RESUMO
Objective To investigate the correlation between gene polymorphisms of coagulation factor Ⅻ(FⅫ)rs1801020 and resistin rs1862513 and unexplained recurrent spontaneous abortion(URSA).Methods A total of 189 patients diagnosed with URSA and 191 healthy postpartum women during the same period were selected from the obstetric clinic of Changning Maternity and Infant Health Hospital from January 2020 to December 2022.The probe PCR was used to detect gene polymorphisms of rs1801020 and rs1862513 in peripheral blood,and the differences in genotype distribution between the groups were observed.Results The frequencies of geno-types and alleles for F Ⅻ rs1801020 in the URSA-A group were 4.9％(CC),35.7％(CT),59.5％(TT),22.7％(C),and 77.3％(T),respectively.In the control A group,the frequencies were 8.0％(CC),47.1％(CT),44.9％(TT),31.5％(C)and 68.5％(T).The frequencies of genotypes and alleles for resistin rs1862513 in the URSA-B group were 11.3％(CC),47.3％(CG),41.4％(GG),34.9％(C)and 65.1％(G).In the control B group,the frequencies were 10.2％(CC),34.1％(CG),55.7％(GG),27.3％(C)and 72.7％(G).There was no significant difference in genotype frequency of the two loci(P＞0.05),but there was a sig-nificant difference in allele frequency(P＜0.05).The distribution frequency of F Ⅻ rs1801020 T allele in the URSA group was higher than that in the control group(X2=6.32,OR=1.567,95％CI:1.100-2.238,P=0.012).The distribution frequency of resistin rs1862513 G allele in URSA group was lower than that in con-trol group(X2=4.96,OR=1.433,95％CI:1.050-1.969,P=0.026).The mutation of F Ⅻ rs1801020 C to T was a risk factor for the occurrence of URSA,while the mutation of rs1862513 C to G was a protective factor for the occurrence of URSA(P＜0.05).The combined genotype analysis showed that compared to the popu-lation carrying the rs1801020 CC+rs1862513 CC genotype combination,the population carrying the rs1801020 TT+rs1862513 CG genotype had a significantly higher risk of URSA(OR=5.684,95％CI:1.210-30.920,P=0.035).Conclusion FⅫ rs1801020 T allele may increase the risk of URSA and resistin rs1862513 G al-lele may the risk of URSA.People with rs1801020 TT+rs1862513 CG genotype combination is more likely to develop URSA than those with rs1801020 CC+rs1862513 CC genotype combination.
RESUMO
Objective To investigate the expression level and clinical significance of hsa_circ_0005075 in serum extracellular vesicles(EVs)of patients with recurrent spontaneous abortion(RSA).Methods Fourteen RSA patients and 14 normal pregnant women from the Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University were enrolled in a training set,and 64 RSA pa-tients and 48 normal pregnant women were enrolled in a validation set.The expression levels of hsa_circ_0005075 in serum EVs were detected by the quantitative real-time PCR(qRT-PCR),and their correlation with clinical pathological parameters of RSA patients were analyzed.Serum anti-thyroid globulin antibody(A-TG)and anti-thyroid peroxidase antibody(A-TPO)were detected by the elec-trochemiluminescence assay.Serum anticardiolipin(ACA)IgA,IgG,and IgM antibodies and anti-β2 glycoprotein 1(β2GP1)IgA,IgG,and IgM antibodies were determined by the chemiluminescence immunoassay.The correlation of these autoantibodies with the lev-els of hsa_circ_0005075 in serum EVs was analyzed by the Pearson correlation.The clinical application value of hsa_circ_0005075 in the diagnosis of RSA was evaluated by the receiver operating characteristic(ROC)curve.Results The detection results of the training set showed that the expression levels of hsa_circ_0005075 in serum EVs of RSA patients(7.69[4.74,42.15])were significantly high-er than that in normal pregnant women(1.02[0.51,4.23],U=28,P＜0.01].Similarly,in the validation set,the expression levels of hsa_circ_0005075 in RSA patients(4.96[1.73,8.89])were also significantly higher than that in normal pregnant women(1.00[0.24,2.96],U=693,P＜0.01).The ROC curve showed that hsa_circ_0005075 in serum EVs had good diagnostic value for RSA(AUCROC=0.774),with 70.3%of sensitivity and75.0%of specificity.In addition,the expression level of hsa_circ_0005075 in serum EVs was significantly correlated with A-TPO(r=0.298,P＜0.05).Conclusion The hsa_circ_0005075 in serum EVs is highly ex-pressed in RSA patients,which may have a potential differential diagnostic value for the diagnosis of RSA.
