Obstetrics and Gynecology Commons^™

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 …

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 …

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 - …

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 …

Prenatal Development: Annotated Bibliography, Victoria J. Molfese, Amanda Prokasky, Kathleen Moritz Rudasill, Ibrahim H. Acar, Xiaoqing Tu, Kate Sirota, Brian Keiser

Department of Child, Youth, and Family Studies: Faculty Publications

For decades, researchers have investigated how events in the prenatal period impact women and their infants. These studies, particularly by researchers in the medical, neuroscience, and behavioral science fields, led to discoveries of important information regarding the prenatal events that were strongly associated with mortality (or death) and morbidity (or incidences of injury, pathology and abnormalities/anomalies, and neurobehavioral sequelae) in the neonatal and infancy periods. Among the many common findings from early research studies, two are particularly noteworthy. First, maternal and fetal risk conditions arising in the prenatal period do not do so in isolation. Sameroff and Chandler characterized this …

Maternal Anaemia And Duration Of Zidovudine In Antiretroviral Regimens For Preventing Mother-To-Child Transmission: A Randomized Trial In Three African Countries, Benn K.D. Sartorius, Matthew F. Chersich, Mary Mwaura, Nicolas Meda, Marleen Temmerman, Marie Louise Newell, Timothy M. M. Farley, Stanley Luchters, The Kesho Bora Study Group

Obstetrics and Gynaecology, East Africa

Background: Although substantiated by little evidence, concerns about zidovudine-related anaemia in pregnancy have influenced antiretroviral (ARV) regimen choice for preventing mother-to-child transmission of HIV-1, especially in settings where anaemia is common.

Methods: Eligible HIV-infected pregnant women in Burkina Faso, Kenya and South Africa were followed from 28 weeks of pregnancy until 12–24 months after delivery (n = 1070). Women with a CD4 count of 200-500cells/mm3 and gestational age 28–36 weeks were randomly assigned to zidovudine-containing triple-ARV prophylaxis continued during breastfeeding up to 6-months, or to zidovudine during pregnancy plus single-dose nevirapine (sd-NVP) at labour. Additionally, two cohorts were …

Incidence And Outcome Of Small For Gestational Age Fetuses: An Experience From A Secondary Care Hospital, Riffat Bano, Nousheen Asim, Ammara Mushtaq, Mehreen Adhi, Noureen Afzal

Department of Obstetrics & Gynaecology

The objective of the study was to determine the frequency and outcome of Small for Gestational Age (SGA) foetuses, and its association with the mode of delivery, foetal birthweight, maternal age and gestational age. It was a hospital-based descriptive study, conducted at Aga Khan Hospital for Women, Karachi, from January 2009 to December 2010. Mode of deliveries, foetal birthweight, maternal age and gestational age of SGA foetuses were recorded and analszed. Of a total of 6024 deliveries during the study period, 722(11.98%) had SGA foetuses. Maternal age in such cased ranged between 20-40 years in 588(81.44%), while 406(56.23%) of these …

The G-Protein-Coupled Estrogen Receptor Agonist G-1 Suppresses Proliferation Of Ovarian Cancer Cells By Blocking Tubulin Polymerization., Cheng Wang, Xiangmin Lv, Chunbo He, G Hua, M-Y Tsai, John S. Davis

Journal Articles: Obstetrics & Gynecology

The G-protein-coupled estrogen receptor 1 (GPER) has recently been reported to mediate the non-genomic action of estrogen in different types of cells and tissues. G-1 (1-[4-(6-bromobenzo[1,3] dioxol-5yl)-3a,4,5,9b-tetrahydro-3H-cyclopenta[c]quinolin-8-yl]-ethanone) was developed as a potent and selective agonist for GPER. G-1 has been shown to induce the expression of genes and activate pathways that facilitate cancer cell proliferation by activating GPER. Here we demonstrate that G-1 has an anticancer potential with a mechanism similar to vinca alkaloids, the commonly used chemotherapy drugs. We found that G-1 blocks tubulin polymerization and thereby interrupts microtubule assembly in ovarian cancer cells leading to the arrest of …

Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta

Department of Obstetrics & Gynaecology

Objective: To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data.
Methods: All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system. Verbal autopsy interviews using modified WHO tool were conducted by trained health workers within 2- 6 weeks of still birth and the cause of death …

Developmental Genes Targeted For Epigenetic Variation Between Twin-Twin Transfusion Syndrome Children, Carmen J. Marsit, Devin C. Koestler, Debra Watson-Smith, Charlotte M. Boney

Dartmouth Scholarship

Background: Epigenetic mechanisms are thought to be critical in mediating the role of the intrauterine environment on lifelong health and disease. Twin-twin transfusion syndrome (TTTS) is a rare condition wherein fetuses share the placenta and develop vascular anastomoses, which allow blood to flow between the fetuses. The unequal flow results in reciprocal hypo- and hypervolemia in the affected twins, striking growth differences and physiologic adaptations in response to this significant stressor. The donor twin in the TTTS syndrome can be profoundly growth restricted and there is likely a nutritional imbalance between the twins. The consequences of TTTS on fetal programming …

Plan B Topic: Annotated Resource List, Payton Roberts

Undergraduate Research Award

No abstract provided.

