Jess Dalton - Academia.edu (original) (raw)

Papers by Jess Dalton

Research paper thumbnail of Collagen 1A1 and Transforming Growth Factor-β Polymorphisms in Women With Cervical Insufficiency

Obstetrics and Gynecology, 2007

Research paper thumbnail of Immunology of normal pregnancy

Seminars in Fetal and Neonatal Medicine, 2006

Since Medawar&amp... more Since Medawar's initial contemplations in 1953 on the mechanisms of immune evasion allowing for the survival of the allogeneic conceptus in an immunologically competent mother, physicians and immunologists alike have struggled to understand the immunological paradox of pregnancy. Ultimately, our attempts to define the immunology of normal pregnancy have broadened our appreciation of the myriad mechanisms at play that enable the promotion of implantation and maintenance of pregnancy. In this review, we summarise what is known regarding the immunology of normal pregnancy, with special emphasis on the relation to common disorders of pregnancy.

Research paper thumbnail of Collagen 1Α1 and Transforming Growth Factor-β Polymorphisms in Women With Cervical Insufficiency

Obstetrics & Gynecology, 2007

To estimate whether polymorphisms in the collagen 1Alpha1 gene (COL1Alpha1) and the transforming ... more To estimate whether polymorphisms in the collagen 1Alpha1 gene (COL1Alpha1) and the transforming growth factor-beta gene (TGF-beta;1) are more common in women with cervical insufficiency than in those without the condition. Medical, obstetric, and family histories and blood were obtained from women with (n=121) and those without (n=165) cervical insufficiency. DNA was extracted and purified by using commercial DNA isolation kits. Samples were analyzed for variants in two genes, the COL1A1 intron 1SP1 and TGF-beta Arg-25-Pro polymorphism, by using an allele-specific polymerase chain reaction assay. Thirty-four of 125 (27.2%) women with cervical insufficiency had at least one first-degree female relative affected. The frequency of the homozygous TT genotype in the COL1A1 gene was increased in women with a history of cervical insufficiency compared with controls (10.8% compared with 3.1%, P=.04). The TGF-beta polymorphisms (ArgPro and ProPro) also were increased in cases (38.3% compared with 14.6%, P<.001). Over one fourth of women with cervical insufficiency have a family history of cervical insufficiency, and the COL1A1 intron 1SP1 and TGF-beta Arg-25-Pro polymorphisms are associated with the condition. These observations suggest that, in part, cervical insufficiency is mediated by genetic factors. II.

Research paper thumbnail of Nuclear factor B1 (NF-B1) and matrix metalloproteinase 9 (MMP9) polymorphisms in women with cervical insufficiency

American Journal of Obstetrics and Gynecology, 2006

The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduc... more The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduction in the incidence of RH alloimmunization worldwide. It is clear, that when given postpartum, Anti-D reduces the risk of Rh alloimmunization. However evidence on the optimal dose is limited. As a result, guidelines for postpartum prophylaxis in Canada vary. The purpose of this study was to determine the current trends in postpartum prophylaxis in Ontario. STUDY DESIGN: An online survey was electronically delivered to hospitals currently providing obstetrical care in Ontario. Information on hospital demographics and policy for postpartum prophylaxis including dosage, testing for fetomaternal hemorrhage and care provider compliance was obtained. RESULTS: Thirty six hospitals participated in the online survey. All hospitals reported having a policy on postpartum RH prophylaxis that was adhered to by care providers 100% of the time. Vast differences in hospital policy were found. 44% of hospitals give eligible patients Anti-D 300mg IM with testing for fetomaternal hemorrhage (FMH) and additional Anti-D as necessary. 19% of hospitals give Anti-D 300mg IM with no testing for FMH. 13% of hospitals give Anti-D 120mg IM with testing for FMH and additional Anti-D as necessary. 3% of hospitals give Anti-D 120mg IM with no testing for FMH. Other reported policies include testing for FMH only when risk factors are present, and Anti-D dose based on mode of delivery. CONCLUSION: Rh alloimmunization is a preventable cause of perinatal morbidity and mortality but continues to occur in 1-2% of susceptible women. Guidelines for postpartum prophylaxis in Canada vary. The results of this survey suggest the current policies in Ontario hospitals are similarly diverse. Further research to determine the optimal dose in the postpartum period is needed to produce clear national guidelines to minimize ongoing RH alloimmunization.

