Obstetrics and Gynecology Commons^™

Maine's Breastfeeding Gap: How Initiation And Duration Differ By Socioeconomic Status, Zoe Miller

Thinking Matters Symposium Archive

The preventive health benefits of breastfeeding for both mothers and children are widely recognized. Leading health authorities recommend exclusive breastfeeding for the first six months of life.

Though breastfeeding rates in the United States have been increasing for the past decade, significant disparities continue across race and socioeconomic status.

The Role Of Ultrasound In The Lebanese Outreach Setting, Reem Abu-Rustum, Fouad M. Ziade, Hadi Danawi

Walden Faculty and Staff Publications

A cross-sectional study was carried out on 669 patients to assess the role of introducing ultrasound into obstetrical outreach in Lebanon. Data were collected, and descriptive statistics were performed. Sonographic findings were compared using Chi-square tests between underserved Lebanese and Syrian refugee mothers. Ultrasound plays a significant role in properly dating pregnancies in addition to identifying at-risk fetuses and detecting placental abnormalities. Medical providers need to make sonographic evaluation in the Lebanese outreach obstetrical setting more available and more systematic in order to secure a safe outcome for underserved Lebanese and Syrian refugee mothers and offspring.

Knowledge And Attitude Towards Rape And Child Sexual Abuse – A Community-Based Cross-Sectional Study In Rural Tanzania, Muzdalifat Abeid, Projestine Muganyizi, Siriel Massawe, Rose Mpembeni, Elisabeth Darj, Pia Axemo

Obstetrics and Gynaecology, East Africa

Background, Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

Methods, A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18–49 years were eligible for the study. Through a three-stage …

Mindfulness: Being Present In The Moment, Stephanie Ann Stathas, Christine Frazer

Walden Faculty and Staff Publications

This article serves to enlighten childbirth educators’ knowledge about mindfulness and the mother-baby benefits associated with incorporating mindfulness- based interventions into practice. Jon Kabat-Zinn, who developed the Mindfulness Based Stress Reduction program, brought the concept of mindfulness into the world of healthcare and mainstream society. Mindfulness is the practice of bringing awareness to the here and now using a variety of methods. Nancy Bardacke has taken the practice of mindfulness further and developed a program for expecting mothers, known as Mindfulness Based Childbirth and Parenting. This program has been shown to reduce stress responses that may be harmful to a …

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 …

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 …

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 …