Complications of clandestine abortions: a cross-sectional study at the Provincial General Hospital of Kananga in the Democratic Republic of Congo

Introduction: the complications of clandestine abortions are formidable throughout the world, particularly in Africa. This study aims to determine the epidemiological and therapeutic profile of the complications of clandestine abortions in the gynecology service of the Provincial Hospital of Kananga. Methods: this is a cross-sectional study conducted from the medical records of pregnant women who experienced the complications of clandestine abortions in the gynecology department of the Provincial Hospital of Kananga from January 01, 2015, to December 31, 2019. It is based on the no probabilistic sampling of suitability. We recorded 38 cases of 58 patients. Results: the frequency of complications of clandestine abortions is 65.51% with an average age of pregnant women of 27.86 (SD 3.23) years and 70% of pregnant women under 30 years old, nulliparity was more concerned in 34.21% (n=13). Pupil students and unemployed are more affected in 55.26% (n=21). Cervical dilation and curettage practiced by nurses led to more complications from clandestine abortions in 69.07% (n=26). Incomplete abortions are the complications most encountered in 1 case out of 3. The aspiration-curettage is established in 1 out of 3 cases, and the mortality rate linked to complications of clandestine abortion was 21.05% (n=8). Conclusion: complications of clandestine abortions constitute a real public health problem in the town of Kananga, incomplete abortions are most encountered and the mortality rate linked to these complications is serious.

¿Necesitás abortar? Estés donde estés te acompañamos: pandemia y acompañamiento de abortos en la ciudad de Neuquén, Argentina, durante 2020 / Do you need to abort? Wherever you are, we accompany you: pandemic and abortions accompaniment in Neuquén, Argentina, during 2020 / Você precisa abortar? Onde quer que você esteja, nós te acompanhamos: pandemia e acompanhamento de abortos em Neuquén, Argentina, durante 2020

Objetivo: describir los cambios que impuso la irrupción de la pandemia por COVID-19 al dispositivo de acompañamientos de abortos durante el año 2020 en la ciudad de Neuquén, Argentina. Metodología: el trabajo tiene un diseño metodológico que combinó aspectos cualitativos y cuantitativos en el análisis. Por un lado, se analizaron documentos elaborados por Socorristasen Redy se realizaron entrevistas semiestructuradas a activistas de La Revuelta. Esto se complementó con análisis de datos estadísticos de los acompañamientos de abortos dentro del sistema de salud entre marzo y diciembre de 2020. Resultados: en el período de estudio, La Revuelta readecuó parte de su dispositivo de acompañamiento y acompañó 270 abortos dentro del sistema de salud. Conclusión: el artículo muestra que la irrupción de la pandemia y la restricción para circular implicaron respuestas rápidas por parte de las activistas de La Revuelta, para continuar acompañando abortos en un momento de gran incertidumbre.

Objective: this article delineates the modifications introduced to the abortion support system in the city of Neuquén, Argentina, during the outbreak of the COVID-19 pandemic in 2020.Methods:the research employs a methodological design incorporating both qualitative and quantitative elements. It involves the analysis of documents prepared by Socorristas en Red, semi-structured interviews with La Revuelta activists, and the examination of statistical data related to abortion accompaniment within the health system from March to December 2020. Results:during the study period, La Revuelta adjusted a segment of its support apparatus and facilitated 270 abortions within the health system. Conclusion: the article illustrates that the pandemic and associated movement restrictions necessitated prompt adaptations by La Revuelta activists to sustain abortion support services amidst a period of considerable uncertainty.

