare Services And Strategies For Improving Postpartum Care In Africa, Danielle Yugbare Belemsaga, Anne Goujon, Joel A. Kiendrebeogo, Els Duysburgh, Seni Kouanda, Olivier Degomme, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Reducing maternal mortality continues to be a major challenge for African countries. We conducted a literature review to identify the factors associated with the utilization of maternal and child healthcare services during the postpartum period and the strategies for strengthening postpartum healthcare in Africa. We carried out an electronic search in several databases of texts published between 1995 and 2012 related to maternal and child health. Seventy-five publications fitted the eligibility criteria. Our analysis shows that to a large extent the socio-economic context was dominant among the factors associated with the quality and utilization of postpartum services. The best interventions …

Underuse Of Modern Methods Of Contraception: Underlying Causes And Consequent Undesired Pregnancies In 35 Low- And Middle-Income Countries, Saverio Bellizzi, Howard L. Sobel, Hiromi Obara, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Study question: What is the contribution of the underuse of modern methods (MM) of contraception to the annual undesired pregnancies in 35 low- and middle-income countries?

Summary answer: Fifteen million out of 16.7 million undesired pregnancies occurring annually in 35 countries could have been prevented with the optimal use of MM of contraception.

What is known already: Every year, 87 million women worldwide become pregnant unintentionally because of the underuse of MM of contraception.

Study design, size, duration: Demographic and health surveys (DHS) of 35 countries, conducted between 2005 and 2012, were analysed.

Participants/materials, setting, methods: Contraceptive use of 12 …

Sexual And Reproductive Health Knowledge, Contraception Uptake, And Factors Associated With Unmet Need For Modern Contraception Among Adolescent Female Sex Workers In China, Megan S. C. Lim, Xu-Dong Zhang, Elissa Kennedy, Yan Li, Yin Yang, Lin Li, Yun-Xia Li, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Objective: In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China.

Methods: A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire …