Obstetrics and Gynecology Commons^™

Breast Milk From Tanzanian Women Has Divergent Effects On Cell-Free And Cell-Associated Hiv-1 Infection In Vitro, Magdalena A. Lyimo, Matilda Ngarina Mosi, Molly L. Housman, Muhammad Zain-Ul-Abideen, Frederick V. Lee, Alexandra L. Howell, Ruth I. Connor

Dartmouth Scholarship

Transmission of HIV-1 during breastfeeding is a significant source of new pediatric infections in sub-Saharan Africa. Breast milk from HIV-positive mothers contains both cell-free and cell-associated virus; however, the impact of breast milk on HIV-1 infectivity remains poorly understood. In the present study, breast milk was collected from HIV-positive and HIV-negative Tanzanian women attending antenatal clinics in Dar es Salaam. Milk was analyzed for activity in vitro against both cell-free and cell-associated HIV-1. Potent inhibition of cell-free R5 and X4 HIV-1 occurred in the presence of milk from all donors regardless of HIV-1 serostatus. Inhibition of cell-free HIV-1 infection positively …

Hormonal Induction Of Polo-Like Kinases (Plks) And Impact Of Plk2 On Cell Cycle Progression In The Rat Ovary, Feixue Li, Misung Jo, Thomas E. Curry, Jing Liu

Obstetrics and Gynecology Faculty Publications

The highly conserved polo-like kinases (Plks) are potent regulators of multiple functions in the cell cycle before and during mitotic cell division. We investigated the expression pattern of Plk genes and their potential role(s) in the rat ovary during the periovulatory period. Plk2 and Plk3 were highly induced both in intact ovaries and granulosa cells in vivo after treatment with the luteinizing hormone (LH) agonist, human chorionic gonadotropin (hCG). In vitro, hCG stimulated the expression of Plk2 in granulosa cells, but not Plk3. This induction of Plk2 expression was mimicked by both forskolin and phorbol 12 myristate 13-acetate (PMA). Moreover, …

Each Day Outdoor Play!Exchange-Early Childhood Leaders, Shelina Bhamani

Department of Obstetrics & Gynaecology

No abstract provided.

“That Pregnancy Can Bring Noise Into The Family”: Exploring Intimate Partner Sexual Violence During Pregnancy In The Context Of Hiv In Zimbabwe, Simukai Shamu, Naeemah Abrahams, Marleen Temmerman, Tamara Shefer, Christina Zarowsky

Obstetrics and Gynaecology, East Africa

Background: Globally, studies report a high prevalence of intimate partner sexual violence (IPSV) and an association with HIV infection. Despite the criminalisation of IPSV and deliberate sexual HIV infection in Zimbabwe, IPSV remains common. This study explored women’s and health workers’ perspectives and experiences of sexuality and sexual violence in pregnancy, including in relation to HIV testing.

Methods: This qualitative study was part of a larger study of the dynamics of intimate partner violence and HIV in pregnancy in Zimbabwe. Key informant interviews were conducted with health workers and focus group discussions were held with 64 pregnant or nursing mothers …

The Ethics Of Vaginal Birth After Cesarean, Sonya Charles

Philosophy and Religious Studies Department Faculty Publications

The decline in providers and facilities that will allow a trial of labor after cesarean forces many women to choose a repeat cesarean. The choice is frequently not much of a choice, however, since the full range of options are often not on the table. This limited 'choice' violates obstetricians' obligations both to respect patients' autonomy and to offer them good care. There has been a vigorous but so far not very fruitful debate in the last few years about the lack of access to a trial of labor after cesarean. Some recently released documents express concern about the limited …

Urban Fathers’ Involvement In Early Childhood Development: A Case Study From Pakistan, Shelina Bhamani

Department of Obstetrics & Gynaecology

This work was published before Shelina joined Aga Khan University.