Objetivo: descrever as mudanças que a pandemia de COVID-19 impôs ao sistema de apoio ao aborto durante o ano de 2020 na cidade de Neuquén, Argentina. Metodologia: o trabalho possui um desenho metodológico que combinou aspectos qualitativos e quantitativos na análise. Por um lado, foram analisados documentos elaborados pelos Socorristas en Rede realizadas entrevistas semiestruturadas com ativistas de La Revuelta. Isto foi complementado com a análise de dados estatísticos de acompanhamento do aborto no sistema de saúde entre março e dezembro de 2020. Resultados: no período do estudo, La Revuelta reajustou parte do seu dispositivo de acompanhamento e acompanhou 270 abortos no sistema de saúde. Conclusão: o artigo mostra que a eclosão da pandemia e a restrição de circulação implicaram respostas rápidas por parte dos ativistas de La Revuelta, para continuarem a acompanhar os abortos num momento de grande incerteza

Unsupervised Medical Abortions: A Cause for Concern of Safety

Medical abortions have been a national as well as social concern for the society, especially in India. There have been certain laws, acts and amendments that have been designed to promote safe abortions. Despite, the rules in place, there is still need to have more awareness as the women still face difficulties in accessing abortion services. The reasons may include legal hurdles, stigma, financial concerns and many more. Through this article, we would like to emphasize the role of government, medical professionals, health care providers to come together and form more dependable guidelines that may help women to access safer abortions.

Support Systems and Limitations in Therapeutic Abortion Care by the Gynecologist-Obstetrician of Public Hospitals in Peru / Sistemas de apoio e limitações na atenção ao aborto terapêutico pelo ginecologista-obstetra de hospitais públicos do Peru

Abstract Objective To identify the barriers to provide to women and adequately train physicians on therapeutic abortions in public hospitals in Peru. Methods Descriptive cross-sectional survey-based study. We invited 400 obstetrics and gynecology specialists from 7 academic public hospitals in Lima and 8 from other regions of Peru. Expert judges validated the survey. Results We collected survey results from 160 participants that met the inclusion criteria. Of those, 63.7% stated that the hospital where they work does not offer abortion training. Most of the participants consider that the position of the Peruvian government regarding therapeutic abortion is indifferent or deficient. The major limitations to provide therapeutic abortions included Peruvian law (53.8%), hospital policies (18.8%), and lack of experts (10.6%). Conclusion Most surveyed physicians supported therapeutic abortions and showed interest in improving their skills. However, not all hospitals offer training and education. The limited knowledge of the physicians regarding the law and institutional policies, as well as fear of ethical, legal, and religious repercussions, were the main barriers for providing abortions.

Resumo Objetivo Identificar as barreiras para oferecer às mulheres e capacitar adequadamente os médicos sobre abortos terapêuticos nos hospitais públicos do Peru. Métodos Estudo descritivo transversal baseado em inquérito. Convidamos 400 especialistas em obstetrícia e ginecologia de 7 hospitais públicos acadêmicos de Lima e 8 de outras regiões do Peru. Juízes especialistas validaram a pesquisa. Resultados Coletamos os resultados da pesquisa de 160 participantes que atenderam aos critérios de inclusão. Destes, 63,7% afirmaram que o hospital onde trabalham não oferece treinamento sobre aborto. A maioria dos participantes considera que a posição do governo peruano em relação ao aborto terapêutico é indiferente ou deficiente. As principais limitações para fornecer abortos terapêuticos incluem a lei peruana (53,8%), políticas hospitalares (18,8%) e falta de especialistas (10,6%). Conclusão A maioria dos médicos pesquisados apoiava o aborto terapêutico e demonstrava interesse em aprimorar suas habilidades. No entanto, nem todos os hospitais oferecem treinamento e educação. O conhecimento limitado dos médicos sobre a lei e as políticas institucionais, além do medo de repercussões éticas, legais e religiosas, foram as principais barreiras para a realização do aborto.

