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PubMed2003

Evidence for cycle-dependent expression of full-length human chorionic gonadotropin/luteinizing hormone receptor mRNA in human endometrium and decidua.

OBJECTIVE: To investigate the expression of full-length and truncated hCG/LH-receptor mRNA in human endometrium and decidua. DESIGN: In vitro experiment. SETTING: Tertiary university center. PATIENT(S): Premenopausal women undergoing hysterectomy because of benign diseases or induced abortions. INTERVENTION(S): Isolation of RNA from endometrial samples, reverse transcription, selective preamplification of full-length hCG/LH receptor mRNA and several shorter fragments of the receptor gene (exons 1-11, 1-10, and 1-5), nested polymerase chain reaction with internal primers. MAIN OUTCOME MEASURE(S): Appropriately sized cDNA product confirmed by sequencing. RESULT(S): All samples derived from the proliferative as well as from the early and mid-luteal phases were positive for all four amplification products, suggesting the expression of a full-length hCG/LH receptor mRNA. Only 5 of 8 samples derived from the late secretory phase and 2 of 12 samples derived from early decidua amplified the entire receptor sequence. In contrast, the shortest fragment (exons 1-5), coding for part of the extracellular receptor domain, was amplified in all samples. CONCLUSION(S): The data suggest cycle-dependent regulation of hCG/LH-receptor mRNA by changes in the alternative splicing pattern and down-regulation of full-length hCG/LH receptor mRNA in early decidua. The major splicing site appears to be located between introns 5 and 9. Alternative splicing may be a mechanism regulating hCG/LH-receptor down-regulation.

Adult↗
PubMed1996

Analysis of the kappa light chain variable region in multiple myeloma.

The study of immunoglobulin heavy chain gene rearrangements in multiple myeloma has revealed extensive divergence from the germline sequences, but no intraclonal diversity with disease evolution. Our study investigated the state of the rearranged kappa light chain variable region (V kappa) gene segments as well as abortive V kappa family gene usage in cases of multiple myeloma expressing lambda light chain. We studied 11 cases of kappa and five cases of lambda light chain-expressing multiple myeloma. Total cellular RNA was extracted from the bone marrow of patients with overt disease and subjected to reverse transcription-polymerase chain reaction (RT-PCR) analysis to amplify clonally rearranged variable region sequences. Direct nucleotide sequencing by the dideoxy-chain termination method was performed on the RT-PCR products. We did not observe preferential usage of certain V kappa gene families. Mutation frequencies of the V kappa segments varied in number. In the majority of cases, extensive somatic mutations occurred within the complementarity determining regions (CDRs) of V kappa, whereas only a limited degree of divergence from the germline was observed in others. In all cases studied. replacement mutations tended to cluster in the CDRs, a finding compatible with an antigen-driven somatic hypermutation process. In 3/5 cases of lambda light-chain expressing multiple myeloma, abortively rearranged V kappa gene segments were amplified from genomic DNA; in two cases a non-templated nucleotide insertion rendering the V kappa sequences out-of-frame was observed, and in the third a stop codon was identified in the open reading frame of the V kappa sequence. Somatic mutations were observed in all cases of abortive V kappa genes studied; however, their distribution does not suggest selection by antigen. We conclude that somatic mutations observed in the V kappa regions of myeloma cells are of variable extent and suggest operation of the antigen selection process. Lack of or minimal somatic hypermutation in a few cases may be in some way implicated in the biological heterogeneity of the disease.

Amino Acid Sequence↗
PubMed1995

A transient association of gamma-tubulin at the midbody is required for the completion of cytokinesis during the mammalian cell division.

gamma-Tubulin, a relatively new member of the tubulin gene family, is localized primarily at the centrosome throughout the mammalian cell cycle and may play a key role in nucleation of cellular microtubule assembly. A transient association of gamma-tubulin at the cytoplasmic bridge of telophase mammalian cells, the midbody, is recently documented. Using immunogold electron microscopy and serial section reconstruction analysis, we show here that the transiently associated midbody gamma-tubulin is localized at the minus ends of microtubules in the midbody structure. Using antisense RNA methods we also demonstrate that a selective depletion of transiently associated midbody gamma-tubulin causes an abortive cytokinesis due to a failure in the morphogenesis of the midbody structure.

Animals↗
PubMed1994

The role of cordocentesis in assessment of mosaicism found in amniotic fluid cell culture.

