Browsing by Author "Turpin, C.A."
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Item Association between adverse pregnancy outcome and imbalance in angiogenic regulators and oxidative stress biomarkers in gestational hypertension and preeclampsia(BioMed Central Ltd., 2015) Turpin, C.A.; Sakyi, S.A.; Owiredu, W.K.B.A.; Ephraim, R.K.D.; Anto, E.O.Background: Gestational hypertension (GH) and Preeclampsia, (PE) are the most complicated amongst hypertensive disorders of pregnancy. The mechanism that links hypertension in pregnancy to adverse maternal outcomes is not fully understood though some relate this to endothelial dysfunction originating from an imbalanced angiogenic regulators and oxidative stress biomarkers. This study assessed the correlation between angiogenic regulators and oxidative stress biomarker levels with adverse pregnancy outcomes among GH and PE participants. Methods: A cohort of pregnant women who received antenatal care at the Obstetrics and Gynaecology department of the Komfo Anokye Teaching Hospital (KATH) were followed. During their antenatal visits, 100 developed PE and 70 developed GE, of these, 50 PE and 50 GH gave informed consent. Their blood samples were taken at time of diagnosis and 48 h post-partum. 50 other aged-matched women who did not develop neither GH nor PE were selected as controls. Placental growth factor (PLGF), soluble fms-like tyrosine kinase 1 (sFlt-1) and 8-epi-prostaglandin F2alpha (8-epi-PGF2aα) levels were estimated by ELISA and total antioxidant capacity (T-AOC) was measured spectrophotometrically. Graphpad Prism was used for data analysis. Results: Median levels of sFlt-1, 8-epi-PGF2aα and sFlt-1/PLGF were elevated among participants with PE co-existing with intrauterine fetal death (IUFD), placental abruptio, placental previa, HELLP syndrome and intrauterine growth restriction (IUGR) compared to PE without adverse outcomes (p = 0.041, p = 0.005, p = 0.0002). Levels of PLGF, T-AOC and PLGF/sFlt-1 were significantly reduced among participants with PE co-existing with IUFD, placental abruptio, placental previa, HELLP syndrome and IUGR compared to PE without adverse outcomes (p = 0.0013, p = 0.006, p < 0.0001). A significant negative correlation of IUGR (p = 0.0030; p < 0.0001), placental abruptio (p < 0.0001; p < 0.0001), IUFD (p < 0.0001; p < 0.0001), stillbirth (p = 0.0183 and p < 0.000), and postpartum haemorrhage (PPH) (p = 0.0420; p = 0.0044) were associated with both PLGF and T-AOC whilst a significant positive correlation of IUGR, placental abruptio (p < 0.0001; p < 0.0001), IUFD (p < 0.0001; p < 0.0001), stillbirth (p < 0.0001; p < 0.0001), and PPH (p = 0.0043; p = 0.0039) were observed with both sFlt-1 and 8-epi-PGF2aα in PE. Conclusions: Imbalance in the levels of angiogenic regulators and oxidative stress biomarkers correlates with adverse pregnancy outcomes among PE participants. Early identification of these imbalance would alert health care givers in anticipation of adverse pregnancy outcome and thus increased surveillance during pregnancy and parturition and measures to ameliorate the adverse outcome.Item Global health design: Clinical immersion, opportunity identification and definition, and design experiences(International Journal of Engineering Education, 2018) Sienko, K.H.; Young, M.R.; Effah Kaufmann, E.; Obed, S.; Danso, K.A.; Opare-Addo, H.S.; Odoi, A.T.; Turpin, C.A.; Konney, T.et.al.We have developed an experiential learning global healthdesign program that emphasizes direct interactions with stakeholders and firsthand exposure to the contexts in which solutions will be implemented. Students in the program gain practical hands-on experience identifying and defining unmet global health needs in low-resource settings, and apply human-centered and co-creative design approaches. Device designs that incorporate rigorously collected and analyzed first-hand data from diverse users and stakeholders rather than anecdotal or poorly represented