Clinical study of role of ultrasound in first trimester vaginal bleeding

Background: Vaginal bleeding is a serious cause which needs an emergency consultation. Major causes are abortion, ectopic pregnancy and molar pregnancy others like cervical erosion, polyp and carcinoma. The objective is to identify cause, assess the prognosis and institute appropriate management.Methods: Prospective study in MMC and RI, OBG, Mysore from November 2015 to September 2017. General physical and pelvic examination done for provisional clinical diagnosis and subjected to Ultrasound. Clinical diagnosis and ultrasound diagnosis were correlated.Results: 100 cases of first trimester bleeding evaluated by Ultrasonography with an incidence 2.37%. Most common cause was abortion (81.6%) then molar (10%) and ectopic pregnancy (9%). Out of 100 cases, 72 cases confirmed, 28 cases proved by ultrasound which was misdiagnosed on clinical examination with disparity of 72 between clinical and ultrasound diagnosis. 13 cases viable pregnancy by ultrasonography with sensitivity, specificity, NPV and PPV of 100% and 69 cases nonviable pregnancies with sensitivity, specificity and NPV of 100%. 9 cases ectopic pregnancy were diagnosed on ultrasound with sensitivity 100%, specificity 98.9%, PPV 99% and accuracy 99%. Clinical diagnosis in diagnosing viable pregnancies has sensitivity 76.92%, specificity 64.36% and PPV 24.39%. In diagnosis nonviable pregnancies, clinical diagnosis, poor statistical correlation with sensitivity 77.58, specificity 83.33%, PPV 86.53% and NPV 72.91%. Ultrasonographic diagnosis proved as very accurate on statistical correlation.Conclusions: Ultrasound is sensitive, cost effective and non-invasive diagnostic tool in first trimester bleeding. In this study, it helped in correct diagnosis of clinically misdiagnosed cases apart from confirming the diagnosis in others.

Prevalence and Determinants of Toxoplasma Seropositivity among Women Who had Spontaneous Abortion in Gombe, North-Eastern Nigeria

Aim: To determine the seroprevalence and determinants of Toxoplasma IgG and IgM seropositivity among women with spontaneous abortion in Gombe.Materials and Methods: Thiswas a cross-sectional study of 302 pregnant women with spontaneous abortion, presenting at the gynaecological emergency units of Federal Teaching Hospital Gombe and State Specialist Hospital Gombe. An interviewer-administered questionnaire was used to collect data, and a venous blood sample was drawn from each participant and tested for Toxoplasma IgG and IgM by ELISA technique. Results: Toxoplasma seroprevalence was 62(20.5%) and was higher in women that owned cats (24% vs 20.1%, OR 1.3, 0.5-3.1) and ate grilled meat (suya) (21.0% vs 11.8%, OR 2.0, 0.4-9.0), but lower in those that washed fruits and vegetables before consumption (OR 0.6, 0.2-1.4).Conclusion:Seroprevalence of Toxoplasmosis in Gombe is high and may be influenced by cat ownership cooking and eating habit.

Recurrent ectopic pregnancies with secondary infertility: a case report

Infertility is defined as 1 year of unprotected sexual intercourse without pregnancy. It is further classified as primary and secondary. Secondary infertility is one in which prior pregnancy not necessarily live birth has occurred. Pelvic infections as a cause for infertility are seen in 12% cases while genital tuberculosis contribute 10-15%. Various studies have well established a relationship between subclinical infection and infertility with the two most potential pathogens being: Chlamydia trachomatis and mycoplasma species. Authors are presenting two cases one of a 30yr female, P0+5, with class 2 obesity with previous three ectopic pregnancies with LSO done 1 year back i/v/o left ruptured ectopic now presenting with secondary infertility for 1 year and another case of a 21 years female, P0+2, with previous two ectopic with LSO done 2 years back now presenting with infertility. These cases emphasize that infections are important causes for recurrent ectopic pregnancies and infertility.