Chromosomal mosaicism presents one of the most difficult problems in prenatal cytogenetic diagnosis, requiring the differentiation of true mosaicism from pseudomosaicism. To overcome associated problems and to prevent termination of normal pregnancies, we investigated 23 pregnancies in which true mosaicism has been found in amniotic fluid cell culture. A fetal blood sample was obtained by cordocentesis for rapid karyotyping, and meticulous sonographic examinations were carried out for detecting fetal abnormalities. The 23 cases in which mosaicisms were found in amniocytes involved five cases with sex chromosomal abnormalities, twelve with autosomal trisomy, four with autosomal structural defects, one with a supernumerary marker and one with tetraploidy. The karyotype from fetal leukocytes confirmed the diagnosis of mosaicism in only three out of 23 cases. These three included: two autosomal trisomies (47,XY + 13/47,XY + 21 and 46,XY/47,XY + 21) and one sex chromosome mosaicism (45,X/46,XY). These were all selected for elective termination of pregnancies by the parents' request. Post abortion karyotype re-confirmed previous karyotype. The other twenty lymphocyte karyotypes were normal, and of these, 19 patients gave birth at term, and one delivered prematurely due to premature rupture of membranes. All 20 born infants were found normal by both neonatal examination and re-karyotypes. We conclude that finding of mosaicism in amniotic fluid culture requires further investigation. Furthermore, in the presence of amniotic fluid cell true mosaicism and normal karyotype in fetal blood, continuation of the pregnancy is safe and to be recommended.

Abortion, Therapeutic↗
PubMed2000

Materno-foetal transmission of hepatitis B infection.

A cross-sectional study was carried out on 352 pregnant women, chosen randomly from those admitted to the labour ward of Ain Shams University Hospitals, Abbassia, Cairo, Egypt. This study was conducted to determine the prevalence of HBsAg among pregnant women and estimate the materno-foetal transmission. The prevalence of HBsAg among studied women was 15.3%, however, 7.1% showed inconclusive positive results. The materno-foetal transmission was documented in 51.8% of positive HBSAg women. Hepatitis B infection among studied women was usually acquired after 20 years of age. Logistic regression model with stepwise forward selection, demonstrated that maternal age, past history of blood transfusion and abortions were contributing factors for +ve HBsAg maternal status, while parity and past history of abortions were contributing factors in materno-foetal transmission.

Adult↗
PubMed1991

Hepatitis B infection in Sana'a City, Republic of Yemen. Prevalence among pregnant women and materno-foetal transmission.

A cross-sectional study was carried out on 130 pregnant women, chosen randomly from those admitted to the labour ward of Al-Thawra general hospital in Sana'a City, Republic of Yemen. This study was conducted to determine the prevalence of HBsAg among pregnant women and estimate the maternofoetal transmission. The prevalence of HBsAg among studied women was 15.4%, however, 6.9% showed inconclusive positive results. The materno-foetal transmission was documented in 50% of positive HBsAg women. Hepatitis B infection among studied women was usually acquired after 20 years of age. Logistic regression model with stepwise forward selection, demonstrated that maternal age, past history of blood transfusion and abortions were contributing factors for +ve HBsAg maternal status, while parity and past history of abortions were contributing factors in materno-foetal transmission.

Adolescent↗
PubMed1990

Issues in nursing care of pregnant patients with cancer.

The co-occurrence of pregnancy and cancer raises numerous psychological issues for the pregnant woman and her family. It also poses a variety of therapeutic dilemmas for the health care professionals involved in her care. Issues such as abortion versus continuing the pregnancy must be resolved quickly, and the selection and timing of chemotherapy, radiation, or surgery are affected by the pregnancy. Despite these problems, there is hope for a good outcome in many pregnancies. The role of nursing and how nurses can enhance the experience is discussed.

Family↗
PubMed1990

Immunoglobulin haplotypes: markers of reproductive success?

Immunoglobulin haplotypes are highly polymorphic and are useful for analyses of both macro- and microdifferentiation of populations. The origins of this diversity are not known, but recent reports suggest strong selection at this locus. Increased rates of first-trimester spontaneous abortions have been reported when parents share GM phenotypes. Reduced fertility has been observed in mixed European descent white and Hutterite populations when both parents share immunoglobulin haplotypes. Population samples with completed family information and GM haplotype data are rare; the objective here is to provide this information on another sample. A sample of 242 Mennonite couples with mothers older than 40 years was divided into 3 groups of matings based on how many haplotypes were shared: 0, 1, or 2. The distribution of mean completed family sizes for the three groups were 3.35 +/- 1.85 (n = 23), 3.47 +/- 1.69 (n = 128), and 3.37 +/- 1.60 (n = 91), respectively; these values were not significantly different (F = 0.145, p = 0.865). The log-rank test was used to compare the time-to-next-birth curves. The intervals between first and later births (2-4 births) were not significantly different for the three subgroups either. There is also only limited evidence for segregation distortion in another sample of 923 offspring (in which at least one parent is heterozygous.