Research paper thumbnail of Polymorphisms in the promoter region of the tumor necrosis alpha (TNF-) gene in women with cervical insufficiency

American Journal of Obstetrics and Gynecology, 2006

The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduc... more The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduction in the incidence of RH alloimmunization worldwide. It is clear, that when given postpartum, Anti-D reduces the risk of Rh alloimmunization. However evidence on the optimal dose is limited. As a result, guidelines for postpartum prophylaxis in Canada vary. The purpose of this study was to determine the current trends in postpartum prophylaxis in Ontario. STUDY DESIGN: An online survey was electronically delivered to hospitals currently providing obstetrical care in Ontario. Information on hospital demographics and policy for postpartum prophylaxis including dosage, testing for fetomaternal hemorrhage and care provider compliance was obtained. RESULTS: Thirty six hospitals participated in the online survey. All hospitals reported having a policy on postpartum RH prophylaxis that was adhered to by care providers 100% of the time. Vast differences in hospital policy were found. 44% of hospitals give eligible patients Anti-D 300mg IM with testing for fetomaternal hemorrhage (FMH) and additional Anti-D as necessary. 19% of hospitals give Anti-D 300mg IM with no testing for FMH. 13% of hospitals give Anti-D 120mg IM with testing for FMH and additional Anti-D as necessary. 3% of hospitals give Anti-D 120mg IM with no testing for FMH. Other reported policies include testing for FMH only when risk factors are present, and Anti-D dose based on mode of delivery. CONCLUSION: Rh alloimmunization is a preventable cause of perinatal morbidity and mortality but continues to occur in 1-2% of susceptible women. Guidelines for postpartum prophylaxis in Canada vary. The results of this survey suggest the current policies in Ontario hospitals are similarly diverse. Further research to determine the optimal dose in the postpartum period is needed to produce clear national guidelines to minimize ongoing RH alloimmunization.

Research paper thumbnail of Idiopathic recurrent pregnancy loss recurs at similar gestational ages

American Journal of Obstetrics and Gynecology, 2010

To determine whether a correlation exists between gestational ages of idiopathic recurrent pregna... more To determine whether a correlation exists between gestational ages of idiopathic recurrent pregnancy loss (iRPL). STUDY DESIGN: Cohort of women with iRPL who had an initial loss (qualifying pregnancy [QP]) with precise documentation of gestational age. Outcomes in the immediate next pregnancy (index pregnancy [IP]) were compared between preembryonic (group I), embryonic (group II), or fetal (group III) losses in the QP. RESULTS: Three hundred thirty-four women met inclusion criteria. In their IP, group I had 41% preembryonic, 28% embryonic, and 10% fetal losses. Group II had 14% preembryonic, 53% embryonic, and 9% fetal losses. Group III had 19% preembryonic, 23% embroyonic, and 29% fetal loses. Correlation coefficient for type of loss among the QPs and IPs was 0.14, P ϭ .009. CONCLUSIONS: Women with iRPL tend to have losses recur in the same gestational age period. Causes for RPL may be gestational age specific and should guide further investigations into causes.

