Obstetrics and Gynecology Commons^™

La Planification Familiale Postpartum Au Burkina Faso - Résumé En Français, Step Up Research Programme Consortium

Reproductive Health

Ce résumé décrit une étude sur la planification familiale post-partum (PFPP) au Burkina Faso. L’étude avait pour but: de donner un aperçu de la disponibilité et la qualité des services prénatals, du post-partum, et de planification familiale au niveau des soins primaires, et d’évaluer la mesure dans laquelle ils fournissent des services efficaces de PFPP; d’évaluer l'accessibilité des services PFPP; d’explorer l’effet de facteurs sociaux, économiques, et culturels sur la demande et l'adoption de la PFPP; d’estimer l’impact, la pertinence, et la mise en œuvre de la politique nationale et des protocoles cliniques par rapport à la PFPP; et d’identifier …

International Seminar On Promoting Postpartum And Post-Abortion Family Planning: Challenges And Opportunities, Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with the Population Council, India, and the Department of Reproductive Health and Research, World Health Organization held a seminar on “Promoting postpartum and post-abortion family planning: Challenges and opportunities” in Cochin, India, November 2014. The seminar brought together 24 scientists, policymakers, and program managers to present and discuss a range of issues relating to postpartum and post-abortion family planning. This report summarizes the papers presented at the seminar which sought to answer several key questions pertaining to postpartum and post-abortion contraception. Several conclusions drawn from the evidence are presented and research …

Unintended Pregnancy And Abortion In India: Country Profile Report, Mary Philip Sebastian, M.E. Khan, Daliya Sebastian

Reproductive Health

A review of literature and analysis of large surveys were carried out with funding from the STEP UP consortium led by Population Council to build a coherent body of robust research-based evidence on the situation in India in the context of unmet need for family planning (FP) and safe abortion services. The study found that there is insufficient training of different cadres of health staff in the public health system on abortion provision, post-abortion care, FP counseling of young couples, emergency contraception, and IUD insertion/removal. Despite service delivery guidelines in India expecting providers to provide FP counseling during antenatal visits, …

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …

Gender Differences In Self-Esteem In Young Adolescents Of Karachi, Shelina Bhamani, Sabeen Jamil, Falak Zehra Mohsin

Department of Obstetrics & Gynaecology

The purpose of this research was to explore the self-esteem trends in adolescents of Karachi, Pakistan with regard to gender differences. The insights from previous literature helped to form the hypothesis that there will be a significant gender difference on the self-esteem of adolescents variable. There were a total 224 (96 male and 126 female) adolescents chosen for this study and the Multidimensional Self-Esteem Scale: a 36 item and a 3 Likert response scale was adapted for this study with the consent of the author. The data analysis revealed that there is a significant gender difference on the variable of …

Incidence And Impact Of Urinary Incontinence, Pain, And Other Comorbidities On Health Related Quality Of Life (Hrqol) For Postpartum Bangladeshi Women, Lori Maria Walton, S. J. M. Ummul Ambia, Bassima Hussein Schbley

Faculty Publications

To investigate the incidence and impact of urinary incontinence (UI) and pain on health related quality of life (HRQOL) for postpartum Bangladeshi women. Methods: Prospective, cross sectional, correlational design (n=94) of postpartum Bangladeshi women, ages 18-44, with history of one or more obstetrical deliveries within the last three years. Subjects completed the Bengali version of the SF-36 and IIQ-7. Results: UI incidence was reported at 45% (n=39/86) total, 44% CS (n=18/41), and 47% (n=21/45) for NVD. IIQ-7 scores and UI presence showed strong correlations in both CS (rho=.729, 84, p<.001) and NVD (rho=.874, 84, p<.001). The highest impact of UI was reported in the CS group. One sample t-test reported significant differences for the sample when compared with the age equivalent norms for the SF-36 domain and component scores (p =.05-.001). Significant differences in HRQOL were reported for women with "pelvic/abdominal pain" and "UI" compared to those without "pain" or without "UI" and strong inverse correlations (rho=.597-.853) were reported for subjects with "pain" on the SF-36 domains (p=.001). The Mixed Birth Mode (MBM) group (n=8) reported UI incidence at 74% (n= 6/8), and pelvic/abdominal pain at 63% (n=5/8). Conclusion: No significant difference was found in UI and HRQOL measures by birth mode. However, pelvic, abdominal pain, and UI impact were found to be significant and inversely correlated to HRQOL. A significant decrease in HRQOL was reported compared to age related norm scores. Future research should address pelvic and abdominal pain and "mixed birth mode" impact on QOL and UI.

