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PubMed1996

Elective uterine myomectomy in pregnant women.

One hundred and six pregnant women with uterine myomas were admitted to a clinical protocol for operative or conservative management of myomas. The criteria for decision to submit to surgery were: (i) recurrent pain; (ii) large or rapidly growing myomas; (iii) large or medium myomas located in the lower uterine segment or deforming the placental site. According to these criteria 18 patients underwent myomectomy (operative group) and 88 were conservatively treated (conservative group). Complications and fetoneonatal outcome were monitored. The data were also compared to a control group of 2463 normal pregnant women. No spontaneous abortion occurred in the operated group, while the conservative group had a 13.6% spontaneous abortion rate (control group: 9.3%). The operated group had the highest cesarean section rate (93.7%), but no post-cesarean hysterectomy. The conservative group had a higher cesarean section rate compared with the pregnant women without myomas (34% vs 16.3%, respectively); they also had a 4.5% post-cesarean hysterectomy rate compared with 0.12% in the control group. Fetoneonatal outcome was good both in the conservative and operated group. The only perinatal death regarded a patient with a large myoma who refused surgery and went into premature labour at 32 weeks of gestation. Therefore, our study demonstrates that myomectomy during pregnancy is of advantage when performed early on selected patients.

Abortion, Spontaneous↗
PubMed2001

Abortion history and breast cancer risk: results from the Shanghai Breast Cancer Study.

Studies of the association between induced abortion and breast cancer risk have been inconsistent, perhaps due to underreporting of abortions. Induced abortion is a well-accepted family planning procedure in China, and women who have several induced abortions do not feel stigmatized. The authors used data from a population-based case-control study of breast cancer among women age 25-64 conducted between 1996 and 1998 in urban Shanghai to assess whether a history of and the number of induced abortions were related to breast cancer risk. In-person interviews were completed with 1,459 incident breast cancer cases ascertained through a population-based cancer registry, and 1,556 controls randomly selected from the general population in Shanghai (with respective response rates of 91% and 90%). After adjusting for confounding, there was no relation between ever having had an induced abortion and breast cancer (odds ratio [OR] = 0.9, 95% confidence interval [CI] 0.7-1.2). Women who had 3 or more induced abortions were not at increased risk of premenopausal breast cancer (OR = 0.9, 95% CI 0.6-1.4) or postmenopausal breast cancer (OR = 1.3, 95% CI 0.8-2.3). These results suggest that a history of several induced abortions has little influence on breast cancer risk in Chinese women.

Abortion, Induced↗
PubMed2004

Is there a place for immunomodulation in assisted reproduction techniques?

We briefly review the history of the concepts of the materno foetal relationship, and the (various) rationales which have been used to justify lymphocyte alloimmunisation (LA) as a treatment for recurrent spontaneous abortion of putative immune origins. The effectiveness of the treatment is at best dubious and limited to a small number of women for which there is no real positive selection rationale, at worst it is not efficient. The rationales themselves are rather "evolutive". The present one is to use the Th1:Th2 paradigm and, thus, to propose to "dampen NK activity" in abortion prone women and this concept has been extended by some to implantation failure. We briefly review why the Th1:Th2 paradigms is no longer fully valid, describe briefly why it is inappropriate for implantation, and conclude that alloimmunisation should no longer be proposed for RSA, hence, more for implantation failure. We, however, do not reject immunotherapy, but we believe that molecular and cellular defects specific approaches should be used, tailored for the specific pathway whose disruption cause the clinical symptom.

Abortion, Spontaneous↗
PubMed1988

Positive selection for male-sterile mutants of Arabidopsis lacking adenine phosphoribosyl transferase activity.

Three mutants of Arabidopsis thaliana deficient in adenine phosphoribosyl transferase activity were isolated by selecting for germination of seeds on a medium containing 0.1 millimolar 2,6-diaminopurine. In each of the mutants, diaminopurine resistance was due to a recessive nuclear mutation at a locus designated apt. The mutants grow more slowly than wild type, and are male sterile due to abortion of pollen development after the meiotic divisions of the pollen mother cells. The reliability and ease with which the mutants can be selected should afford novel opportunities to investigate purine metabolism, pollen development, and genetic problems which require the ability to select for loss-of-function mutations.

Journal Article↗
PubMedDate not supplied

Fetal Rh blood group determination in pregnancy termination by dilatation and evacuation.