Research paper thumbnail of 92: Time of initial pregnancy loss does not predict subsequent live birth in recurrent pregnancy loss

American Journal of Obstetrics and Gynecology, 2009

Research paper thumbnail of Timing in gestation of recurrent pregnancy loss

American Journal of Obstetrics and Gynecology, 2005

Research paper thumbnail of Collagen 1A1 and Transforming Growth Factor-β Polymorphisms in Women With Cervical Insufficiency

Obstetrics and Gynecology, 2007

Research paper thumbnail of Immunology of normal pregnancy

Seminars in Fetal and Neonatal Medicine, 2006

Since Medawar&amp... more Since Medawar's initial contemplations in 1953 on the mechanisms of immune evasion allowing for the survival of the allogeneic conceptus in an immunologically competent mother, physicians and immunologists alike have struggled to understand the immunological paradox of pregnancy. Ultimately, our attempts to define the immunology of normal pregnancy have broadened our appreciation of the myriad mechanisms at play that enable the promotion of implantation and maintenance of pregnancy. In this review, we summarise what is known regarding the immunology of normal pregnancy, with special emphasis on the relation to common disorders of pregnancy.

Research paper thumbnail of Collagen 1Α1 and Transforming Growth Factor-β Polymorphisms in Women With Cervical Insufficiency

Obstetrics & Gynecology, 2007

To estimate whether polymorphisms in the collagen 1Alpha1 gene (COL1Alpha1) and the transforming ... more To estimate whether polymorphisms in the collagen 1Alpha1 gene (COL1Alpha1) and the transforming growth factor-beta gene (TGF-beta;1) are more common in women with cervical insufficiency than in those without the condition. Medical, obstetric, and family histories and blood were obtained from women with (n=121) and those without (n=165) cervical insufficiency. DNA was extracted and purified by using commercial DNA isolation kits. Samples were analyzed for variants in two genes, the COL1A1 intron 1SP1 and TGF-beta Arg-25-Pro polymorphism, by using an allele-specific polymerase chain reaction assay. Thirty-four of 125 (27.2%) women with cervical insufficiency had at least one first-degree female relative affected. The frequency of the homozygous TT genotype in the COL1A1 gene was increased in women with a history of cervical insufficiency compared with controls (10.8% compared with 3.1%, P=.04). The TGF-beta polymorphisms (ArgPro and ProPro) also were increased in cases (38.3% compared with 14.6%, P<.001). Over one fourth of women with cervical insufficiency have a family history of cervical insufficiency, and the COL1A1 intron 1SP1 and TGF-beta Arg-25-Pro polymorphisms are associated with the condition. These observations suggest that, in part, cervical insufficiency is mediated by genetic factors. II.

Research paper thumbnail of Nuclear factor B1 (NF-B1) and matrix metalloproteinase 9 (MMP9) polymorphisms in women with cervical insufficiency

American Journal of Obstetrics and Gynecology, 2006

The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduc... more The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduction in the incidence of RH alloimmunization worldwide. It is clear, that when given postpartum, Anti-D reduces the risk of Rh alloimmunization. However evidence on the optimal dose is limited. As a result, guidelines for postpartum prophylaxis in Canada vary. The purpose of this study was to determine the current trends in postpartum prophylaxis in Ontario. STUDY DESIGN: An online survey was electronically delivered to hospitals currently providing obstetrical care in Ontario. Information on hospital demographics and policy for postpartum prophylaxis including dosage, testing for fetomaternal hemorrhage and care provider compliance was obtained. RESULTS: Thirty six hospitals participated in the online survey. All hospitals reported having a policy on postpartum RH prophylaxis that was adhered to by care providers 100% of the time. Vast differences in hospital policy were found. 44% of hospitals give eligible patients Anti-D 300mg IM with testing for fetomaternal hemorrhage (FMH) and additional Anti-D as necessary. 19% of hospitals give Anti-D 300mg IM with no testing for FMH. 13% of hospitals give Anti-D 120mg IM with testing for FMH and additional Anti-D as necessary. 3% of hospitals give Anti-D 120mg IM with no testing for FMH. Other reported policies include testing for FMH only when risk factors are present, and Anti-D dose based on mode of delivery. CONCLUSION: Rh alloimmunization is a preventable cause of perinatal morbidity and mortality but continues to occur in 1-2% of susceptible women. Guidelines for postpartum prophylaxis in Canada vary. The results of this survey suggest the current policies in Ontario hospitals are similarly diverse. Further research to determine the optimal dose in the postpartum period is needed to produce clear national guidelines to minimize ongoing RH alloimmunization.

