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PubMed1980

Menarcheal age and spontaneous abortion: a causal connection?

Data from a Norwegian investigation on family planning were used to study the relation between menarcheal age and spontaneous abortion rate. Abortion rates were found to be 1.5-2 times higher among women with a menarcheal age of 12 years or less than among those with a menarcheal age of 14 years or more. The possibility that the difference in rates could be attributed to social factors was examined, but no significant relation of this kind was found. The connection between menarcheal age and spontaneous abortion rate may explain the low fertility of early maturers reported by Kiernan (Ann Hum Biol 4:301-308, 1977).

Abortion, Spontaneous↗
PubMed2005

The incidence of induced abortion in Uganda.

CONTEXT: Although Uganda's law permits induced abortion only to save a woman's life, many women obtain abortions, often under unhygienic conditions. Small-scale studies suggest that unsafe abortion is an important health problem in Uganda, but no national quantitative studies of abortion exist. METHODS: A nationally representative survey of 313 health facilities that treat women who have postabortion complications and a survey of 53 professionals who are knowledgeable about the conditions of abortion provision in Uganda were conducted in 2003. Indirect estimation techniques were applied to the data to calculate the number of induced abortions performed annually. Abortion rates, abortion ratios and unintended pregnancy rates were calculated for the nation and its four major regions. Data on contraceptive use and unmet need were obtained from Demographic and Health Surveys. RESULTS: Each year, an estimated 297,000 induced abortions are performed in Uganda, and nearly 85,000 women are treated for complications. Abortions occur at a rate of 54 per 1,000 women aged 15-49 and account for one in five pregnancies. The abortion rate is higher than average in the Central region (62 per 1,000 women), the country's most urban and economically developed region. It is also very high in the Northern region (70 per 1,000). Nationally, about half of pregnancies are unintended; 51% of married women aged 15-49 and 12% of their unmarried counterparts have an unmet need for effective contraceptives. CONCLUSIONS: Unsafe abortion exacts a heavy toll on women in Uganda. To reduce unplanned pregnancy and unsafe abortion, and to improve women's health, increased access to contraceptive services is needed for all women.

Abortion, Induced↗
PubMed1982

Race-specific patterns of abortion use by American teenagers.

Between 1972 and 1978, as legal abortion became more widely available nationally, abortion rates (abortions per 1,000 women) and ratios (abortions per 1,000 live births) increased for all American teenagers; from 1972 to 1975, the rates and ratios for teenagers for Black and other races increased faster than those for White teenagers. For all seven years, abortion rates were higher for teenagers of Black and other races than for white teenagers. This reflected both higher proportions of sexually active teenagers of Black and other races and a greater risk of pregnancy in these teenagers compared with White teenagers. Race-specific differences in legal abortion ratios narrowed during the seven-year interval, as did differences in alternative outcomes of teenage premarital pregnancies (term births, illegal abortions).

Abortion, Legal↗
PubMed1988

Rate of spontaneous abortion after first trimester sonographic demonstration of fetal cardiac activity.

The incidence of spontaneous abortion once embryonic development has reached the stage of sonographically demonstrable cardiac activity has not been precisely determined in a large population. This retrospective study was designed to determine the risk of pregnancy loss after first trimester sonographic confirmation of fetal cardiac activity. A total of 840 patients were referred for ultrasound examination to the Perinatal Center, University of Cincinnati, between January 1, 1979 and December 31, 1985 who fulfilled the criteria of singleton pregnancy with sonographically visible fetal cardiac activity and crown-rump length consistent with gestational age less than or equal to 12 weeks. Patients were grouped into two categories based on the absence (control) or presence of vaginal bleeding (bleeding) prior to or at the time of the ultrasound examination. The abortion rates for the two groups were 5.2 and 16.4%, respectively (P less than 0.001). The relative risk of abortion in patients with vaginal bleeding was nearly four-fold greater than the control population. In the control group there was a significantly greater incidence of pregnancy loss in the greater than or equal to 34 years age group compared to less than 34 years age patients (4.4 versus 11.1%, P less than 0.05). Although there was no significant effect of race on abortion rates, low socioeconomic status almost doubled the relative risk of miscarriage. We conclude that the presence of visible fetal cardiac activity in the first trimester predicts a decreased risk for spontaneous abortion compared to generally reported rates. The significant risk factors for increased chance of abortion are vaginal bleeding, advanced maternal age, and low socioeconomic status.

Abortion, Spontaneous↗
PubMed1992

A method for calculating rates of induced abortion.

