Proceedings in Obstetrics and Gynecology
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Intrauterine fetal demise with caudal regression syndrome, a case report
Get PDFBackground: The causes of intrauterine fetal demise are varied and not entirely well-understood. Multiple observational studies have shown that both perinatal and infant mortality rates are increased in children of diabetic mothers when compared to those of nondiabetic mothers.Case: We present a case involving a 22-year-old G4P0120 with poorly controlled type 1 diabetes mellitus and a complex medical history including two first trimester fetal losses, and second trimester intrauterine fetal demise who presented during the second trimester for care and was found to have a fetus with ultrasound findings consistent with caudal regression syndrome. When she presented in labor at term intrauterine fetal demise was identified.Discussion: Infants and fetuses of diabetic mothers are at a higher risk for congenital anomalies, one of which is the potentially devastating caudal regression syndrome. However, it appears that this risk may be lowered with strict glycemic control both before and during pregnancy
Preterm Birth: At the Edge of Viability. University of Iowa Obstetrics and Gynecology Postgraduate Conference. November 4, 2016
Get PDFPoster Presentations at Preterm Birth: At the Edge of Viability, the University of Iowa Obstetrics and Gynecology Postgraduate Conference, November 4, 2016
Case of Eccrine hidrocystoma of the vulva
Get PDFObjective: Eccrine hidrocystomas are benign cystic lesions that are very rare; their presence on the vulva is extraordinarily rare. We present a woman with a solitary eccrine hidrocystoma of the vulva.Case: A 36-year-old woman presented with a six month history of an asymptomatic and enlarging blue-black lesion on the left labia. The histopathological diagnosis after excision was eccrine hidrocystoma. After removal, she had complete healing of the site and did not require any further intervention.Conclusions: Eccrine hidrocystomas are benign tumors. Their clinical presentation on the vulva can mimic other benign or malignant lesions, therefore biopsy and histological evaluation is necessary
Insulin sensitizing agent improves clinical pregnancy rate and insulin resistant parameters in polycystic ovarian syndrome patients with acanthosis nigricans: a randomized controlled study
Get PDFObjective: To investigate the effect of adding metformin to clomiphene citrate (CC) in polycystic ovarian syndrome (PCOS) patients with acanthosis nigricans (AN) who were previously not responding to CC.Material and Methods: A double blinded randomized controlled trial (NCT02562664) included 66 PCOS women with acanthosis nigricans who were CC resistant (at least 3 months). Day 3 follicle stimulating hormone (FSH) level, fasting insulin, fasting glucose and homeostatic model assessment were used to quantify insulin resistance. Participants were randomly assigned to either group I (CC with placebo tablets) or group II (CC with metformin) for three cycles. Insulin resistance parameters as well as clinical pregnancy rate had been evaluated in both groups. The statistical analysis was done using Chi- square and Fischer exact tests. Results: The demographic data was comparable in both groups, however; there was higher cumulative pregnancy rate after three cycles of stimulation in group II (18/33) (54.5%) in comparison with group I (7/33) (21.1%) (P=0.03). There was a significant improvement in the insulin resistance parameters after three months of combining clomiphene citrate with metformin as compared with CC alone. Conclusion: Adding metformin to CC in clomiphene citrate resistant PCOS patients who have acanthosis nigricans improves the pregnancy rate and insulin resistant parameters
Effects of a community-based intervention package on postnatal care seeking behavior in rural Bangladesh: a cluster-randomized controlled trial
Get PDFBackground: Community-based Postnatal Care (PNC) initiatives have been found to improve maternal and neonatal health.Objectives: This paper aims at evaluating the effectiveness of a Community-Based Intervention Package in providing ‘limited’ PNC services by Community Support Systems (CmSS) and in increasing maternal PNC visits from Skilled Healthcare Providers (SHPs) in rural Bangladesh as well as identifying the predictors of maternal PNC from SHPs.Methods: A cluster-randomized controlled trial was employed where 6 clusters (each with an average population of about 28,000) of Narsingdi District were randomly assigned to the intervention and the comparison group. Sample sizes for pre- and post-intervention were 675 and 702, respectively, collected in June 2010 and December 2011, respectively, from mothers with a recent live birth. Logistic regression was used in examining the main outcomes and the predictors of maternal PNC from SHPs.Results: The coverage of ‘limited’ PNC services by the CmSS members to the mothers did not increase significantly (p=0.25), nor did the maternal PNC from SHPs (p=0.11). Both delivery at a Healthcare Facility and delivery by SHPs increased the odds of taking at least one PNC from SHPs 10-fold with 95% confidence intervals of 4.52-24.04 (pConclusion: This intervention was found to be effective neither in providing limited PNC services by the CmSS members, nor in increasing maternal PNC from SHPs in our study. Further research with proper monitoring and sufficient number of clusters is recommended
Awareness of Pap test among women attending a tertiary center in Bangalore, India