The use of emergency contraception among female senior high students in the Ho municipality of the Volta Region, Ghana

Background: Emergency contraception (EC) is one option for preventing unplanned pregnancy when it is available and properly used. Unsafe abortions are responsible for nearly one third of maternal deaths in sub-Saharan Africa and about quarter of unsafe abortions are among teenagers.Methods: A quantitative descriptive cross-sectional study. Data was collected using a pretested questionnaire. 260 senior high students were selected using a systematic sampling method in the Volta Region, Ghana. Data were cleaned and entered into SPSS version 22 and analysed into descriptive statistics.Results: Respondents acquired awareness about EC from friends (36.9%), family members (5.6%) and the mass media (41.6%). The required time for EC to be taken were stated as immediately after sex (57.9%), 24 hours after sex (1.2%) and (30.6%) did not know. 28.4% of participants indicated they would not use EC in the future as their faith was against it, 18.0% believed EC is ineffective and 24.9% consider it dangerous to their health. Reasons for use of EC included condom slipped (35.7%), inability to be on daily pill (33.7%), forced unprotected sex (8.2%) and miscalculation of the safe menstrual period (22.4%). There was a significant relationship between age and history of use of EC (p=0.000, c2=8.128, n=260).Conclusions: Strengthening education in Senior High Schools on sexual and reproductive health, with special emphasis on emergency contraceptives as a pregnancy preventive procedure will remain imperative to reducing the canker of maternal mortality attributed to adolescent abortions while improving understanding of the appropriate use of EC.

Analysis of frequency of congenital fetal anomalies diagnosed on antenatal ultrasound in a tertiary care hospital of Balochistan

Background: The objective of our study is to check the incidence of various congenital fetal anomalies in antenatal period by ultrasonography in a subset of population.Methods: This cross sectional study was conducted in the department of Radiology, Bolan Medical Complex Hospital Quetta from November 2017 to October 2018. Total of 1323 second and third trimester pregnancies were analyzed for a period of one year. 34 fetal anomalies were detected making the prevalence of 2.5%. Information obtained from history, clinical examination and Ultrasound examination were recorded. The data was analyzed in SPSS 20.These patients were also interviewed for folic acid supplementation and consanguineous marriage.Results: 1323 patients were examined with congenital abnormalities detected in 34 fetuses. Among 34 fetuses, 20 were male and 14 were female fetuses. Out of 34, mother of 24 fetuses verified that they did not take folic acid supplementation. Consanguineous marriage recognized as the important risk factor as found in 22 congenital abnormal fetus.  CNS anomalies were the most commonly occurring anomalies with prevalence of (0.9%) followed by gastrointestinal tract anomalies (0.3%) and Urinary tract anomalies (0.3%).Conclusions: The fetus prognosis largely depends on early detection of its any congenital anomaly on antenatal ultrasound as they can result in abortions, still births and other fetal defects. So antenatal ultrasound is very important and safe method for early detection and management of fetal anomalies.

Determinants of anemia among pregnant women: A hospital based cross sectional study

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed.

Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

Background: To compare the effectiveness, side effects, and patient satisfaction of buccal versus vaginal misoprostol administration in first trimester abortions.Methods: Women opting for first trimester abortion received oral Mifepristone followed 48 hours latermisoprostol. Group A received Misoprostol via buccal route whereas group B received Misoprostol vaginally. A comparative analysis using SPSS was done.Results: Giving 800µg Misoprostol by either buccal or vaginal route after oral Mifepristone have comparable efficacy in terms of complete abortion rate (96% in buccal group versus 98% in vaginal group; p value = 0.495), failure rate being statistically similar (4% versus 2%). Drug abortion interval was comparable in the two groups. (11.16 hour in buccal group and 12.32 hours in vaginal group). Few side effects like nausea and vomiting, shivering, diarrohea was significantly higher with vaginal Misoprostol while abdominal cramps, altered taste were found more with the buccal group.Conclusions: Buccal Misoprostol is comfortable and easier to administer when compared to other routes and it has potential to be developed as a self-administered regimen. Buccal Misoprostol is as efficacious as vaginal Misoprostol with significantly lesser side effects up to 7 weeks of period of gestation.

