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PubMed1970

Differential reactivity of human serums with early antigens induced by Epstein-Barr virus.

Inoculation of 64-10 or Raji cultures with Epstein-Barr virus derived from the HRI-K clone of the P3J Burkitt's lymphoma line caused abortive infections in most of the lymphoblastoid cells with synthesis of "early antigens" but few, if any, capsids. Antibodies to early antigens were detected by indirect immunofluorescence in serums of many patients with infectious mononucleosis, Burkitt's lymphoma, or nasopharyngeal carcinoma. These antibodies were rarely present in other serums even though some of them showed high titers of antibodies to Epstein-Barr virus when assayed on EB3 Burkitt tumor cells; they also prevented synthesis of early antigens, provided the serums were mixed with the virus prior to inoculation. Antibodies to early antigens possibly reflect current or recent disease processes that are associated with the virus.

Antigen-Antibody Reactions↗
PubMed1997

Infection of primary cultures of human neural cells by human coronaviruses 229E and OC43.

We evaluated the ability of human coronaviruses to infect primary cultures of human neural cells. Double immunofluorescence with antibodies to virus and cell markers showed infection of fetal astrocytes and of adult microglia and astrocytes by strain OC43. RNA amplification revealed infection of fetal astrocytes, adult microglia, and a mixed culture of adult oligodendrocytes and astrocytes by strain 229E. Infectious virus was released only from fetal astrocytes, with higher titers for OC43. Human coronaviruses have the capacity to infect some cells of the central nervous system, although infection of adult cells appears abortive.

Adult↗
PubMed2000

[Maternal mortality in the maternity ward of Befelatanana. University Hospital of Antananarivo].

OBJECTIVE: A retrospective study was conducted to assess mortality rates at the Befelatanana Women's Hospital from January 1st 1988 through December 31st 1997, define trends, study causes and identify problems encountered during treatment and those related to the referral system, in order to improve prevention and patient management MATERIAL: and method. Birth and death registries, operation reports and patient charts were analyzed. All maternal deaths wether of direct or indirect obstetrical origin were considered. RESULTS: There were 997 cases of maternal death among 91, 032 births, i.e. 1.09% or 1,245 maternal deaths per 100,000 live births. Among direct obstetrical causes of death (93%), 65.8% involved infectious complications and 22.9% renal and vascular complications.Other causes were anesthesia accidents and thrombolic events. Among the direct obstetrical causes, complicated delivery was responsible for 57.4% of the deaths and 42.6% of the abortions. Indirect obstetrical causes were due to malaria (68.6%), heart disease (21.4%) and asthma (10%). DISCUSSION: This high rate of maternal death illustrates the serious situation of obstetrics in our region. Our aim is to reduce this rate by promoting the Birth Place Without Risk program and improving management conditions. Implementation of this ambitious program requires implication of political decisions makers convinced of the importance of improving women's conditions and the health care system in Madagascar.

Asthma↗
PubMed1991

Rubeola during pregnancy.

We report three cases of rubeola during pregnancy complicated by pneumonia. All had bacterial superinfection of the lungs and a clinically mild hepatitis. One woman delivered at term and two underwent successful tocolysis, one of whom had an unexplained stillbirth 7 weeks later. Rubeola virus is not a teratogen, although it has been associated with increased spontaneous abortion and perinatal mortality.

Adult↗
PubMed1976

Pathological features of the placenta in fetal death.

Few studies of the histopathological features of the placenta in cases of fetal death are available. We will describe the placental findings from 24 midtrimester spontaneous abortions and 54 stillborn infants of more than 28 weeks' gestation. In almost 100% of midtrimester abortions and in 48% of the placentas from stillborn infants of more than 28 weeks' gestation, chorioamnionitis, deciduitis, and/or villitis were present. Because of this very high percentage of lesions, which suggests an infectious causation, it is mandatory that studies be performed that might identify pathogens. One third of the stillborn infants of more than 28 weeks' gestation were associated with maternal complications (diabetes, preeclampsia, and urinary tract infection), in addition to placental fetal vasculopathy, ischemia, infarcts, and chorangiosis (villous capillary hyperplasia). We emphasize the use of the placenta for the recognition of maternal diabetes.

