Papers by Asha Rijhsinghani
International Journal of Environmental Research and Public Health, Dec 21, 2020
PubMed, Nov 1, 2002
Objective: To examine the practice patterns and differences between faculty members in obstetrics... more Objective: To examine the practice patterns and differences between faculty members in obstetrics and gynecology (OB/G) and family practice (FP) residency programs in administering Rho(D) immune globulin (RhIG) for threatened abortion. Study design: A questionnaire was mailed to 50% (222) of all FP residencies and 100% (267) of OB/G programs in the United States. The obstetric curriculum coordinator at each FP residency and the director of obstetrics or maternal-fetal medicine at each OB/G residency were asked to respond. A total of 156 (70%) FP questionnaires and 186 (70%) OB/G questionnaires were returned after two mailings. Results: Seventy-six percent of FP faculty and 85% of OB/G faculty reported giving RhIG in threatened abortion. Physicians with advanced training were more likely to recommend giving RhIG. Conclusion: Most FP and OB/G residency faculty report using RhIG in threatened abortion. The practice has become part of the medical culture despite the lack of supporting evidence and should be revaluated in that light.
American Journal of Obstetrics and Gynecology, Dec 1, 2007
Amniocentesis is frequently performed for sonographically-detected fetal anomalies. Array compara... more Amniocentesis is frequently performed for sonographically-detected fetal anomalies. Array comparative genomic hybridization (CGH) is a higher resolution technique that may detect the presence of microdeletions or microduplications not visible by metaphase karyotype. STUDY DESIGN: Subjects (nϭ21) undergoing clinically-indicated amniocentesis for anomalies had array CGH in addition to metaphase karyotype. Parental blood samples were obtained at the time of amniocentesis. Amniotic fluid was sent directly for DNA isolation if there was an adequate specimen. With oligohydramnios or maternal blood contamination, amniocytes were cultured prior to isolating DNA. Fetal DNA was evaluated on a targeted bacterial artificial chromosome (BAC) array for the presence of microdeletions and microduplications. If abnormalities were found on the prenatal array, parental samples were subsequently evaluated. RESULTS: In 3/21 cases array CGH results differed from the metaphase karyotype. In 1/21 a 1p deletion spanning 3 clones was identified in the fetus with an identical deletion in the mother, a finding that may represent a benign copy number variation. In 1/21 a fetal microduplication of 2 clones on Yp was found in a genetic female (parental results pending). One in 21 cases had triploidy and as expected, was not detectable by array CGH. CONCLUSION: Array CGH may offer increased sensitivity of detection of molecular cytogenetic abnormalities in the setting of sonographic fetal anomalies. In this preliminary series, 2/21 (10%) cases resulted in the identification of copy number variations (CNVs). Further research will be necessary to determine the clinical significance of CNVs in the setting of fetal sonographic abnormalities.
American Journal of Perinatology, 1990
Twenty-five patients undergoing nipple stimulation contraction stress tests were enrolled in this... more Twenty-five patients undergoing nipple stimulation contraction stress tests were enrolled in this study. Plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha and plasma prolactin concentrations were analyzed before and during the contraction stress tests. Prolactin concentrations were significantly higher (p less than 0.01) in patients who responded with a successful stress test versus those who did not. No significant changes were observed in the mean concentration of plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha levels between the two groups.
Obesity, Mar 22, 2017
Infants born at less than 34 weeks' gestational age are at higher risk for morbidity and mortalit... more Infants born at less than 34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. Methods: Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed. BMI categorization followed the National Institutes of Health BMI classification that subdivides obesity into three ascending BMI groups. Results: Records were obtained on 1,224 women, of whom 31.6% were classified with obesity. Despite similar mean gestational age (31 to 31.6 weeks, P 5 0.57) and birth weight (1,488 to 1,569 g, P 5 0.51) of the infants in the BMI categories, delivery room (DR) resuscitation was more common for infants of women with level III obesity (63.2%, P 5 0.04) with a trend toward the continued need for assisted ventilation (54.7%, P 5 0.06). Conclusions: Preterm infants of women with level III obesity were more likely to require DR resuscitation with a trend to continued need for ventilatory support beyond 6 hours of age. This could impact utilization of DR resources at delivering hospitals.
Prenatal Diagnosis, Jul 26, 2016
Obstetrics & Gynecology, Dec 1, 1997
To determine the magnitude of the risk and the predictive clinical characteristics for developmen... more To determine the magnitude of the risk and the predictive clinical characteristics for development of preeclampsia when triploidy is diagnosed in the second trimester. Methods: A retrospective analysis of databases maintained by the cytogenetics laboratories at the University of Iowa and University of North Carolina was performed to identify all cases of triploidy. We examined the karyotype, maternal serum screening (particularly the hCG level), ultrasound results, and evidence of maternal hypertensive disease. Results: Seventeen cases of triploidy were identified between 1987 and 1996. Preeclampsia or hypertension complicated six of these cases with onset between 15 and 22.5 weeks' gestation. In these six cases, the serum hCG level was extremely high. Serum screening results were available in seven cases in which preeclampsia did not develop, and the hCG levels were under 0.09 multiples of the median in five of the seven cases. In all six cases in which preeclampsia or hypertension developed, there was sonographic evidence of placentomegaly. Sonographic findings in 16 of 17 cases revealed fetal growth restriction, oligohydramnios, fetal anomalies, placentomegaly, or a combination of these. Conclusion: In our series of pregnancies complicated by triploidy, the risk of developing preeclampsia or hypertension in the second trimester was 35%. It appears that elevated serum hCG levels and placentomegaly are associated with a higher risk of preeclampsia but low hCG levels are not. This information is important in counseling patients who are hesitant to terminate a pregnancy purely for a fetal abnormality, even if the anomaly is lethal.