No full textIntroduction: In India, cervical cancer is the most common woman-related cancer, killing 1 woman every 8 minutes. Cervical cancer is more common in women who do not have a Pap test regularly. Secondary prevention achieved through Pap smear testing is the single most effective tool in reducing deaths due to cervical cancer. Scores of women in India fail to carry out this important test till today. In spite of the high incidence of cervical cancer reported from India, to the best of our knowledge, studies on assessing the knowledge and attitude of this test among women has been scanty. Hence, this study has been undertaken.Objective: The aims of this study are to explore the knowledge of Pap test among women and the association between symptomatology and reasons for availing the Pap test.Methods: The study was performed among 251 women aged between 20 and 65 years. The data was collected through a questionnaire containing their personal details and knowledge of the test. The same was tabulated.Results: The study, conducted over a period of 2 months in a tertiary care urban center, revealed that 80.1% of the subjects were not even aware of the term “Cervical Cancer” and a mere 11.6% were aware of the lifesaving Pap smear test. 36.6% of the subjects experienced one of the cardinal symptoms of cervical cancer while only 2% approached the doctor to avail the test. The remaining underwent it on recommendation by the doctor.Conclusion: This study will increase awareness of the Pap test and cervical cancer, thereby paving a way for the prevention of cancer of the cervix
The second case of Horn Kolb Syndrome in the same woman in Turkey, diagnosed prenatally at 16 weeks of pregnancy
Get PDFBackgroundAcheiropodia is a rare form of skeletal dysplasias. It is characterized by the amputation of the upper and lower extremities and with aplasia of the hands and feet. Acheiropodia formerly was known as a disease affecting only people of Brazilian ancestry. The first case out of Brazil was reported from our clinic in 2012. In the present report, we summarize the second case of acheiropodia, which was diagnosed prenatally in the same patient.CaseA 39 years old G7P2A4 pregnant woman admitted to our clinic for a regular obstetrics visit at 16th weeks gestation in May 2013. Her history was significant for early pregnancy oligohydramnios with fetal loss. In the post-abortion examination, the fetus was found to be affected with acheiropodia. Since she had a history of acheiropodia a detailed ultrasound examination was performed. The fetal head and body including the intra-cranial, thoracic and abdominal structures were normal; however, distal long bones of the upper and the lower extremities could not be demonstrated. Three days later she was admitted with vaginal bleeding. Post abortion macroscopic examination revealed the absence of distal parts of the both upper and lower extremities without any other demonstrable anomalies.ConclusionAcheiropodia is a rare disease which may be seen outside of South America. Evaluation of the continuity and normal appearance of the extremities should be integrated to the routine antenatal ultrasound examination
Global fetal DNA methylation and birth outcomes in obese women
Get PDFPregnant women who are obese are more likely to have gestational diabetes, gestational hypertension, pre-eclampsia, macrosomia, operative vaginal delivery, and cesarean delivery. Obesity also has adverse implications for the neonate. Congenital anomalies are more common in children born to obese women. These include neural tube defects, gastroschisis, cardiovascular anomalies, and others. Although the connection between maternal obesity and chronic health conditions has been described, the mechanism by which this occurs is less well understood. Changes to the epigenetic structure of offspring DNA have been proposed as one such mechanism
The role of physicians in transitional justice: combatting the aftermath of mass rape in Bosnia-Herzegovina
Get PDFBetween 1992-1995, an estimated 20,000-50,000 women were raped during the war in Bosnia-Herzegovina. Twenty years later, victims of war rape continue to experience severe mental health disorders, Posttraumatic Stress Disorder (PTSD), and multiple co-morbidities. A recent comprehensive study of rape survivors who have utilized non-governmental organization (NGO) services demonstrate alarming reports of chronic gynecologic problems. The purpose of this paper is to discuss the role of war-related sexual violence in Bosnia-Herzegovina. Specifically, it will examine the role of medical professionals in post-conflict societies, through documenting human rights abuses and providing clinical care for victims
Division of Reproductive Science Research
Get PDFThe Division of Reproductive Science Research at the University of Iowa has a long tradition and was formally organized in 2009. Since then, the division has enjoyed extensive growth and development in many areas of reproductive research. Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the NIH Office of Research on Women’s Health, a Women’s Reproductive Health Research Career Development Center, was established to train future physician-scientists. Further, to enhance our capability to perform translational research, the Women’s Health Tissue Repository was established. This robust bio-repository includes the Maternal Fetal Tissue Bank, the Paternal Contributions to Children’s Health Biobank, the Well Woman Bank, the Reproductive Endocrinology and Infertility Biobank, and the Gynecologic Malignancies Biobank. Together, these biobanks collect samples from all stages of women’s lives and have deep clinical annotations