RESUMO
An increasing number of studies in recent years have focused on the association between female endometrial microbiota and fertility.Once the endometrial microflora microecology is unbalanced,it will cause a series of endometrial lesions,thereby destroying endometrial receptivity,affecting embryo implantation,resulting in embryo implantation or implantation failure.Among them,the most concerned is the positive significance of lactobacillus-led microbiota on reproductive outcome.Although the relationship between endometrial microbiota and reproductive outcome has not reached a consensus,most studies recognize the positive impact of lactobacillus-led microbiota on reproductive outcome.In this review,the relationship between lactobacillus-dominated microbiota and reproductive outcome is reviewed.
RESUMO
Objective To analyze the risk factors of recurrent spontaneous abortion(RSA),construct a prediction model based on the risk factors,and evaluate its efficacy in predicting the occurrence of RSA.Methods A total of 324 pregnant women who were registered in the Department of Reproductive Medicine of the Third Affiliated Hospital of Xinxiang Medical University from January 2019 to October 2022 were selected as the research subjects,and they were divided into normal group(n=234)and abortion group(n=90)according to the presence or absence of RSA.Univariate and multivariate logistic regression were used to analyze the risk factors of RSA,a prediction model was constructed based on the selected risk factors,and predictive efficiency of the model was evaluated by drawing the receiver operating characteristic(ROC)curve.Results Univariate analysis showed that there were significant differences in 25-hydroxyvitamin D[25-(OH)D],progesterone(P),homocysteine(Hey),fibrinogen(FIB),D-dimer(D-D),thyroid-stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),pulse index(PI),resistance index(RI)and ratio of peak systolic velocity to lowest diastolic velocity(S/D)between the two groups(P＜0.05);there were no significant differences in age,pre-pregnancy body mass index,pre-pregnancy menstrual cycle,gestational sac size,free triiodothyronine(FT3)and free thyroxine(F4)between the two groups(P＞0.05).Multivariate logistic regression analysis showed that low 25-(OH)D and P,as well as high Hey,TPOAb,PI,RI and S/D,were risk factors for RSA in pregnant women(P＜0.05).The ROC curve analysis results showed that the sensitivity,accuracy,positive predictive value and area under the curve of the constructed model in predicting the occurrence of RSA were 92.60％,90.25％,89.26％and 0.914,respectively.Conclusion Decreased 25-(OH)D and P as well as increased Hcy,TPOAb,PI,RI and S/D are risk factors for RSA,and the constructed model based on these risk factors has high efficiency in predicting the occurrence of RSA.
RESUMO
Objective To observe the effect of Shoutai Pills on endometrial decidualization of mice with recurrent spontaneous abortion(RSA);To explore its possible mechanism in the treatment of RSA based on histone modification.Methods Totally 40 female CBA/J mice were divided into normal group,model group,Shoutai Pills low-dosage group(7.5 g/kg),Shoutai Pills high-dosage group(15 g/kg)and dydrogesterone group(3 mg/kg).The normal group were co housed with BALB/C male mice,while the other groups were co housed with DBA/2 male mice to establish an RSA mouse model.After modeling,the administration groups were given corresponding medication solution by gavage,while the normal group and model group were given equal volume of pure water by gavage for 10 consecutive days.The embryo condition was observed and the embryo loss rate was calculated,ELISA was used to detect serum prolactin(PRL)content,HE staining was used to observe the morphological changes of decidual tissue,RT-PCR was used to detect PRL mRNA expression in decidual tissue,Western blot was used to detect the protein expressions of H4ac,H3K27ac,H3K27me3.Results Compared with the normal group,the model group mice showed a significant increase in embryo loss rate,a significant decrease in serum PRL content,disordered arrangement of decidual cells,and extensive bleeding and necrosis;the expression of PRL mRNA and protein in decidual tissue significantly decreased,the protein expressions of H4ac and H3K27ac significantly decreased,while the expression of H3K27me3 protein significantly increased,with statistical significance(P<0.05).Compared with the model group,the embryo loss rate of Shoutai Pills low-and high-dosage groups and the dexamethasone group significantly decreased,the serum PRL content significantly increased,tightly arranged decidual cells,reduced necrosis,and intact glands;the expression of PRL mRNA and protein in decidual tissue of mice in Shoutai Pills high-dosage group and the dexamethasone group significantly increased,the protein expressions of H4ac and H3K27ac significantly increased,the expression of H3K27me3 protein significantly decreased,with statistical significance(P<0.05).Conclusion Shoutai Pills can promote endometrial decidualization in RSA mice,which is related to the changes of histone modification in endometrial stromal cells.