Abortion, Spontaneous↗
PubMed1983

[Exposure to diethylstilbestrol during intrauterine life. Signs that should suggest this. Therapeutic implications].

From now on it is general knowledge that there is marked increase in the frequency of clear cell cancers of the cervix and of the vagina in daughters whose mothers were given diethylstilboestrol (DES) during their pregnancies. Equally well known is the high fréquency of vaginal adenosis in these patients. Since 1977, moreover, several North American writers have commented on the lowering in reproductive capacity of these women. It seems that women who were exposed to DES in utero had a greater frequency of extra-uterine pregnancies, spontaneous abortions, and perinatal mortality of their offspring as compared with carefully selected control series. These complications seem to have a predilection for women who have abnormal cervices of who have a T-shaped hypoplastic uterus found on hysterosalpingography. Recently it has been found that there is a higher level of female sterility as compared with male sterility in these patients. Reviewing the literature and describing the principal abnormalities has made it possible for us to produce a hypothesis. This should explain how the action of DES on the mesonephric canals of Wolff causes changes in the shape of the uterus.

Diethylstilbestrol↗
PubMed2006

Incestuous paternity detected by STR-typing of chorionic villi isolated from archival formalin-fixed paraffin-embedded abortion material using laser microdissection.

Microscopic examination of a blood clot expelled by a physically and mentally disabled woman taken to the emergency room because of genital bleeding revealed the presence of chorionic villi encircled by decidua, hemorrhage, and necrosis. In order to identify the father of the product of conception, sections of formalin-fixed, paraffin-embedded abortion material were subjected to laser microdissection: DNA extraction from chorionic villi selectively isolated from the surrounding tissues allowed successful STR-typing of fetal cells, which was otherwise prevented by excess maternal DNA. The large number of homozygous genotypes in the fetal profile suggested incestuous paternity. Analysis of reference DNA samples from male relatives excluded the woman's father, paternal grandfather, and maternal grandfather, whereas the obligate paternal alleles of the fetus were constantly present in the genotypes of the woman's brother, clearly demonstrating brother-sister incest (probability of paternity > 99.99999%).

Aborted Fetus↗
PubMed2003

Embolization of a uterine arteriovenous malformation followed by a twin pregnancy.

BACKGROUND: Uterine arteriovenous malformation is a lesion that can cause recurrent pregnancy loss. Very few successful pregnancies have been reported after selective embolization of an arteriovenous malformation. CASE: A 42-year-old gravida 6 para 0 with a history of four first-trimester spontaneous abortions was found to have a uterine arteriovenous malformation by hysterosalpingogram, which was confirmed by magnetic resonance angiography. She underwent selective transcatheter embolization of the arteriovenous malformation. A twin gestation was later conceived via in vitro fertilization. The twins were delivered by cesarean at term. CONCLUSION: Uterine arteriovenous malformation can be successfully treated with selective embolization, with good obstetric outcome.

Adult↗
PubMed1974

Structural and functional asymmetries of myelinated branches in the frog muscle spindle.

1. Most of the axons innervating single-type muscle spindles in the frog sartorius muscle divide into myelinated branches at a node; one of the branches subdivides (Bs) and the other does not (Bn).2. Electrical responses at the afferent nerve terminal of the isolated spindles were recorded extracellularly and intracellularly with micro-electrodes, concurrently with the terminal responses by the paraffin gap method.3. By recording spontaneous orthodromic and provoked antidromic impulses and by stimulating the nerve terminals with micro-electrodes and inactivating the terminals with micro-application of potassium ion, it was deduced that propagated and abortive spikes are almost always generated at the terminal of Bn (Tn), not at the terminals of Bs (Ta and Tb).4. The site of impulse initiation, as determined in (3), was found, after measurement of the lengths of the myelinated branches in each preparation, to be essentially the terminal nearest the parent axon.5. Selective inactivation of Tn by far-ultra-violet light removed both propagated and abortive spikes. Both types of spikes survived after irradiation of Ta and Tb, although the relationship between spike frequency and spindle stretch was altered. The same results were obtained after transection of the branches with a laser microbeam.

