Obstetrics and Gynecology Commons^™

Health Related Quality Of Life Changes Among Users Of Depot Medroxyprogesterone Acetate (Dmpa) For Contraception, Sikolia Wanyonyi

Master of Medicine in Obstetrics and Gynecology

Background: Contraceptive use is often a lifestyle choice that could impact on the quality of life. Depot medroxyprogesterone acetate (DMPA), like any other contraceptive method has other effects besides fertility control. Understanding how these impacts on the quality of life could assist in client counseling, eventually leading to informed choices. Objective: To determine health related quality of life changes associated with the use of DMPA for contraception. Methods: A longitudinal observational study was carried out between December 2008 and September 2009 at family planning clinics at the Aga Khan University Hospital and Family Health Options, Kenya (FHOK) after institutional and …

Is It Possible To Reduce Rates Of Placenta Praevia, Sheena Memon, Kaweeta Kumari, Haleema Yasmin, Sheerin Bhutta

Department of Obstetrics & Gynaecology

To determine factors responsible for rising rates of placenta praevia. This comparative study was performed at Jinnah Post Graduate Medical Centre Karachi, (Group-A) from September 2000 to February 2002 and (Group-B) from January 2008 to January 2009. All women with major degree of placenta praevia diagnosed on ultrasound who came in emergency or through out patient department were included in the study. Patients with mild degree of placenta praevia were excluded. Group A had 100 patients and Group B, 58 patients. Chi-Squire test was used for comparison of previous study and current study. The number of unbooked cases in both …

Birth Weight Estimation--A Sonographic Model For Pakistani Population, Waseem Akhtar, Arif Ali, Mubashir Aslam, Farah Saeed, Salman, Nadeem Ahmad

Department of Radiology

OBJECTIVE: To develop a sonographic birth weight estimation model for Pakistani population and to validate the published models in the same population.

METHODS: Data was collected for pregnant women who presented to Radiology Department of Aga Khan University Hospital Karachi from January 2007 to July 2008 and had undergone ultrasound estimation of foetal weight within 4 days prior to a term delivery (37-42 weeks gestation). The neonate's actual birth weight was used to validate the published foetal weight estimation models and modified sonographic birth weight estimation model was derived for our population by using linear regression.

RESULTS: Modified sonographic birth …

Implementing A Maternal Newborn Service Excellence Program: Lessons Learned (Poster), Judith Pfeiffer Bsn, Rnc

Patient Care Services / Nursing

No abstract provided.

Parent-Child Communication About Sexual And Reproductive Health In Rural Tanzania: Implications For Young People's Sexual Health Interventions, Joyce Wamoyi, Angela Fenwick, Mark Urassa, Basia Zaba, William Stones

Obstetrics and Gynaecology, East Africa

Background

Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH) with their children. These approach has had limited success because of failure to factor in the young person's family context, and the influence of parents. This paper explores parent-child communication about SRH in families, content, timing and reasons for their communication with their children aged 14-24 years in rural Tanzania.

Methods …

Improving Sexual Health, P.U.L.S.E., And E.R.O.S. At California Polytechnic State University, San Luis Obispo, Megan (Meg) Rust

Psychology and Child Development

This project is designed to update and refine EROS educators’ knowledge of sexual health and to gain insight into Cal Poly students’ general knowledge of sexual health.  Educators are given extensive training during the entire quarter before they begin their positions, but information is constantly changing. This project intends to initiate up to date informational tools that can be revised as new psychological or medical discoveries are made in the realm of sexuality and sexual health.

The Use Of The Use Of Negative Pressure Wound Therapy In Vulvar Wounds, E. K. Ricci, Md, J. Brace, Phd, Crn, Bc, Cwocn, Aprn, N. G. Rosenblum, Md, Phd

Department of Obstetrics and Gynecology Faculty Papers

Patients with severe HS or Necrotizing Fasciitis often require extensive surgical debridement.

Traditionally, these wounds have been closed using split-thickness skin grafts with or without the use of the VAC device.

Our case study demonstrates good outcomes using the VAC device alone to achieve complete closure when applied immediately following debridement with frequent VAC changes.

