OBJECTIVE: To evaluate the incidence of chromosomal abnormalities in ectopic pregnancy chorionic villi. METHODS: A prospective study of patients with the diagnosis of ectopic pregnancy was conducted, with chorionic villi obtained at the time of surgical therapy cultured and analyzed for karyotype. Review of the patient's medical record and ultrasound evaluation was then completed and findings correlated with karyotype results. RESULTS: Twenty- two patients undergoing surgery for the diagnosis of ectopic pregnancy yielded chorionic villi for culture. Successful culture was performed in 21 patients, with 3 (14%) revealing abnormal karyotypes. Review of the medical record showed ultrasound results consistent with fetal development or a gestational sac in 15 of 18 patients with normal chromosomal analysis. Three of 6 patients without fetal development yielded abnormal chromosomal findings. CONCLUSION: Our results confirm that a high degree of success can be achieved in the karyotype analysis of ectopic pregnancy chorionic villi and that these conceptuses have a rate of abnormality similar to that reported for intrauterine gestations. Our data further suggest that when a gestational sac or fetal pole is identified by ultrasound, there is usually a normal karyotype.

No description available.

Includes bibliographical references / Aim: The aim of this study was to determine the adequacy of the dietary intake of pregnant women attending Bishop Lavis MOU, in the Tygerberg area of Cape Town. Methods: One hundred and fifty-two women between 12 and 20 weeks' gestational age participating in the Main PASS study were recruited. They completed three interviewer-administered 24-hour dietary recall assessments on three different days, each approximately two weeks apart. Dietary reference values for adequate nutritional intake during pregnancy and the South African food based dietary guidelines and NARs and MAR were used to assess the nutritional adequacy. Anthropometric and socio-demographic information was also collected. Results: The results indicate that just over a quarter of the sample were classified as teenage pregnancies. The majority had between grades eight and ten, and had a monthly household income between R500 and R5000. With a mean energy intake of 10 168.4kJ, majority (79.5%) of the study sample did not meet the energy DRI. Close to half (42.8 %) of the study sample did not meet the DRI for protein intake. All participants met the carbohydrate EAR, and many exceeded the recommended fat intake. The intake of sugar and saturated fats exceeded recommendations with sugar contributing to almost half of the total energy from carbohydrates. The intakes of vitamin A, D and E, pantothenate, biotin, folate, calcium, iron, magnesium, potassium, and manganese fell below the recommendations. Sugar was the most commonly consumed food item, followed by potato, chicken, milk, and white bread. Apples were the most commonly consumed fruit. When compared to the FBDG, the study sample consumed double the recommended portions of starch, half the recommended daily fruit and vegetables, and half the recommended legumes. Conclusion: The high intake of refined carbohydrates, especially sugar, and the high intake of foods high in saturated fats needs to be addressed. Micronutrient intake is generally poor, especially with nutrients that are vital to proper growth and development of the foetus. Education on appropriate dietary changes, as well as suggestions to make implementation of such changes affordable would be invaluable, and may contribute towards decreasing the incidence of adverse pregnancy outcomes.

Thesis (M.S.)--Boston University

A dissertation submitted in partial fulfillment ofthe requirements for the degree of Master of Arts (Counselling Psychology) in the Department of Psychology University of Zululand, 2008. / Attitudes determine commitment in their broad sense, though this is rarely understood in this fashion. An abortion decision is influenced by many factors that eventually lead to such a decision just to mention a few; general health of the mother, rape, occupational status of the expectant mother and the pressure from the society. Termination of pregnancy is sometimes if not most incongruent with one's belief and morale. Midwives as trained individuals to care for the needs of the patients who want to abortion have to step over their moral judgement and provide the service (abortion). In the recent past some reports on service delivery (abortion) stated challenges that midwives face within their health institutions, as well the pressure from the general public of South Africa expressing genuine opposition to termination of pregnancy policy, times do change together with the mentally and stereotypes closely attached to termination of pregnancy, although the reproductive policies are a sensitive issue in most countries. The study focuses on the attitudes of the midwives toward termination of pregnancy and it explores the difference on attitude between public and private hospitals. The findings of the study suggest that there is difference on attitude with regards to termination of pregnancy, amongst the midwives in public and private hospitals, this discrepancy also exist amongst senior midwives compared to junior midwives. There are however, a number of reasons for this, but the obvious one maybe that senior midwives have reached self actualization in their careers and view the professional duties beyond egocentric needs and morale, and this facilitate the expected role of the health service providers, which is to cater for the needs of the desperate public.

