Obstetrics and Gynecology Commons^™

Legal Principles And Seminal Legal Cases In Oocyte Donation, Jody L. Madeira, Susan L. Crockin

Articles by Maurer Faculty

Oocyte donation has played an increasingly important role in assisted reproductive technologies since the early 1980s. Over the past 30 years, unique legal standards have evolved to address issues in the oocyte donation procedure itself as well as the disputes over issues, such as parentage, that inevitably arise with new technologies, particularly for individuals seeking to build nontraditional families. This essay will explore oocyte donation's legal aspects as well as seminal law concerning the procedure, including statutory law (uniform and model provisions and enacted state laws) and selected judicial opinions concerning surrogacy and parentage, testing of oocyte donors, mix-ups of …

The Role Of Non-Neuronal Acetylcholine In Urogenital Chlamydial Infection, Jessica R. Lockhart

Electronic Theses and Dissertations

Chlamydia trachomatiscauses a bacterial sexually transmitted infection, Chlamydia, that is often chronic and casues reproductive complications in women. We hypothesized that Chlamydia infection increases local acetylcholine (ACh) production, which regulates the host’s inflammatory response to the infection. Female mice infected with C. muridarumwere sacrificed at days 3, 9, 15, and 21 post-infection, genital tract tissues harvested, and immunohistochemistry performed to enumerate ACh-producing cells. Infection increased the number of ACh-producing cells in cervical tissue at days 3,15, and 21 post-infection (pi), uterine tissue at day 3 and 9 pi, and ovarian tissue day 3, 15, and 21 pi. These …

Using The Engagedmd Multimedia Platform To Improve Informed Consent For Ovulation Induction, Intrauterine Insemination, And In Vitro Fertilization, Jody L. Madeira, Jennifer Rehbein, Mindy S. Christianson, Miryoung Lee, J. Preston Parry, Guido Pennings, Steven R. Lindheim Md

Articles by Maurer Faculty

Objective: To study patient and provider feedback on how a multimedia platform (EngagedMD) helps patients to understand the risks and consequences of in vitro fertilization (IVF), ovulation induction (OI), and intrauterine insemination (IUI) treatments and the impact of the informed consent process.

Design: Prospective survey study.

Setting: IVF units in the United States.

Patient(s): Six-thousand three-hundred and thirty-three patients who viewed the multimedia platform before IVF or OI-IUI treatment at 13 U.S. IVF centers and 128 providers.

Intervention(s): Quantitative survey with 17 questions.

Main Outcome Measure(s): Assessment of the impact of a multimedia platform on patient anxiety, comprehension, and satisfaction …

The Logistics Of Voucher Management: The Underreported Component In Family Planning Voucher Discussions, Moazzam Ali, Madeline Farron, Syed Khurram Azmat, Waqas Hameed

Community Health Sciences

Background: The purpose of health care vouchers or coupons is to receive a health service in exchange which is fully or partially subsidized, such as any treatment offered for communicable disease; for immunization; antenatal care-/postnatal care-related maternal health services; a family planning (FP) service; or to get a health commodity like a medicine. Vouchers are targeted for a group of people who can benefit the most such as on the basis of poverty ranking, marginalized or living in rural areas. According to the World Health Organization, voucher schemes in the area of sexual and reproductive health are considered of high …

Maternal And Infant Attributes And Antecedents Of Breastfeeding, Riyan Yanes, Jessie Lakota Dinelli

Grace Peterson Nursing Research Colloquium

Abstract

Background: The Center for Disease Control (CDC) claim that breastfeeding rates are increasing in the United States. Surveys show that 81.1% of newborn infants started to breastfeed in 2013 (2016). Unfortunately, breastfeeding duration did not meet the recommended length and of the infants born in 2013, 51.8% were breastfeeding at 6 months and 30.7% at 12 months (CDC, 2016). Breastfeeding offers various health benefits to the mother and child, which is why the identification of antecedents and attributes to breastfeeding need to be addressed in order to impact mothers and infants.

Objectives: The goal of this study is to …

Associations Of Demographic Factors And Tobacco Use With Progesterone And Estradiol During Pregnancy, Kristin Ashford, Emily Rayens, Amanda T. Wiggins, Mary Kay Rayens, Molly Malany Sayre, John O'Brien

Perinatal Research and Wellness Center Faculty Publications

Objective: To evaluate the association of biochemically validated prenatal tobacco use with serum progesterone and estradiol in the second trimester of pregnancy, controlling for demographic and personal factors.