Accurate measurement of induced abortion is necessary for understanding the fertility dynamics of a population and for making projections about the future. Changes in abortion rates can amplify or dampen the impact of changes in contraception. This paper presents a methodology for calculating marital induced abortion rates from observed marital fertility and contraceptive prevalence and for modeling the impact of substituting contraception for abortion on future fertility. The methodology is validated against observed abortion complications in three populations, and the impact of substituting contraception for abortion on expected fertility is demonstrated.

Abortion, Induced↗
PubMed2004

Effects of retention of fetal membranes on subsequent reproductive performance of dairy ewes.

Seventy-one pairs of ewes with or without retention of fetal membranes in the previous lambing season, were included in a cohort study of 25 flocks in southern Greece; in 27 pairs regulation of the breeding cycle was applied, whilst in the other 44 pairs natural mating took place. The following measures of reproductive performance were calculated: cycling rate, mating rate, return-to-estrus rate, abortion rate, lambing rate, total lambs born per ewe, liveborn lambs per ewe, stillbirth rate, lamb-bodyweight per ewe; furthermore, the incidence risk of retention of fetal membranes during the lambing examined in this study was also calculated. No statistically significant differences were observed in the reproductive performance among ewes that had or had not retained their fetal membranes during the previous lambing, whether the breeding cycle was regulated or not. The incidence risk of retention of fetal membranes among ewes that had not retained its placenta in the previous lambing was 1.6%, whilst that among ewes that had retained its placenta in the previous lactation was 0%. It is concluded that retention of fetal membranes did not appear to adversely affect subsequent reproductive performance of ewes.

Abortion, Veterinary↗
PubMed2006

Proximal tubal occlusion and salpingectomy result in similar improvement in in vitro fertilization outcome in patients with hydrosalpinx.

OBJECTIVE: To evaluate and compare the clinical impact of proximal tubal occlusion and salpingectomy when performed before IVF in patients with hydrosalpinges. DESIGN: Prospective randomized study. SETTING: Assisted reproduction unit in an obstetrics and gynecology department in a university hospital in Greece as well as assisted reproduction unit in an urban clinic in a major city in Greece. PATIENT(S): One hundred fifteen patients with unilateral or bilateral hydrosalpinges who were candidates for IVF treatment. INTERVENTION(S): Laparoscopic proximal tubal occlusion, laparoscopic salpingectomy, controlled ovarian hyperstimulation, IVF, and embryo transfer. MAIN OUTCOME MEASURE(S): Implantation rate, clinical-pregnancy rate, ongoing-pregnancy rate, abortion rate, and ectopic-pregnancy rate. RESULT(S): Patients who underwent proximal tubal occlusion before IVF demonstrated significantly increased implantation, clinical-pregnancy, and ongoing-pregnancy rates compared with those with no surgical intervention and demonstrated implantation, clinical-pregnancy, and ongoing-pregnancy rates comparable to those who underwent salpingectomy. CONCLUSION(S): Proximal tubal occlusion, when performed in women with unilateral or bilateral hydrosalpinges before their IVF treatment, represents a potentially beneficial surgical procedure, increasing significantly the chances for successful implantation and for clinical and ongoing pregnancy. Proximal tubal occlusion may be viewed as a valid alternative when salpingectomy is technically difficult or not feasible.

Adult↗
PubMed2001

Effects of sarcoptic mange on the reproductive performance of ewes and transmission of Sarcoptes scabiei to newborn lambs.

In each of two experiments, the reproductive performance of ewes naturally infested with sarcoptic mange and of uninfested ewes was assessed in in-season natural breeding conditions (experiment I) or in out-of-season controlled breeding conditions (experiment II). A statistically significant difference was observed in the total lambs born per ewe (infested ewes, 1.2; controls, 1.6), in the liveborn lambs per ewe (infested ewes, 1.2; controls, 1.5) and in the lamb body weight per ewe (infested ewes, 3.33kg; controls, 4.53kg) under natural breeding conditions, as well as in the lamb body weight per ewe (infested ewes, 3.37kg; controls, 4.14kg) among ewes under controlled breeding conditions. No adverse effects were observed in the other reproductive indices, cycling rate, mating rate, return-to-oestrus rate, abortion rate, lambing rate and stillbirth rate. Sarcoptic mange was observed in the offspring of infested ewes after 30 days and in the offspring of uninfested controls 60 days after their birth.

Animals↗
PubMed1989

Size and management effects on reproduction in first-, second- and third-parity beef cows.