In August of 1969 abortion became legal in Oregon. About a year later, in October of 1970, the Planned Parenthood Association in Portland began to offer pregnancy testing and counseling as part of their services. This is a new and separate program which is designed to help women find out if they are pregnant as early as possible (at low or no fee) and provide counseling on the problems connected with unwanted pregnancy. This study is based on a sample of women seeking pregnancy counseling at Planned Parenthood in Portland in the calendar year 1971. During that year about 1,230 pregnancy tests were done through the agency: of these, 549 were positive, and 681 were negative. From the 549 positive tests a 20% random sample was drawn by utilizing the terminal digits of 2 and 6 in the six digit clinic number assigned every patient. This sample numbered 113 cases: of these, l09 records were located. The present study is based on data from these 109 records. While the ultimate concern of this study, like that of other research on contraception and abortion, is to develop knowledge useful in reducing unwanted pregnancies, the immediate purpose is to provide Planned Parenthood Association in Portland with information about the new group that it is serving. The study tries to do this by: 1) Comparing this new group with presently available statistics on the total clinic population, 2) Analyzing the attributes of this special group of clients: the pregnancy counseling group, 3) Making recommendations to the agency on forms, procedures and recording which the researcher feels will improve the service to this group, and 4) Making suggestions as to further research that would develop additional information helpful in serving these clients. The major effort in this study is to display the information derived from the sample in a way which will be useful to both the agency and to others doing research in the field of contraception and abortion.

Indiana University-Purdue University Indianapolis (IUPUI) / The maternal liver exhibits robust adaptations to pregnancy to accommodate the metabolic needs of developing and growing placenta and fetus by largely unknown mechanisms. We found that achaete-scute homolog 1 (Ascl1), a basic helix-loop-helix transcription factor essential for neuronal development, is highly activated in maternal hepatocytes during the second half of gestation in mice. Our aim is to investigate whether and how Ascl1 plays a pregnancy-dependent role. We deleted the Ascl1 gene in the maternal liver using three independent mouse models from mid-gestation until term and identified multiple Ascl1-dependent phenotypes. When Ascl1 was deficient in maternal hepatocytes, maternal livers exhibited aberrant hepatocyte histology, fat accumulation, increased hepatocyte cell cycle, and enlarged size, accompanied by reduced albumin production and elevated levels of free fatty acids, ALT, and AST in the maternal blood, indicating maternal liver dysfunction. In the same situation, maternal spleen and pancreas displayed marked enlargement without an overt structural change; the placenta exhibited striking overgrowth with increased ALP production; and the cecal microbiome showed alterations in the relative abundance of several bacterial subpopulations. Moreover, litters born from maternal hepatic Ascl1 null mutated dam experienced abnormal postnatal growth after weaning. RNA-seq analysis revealed Ascl1-regulated genes in the maternal liver associated with Ascl1-dependent phenotypes. Of particular interest, we found that, in maternal hepatocytes, Ascl1 loss-of-function caused the activation of paternally imprinted gene insulin-like growth factor 2 (Igf2) encoding a major placental and fetal growth factor. IGF2 is also a known mitogen for hepatocytes and several hematopoietic lineages. Thus, IGF2 is a potential inducer of Ascl1-dependent phenotypes including placental overgrowth and maternal organ enlargement. Our studies revealed Ascl1 as a novel regulator of maternal liver physiology during pregnancy. Ascl1 activation in maternal hepatocytes is essential for normal placental growth and appropriate maternal organ adaptations, ensuring the health of both the mother and the fetus.