Selling Art: An Empirical Assessment Of Advertising On Fertility Clinics' Websites, Jim Hawkins

Indiana Law Journal

Scholarship on assisted reproductive technologies (ART) has emphasized the commercial nature of the interaction between fertility patients and their physicians, but little attention has been paid to precisely how clinics persuade patients to choose their clinics over their competitors’. This Article offers evidence about how clinics sell ART based on clinics’ advertising on their websites. To assess clinics’ marketing efforts, I coded advertising information on 372 fertility clinics’ websites. The results from the study confirm some suspicions of prior ART scholarship while contradicting others. For instance, in line with scholars who are concerned that racial minorities face barriers to accessing …

Selling Art Or Selling Out?: A Response To Selling Art: An Empirical Assessment Of Advertising On Fertility Clinics' Websites, Jody L. Madeira

Indiana Law Journal

Roundtable on Regulating Assisted Reproductive Technology 2012

Cryotherapy Following Visual Inspection With Acetic Acid And Lugol's Iodine (Via/Vili) In Khwisero, Western Kenya: Lesson From The Field Affecting Policy And Practice, Sammy Ngichabe, Patricia Muthaura, Christine W. Murungi, J. Muyoka, Elkanah Omenge, L Muchiri

Obstetrics and Gynaecology, East Africa

Background: Cervical cancer can be prevented and mortality/morbidity reduced by early detection and referral. Developing countries are likely to benefit from more cost effective methods of screening and treatment. Visual inspection with acetic acid and Lugol`s iodine (VIA/VILI) offers a see and treat solution thus an affordable and efficient way to identify pre-malignant lesions. Immediate treatment with cryotherapy can be offered if pre-malignant lesions are found on visual inspection. Cryotherapy is a simple procedure that is curative for dysplasia; it is likely to benefit cervical dysplasia cases picked early in resource poor settings, however there are several factors that …

Jordanian Ethical Perceptions Of Preimplantation Genetic Diagnosis, Sarah C. Miller

Independent Study Project (ISP) Collection

Preimplantation Genetic Diagnosis (PGD) is a procedure that can be done during In Vitro Fertilization (IVF), involving genetic and chromosomal screening of fertilized embryos prior to implantation into a woman’s uterus. After PGD, only the embryos possessing the desired characteristics are implanted, while the other embryos are frozen for future use, or discarded. PGD is used for family balancing (gender selection for balancing the gender dynamic within a family), gender selection to screen out sex-linked diseases, or a broader genetic screening for diseases known to be present in the patient’s family history.

Many ethical questions have been raised about PGD, …

Wilson’S Disease In Pregnancy: Case Series And Review Of Literature, Ayesha Malik, Ali Khawaja, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Background: Wilson’s disease is a rare, autosomal recessive inherited disorder characterized by impaired liver metabolism of copper leading to decreased biliary excretion and incorporation of ceruloplasmin levels mainly in the liver and brain. Untreated Wilson’s disease has been shown to cause subfertility and even in cases where pregnancy occurs, it often results in spontaneous miscarriage.

Case presentations: We present four cases of successful pregnancy outcomes in three patients diagnosed with Wilson’s disease along with the literature review. All the patients were managed with zinc sulphate without any postnatal complications.

Conclusion: Patients with Wilson’s disease receiving regular treatment who remain asymptomatic …

Is There A Viability-Vulnerability Tradeoff? Sex Differences In Fetal Programming, Curt A. Sandman, Laura M. Glynn, Elyssia Poggi Davis

Psychology Faculty Articles and Research

OBJECTIVE: In this paper we evaluate the evidence for sex differences in fetal programming within the context of the proposed viability-vulnerability tradeoff.

METHODS: We briefly review the literature on the factors contributing to primary and secondary sex ratios. Sex differences in fetal programming are assessed by summarizing previously published sex difference findings from our group (6 studies) and also new analyses of previously published findings in which sex differences were not reported (6 studies).

RESULTS: The review and reanalysis of studies from our group are consistent with the overwhelming evidence of increasing risk for viability among males exposed to environmental …