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PubMed2003

Factors associated with an optimal pregnancy outcome in an oocyte donation program.

PURPOSE: To identify donor and recipient variables that may have a significant impact on pregnancy outcome in order to optimize results of an oocyte donation program. METHOD: Retrospective analysis through a Generalized Estimating Equation (GEE) approach to clustered and binary clustered data, linear mixed effects model, scatter plot smoothing functions, and receiving operator characteristics (ROC) curves. SETTING: University-based center. INTERVENTION(S): None. MAIN OUTCOME MEASURES: Pregnancy and implantation rates. PATIENTS: 257 donation and transfer cycles. RESULT(S): Overall results were as follows: clinical pregnancy rate, 47%; implantation rate, 22%; abortion rate, 19%; and overall multiple pregnancy rate, 35%. The total reproductive potential was 60%. Implantation and pregnancy rates were not significantly related to any variable from donors or recipients. Abortion rate increased significantly with donors' increased basal serum LH. Pregnancy rate was significantly enhanced with improved embryo quality. In donors stimulated more than once, the pregnancy rate was 84%. CONCLUSION(S): Although no single or combined donor or recipient variable(s) could be identified as predictor(s) of pregnancy, the data suggest that donors < or = 33 years of age with basal cycle day 3 serum levels of FSH 4-8 IU/L, LH < 8 IU/L, and E2 < 70 pg/mL had an optimal outcome. Transfer of two selected embryos on day 3 yields a favorable pregnancy outcome while significantly decreasing the occurrence of multiple pregnancies. These policies, in addition to embryo cryopreservation, were associated with optimal pregnancy outcome in oocyte donation.

Adult↗
PubMed2000

[Development of reproductive health in women in the Czech Republic 1993-1997. III. Induced abortion].

OBJECTIVE: To analyze the effect of changes in system of health and social care on reproductive health of women. In particular to analyze the changes in frequency of induced abortions as a basis for evaluation of changes in contraceptive use. DESIGN: Retrospective comparative epidemiological study. SETTING: Institute for the Care of Mother and Child, Praha 4--Podolí. METHODS: The database of the Czech Office of Health Statistics and Information was used. Besides comparison of absolute numbers of induced abortions we used international criteria "Abortion rate" and "Abortion ratio". These parameters were compared with maternal age, marital status, level of education, and number of children. RESULTS: Since the legislature on induced abortions came into effect till 1991 the annual variations of the number of induced abortions in the Czech Republic were inverse to changes in number of births due to current fertility. However, since then the number of abortions has been decreasing while the number of births was also decreasing. Using the abortion ratio as a measure, we were able to observe the decrease from 34.3 to 29.1% during 1993-1997, however the later value is still higher than in developed world. According to the selected social-demographic parameters of women we have seen the highest decrease of absolute number of abortions among married women, women with two children, and women with secondary education. According to the number of abortions per 1000 women of reproductive age there has also been decrease among married women, however also among women 15-19 year and among women with university education. The smallest decrease of abortion rate has been observed among single women. CONCLUSIONS: In this part of the study we analyzed the decrease of induced abortions during 1993-1997 related to four selected social-demographic characteristics of women of reproductive age. Our results will be used for further analyses of relationship of contraception and induced abortions during the specified period. Such analysis is a subject of separate study.

Abortion, Induced↗
PubMed2002

[Births and abortions among Amsterdam teenagers according to ethnicity, 1996-1998].