American Journal of Perinatology Reports, Oct 1, 2019
Thyroid disorders are the most common endocrinopathies in women of reproductive age, with overall... more Thyroid disorders are the most common endocrinopathies in women of reproductive age, with overall prevalence for hyperthyroidism in the United States at 1.2%. 1 During pregnancy, hyperthyroidism is less common at 0.1 to 0.4%, but Graves' disease accounts for 85% of these cases. 2,3 Graves' disease poses significant risks to the pregnancy and the fetus. Patients with hyperthyroidism in pregnancy are at increased risk of spontaneous abortion, fetal growth restriction, and stillbirth. 4,5 Neonates born to these mothers exhibit hyperthyroidism in 2 to 5% of cases, which can present immediate and long-term challenges including cardiac insufficiency, liver dysfunction, and psychomotor disabilities. 6-9 Assessment of fetal thyroid dysfunction is difficult in utero, as it can involve invasive procedures such as cordocentesis in addition to serial ultrasounds. Studies have investigated maternal thyroid autoimmune antibodies as an alternative method in predicting fetal thyroid function. The antibodies have been shown to be persistently elevated despite successful treatment of Graves' disease 10 and can cross the placenta to influence fetal thyroid activity.
Sage Open Medicine, 2023
Over the previous three decades, the prevalence and growth of overweight and obese status has ris... more Over the previous three decades, the prevalence and growth of overweight and obese status has risen relentlessly in both the general population and pregnant women. This rise is seen in both higher pre-pregnancy body mass index measurements along with excessive weight gain during pregnancy. Maternal obesity has been shown to exacerbate co-morbidities such as insulin resistance, pregnancy induced hypertension, and infectious states in parturient mothers. These changes have been shown to subsequently increase rates of fetal anomalies and affect fetal growth, as well as various aspects of the delivery such as rates of instrumented vaginal deliveries and an increase in delivery by cesarean section. Maternal obesity increases fetal birth weight, influences the delivery room resuscitation of the neonate by increasing the need for respiratory support, and increases the risk of neonatal hypoxic ischemic encephalopathy. This review also looks at recent studies revealing the strong association between maternal and offspring obesity and other long-term neurodevelopmental outcomes of offspring.
American Journal of Obstetrics and Gynecology, 2019
Jaypee Brothers Medical Publishers (P) Ltd. eBooks, 2012
American Journal of Obstetrics and Gynecology, Dec 1, 2009
Steroid metabolism gene SNPs are associated with respiratory outcome in patients exposed to at le... more Steroid metabolism gene SNPs are associated with respiratory outcome in patients exposed to at least one course of ACS. Risks for respiratory outcome are affected by minor allele carriage as well as by treatment with multiple ACS. OR, 95%CI for RDS and CPV Outcome in Single (S) and Multiple (M) ACS
Journal of The Society for Gynecologic Investigation, Apr 1, 1995
American Journal of Obstetrics and Gynecology, Dec 1, 2003
Journal of The Society for Gynecologic Investigation, Mar 1, 1996
Proceedings in obstetrics and gynecology, Feb 15, 2012
PubMed, Aug 1, 1996
Background: In patients with fever following vaginal delivery, physicians must differentiate beni... more Background: In patients with fever following vaginal delivery, physicians must differentiate benign self-resolving fevers from fevers with more serious causes, especially endometritis. To help differentiate these clinical entities, we explored the characteristics and risk factors for benign "single-day" postpartum fever. Methods: We conducted a retrospective cohort study of 2137 vaginal deliveries. Patients were randomly selected from the 25,687 vaginal deliveries that took place between 1979 and 1992 at The University of Iowa Hospitals and Clinics. The data were analyzed using odds ratios and multiple logistic regression. Results: Benign fevers occurred in 3.3% of patients, while endometritis was diagnosed in 1.6%. After controlling for confounding variables, two clinical factors were independently associated with single-day fever: primiparity (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.0 to 5.7) and use of a uterine pressure catheter (OR, 2.4; 95% CI, 1.5 to 3.7). These factors were not associated with endometritis. The first postpartum temperature elevation ( > or = 38.0 degrees C) occurred earlier in patients with single-day fever than in patients with endometritis (4.0 +/- 4.6 hours postpartum vs 30.2 +/- 27.0 hours postpartum, P < .001). The maximum temperature elevation was lower, on average, in patients with single-day fever than in patients with endometritis (38.2 degrees +/- 0.2 degrees C vs 38.9 degrees +/- 0.6 degrees C, P < .001). Conclusions: Single-day fever was more likely to occur in primiparous women and in women who were monitored with a uterine pressure catheter. Most women with benign single-day fevers had early low-grade fevers, whereas women with endometritis had higher fevers that occurred later in the postpartum period.
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Papers by Asha Rijhsinghani