Duration Of Maternal Human Papilloma Virus Infection And Risk Of Spontaneous Preterm Birth, K. Soin, Ms, N. S. Seligman, Md, A. Nnoli, Md, K. Dysart, Md, J. K. Baxter, Md, Mscp

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

Duration of HPV infection was not a significant risk factor for spontaneous PTB <37 weeks.

Cervical HPV DNA and HPV serology may further delineate the relationship between HPV infection and SPTB <37 weeks.

A larger sample size may be necessary to show a difference.

The 3.5x higher rate of fetal death > 23 weeks in our study (compared to fetal death > 20 weeks in the U.S.) needs further investigation.

Body Mass Index And Cerclage Success, A. Suhag, Md, N. S. Seligman, Md, V. Berghella, Md

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

Among women with a cerclage, pre-pregnancy BMI was not a significant predictor of SPTB <35 weeks.

There was a non-significant trend toward increased rates of SPTB at all gestational age cutoffs.

Morbidly obese women consistently had worse outcomes than obese and normal/overweight women.

Compared to normal/overweight, GA at delivery decreases by 1 week for obese and 2 weeks for morbidly obese women.

Recent Change In The Incidence Of Cervical Cerclage, Maria Bisulli, Md, Neil S. Seligman, Md, Komal Soin, Ms, Anju Suhag, Md, Vincenzo Berghella, Md

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

More selective indications for cervical cerclage based on recent randomized studies were associated with decreased cerclage placement.

The decrease in incidence of history-indicated cerclage may be due to the fact that more women with prior PTB are being followed by transvaginal cervical length measurements.

The decrease in incidence of ultrasound-indicated cerclage may be due to the use of 17-hydroxy progesterone caproate in women with PTB.

First Trimester Screening And Its Impact On Uptake Of Diagnostic Testing, Deanna Darnes

Dissertations and Theses (Open Access)

Introduction: First Trimester Screening (FTS) combines maternal age with fetal nuchal translucency (NT) and maternal analytes to identify pregnancies at an increased risk for Down syndrome and trisomy 18. Though the accuracy of this screening is high, it cannot replace the conclusive accuracy of prenatal diagnostic testing (PDT). Since FTS has been available, a decrease in the number of women who pursue PDT has been observed. This study sought to determine if there has been a significant change in the amount of PDT performed in our clinics, if the type of FTS result affects the patient’s decision regarding PDT, and …

Reproductive Health Services For Populations At High Risk Of Hiv: Performance Of A Night Clinic In Tete Province, Mozambique, Yves Lafort, Diederike Geelhoed, Luisa Cumba, Carla Das Dores Mosse Lázaro, Wim Delva, Stanley Luchters, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Different models exist to provide HIV/STI services for most-at-risk populations (MARP). Along the Tete traffic corridor in Mozambique, linking Malawi and Zimbabwe, a night clinic opening between 4 and 10 PM was established targeting female sex workers (FSW) and long-distance truck drivers (LDD). The clinic offers free individual education and counselling, condoms, STI care, HIV testing, contraceptive services and outreach peer education. To evaluate this clinic model, we assessed relevance, service utilisation, efficiency and sustainability.

Methods: In 2007-2009, mapping and enumeration of FSW and LDD was conducted; 28 key informants were interviewed; 6 focus group discussions (FGD) were held …

Pregnancy Outcomes In Female Liver Recipients Transplanted Under The Age Of 21, Carlo B. Ramirez, Warren R. Maley, Cataldo Doria, Lisa A. Coscia, Michael J. Moritz, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions: Liver recipients transplanted under the age of 21 are able to maintain pregnancy with 75% resulting in a livebirth. Pregnancy, potential risks for mother and newborn, and long-term maternal survival should be discussed with the recipient and the parents of the recipient. Transplant centers are encouraged to report pregnancy outcomes in these recipients to the NTPR.