Study design: This secondary analysis of a multicenter longitudinal study included 114 women with singleton pregnancies. Multiple regression analysis assessed whether prenatal tobacco use was related to hormone levels during the second trimester, controlling for covariates (age, body mass index, and race or ethnicity, with gestational age added to subsequent models).

Result: In the initial regressions, tobacco users had significantly lower progesterone level compared with nonsmokers (p = .037), while estradiol …

Initiating Patient Discussions About Oocyte Cryopreservation: Attitudes Of Obstetrics And Gynaecology Resident Physicians, Brennan Peterson, C. Gordon, Julia K. Boehm, M. C. Inhorn, P. Patrizio

Marriage and Family Therapy Faculty Articles and Research

This study examined the attitudes of obstetrics and gynaecology (OB/GYN) resident physicians to initiating patient discussions regarding medical and elective oocyte cryopreservation (OC). The study used a cross-sectional online survey of OB/GYN medical residents in the USA, sampled from residency programmes approved by the American Council for Graduate Medical Education. In total, 208 medical residents, distributed evenly between postgraduate years 1–4, participated in the study. Residents' fertility knowledge and attitudes to initiating discussions about OC were gathered. Forty percent (n = 83) believed that OB/GYN residents should initiate discussions about OC with patients (initiators), while 60% (n = 125) did …

Mapping Maternal Mortality Rate Via Spatial Zero-Inflated Models For Count Data: A Case Study Of Facility-Based Maternal Deaths From Mozambique, Osvaldo Loquiha, Niel Hens, Leonardo Chavane, Marleen Temmerman, Nafissa Osman, Christel Faes, Marc Aerts

Obstetrics and Gynaecology, East Africa

Maternal mortality remains very high in Mozambique, with estimates from 2015 showing a maternal mortality ratio of 489 deaths per 100,000 live births, even though the rates tend to decrease since 1990. Pregnancy related hemorrhage, gestational hypertension and diseases such as malaria and HIV/AIDS are amongst the leading causes of maternal death in Mozambique, and a significant number of these deaths occur within health facilities. Often, the analysis of data on maternal mortality involves the use of counts of maternal deaths as outcome variable. Previously we showed that a class of hierarchical zero-inflated models were very successful in dealing with …

Port Site Parasitic Leiomyoma After Laparoscopic Myomectomy: A Case Report And Review Of The Literature, Felix Oindi, Steve Mutiso, Timona Obura

Obstetrics and Gynaecology, East Africa

Background: Uterine fibroids are the commonest benign gynecological tumors. Laparoscopic myomectomy is becoming increasingly popular as one of the surgical treatment options for symptomatic cases. Large tissues such as leiomyomas or even the uterus need to be morcellated in order to be retrieved from the abdominal cavity. Some of the morcellated fragments or small fibroids may be accidentally left in the abdominal cavity during the retrieval process. These may subsequently become implanted in the abdominal cavity, develop blood supply from the surrounding structures, and grow to form parasitic myomas with varied clinical presentation, depending on the location and size.

Case …

Aberrant Arid5b Expression And Its Association With Ikaros Dysfunction In Acute Lymphoblastic Leukemia., Zheng Ge, Qi Han, Yan Gu, Qinyu Ge, Jinlong Ma, Justin Sloane, Guofeng Gao, Kimberly J. Payne, Laszlo Szekely, Chunhua Song, Sinisa Dovat

Abington Jefferson Health Papers

Mutations and single nucleotide polymorphisms of AT-rich interactive domain-containing protein 5B (ARID5B) are involved in the oncogenesis of acute lymphoblastic leukemia (ALL) and treatment outcomes. However, ARID5B expression and clinical significance in ALL remain unclear. We found ARID5B is significantly down-regulated in ALL compared to healthy bone marrow controls. ARID5B also interacts with PHD finger protein 2 (PHF2). Low expression of ARID5B (ARID5B^low) or ARID5B and PHF2 (ARID5B^lowPHF2^low) is correlated with the markers of cell proliferation and poor prognosis in ALL patients. Ikaros directly regulates ARID5B expression in ALL. Restoring Ikaros function by Casein …