The effects of size, management and size x management interactions on reproduction in beef cattle were determined by using 3,126 breeding and calving records from 1980 to 1985. Cows were from three synthetic lines that differed in mature size (small, medium and large). The lines differed also in the percentages of Jersey, Angus and Simmental. Each line was replicated in two herds. One herd (Rhodes) followed a spring calving schedule and weaned calves at about 180 d of age. The other herd (McNay) calved cows in the fall and weaned calves early at about 45 d of age. Cycling rate, conception rate, abortion rate and calving rate were each evaluated for first-, second- and third-parity dams. An important interaction (P less than .05) was found between lines and management in heifers. Cycling rate and calving percentage were almost identical for all three lines in the Rhodes herd, but small heifers in the McNay herd had about 20% higher cycling (83.8 vs 63.1%) and calving rates (73.8 vs 53.0%) than large heifers. Line x management interactions were not significant in second- and third-parity dams, but line did remain a significant source of variation in calving rate. Calving rates in second-parity dams were 85.0, 78.1 and 70.7% for small, medium and large cows, respectively. In third-parity dams, small cows had a higher calving rate (P less than .05) than either medium or large cows (80.9 vs 66.1 or 68.7%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Husbandry↗
PubMed2000

Effects of induction anesthetic agents on outcome of assisted reproductive technology: a comparison of propofol and thiopental sodium.

BACKGROUND: The use of propofol, as compared to barbiturates (e.g. thiopental), for short surgical procedures has been associated with more rapid recovery from the procedure. Propofol, an intravenous anesthetic drug, is frequently used as an adjunct to transvaginal oocyte retrieval but little is known about its effects upon fertilization, embryo development, and pregnancy rate when used drug the for induction of general anesthesia. This study was conducted to compare the outcome of assisted reproductive technology (ART) with the use of propofol versus thiopental sodium for the induction of general anesthesia during oocyte retrieval. METHODS: In this retrospective study, 92 cases of infertile patients who underwent oocyte retrieval under the induction of general anesthesia with, respectively, either propofol (Group I, 72 cases) or thiopental sodium (Group II, 20 cases) were compared for fertilization rate, cleavage rate, and pregnancy rate. RESULTS: The fertilization rate was 68.9% for Group I and 66.7% for group II (p = 0.614). The cleavage rate was 96.5% for Group I and 94.8% for Group II (p = 0.294). The rate of good embryo grading and poor embryo grading was, respectively, 85.1% and 14.9% for Group I, versus 85.7% and 14.3% for Group II (p = 0.887). The pregnancy rate was 30.5% for Group I and 20.0% for Group II (p = 0.354). The implantation rate and abortion rate was, respectively, 9.1% and 18.2% for Group I versus 7.2% and 25.0% for Group II (implantation rate, p = 0.590; abortion rate, p = 0.600). CONCLUSION: There were no significant differences between these two groups for fertilization rate, cleavage rate, pregnancy rate, implantation rate and abortion rate. We suggest cautious use of propofol for the procedure of oocyte retrieval despite its associated more rapid post-operative recovery including less nausea/vomiting.

Anesthetics, Intravenous↗
PubMed1990

[A cross-sectional study of health status and the development of their offspring among woman workers exposed to hazards at factories in Dalian].

A cross-sectional study of health status and the development of their offspring among 3,555 woman workers exposed to a variety of hazardous factors at 14 factories was conducted in 1988 in Dalian. 2,054 woman workers who were not exposed to any kind of the Hazards were used as control group. The relative risk (RR) and the attributive risk (AR) were used to compare the incidence of the study group with that of the control. There are statistically significant excesses of irregular menstruation rate, abortion rate premature and still birth rate in the study group. The rate of congenital malformations of the offsprings of women exposed to benzene is significantly high and so are women working in chemical industry, but it is not significantly different between those exposed to lead and the control group. The incidence of gynecopathy among the study group women consistently is higher than the control group indicating that the hazards in factories can adversely affect the menstruation, reproduction, and the development of their offspring of woman workers.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

On the complication risk of early amniocentesis versus standard amniocentesis.

In the last 6 years early amniocentesis for the prenatal diagnosis of chromosome aberrations has been established in many centers worldwide, but knowledge about the gynecological safety of the procedure is sparse. From 1990 to 1995 at the Evangelisches Krankenhaus Oberhausen (Germany) 3,277 early amniocenteses (between weeks 11 and 14) and 1,808 standard amniocenteses were performed in low-risk indication groups (advanced maternal age and anxiety). A complete follow-up including reports of fetal outcome was obtained in 4,444 cases (87.5%). A pregnancy age-related abortion rate was determined with a slightly higher rate of abortions up to week 28 of gestation in early amniocentesis. The total abortion rate up to week 28 after the procedure for cases with complete follow-up was 2% in early amniocentesis. Compared to standard amniocentesis performed under the same clinical conditions with an abortion rate of 1.3%, there is no statistical difference between early and standard amniocentesis (p = 0.0971). Hip and foot dislocations (22 cases) and pulmonary distress syndromes (8 newborns) showed no significant correlation with the gestational week. Given the high normal background rate of spontaneous abortions in the early period of pregnancy without an invasive procedure, early amniocentesis can be considered as a safe alternative to chorionic villus sampling and standard amniocentesis.