Feasibility of Rh blood group determination from fetal samples at the time of second trimester abortion by dilatation and evacuation method was investigated. Fetal cord blood was found to be obtained easily, especially when gestational age was more than fifteen weeks. Fetal blood typing was performed easily and accurately. Selective prophylactic immunization of Rh negative patients undergoing dilatation and evacuation procedures is suggested.

Abortion, Therapeutic↗
PubMed2005

Spontaneous abortion in IVF couples--a role of male welding exposure.

BACKGROUND: Fume from welding of stainless steel contains hexavalent chromium, which in animal studies can induce paternally mediated spontaneous abortion. Human studies have shown conflicting results. The best studies include early pregnancy experience, but these are expensive to conduct. In vitro fertilization (IVF) provides new design opportunities. Our aim was to study pregnancy survival in IVF treated women with respect to paternal welding exposure. METHODS: We mailed a questionnaire to 5879 couples from the Danish IVF register that covers all IVF treatments after 1993 (response ratio 68.2%). A subgroup of male metal workers received a second questionnaire on exposure to welding (n = 319 men, response ratio 77%). Information on outcome was collected from national health registers. Survival of the first hCG-positive pregnancy was analysed using Cox regression. RESULTS: The proportion of pregnancies terminated by spontaneous abortion before 28 gestational weeks was 18% (n = 91 pregnancies) and 25% (n = 128) in pregnancies with paternal exposure to stainless steel welding and mild steel welding, respectively. In the reference group of 2925 pregnancies the abortion ratio was 28%. The risk ratio for pregnancies with paternal exposure to stainless steel was 0.6 (95% CI 0.4-1.0). CONCLUSIONS: We found no increased risk of spontaneous abortion in IVF treated women, who became pregnant by a man exposed to welding of any sort. Since the process of fertilization and selection of IVF pregnancies differs from natural pregnancies the negative results need not apply to other pregnancies.

Abortion, Spontaneous↗
PubMed1989

Employment status as a confounder when assessing occupational exposures and spontaneous abortion.

Studies of occupational exposure and spontaneous abortion may use pregnancies during which the mother was unemployed as part or all of the unexposed comparison group. Any type of maternal employment, however, may be a risk factor for spontaneous abortion, and potential confounder in occupational reproductive studies. This study evaluates the effect of employment in a cohort of pregnancies of 1535 women. Employed pregnancies had a significantly higher rate of spontaneous abortion (14.5%) than unemployed pregnancies (11.7%) (RR = 1.23, 95% CI = 1.02, 1.49). Gravidity acted as an effect modifier, as the employment effect was seen only in multigravidous pregnancies (RR = 1.38, 95% CI = 1.11, 1.72) and not primigravidous pregnancies (RR = 0.96). The effect persisted when an independent sample of one randomly selected pregnancy per woman was used for the analysis (RR = 1.27, 95% CI = 0.90, 1.79). The data were examined for confounding by other factors which could explain the excess in spontaneous abortion among employed pregnancies. The employment effect persisted with adjustment for other risk factors including maternal age, education, income, maternal diabetes, race, alcohol usage and smoking, and prior pregnancy ending in induced abortion. Stratifying by prior pregnancy loss eliminated the employment effect among those with prior loss (RR = 1.03) but enhanced the effect among those multigravidous without the risk factor (RR = 1.50, 95% CI = 1.15, 1.97). Selection bias, also, was explored as a possible explanation of this employment effect, but could not be substantiated. Assessment of a true exposure effect requires consideration of a potential employment effect either in the design or analysis.

Abortion, Spontaneous↗
PubMed1983

Spontaneous abortions among factory workers. The importance of gravidity control.

The purpose of this study were twofold. First to demonstrate the impact of gravidity control on the crude odds ratio (OR), the risk estimate of the total number of spontaneous abortions among all chemically exposed women in comparison with non-exposed women. Second, to discuss whether the increased proportion of higher gravidities among the exposed subjects did compensate for an increased risk of spontaneous abortion provoked by the chemical exposure. The study included 262 factory workers occupationally exposed predominantly to organic solvents and 241 reference women who were socially comparable and relatively free from chemical exposure of their work. The subjects are included in a historical prospective survey of 6 730 women representing 12 selected occupations in the Danish county of Funen. The data were collected by postal questionnaires in May 1980. The crude OR of spontaneous abortions among factory workers was significantly increased, but when controlled for gravidity, it was no longer statistically significant. The childbearing behaviour of the two groups of women was compared in a logistic regression analysis which suggested that the increased proportion of higher gravidities among the factory workers was not only due to a compensatory behaviour. A desire for more children among the factory workers, or a less careful use of contraception compared to the reference group might explain the findings. Consequently, gravidity should probably be controlled.

