Proceedings in Obstetrics and Gynecology
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Wnt signaling in granulosa cell tumors of the ovary
Get PDFGranulosa cell tumors (GCT), a malignant type of sex-cord stromal tumor, account for approximately 2-5% of all ovarian malignancies. They are often identified before they have spread beyond the ovary, but advanced disease can be quite challenging to treat. Wnt signaling has been suggested to contribute to the formation of GCT. We hypothesized Wnt signaling was involved in human GCT
Clinicopathological predictors of chemoresponsiveness in epithelial ovarian cancer: a preliminary institutional study
Get PDFObjective: One-third of women with epithelial ovarian cancer are resistant to standard platinum-based chemotherapy, and insufficient data exist in predicting response to chemotherapy. We describe the clinical and pathological factors of patients with complete and incomplete response to treatment.Method: In this retrospective study, data was reviewed from 75 medical charts of 243 patients with primary epithelial ovarian cancers as a preliminary study. All patients underwent chemotherapy and cytoreductive surgery for primary disease. Fifty-six patients had complete response (CR) to chemotherapy and 19 had incomplete response (IR). Fifty-eight and 17 patients had optimal and suboptimal cytoreductive surgery, respectively. Clinical and pathological factors were compared in patients with complete and incomplete response to treatment, and optimal and suboptimal surgery. Overall survival (OS), cancer-specific survival (CSS), and time to recurrence (TTR) were estimated using the Kaplan-Meier method for patient groups.Results: The majority of patients in both the CR and IR groups were diagnosed at advanced stage ovarian cancer. The CR group had significantly lower preoperative CA125 and was more likely to have optimal chemotherapy. The CR group was also more likely to have lymph nodes removed during cytoreductive surgery. A significantly lower percentage of CR patients died from the disease and had statistically longer disease free survival. Patients who underwent suboptimal surgery had significantly shorter survival, but no difference existed in the time until recurrence between patients with optimal and suboptimal surgery. OS, CSS, and TTR were significantly increased in the CR group and in patients that had optimal surgery.Conclusion: Complete response during treatment and optimal surgery significantly increases OS, CSS, and TTR. Preoperative CA125 and lymph node removal during surgery may be predictive of complete treatment response
Impact of obesity on rates of successful vaginal delivery after term induction of labor
Get PDFObjective: Determine success of term inductions of labor among an obese patient population.Methods: A retrospective chart review of all women greater than 37 weeks gestation who underwent induction of labor at University of Iowa Hospital and Clinics (12-2012 to 03-2013). Chart abstraction included data from the patient’s prenatal care, medical history, labor history, delivery and postpartum course. Subjects were stratified by pre-pregnancy BMI.Results: 74 inductions occurred at greater than 37 weeks gestation during the study period. Successful vaginal delivery (operative and spontaneous) occurred for 80.4% of normal weight women versus 82.6% for women who were obese pre-pregnancy (p=0.85). Induction of obese women was associated with significantly longer infant admission (2.82 days vs 6.09 days, p=0.03) and a higher likelihood to be admitted to neonatal intensive care (5.88% vs 26.09%, p=.021).Conclusions: While rates of successful vaginal delivery following induction were similar between normal weight and obese women, infants of obese women were more likely to require admission to neonatal intensive care and require longer hospital stays
Division of Maternal Fetal Medicine
Get PDFThe Division of Maternal Fetal Medicine at the University of Iowa provides care for women with medical, surgical, and obstetrical complications of pregnancy. The patients are cared for in a series of clinics, including the High Risk Obstetric Clinic and the multidisciplinary Fetal Diagnosis and Therapy Unit. The majority of level II scans, anomaly consultations, and interventional fetal procedures in Iowa are performed by this unit
Division of Reproductive Endocrinology and Infertility
Get PDFThe Division of Reproductive Endocrinology and Infertility at the University of Iowa is very active clinically and is proud of our highly successful IVF Program. We have one of the highest rates of single embryo transfer with IVF in the country and continue to maintain outstanding pregnancy rates while reducing multiple rates leading to safer IVF treatment. In addition to our IVF and regular Reproductive Endocrinology clinics, we have a Pediatric and Adolescent Gynecology Clinic, a Fertility Preservation Program, and a Uterine Fibroid Clinic
Prenatal diagnosis of fetal acrania using two and three dimensional ultrasound
Get PDFMalformations of the central nervous system are one of the most common congenital anomalies of the fetus. In this report we aimed to summarize a case of fetal acrania diagnosed in the first trimester and the use of two and three-dimensional ultrasound in early diagnosis of the disease
Division of Urogynecology and Reconstructive Pelvic Surgery
Get PDFThe Division of Urogynecology and Reconstructive Pelvic Surgery at the University of Iowa focuses on the outpatient evaluation and management of female pelvic floor disorders, including urinary incontinence, pelvic organ prolapse, and other urinary and defecatory disorders. Outpatient diagnostic testing is available, including urodynamic tests and cystourethroscopy. We offer a wide spectrum of clinical care for pelvic floor disorders, including nonsurgical (e.g. pessaries and behavioral therapies) and surgical therapies. Clinic-based procedures (such as transurethral bulking injections and intra-detrusor botulinum toxin injections) are offered, as well as outpatient and inpatient surgeries. Special clinical initiatives include our minimally-invasive surgery program for urinary incontinence and prolapse, including outpatient slings and robotic hysterectomy and sacrocolpopexy
Primitive forcible contraception in sub-Saharan Africa
Get PDFA 33-year-old multiparous patient was admitted to our gynecology outpatient service with complaints of severe abdominal pain, vaginal bleeding, malodorous vaginal discharge, difficulty in sexual intercourse and difficulty in urination for the last one month. Hereby, we aimed to show this creative, brutal and primitive way of contraception in a local tribe in the Darfur region of sub-Saharan Africa
ACOG Iowa Section Report, November 2015
Get PDFThe Iowa Section of (ACOG), The American College/Congress of Obstetricians and Gynecologists, the strengths of our membership are education, research, political advocacy and service to women including internationally
The impact of clinical clerkships on medical students’ attitudes toward contraception and abortion: a pilot study
Get PDFObjective: Investigate the impact of clinical clerkships on medical students’ attitudes toward contraception and abortion.Methods: As part of their required curriculum, second-year medical students at the University of Iowa complete an anonymous survey that presents eight questions involving specific contraception and abortion scenarios. In this pilot study, all 159 members of the Class of 2013 who had previously completed this required anonymous survey were invited to re-take the survey at the conclusion of their fourth year. Additional questions, asking the students if they felt that clinical clerkships had changed their perspectives on contraception and abortion in general, were included.Results: Of the 159 members of the Class of 2013, 42 volunteered to participate, for a response rate of 26%. Twenty students (47.62%) felt that clinical clerkships had changed their perspectives on contraception and thirteen students (39.95%) felt that clinical clerkships had changed their perspectives on abortion. The percentage of students who felt comfortable referring a patient to a colleague for an abortion increased significantly from 71.33% to 90.48% (p=0.024). Responses to the other seven questions included in the survey did not differ significantly pre and post-clerkships.Conclusions: This pilot study, although limited by a low response rate, suggests that clinical clerkships have the ability to impact medical students’ attitudes toward contraception and abortion in general, as well as toward specific scenarios involving abortion