OBJECTIVE: To determine the number of teenage births and abortions in Amsterdam, the Netherlands, in total and according to age and ethnic origin. DESIGN: Retrospective analysis of routinely collected data. METHOD: Based on data collected from the municipal population register and the abortion clinics in Amsterdam, birth rates, abortion rates and abortion ratios were calculated for the period 1996-1998. The birth rate was the number of live births and the abortion rate the number of abortions per 1000 teenage girls. The abortion ratio was the number of abortions per 100 pregnancies. RESULTS: The average birth rate and abortion rate for the period 1996-1998 were 3.2 and 7.6 for 14- to 16-year-old girls respectively, and 25.0 and 29.5 for 17- to 19-year-old girls respectively. Among 14- to 16-year-old girls 70 pregnancies out of 100 ended in an abortion and among 17- to 19-year-old girls 54 pregnancies out of 100. In both age groups the birth rate for Surinamese, Antillian, Moroccan, Turkish and Ghanian girls was higher than for Dutch girls. There was one exception: Moroccan girls aged 14-16 years did not have a higher birth rate than Dutch girls of the same age. Surinamese, Antillian and Ghanian girls aged 14-16 years and 17-19 years also had a higher abortion rate compared with Dutch girls of the same age. The Turkish and Moroccan girls did not have (much) higher abortion rates. In both age groups the abortion ratio was lowest for Turkish teenagers and highest for Ghanian teenagers. The figures for second-generation immigrant teenagers were more akin to those of the native Dutch girls than those of first-generation immigrants. CONCLUSION: In Amsterdam unwanted pregnancies were most frequent in Surinamese, Antillian and Ghanian teenage girls. To prevent these pregnancies further research into the (cultural) determinants of sexual behaviour is necessary.

Abortion, Induced↗
PubMed2003

Day 2 vs. day 3 embryo transfer after intracytoplasmic sperm injection. A prospective, randomized study.

OBJECTIVE: To compare, in a prospective, randomized study, implantation and pregnancy rates between day 2 and day 3 embryo transfer intracytoplasmic sperm injection (ICSI). STUDY DESIGN: A total of 106 patients undergoing ICSI cycles who had at least 1 embryo suitable for cryopreservation were prospectively randomized into 2 groups: group I, embryo transfer performed on day 2; group II, embryo transfer performed on day 3. RESULTS: Patient ages did not differ (P = .58) between groups I (33.1 +/- 4.5) and II (32.7 +/- 4.4). The number of oocytes retrieved from group I (13.7 +/- 5.2) was similar (P = .82) to that retrieved from group II (13.7 +/- 5.4). In addition, there was no difference (P = .30) in the number of oocytes retrieved at metaphase II between groups I (10.6 +/- 4.4) and II (9.7 +/- 4.2). Fertilization and cleavage rates were also similar (P = .58 and P = .50, respectively) between groups I (78.2 +/- 14.0% and 98.7 +/- 4.3%) and II (76.2 +/- 14.8% and 99.8 +/- 1.24%, respectively). The total number of embryos and of embryos transferred were similar (P = .22 and P = .36; respectively) for groups I (8.0 +/- 3.0, 2.8 +/- 0.7) and II (7.16 +/- 3.2, 2.6 +/- 0.8). Pregnancy rates per transfer, implantation rates and abortion rates were also similar for groups I (43.4%, 20.8% and 8.7%, respectively) and II (41.5%, 24.1% and 23%, respectively) (P = 1.0, P = .57 and P = .24, respectively). CONCLUSION: The results suggest that extending the embryo culture period from 2 to 3 days for patients who had at least 1 embryo left for cryopreservation had no effect on implantation, pregnancy or abortion rates in an ICSI program.

Adult↗
PubMed2002

Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm obtained from patients with obstructive and nonobstructive azoospermia.

