The unwanted child: caring for the fetus born alive after an abortion.
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Aborted Fetus↗
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Fertility technologies and trans-kin altruism.
If a couple wishes to have children, is able to have them through the usual biological process, and there are no known genetic problems facing such children, then that couple would be best advised to have biological offspring. In fact, most people would consider this to be simply the natural "default setting" for such decisions. But if they are not able to have such offspring, or if there is a significant probability that such offspring would have some catastrophic genetic problem, then it might be better for the couple to adopt a child not related to them biologically. This would, in the first place, avoid problematic uses of fertility technologies, such as the use of ova from aborted fetuses. But it would also provide an opportunity for the exercise of trans-kin altruism, something which is not always easy to practice but which is an essential feature of our humanity as it has developed through the evolutionary process. That is to say, there are both negative and positive reasons for adoption. Negatively, it may enable us to avoid ethically questionable uses of technology. Positively, it responds to and reinforces a feature of our evolutionary history which is crucial to what it means for us to be human.
Aborted Fetus↗
Planned Parenthood of Southeastern Pennsylvania v. Casey, 13 June 1988.
The plaintiffs challenged the constitutionality of the Pennsylvania Abortion Control Act of 1982, arguing that it impermissibly burdened a woman's right to have an abortion. The Court found unconstitutional the following aspects of the law: 1) the lack of a requirement that a minor's petition would be sealed from the moment that it is filed; 2) the provision that reports filed by facilities receiving public funds be subject to public inspection; 3) the requirement that the referring physician be identified on the individual abortion report; 4) the requirement that facilities report the length and weight of any fetus aborted after the nineteenth week of pregnancy; 5) the requirement that a physician report the basis for his medical judgment; 6) the requirement that information regarding the woman's personal history be included in the reports; and 7) the requirement that a physician make a determination of the viability of a fetus prior to performing an abortion after the nineteenth week of pregnancy. The Court upheld the following provisions of the law: 1) the requirement that the abortion provider receive from the parent a nonnotarized verification, stating that the signer was the minor's parent or legal guardian; 2) general reporting requirements; 3) the requirement that the physician performing the abortion be identified in the report; 4) the requirement that the legislature prepare a statistical report from information on abortions contained in individual reports; and 5) requests that reports contain information on "estimated menstrual weeks of gestation," the nature of complications, medical treatment given, and the nature and extent of any permanent condition caused by any complications.
Abortion, Induced↗
Neosporosis-associated abortion in a dairy goat.
Neospora canium tachyzoites and tissue cysts were found in tissues of a goat fetus aborted after 3.5 months of gestation. The fetus had hydrocephalus and a hypoplastic cerebellum. The predominant lesion in the fetus was severe encephalitis associated with numerous N canium tissue cysts. Parasites in fetal tissues reacted positively with N caninum antibodies in immunohistochemical tests. The doe was clinically normal and had a 1:800 antibody titer to N caninum as determined by use of an indirect fluorescent antibody test 9 months after abortion. Five of 77 other does from this herd also had indirect fluorescent antbody titers to N caninum that were > or = 1:100.
Abortion, Veterinary↗
A standard of fetal growth for the United States of America.
The appropriate interpretation of monitored fetal growth throughout pregnancy in individual patients and populations is dependent upon the availability of adequate standards. There is no adequate standard of fetal weight throughout pregnancy that is suitable for patients in the U.S.A. To determine such a standard for infants delivered at about sea level the 10th, 25th, 50th, 75th, and 90th percentiles of fetal weight for each menstrual week of gestation were calculated from 430 fetuses at 8 to 20 menstrual weeks' gestation aborted with prostaglandins and from 30,772 liveborn infants delivered of patients at 21 to 44 menstrual weeks' gestation. Median fetal crown-to-rump lengths and crown-to-heel lengths were derived from measurements of 496 aborted fetuses of 8 to 21 weeks' gestation. Fetal weight correction factors for parity, race (socioeconomic status), and fetal sex were calculated. The derived fetal growth curves are useful for clinical, public health, and investigational purposes.
Body Height↗
Expression of adhesion and extracellular matrix molecules in the developing human brain.