RESUMO
Immune factors play an important role in recurrent spontaneous abortion(RSA),and immune imbalance affects embryo implantation,growth,and development.There is currently no consensus on the etiology and pathogenesis of RSA caused by immune factors.Based on the theory of latent toxic in TCM and combined with the pathological mechanism of the dynamic changes of immune abnormal substances in the body,this article proposed that latent toxic is the key cause of RSA caused by immune factors.Furthermore,it expounded the pathogenic characteristics of latent toxic:combination of heat and blood stasis hidden in the womb,and latent toxic plays a role in embryo formation under qi deficiency conditions.It is established that latent toxin stagnation in the membrane is the pathogenic mechanism.Moreover,this article revealed the variable pathological changes such as the blockage of the inner membrane system and the outer membrane system.Treatment should be based on the basic methods of tonifying qi and nourishing blood,tonifying kidney to secure the Thoroughfare Vessel,clearing heat and cooling blood,promoting blood circulation and removing blood stasis.This article could provide a theoretical basis for TCM syndrome differentiation and treatment of RSA caused by immune factors.
RESUMO
Objective:To investigate the expression of Toll-like receptor 4(TLR4)and extracellular signal-regulated protein kinase 1/2(ERK1/2)in decidua tissue of patients with unexplained spontaneous abortion and their correlation.Methods:The expres-sions of TLR4,ERK1/2 and p-ERK1/2 in decidua tissues of 32 patients with unexplained spontaneous abortion(abortion group)and 32 normal pregnancy(control group)were detected by immunohistochemistry and Western blot,respectively.The correlation between TLR4 and p-ERK1/2 in abortion group were analyzed by Pearson hierarchical correlation analysis.Results:In immunohistochemical experiments,the cytoplasm of decidua cells in the two groups is the expression locus of TLR4,ERK1/2 and p-ERK1/2,the expression of the three proteins were different,and the expressions of TLR4 and p-ERK1/2 in abortion group were significantly higher than that in control group(P<0.01).There was no significant difference in ERK1/2 expression between abortion group and control group(P>0.05);In decidua tissue samples of abortion group,the protein level of TLR4 was higher than that of control group(P<0.05);the pro-tein level of p-ERK1/2 was significantly higher than that of control group(P<0.01),and the protein level of ERK1/2 in decidua tissue of abortion group was not statistically different from that of control group(P>0.05).TLR4 was positively correlated with p-ERK1/2 expression in abortion group(r=0.890,P<0.01).Conclusion:Abnormal activation of TLR4/ERK1/2 signaling pathway may be one of the mechanisms of unexplained spontaneous abortion.
RESUMO
Abstract Objective: This study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy. Methods: This prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed. Results: The spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27). Conclusions: The prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.
RESUMO
Abstract Objective 26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological abnormalities, about half of the cases of pregnancy loss in its first half remain unexplained. Methods The review includes observational controlled studies (case-control or cohort, longitudinal studies, reviews, meta-analyses), which include the study of biochemical factors for predicting pregnancy losses in the first half, in singlet pregnancy. The Newcastle-Ottawa Scale (NOS) was used to assess the research quality. Results Finally, 27 studies were included in the review, which has 134904 examined patients. The results of the review include estimates of β-human chorionic gonadotropin, progesterone, pregnancy-associated protein - A, angiogenic vascular factors, estradiol, α-fetoprotein, homocysteine and CA-125 as a predictors or markers of the first half pregnancy losses. Conclusion It may be concluded that to date, research data indicate the unavailability of any reliable biochemical marker for predicting pregnancy losses in its first half and require either a combination of them or comparison with clinical evidence. A fairly new model shall be considered for the assessment of α-fetoprotein in vaginal blood, which may have great prospects in predicting spontaneous miscarriages.