Birth Control: To What Extent Do Women Report Being Informed And Involved In Decisions About Pregnancy And Birth Procedures?, Rachel Thompson, Yvette D. Miller

Dartmouth Scholarship

Background: Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia.

Methods: Participants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about …

Is Music Therapy A Complementary Treatment Option For Perinatal Women Experiencing Stress And Anxiety?, Samantha L. Wallace Mph

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy is a complementary treatment option for perinatal women experiencing stress and anxiety.

STUDY DESIGN: Literature review of three English language studies, published between 2006 and present.

DATA SOURCES: Three randomized controlled trials (RCTs) were found using a search of Pubmed, Medline, OVID, and Cochrane databases. These studies analyzed the use of a music therapy intervention among pregnant or postpartum women suffering stress, anxiety and/or depression.

OUTCOMES MEASURED: The outcomes of interest include stress, anxiety and severity of depression symptoms. Outcomes …

Cervical Remodeling/Ripening At Term And Preterm Delivery: The Same Mechanism Initiated By Different Mediators And Different Effector Cells, Juan Miguel Gonzalez Velez

Wayne State University Dissertations

Premature cervical remodeling/ripening is believed to contribute to preterm delivery (PTD), the leading cause of perinatal morbidity and mortality. Despite considerable research, the causes of term and PTD remain unclear, and there is no effective treatment for PTD. We tested the hypothesis that complement activation plays a role in cervical remodeling and PTD. We studied cervical remodeling at term.

We studied two mouse models of inflammation-induced PTD. The first model was induced by vaginal administration of lipopolysaccharide (LPS)and the second one by administration of progesterone antagonist RU486. Increased cervical C3 deposition and macrophage infiltration and increased serum C3adesArg and C5adesArg …

International Standards For Fetal Growth Based On Serial Ultrasound Measurements: The Fetal Growth Longitudinal Study Of The Intergrowth-21st Project, Aris T. Papageorghiou, Eric O. Ohuma, Douglas G. Altman, Tullia Todros, Leila Cheikh Ismail, Ann Lambert, Yasmin A. Jaffer, Enrico Bertino, Michael G. Gravett, J Alison Noble, Ruyan Pang, Cesar G. Victora, Fernando C. Barros, Maria Carvalho, Laurent J. Salomon, Zulfiqar A. Bhutta, Stephen H. Kennedy, José Villar

Obstetrics and Gynaecology, East Africa

Background: In 2006, WHO produced international growth standards for infants and children up to age 5 years on the basis of recommendations from a WHO expert committee. Using the same methods and conceptual approach, the Fetal Growth Longitudinal Study (FGLS), part of the INTERGROWTH-21st Project, aimed to develop international growth and size standards for fetuses.

Methods: The multicentre, population-based FGLS assessed fetal growth in geographically defined urban populations in eight countries, in which most of the health and nutritional needs of mothers were met and adequate antenatal care was provided. We used ultrasound to take fetal anthropometric measurements prospectively from …

Characteristics Of Participants In An Hiv Prevention Intervention For Youth In Rwanda: Results From A Longitudinal Study, Hanne Celis, Brian A. Jingwa, Olivier Degomme, Ronan Van Rossem, Marleen Temmerman, Kristien Michielsen

Obstetrics and Gynaecology, East Africa

Introduction: This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda.

Methods: A baseline survey among 1071 students (mean age 17 years) assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, participation in group discussions and individual counseling.

Results: Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active), and boys, were …

Pregnancy Outcomes In Benghazi, Libya, Before And During The Armed Conflict In 2011, Z. Bodalal, K. Agnaeber, N. Nagelkerke, B. Stirling, Marleen Temmerman, O. Degomme

Obstetrics and Gynaecology, East Africa

Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes. This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011. Data were collected on all women admitted to the delivery ward during February to May 2011 (the months of the most active fighting in the city) (n = 7096), and October to December 2010 (the months immediately before the war) (n = 5935). Compared with the preceding months there was a significant rise during the conflict in the …

A Cross-Sectional Study On Attitudes Toward Gender Equality, Sexual Behavior, Positive Sexual Experiences, And Communication About Sex Among Sexually Active And Non-Sexually Active Adolescents In Bolivia And Ecuador, Sara De Meyer, Lina Jaruseviciene, Apolinaras Zaborskis, Peter Decat, Bernardo Vega, Kathya Cordova, Marleen Temmerman, Olivier Degomme, Kristien Michielsen

Obstetrics and Gynaecology, East Africa

Background: It is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents’ sexual health.

Objective: The aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries.

Design: In 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14–18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the …

Sexual Health Is Dead In My Body: Participatory Assessment Of Sexual Health Determinants By Refugees, Asylum Seekers And Undocumented Migrants In Belgium And The Netherlands, Ines Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Although migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants’ sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands define sexual health, search for sexual health information and perceive sexual health determinants.