Research paper thumbnail of Polymorphisms in the promoter region of the tumor necrosis alpha (TNF-) gene in women with cervical insufficiency

American Journal of Obstetrics and Gynecology, 2006

The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduc... more The development of Anti-D immunoprophylaxis has been primarily responsible for the dramatic reduction in the incidence of RH alloimmunization worldwide. It is clear, that when given postpartum, Anti-D reduces the risk of Rh alloimmunization. However evidence on the optimal dose is limited. As a result, guidelines for postpartum prophylaxis in Canada vary. The purpose of this study was to determine the current trends in postpartum prophylaxis in Ontario. STUDY DESIGN: An online survey was electronically delivered to hospitals currently providing obstetrical care in Ontario. Information on hospital demographics and policy for postpartum prophylaxis including dosage, testing for fetomaternal hemorrhage and care provider compliance was obtained. RESULTS: Thirty six hospitals participated in the online survey. All hospitals reported having a policy on postpartum RH prophylaxis that was adhered to by care providers 100% of the time. Vast differences in hospital policy were found. 44% of hospitals give eligible patients Anti-D 300mg IM with testing for fetomaternal hemorrhage (FMH) and additional Anti-D as necessary. 19% of hospitals give Anti-D 300mg IM with no testing for FMH. 13% of hospitals give Anti-D 120mg IM with testing for FMH and additional Anti-D as necessary. 3% of hospitals give Anti-D 120mg IM with no testing for FMH. Other reported policies include testing for FMH only when risk factors are present, and Anti-D dose based on mode of delivery. CONCLUSION: Rh alloimmunization is a preventable cause of perinatal morbidity and mortality but continues to occur in 1-2% of susceptible women. Guidelines for postpartum prophylaxis in Canada vary. The results of this survey suggest the current policies in Ontario hospitals are similarly diverse. Further research to determine the optimal dose in the postpartum period is needed to produce clear national guidelines to minimize ongoing RH alloimmunization.

Research paper thumbnail of Idiopathic recurrent pregnancy loss recurs at similar gestational ages

American Journal of Obstetrics and Gynecology, 2010

To determine whether a correlation exists between gestational ages of idiopathic recurrent pregna... more To determine whether a correlation exists between gestational ages of idiopathic recurrent pregnancy loss (iRPL). STUDY DESIGN: Cohort of women with iRPL who had an initial loss (qualifying pregnancy [QP]) with precise documentation of gestational age. Outcomes in the immediate next pregnancy (index pregnancy [IP]) were compared between preembryonic (group I), embryonic (group II), or fetal (group III) losses in the QP. RESULTS: Three hundred thirty-four women met inclusion criteria. In their IP, group I had 41% preembryonic, 28% embryonic, and 10% fetal losses. Group II had 14% preembryonic, 53% embryonic, and 9% fetal losses. Group III had 19% preembryonic, 23% embroyonic, and 29% fetal loses. Correlation coefficient for type of loss among the QPs and IPs was 0.14, P ϭ .009. CONCLUSIONS: Women with iRPL tend to have losses recur in the same gestational age period. Causes for RPL may be gestational age specific and should guide further investigations into causes.

Research paper thumbnail of 92: Time of initial pregnancy loss does not predict subsequent live birth in recurrent pregnancy loss

American Journal of Obstetrics and Gynecology, 2009

Research paper thumbnail of Timing in gestation of recurrent pregnancy loss

American Journal of Obstetrics and Gynecology, 2005