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CLINICAL RESEARCH IN REPRODUCTIVE HEALTH
by
Rachel Leah Steward
A Thesis Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF SCIENCE
(CLINICAL AND BIOMEDICAL INVESTIGATIONS)
May 2011
Copyright 2011 Rachel Leah Steward
Object Description
| Title | Clinical research in reproductive health |
| Author | Steward, Rachel Leah |
| Author email | rachelst@usc.edu; rachel.steward@usc.edu |
| Degree | Master of Science |
| Document type | Thesis |
| Degree program | Medicine |
| School | Keck School of Medicine |
| Date defended/completed | 2011-03-25 |
| Date submitted | 2011 |
| Restricted until | Unrestricted |
| Date published | 2011-04-27 |
| Advisor (committee chair) | Azen, Stanley |
| Advisor (committee member) |
Mishell, Daniel Stanczyk, Frank Wilson, Melissa |
| Abstract | The work described in this thesis aims to add evidence to current clinical practices in reproductive health. The first chapter examines the risk of increased maternal morbidity with the use of digoxin as a feticidal agent when injected prior to a dilation and evacuation (D&E) procedure. The second chapter is devoted to evaluating the thickening of cervical mucus as a mechanism of action of combined oral contraceptive pills (COCs).; The first study described is a retrospective cohort study of 4,906 D&E procedures performed at Planned Parenthood of Los Angeles. Our hypothesis prior to conducting the study was that injection of digoxin conferred little increase in extramural delivery or infection when used as a feticidal agent. In this cohort, extramural delivery frequency was 0.30% and infection frequency was 0.04%. These frequencies are consistent with published rates for the procedure itself. Our data adds to the growing body of literature supporting physician discretion to use digoxin as a feticidal agent prior to performing a D&E.; The second study is an ongoing open-label investigator blinded, randomized controlled crossover equivalency study comparing in vitro sperm penetrability and quality of cervical mucus on the last day of the hormone free interval of women assigned to one of two groups. Our hypothesis is that the cervical mucus of women taking COCs will be of poor quality compared to their own mid-cycle cervical mucus. We also hypothesize that the cervical mucus on the last hormone free day of women taking a 21/7 regimen will be of equivalently poor quality as those on the 24/4 regimen. The data collection for this study is on-going but our preliminary results are consistent with this hypothesis. |
| Keyword | Digoxin; birth control pills; reproductive health |
| Geographic subject (city or populated place) | Los Angeles |
| Geographic subject (state) | California |
| Geographic subject (country) | USA |
| Coverage date | 2000/2008 |
| Language | English |
| Part of collection | University of Southern California dissertations and theses |
| Publisher (of the original version) | University of Southern California |
| Place of publication (of the original version) | Los Angeles, California |
| Publisher (of the digital version) | University of Southern California. Libraries |
| Provenance | Electronically uploaded by the author |
| Type | texts |
| Legacy record ID | usctheses-m3790 |
| Rights | Steward, Rachel Leah |
| Repository name | Libraries, University of Southern California |
| Repository address | Los Angeles, California |
| Repository email | http://www.usc.edu/isd/libraries/services/ask_a_librarian/email/ |
| Filename | etd-Steward-4405 |
| Archival file | uscthesesreloadpub_Volume48/etd-Steward-4405.pdf |
Description
| Title | Page 1 |
| Full text | CLINICAL RESEARCH IN REPRODUCTIVE HEALTH by Rachel Leah Steward A Thesis Presented to the FACULTY OF THE USC GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree MASTER OF SCIENCE (CLINICAL AND BIOMEDICAL INVESTIGATIONS) May 2011 Copyright 2011 Rachel Leah Steward |
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