Obstetrics and Gynecology Commons^™

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 …

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 …

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 …

An Investigation Of The Effects Of Pitocin For Labor Induction And Augmentation On Breastfeeding Success, Megan J. Lewis

Scripps Senior Theses

Rates of labor induction and augmentation have been increasing in recent decades (Glantz, 2005). According to the Listening to Mothers II survey, half of all labors in the U.S. are induced or augmented with Pitocin or other synthetic form of the hormone oxytocin (Declercq et al., 2006). Oxytocin, a naturally occurring hormone released in the pituitary gland, is involved in the stimulation of uterine contractions during labor and in the milk ejection reflex during breastfeeding, and research suggests it also has various effects on the brain, such as eliciting maternal behavior. However, studies have shown that exogenous oxytocin can interfere …

Comparison Of Conventional Cervical Cytology Versus Visual Inspection With Acetic Acid (Via) Among Hiv-Infected Women In Western Kenya, Hillary Mabeya, Kareem Khozaim, Tao Liu, Elkanah Omenge, David Chumba, Latha Pisharodi, J. Carter, Susan Cu-Uvin

Obstetrics and Gynaecology, East Africa

Objective: To determine the accuracy of visual inspection with Acetic Acid (VIA) versus conventional Pap smear as a screening tool for cervical intraepithelial neoplasia (CIN)/cancer among HIV-infected women.

Materials and Methods: 150 HIV-infected women attending the Moi Teaching and Referral Hospital HIV clinic in Eldoret underwent conventional Pap smear, VIA, colposcopy and biopsy. VIA and Pap smears were done by nurses while colposcopy and biopsy were done by a physician. Receiver Operating Characteristic (ROC) analysis was conducted to compare the accuracies between VIA and Pap smear in sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results: Among …

The Pregnancy Project: Impact Of Ultrasound Use During Pregnancy Care, Paige Ricci

Annual Undergraduate Conference on Health and Society

Use of ultrasounds during pregnancy continues to increase and there is much debate as to what the best practice is regarding their use, for what types of patients, at what volume level. Current evidence suggests, the extended routine use of ultrasound technology should be for all women that present complications to screen for structural anomalies during pregnancy. However, others have suggested that excessive ultrasound use may be both unnecessary, costly and potentially harmful. Evidence further suggests that mothers find the use of technology to be security enhancing during pregnancy and through the process of care, and that ultrasound use is …

Rates Of Iucd Discontinuation And Its Associated Factors Among The Clients Of A Social Franchising Network In Pakistan, Syed Khurram Azmat, Babar Tasneem Shaikh, Waqas Hameed, Mohsina Bilgrami, Ghulam Mustafa, Muhammad Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed

Community Health Sciences

Background: Modern Intrauterine contraceptive device (IUCD) is very safe, highly effective reversible and inexpensive family planning method which offers 5-10 years of protection against pregnancy. The contraceptive use in Pakistan has been merely 30% for over a decade with IUCD being the least used method. Higher discontinuation rates are documented in developing countries; however no such data is available for Pakistan. Marie Stopes Society (MSS) established a social franchise outlets network branded as 'SURAJ' (Sun) in Pakistan to provide quality family planning services. This study attempts to determine IUCD discontinuation rates and its associated risk factors. Using a semi-structured questionnaire, …

Outer Space And Oocyte Developmental Competence., Andrew J Watson

Obstetrics & Gynaecology Publications

No abstract provided.

Barriers And Perceptions Regarding Different Contraceptives And Family Planning Practices Amongst Men And Women Of Reproductive Age In Rural Pakistan: A Qualitative Study, Syed Khurram Azmat, Ghulam Mustafa, Waqas Hameed, Muhammad Ali, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: Pakistan ranks as one of the most poorest and most populous in the world with poor reproductive health indicators. This study helps in understanding barriers and perceptions regarding Family Planning (FP), modern contraception, quality of care and free of charge FP services amongst men and women in rural Pakistan.
Methods: Employing purposive sampling and Focus Group Discussion (FGD) technique, this qualitative study was conducted with men and women of reproductive age in Pakistan. A total of eight FGDs were conducted in Sindh and Punjab provinces. Being descriptive in nature, the study provided a thematic analysis of the relevant health …

Puerperal Fever From Hippocrates To Pasteur, Hunter A. Hammill

Houston History of Medicine Lectures (2006-2012)

The death of a mother in childbirth leaving a newborn deserted is a sort of a desecration. This was a frequent event for early physicians. It was felt to be caused by miasmas or punishment from the gods. DaVinci felt the cause was milk stasis, Hippocrates - lochia, Virchow - weather. Then came Semmelweis, Pasteur and Lister. They started a battle with ignorance, hospital administration, budget and academic politics. Ending with the murder of Semmelweis!