Reporte de 4 casos de inversión de cromosoma 9 en una muestra de 4755 líquidos amnióticos en una población venezolana

La inversión del cromosoma 9, inv (9), es una reordenación cromosómica relativamente común y generalmente se considera como una variante normal. No obstante, varios estudios han sugerido una posible asociación con síndrome metabólico, obesidad, galactosemia, diabetes mellitus y aborto espontáneo recurrente. Este estudio tiene como objetivo describir cuatro casos con la misma inversión cromosómica 9, inv (9) (p12; q12), y compararlo con lo que ha sido expuesto en la literatura. Se realizaron una serie de casos retrospectivos. Se evaluó una gran base de datos de informes de amniocentesis realizados en el centro Policlínica Metropolitana de Caracas entre 2005 y 2016. Como parte del protocolo del centro, todas las muestras de líquido amniótico recuperadas se centrifugaron a 800 rpm. Finalmente, se realizó un análisis de 20 bandas en metafase G para el cariotipo. Se recuperaron todos los cariotipos que informaron inv (9) (p12; q12). De 4755 informes de amniocentesis, se identificaron un total de 4 casos de inv (9) (p12; q12) pericéntrico. Según la literatura, este tipo de reordenamiento se ha asociado a algunas enfermedades metabólicas. Este hallazgo está respaldado por el hecho de que esta región cromosómica contiene el factor 1 promotor de insulina y el factor iniciador para la alfa quinasa 3 del factor de iniciación de traducción eucariótico, ambos implicados en la diabetes transitoria. Existe escasa literatura sobre este tipo de inversión, y se necesitan más estudios para un análisis de correlación adecuado. Los resultados de esta breve serie y los hallazgos de la literatura respaldan la importancia de los primeros estudios de cariotipo para identificar posibles asociaciones.

The inversion of chromosome 9, inv (9), is a relatively common chromosomal rearrangement and is commonly considered as a normal variant. However, several studies have suggested a possible association with metabolic syndrome, obesity, galactosemia, diabetes melli-tus and recurrent spontaneous abortion. This study aims to describe four cases with the same chromosome inversion 9, inv (9) (p12; q12), and compare them with what has been shown in the literature. A set of retrospective cases were carried out. A large database of amniocentesis reports made at the Policlinica Metropolitana of Caracas between 2005 and 2016 were analyzed. As part of the protocol of the Center, all recovered amniotic fluid samples were centrifuged at 800 rpm. Finally, an analysis of 20 metaphase G bands was performed for the karyotype. All the karyotypes that reported inv (9) (p12; q12) were recovered. According to 4755 reports of amniocentesis, a total of 4 cases of inv (9) pericentric (p12; q12) were identified. Based on the literature, this type of rearrangement has been associated with some metabolic diseases. This finding is supported by the fact that this chromosomal region contains the insulin promoter factor-1 and the initiating factor for alpha kinase 3 of the eukaryotic translation initiation factor, both involved in transient diabetes. There is not enough literature on this type of inversion, and more and more studies are needed to perform an adequate correlation analysis. The findings of this brief series and the literature review support the importance of the first karyotype studies to identify possible associations.

A inversão do cromossomo 9, inv (9), é um rearranjo cromossômico relativamente comum e é geralmente considerada como uma variante normal. No entanto, vários estudos sugeriram uma possível associação com a síndrome metabólica, obesidade, galactosemia, diabetes mellitus e aborto espontâneo recorrente. Este estudo tem como objetivo descrever quatro casos com a mesma inversão cromossômica 9, inv (9) (p12q12), e compará-lo com o exposto na literatura. Uma série de casos retrospectivos foi feita. Avaliara-se uma grande base de dados de relatórios de amniocentese realizada no centro Policlínica Metropolitana de Caracas entre 2005 e 2016. Como parte do protocolo do centro, todas as amostras de líquido amniótico recuperadas foram centrifugadas a 800 rpm. Finalmente, uma análise de 20 bandas G foi realizada para o cariótipo. Todos os cariótipos com inv (9) (p12q12) foram recuperados. Dos 4.755 relatos de amniocentese, foram identificados 4 casos de inv (9) pericêntricos (p12q12). Segundo a literatura, esse tipo de rearranjo tem sido associado a algumas doenças metabólicas. Esta conclusão é apoiada pelo facto de que esta região cromossómica contém o fator promotor de insulina 1 e o fator iniciador para a 3-quinase alfa do fator de início de tradução de euca-riotos, ambos envolvidos na diabetes transitória. Há escassa literatura sobre este tipo de inversão, e mais estudos são necessários para uma análise de correlação adequada. Os resultados desta breve série e os resultados encontrados na literatura corroboram a importância dos primeiros estudos de cariótipos para identificar possíveis associações.