RESUMO
Abstract Background: This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A. Methods: A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC. Results: After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; p < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; p = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; p = 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880). Conclusion: This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.
RESUMO
Abstract Aim miR-141-5p expression in patients with Early Spontaneous Abortion (ESA) and its correlation with hormone levels during pregnancy were investigated. Methods A total of 70 pregnant women with ESA were selected as the research group, and 70 normal pregnant women who chose abortion for non-medical reasons were selected as the Con group. Serum β-HCG, Progesterone (P), and Estrogen (E2) were detected by enzyme-linked immunosorbent assay. Differentially expressed miRNAs were screened by miRNA microarray analysis. miR-141-5p expression was detected by RT-qPCR, and its correlation with serum β-HCG, P, and E2 levels was analyzed. The diagnostic value of miR-141-5p for ESA was evaluated by the ROC curve. Results Serum β-HCG, P, and E2 were decreased and serum miR-141-5p was increased in patients with ESA. Pearson correlation analysis showed that serum β-HCG, P, and E2 levels were negatively correlated with miR-141-5p expression levels. ROC curve showed that miR-141-5p had a diagnostic value for ESA. Conclusions miR-141-5p is related to hormone levels during pregnancy and is expected to become a new candidate diagnostic marker for ESA.
RESUMO
Background: Majority of spontaneous pregnancy loss occur in early gestation. Early pregnancy loss causes great physical and psychological distress to couples and creates apprehension in achieving future reproductive success. Previous abortions have a definite impact on the successful outcome of future pregnancies. Hence for such pregnancies careful antenatal care is mandatory. Careful surveillances required in pregnancies preceded by spontaneous abortions, for early detection of possible complications.Methods: This was a prospective observational comparative study conducted on 184 antenatal women (92 patients with previous spontaneous abortion, no full-term delivery, selected as cases while 92 patients with previous full term normal vaginal delivery with no previous abortion selected as control) attending antenatal OPD at Holy Family Hospital, New Delhi, from October 2020 to May 2022. All women received regular antenatal care and were followed up till delivery for maternal and foetal outcome.Results: For predicting pregnancy outcome following previous spontaneous abortion showed statistically significant in term of obesity, 56.52% patients were obese in cases while in controls only 48.91%. Duration of marriage, in cases is 2.22 years, where as in controls were 4.24 years with significant result. Interpregnancy interval (months) in cases was 10.58±4.19 whereas in controls it was 32.53±14.41 with significant result. Antenatal complications in term of GDM, hypothyroidism, IUGR more in cases than controls.Conclusions: We found that prior spontaneous abortion miscarriage is definitely a risk factor for the next pregnancy, making present pregnancy a high-risk pregnancy.
RESUMO
Background: Majority of spontaneous pregnancy loss occur in early gestation. Early pregnancy loss causes great physical and psychological distress to couples and creates apprehension in achieving future reproductive success. Previous abortions have a definite impact on the successful outcome of future pregnancies. Hence for such pregnancies careful antenatal care is mandatory. Careful surveillances required in pregnancies preceded by spontaneous abortions, for early detection of possible complications.Methods: This was a prospective observational comparative study conducted on 184 antenatal women (92 patients with previous spontaneous abortion, no full-term delivery, selected as cases while 92 patients with previous full term normal vaginal delivery with no previous abortion selected as control) attending antenatal OPD at Holy Family Hospital, New Delhi, from October 2020 to May 2022. All women received regular antenatal care and were followed up till delivery for maternal and foetal outcome.Results: For predicting pregnancy outcome following previous spontaneous abortion showed statistically significant in term of obesity, 56.52% patients were obese in cases while in controls only 48.91%. Duration of marriage, in cases is 2.22 years, where as in controls were 4.24 years with significant result. Interpregnancy interval (months) in cases was 10.58±4.19 whereas in controls it was 32.53±14.41 with significant result. Antenatal complications in term of GDM, hypothyroidism, IUGR more in cases than controls.Conclusions: We found that prior spontaneous abortion miscarriage is definitely a risk factor for the next pregnancy, making present pregnancy a high-risk pregnancy.
