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PubMed1999

HIV testing and prevention issues for women attending termination assessment clinics.

The prevalence of HIV infection in London is nearly threefold in women who seek terminations compared to women who carry to term. Despite the higher prevalence, HIV testing is not systematically offered to women attending termination of pregnancy assessment clinics (TOPCs). The Department of Health has given clear guidance on HIV testing in antenatal clinics and most London antenatal clinics have implemented policies on HIV testing. No similar guidance exists for TOP clinics. This paper describes the results from a study examining HIV testing and prevention issues for women attending five TOPCs in North London. Data on risk disclosure, HIV testing intentions and awareness of HIV infection and testing were analysed for 141 women who completed a self-administered questionnaire. Women who expressed an intention to have an HIV test were more likely to be from ethnic minority origin, to report that their partner intends to have an HIV test and to perceive it as easier to talk to their partner about HIV testing, compared to women who did not report an intention to test for HIV The former group also were more likely to have had a previous HIV test and perceived their personal control for staying HIV negative as greater compared to others. Fifty six (39.8 per cent) women disclosed one or more potential risk factors for HIV Women with risks were more knowledgeable about HIV infection, perceived their personal chances of being HIV positive as greater and experienced greater worry about past risks, compared to women who disclosed no risks. However, women who disclosed risk factors were no more likely to intend to have an HIV test. Knowledge on HIV infection, testing and potential interventions to reduce mother-to-baby transmission was low, with fewer than one in four women being aware that transmission may be reduced by AZT, Caesarean section and bottle feeding. Given the findings about the level of risk disclosed and women's positive attitude towards information on HIV infection and testing, this client group should no longer be overlooked in the planning of future policies on HIV testing for populations at risk.

AIDS Serodiagnosis↗
PubMed1999

Outbreak of abortion associated with Neospora caninum infection in a beef herd.

Abortion outbreaks caused by infection with Neospora caninum in beef cattle have not been well documented. Neospora caninum infection was confirmed in 4 fetuses that were aborted by cattle in a 350-head beef herd; an additional 58 cattle aborted during the next 2.5 months. Overall, 44.4% (157/354) of the cattle in the herd did not become pregnant or experienced fetal loss during this period. Initially, 81.3% (282/347) of the herd was seropositive for antibodies to N caninum, and seropositive cows were 6.2 times as likely to not be pregnant as were seronegative cows. Other potential causes of abortion were not identified in this herd. Following the outbreak, few cattle in the herd or in a second exposed herd seroconverted, but high antibody titers persisted in most seropositive cattle through the end of the calving season. Evidence of cow-to-fetus transmission of the organism was detected in > 82% of seropositive cows.

Abortion, Veterinary↗
PubMed1976

Postabortal and postpartum tetanus. A review of 19 cases.

The occurrence of postabortal and postpartum tetanus over a 7 1/2-year period at Groote Schuur Hospital, Cape Town, is reviewed. Of all the women between the ages of 15 years and 50 years who were admitted with tetanus, 34,7% were admitted after abortions. The mortality rate was 15,8%, which appears to be the lowest thus far reported. Possible methods of preventing postabortal tetanus are discussed.

Abortion, Incomplete↗
PubMed1992

[Preventive antibiotics in induced first-trimester abortion].

The frequency of infection following induced first-trimester abortion is 3-5%. Duration of hospitalization is often five days, and the total costs per abortion were 5,400 Dkr (approximately pounds 500) in Denmark in 1979. Sequelae of postabortal infection are similar to and occur with the same frequency as sequelae to "spontaneous" pelvic inflammatory disease. Thus, secondary infertility was found in 10% of women with postabortal infection, spontaneous abortion in 22%, dyspareunia in 20%, and chronic pelvic pain in 14%. The risk of ectopic pregnancy is probably also increased. Surgical scrub cannot sterilize the endocervix and, as a consequence, abortion is performed in a contaminated field. The presence of pathogenic bacteria, i.e. Chlamydia trachomatis, therefore increases the risk of postoperative infection. The organism is found in approximately 7% of those applying for abortion and the risk of sustaining infection is 20%. Other risk factors are previous pelvic inflammatory disease, vaginal infection, first pregnancy and young age. Prophylactic antibiotics halve the incidence of infection, but by applying prophylaxis to risk groups only, the amount of prescriptions can be reduced. Prophylaxis need only be administered peroperatively, and tetracyclines, metronidazol, and penicillin/pivampicillin have been found to be effective. Women applying for abortion should be examined for C. trachomatis and positive cases treated no later than at the time of the abortion.

Abortion, Induced↗
PubMed2003

Severe acute maternal morbidity and maternal death audit--a rapid diagnostic tool for evaluating maternal care.

OBJECTIVE: To analyse severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria region over a 2-year period (2000-2001). SETTING: Public hospitals in the Pretoria region, South Africa, serving a mainly indigent urban population. METHODS: A descriptive study was performed whereby women with SAMM and maternal deaths were identified at daily audit meetings and an audit form was completed for all cases fulfilling the definition of SAMM ('near miss') and for all maternal deaths. RESULTS: The number of maternal deaths declined slightly but not significantly from 18 deaths in 2000 to 16 in 2001. This represents a change in the maternal mortality ratio (MMR) from 130/100,000 live births in 2000 to a MMR of 100/100,000 live births in 2001. However, when data for women with SAMM and maternal deaths were combined, there was a significant increase in major maternal morbidity from 90 cases (SAMM and maternal death rate 649/100,000 live births) in 2000 to 142 cases (SAMM and maternal death rate 889/100,000 live births) in 2001 (p = 0.006). This increase was due to a significant increase in severe maternal morbidity related to abortions and obstetric haemorrhages. CONCLUSION: Analysis of maternal deaths only in the Pretoria region failed to identify abortions and haemorrhages as major maternal care problems. When data for women with SAMM were combined with data for maternal deaths, however, these problems were clearly identified, and remedial action could be taken. Including SAMM in maternal death audits increases the rapidity with which health system problems can be identified.