PURPOSE: We assessed fertilization, pregnancy and miscarriage rates in patients with obstructive and nonobstructive azoospermia who underwent intracytoplasmic sperm injection. MATERIALS AND METHODS: From June 1996 to March 2000, 166 consecutive patients (198 intracytoplasmic sperm injection cycles) with azoospermia were studied. Of these 198 cycles 68 were performed due to nonobstructive azoospermia using testicular spermatozoa and 130 were performed due to obstructive azoospermia using epididymal spermatozoa. RESULTS: The normal (2 pronuclei) and abnormal (1 plus 3 pronuclei) fertilization rates for obstructive and nonobstructive azoospermia were 60.5% and 16.6%, and 54% and 16.4%, respectively (p >0.05). The pregnancy rate per cycle, pregnancy rate per patient and abortion rate were 30%, 39.8% and 28% for obstructive azoospermia, and 22%, 28.3% and 40% for nonobstructive azoospermia (p <0.05). The normal and abnormal fertilization rates were 58.7% and 21.4% for percutaneous epididymal sperm aspiration (PESA), 62.3% and 10.4% for PESA plus testicular sperm aspiration (TESA), and 57.3% and 14.5% for TESA, respectively (p >0.05). The pregnancy rate per cycle, pregnancy rate per patient and abortion rate were 34.6%, 54.5% and 11.1% for PESA, 37.5%, 37.5% and 33.3% for PESA plus TESA, and 26.1%, 31% and 41% for TESA, respectively (PESA versus PESA plus TESA p >0.05, and PESA and PESA plus TESA versus TESA p <0.05). Epididymal or testicular motile sperm resulted in a lower abortion rate than epididymal or testicular immotile sperm (p = 0.03). CONCLUSIONS: No differences were noted in the fertilization and embryo transfer rates irrespective of etiology (obstructive versus nonobstructive) and type of spermatozoa (epididymal versus testicular). Testicular sperm retrieval results in lower fertilization and pregnancy rates as well as higher abortion rates than epididymal sperm retrieval.

Adult↗
PubMed1982

Inflammatory bowel disease and pregnancy.

Inflammatory bowel disease (IBD) commonly affects women of childbearing age, leading to concerns about the effects of the disease on fertility and pregnancy, the effect of pregnancy on the disease, and the diagnosis and treatment of IBD in the pregnancy women. The literature regarding these issues is reviewed, and a representative case report is discussed. Ulcerative colitis has no effect on fertility. Crohn's disease appears to be associated with an increased risk of infertility. "Subfertility," a temporary inability to conceive associated with chronic disease activity, is perhaps a more suitable description. There have been no studies regarding infertility and males with IBD, although sulfasalazine has recently been reported to cause reversible infertility in men. Ulcerative colitis is not associated with a higher spontaneous abortion rate than the general population, although it is not clear whether certain subgroups of patients have a higher rate of abortion. A similar conclusion has been reached for Crohn's disease, although reported abortion rates of 10-25% are somewhat higher than the general population. Approximately 30-50% of pregnant women with ulcerative colitis have exacerbations during their pregnancy or postpartum, a figure that is applicable to Crohn's disease as well, and which is no different than a control population of nonpregnant women with IBD. Patients with active ulcerative colitis at conception have a higher incidence of disease exacerbation than those with quiescent disease. Postpartum recurrences are more frequent in Crohn's disease, occurring in up to 40% of patients, but respond to standard medical therapy. Women who have had an ileostomy for ulcerative colitis consistently and successfully carry pregnancy to term. There is no data regarding women who have had an ileostomy for Crohn's disease. The approach to the women with abdominal pain during pregnancy is reviewed, including the use of radiographic procedures. No amount of radiation exposure can be considered safe, but the judicious use of standard radiographic tests when considered necessary for the health of the mother appear to be associated with little risk for the fetus. The medial treatment of IBD during pregnancy is the same as that for the nonpregnant patient. Despite animal data to the contrary, the bulk of human data suggests that steroids, when used to treat a variety of conditions including IBD, pose little risk to the human fetus. Similarly, despite the theoretical risk of kernicterus, sulfasalazine appears to be a safe drug even when used during the third trimester of pregnancy.U

Abortion, Spontaneous↗
PubMed2001

Seroprevalence study of bovine neosporosis in Mexico.

An indirect enzyme-linked immunosorbent assay was used to obtain epidemiologic information on bovine neosporosis in dairy herds of the Mexican central plateau. Sera were collected from 1,003 cows from 50 dairy herds. Forty-three herds (group A) had been experiencing a high abortion rate. The abortion rates for the remaining 7 herds (group B) were within normal limits for Mexico. Five-hundred sixty-one (56%) of the 1,003 sera were positive. The seroprevalence of Neospora caninum antibodies was 72% (95% CI = 68-75%) in group A and 36% (95% CI = 31-40%) in group B. These results clearly show that infection with N. caninum is widespread in Mexican dairy herds, as indicated by seropositive cows in group A and group B herds at the time of the sample collection.