Abortion, Spontaneous↗
PubMed2001

Cytogenetic analysis of trophoblasts by comparative genomic hybridization in embryo-fetal development anomalies.

Cytogenetic studies of spontaneous abortions or intrauterine fetal death depend on conventional tissue culturing and karyotyping. This technique has limitations such as culture failure and selective growth of maternal cells. Fluorescent in situ hybridization (FISH) using specific probes permits diagnosis of aneuploidies but is limited to one or a few chromosomal regions. Comparative genomic hybridization (CGH) provides an overview of chromosomal gains and losses in a single hybridization directly from DNA samples. In a prospective study, we analyzed by CGH trophoblast cells from 21 fetuses in cases of spontaneous abortions, intrauterine fetal death or polymalformed syndrome. Six numerical chromosomal abnormalities including one trisomy 7, one trisomy 10, three trisomies 18, one trisomy 21 and one monosomy X have been correctly identified by CGH. One structural abnormality of the long arm of chromosome 1 has been characterized by CGH. One triploidy and two balanced pericentromeric inversions of chromosome 9 have not been identified by CGH. Sexual chromosomal constitutions were concordant by both classical cytogenetic technique and CGH. Contribution of trophoblast analysis by CGH in embryo-fetal development anomalies is discussed.

Abortion, Spontaneous↗
PubMedDate not supplied

A study of alloreactivity in couples with habitual abortions of unknown etiology.

During 2003, we investigated 22 couples with three or more consecutive spontaneous abortions without liveborn children. The study group consisted of 9 couples with three or more successive spontaneous abortions without liveborn children and without known endogenous or exogenous causes of habitual abortions. The first control group comprised 9 couples with liveborn children, while the second one included 9 randomly selected couples without children. The immunologic status was evaluated in regard to functional capacity of lymphocytes, response of T-lymphocytes to disabled histocompatible antigens of partner's lymphocytes, and T-lymphocytes to partner's alloantigens. In women from study and control groups there were no statistically significant differences in general immunologic status functional capacity of lymphocytes). In women from the study group, T-lymphocytes response to stimulation by disabled partner's lymphocytes was significantly lower compared to both control groups (P < 0.05). However, the immunologic reaction of women from the study group to alloantigens of men from control groups did not show any significant difference compared to control groups results (P > 0.05). According to our study, it can be concluded that immunologic factors have an important role in a great proportion of habitual abortions with unknown etiology.

Abortion, Habitual↗
PubMed2002

Issues surrounding prenatal genetic testing for achondroplasia.

OBJECTIVES: Mutations in the gene encoding fibroblast growth factor receptor 3 cause achondroplasia, the most prevalent form of dwarfism. Since the discovery of the mutations and gene in 1994, commercial testing has been available for use in prenatal diagnosis. This study sought to determine the awareness of, interest in and use of prenatal genetic testing for achondroplasia. METHODS: Surveys were collected from both individuals affected with achondroplasia (n = 189) and their average statured relatives (n = 136). RESULTS: The majority of participants were aware of the prenatal genetic testing at the time they were surveyed, but less than 10% had actually used the testing. Affected individuals were much more interested in using the testing if they became pregnant (62%) than were their relatives (28%). The groups were remarkably similar in their interest in using the testing to identify the lethal, homozygous form of achondroplasia and in their unwillingness to consider termination of pregnancies based on a diagnosis of either achondroplasia or average stature. Affected status and perception of the condition were correlated with the importance placed on knowing the prenatal diagnoses of achondroplasia and average stature. Views on abortion were highly correlated with all aspects of interest in prenatal diagnosis for achondroplasia. CONCLUSION: These results elucidate the role of selected attitudes and beliefs that contribute to reproductive decision making about achondroplasia. Furthermore, the findings provide insights into education and counseling issues for families and health care practitioners.

Abortion, Induced↗