Methods: Applying Community-based Participatory Research as the overarching research approach, we conducted 223 in-depth interviews with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. The Framework Analysis Technique …

Promoting Reproductive Options For Hiv-Affected Couples In Sub-Saharan Africa, Okeoma Mmeje, Craig R. Cohen, Alfred Murage, John Ong’Ech, James Kiarie, Sheryl Van Der Poel

Obstetrics and Gynaecology, East Africa

HIV-affected couples have unique challenges that require access to information and reproductive services which prevent HIV transmission to the uninfected partner and offspring while allowing couples to fulfill their reproductive goals. In high HIV prevalent regions of sub-Saharan Africa, HIV-affected couples require multipurpose prevention technologies (MPTs) to enhance their reproductive healthcare options beyond contraception and prevention of HIV/sexually transmitted infections (STIs) to include assistance in childbearing. The unique characteristics of the condom and its accepted use in conjunction with safer conception interventions allow HIV-serodiscordant couples an opportunity to maintain reproductive health, prevent HIV/STI transmission, and achieve their reproductive goals while …

Ovarian Sex Cord Stromal Tumours In Children And Young Girls - A More Than Two Decade Clinicopathological Experience In A Developing Country, Pakistan, Saroona Haroon, Romana Idrees, Aleena Zia, Aisha Memon, Saira Fatima, Naila Kayani

Department of Pathology and Laboratory Medicine

Background: Ovarian sex-cord stromal tumours (SCST) are rare, and relatively infrequent in children. These have to be distinguished from more common germ cell tumors in children and also from benign epithelial neoplasms.
Objectives: The purpose of our study was to report the clinical and pathological findings in young patients with these tumours in our population.
Material and Methods: The present observational cross-sectional study included all subjects SCST, in Aga Khan University Hospital Histopathology Laboratory, Karachi, Pakistan, from January 1992 till July 2013.
Results: Of the total of 513 SCSTs presented during the study period, 39 fulfilled inclusion criteria and were …

Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website And App, Lydia Hearn, Margaret Miller, Leanne Lester

Research outputs 2014 to 2021

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to …

Mothering And The Functional Self: A Hermeneutic Exploration Of Texts On Perinatal Mood And Anxiety Disorders, Kathleen M. Pape

Antioch University Dissertations & Theses

Mothering is a rich and complex experience involving challenging tasks, a developing relationship with one's child, and socially defined roles. How mothering is viewed varies depending on the cultural norms and historical era under consideration. This study is a textual interpretation of three books written about perinatal mental health, especially how those texts describe the challenges and struggles of birthing and mothering. I develop understandings about how clinicians respond to those issues and in the process understand themselves, their practices, and their sociocultural roles. I consider the shape of the current social terrain that brings to light the experiences of …

Serum Concentrations Of The Biomarkers Ca125, Ca15-3, Ca72-4, Tpsa And Papp-A In Natural And Stimulated Ovarian Cycles, Melissa J. Stemp, Peter Roberts, Allison Mcclements, Vincent Chapple, Jay Natalwala, Michael L. Black, Phillip L. Matson

Research outputs 2014 to 2021

Objective: Biomarkers associated with cancer screening (CA125, CA15-3, CA72-4, total prostate specific antigen [tPSA]) and the monitoring of pregnancy (pregnancy associated plasma protein-A [PAPP-A]) were measured during natural and stimulated ovarian cycles in disease-free non-pregnant women to determine if they could reflect normal events relating to ovulation and/or endometrial changes. Methods: A total of 73 blood samples (10 women) collected throughout the natural menstrual cycle, and 64 blood samples (11 women) taken during stimulated ovarian cycles, were analysed on the Roche Cobas e411 automated analyser. Results: Detectable levels of tPSA were measured in at least one point in the cycle …

Homebirth In Wa: Why Women Make This Choice, Colleen Ball

Theses: Doctorates and Masters

Background: Homebirths in Western Australia (WA) account for approximately 0.8% of all births. Two consecutive reports from the Perinatal and Infant Mortality Monitoring Committee found increased rates of perinatal mortality in homebirths and recommended a prospective cohort study to assess mortality and morbidity outcomes for women with planned home births in WA. The Homebirth in WA Study, of which this thesis is a component, has been funded by a directed research grant.

