Obstetrics and Gynecology Commons^™

Severe Propylthiouracil-Induced Hepatotoxicity In Pregnancy Managed Successfully By Liver Transplantation: A Case Report, Evan Sequeira, Sikolia Wanyonyi, Raj Dodia

Obstetrics and Gynaecology, East Africa

Introduction: Propylthiouracil-induced severe hepatotoxicity is a relatively rare occurrence, with very few cases reported in the literature. The management of this complication in pregnancy can be a challenge because of the effects of the various treatment options on the fetus.

Case presentation: We report a rare case of fulminant hepatic failure in a 36-year-old gravida 2 black woman of African descent that occurred at 17 weeks gestation following propylthiouracil treatment for Graves’ disease. Her liver failure was managed by liver transplantation and thyroidectomy. Her pregnancy was continued to term, though with not so favorable early childhood sequelae.

Conclusion: This case …

Evolution Of Foetal Echocardiography As A Screening Tool For Prenatal Diagnosis Of Congenital Heart Disease, Nuruddin Badruddin Mohammed, Anandakumar Chinnaiya

Department of Obstetrics & Gynaecology

Congenital cardiac anomalies are the most common anomalies, with an estimated incidence of about 4-13 per 1000 live births. Proper perinatal and neonatal management is dependent upon accurate prenatal diagnosis. Approximately 10% of foetuses with cardiac abnormalities have identified risk factors; hence, most of the anomalies occur in pregnancies without prenatal risk factors. Foetal echocardiography allows for prenatal diagnosis of congenital heart disease and serves as a routine screening tool for congenital heart defects. Advanced technology, has not only allowed more accurate and early detection of cardiac abnormalities but has also improved the care and outcome of selected foetuses with …

Identification Of A Mechanism For Increased Cardiovascular Risk Among Individuals With Low Vitamin D Concentrations., Peter F Schnatz, Matthew Nudy, David M O'Sullivan, Kelly Ethun, Susan E Appt, Thomas B Clarkson

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The aim of this study was to investigate the plasma concentrations of vitamin D and its association with plasma lipid profiles.

METHODS: Plasma vitamin D3 and lipid concentrations were measured in 119 female cynomolgus monkeys (premenopausal, n = 49; ovariectomized, n = 70) consuming approximately 1,000 IU per day of vitamin D3. In a subset of the ovariectomized monkeys (n = 23), vitamin D3 was remeasured after 6 months. The concentrations of vitamin D3 were analyzed as a continuous variable and were divided at the median into high (≥48 ng/mL) versus low (<48 ng>/mL) groupings.

RESULTS: Among the 119 …

The Role Of Acidic Fibroblast Growth Factor And Fibroblast Growth Factor Receptor 4 In High Grade Serous Carcinoma, Tarrik Zaid

Dissertations and Theses (Open Access)

Background: High grade serous carcinoma whether ovarian, tubal or primary peritoneal, continues to be the most lethal gynecologic malignancy in the USA. Although combination chemotherapy and aggressive surgical resection has improved survival in the past decade the majority of patients still succumb to chemo-resistant disease recurrence. It has recently been reported that amplification of 5q31-5q35.3 is associated with poor prognosis in patients with high grade serous ovarian carcinoma. Although the amplicon contains over 50 genes, it is notable for the presence of several members of the fibroblast growth factor signaling axis. In particular acidic fibroblast growth factor (FGF1) …

Tgfb1 Disrupts The Angiogenic Potential Of Microvascular Endothelial Cells Of The Corpus Luteum., Dulce Maroni, John S. Davis

Journal Articles: Obstetrics & Gynecology

Cyclical formation and regression of the ovarian corpus luteum is required for reproduction. During luteal regression, the microvasculature of the corpus luteum is extensively disrupted. Prostaglandin F2α, a primary signal for luteal regression, induces the expression of transforming growth factor β1 (TGFB1) in the corpus luteum. This study determined the actions of TGFB1 on microvascular endothelial cells isolated from the bovine corpus luteum (CLENDO cells). We hypothesized that TGFB1 participates in the disruption of the microvasculature during luteal regression. TGFB1 activated the canonical SMAD signaling pathway in CLENDO cells. TGFB1 (1 ng/ml) significantly reduced both basal and fetal-calf-serum-stimulated DNA synthesis, …