Animal Husbandry↗
PubMed1983

Spontaneous abortion and induced abortion: an adjustment for the presence of induced abortion when estimating the rate of spontaneous abortion from cross-sectional studies.

The existence of high rates of induced abortion in the population may distort currently employed measures of the rate of spontaneous abortion. Since the frequency of induced abortion varies greatly between and within populations, an appropriate correction is needed to restore the comparability of spontaneous abortion rates. A simplified estimate of the "true" rate of spontaneous abortion is proposed. This statistic yields a sufficient approximation for most purposes.

Abortion, Induced↗
PubMed1994

Fertilization efficiency of morphologically abnormal spermatozoa in assisted reproduction is further impaired by antisperm antibodies on the male partner's sperm.

OBJECTIVE: To investigate the influence of antisperm antibodies on the sperm surface on the outcome of IVF and GIFT. DESIGN: Matched controlled retrospective review of two large series. SETTING: Reproductive endocrine divisions of two level-three academic centers. PATIENTS: Twenty-nine male factor patients (38 IVF cycles) showing positive antisperm antibodies on the sperm by immunobead test treated by IVF at the Norfolk program and 56 similar patients (57 cycles) treated by GIFT at the Tygerberg program. Twenty-nine male factor patients (29 IVF cycles) with negative antisperm antibodies screening matched by wife's stimulation protocol and baseline semen analysis characteristics were used as controls in Norfolk; 56 GIFT patients (56 GIFT cycles) matched similarly were the Tygerberg controls. Study and control groups were divided according to sperm morphology pattern in normal, good, and poor prognosis subgroups for comparison. MAIN OUTCOME MEASURES: Fertilization rate of preovulatory oocytes used in IVF in Norfolk and of GIFT supernumerary preovulatory oocytes in Tygerberg; total and term pregnancy rates (PRs) and abortion rates. RESULTS: Fertilization rate was significantly lower in the IVF (41.9% +/- 2.8%) as well as in the GIFT (26.8% +/- 3.8%) (mean +/- SE) study groups than in the respective control groups (73.1% +/- 3.9% and 61.8% +/- 3.9%). Total and term PRs in IVF per cycle (21.1% +/- 6.6%; 13.2% +/- 5.5%) and per transfer (23.5% +/- 7.4%; 14.7% +/- 6.1%), and in GIFT (25.0% +/- 5.8%; 19.6% +/- 5.3%) in the study groups were also lower when compared with their control counterparts (IVF per cycle: 62.1% +/- 6.2% and 41.4% +/- 6.0%; IVF per transfer: 41.9% +/- 2.0% and 27.9% +/- 1.9%; GIFT: 31.6% +/- 6.2% and 28.1% +/- 6.0%), but the difference did not reach statistical significance. Abortion rates were similar in the IVF study group (37.5% +/- 17.1%) and its control groups (39.9% +/- 11.5%). The abortion rate in the GIFT study group was 14.3% +/- 9.4%, and no abortions were recorded in the control group (not significant). CONCLUSIONS: The presence of antisperm antibodies on the sperm surface per se impairs the outcome of assisted reproduction, mainly in terms of fertilization rate of preovulatory oocytes, and possibly in terms of total and term PRs. This holds true regardless of the impact of other semen parameters, particularly the morphology of the sperm within the semen sample.

Abortion, Spontaneous↗
PubMed1996

Low-dose gonadotrophin stimulation for luteal phase defects--does absence of LH help pregnancy rates?