Aim: The aim of this study was to explore the specific reasons why women in WA choose homebirth. Research on homebirths is focused on perinatal outcomes and …

Transvaginal Ultrasonography In Ovarian Cancer Screening: Current Perspectives, John R. Van Nagell Jr., John T. Hoff

Obstetrics and Gynecology Faculty Publications

Transvaginal ultrasonography (TVS) is an integral part of all major ovarian cancer screening trials. TVS is accurate in detecting abnormalities in ovarian volume and morphology, but is less reliable in differentiating benign from malignant ovarian tumors. When used as the only screening test, TVS is sensitive, but has a low positive predictive value. Therefore, serum biomarkers and tumor morphology indexing are used together with TVS to identify ovarian tumors at high risk for malignancy. This allows preoperative triage of high-risk cases to major cancer centers for therapy while decreasing unnecessary surgery for benign disease. Ovarian cancer screening has been associated …

Grant Application: Randomized Comparison Of Two Internet-Supported Natural Family Planning Methods, Richard J. Fehring

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

No abstract provided.

Comparison Of Abstinence And Coital Frequency Between Two Natural Methods Of Family Planning, Richard J. Fehring, Thomas Bouchard, Mary Schneider

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Problem Statement: The length of periodic abstinence, due to overestimation of the fertile phase of the menstrual cycle is often a reason for dissatisfaction, discontinuation, and user error with natural family planning (NFP) methods. The objective of this research was to compare the length of required abstinence (i.e., estimated fertility) and coital frequency between two NFP methods.

Study Design: Analysis of existing data from a 12 month prospective comparison study in which participants were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group, both of which included a fertility algorithm as …

Grand Multiparity: Is It Still A Risk In Pregnancy?, Andrew H. Mgaya, Siriel N. Massawe, Hussein Kidanto, Hans N. Mgaya

Faculty of Health Sciences, East Africa

Background The association of grand multiparity and poor pregnancy outcome has not been consistent for decades. Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. We compared the maternal and perinatal complications among grand multiparous and other multiparous women in Dar es Salaam in Tanzania.

Methods A cross-sectional study was undertaken at Muhimbili National Hospital (MNH). A standard questionnaire enquired the following variables: demographic characteristics, antenatal profile and detected obstetric risk factors as well as maternal and neonatal risk …

Primary Healthcare Providers’ Views On Improving Sexual And Reproductive Healthcare For Adolescents In Bolivia, Ecuador, And Nicaragua, Lina Jaruseviciene, Miguel Orozco, Marcia Ibarra, Freddy Cordova Ossio, Bernardo Vega, Nancy Auquilla, Joel Medina, Anna C. Gorter, Peter Decat, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved.

Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology.

Results: Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

Screening For Tuberculosis In Pregnancy: Do We Need More Than A Symptom Screen? Experience From Western Kenya, R J. Kosgei, D Szkwarko, S Callens, P Gichangi, Marleen Temmerman, A-B Kihara, J J. Sitienei, E J. Cheserem, P M. Ndavi, A J. Reid, E J. Carter

Obstetrics and Gynaecology, East Africa

Objectives: 1) To explore the utility of tuberculosis (TB) symptom screening for symptoms of ⩾2 weeks’ duration in a routine setting, and 2) to compare differences in TB diagnosis between human immunodeficiency virus (HIV) infected and non-HIV-infected pregnant women in western Kenya.

Design: Comparative cross-sectional study among pregnant women with known HIV status screened for TB from 2010 to 2012, in Eldoret, western Kenya.

Results: Of 2983 participants, respectively 34 (1%), 1488 (50.5%) and 1461 (49.5%) had unknown, positive and negative HIV status. The median age was respectively 30 years (interquartile range [IQR] 26–35) and 26 years (IQR 24–31) in …

Conscientious Objection To Provision Of Legal Abortion Care, Brooke R. Johnson Jr, Eszter Kismödi, Monica V. Dragoman, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Despite advances in scientific evidence, technologies, and human rights rationale for providing safe abortion, a broad range of cultural, regulatory, and health system barriers that deter access to abortion continues to exist in many countries. When conscientious objection to provision of abortion becomes one of these barriers, it can create risks to women’s health and the enjoyment of their human rights. To eliminate this barrier, states should implement regulations for healthcare providers on how to invoke conscientious objection without jeopardizing women’s access to safe, legal abortion services, especially with regard to timely referral for care and in emergency cases when …

Executive Summary: Randomized Comparison Of Two Internet-Supported Methods Of Natural Family Planning, Richard J. Fehring, Mary Schneider

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Only 0.2% of US women use modern methods of natural family planning, i.e., the basal body temperature and the cervical mucus methods of natural family planning (NFP). The reason that such few women use NFP methods is because they are often ineffective, they are difficult to use, there is lack of access to properly trained NFP teachers, a lack of motivation to use a behavioral method, and health professionals are reluctant to prescribe NFP methods. One way to potentially increase the use of NFP methods is to provide easy access to an effective but simplified NFP method that uses a …