A Prospective Characterization Of Postpartum Changes In Uterine Fibroid Volume Among Black African Women, Christine W. Murungi

Master of Medicine in Obstetrics and Gynecology

Background: Fibroids are benign smooth muscle tumours of the uterus common in women of reproductive age. The prevalence is thought to be higher amongst women over the age of 35 years and in African women. More women are delaying their child bearing leading to an increase in the number of women dealing with pregnancy in the context of fibroids. The relationship between pregnancy and fibroids is controversial. It is thought that pregnancy exerts a protective effect, an observation made from epidemiological and animal studies. Although the mechanism is not clear, the postpartum period is thought to possibly explain this benefit. …

African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain

Journal of Health Disparities Research and Practice

North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …

Process Evaluation In Action: Lessons Learned From Alabama Reach 2010, M. C. Nagy, Rhoda E. Johnson, Robin C. Vanderpool, Mona N. Fouad, Mark Dignan, Theresa A. Wynn, Edward E. Patridge, Isabel Scarinci, Cheryl Holt, Sharina D. Person

Journal of Health Disparities Research and Practice

The CDC-funded Alabama Racial and Ethnic Approaches to Community Health (REACH 2010) project is designed to reduce and eliminate disparities in breast and cervical cancer between African American and white women in six rural and three urban counties in Alabama. In this manuscript, we report on the development, implementation, results, and lessons learned from a process evaluation plan initiated during the Phase I planning period of the Alabama REACH 2010 program. The process evaluation plan for Alabama REACH 2010 focused on four main areas of activity that coincided with program objectives: assessing coalition development, building community capacity, conducting a needs …

Molecular Genetic Studies And Delineation Of The Oculocutaneous Albinism Phenotype In The Pakistani Population, Thomas J. Jaworek, Tasleem Kausar, Shannon M. Bell, Nabeela Tariq, Muhammad I. Maqsood, Asma Sohail, Muhammad Ali, Furhan Iqbal, Shafqat Rasool, Saima Riazuddin, Rehan S. Shaikh, Zubair M. Ahmed

Obstetrics and Gynecology Faculty Publications

Background: Oculocutaneous albinism (OCA) is caused by a group of genetically heterogeneous inherited defects that result in the loss of pigmentation in the eyes, skin and hair. Mutations in the TYR, OCA2, TYRP1 and SLC45A2 genes have been shown to cause isolated OCA. No comprehensive analysis has been conducted to study the spectrum of OCA alleles prevailing in Pakistani albino populations.

Methods: We enrolled 40 large Pakistani families and screened them for OCA genes and a candidate gene, SLC24A5. Protein function effects were evaluated using in silico prediction algorithms and ex vivo studies in human melanocytes. The effects of splice-site …

Pregnancy Loss Rate Following Amniocentesis, Shama Munim, Humera Ismail

Department of Obstetrics & Gynaecology

Objective: To determine pregnancy loss rate following amniocentesis in a mainstream urban healthcare centre.
Methods: We analysed cases of all pregnant women who underwent Amniocentesis at the Foetal Medicine Unit of Aga Khan University Hospital, Karachi, during 2001 to 2010. Cases of unknown pregnancy outcome were excluded, and after the process of consent, the final study population was 228 patients. Two operators performed the procedure using 22 G needle.
Results: The mean age of women in the study was 32 +/- 6 years. The commonest indication of the procedure was a previous baby with Down's Syndrome. Majority 197 (86.6%) cases …

Post-Abortion Care Family Planning Use In Pakistan, Syed Khurram Azmat, Waqas Hameed, Muhammad Ishaque, Ghulam Mustafa, Aftab Ahmed

Community Health Sciences

Introduction: The stagnated CPR and high unmet need for contraception lead to approximately 890,000 induced abortions every year in Pakistan. A fairly recent study from Pakistan also revealed that around 40% of abortions are performed by unskilled workers in backstreet clinics. Considering these grave statistics, it should not come as surprise that unwanted pregnancies are the leading cause of induced abortions in Pakistan. Despite country's inferior situation, there is no data available in Pakistan that unveils the much needed information pertaining to post-abortion care family planning (PAC) use. Thus, this paper attempts to document socio-demographic profile seeking post-abortion care clients; …

Delivering Quality Care: The Roles And Future Of Midwives In Southern California, Abigail Jones

Scripps Senior Theses

The United States is ranked 27^th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the …

Frequency And Associated Factors For Anxiety And Depression In Pregnant Women: A Hospital-Based Cross-Sectional Study., Niloufer Sultan Ali, Iqbal Azam Syed, Badar S. Ali, Ghurnata Tabbusum, Sana S. Moin