Representações europeias sobre controle de natalidade e aborto em sociedades islâmicas e haréns no período moderno / European representations of birth control and abortions in Islamic societies and harems in the modern period

Resumo Ao longo do período moderno, as mulheres islâmicas, residentes em palácios ou em casas comuns, recorriam a medidas para prevenir a concepção ou, quando a gravidez ocorria, para induzir o aborto. Para tanto, faziam uso de ervas, drogas abortivas ou contavam com o auxílio de outras mulheres para interromper uma gestação indesejada. Os registros sobre tais práticas eram feitos por europeus - em alguns casos, médicos - que viajaram para as regiões islâmicas e que retrataram esse cenário em suas narrativas. Além dos abortos, também se noticiava o infanticídio nos palácios imperiais. Discute-se aqui como tais fontes descreviam o controle de natalidade, e como problematizavam o harém lascivo - tópos recorrente na literatura orientalista - a partir da óptica médica.

Abstract Throughout the modern period, Islamic women (whether they lived in palaces or normal houses) resorted to measures to prevent conception or to induce abortion when pregnancy occurred. They used herbs and abortifacient drugs or relied on help from other women to eliminate unwanted pregnancies. Such practices were recorded by Europeans - in some cases, doctors - who traveled to Islamic regions and described these scenes in their narratives. In addition to abortions, infanticide was also observed in the imperial palaces. Here we discuss how these sources described birth control, and how they investigated the lascivious harem, a recurring trope in orientalist literature, from a medical perspective.

Awareness regarding abortions and medical termination of pregnancy act among medical students in Puducherry, India.

Background: Maternal mortality is an important indicator of women’s health and social well-being. According to the WHO report, each year, an estimated 190 women for every 100,000 live births die due to maternal causes. In India, unsafe abortion and related complications accounts for 9% of all maternal deaths. Abortion was made legal in India by the Medical Termination of Pregnancy (MTP) act, which was enacted by Indian Parliament in the year 1971. But the number of unsafe abortions has not declined. Methods: A present study was conducted by the Department of Obstetrics and Gynaecology of Pondicherry Institute of Medical Sciences, in Puducherry, India. All undergraduate students of VIIth semester MBBS participated in the study. A pre-designed semi-structured questionnaire was used to collect information regarding the awareness and perceptions on abortion care and Medical Termination of Pregnancy Act in India. Data were entered in Microsoft Excel 2007. Averages were calculated and chi square test was applied to find the significant difference. Results: Among a total of 75 participants, 41(54.7%) were female and 34 (45.3%) were male students. Majority of the students (97.3%) were aware of the fact that unsafe abortions are a serious health problem in India and all of the students (100.0%), were aware of the MTP Act of India. But only 36.0% students were aware of the fact, that consent from husband was not required to undergo abortion. To reduce the number of unsafe abortions in India majority of the medical students (45.3%) were of the opinion that easy access to MTP services in the community is an effective measure. Conclusions: Legalization of abortions through the MTP Act in India resulted in a considerable decrease in maternal mortality through the decline in abortions but it has failed to ensure effective implementation and access to medically safe abortion services. Training in basic contraceptive counseling and abortion care should be incorporated in basic medical education in India.

A case report: Unsafe abortion.