Abnormal Placental Findings Associated With Non-Reassuring Fetal Monitoring And Excellent Neonatal Outcomes, Gary Ventolini, Shanthi Ramesh, Sheela M. Barhan, Ran Neiger

Obstetrics and Gynecology Faculty Publications

Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a …

Pregnancy Loss And Distress Among U.S. Women, Karina M. Shreffler, Arthur L. Greil, Julia Mcquillan

Department of Sociology: Faculty Publications

Although pregnancy loss—especially miscarriage— is a relatively common experience among reproductive-aged women, much of our understanding about the experience has come from small clinic-based or other nonrepresentative samples. We compared fertility-specific distress among a national sample of 1,284 women who have ever experienced a stillbirth or miscarriage. We found that commitment/attachment to pregnancy that ended in loss as well as current childbearing contexts and attitudes were associated with distress following pregnancy loss. Practitioners working with women or couples who have experienced pregnancy loss should be aware of the importance of characteristics associated with higher distress, such as whether the pregnancy …

Prevalence Of Postpartum Depression Using The Edinburgh Postpartum Depression Scale At The Aga Khan University Hospital, Nairobi, Warfa Khadija

Master of Medicine in Obstetrics and Gynecology

Background: Postpartum depression is an illness that affects 10-20% of mothers following delivery; the impact it has on the family, partner and the new born baby is significant. There are insufficient data in Kenya as its rate and severity hence the impact is unknown. Screening could allow earlier treatment of these mothers and prevent the long term effects on the family. Objectives: The primary objective was to identify the prevalence of postpartum depression at the Aga Khan University Hospital and to identify associations between participant’s socio demographics and depression. Methods: Cross sectional study to screen postpartum women six weeks after …

The Use Of Mcv And Mch To Screen For Iron Deficiency In Pregnancy Among Women With Normal Haemoglobin Values, Charles M. Muteshi

Master of Medicine in Obstetrics and Gynecology

Background: Worldwide the commonest cause of anaemia is inadequate nutritional supply manifest as iron deficiency. Iron deficiency affects 25% of the world’s population and up to 50% in the developing world. Most susceptible are women of child bearing age and infants. In pregnancy most iron deficiency is detected when there is already resultant anaemia by measuring the haemoglobin content. It is important to develop a tool that could pick out women who are iron deficient before anaemia ensues. This study aims to determine the predictive ability of red cell mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) in screening …

Domestic Violence And Pregnancy: The Challenge Of Framing A European-Wide Research Question., Caroline Andries, Nicola Buckley, Kristien Roelens, Ingunn Studsrød, Marleen Temmerman, An-Sofie Van Parys, Elisabeth Willumsen

Obstetrics and Gynaecology, East Africa

No abstract provided.

Effect Of Anchoring On Perceived Amniocentesis Related Miscarriage Risk Within A Latina Population, Laura E. Panos

Dissertations and Theses (Open Access)

Most recognized pregnancies are completed without difficulty, yet there is always a 3-5% background risk to have a child with a birth defect. Amniocentesis, the most common type of prenatal diagnostic test, is used to detect chromosomal abnormalities, such as Down syndrome. Amniocentesis is associated with a risk of complications that can lead to a miscarriage, which is typically quoted to be between 1 in 300 and 1 in 500. Amniocentesis uptake rates are typically lowest within the Latina community, and although the factors related to this have been studied before, no specific conclusions have been reached.

The general population …

Polycystic Ovary Syndrome (Pcos) In Urban India, Heidi A. Manlove

UNLV Theses, Dissertations, Professional Papers, and Capstones

This thesis research focuses on urban women in India diagnosed with polycystic ovary syndrome (PCOS). PCOS is a complex metabolic, endocrine and reproductive disorder affecting approximately 5-10% of the female population in developed countries. The prevalence of PCOS is on the rise in developing nations like India, which are undergoing rapid nutritional transitions due to Westernized diets and lifestyle. However, less appreciated in the literature are the developmental psychosocial impacts for women diagnosed with PCOS, especially in developing countries. Thus, the goal of my thesis research was to contribute to the small but growing literature by investigating psychosocial dimensions of …

Adolescent Medicine, Carol L. Watwood

DLPS Faculty Publications

No abstract provided.