information are more effective at meeting true needs. To date, more than 100 undergraduate student participants have identified hundreds of needs in collaboration with sub-Saharan and Asian healthcare providers. Approximately 400students from the U.S., Ghana, Ethiopia, and Ugandahave contributed to the generation of technology concept solutions to address these needs. Program outcomes include approximately100student design projects completed at multiple institutions, student-led design-based conference publications and journal articles, device commercialization, and peer-to-peer mentoring within traditional capstone design courses. In this paper we describe the curricular elements of the clinical immersion and design ethnography experience. Additionally, we describe programmatic best practices that have emerged over the past 10 years and challenges students encounter when performing this front-end design workItem Incidence, causes and correlates of maternal near‐miss morbidity: a multi‐centre cross‐sectional study(BJOG: An International Journal of Obstetrics and Gynaecology, 2019-05) Oppong, S.A.; Bakari, A.; Bell, A.J.; Bockarie, Y.; Adu, J.A.; Turpin, C.A.; Obed, S.A.; Adanu, R.M.K.; Moyer, C.A.To explore the incidence and factors associated with maternal near‐miss. Cross‐sectional study with an embedded case‐control study. Three tertiary referral hospitals in southern Ghana. All women admitted to study facilities with pregnancy‐related complications or for birth. An adapted version of the WHO Maternal Near Miss Screening Tool was used to identify maternal near‐miss cases. These were compared with unmatched controls (uncomplicated deliveries) in a ratio of 1:2. Incidence of maternal near‐miss, maternal near‐miss‐maternal mortality ratio, and cause of and factors associated with maternal near‐miss. Out of 8,433 live births, 288 maternal near‐miss cases and 62 maternal deaths were identified. 454 healthy controls were recruited for comparison. Maternal near‐miss and maternal death incidence ratios were 34.2 (95% CI:30.2 ‐ 38.1) and 7.4 (95% CI:5.5 ‐ 9.2) per 1000 live births respectively with a maternal near‐miss‐mortality ratio of 4.6:1. Cause of near‐miss was preeclampsia/eclampsia (41.0%), haemorrhage (12.2%), maternal sepsis (11.1%), and ruptured uterus (4.2%). Major factor associated with maternal near‐miss was maternal fever within the seven days before birth (OR:5.95 95%CI:3.754 ‐ 9.424). Spontaneous onset of labor was protective against near miss OR:0.09 95% CI: 0.057 ‐ 0.141) For every maternal death, there were nearly five maternal near‐misses. Women having a fever in the seven days prior to delivery were six times more likely to experience a near‐miss than women not having fever. This article is protected by copyright. All rights reserved.Item Preference of Ghanaian Women for Vaginal or Caesarean Delivery Postpartum(Ghana Medical Journal, 2009-03) Danso, K.A.; Schwandt, H.M.; Turpin, C.A.; Seffah, J.D.; Samba, A.; Hindin, M.J.Objective: To determine Ghanaian women’s preferred mode of delivery and opinion of caesarean section after caesarean delivery. Design: A cross sectional study of women who recently delivered by caesarean section prior to hospital discharge. Setting: Two teaching hospitals in Ghana: Komfo Anokye Teaching Hospital, Kumasi, and Korle-Bu Teaching Hospital, Accra. Respondents: 154 patients who delivered by caesarean section between the 1st and 31st August, 2003 were interviewed. Of the 154 initiating the interview, 151 completed, and 145 had complete data. Main Outcome Measures: Delivery preference and general opinion of caesarean delivery. Results: The majority of women interviewed indicated that they preferred vaginal delivery (55%). Despite preference for vaginal delivery among these women who had delivered by caesarean section, the majority had a generally positive opinion of caesarean section (53%). Conclusion: Ghanaian women with experience of caesarean delivery prefer vaginal delivery.