Obstetrics and Gynecology Commons^™

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 …

Detection Of The Dietary Xenoglycan N-Glycolylneuraminic Acid (Neu5gc) And Anti-Neu5gc Antibodies Within Reproductive Tracts Of Male And Female Infertility Subjects, Julie M. Sroga, Diana H. Wu, Fang Ma, Eilllen Tecle, Ilana B. Ressler, Rose Maxwell, Rachael Ferrari, Leah Whigham, Pascal Gagneux, Steven Lindheim

Obstetrics and Gynecology Faculty Publications

Objective

To assess the frequency of dietary xenoglycanNeu5Gc and antibodies in males and females and its impact on fertility.

Design

Prospective study of semen, uterine lavage, and follicular fluid from subjects undergoing infertility evaluation or in vitro fertilization (IVF) and fertile controls.

Setting

University based infertility program.

Participants

Males (n=23) and females (n=27) undergoing semen analysis and saline infusion sonography as part of their diagnostic evaluation and 37 women undergoing IVF were compared to fertile male (n=15) and female (n=14) controls.

Intervention

Neu5Gc was measured by affinity purified antibody staining on Western blots, flow cytometry, and by high performance liquid …

Short-Term Effects On The Fetus And Long-Term Outcome On Children Exposed To Maternal Chemotherapy, Yocheved Kramer

The Science Journal of the Lander College of Arts and Sciences

Ethical questions with regard to treatment arise when pregnant women are diagnosed with cancer. Does the health of the mother or the health of the fetus take priority? However, research suggests that concern over transplacental transfer should not deter those seeking treatments since avoidance of favorable transfer drugs can allow chemotherapy to be a viable option if properly administered. Doctors highly contraindicate the use of chemotherapeutic drugs in the first trimester due to high risks such as teratogenesis and fetal death. However, they reassure that treatment can be given in the final two trimesters. It presents minimal consequences as long …

Twenty Years After International Conference On Population And Development: Where Are We With Adolescent Sexual And Reproductive Health And Rights?, Venkatraman Chandra-Mouli, Joar Svanemyr, Avni Amin, Helga Fogstad, Lale Say, Françoise Girard, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in …

Challenges And Opportunities For Implementing Evidence-Based Antenatal Care In Mozambique: A Qualitative Study, Adriano Biza, Ingeborg Jille-Traas, Mercedes Colomar, Maria Belizan, Jennifer Requejo Harris, Beatrice Crahay, Mario Merialdi, My Huong Nguyen, Fernando Althabe, Alicia Aleman, Eduardo Berge, Alicia Carbonell, Leonardo Chavane, Therese Delvaux, Diederike Geelhoed, Metin Gülmezoglu, Celsa Regina Malapende, Armando Melo, Nafissa Bique Osman, Mariana Widmer, Marleen Temmerman, Ana Pilar Betrán

Obstetrics and Gynaecology, East Africa

Background: Maternal mortality remains a daunting problem in Mozambique and many other low-resource countries. High quality antenatal care (ANC) services can improve maternal and newborn health outcomes and increase the likelihood that women will seek skilled delivery care. This study explores the factors influencing provider uptake of the recommended package of ANC interventions in Mozambique.

Methods: This study used qualitative research methods including key informant interviews with stakeholders from the health sector and a total of five focus group discussions with women with experience with ANC or women from the community. Study participants were selected from three health centers located …

Barriers To Modern Contraceptive Methods Uptake Among Young Women In Kenya: A Qualitative Study, Rhoune Ochako, Mwende Mbondo, Stephen Aloo, Susan Kaimenyi, Rachel Thompson, Marleen Temmerman, Megan Kays

Obstetrics and Gynaecology, East Africa

Background: Young women in Kenya experience a higher risk of mistimed and unwanted pregnancy compared to older women. However, contraceptive use among youth remains low. Known barriers to uptake include side effects, access to commodities and partner approval.