Pain Threshold, Tolerance And Catastrophization In Women With Dyspareunia, Jennifer Bivens, Hilary Billings, Jenna Dilauro, Lea Thaler, Marta Meana

Festival of Communities: UG Symposium (Posters)

This study examined the impact of pain and sexual stimuli on the experience of experimentally induced pain, as well as pain threshold, tolerance and catastrophization levels in women with dyspareunia compared to control women.

Should Designer Babies Be Regulated?, Alec Madriaga, Natasha Bates

Festival of Communities: UG Symposium (Posters)

Designer babies have been frequently used to help prevent genetic defect of offspring. The two main procedures that can help prevent offspring of having a genetic defect is by IVF, In Vitro Fertilization, or PGD, Preimplantation Genetic Disorder. It is a topic currently being debated ethically on whether it is okay to design a baby and how far people may take the procedures to design a baby before it gets out of hand. Two sides can be approached to this topic: Should designer babies be regulated or should it not be regulated? A concern that is plaguing the minds of …

Care During Labor And Birth For The Prevention Of Intrapartum-Related Neonatal Deaths: A Systematic Review And Delphi Estimation Of Mortality Effect, Anne C. C. Lee, Simon Cousens, Gary L. Darmstadt, Hannah Blencowe, Robert Pattinson, Neil F. Moran, G. Justus Hofmeyr, Rachel A. Haws, Shereen Zulfiqar Bhutta, Joy E. Lawn

Department of Obstetrics & Gynaecology

Background: Our objective was to estimate the effect of various childbirth care packages on neonatal mortality due to intrapartum-related events ("birth asphyxia") in term babies for use in the Lives Saved Tool (LiST).

Methods: We conducted a systematic literature review to identify studies or reviews of childbirth care packages as defined by United Nations norms (basic and comprehensive emergency obstetric care, skilled care at birth). We also reviewed Traditional Birth Attendant (TBA) training. Data were abstracted into standard tables and quality assessed by adapted GRADE criteria. For interventions with low quality evidence, but strong GRADE recommendation for implementation, an expert …

Evaluation Of Compliance And Outcomes Of A Management Protocol For Massive Postpartum Hemorrhage At A Tertiary Care Hospital In Pakistan, Lumaan Sheikh, Nida Najmi, Umair Khalid, Taimur Saleem

Department of Obstetrics & Gynaecology

Background: Massive postpartum hemorrhage is a life threatening obstetric emergency. In order to prevent the complications associated with this condition, an organized and step-wise management protocol should be immediately initiated.

Methods: An evidence based management protocol for massive postpartum hemorrhage was implemented at Aga Khan University Hospital, Karachi, Pakistan after an audit in 2005. We sought to evaluate the compliance and outcomes associated with this management protocol 3 years after its implementation. A review of all deliveries with massive primary postpartum hemorrhage (blood loss >= 1500 ml) between January, 2008 to December, 2008 was carried out. Information regarding mortality, mode …

Expect The Unexpected: Researching Pregnant Women’S Social Supports, Amy Ma

Inquiry Journal 2011

No abstract provided.

Response To An Abnormal Ovarian Cancer-Screening Test Result: Test Of The Social Cognitive Processing And Cognitive Social Health Information Processing Models, Michael A. Andrykowski, Edward J. Pavlik

Behavioral Science Faculty Publications

All cancer screening tests produce a proportion of abnormal results requiring follow up. Consequently, the cancer-screening setting is a natural laboratory for examining psychological and behavioural response to a threatening health-related event. This study tested hypotheses derived from the social cognitive processing and cognitive-social health information processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n = 278) receiving an abnormal screening test result a mean of 7 weeks earlier were assessed prior to a repeat screening test intended to clarify their previous abnormal result. Measures of disposition (optimism, informational coping style), …

Primary Hyperparathyrodism In Pregnancy And Review Of Literature, Tahira Naru, Rozilla Sadia Khan, Mohammed Ataullah Khan

Department of Obstetrics & Gynaecology

hyperparathyroidism (PHPT) is rare condition during pregnancy; however, it can carry significant risks to both mother and foetus during and after the pregnancy. The definitive treatment is parathyroidectomy undertaken preferably in the second or early third trimester. A case of asymptomatic PHPT diagnosed and treated by parathyroidectomy in the third trimester is described.