Abortion, Induced↗
PubMed2006

[Case report: equine arteritis virus (EAV) as the cause of abortion in alpacas?].

Here we report a case of a late abortion of a primiparous alpaca where genome fragments of the equine viral arteritis virus (EAV) could be detected in fetal tissues using reverse transcription polymerase chain reaction (RT-PCR). All five alpacas of the herd had virus neutralizing antibodies against EAV. EAV thus must be regarded as a potential agent for abortions in alpacas. Possible routes of introduction of the virus are discussed.

Abortion, Veterinary↗
PubMed2006

Evaluation of the efficacy of a modified-live combination vaccine against abortion caused by virulent bovine herpesvirus type 1 in a one-year duration-of-immunity study.

This study demonstrated that a multivalent vaccine containing modified-live bovine herpesvirus type 1 (BHV-1) protected pregnant heifers and their fetuses against virulent BHV-1 challenge exposure at 365 days after vaccination. The percentage of abortions or fetal deaths caused by BHV-1 was significantly higher in control heifers (10 of 10 [100.0%]) than BHV-1-vaccinated heifers (three of 19 [15.8%]).

Abortion, Veterinary↗
PubMed1992

Thymic abnormalities in fetuses aborted from human immunodeficiency virus type 1 seropositive women.

Pathological abnormalities of the thymus were found in 3 of 37 fetuses aborted from human immunodeficiency virus (HIV)-infected mothers. These lesions were located predominantly in the thymic cortex, which contains mostly immature lymphocytes. Areas of focal lymphocyte depletion were infiltrated with CD4+ macrophages and were associated with abnormalities of the epithelial stromal network. No evidence of extensive HIV infection in any of the 37 thymuses was detected by either immunofluorescence or in situ hybridization techniques, although rare cells that expressed HIV antigens were found in 3 fetuses. Although less extensive, this thymic fetopathy was similar to that described in postnatal acquired immunodeficiency syndrome thymuses, strongly suggesting that the lesions were related to HIV infection. Thymic fetopathy might represent the initial injury to the lymphoid system in HIV-infected infants in whom early and severe immunosuppression develops.

Abortion, Induced↗
PubMed1990

Reproductive and neonatal losses associated with possible encephalomyocarditis virus infection in pigs.

A possible infection with encephalomyocarditis virus was investigated on two Minnesota pig farms which experienced an increase in stillborn and mummified fetuses, high pre-weaning mortality and reduced farrowing rates. The monthly averages for the numbers of piglets born dead per litter on farms A and B reached 4-6 and 3-6, the pre-weaning mortalities 50 per cent and 31 per cent, and the farrowing rates 52 per cent and 63 per cent, respectively. Serological and histopathological examinations supported a diagnosis of infection with encephalomyocarditis virus, but attempts to isolate the virus failed. Specific antibody to the virus was detected in both fetal and neonatal sera collected from abnormal litters. The predominant histopathological finding was myocarditis consisting of focal or diffuse mononuclear cell infiltration. The detection of specific antibody, and the myocardial lesions in stillborn fetuses, suggested that the problems were associated with infection by encephalomyocarditis virus.

Abortion, Veterinary↗
PubMed1990

[Appendicitis in pregnancy].

The incidence, symptoms, clinical and paraclinical findings, and complications of appendicitis during pregnancy is reviewed. The symptoms and signs do not differ from those in non-pregnant women with the disease. Uterine contractions may occur. The pregnancy ought not to divert the clinicians attention from the disease which is complicated by a considerable foetal mortality, premature labour and abortion. These complications are especially connected with perforated appendicitis. The perforation frequency is related to the delay prior to operation. Immediate appendectomy is recommended as soon as the disease is suspected, making use of prophylactic tocolytic therapy. Antibiotics should be administered according to the usual recommendations. Abdominal delivery should be reserved for obstetric indications only.

Abortion, Spontaneous↗
PubMed1989

Latent listeriosis may cause habitual abortion intrauterine deaths, fetal malformations. When diagnosed and treated adequately normal children will be born.

We endeavoured to prove latent listeriosis (LL), a chronic and asymptomatic infection, in women who suffered from repeated accidents in their pregnancies. By the reduction of immune defences in the pregnant woman, the latent infection may break out again, affecting thus the fetus and causing abortion, stillbirths or malformations. In such women the diagnosis of LL is urgent right from the start of pregnancy, and so is the antilisteria treatment to protect the fetus. Antilisteric antibodies are readily detected by indirect immunofluorescence (IIF), using live antigen or antigen not inactivated by high temperatures of inadequate conservation, as is frequent in currently used agglutination test reactives. Out of the 309 women, 207 had a total of 334 abortions, 67 prematures, 75 stillbirths, 43 malformed living or dead offsprings. High positivity of IIF was the only aetiologic date to explain these accidents. Treatment of new pregnancies of a part of these IIF-positive women led to birth of 152 normal children, negative by IIF for listeriosis. The search for LL at the onset of any pregnancy, same as done in various infections (lues, toxoplasmosis, etc.) is therefore warmly recommended.

Abortion, Habitual↗