Abortion, Induced↗
PubMed1994

The impact of maternal age on clinical pregnancy and spontaneous abortion in women undergoing in vitro fertilization and gamete intra-fallopian transfer.

The age at which women should be advised against proceeding with initial or further infertility treatment is one of the many unresolved questions in this area of women's health and was the subject of investigation in this study. One of the major difficulties in determining the impact of maternal age on outcomes is the practice of researchers (publishing in journals) and infertility practitioners (reporting to national registers) of coding age as a categorical rather than a continuous variable. In this study, groups of younger (< 30 years) and older (> 35 years) women undergoing assisted reproduction treatments were compared with regards to clinical pregnancy and spontaneous abortion rates following in vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT). Response to different ovarian stimulation protocols was also assessed for the 2 groups. The significance of the relationship between maternal age, clinical pregnancy rates, spontaneous abortion rates and the type of treatment and stimulation protocol employed, was tested using a series of binomial distributions. The results indicated that maternal age adversely affects both clinical pregnancy rates and rates of spontaneous abortion, when summed across treatments and stimulation protocols. However, while the age/outcome relationship held for IVF, the GIFT by age relationship was not significant. Stimulation protocols using clomiphene citrate (CC) or gonadotrophin agonists (GnRHa) may impact negatively on older women.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗
PubMed1999

Influence of advanced age on the blastocyst development rate and pregnancy rate in assisted reproductive technology.

OBJECTIVE: To evaluate the percentage of blastocysts developing, the pregnancy rate, the implantation rate, and the abortion rate in women >40 years of age using a cell-free culture system for the development of viable human blastocysts. DESIGN: Retrospective clinical study. SETTING: Private IVF units. PATIENT(S): Two hundred ninety-three cycles in patients undergoing IVF treatment for infertility. Sixty-two cycles were in patients > or =40 years of age, and 231 cycles were in patients <40 years of age. INTERVENTION(S): Pronucleate oocytes obtained from IVF were cultured in vitro for 5-6 days. One to four embryos were transferred. MAIN OUTCOME MEASURE(S): Blastocyst development rate, pregnancy rate, implantation rate, and abortion rate. RESULT(S): From 293 cycles, 3,115 pronucleate oocytes were cultured, producing 1,175 blastocysts. In the women >40 years of age, the blastocyst development rate was 22.2%, and in the younger group, the rate was 40.5%. The pregnancy rate and implantation rate in the > or =40-year age group were 21.1% and 8.9%, respectively; corresponding rates in the younger group were 44.6% and 19.9%. The abortion rate was increased for the > or =40-year age group (25% versus 13.3%). CONCLUSION(S): Success rates for the development of viable human blastocysts, pregnancy, and implantation decline significantly in women > or =40 years old.

Abortion, Spontaneous↗
PubMedDate not supplied

Trends in rates of live births and abortions following state restrictions on public funding of abortion.

Abortion rates rose following the expanded legalization of abortion by the Supreme Court decision in Roe v. Wade. As a result, the impact of the restriction on Federal funding of abortions under the Hyde Amendment in 1977 was not clear. However, abortion rates had plateaued by 1985, when State funding of Medicaid abortions was restricted in Colorado, North Carolina, and Pennsylvania. Analysis of statewide data from the three States indicated that following restrictions on State funding of abortions, the proportion of reported pregnancies resulting in births, rather than in abortions, increased in all three States. In 1985, the first year of State restrictions on the use of public funds for abortion, Colorado, North Carolina, and Pennsylvania recorded 1.9 to 2.4 percent increases in the proportion of reported pregnancies resulting in live births, after years of declining rates. With adjustments for underreporting of abortion, there was an overall 1.2 percent rise in the proportion of pregnancies resulting in live births in those States. Nationally the proportion rose only 0.4 percent. By 1987, the three States had experienced increases above 1984 levels of 1.6 to 5.9 percent in the proportion of reported pregnancies resulting in live births. The experiences of the three States can be used in projecting an expected increase in the proportions of reported pregnancies resulting in live births, rather than in abortions, for similar States. A projection for California, for example, showed that an increase could be expected in the first year of restrictions on the use of public funds for abortion of at least 4,000 births, which could be expected largely to affect women of low income.