Reducing Emergency Births By Modification In Oxytocin Utilization, Gary Ventolini, Michael L. Galloway, Sheela M. Barhan, Marc R. Belcastro

Obstetrics and Gynecology Faculty Publications

Background: The purpose of our study was to explore the correlation between the amount of oxytocin use and emergency vacuum, forceps, cesarean births and neonatal intensive care unit (NICU) response to fetal distress. In 2004, we restricted the criteria for oxytocin utilization for labor induction and augmentation.

Methods: This retrospective study was carried out at a large private university tertiary care hospital- affiliated, and included data from the years 2005 to 2007. We utilized hospital data from vital statistics, labor and delivery, central pharmacy and NICU. Information obtained included maternal characteristics, annual birth data, indication and numbers of emergency vacuum, …

Spontaneous Bilateral Tubal Pregnancy, Aisha Syed Wali, Rozilla Sadia Khan

Department of Obstetrics & Gynaecology

With the increase in incidence of ectopic pregnancy over the decades, bilateral ectopic pregnancy is also increasing. It is usually associated with assisted reproductive techniques (ART) but in recent years few cases of spontaneous bilateral ectopic pregnancy have been reported. Gynaecologists should be aware of this and that ultrasonography has limitations in diagnosis. In cases of ectopic pregnancy where contralateral adnexa is not clearly identified on ultrasound and fertility needs to be conserved, patient should be managed by experts in well equipped centres. A case of spontaneous bilateral tubal pregnancy that remained undiagnosed till laparotomy, is described.

Cholesterol Side-Chain Cleavage Gene Expression In Theca Cells: Augmented Transcriptional Regulation And Mrna Stability In Polycystic Ovary Syndrome, Jessica K. Wickenheisser, Jessica M. Biegler, Valen L. Nelson-Degrave, Richard S. Legro, Jerome F. Strauss Iii, Jan M. Mcallister

Obstetrics and Gynecology Publications

Hyperandrogenism is characteristic of women with polycystic ovary syndrome (PCOS). Ovarian theca cells isolated from PCOS follicles and maintained in long-term culture produce elevated levels of progestins and androgens compared to normal theca cells. Augmented steroid production in PCOS theca cells is associated with changes in the expression of genes for several steroidogenic enzymes, including CYP11A1, which encodes cytochrome P450 cholesterol side-chain cleavage. Here, we further examined CYP11A1 gene expression, at both the transcriptional and post-transcriptional level in normal and PCOS theca cells propagated in long-term culture utilizing quantitative RT-PCR, functional promoter analyses, and mRNA degradation studies. The minimal …

Mouse Rc/Btb2, A Member Of The Rcc1 Superfamily, Localizes To Spermatid Acrosomal Vesicles, Jiannan Wang, Maria E. Teves, Xuening Shen, David R. Nagarkatti-Gude, Rex A. Hess, Scott C. Henderson, Jerome F. Strauss Iii, Zhibing Zhang

Obstetrics and Gynecology Publications

Mouse RC/BTB2 is an unstudied protein of the RCC1 (Regulator of Chromosome Condensation) superfamily. Because of the significant remodeling of chromatin that occurs during spermiogenesis, we characterized the expression and localization of mouse RC/BTB2 in the testis and male germ cells. The Rc/btb2 gene yields two major transcripts: 2.3 kb Rc/btb2-s, present in most somatic tissues examined; and 2.5 kb Rc/btb2-t, which contains a unique non-translated exon in its 5′-UTR that is only detected in the testis. During the first wave of spermatogenesis, Rc/btb2-t mRNA is expressed from day 8 after birth, reaching highest levels of expression at day …