Female↗
PubMed2006

[Search for Neospora caninum DNA in bull semen using PCR ].

Neospora caninum represents one of the most frequent abortifaciant organisms worldwide. The parasite is diaplacentally transmitted from the pregnant cow to the fetus, where it normally leads to the delivery of a healthy, however persistently infected calf. Abortion thus is a relative rare event. The transmission of bovine neosporosis occurs in more than 90% of the cases vertically due to the endogenous reactivation of a persistently infected mother. Exogenous infections are therefore responsible for less than 10% of the cases. The question arises about which infection sources may be relevant in this context. In Switzerland, the role of dogs as definitive hosts has been shown to be of low significance in that respect. Recently, discussion focused on the potential of infectious bull semen following natural or artificial insemination. Thus, a few years ago a report documented the detectability of N. caninum-DNA in the semen of naturally infected bulls by nested-PCR. As a consequence, we decided to gain own experience by investigating 5 separate semen specimens per animal, originating from 20 N. caninum-seropositive bulls used for artificial insemination in Switzerland. All probes turned out to be negative by nested PCR. Based upon our laboratory experiences, the potential bull semen-associated Neospora-problem seems not to affect the Swiss bull population, thus there is no evidence to include further respective means of control.

Abortion, Veterinary↗
PubMed1995

Postattachment neutralization of papillomaviruses by monoclonal and polyclonal antibodies.

Postattachment neutralization of papillomaviruses (PVs) was analyzed in three PV-infectivity models: (i) the BPV-1-induced focus-forming assay using C127 cells; (ii) in vitro abortive infection of rabbit RK-13 and Sf1Ep cells with CRPV; and (iii) HPV-11-induced morphological transformation of human foreskin chips in the athymic mouse xenograft system. In each assay system, aliquots of infectious virus were added to the appropriate target cells and incubated at 37 degrees, followed at various postinfection time intervals with neutralizing monoclonal antibodies (N-MAbs) that target surface conformational epitopes. In all three model systems, the N-MAbs were able to neutralize PV infection when added as late as 8 hr after addition of infectious PV to host cells. These results imply that papillomaviruses attach to but do not penetrate inside host cells for a significant period of time and that the bound virus is thus still susceptible to neutralization by neutralizing antibodies.

Animals↗
PubMed1997

Deliveries, abortion and HIV-1 infection in Rome, 1989-1994. The Lazio AIDS Collaborative Group.

The prevalence of HIV-1 among women of reproductive age is currently estimated at the time they give birth. We assessed HIV-1 prevalence at the end of pregnancy, whether they delivered or had an induced or spontaneous abortion. Women admitted at the end of pregnancy to hospitals in the Lazio Region, Italy, were tested for antibodies to HIV-1. Consent for testing was granted by 97.1% of 218,357 subjects; women who did not consent were tested anonymously. The prevalences of infection were 0.34% in 1989, 0.38% in 1990, 0.28% in 1991, 0.23% in 1992, 0.28% in 1993, and 0.24% in 1994. Significantly higher prevalences of infection were associated with induced abortion (0.49%) than with delivery (0.18%; OR: 2.72; 95% CI: 2.29-3.22) and among women who refused (0.85%) than among those who consented to testing (0.27%; OR: 3.14; 95% CI: 2.35-4.19). A significant temporal reduction in prevalence was observed only among women who delivered (0.15% in 1993 and 1994; 0.26% in 1989 and 1990). The prevalence of HIV-1 infection is thus higher among women undergoing induced abortions than among those who deliver and higher among women who refuse testing than among those who consent. Studies confined to neonatal testing or to voluntary testing of pregnant women would thus underestimate the prevalence of HIV-1 among women of reproductive age.

AIDS Serodiagnosis↗
PubMed2001

Confirmatory serologic testing for acute toxoplasmosis and rate of induced abortions among women reported to have positive Toxoplasma immunoglobulin M antibody titers.