Based on data suggesting that higher serum LH levels during the follicular phase may decrease subsequent pregnancy rates and increase spontaneous abortion rates, the study presented herein was designed to compare the pregnancy and abortion rates in patients treated with gonadotrophin preparations with and without LH content. Infertile patients with luteal phase defects related to releasing eggs prior to complete follicular maturation were randomized into two treatment arcs: ultra-low-dose (75IU) human menopausal gonadotrophin (hMG) versus pure FSH. However, they were given the right to refuse the recommended treatment and use the other one if they preferred. Pregnancy and spontaneous abortion rates were determined for first cycle of therapy. The pregnancy rates for hMG versus pure FSH was 22.7 percent and 20.3 percent, respectively. The spontaneous abortion rates were also similar (8 percent and 9.1 percent). There were no multiple births resulting from these 36 pregnancies. Ovarian hyperstimulation syndrome was not observed in any of the 164 stimulation cycles. These data demonstrate that the use of an ultra-low-dose gonadotrophin stimulation regimen is an effective method of correcting infertility related to luteal phase defects related to follicular maturation defects since the overall pregnancy rate per first cycle of treatment was 22 percent despite a minimum of 10 months of infertility duration. Furthermore, an ultra-low-dose gonadotrophin regimen is safe for treating luteal phase defects in that there was no ovarian hyperstimulation or multiple births demonstrated. These results also show no advantage of choosing a preparation devoid of LH, thus giving the patient the opportunity to purchase the least expensive medication that is available.

Abortion, Spontaneous↗
PubMed1996

Expectant Treatment of Mild Endometriosis Selectively Favors Survival of Female Fetuses

In this prospective cohort study, 30 women diagnosed at laparoscopy with mild endometriosis were treated expectantly and followed for 10 years. Eleven women had primary infertility and 19 secondary infertility. Before the diagnosis of endometriosis, 19 women had a total of 32 pregnancies: the female live birth rate was 25%, male live birth rate 28%, spontaneous abortion rate 44%, and ectopic pregnancy rate 3%. After expectant treatment of mild endometriosis, 25 women had a total of 51 pregnancies: the female live birth rate was 52.9%, male live birth rate 27.4%, spontaneous abortion rate 19.6%, and ectopic pregnancy rate zero. Expectant treatment of mild endometriosis in 30 infertile women resulted in 41 live-born infants: 66% females and 34% males. We conclude that expectant treatment of mild endometriosis selectively favors the survival of female infants.

Journal Article↗
PubMed2004

[Comparative analysis of two methods of transvaginal multifetal pregnancy reduction].

OBJECTIVE: To make a comparatively analysis of the effects of 10% KCl injection into the fatal cardiac area and yolk-sac aspiration on multifetal pregnancy reduction. METHODS: Twenty-three patients with multifetus were selected in the investigation. Eight of the patients accepted 10% KCl injection into the fatal cardiac area, and 15 of them received yolk-sac aspiration. The average number of punctures, average time of reduction operation, failure rate of operation, abortion rate, and infection rate were observed. RESULTS: The average time of reduction operation[(2.8 +/- 0.7) min] of aspiration was significantly lower than that of 10% KCl injection [(5.11 +/- 1.35) min] (P < 0.05). The infection rate of yolk-sac aspiration was 6.7%, lower than that of 10% KCl injection (37.5%) (P > 0.05). Cardic area injection showed a higher infection rate, and no significant difference was observed in the average number of punctures, failure rate of operation and abortion rate(P > 0.05). CONCLUSION: Although both yolk-sac aspiration and cardiac area injection were safe and reliable methods for multifetal pregnancy reduction, the former is worth recommending for its shorter operation time heeded and lower infection rate, especially for the multifetal patients within 60 gestation days.

Adult↗
PubMed2006

Effectiveness of 400 or 600 micrograms of vaginal misoprostol for terminations of early pregnancies.