Prenatal Tobacco And Marijuana Co-Use: Impact On Newborn Neurobehavior., Laura R. Stroud, George D. Papandonatos, Meaghan Mccallum, Tessa Kehoe, Amy L. Salisbury, Marilyn A. Huestis

Institute of Emerging Health Professions Faculty Papers

Tobacco and marijuana are some of the most common prenatal substance exposures worldwide. The social acceptability and political landscape of marijuana and its potency have changed dramatically in the last two decades leading to increased use by pregnant women. Despite evidence for increasing marijuana use and high rates of co-use of tobacco (TOB) and marijuana (MJ) during pregnancy, the impact of prenatal exposure to each substance is typically studied in isolation. We investigated the influence of co-exposure to TOB and MJ on infant neurobehavioral development over the first postnatal month. Participants were 111 mother-infant pairs from a low-income, diverse sample …

Utilizing V-Y Fasciocutaneous Advancement Flaps For Vulvar Reconstruction., Lauren C. Hand, Talia Maas, Nadia Baka, Rebecca J. Mercier, Patrick J. Greaney, Norman G. Rosenblum, Christine H. Kim

Department of Obstetrics and Gynecology Faculty Papers

Objectives: We aimed to analyze the outcomes of patients who underwent vulvectomy with subsequent V-Y fasciocutaneous flap reconstruction.

Methods: All medical records of all patients who underwent vulvectomies with V-Y fasciocutaneous flap reconstruction from January 2007 to June 2016 were retrospectively reviewed. Patient clinical and surgical data, demographics, and outcomes were abstracted.

Results: Of the 27 patients, 42 flaps were transferred. A simple vulvectomy was performed in 8 (30%) patients, partial radical vulvectomy in 15 (56%), and radical vulvectomy in 4 (15%). The median area of defect was 30 cm

Conclusions: The use of a V-Y fasciocutaneous advancement flap for …

Levonorgestrel Only Emergency Contraceptive Use And Risk Of Ectopic Pregnancy In Eldoret Kenya: A Case-Control Study, Sahara Shurie, Edwin Were, Elkanah Omenge, Alfred Keter

Obstetrics and Gynaecology, East Africa

Introduction: ectopic pregnancy is one of the causes of maternal morbidity and mortality in Sub-Saharan Africa. Levonorgestrel (LNG) only emergency contraceptive pill is a well-established emergency contraceptive pill that is administered within 72 hours after unprotected intercourse. This study aimed at determining whether or not there is a significant association between levonorgestrel emergency contraceptive use and the occurrence of ectopic pregnancy.

Methods: case-control (1:3) study among 79 women with ectopic pregnancy (cases) matched against 237 women without (controls) at Moi Teaching and Referral Hospital in Eldoret, Kenya; Sociodemographic and clinical data were collected using a questionnaire. Association between ectopic pregnancy …

The Ties That Bind: Cradling In Tajikistan, Lana B. Karasik, Catherine S. Tamis-Lemonda, Ori Ossmy, Karen E. Adolph

Publications and Research

A traditional childrearing practice—“gahvora” cradling—in Tajikistan and other parts of Central Asia purportedly restricts movement of infants’ body and limbs. However, the practice has been documented only informally in anecdotal reports. Thus, this study had two research questions: (1) To what extent are infants’ movements restricted in the gahvora? (2) How is time in the gahvora distributed over a 24-hour day in infants from 1–24 months of age? To answer these questions, we video-recorded 146 mothers cradling their infants and interviewed them using 24-hour time diaries to determine the distribution of time infants spent in the gahvora within a day …

Nadolol In Pregnancy: A Medical Student’S Reflection On Her Pregnancy, Rebecca King-Mallory, Shawndra Barker, Kaitlin Mcgrogan, Adam M. Franks

Marshall Journal of Medicine

Hypertension is a common concern during pregnancy. Beta-blockers are one potential treatment, but third trimester exposure has correlated with an increased risk of perinatal events. Nadolol, a nonselective beta blocker, has properties that differ from those of its selective counterparts, including longer half-life, decreased protein binding, and renal excretion in the unchanged form. There is very limited data on the use of nadolol during pregnancy, and its safety has not been completely evaluated. This case study documents the perinatal outcomes of nadolol use throughout a medical student’s pregnancy and explores the experience in obtaining and undergoing medical care.