RESUMO
Objetivo: Discutir o papel das trombofilias na perda gestacional de repetição, com foco em prevalência/associação dessas patologias com perdas de repetição e seu tratamento, por meio de resultados de ensaios clínicos, revisões sistemáticas e metanálises. Métodos: Trata-se de uma revisão não sistemática de artigos publi- cados nas bases eletrônicas PubMed, Cochrane e SciELO nos últimos cinco anos, utilizando os seguintes descritores: "recurrent pregnancy loss", "recurrent abortion", "habitual abortion", "thrombophilia", "antiphospholipid syndrome" e "treatment". Resultados: A maioria dos estudos relatou forte associação entre os anticorpos antifosfolípides específicos e a síndrome do anticorpo antifosfolípide com perda gestacional de repetição. Mulheres portadoras da mutação do fator V de Leiden, mutação do gene da protrombina e deficiência de proteína S apresentaram alto risco de perda gestacional de repetição em uma grande revisão sistemática. Estudos recentes demonstraram taxas de prevalência das trombofilias hereditárias e da síndrome do anticorpo antifosfolípide, em mulheres com perda gestacional de repetição, semelhantes às da população em geral. Os estudos atuais endossam o uso da heparina associada à aspirina em mulheres com síndrome do anticorpo antifosfolípide, com aumento da taxa de nascidos vivos, mas sem diferença em re- lação às complicações obstétricas. Conclusão: Apesar de novos estudos demons- trarem que a prevalência das trombofilias hereditárias e adquiridas em mulheres com perda gestacional de repetição é semelhante à da população em geral, reco- menda-se a pesquisa rotineira de síndrome do anticorpo antifosfolípide nessas pacientes. O uso de aspirina em baixas doses associada à heparina é a intervenção farmacológica de primeira linha para a prevenção de perda gestacional de repeti- ção em pacientes com síndrome do anticorpo antifosfolípide.
Objective: To discuss the role of thrombophilias in recurrent pregnancy loss, focu- sing on the prevalence/association of these pathologies with recurrent abortion and treatment, through results of clinical trials, systematic reviews and meta-analyses. Methods: This is a non-systematic review of articles published in electronic databa- ses PubMed, Cochrane, SciELO in the last five years, using the following descriptors: "recurrent pregnancy loss", "recurrent abortion", "habitual abortion", "thrombophilia", "antiphospholipid syndrome", and "treatment". Results: Most studies have reported a strong association between specific antiphospholipid antibodies and antiphospho- lipid antibody syndrome with recurrent pregnancy loss. Women carrying the factor V Leiden mutation, prothrombin gene mutation, and protein S deficiency were shown to be at high risk of recurrent pregnancy loss in a large systematic review. Recent studies have shown prevalence rates of hereditary thrombophilias and antiphospholipid antibody syndrome, in women with re- current pregnancy loss, similar to those of the general po- pulation. Current studies endorse the use of heparin plus aspirin in women with antiphospholipid antibody syndrome, with an increase in live birth rate, but with no difference in obstetric complications. Conclusion: Although new studies demonstrate that the prevalence of hereditary and acquired thrombophilias in women with recurrent pregnancy loss is si- milar to that of the general population, routine investigation of antiphospholipid antibody syndrome in these patients is recommended. The use of low-dose aspirin plus heparin is the first-line pharmacological intervention for the prevention of recurrent pregnancy loss in patients with antiphospholipid antibody syndrome.
Assuntos
Humanos , Feminino , Gravidez , Trombofilia/diagnóstico , Aborto , Fator V , Protrombina/genética , Heparina/farmacologia , Aspirina/farmacologia , Deficiência de Proteína S/complicaçõesRESUMO
Background: Early and accurate diagnosis of the cause of pelvic pain in first trimester of pregnancy is essential for appropriate clinical decision making thereby enabling correct and timely management. The aim of the study was to evaluate the role of ultrasonography in evaluation various causes of pelvic pain in the first trimester of pregnancy and correlate the imaging findings with clinical/per-operative findings.Methods: This was a prospective observational study approved by the Institutional Review Board and conducted from November 2016 to March 2018. 67 patients with pelvic pain in their first trimester, attending the antenatal clinic or OBG emergency underwent pelvic ultrasonography and the findings were correlated with clinical/per-operative findings.Results: Ectopic pregnancies formed the largest individual group comprising of 45 (67.2%) cases of the total study population followed by spontaneous abortion 5(7.5%). Other causes included subchorionic haemorrhage, ovarian torsion, uterine fibroid, simple/haemorrhagic/dermoid cyst of ovary and acute appendicitis. 4 (6%) patients had normal intrauterine pregnancy.Conclusions: Ultrasonography has high diagnostic accuracy of 94% and 100% sensitivity for detecting the cause of first trimester pelvic pain.