Unsafe Abortion constitutes a major cause of maternal morbidity and mortality in developing countries. It is randomly practiced though exact statistics is not available due to lack of cooperation from concerned parties. Complications occur in a large portion of these cases which ultimately require tertiary care. This case report of complications associated with an unsafe abortion highlights the need for raising the awareness among women and healthcare providers regarding education on contraception and availability of safe and legal abortions with better access to abortion and post abortion services.

Clinical observation of propofol compound remifentailuesed for painless abortions surger / 中国药学杂志

OBJECTIVE: To compare the efficacies of different target concentrations of propofol combinded with remifentanil for painless induced abortions, thus to explore the best target concentrations. METHODS: One hundred and twenty ASAI-II patients receiving elective painless induced abortions between May 2011 and October 2011 were randomly divided into three groups. The target concentrations of propofol were 2, 3, and 4 μg·mL-1, respectively. The hemodynamic changes and body movements at different time and the time of leaving operating room in the three groups were compared. RESULTS: The patients in the three groups all finished operations. The MAPs and HRs when dilating uterine and aspirating embryo bud were significantly increased, and the incidence of body movements was the highest in the 2 μg·mL-1 group; the number of apnea cases and the time of leaving operation room in the 4 μg·mL-1 group were significantly higher than the other two groups. CONCLUSION: When using propofol at target concentration of 3 μg·mL-1 combined with remifentanil at target concentration of 3 μg·mL-1 for painless induced abortions, the patients had stable perioperative MAP and HR, less apnea cases, and shorter time of leaving operation room. So these are the ideal target plasma concentrations for controlled anesthesia for painless induced abortions.

Lymphoedema - distichiasis syndrome with recurrent abortions.

Lymphoedema-distichiasis syndrome, a type of familial lymphoedema praecox, is a rare, primary lymphoedema of pubertal onset associated with distichiasis and other associations including congenital heart disease, ptosis, varicose veins, cleft palate, and spinal extradural cysts. We report a case of familial lymphoedema with associated distichiasis, atrial septal defect, varicose veins, and recurrent abortions in a 29-year-old female.

Estudio citogenético en 677 casos de aborto espontáneo / Cytogenetic study of 677 spontaneous abortions

INTRODUCCIÓN: La reproducción humana es un proceso relativamente ineficaz. Los abortos espontáneos ocurren entre el 15 a 20 por ciento de los embarazos clínicamente reconocidos. El impacto emocional se acentúa debido a la falta de diagnóstico. OBJETIVO: Describir la experiencia del Laboratorio de Citogenética de la Clínica Sanatorio Alemán de Concepción e identificarlas alteraciones más frecuentes y su relación estadística con la edad materna. MATERIAL Y MÉTODO: 677 muestras de tejido obtenidas de abortos espontáneos, ocurridos desde julio de1996 a abril de 2009. Es un trabajo de tipo transversal donde las muestras utilizadas son las vellosidades coriónicas, cultivadas en medios estandarizados. RESULTADOS: De las 677 muestras estudiadas, en 259 se obtuvo un cariotipo normal (38,3 por ciento). En 418 muestras se encontraron anomalías cromosómicas, correspondiendo estas a un 61,7 por ciento. Entre los cariogramas alterados se encontraron: 265 trisomías (63,4 por ciento), 83 poliploidías (19,9 por ciento), 48 monosomías (11,5 por ciento) y 22 alteraciones estructurales (5,3 por ciento). La trisomía más frecuente fue la 16 (34,4 por ciento), seguida de la trisomía 21 (13,6 por ciento). Se encontró una relación estadísticamente significativa entre la edad de la madre (> 37 años) y la presencia de alteraciones citogenéticas (p<0,0001). DISCUSIÓN: El 61,7 por ciento de los abortos presentó alguna alteración del cariotipo. La trisomía 16 fue la aberración más frecuente concordando con la literatura. La trisomía 21 se presentó en un 13,6 por ciento siendo más frecuente que lo encontrado en series extranjeras. En el grupo mayor de 37 años existe mayor prevalencia de anomalías cromosómicas siendo estadísticamente significativa (p<0,0001).