OBJECTIVES: To compare the effectiveness and side effects of transvaginal application of 400 or 600 ug of misoprostol for termination of pregnancy. STUDY DESIGN: A prospective randomized single-blinded trial. SETTING: Department of Obstetrics & Gynecology, Bhumibol Adulyadej Hospital. MATERIAL AND METHOD: One-hundred-and-twenty-five pregnant women with less than 20 weeks gestational, at Bhumibol Adulyadej Hospital from June 1, 2003 to May 31, 2004 were recruited. The termination of pregnancy had been suggested by the obstetrician and the decision was made by the patient and her husband. The samples were randomized into 2 groups. Group 1 had 65 patients and 400 ug of misoprostol was applied three times in a 6 hour interval. Group 2 had 60 patients and 600 ug of misoprostol was applied in the same manner. Both groups were observed and evaluated within 24 hours. MAIN OUTCOME MEASURES: Rate of complete abortion and side effects of both 400 and 600 microg misoprostol within 24 hours. RESULTS: No statistical significant difference was found in the general characteristics of both sample groups. Group 1 had an abortion rate of 38.3% while group 2 had an abortion rate of 56.92%. This was statistically significant (p < 0.05). The time interval after insertion to complete abortion was 9.15 +/- 6.09 hours in group 1 and 8.85 +/- 4.68 hours in group 2. Side effects, such as fever, lower abdominal pain, massive vaginal bleeding and diarrhea showed no statistical difference (p > 0.05). CONCLUSION: Transvaginal application of 600 ug misoprostol (3 times every 6 hours) caused a higher rate of complete abortion compared with an application of 400 ug misoprostol. The side effect of both groups showed no statistical difference.

Abortifacient Agents, Nonsteroidal↗
PubMed2006

Comparison of assisted reproductive technology utilization and outcomes between Caucasian and African American patients in an equal-access-to-care setting.

OBJECTIVE: Racial disparity in assisted reproductive technology (ART) outcomes has been reported but remains controversial. Reasons for the disparity are unclear, and access to care has been suggested as a causative factor. In this study, we sought to examine minority utilization of ART in the Department of Defense (DoD) compared with minority utilization in the U.S. ART population. Outcomes from ART were compared between Caucasian (Cau) and African American (AA) patients, and etiologies of disparity were examined. DESIGN: Retrospective cohort study. SETTING: University-based ART program. PATIENT(S): A total of 1,457 patients undergoing first-cycle fresh, nondonor ART. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate, live birth rate, implantation rate, spontaneous abortion rate. RESULT(S): Within the DoD population, AA women had a fourfold increase in utilization of ART services relative to the U.S. ART population. In this equal-access-to-care setting, AA women experienced a clinically significant decrease in live birth rate that did not reach statistical significance (29.6% vs. 35.8%, risk ratio [RR] 0.83, 95% confidence interval [CI] 0.67-1.02) and a statistically significant increase in spontaneous abortions compared with Cau women (25% vs. 15.9%, RR 1.57, 95% CI 1.05-2.36). This might be explained, in part, by a higher prevalence of uterine leiomyomas in AA women (30.8% AA vs. 10.7% Cau, RR 2.85, 95% CI 2.06-3.95). For both AA and Cau women, the presence of fibroids at baseline ultrasound was associated with reductions in clinical pregnancy rates (35% with leiomyomas vs. 43.2% without leiomyomas, RR 0.74, 95% CI 0.51-0.98), live birth rates (26.2% vs. 36.0%, RR 0.63, 95% CI 0.44-0.90), and implantation rates (25.6% vs. 31.1% RR 0.82, 95% CI 0.69-0.98). CONCLUSION(S): Utilization of ART services among AA women increased when access to care was improved. A clinically significant reduction in live birth rate and statistically significant increase in spontaneous abortion rate was observed in AA women compared with Cau women. Leiomyomas were three times more prevalent in AA women and reduced ART success, regardless of race. The persistence of racial differences in an equal-access-to-care environment might be explained, in part, by the increased prevalence of leiomyomas in AA women.

Adult↗
PubMed2003

Blastocyst formation--good indicator of clinical results after ICSI with testicular spermatozoa.