Cell adhesion molecules and extracellular matrix molecules have important roles in cell migration and connection. Their developmental expression has not been fully described in humans. In this report, these molecules were examined by immunohistochemistry in frontal tissue samples from 14- to 28-week-old fetuses aborted for obstetric reasons (n = 20) and four fetuses with nervous system abnormalities. Neural cell adhesion molecule (NCAM), tenascin, and laminin were expressed after 17 weeks. Neural cell adhesion molecule was observed in the neuropil, whereas tenascin and laminin also had cellular and vascular expression. Thrombospondin and fibronectin, apparent after 14 weeks, showed a redistribution from periventricular to outer cortical layers after midgestation. N-cadherin and integrin were observed in mid- and late gestation. Maternal or environmental conditions seemed to influence the pattern of expression. Fetuses with nervous system abnormalities had altered expression of several molecules. The descriptive data obtained in this study might constitute a basis for further studies investigating the role of these molecules in developmental abnormalities of the brain.
Brain↗
Abortion of a mummified fetus associated with short uterine body in a mare.
A mummified fetus was aborted at 284 days of gestation from a Quarter Horse mare with a history of consecutive abortions. The abortion occurred 12 days after administration of supplemental progestogen had been discontinued. Results of a breeding soundness evaluation revealed that this mare had a short uterine body. Other abnormalities were not discovered. This condition may have been responsible for repeated abortions in this mare, and may represent a cause of fetal mummification other than twin pregnancy in mares.
Abortion, Habitual↗
Nail-patella syndrome in a spontaneously aborted 18-week fetus: ultrastructural and immunofluorescent study of the kidneys.
Nail-patella syndrome (NPS), hereditary onycho-osteodysplasia, is an autosomal dominant disorder of nail dystrophy, patellar absence or hypoplasia, incomplete elbow extension, conical posterior iliac horns, and nephropathy. We studied the kidneys of an 18-week spontaneously aborted fetus of a mother with the NPS. Ultrastructural examination of the kidney showed thickening of the capillary walls of the glomeruli and mesangium. There was irregular thickening of basement membranes with subendothelial fibrillar electron-dense deposits. Immunofluorescence showed fibrinogen deposition in glomerular basement membranes. Fibrinogen deposition in utero may ultimately lead to glomerular fibrosis and intrabasement membrane collagen deposition as seen in the adult renal lesion of this syndrome. This is the first report of the NPS in which the renal abnormalities have been studied in a fetus. These findings provide support for possible prenatal diagnosis of NPS by intra-uterine kidney biopsy.
Abortion, Spontaneous↗
Congenital hydranencephalic-hydrocephalic syndrome with proliferative vasculopathy: a possible relation with mitochondrial dysfunction.
We report the case of a fetus aborted at gestation week 20 because of hydranencephalic-hydrocephalic syndrome. The fetus was the third pregnancy of a nonconsanguineous couple whose first child exhibited congenital hydranencephalic-hydrocephalic syndrome associated with muscle histology findings consistent with mitochondrial cytopathy and deficiency of complexes III and IV of the respiratory chain and whose second pregnancy had terminated in an elective abortion on detection of progressive hydrocephalus at gestation week 19. The third pregnancy had a normal course according to obstetric and ultrasonography examinations performed at gestation weeks 5, 10, and 15, and negative results were obtained in standard serologic and polymerase chain reaction (PCR) tests for prenatal infections of the mother. However, the ultrasonography examination at gestation week 18 revealed hydrocephalus, in response to which the parents requested an abortion, which was performed at gestation week 20; the fetus was male and with no evident external malformations. Histopathologic studies of the brain and medulla oblongata revealed proliferative vasculopathy (glomeruloid vessels, intracytoplasmic inclusions, and microcalcifications) and intracytoplasmic inclusions in the voluntary muscle. Microbiologic and PCR tests of hepatic and spleen tissue were negative for prenatal infections. In view of the precedent of a sister with mitochondrial dysfunction, these findings raise the pos sibility that at least some cases of familial syndrome of congenital hydranencephalic-hydrocephalic syndrome with proliferative vasculopathy can be attributed to alterations in the mitochondrial respiratory chain.