Conference Proceedings: Aurora Scientific Day 2018

Journal of Patient-Centered Research and Reviews

This journal supplement includes selected abstracts from among the more than 50 presented at the 44th annual Aurora Scientific Day research symposium. Held May 25, 2018, in Milwaukee, Wisconsin, Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system with hospitals and clinics in Wisconsin and Illinois.

High Report Of Miscarriage Among Women Living With Hiv Who Want To Conceive In Uganda., Sarah Finocchario-Kessler, Kathy Goggin, Vincent S. Staggs, Rhoda K. Wanyenze, Jolly Beyeza-Kashesya, Deborah Mindry, Josephine Birungi, Glenn J Wagner

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Data on early miscarriage incidence is limited due to various social and methodological barriers. We report on 24-month pregnancy outcomes of 299 female Ugandan HIV clients in committed relationships with an intention to conceive. Miscarriage data are reported as auxiliary findings to a larger study (5R01HD072633).

RESULTS: 127 (42%) participants reported a pregnancy during the study; among the remaining 172, 82 indicated they stopped trying to conceive, and 16 dropped out prior to month 24. Of the 127 pregnancies, 55 (43%) resulted in live births, 67 (53%) in spontaneous miscarriage, 1 (< 1%) in stillbirth, 1 (< 1%) in abortion, and 3 (2%) in unknown outcomes. Three-quarters (75%) of miscarriages for which time until miscarriage was available were reported to occur in the first trimester (mean = 11.3 weeks gestation). The 67 participants who reported a miscarriage tended to be older (mean 33 vs. 30 years), but the significance of age did not persist after adjusting for multiple tests. We observed relatively low rates of pregnancy and high rates of miscarriage among this cohort of HIV-positive women wanting to conceive. Rigorously designed studies are needed to better understand the observed high rate of early miscarriage among HIV-infected women.

Integration Of Postpartum Care Into Child Health And Immunization Services In Burkina Faso: Findings From A Cross-Sectional Study, Danielle Yugbaré Belemsaga, Anne Goujon, Aristide Bado, Seni Kouanda, Els Duysburgh, Marleen Temmerman, Olivier Degomme

Department of Obstetrics & Gynaecology

Background: The Missed Opportunities for Maternal and Infant Health (MOMI) project, which aimed at upgrading maternal and infant postpartum care (PPC), implemented a package of interventions including the integration of maternal PPC in infant immunization services in 12 health facilities in Kaya Health district in Burkina Faso from 2013 to 2015. This paper assesses the coverage and the quality of combined mother-infant PPC in reproductive, maternal, newborn and child health services (RMNCH).
Methods: We conducted a mixed methods study with cross-sectional surveys before and after the intervention in the Kaya health and demographic surveillance system. On the quantitative side, two …

Sentinel Lymph Node In Early Stage Ovarian Cancer; A Literature Review, Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Vladislav Brasoveanu, Iulian Brezean

Journal of Mind and Medical Sciences

Although sentinel lymph node mapping has been widely implemented in gynecological malignancies in order to minimize the number of unnecessary lymph node dissections and to diminish postoperative morbidity rate, little is known about ovarian cancer sentinel lymph node mapping. This article presents a literature review regarding the effectiveness, safety and benefits of this method.

Sentinel lymph node detection in early stage ovarian cancer seems to be a safe and effective method, able to minimize the rate of patients submitted to unnecessary lymph node dissection. The second goal of the procedure, to minimize the risk of missing involved lymph nodes, seems …

Postpartum Depression: Prevention And Multimodal Therapy, Anca Daniela Stanescu, Denisa Oana Balalau, Liana Ples, Stana Paunica, Cristian Balalau

Journal of Mind and Medical Sciences

A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. Furthermore, changes also occur in the mother's familial and interpersonal world after childbirth. While some mothers have positive emotions at birth, such as joy and pleasure, others complain of negative experiences varying from sadness and depression to psychosis. Thus, the risk of depression is higher for women during the postpartum period, having a tendency to decrease in most cases over the first 2 weeks after delivery. Unfortunately, this favorable evolution does not happen in about 1 in 4-7 women, who develops postpartum depression. Postpartum depression …