Use Of An Animal Model To Explore Prenatal Predictors Of Insulin And Glucose Metabolism In Southwestern Alaskan Yupiit, Julie Jo Kachinski

UNLV Theses, Dissertations, Professional Papers, and Capstones

Compared to other North American indigenous populations, Southwest Alaskan Yupiit exhibit very low rates of type 2 diabetes despite the occurrence of common risk factors. Contemporary Yupiit obtain a substantial portion of their calories from traditional foods, which contain high amounts of omega-3 polyunsaturated fatty acids. Epidemiological and experimental animal research has linked glucose and insulin homeostasis with a diet high in omega-3s. This study used an experimental animal model to explore potential diabetes protective effects (for adult offspring) of prenatal maternal nutrition modeled on traditional locally-obtained Yupiit diets. The results of this study showed that the adult offspring whose …

The Interim Window: Women’S Experiences During In Vitro Fertilization Leading To Maternal Embryo Attachment, Tammy Mackinnon Lampley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Infertility affects about 7.3 million women and their partners in the U.S., about 12% of the reproductive-age population. In vitro fertilization (IVF) has been used successfully in the United States since 1981. The number of women seeking artificial reproductive techniques (ART) has increased dramatically and the number of ART cycles performed in the United States has more than doubled, from 64,681 in 1996 to 134,260 in 2005 and 99% of these are IVF. Studies indicated that women rank waiting for the outcome of and IVF treatment and a negative pregnancy result as the most stressful events during their treatment. Although …

Non-Invasive Prenatal Determination Of Fetal Rhd Genotyping From Maternal Plasma: A Preliminary Study In Pakistan, Nuruddin Badruddin Mohammed, Fatima Kakal, Mehreen Somani, Wajiha Zafar

Department of Obstetrics & Gynaecology

Objectives: To determine the accuracy of the non-invasive pre-natal real-time polymerase chain reaction based fetal RhD genotyping from maternal plasma.

Study Design: Cross-sectional study.

Place And Duration Of Study: Juma Health Sciences Research Laboratory, The Aga Khan University Hospital, Karachi, from July to December 2008.

Methodology: Cell-free plasma DNA from 21 D-negative women with D-positive spouse between 20-39 weeks of gestation was tested for the presence of exon 5 region of RhD gene using real-time polymerase chain reaction. b-globin was employed as the house-keeping gene. Sensitivity and specificity of the real-time PCR-based non-invasive fetal RhD genotyping was obtained by calculating …

Presenting Signs And Symptoms Of Ovarian Cancer At A Tertiary Care Hospital, Ambareen Khan, Khusro Sultana

Department of Obstetrics & Gynaecology

Objective: To identify early warning signs and symptoms of ovarian cancer to create awareness for early diagnosis and management of the disease.
Methods: This study was conducted at the department of Gynaecology and Obstetrics, Liaquat National Hospital, Karachi from 2003 to 2007, having 75 patients. The information collected included age, education, and self perceived state of socio-economic class, presenting clinical signs and symptoms, basic and specific laboratory investigations. The disease was staged from I to IV upon surgical staging and the type of cancer was determined by histopathological examination.
Results: Mean age of the patients was 51 +/- 12.3 years. …

Sharing Neurological Expertise: Development Of A High Risk Obstetrical Course, Maureen T. Smith Msn, Rn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Can Urethral Retroresistance Pressures Predict Midurethral Sling Outcomes?, Patrick J. Culligan, Jennifer Lewis-Priestley, Linda Blackwell, Susan B. Tate

Faculty Articles

OBJECTIVE: To determine whether preoperative urethral resistance pressure (URP) measurements could predict success or failure of a tension-free vaginal tape (TVT) sling.

METHODS: Subjects came from a previously published study comparing URP measurements to a validated urinary incontinence symptom survey (UISS). We contacted patients from that study to determine whether they had subsequently undergone TVT surgery. Within that cohort, we determined the “current” (i.e., postoperative) UISS and Sandvik urinary incontinence severity score. Success of a TVT sling in this group was defined in 4 ways: (1) postoperative UISS score < 3, (2) postoperative UISS score < 75% of the preoperative score, (3) postoperative Sandvik score < 6, and (4) postoperative Sandvik score < 2. These definitions of “success” were compared across demographic and treatment variables using the Student’s t test, ANOVA, χ 2 and ROC curves.

RESULTS: We contacted 69 women who had in fact received …

The Outcome Of Patients With Platinum-Resistant/Refractory Ovarian Cancer Treated With The Combination Of Pegylated Liposomal Doxorubicin And Gemcitabine, Vijaya Galic Md, Mba, Richard Boulay Md, M Bijoy Thomas Md, Cody Gillenwater, Christine C. Chen Md, Martin Martino Md

Department of Obstetrics & Gynecology

No abstract provided.