OBJECTIVE: Results obtained with commercial testing kits for immunoglobulin M Toxoplasma antibodies may be inaccurate or may be inaccurately interpreted, which may influence whether a woman decides to terminate the pregnancy. This study was undertaken to determine whether confirmatory testing at a reference laboratory and communication of the results and an expert interpretation to the patient's physician would affect the rate of induced abortions among pregnant women with positive results of testing for immunoglobulin M Toxoplasma antibodies in outside laboratories. STUDY DESIGN: This was a retrospective cohort study of 811 consecutive pregnant women for whom the toxoplasma serologic profile was performed at a reference laboratory. Almost all the patients had been informed by their physicians that a result of a test for immunoglobulin M Toxoplasma antibodies performed in an outside laboratory was positive. Women were separated into those with a toxoplasma serologic profile result suggestive of a recently acquired infection (group 1) and those with a result suggestive of an infection acquired in the more distant past (group 2). Physician reports of induced abortions were used to determine rates of induced abortion in groups 1 and 2. RESULTS: Of the 811 women 321 (39.6%) were considered likely to have a recent infection (group 1) and 490 (60.4%) were considered likely to have a past infection (group 2). Physicians reported pregnancy outcomes for 433 (53.4%) of 811 women (65.1% and 45.7% in groups 1 and 2, respectively). Whereas 36 of 209 women in group 1 (17.2%) terminated the pregnancy, only 1 of 224 women in group 2 (0.4%) chose abortion (P <.001). CONCLUSION: Confirmatory serologic testing in a reference laboratory and communication of the results and their correct interpretation by an expert to the patient's physician decreased the rate of unnecessary abortions by approximately 50% among women for whom positive immunoglobulin M Toxoplasma test results had been reported by outside laboratories.

Abortion, Induced↗
PubMed1985

Fever during pregnancy and spontaneous abortion.

The hypothesis that maternal fever during pregnancy is a risk factor for spontaneous abortion was tested in a case-control study by comparing the frequencies and timing of fevers of 100 F (37.78 C) or more among three groups of women: women having euploid abortions, women having aneuploid abortions, and women delivering at 28 weeks gestation or later (controls). Cases and controls were identified in three New York City hospitals between August 1979 and June 1982. It was hypothesized that if fever was an antecedent, rather than a symptom of spontaneous abortion, an association would be detected with euploid but not with aneuploid abortions. Among public patients, reported fevers were significantly more frequent among euploid abortions than among controls (18% vs. 7.1%, odds ratio = 2.96), whereas reported fevers were not more frequent among aneuploid abortions (3.9% vs. 7.1%, odds ratio = 0.52). It was also postulated that variation in the strength of the association of fever with euploid abortion with the duration of the interval between the fever and the abortion might yield insight about mechanisms underlying an association. The odds ratios for fever occurring at three intervals--in the same calendar month as a euploid abortion, one month before, and two or more months before--were 6.04, 3.28, and 1.41, respectively. The findings for private patients--for whom a control group was not recruited--are compatible with those for public patients although not statistically significant: the odds of fever with euploid abortion were 2.18 times those with aneuploid abortion.

Abortion, Spontaneous↗
PubMed2000

Pregnancies before and after HIV diagnosis in a european cohort of HIV-infected women. European Study on the Natural History of HIV Infection in Women.

OBJECTIVES: Because most HIV-infected women are of reproductive age, we investigated whether their reproduction planning was affected by their HIV diagnosis. DESIGN: The European women study is a prospective, multicentre cohort of 485 HIV-infected women with a known interval of seroconversion. METHODS: The incidence of pregnancy was measured with person-time methods. Generalized estimating equation analysis was used to determine risk factors for pregnancy and pregnancy outcomes. RESULTS: In 449 women, the age-adjusted incidence of pregnancies decreased from 8.6 before HIV diagnosis to 8.2 and 6.0 per 100 person-years in 0-4 and over 4 years after HIV diagnosis, respectively (P = 0.14). The proportion of induced abortions increased from 42% before to 53% after HIV diagnosis (P < 0.05). The risk of spontaneous abortion did not increase as a result of HIV infection. Since 1995, the proportion of births increased (P = 0.009), whereas that of induced abortions decreased (P = 0.01) compared with earlier years. An increased risk of pregnancy after HIV diagnosis was found in northern and central European women compared with southern European women; there was a lower risk in single women than in women with a steady partner. Of all pregnant women, single women, women between 15 and 25 years of age, and women with multiple partners were at increased risk for induced abortion both before and after HIV diagnosis. CONCLUSION: The incidence of pregnancy decreased with HIV disease progression. Pregnancies after HIV diagnosis appear to be related largely to social and cultural attitudes. The number of induced abortions was high before HIV diagnosis and it significantly increases thereafter.

