Amy Voedisch

All Publications

• Postpartum intrauterine devices: Clinical and programmatic review. American journal of obstetrics and gynecology Goldthwaite, L. M., Cahill, E. P., Voedisch, A. J., Blumenthal, P. D. 2018

  Abstract

  The immediate postpartum period is a critical moment for contraceptive access and an opportunity to initiate long acting reversible contraception, including insertion of an intrauterine device (IUD). The use of the IUD in the postpartum period is a safe practice with few contraindications and many benefits. While an IUD placed during the postpartum period is more likely to expel compared to one placed at the postpartum visit, women initiating IUDs at the time of delivery are also more likely to continue to use an IUD compared to women planning to follow up for an interval IUD insertion. This review will focus on the most recent clinical and programmatic updates on postpartum IUD practice. We discuss postpartum IUD expulsion and continuation, eligibility criteria and contraindications, safety in regards to breastfeeding, and barriers to access. Our aim is to summarize evidence related to postpartum IUDs and encourage those involved in the health care system to remove barriers to this worthwhile practice.

  View details for PubMedID 30031750

• Early Pregnancy Failure BEREK and Novac's Gynecology Voedisch, A. J., Cahill, E. 2018; 16
• Difficult implant removals CURRENT OPINION IN OBSTETRICS & GYNECOLOGY Voedisch, A., Hugin, M. 2017; 29 (6): 449–57

  Abstract

  Subdermal contraceptive implant insertions have rapidly increased worldwide. These devices are usually removed 3-5 years after insertion. Although removals are generally straightforward, difficult removals can occur. This review discusses the overall approach to potentially problematic removals and the appropriate steps to avoid complications and safely remove implants.Given the rapid uptake of contraceptive implants and subsequent need for removals, an Implants Removal Task Force was formed to create standard protocols for difficult implant removals worldwide. These protocols detail how to identify a nonpalpable implant and the subsequent steps needed for safe removals that avoid vascular or neurological complications.Rapid uptake of subdermal implants has created a need for a comprehensive approach in the unlikely setting of a difficult implant removal. Standard protocols now exist to aid clinicians in the safe removal of these implants.

  View details for PubMedID 28938375

• Long-term culture of human liver tissue with advanced hepatic functions. JCI insight Ng, S. S., Xiong, A., Nguyen, K., Masek, M., No, D. Y., Elazar, M., Shteyer, E., Winters, M. A., Voedisch, A., Shaw, K., Rashid, S. T., Frank, C. W., Cho, N. J., Glenn, J. S. 2017; 2 (11)

  Abstract

  A major challenge for studying authentic liver cell function and cell replacement therapies is that primary human hepatocytes rapidly lose their advanced function in conventional, 2-dimensional culture platforms. Here, we describe the fabrication of 3-dimensional hexagonally arrayed lobular human liver tissues inspired by the liver's natural architecture. The engineered liver tissues exhibit key features of advanced differentiation, such as human-specific cytochrome P450-mediated drug metabolism and the ability to support efficient infection with patient-derived inoculums of hepatitis C virus. The tissues permit the assessment of antiviral agents and maintain their advanced functions for over 5 months in culture. This extended functionality enabled the prediction of a fatal human-specific hepatotoxicity caused by fialuridine (FIAU), which had escaped detection by preclinical models and short-term clinical studies. The results obtained with the engineered human liver tissue in this study provide proof-of-concept determination of human-specific drug metabolism, demonstrate the ability to support infection with human hepatitis virus derived from an infected patient and subsequent antiviral drug testing against said infection, and facilitate detection of human-specific drug hepatotoxicity associated with late-onset liver failure. Looking forward, the scalability and biocompatibility of the scaffold are also ideal for future cell replacement therapeutic strategies.

  View details for DOI 10.1172/jci.insight.90853

  View details for PubMedID 28570275

• Postpartum Contraception Contemporary OB-GYN Voedisch, A. J., Blumenthal, P. 2012; 57 (1)
• Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception HUMAN REPRODUCTION UPDATE Blumenthal, P. D., Voedisch, A., Gemzell-Danielsson, K. 2011; 17 (1): 121-137

  Abstract

  Despite increasing contraceptive availability, unintended pregnancy remains a global problem, representing as many as 30% of all known pregnancies. Various strategies have been proposed to reverse this disturbing trend, especially increased use of long-acting reversible contraceptive (LARC) methods. In this review we aim to discuss the role of LARC methods and importance of contraceptive counseling in reducing unintended pregnancy rates.References/resources cited were identified based on searches of medical literature (MEDLINE, 1990-2009), bibliographies of relevant publications and the Internet.LARC methods-copper intrauterine devices (IUDs), progestogen-releasing intrauterine system and injectable and implantable contraceptives-are safe and effective contraceptive options (unintended pregnancy rates with typical versus perfect use: 0.05-3.0 versus 0.05-0.6%) that are appropriate for a wide range of women seeking to limit or space childbearing. Despite their safety and efficacy records, these methods remain underutilized; injectable and implantable methods are used by an estimated 3.4% and intrauterine methods by 15.5% of women worldwide. LARC methods require no daily or coital adherence and avoid the adverse events and health risks of estrogen-containing contraceptives. The copper IUD and progestin-only injections and implants have been shown to be more cost-effective than more commonly used methods, such as condoms and the pill (5-year savings: $13,373-$14,122, LARC; $12,239, condoms; $12,879, pill). Women who are considering use of LARC methods should receive comprehensive contraceptive counseling, as women who receive counseling before use demonstrate higher rates of after-use method satisfaction, continuation and acceptance than those who do not.

  View details for DOI 10.1093/humupd/dmq026

  View details for Web of Science ID 000285415400011

  View details for PubMedID 20634208

• Hormonal Contraception: New Approaches for Select Patients The Female Patient Carrie, F., Voedisch, A. J., Blumenthal, P. 2010; 35
• Sterilization Precis Voedisch, A. J., Blumenthal, P. 2010; 4th