INTRODUCCION: The human reproduction is a relatively inefficient process. In the 15 to 20 percent of the pregnancy clinically diagnosticated finish in spontaneous abortions. The great emotional impact, that in many times is worst by the lack of diagnostic. OBJECTIVE: Describe experience of the Cytogenetic Laboratory of Clínica Sanatorio Alemán of Concepción Chile and determinate the frequency of alteration and his relationship with maternal age. MATERIAL AND METHOD: 677 samples of tissue of spontaneous abortions, taked from July, 1996 to April, 2009. It is a descriptive work; the samples are chorionic villous, cultivated in standard solutions. RESULTS: Of 677 samples in 259 was found a normal cariotype (38.3 percent). In 418 was found some type of chromosome aberrations (61.7 percent). The distribution of the abnormal result is the follow: 265 trisomies (63.4 percent), 83 polyploidy (19.8 percent), 48 monosomy (11.5 percent) and 22 abnormalities structures (5.3 percent). Of the trisomies the most recurrent is 16 trisomy with the 34.4 percent, follow by the 21 trisomy with 13.6 percent and the 22 trisomy with 12.8 percent. In the statistic analysis we found a statistically significant relation between the age of the mother (<38 years) and the development of chromosomal alterations (p<0.0001). DISCUSSION: The 61.7 percent of abortions show some cytogenetic alteration. The 16 trisomies were the most frequent, agreeing with the literature. The trisomy 21 was more common than published to date. In older women is most frequent found chromosome aberrations (p<0.0001).

Coagulation inhibitors and activated protein C resistance in recurrent pregnancy losses in Indian women.

Background: Thrombophilias, both acquired and inherited, have been investigated in the etiopathogenesis of unexplained recurrent pregnancy loss. Aim: To study coagulation inhibitors and activated protein C resistance (APCR) in recurrent pregnancy losses (RPL) occurring in second and third trimesters. Materials and Methods: A total of 30 pregnant women (group A) with two or more recurrent unexplained fetal loses were evaluated for APCR, protein C deficiency, protein S deficiency, antithrombin deficiency, and antiphospholipid antibodies (APLA). Thirty age-matched controls were taken (group B) comprising of pregnant women with at least one live issue. Statistical Analysis: Comparisons between two group frequencies and group means were made using Chi square test and Student's t test, respectively. Results: Protein C and protein S levels were reduced in group A compared with group B and the difference was statistically significant (P=0.005 and P=0.032, respectively). The mean value of antithrombin was slightly reduced in group A compared with group B. APCR was observed in 16.6% cases and 3.3% controls. However, the difference was not statistically significant. APLA was observed in 20% cases and none of the controls. Of these, lupus anticoagulant was positive in 16.6% cases and anticardiolipin antibodies in 10% cases. Combined defects were seen in seven patients. Conclusion: There is a significant risk of RPL in pregnant women with thrombophilias. Therefore, screening for thrombophilias may be justified in pregnant women with unexplained recurrent fetal wastage, especially in second and third trimester.

Chromosomal abnormalities as a cause of recurrent abortions in Egypt.

BACKGROUND: In 4%-8% of couples with recurrent abortion, at least one of the partners has chromosomal abnormality. Most spontaneous miscarriages which happen in the first and second trimesters are caused by chromosomal abnormalities. These chromosomal abnormalities may be either numerical or structural. MATERIAL AND METHODS: Cytogenetic study was done for 73 Egyptian couples who presented with recurrent abortion at Genetic Unit of Children Hospital, Mansoura University. RESULTS: We found that the frequency of chromosomal abnormalities was not significantly different from that reported worldwide. Chromosomal abnormalities were detected in 9 (6.1%) of 73 couples. Seven of chromosomal abnormalities were structural and two of them were numerical. CONCLUSION: Our results showed that 6.1% of the couples with recurrent abortion had chromosomal abnormalities, with no other abnormalities. We suggest that it is necessary to perform cytogenetic in vestigation for couples who have recurrent abortion.