Abortion, Induced↗
PubMed2004

A fatal case of Clostridium sordellii septic shock syndrome associated with medical abortion.

BACKGROUND: Clostridia bacteria are infrequent human pathogens. In the obstetric and gynecologic literature, Clostridium sordellii infections have been very rarely reported. This is a case of infection following medical termination of early pregnancy with mifepristone and misoprostol. CASE: A 27-year-old woman presented for termination of pregnancy at 5.5 weeks from her last menstrual period. She received mifepristone 200 mg orally followed by 800 microg vaginal misoprostol. Three days after administration of misoprostol, she complained of dizziness, pelvic pain, and bleeding. The next day, she experienced worsening of symptoms and was hospitalized. She developed pulmonary edema, ascites, and heart failure. Despite supportive measures, antibiotics, and hysterectomy, she died 3 days later. The post mortem examinations indicated that death was caused by shock secondary to C sordellii infection. CONCLUSION: The frequency of infection following medical abortion is low. The rapid and fatal course of this infection is similar to other obstetric and gynecologic cases reported in the literature. Although providers should remain vigilant to the possibility of infection following medical abortion, the overall proven safety of medical abortion remains the same.

Abortion, Therapeutic↗
PubMed2005

An unusual cause of sepsis during pregnancy: recognizing infection with chlamydophila abortus.

BACKGROUND: Chlamydophila abortus (formerly Chlamydia psittaci serovar 1) is a rare but severe cause of gestational septicemia, with particular problems in diagnosis and clinical management. CASE: A 32-year-old woman in her fourth pregnancy (16th week of gestation) presented with progressive septicemia after extensive contact with abortive material from her goat flock. Treatment with levofloxacin could not prevent abortion. Multiorgan failure requiring catecholamines and artificial ventilation developed in the patient. After the agent was identified by polymerase chain reaction from acute-phase serum, macrolides were administered and yielded clinical improvement. The patient fully recovered. There were no sequelae in the subsequent 6 months. CONCLUSION: Cp abortus must be considered in gestational septicemia after contact with ruminants. Polymerase chain reaction from acute-phase serum is a quick and easy way to establish the diagnosis. Macrolide antibiotics are still the treatment of choice.

Abortion, Spontaneous↗
PubMed1998

The impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia.

OBJECTIVES: To describe the impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia, and to identify factors associated with a re-emerging problem. DESIGN AND METHODS: A population-based descriptive study using data from South Australian notifications of disease, births and terminations of pregnancy, the rubella immunisation programme, antenatal rubella antibody screening and paediatric hospital case records. SETTING: South Australia (population 1.48 million people; 20,000 births per year). MAIN OUTCOME MEASURES: Incidence of rubella (age-sex specific), congenital rubella syndrome and rubella-related terminations of pregnancy; antenatal rubella sero-positive rates; rubella immunisation uptake rates. RESULTS: Rubella notification rates in 1990-1996 were significantly higher for males than females for ages 15-34 years. There were five cases of congenital rubella syndrome notified in 1980-1996 compared with at least 20 confirmed or compatible cases in 1965-1979. Rubella-related terminations of pregnancy are now rare, with the last termination for maternal rubella being in 1993. The antenatal rubella sero-positive rate in 1995 was 96.7%, but was significantly lower among Asian women born overseas (78.6% among those 30 years or older). Vaccination uptake rates in schoolgirls decreased between 1990 and 1994 (91.2% to 86.9%). CONCLUSIONS: Since the introduction of rubella immunisation, the incidence of rubella infection among women of reproductive age, and of rubella-related terminations, has fallen. Congenital rubella syndrome has not been notified since 1990 but its risk persists with a recent increase in rubella notifications, a fall in school immunisation rates, a relatively low antenatal sero-positive rate among older Asian women born overseas and the trend towards giving birth at older ages. Effective immunisation programmes must be maintained, particularly in schools and for young children and migrant women.

Abortion, Induced↗