Methods: To inform a youth focussed behaviour change communication campaign, Population Services Kenya developed a qualitative study to better understand these barriers among young women. The study was carried out in Nyanza, Coast, and Central regions. Within these regions, urban or peri-urban districts were purposively selected based on having contraceptive prevalence rate close to the regional average and having a population with …

Advancing The Sexual And Reproductive Health And Human Rights Of Women Living With Hiv: A Review Of Un, Regional And National Human Rights Norms And Standards, Rajat Khosla, Nuna Van Belle, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Introduction: The right to sexual and reproductive health (SRH) is an essential part of the right to health and is dependent upon substantive equality, including freedom from multiple and intersecting forms of discrimination that result in exclusion in both law and practice. Nonetheless, general and specific SRH needs of women living with HIV are often not adequately addressed. For example, services that women living with HIV need may not be available or may have multiple barriers, in particular stigma and discrimination. This study was conducted to review United Nations Human Rights Council, Treaty Monitoring Bodies and Special Rapporteur reports …

Male Partners' Involvement In Prevention Of Mother-To-Child Hiv Transmission In Sub-Saharan Africa: A Systematic Review, Rosa Marlene Manjate Cucoa, Kha´Tia Munguambe, Nafissa Bique Osman, Olivier Degomme, Marleen Temmerman, Mohsin M. Sidat

Obstetrics and Gynaecology, East Africa

In sub-Saharan Africa (SSA), male partners are rarely present during prevention of mother-to-child transmission (PMTCT) services. This systematic review aims to synthesize, from a male perspective, male partners' perceived roles, barriers and enablers of their involvement in PMTCT, and highlights persisting gaps. We carried out a systematic search of papers published between 2002 and 2013 in English on Google Scholar and PubMed using the following terms: men, male partners, husbands, couples, involvement, participation, Antenatal Care (ANC), PMTCT, SSA countries, HIV Voluntary Counseling and Testing and disclosure. A total of 28 qualitative and quantitative original studies from 10 SSA countries were …

Intimate Partner Violence And Psychosocial Health, A Cross-Sectional Study In A Pregnant Population, An-Sofie Van Parys, Ellen Descheppe, Kristien Michielsen, Anna Galle, Kristien Roelens, Marleen Temmerman, Hans Verstraelen

Obstetrics and Gynaecology, East Africa

Background: The objective of this paper is to explore whether IPV 12 months before and/or during pregnancy is associated with poor psychosocial health.

Methods: From June 2010 to October 2012, a cross-sectional study was conducted in 11 antenatal care clinics in Belgium. Consenting pregnant women were asked to complete a questionnaire on socio-demographics, psychosocial health and violence in a separate room. Overall, 2586 women were invited to participate and we were able to use data from 1894 women (73.2 %) for analysis. Ethical clearance was obtained in all participating hospitals.

Results: We found a significant correlation between IPV and poor …

Twenty Years After International Conference On Population And Development: Where Are We With Adolescent Sexual And Reproductive Health And Rights?, Venkatraman Chandra-Mouli, Joar Svanemyr, Avni Amin, Helga Fogstad, Lale Say, Françoise Girard, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in …

Opportunities To Improve Postpartum Care For Mothers And Infants: Design Of Context-Specific Packages Of Postpartum Interventions In Rural Districts In Four Sub-Saharan African Countries, Els Duysburgh, Birgit Kerstens, Seni Kouanda, Charles Paulin Kaboré, Danielle Belemsaga Yugbare, Peter Gichangi, Gibson Masache, Beatrice Crahay, Gilda Gondola Sitefane, Nafissa Bique Osman, Severiano Foia, Henrique Barros, Sofia Castro Lopes, Susan Mann, Bejoy Nambiar, Tim Colbourn, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Postpartum maternal and infant mortality is high in sub-Saharan Africa and improving postpartum care as a strategy to enhance maternal and infant health has been neglected. We describe the design and selection of suitable, context-specific interventions that have the potential to improve postpartum care.