Abortion, Legal↗
PubMed2002

The same immunoregulatory molecules contribute to successful pregnancy and transplantation.

PROBLEM: At least two dendritic cell-associated molecules have been shown to contribute to the successful outcome of organ and tissue allografts in mice, namely CD200 and MD-1. CD200 is up-regulated in rodent transplantation models where successful inhibition of rejection is accomplished, and is believed to signal immunosuppression following engagement of a receptor, CD200R, on macrophages and/or gammadelta T-cell receptor (gammadelta TCR+ cells MD-1 is implicated in controlling expression of costimulatory molecules including CD80/CD86 which induce an immunorejection response, and thus inhibition of MD-1 expression also facilitates increased graft survival MD-1 also stabilizes expression of CD14, part of the receptor complex for LPS. As well as the inhibition of rejection which follows blockade of MD-1 expression and/or augmentation of CD200 expression, an altered polarization in cytokine production is seen, with increased expression of interleukin-4 (IL-4), IL-10 and transforming growth factor-beta (TGF-beta), and decreased IL-2, interferon-gamma (IFN-gamma) and tumor nerosis factor-alpha (TNF-alpha). Successful pregnancy in allopregnant mice also depends upon control of graft rejection mechanisms. Proinflammatory T-helper 1 (Th1) cytokines (TNF-alpha + IFN-gamma + IL-1) have been shown to cause spontaneous abortion in mice by activating a novel prothrombinase, fibrinogen-like peptide (fibroleukin) fgl2, which may promote fibrin deposition in the graft rejection process; expression of IL-10, TGF-beta, and progesterone-induced blocking factor (PIBF) in contrast leads to lowering of abortion rates. Interestingly, the spontaneous abortion rates in abortion-prone CBA x DBA/2 matings and in the low abortion rate CBA x BALB/c matings were lower than the frequency of implantation sites showing fibrin(hi) + fgl2 (mRNA)hi, implying regulation of the pro-abortion consequences of fgl2 expression. METHODS: We have investigated, by in situ hybridization, CD200, MD-1 and fgl2 expression in implantation sites in different strains of mice, and studied the effects of anti-MD-1, anti-CD200 and CD200Fc immunoadhesin on fetal and allograft survival. The role of indoleamine dioxygenase (IDO) was evaluated. RESULTS: CD200 mRNA expression occurred in the same sites as fgl2 mRNA. Anti-CD200 antibody raised the abortion rate to predicted levels, and infusion of a CD200 immunoadhesin reduced the abortion rate, as did an anti-MD-1 antibody. The latter also improved organ and tissue graft survival. Suppression by antigen-presenting macrophages triggered by CD200 is dependent upon intact IDO activity. CONCLUSION: Regulation of CD200 and MD-1 expression may control both pregnancy and allograft survival.

Animals↗
PubMedDate not supplied

Abortion in Vietnam: measurements, puzzles, and concerns.

This report summarizes current knowledge about abortion in Vietnam, drawing upon government statistics, survey data, and fieldwork undertaken by the author in Vietnam throughout 1993 and part of 1994. The official total abortion rate in Vietnam in 1992 was about 2.5 per woman, the highest in Asia and worrisome for a country with a still-high total fertility rate of 3.7 children per woman. Vietnamese provinces exhibited substantial variation in both the rate of abortion and the type of procedures performed. Among the hypotheses explored to explain Vietnam's high rate of abortion are the borrowing of family planning strategies from other poor socialist states where abortion is common; current antinatal population policies that interact with a lack of contraceptive alternatives; and a rise in pregnancies among young and unmarried women in the wake of recent free-market reforms. Because family-size preferences are still declining, abortion rates may continue to increase unless the incidence of unwanted pregnancy can be reduced, a goal that Vietnamese population specialists are seeking to achieve.

Abortion, Legal↗
PubMedDate not supplied

Incidence of spontaneous abortion following artificial insemination by donor.

This study examines the frequency of spontaneous abortions in pregnancies achieved by artificial inseminations with donor semen (AID), with special respect to the use of cryopreserved semen and ovulation induction with clomiphene citrate. The abortion rate was found to be similar in AID series using frozen semen to those using fresh semen, nor was the rate increased in composite AID series (both fresh and frozen semen) when compared with the rate of spontaneous abortions in the general population. When clomiphene was used, the abortion rate was increased only in groups of anovulatory and irregularly ovulating women. Those AID series where all women treated are given clomiphene show no increase in abortion rates. The discussion is focused on factors that influence the abortion rate and on possible etiological factors.

Abortion, Spontaneous↗