Abortion, Induced↗
Chronic alterations in cardiac mechanics after fetal closed heart operation.
Pulmonary artery banding was performed in 8 fetal sheep at 125 days' gestation to evaluate the feasibility of fetal closed cardiac operation. At 135 days' gestation, the fetuses were delivered and the cardiac mechanics were evaluated using a modified Langendorff isolated heart preparation. Two of the 8 fetuses aborted spontaneously 2 and 7 days after operation. Six fetuses (75%) survived the 10 days after delivery. The left ventricular cardiac mechanics in the banded fetuses (group I) were compared with those in 8 control fetuses (group II). All fetal hearts in both groups displayed a significant volume-pressure relationship. The volume-pressure curve was found to be shifted upward and to the left in the fetal hearts after pulmonary artery banding. The left ventricles subjected to increased in utero preload secondary to pulmonary artery banding were capable of generating greater peak systolic and developed pressures. Because the fetal heart manifests a Starling type of preload reserve, as such, it demonstrates that the possibility exists for subsequent fetal development to be altered by intrauterine intervention.
Animals↗
Phenotypic characterization of Brucella strains isolated from livestock in Nigeria.
Isolation of brucellae from aborted fetuses, hygroma fluids, milk and vaginal swabs obtained from aborting cattle, sheep, goats, pigs, and horses in Nigeria was carried out. A total of 25 isolates, obtained mainly from cattle, sheep and horses, were biotyped. All strains belonged to one species, Brucella abortus biovar 1. The epidemiological significance of this finding is discussed. Some preliminary observations on the zoonotic and public health implications of Brucella infection in Nigerian livestock are presented. A control programme involving improved management, animal movement restrictions, public health education and mass vaccination of animals is suggested.
Abortion, Veterinary↗
Serological investigation of an outbreak of Neospora caninum-associated abortion in a dairy herd in southeastern United States.
An outbreak of Neospora caninum-associated abortion occurred in a South Carolina dairy wherein greater than 10% of the herd aborted over a 4-month period. Of the total number of cows at mid-late gestation, nearly 40% (28/71) aborted while the remaining 60% (43/71) gave birth to normal calves. Immunohistochemical examination of brain tissue from a subset of aborted fetuses confirmed N. caninum as the causative agent of abortion in these animals. A variety of serological assays, including indirect fluorescence antibody test (IFAT), recombinant enzyme-linked immunosorbent assay (rELISA), ISCOM-ELISA, avidity ELISA, and Neospora agglutination test (NAT), were used to evaluate sera collected during the outbreak from 240 cows for antibodies to N. caninum. IFAT and ISCOM-ELISA testing showed that nearly 80% of the dairy cows had antibodies to N. caninum. NAT and rELISA had similar levels of seropositivity relative to IFAT and ISCOM-ELISA, but the percentage of positive sera was dependent on the cut-off value chosen. As indicated by kappa coefficient statistical analysis, ISCOM-ELISA and IFAT exhibited the highest level of agreement in identifying N. caninum-positive and -negative cows. A decrease in the percentage of seropositive cows as determined by ISCOM-ELISA and IFAT with increasing cow age was noted. However, no significant difference was observed between cow age and abortion status. In addition to these tests, an avidity ELISA was performed on all sera with high (> or =0.4) ISCOM-ELISA readings. Avidity index (AI) increased with time post-abortion suggesting that most abortions were due to recent N. caninum infection. Of the cows at risk for abortion, the mean serological AI of aborting cows was significantly lower (P<0.05) than mean serological AI of non-aborting cows.
Abortion, Veterinary↗
The contribution of environmental teratogens to embryonic and fetal loss.