RESUMO
Background: Early and accurate diagnosis of the cause of pelvic pain in first trimester of pregnancy is essential for appropriate clinical decision making thereby enabling correct and timely management. The aim of the study was to evaluate the role of ultrasonography in evaluation various causes of pelvic pain in the first trimester of pregnancy and correlate the imaging findings with clinical/per-operative findings.Methods: This was a prospective observational study approved by the Institutional Review Board and conducted from November 2016 to March 2018. 67 patients with pelvic pain in their first trimester, attending the antenatal clinic or OBG emergency underwent pelvic ultrasonography and the findings were correlated with clinical/per-operative findings.Results: Ectopic pregnancies formed the largest individual group comprising of 45 (67.2%) cases of the total study population followed by spontaneous abortion 5(7.5%). Other causes included subchorionic haemorrhage, ovarian torsion, uterine fibroid, simple/haemorrhagic/dermoid cyst of ovary and acute appendicitis. 4 (6%) patients had normal intrauterine pregnancy.Conclusions: Ultrasonography has high diagnostic accuracy of 94% and 100% sensitivity for detecting the cause of first trimester pelvic pain.
RESUMO
Background. Abortion is the termination of a pregnancy before the age of fetal viability which, according to the WHO, is 22 weeks of pregnancy and/or with the fetus weigh less than 500 g. Spontaneous abortion is a public health problem. It's one of the most common complications of pregnancy. In order to contribute to the decrease of the morbidity and mortality linked to spontaneous abortions, we conducted this study, which the general objective was to study risk factors of spontaneous abortion. We carried out a cross-sectional case-control study in the District Hospitals of Biyem Methods. - Assi and Efoulan in Yaoundé. During six months, we collected 3774 records of pregnant women from January 1, 2020 to December 31.,2020. For each case (record of woman who had a spontaneous abortion), two controls (records of those who gave birth spontaneously at term) of the same age, were immediately recruited. Data were analyzed using IBM SPSS Version.23.0 software. Tools used to assess our results were: Fischer's exact test, frequency, odds ratio (OR) and P, with P signicant for any value less than 5%. We recruited 104 cases and 208 controls. Being unmarried, being from the littoral region, having a Results. history of stress, smoking, having started antenatal care and having had prenuptial check-up, independently increased the risk of spontaneous abortion with respectively aOR = 2.8 IC=1.24-6.31 aP= 0.013, aOR=4.31 IC= 1.09-17.02 aP= 0.037, aOR=11.86; CI=3.88-36.19; aP=<0.001, aOR=8.57; CI=3.41-21.54; aP=<0.001, aOR=10.4; CI=1.12-96.82; aP=0.04) and aOR=3.37; CI=1.67-6.79; aP<0.001). These risk factors being mostly modiable, should be sought and prevented Conclusion. in order to improve the prognosis of pregnancies in our context
RESUMO
Background: The pregnancy time is critical for both the mother抯 and the baby抯 health. The most common unfavourable pregnancy outcome is spontaneous abortion. Spontaneous pregnancy loss is a surprisingly common event, with roughly 15% of all clinically diagnosed pregnancies ending in pregnancy failure. Couples who suffer from frequent miscarriages may find it difficult to cope physically and emotionally. This study was planned to evaluate the association of preterm delivery, low birth weight, IUGR, recurrence of abortion, still birth, IUD, PROM, or any other adverse outcome in patients with history of previous spontaneous abortions. Objectives were to look for association between previous spontaneous abortion and preterm delivery, low birth weight, IUGR, recurrence of abortion, stillbirth, IUD, PROM and other complications in subsequent pregnancies.Methods: This was a prospective observational study done with 150 samples. The information such as demographic data of the antenatal women, clinical history, past obstetrics history, clinical examination, laboratory investigations and outcome of present pregnancy were collected and evaluated.Results: Maternal complications such as UTI (4.6%), Infection and fever (5.3%), PROM (2.7%), PPH (4%), hyperemesis 4%, PPROM 2.7% were observed. In study population, 60% of the foetus were in cephalic position, 19% in breech presentation and 21% in shoulder presentation. 29% of the women had preterm delivery, 34% were delivered by LSCS and 6% had spontaneous abortions. Low birth weight babies delivered in 25% cases. Foetal distress was observed in 15%, FGR in 9%, still birth in 3% and IUD in 1%.Conclusions: Women with previous spontaneous abortion are associated with a higher incidence of preterm delivery, cesarean section rate, neonatal low birth weight, fetal distress and high possibility of infection. Therefore, patients with previous spontaneous miscarriage represent a high-risk population for obstetric complication and close surveillance during the antenatal period is required.