BACKGROUND: The aim of this study was to evaluate the role of blastocyst culture in patients with azoospermia. METHODS: In 98 cycles embryos were cultured for 2 days and in 128 cycles for 5 days to reach the blastocyst stage; a maximum of two of the most developed embryos were transferred in each group. RESULTS: There was a negative correlation between a high (>/=20 IU/l) male serum FSH and embryo development, manifested as embryos not reaching the morula stage on day 5 (r = 0.387; P < 0.05). After prolonged culture, 23% of embryos reached the blastocyst stage. The pregnancy rates per transfer, and the abortion rates were approximately the same in the day 2 group and the day 5 group (20 versus 20% and 19 versus 18% respectively). After blastocyst transfer, a high clinical pregnancy rate (55%) and a low abortion rate (6%) were achieved, whereas the transfer of arrested embryos provided a low pregnancy rate (2%) and a high abortion rate (100%). If only blastocysts had been transferred on day 5, the clinical pregnancy rate per started cycle would have been approximately the same in both groups (13 versus 16%). CONCLUSIONS: Blastocyst formation is a good indicator of clinical results after ICSI with testicular sperm.

Abortion, Spontaneous↗
PubMed1983

Termination of pregnancy in teenagers.

This is a study of some epidemiological aspects of fifty-three unmarried girls, aged sixteen years and under, who were referred for therapeutic termination of pregnancy during the year 1976. Although the results showed that the overall abortion rate in Canada is much higher than in Newfoundland, the abortion rate in the 14-16 year age group is higher in the Province than in the rest of Canada. Secondly, the abortion rate for the fifteen year age group in this Province is higher than that for the sixteen year old girls, suggesting that more pregnancies in the older age group go to term. The rate of abortions among some religious denominations is significantly higher than in others. Urban living does not appear to produce an increase in abortion rates in these age groups. Interruption of schooling due to the occurrence of pregnancy is not a cause for concern in about half of this group. There is some evidence in support of the contention that precocious maturation is related to early pregnancy.

Abortion, Therapeutic↗
PubMed2004

Human and animal brucellosis in Jordan between 1996 and 1998: a study.

Between 1996 and 1998, a total of 2,494 samples of blood from humans and animals were collected and tested for brucellosis. This total included 1,594 samples of animal blood, collected from 1,050 sheep from 20 flocks, and 544 goats from eight herds. The serum samples were tested using the Rose Bengal test, the tube agglutination test, the complement fixation test and an enzyme-linked immunosorbent assay. Moreover, a complete history was compiled from each flock/herd. The rate of abortions in sheep due to brucellosis ranged from 0.5% to 56%, with a mean of 33.2%. The goats had a higher abortion rate. Thirty-four aborted sheep foetuses collected from these 20 flocks were bacteriologically and pathologically examined. A pure culture of Brucella melitensis biotype 3 was isolated from 21 of the aborted foetuses. The human blood samples were collected from two groups: first, from 800 apparently healthy people who were reporting to community hospitals for routine health checks and secondly, from 100 people from groups with a high-risk of contracting brucellosis, such as veterinarians, sheep-herders and laboratory technicians. The Brucella antibody titres for the 900 human serum samples were obtained using the microtitre agglutination test. The cumulative percentage of the serum samples showing a titre reading greater than 1:80 was higher in the at-risk group than among the normal population (7% compared to 4.1%). Although these results were not statistically significant, the higher percentage of positive reactors among the high-risk group may indicate an increased risk factor among professional agricultural and veterinary personnel in Jordan. It was concluded that brucellosis is common in sheep and goats in Jordan, subjecting the human population to high risks. Brucella melitensis Rev. 1 vaccination has been internationally recognised as the key to successfully controlling the disease. All animals in Jordan were repeatedly vaccinated between 1996 and 1998 on a trial basis, using a reduced dose of 1 x 10(5) colony-forming units (CFU). Cumulative data on the annual rate of human cases of brucellosis indicate that fewer people are affected each year. The same is true for the rate of abortions in animals. Such evidence strongly suggests that the vaccination programme has been successful. However, as wild strains of Brucella have also been isolated from vaccinated animals, the authors recommend increasing the amount of vaccine to a full dose of 1 to 2 x 10(9) CFU and vaccinating young female animals between the ages of three and eight months. To avoid brucellosis in humans, people should be educated about the dangers of contact with infected animals and the consumption of raw milk and milk products.

Abortion, Veterinary↗