Environmental causes of human malformations account for approximately 10% of malformations, and less than 1% of all human malformations are related to prescription drug exposure, chemicals, or radiation. Malformations caused by drugs and other therapeutic agents are important, however, because these exposures are preventable. As we better understand the mechanisms of teratogenesis from all etiologies, we may learn how best to predict and test for teratogenicity and apply this knowledge to the prevention of human birth defects. Spontaneous abortions account for a much higher percentage of reproductive failure than do congenital malformations, but a very high proportion of aborted fetuses are malformed or defective. Therefore, the consequences of abortion are much different than the consequences of having a survival malformed infant, from both the medical and psychologic perspectives. We are less certain about the contribution of environmental, physical, and chemical agents to the incidence of spontaneous abortion. Although we realize that spontaneous abortions are a significant medical and emotional burden to a family, a surviving malformed infant can be greater burden to that family. We do not have an accurate picture of the contribution of environmental agents to the incidence of spontaneous abortion. At the present time, it would appear that only a very small proportion of abortions can be attributed to exposure to environmental toxicants during pregnancy (Tables 1 and 2). Conversely, it is the scientific and medical community's responsibility to prevent the introduction and use of agents that cause unwanted embryonic and fetal loss. Because the teratogenic and abortigenic effects of environmental agents differ, one cannot conclude that an agent is an abortifacient because it is teratogenic, nor can one conclude that an agent is not an abortifacient because it is not teratogenic (Table 2).
Abnormalities, Drug-Induced↗
The effects of gemeprost on the second trimester fetus.
OBJECTIVE: To determine whether the use of gemeprost is associated with histological changes in the second trimester fetus. SETTING: Histopathology department of a university hospital. DESIGN: Retrospective comparison of histological features in fetuses aborted following maternal administration of gemeprost, with those in fetuses after spontaneous miscarriage. OUTCOME MEASURES: Degree of tissue fragmentation; other histological abnormalities. RESULTS: Significantly greater fragmentation of the liver was found in fetuses exposed to gemeprost (P = 0.046). Nonsignificant effects were found for brain (P = 0.082) and heart (P = 0.183), and no effect was seen on the kidney, adrenal and lung. No other significant histological differences were found between the two groups. CONCLUSIONS: This study is the first to document an effect of gemeprost on the fetus, but confirmation is required in further studies. Other implications are discussed.
Abortifacient Agents, Nonsteroidal↗
Congenital juvenile granulosa cell tumor of the testis in a fetus showing full 69,XXY triploidy.
Testicular juvenile granulosa cell tumor (TJGCT) occurs predominantly in infancy and may be associated with sex chromosomal abnormalities. We report a fetus aborted because of cytogenetically confirmed complete XXY triploidy. External genitalia of the fetus were female, with a short and patent vagina. The tumor presented as an abdominal multicystic mass with typical histologic and immunohistological features of JGCT. It was connected with a tubular uterus-like structure. The other gonad was an inguinally localized testis that showed histologically a Sertoli cell adenoma. Malformations typical for triploidy were also present: agenesis of the corpus callosum, stenosis of the pulmonary ostium, and hypoplasia of the lungs and adrenals. To our knowledge this is the first case of TJGCT in a triploid fetus.
Abortion, Eugenic↗
India steps up effort to halt abortions of female fetuses.
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Abortion, Eugenic↗
Lymphatic malformation in human fetuses. A study of fetuses with Turner's syndrome or status Bonnevie-Ullrich.
In 7 spontaneously aborted fetuses characterized by a large cystic hygroma in the nuchal region and a prominent and generalized edema, the structure and extension of the lymphatic system was studied. In all fetuses marked malformations of this system were found. Although the morphologic appearance seemed to vary greatly it is suggested that the disorder is essentially a generalized hypoplasia and partial agenesis of the lymphatic system, which ceases to extend peripherally at an early embryonic stage. A suggestion as to the mechanism of this growth inhibition is made.
Female↗
Ocular ultrastructural study in a fetus with type II glycogenosis.
The general pathological and ocular studies in an aborted fetus with type II glycogenosis revealed the widespread lysosomal storage of glycogen. Obvious lesions are observed in the viscera, in the skeletal and ocular muscles, and in all ocular tissues except the pigment epithelium of the retina. Brain and heart are relatively spared. Conjunctival and skin biopsies have a diagnostic importance, since specific alterations are evident early in the course of the disease.
Conjunctiva↗