The study explored teenage mothers’ narratives of their subjective experience as teenage mothers. The research draws on social constructionist theory to theorize and deconstruct teenage pregnancy as a social problem. Eight teenage mothers’ between the age of fifteen and nineteen years old were interviewed through semi-structured interviews and analyzed through thematic content analysis. The key themes that emerged in the study were around getting the news about the pregnancy, giving birth and life thereafter, being at school and rising beyond the stigma of being a teenage mother. It was also found that dominant discourses in society played a pivotal role in teenage mothers’ construction of the self and their experiences of being marginalised from mainstream society. Despite some of the challenges encountered, the participants were all able to persevere towards their goals and aspirations such as performing well academically and developing a clear sense of self. The report concludes with recommendations are implications for future research.

A research report submitted to Faculty of Health Sciences in partial fulfilment of the requirements for the degree of Master of Science in Epidemiology in the field of Implementation Science, School of Public Health University of The Witwatersrand. Johannesburg June 2018. / Background Intermittent Preventive Therapy using sulfadoxine pyrimethamine (IPTp-SP) is a malaria control strategy to reduce cases of malaria in malaria endemic countries. However, the administration of the recommended three doses of IPTp throughout the stages of pregnancy still remains low in Nigeria even though, Nigeria is a malaria endemic country. Quality improvement approach has been demonstrated to improve practice among healthcare providers. This study therefore used a quality improvement approach to train and coach healthcare providers in order to improve the administration of the recommended doses of IPTp to pregnant women receiving antenatal care (ANC) services. Methods A quasi-experimental study design was carried out to evaluate the effect of quality improvement approach consisting of training and coaching of healthcare providers to improve the administration of IPTp during ANC service. Primary Healthcare Centre (PHC) Samaru was purposively selected and twelve healthcare providers participated in the study. ANC daily register was reviewed pre-intervention, intervention and post-intervention period of the study. Data were analysed using line graphs and run charts. Results A total of 36 ANC visit weeks were observed between 21st November 2016 and 27th July 2017. The mean level for IPTp1 administration pre-intervention was 105.85% (SD: 29.28) and 75.20% (SD: 16.89) for IPTp2+. The levels of IPTp1 administration were relatively stable from Week 1 to Week 10 although, there was overestimation of IPTp1 as 8 of the 16 Weeks in the pre-intervention period i.e. Weeks 3, 5, 7, 8, 11, 13, 15 and 16 all had more than 100% of eligible women administered IPTp1. The patterns of IPTp2+ administrations shows the levels of IPTp2+ administration were erratic. There was evidence indicating the process of IPTp1 was relatively stable post-intervention as the data crosses the median line only six times i.e. 7 runs. This indicates that the process of IPTp1 was within normal variation over the post-intervention period. There was an upward shift showing immediate improvement of the administration of IPTp2+ post-intervention although, there was a non-random variation in the administration of IPTp2+. The iv improvements of IPTp were not sustainable due to stock-outs. The quality of the ANC daily register was poor. Conclusion The integrated training and coaching intervention approach improved the administration of the recommended three doses of IPTp within the context of a PHC. These findings should be interpreted with caution as the impact of the intervention may not have reached its full impact due to the short post-intervention assessment. Stock-outs remains a huge barrier to the administration of IPTp under DOT during ANC services. The data quality of the ANC daily register improved post-intervention however, there were still slight errors thus, indicating that healthcare providers need constant coaching. It is important to integrate training and coaching of healthcare providers in order to have desired and sustained outcomes. Keywords: Malaria in pregnancy, IPTp, IPTp-SP, SP, ANC, Pregnant women, Healthcare providers, administration, QI, integrated training and coaching. / LG2018

Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, In fulfilment of the requirements for the degree of Master of Science in Nursing Education Johannesburg, 2015 / This is an exploratory, descriptive study intending to determine factors that influence the uptake of Reproductive Health Services (RHS) by female students at the university in Johannesburg with a view to improving access and delivery of service in a more efficient manner. Despite the availability of free, accessible and confidential RHS on campus, anecdotal data shows an increased number of students who present with unintended pregnancies and soliciting termination of pregnancy. Through the survey and semi-structured interviews the researcher attempts to determine factors influencing the uptake of campus RHS by female students. The present text seeks to answer the following research questions: What is the socio-demographic profile of actual and potential users of RHS on campus and what factors influence the uptake of RHS on campus? Keywords: Reproductive health, access, utilisation, unwanted pregnancy