RESUMO
Background: Spontaneous abortion (SA) is one of the most common unfavourable reproductive outcomes among women around the world, making maternal health promotion a major challenge. The aim of the current study was to identify the potential predictors associated with SA and recognized the need for providing home-based post-abortion care counselling to lower post abortion complications.Methods: A hospital-based cross-sectional study was conducted among the rural women ages of 18 and 45 years who had experienced at least one spontaneous miscarriage of less than 20 weeks of pregnancy. Participants were interviewed using a standardized questionnaire that included demographic, socioeconomic, and reproductive health information. Home based post abortion care protocol was introduced among the target populations for prevention of post abortion complications and maternal satisfaction was assessed after one week of implementation.Results: Of the 485 patients screened for eligibility, 24.12% had a history of at least one SA. The multivariate analysis revealed that occurrence of SA in our study is significantly associated with gravidity, multiparity, previous pregnancy complications, with a history of unfavourable fetal outcome and maternal comorbidities. Home based post abortion care protocol resulted higher maternal satisfaction and lower post abortion infection rate.Conclusions: The findings of our study reveals multiple modifiable factors may increase the risk of spontaneous abortion. One of the community participatory interventions in terms of providing home based post abortion care module resulted a significant impact on improving maternal satisfaction and lower post abortion infection rate among rural women.
RESUMO
OBJECTIVE@#To investigate the efficacy of Bushen Huoxue Fang (BSHXF, a traditional Chinese medicine formula) for improving recurrent spontaneous abortion (RSA) in mice and the role of tyrosine kinase (JAK2) and transcriptional activator (STAT3) signaling pathway in its therapeutic mechanism.@*METHODS@#Female CBA/J mice were caged with male DBA/2 mice to establish RSA mouse models, which were randomly divided into model group, dydrogesterone group and BSHXF group, with the female mice caged with male BALB/c mice as the control group (n=6). From the first day of pregnancy, the mice were subjected to daily intragastric administration of BSHXF, dydrogesterone, or distilled water (in control and model groups) for 12 days. After the treatments, serum levels of antithrombin III (AT-III), activated protein C (APC), tissue plasminogen activator (t-PA), progesterone, human chorionic gonadotropin (HCG), and estradiol (E2) were detected in each group using ELISA. HE staining was used to observe the morphological changes of the endometrium of the mice. Western blotting was performed to determine the expressions of p-JAK2, p-Stat3 and Bcl-2 in the placenta of the mice.@*RESULTS@#Compared with the control mice, the mouse models of RSA showed a significantly increased embryo loss rate with decreased serum levels of AT-III, T-PA, progesterone, APC and HCG, increased placental expressions of p-JAK2, p-STAT3 and Bax, and decreased expression of Bcl-2 (P < 0.05). Treatments with BSHXF and dydrogesterone both increased serum levels of AT-III, t-PA and HCG in the mouse models; Serum APC level was significantly reduced in BSHXF group and serum progesterone level was significantly increased in dydrogesterone group (P < 0.05).@*CONCLUSION@#BSHXF can improve the prethrombotic state and inhibit cell apoptosis by downregulating the JAK2/STAT3 pathway to increase the pregnancy rate in mouse models of RSA.