Department of Family Medicine

Antepartum anxiety and/or depression is a major public health problem globally. The aim of this study was to estimate the frequency of antepartum anxiety and/or depression among pregnant women. This was a cross-sectional study conducted in a tertiary care hospital among pregnant women. A total of 165 pregnant women were interviewed by a clinical psychologist using HADS for assessing anxiety and/or depression and also collected information regarding sociodemographic, obstetric, family relationships, and home environment. Out of the total of 165 pregnant women about 70 percent of them were either anxious and/or depressed. The increasing age of women (P-value = 0.073), …

The Antecedents, Process, And Consequences Of Female Sterilization For Low-Income Women In Mumbai, Marie A. Brault

Master's Theses

Surgical sterilization is the primary method of family planning among low-income women in India; the result of limited knowledge and poor access to family planning alternatives. To understand the dynamics of sterilization, 37 in-depth interviews were conducted with sterilized women from the study community, as well as key informant interviews with community men, providers and government officials. The results indicate that sterilization decisions are made after exceeding ideal family size, that the procedures for sterilization frequently do not follow official protocol, but that for the most part women are highly positive about being free of the risk of unwanted conception.

Embryo Collection Induces Transient Activation Of Xbp1 Arm Of The Er Stress Response While Embryo Vitrification Does Not., Tamara Abraham, Christopher L Pin, Andrew J Watson

Obstetrics & Gynaecology Publications

Embryo cryopreservation has become a standard procedure in the practice of assisted reproduction. While routinely performed in IVF labs, the effects of embryo vitrification on the molecular mechanisms governing preimplantation development remain largely unknown. The endoplasmic reticulum stress (ER stress) response is an evolutionary conserved mechanism that cells employ to manage ER stress. ER stress can be defined as an imbalance between protein synthesis and secretion within the ER. The primary focus of this study was to investigate whether standard embryo manipulations, including embryo collection, culture and vitrification, result in activation of the ER stress pathway in vitro and to …

Hidden Violence Is Silent Rape: Sexual And Gender-Based Violence In Refugees, Asylum Seekers And Undocumented Migrants In Belgium And The Netherlands, Ines Keygnaert, Nicole Vettenbu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Although women, young people and refugees are vulnerable to sexual and gender-based violence (SGBV) worldwide, little evidence exists concerning SGBV against refugees in Europe. Using community-based participatory research, 223 in-depth interviews were conducted with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Responses were analysed using framework analysis. The majority of the respondents were either personally victimised or knew of a close peer being victimised since their arrival in the European Union. A total of 332 experiences of SGBV were reported, mostly afflicted on them by (ex-)partners or asylum professionals. More than half of the reported violent …

Progesterone And Preterm Birth Prevention: Translating Clinical Trials Data Into Clinical Practice, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE:

We sought to provide evidence-based guidelines for using progestogens for the prevention of preterm birth (PTB).

METHODS:

Relevant documents, in particular randomized trials, were identified using PubMed (US National Library of Medicine, 1983 through February 2012) publications, written in English, which evaluate the effectiveness of progestogens for prevention of PTB. Progestogens evaluated were, in particular, vaginal progesterone and 17-alpha-hydroxy-progesterone caproate. Additionally, the Cochrane Library, organizational guidelines, and studies identified through review of the above were utilized to identify relevant articles. Data were evaluated according to population studied, with separate analyses for singleton vs multiple gestations, prior PTB, or short …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

Provider Variations In Cesarean Section (Cs) And Vaginal Birth After Cesarean (Vbac) Practice, Rita Elizabeth Marrero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Centers for Disease Control and Prevention's National Center for Health Statistics (2010) report that nearly one-third of babies were born by Cesarean section (CS) in 2007. Of interest, six states, including Nevada, experienced increases of more than 70% in the last 10 years (CDC, 2007). Based on the increased rate of CS deliveries, the National Institutes of Health (NIH) convened a consensus panel in 2010, which urged the medical community to reduce barriers to women who want to try a vaginal birth after Cesarean delivery (VBAC) in the hope this would safely decrease the total CS rate. For clinicians …