Animals↗
PubMed2000

Contraceptive intentions of women seeking induced abortion in the city of Jos, Nigeria.

This is a prospective study involving 120 women who requested abortion for an unplanned and unwanted pregnancy. We sought to determine their contraceptive intentions and use. The characteristics of these women revealed that the majority were young, single schoolgirls with 68.5% of them being nulliparous. Over 90% had had their first sexual experience before the age of 20 years. Although, 113 (94%) were aware of the availability of contraceptive services only 70 (62%) of these had ever used a method and the majority of the contraceptive methods selected were ineffective. Although 97 (80.8%) had a positive intention towards post-abortion family planning, only 18 (18.5%) eventually agreed and were offered a method after the termination of pregnancy. The study revealed a high risk group of unplanned and unwanted pregnancy in Jos but low contraceptive use despite the high positive intentions expressed by this cohort of patients. Effective post-abortion contraception counselling should be incorporated into family planning in Nigeria in order that clients who express positive intentions to the use of family planning actually use the method thereby reducing the incidence of repeated induced abortions and its social and medical consequences.

Journal Article↗
PubMed2003

Epidemiology of ovine brucellosis in Awassi sheep in Northern Jordan.

We used a combined cross-sectional and longitudinal design to estimate seroprevalence of Brucella antibodies in Awassi sheep and the incidence of abortion due to brucellosis during one lambing season, and to test risk factors. The Brucella organisms isolated from aborted fetuses and vaginal swabs were characterized as Brucella melitensis biotype 3. Seventy Awassi sheep flocks were selected randomly from Northern Jordan. Sixty two of the 70 flocks were used in the cross-sectional study and 8 flocks were monitored for three consecutive months to estimate the incidence of abortion. Questionnaire data and 602 serum samples were collected and analyzed. Thirty five flocks (56%) were brucellosis-seropositive by the Rose Bengal plate-agglutination test (RBT) and 28 (45%) by enzyme-linked immunosorbent assay (ELISA). The crude seroprevalence of brucellosis at the individual-animal level was 14.3% by RBT, 7.2% by ELISA and 2.2% using both tests in series. The flock-specific, animal-level abortion risk ranged between 2.5 and 50% (median=22.6%). The flock brucellosis-status was used as the outcome variable in a multivariable logistic regression. Grazing at communal pasture increased odds, but usage of disinfectants, previous vaccination for brucellosis, and tap water were protective. The animal-level incidence of abortion was 20% and the specific incidence risk of abortion due to brucellosis was 13%.

Abortion, Veterinary↗
PubMed1991

Induced abortions, contraceptive practices, and tobacco smoking as risk factors for ectopic pregnancy in Athens, Greece.

A case-control study of the role of induced abortion and other factors on the subsequent occurrence of ectopic pregnancy was undertaken in 1986-1987 in Athens, Greece, where a similar study 20 years ago found a tenfold risk of ectopic pregnancy among women with one or more illegal induced abortions. Seventy women residents of Athens, consecutively admitted to the major state maternity hospital with a diagnosis of ectopic pregnancy, were individually matched with women with a newly diagnosed pregnancy of the same order as the ectopic index pregnancy. Two control women were found for each of 63 cases, but only one control for each of the remaining seven cases. All cases and controls were interviewed by the same qualified obstetrician. Statistical analysis was undertaken with stratification of individual matched triplets and pairs, as well as through conditional multiple regression procedures. The relative risk of recurrence of an ectopic pregnancy was 6.39 with 95% confidence interval (CI) 1.96-21.04. Miscarriages did not increase the risk of ectopic pregnancy. The relative risk for subsequent ectopic pregnancy among women with one or more induced abortion, compared to women without such abortions, was 1.87 (CI 0.84-4.16) controlling only for the matching factors, and 1.71 (CI 0.69-4.27) when marital status (a possible selection factor) was also accounted for in the conditional logistic regression. There was no evidence for increasing risk with increasing number of induced abortions. Past use of an intrauterine device (IUCD) was associated with a relative risk of 3.89 (0.72-21.02); the relative risk increased with the duration of use of the IUCD.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMedDate not supplied

[Do extended preventive indications for cervix cerclage increase labor complications? A statistical analysis on direct and indirect complications of cerclage using Bavarian perinatal data 1978-1980].