Methods: The study is implemented in rural districts in Burkina Faso, Kenya, Malawi and Mozambique. We used the four steps ‘systems thinking’ approach to design and select interventions: 1) we conducted a stakeholder analysis to identify and convene stakeholders; 2) we organised stakeholders causal analysis workshops in which the local postpartum situation and challenges and …

Achieving Pregnancy Safely In Hiv-Affected Individuals And Couples: An Important Strategy To Eliminate Hiv Transmission From Mother-To-Child And Between Sexual Partners, Mmeje Okeoma, Betty Njoroge, Craig Cohen, Marleen Temmerman, Sten H. Vermund, Sheryl Van Der Poel

Obstetrics and Gynaecology, East Africa

HIV-infected individuals are living longer, more productive lives. HIV-affected individuals and couples experience personal and social desires to reproduce for all the same reasons as uninfected individuals and couples,1 and thus require safe reproductive options. HIV prevention interventions often do not consider the childbearing desires of HIV-affected individuals or couples, especially in low- and middle-income countries (LMICs). Failure to assist women with desired fertility can contribute to continued HIV transmission and must be addressed within national elimination of mother-to-child transmission (eMTCT) strategies.

A human rights perspective suggests that HIV-affected couples* should have the same ability to choose if and when …

Variables In Vbac Success: A Retrospective Review Of Trial Of Labor After Cesarean (Tolac) And Labor Support, Jenna A. Koblentz

Scripps Senior Theses

For most of the 20^th century, the saying “once a cesarean, always a cesarean” was a rule in the United States. Today, the National Institutes of Health (NIH) opposes the dictum and urges women to consider trial of labor after cesarean (TOLAC). However, the factors that lead to a successful outcome remain unclear, as research continues to be conducted in hopes of creating a predictive model for vaginal birth after cesarean (VBAC) success.

The NIH’s request for more research in this area of obstetrics led to this retrospective cohort study of all TOLACs at Marin General Hospital (MGH) from …

Comprendre Les Grossesses Non Désirées Au Sénégal : Rapport Du Profil Pays [Compte Rendu De L’Atelier De Dissémination Des Résultats Auprès Des Parlementaires], Babacar Mane, Bocar Mamadou Daff, Marie-Jesus Buabey, Abdelylah Lakssir

Reproductive Health

En partenariat avec le Ministère de la Santé et de l'Action Sociale et l’initiative Partners in Population and Development, le bureau du Population Council—Sénégal a organisé une rencontre avec des membres de l’Assemblée Nationale et d’autres acteurs locaux clés pour diffuser les résultats du rapport de l’étude sur le profil pays menée dans le cadre du projet de recherche "Strengthening Evidence for Programming on Unintended Pregnancy” plus connu sous l’acronyme “STEP UP.” A l’issue de la réunion, les recommandations ont été formulées concernant la législation, le renforcement des capacités et la prise en charge des problèmes de santé de la …

Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi

Reproductive Health

The overall goal of this study was to generate evidence on the availability, use, and quality of care for medical abortion services in private facilities (pharmacies and clinics) in Kenya. With the passing of a new constitution in 2010, there was renewed interest in the right to health and the need to reduce the high levels of maternal morbidity and mortality arising from unsafe abortion in the country. In spite of recent developments, there is limited understanding of the extent to which the changes have influenced the provision of medical abortion information and services in the country, the acceptability of …

Conceptualizing And Measuring Unintended Pregnancy And Birth: Moving The Field Forward, Population Council

Reproductive Health

Given the complexity of conceptualizing and measuring unintended pregnancy, STEP UP convened an expert group meeting in Accra, Ghana with the objectives of contributing to a clearer understanding and agreed-upon definition of unintended pregnancy; reviewing existing approaches to the conceptualization and measurement of unintended pregnancy; drawing from existing approaches to propose and draft indicators, metrics, data collection instruments, and analysis strategies for measuring and tracking unintended pregnancy through multiple data collection procedures; and identifying challenges and opportunities for communicating evidence on unintended pregnancy and informing policy, planning, and investment decisions. Following presentations and discussions on these issues, participants reviewed the …