On the basis of 159.710 single pregnancies with 11.321 cerclages documented in the Bavarian Perinatal Survey of 1978-1980, with 2.676 single-child births, and 514 cerclages performed on the authors' own patients, possible complications of the extended indication for cerclage were determined as follows: The late abortion rate was not increased. Possibly because the group represented a negative selection, rupture of the membranes prior to labour, infant mortality due to infection, and premature labour were significantly more common in gravidae who had undergone cerclage. However, it was not possible to identify a causal connection between these and the cerclage operation. With regard to indirect complications there was an appreciable increase in the number of caesarean deliveries among cerclage patients, a slight increase in the number of cases in which labour lasted over 12 hours, and a significant increase in the number of lacerations of the cervix. There was no increase in the incidence of post-term births, malformations, stillbirths, or infantile acidosis among the children of patients who had undergone cerclage.

Abortion, Spontaneous↗
PubMed2004

An evaluation of economics and acceptability of screening for Chlamydia trachomatis infection, in women attending antenatal, abortion, colposcopy and family planning clinics in Scotland, UK.

OBJECTIVE: The aims of this study were to determine cost effectiveness of screening for Chlamydia trachomatis in hospital-based antenatal and gynaecology clinics, and community-based family planning clinics. Additionally, women's views of screening were determined in the hospital-based clinics. DESIGN: Cost effectiveness based on decision model. Model probabilities were generated for a hypothetical sample of 250 women in each age group in each setting, based on prevalence studies, published data and expert opinion. A prospective observational study was used to generate data on prevalence and acceptability. SETTING: Antenatal, gynaecology and family planning clinics in Aberdeen, Edinburgh and Glasgow. SAMPLE: Prevalence was estimated in 2817 women. Acceptability was determined in 484 women. METHODS: An economic evaluation was performed using prevalence data from this and a previous study, and using outcome data from the literature and observational work. Incremental cost effectiveness ratios were estimated for each age group and clinical setting. Sensitivity analyses were performed to determine the robustness of incremental cost effectiveness ratios to changes in the incidence of long term sequelae and costs. The prevalence of infection was determined by nucleic acid amplification of urine samples or endocervical swabs. Knowledge of C. trachomatis and women's views of screening were determined using structured questionnaires. MAIN OUTCOME MEASURES: Direct health service costs of screening, incidence and costs associated with adverse sequelae, women's views of screening and prevalence of infection. RESULTS: The estimated cost of screening 250 women in each age group in each the four sample populations (total population of 3750) is 49,367 UK pounds, while preventing 64 major sequelae. This represents a net cost of 771.36 UK pounds in preventing one major sequela. Selective screening of all women under 20 years and all patients attending abortion clinics were shown to be the most cost effective strategies. These results were relatively insensitive to changes in estimated parameters, such as uptake rate, probabilities and unit costs of all major sequelae averted. Prevalence (95% CI) of infection in the highest risk groups (those aged under 20 in both antenatal and abortion clinics) was 12.1% (8.6-16.7) and 12.7% (7.3-21.2), respectively. The majority (>95%) of women agreed with a policy of regular screening for C. trachomatis, and screening in the settings employed in this study was largely acceptable. CONCLUSIONS: A single episode of screening for C. trachomatis does not result in net cost savings. Currently recommended strategies of screening for C. trachomatis in women under 25 years of age in abortion clinics are supported by our data on prevalence and acceptability. These data also suggest that hospital-based screening strategies should be further extended to include younger women attending antenatal clinics and all women of reproductive age attending colposcopy clinics.

Ambulatory Care↗
PubMed2000

Analysis of the underestimation of induced abortions in a survey of the general population in France.

INTRODUCTION: A pilot study has been conducted in France to estimate the extent of underreporting of induced abortion and the factors linked to underreporting. METHODS: A representative random sample of 300 women aged between 18 and 44 years of age who had been pregnant during the previous 2 years and 100 women who had not was selected from the telephone directory. Interviews were conducted by telephone. RESULTS: The annual incidence of induced abortion for the 18-44-year-old age group was 6.9 per 1000 (95% confidence interval 2.2-11.6), while the rate derived from national statistics was 15 per 1000. Five women who reported a therapeutic abortion in their lifetime had confused induced abortion and therapeutic abortion. There was no significant difference in the proportion of women reporting induced abortion in their lifetime between those answering with another adult present and those who were alone when answering (13.1% versus 11.1%, p = 0.8). There was also no significant difference according to the sex of the interviewer (10.0% for men versus 12.2% for women, p = 0.6). CONCLUSION: The results suggest that the context in which the questions were asked does not affect the validity of the answers and that there is a problem in the comprehension of the terminology used. Extensive rewriting and reformulation of the questions is required to minimize the underreporting of induced abortion.

Abortion, Induced↗