WorldWideScience

Sample records for early spontaneous miscarriage

  1. Body Mass Index and spontaneous miscarriage.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    OBJECTIVE: We compared the incidence of spontaneous miscarriage in women categorised as obese, based on a Body Mass Index (BMI) >29.9 kg\\/m(2), with women in other BMI categories. STUDY DESIGN: In a prospective observational study conducted in a university teaching hospital, women were enrolled at their convenience in the first trimester after a sonogram confirmed an ongoing singleton pregnancy with fetal heart activity present. Maternal height and weight were measured digitally and BMI calculated. Maternal body composition was measured by advanced bioelectrical impedance analysis. RESULTS: In 1200 women, the overall miscarriage rate was 2.8% (n=33). The mean gestational age at enrolment was 9.9 weeks. In the obese category (n=217), the miscarriage rate was 2.3% compared with 3.3% in the overweight category (n=329), and 2.3% in the normal BMI group (n=621). There was no difference in the mean body composition parameters, particularly fat mass parameters, between those women who miscarried and those who did not. CONCLUSIONS: In women with sonographic evidence of fetal heart activity in the first trimester, the rate of spontaneous miscarriage is low and is not increased in women with BMI>29.9 kg\\/m(2) compared to women in the normal BMI category.

  2. SPONTANEOUS MISCARRIAGE: STATE STUDY QUESTIONS

    Directory of Open Access Journals (Sweden)

    E. I. Borovkova

    2014-01-01

    Full Text Available Review of the literature devoted to the problem of early pregnancy losses. Presented modern classification, The etiology and pathogenesis of complications, diagnostic criteria and differential diagnosis, and treatment standards and opportunities for prevention.

  3. Recurrent spontaneous miscarriage: controversies in etiology and pathogenesis

    Directory of Open Access Journals (Sweden)

    O. S. Kryvopustov

    2016-01-01

    Full Text Available Aim. We have studied and analyzed the available scientific sources over the past five years in order to systematize the available literature of recent years about research regarding recurrent spontaneous miscarriage. Methods. During this studying we used methods of observation, systematization and content analysis. Results. Modern views on etiology and pathogenesis of recurrent spontaneous miscarriage, in particular were presented in the article. Attention is focused on risk factors such as genetic disorders, anatomical abnormalities, endocrine pathology, infectious agents, autoimmune and immune disorders. Conclusions. Our research iindicated role of progesterone and highlighted importance of genetic polymorphisms in the etiology and pathogenesis of recurrent spontaneous miscarriage.

  4. Miscarriage

    Science.gov (United States)

    ... can be a symptom of miscarriage, but many women also have it in early pregnancy and don't miscarry. To be sure, contact your health care provider right away if you have bleeding. Women who miscarry ...

  5. [Early recurrent miscarriage: Evaluation and management].

    Science.gov (United States)

    Gallot, V; Nedellec, S; Capmas, P; Legendre, G; Lejeune-Saada, V; Subtil, D; Nizard, J; Levêque, J; Deffieux, X; Hervé, B; Vialard, F

    2014-12-01

    To establish recommendations for early recurrent miscarriages (≥3 miscarriages before 14weeks of amenorrhea). Literature review, establishing levels of evidence and recommendations for grades of clinical practice. Women evaluation includes the search for a diabetes (grade A), an antiphospholipid syndrome (APS) (grade A), a thyroid dysfunction (grade A), a hyperprolactinemia (grade B), a vitamin deficiency and a hyperhomocysteinemia (grade C), a uterine abnormality (grade C), an altered ovarian reserve (grade C), and a couple chromosome analysis (grade A). For unexplained early recurrent miscarriages, treatment includes folic acid and progesterone supplementation, and a reinsurance policy in the first quarter (grade C). It is recommended to prescribe the combination of aspirin and low-molecular-weight heparin when APS (grade A), glycemic control in diabetes (grade A), L-Thyroxine in case of hypothyroidism (grade A) or the presence of thyroid antibodies (grade B), bromocriptine if hyperprolactinemia (grade B), a substitution for vitamin deficiency or hyperhomocysteinemia (grade C), sectionning a uterine septum (grade C) and treating an uterine acquired abnormality (grade C). These recommendations should improve the management of couples faced with early recurrent miscarriages. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Miscarriage

    Science.gov (United States)

    ... ve had a miscarriage, your provider may recommend: Dilation and curettage (also called D&C). This is ... angry, confused or alone. It’s OK to take time to grieve after a miscarriage. Ask your friends ...

  7. Spontaneous miscarriages and infant deaths among female farmers in rural South Africa

    National Research Council Canada - National Science Library

    Saloshni Naidoo; Leslie London; Alex Burdorf; Rajen Naidoo; Hans Kromhout

    2011-01-01

    Objectives This study examined associations of demographics and occupational factors with spontaneous miscarriages and infant deaths among women working in agriculture in KwaZulu-Natal, South Africa...

  8. Aneuploidy in Early Miscarriage and its Related Factors

    Science.gov (United States)

    Jia, Chan-Wei; Wang, Li; Lan, Yong-Lian; Song, Rui; Zhou, Li-Yin; Yu, Lan; Yang, Yang; Liang, Yu; Li, Ying; Ma, Yan-Min; Wang, Shu-Yu

    2015-01-01

    Background: Genetic factors are the main cause of early miscarriage. This study aimed to investigate aneuploidy in spontaneous abortion by fluorescence in situ hybridization (FISH) using probes for 13, 16, 18, 21, 22, X and Y chromosomes. Methods: A total of 840 chorionic samples from spontaneous abortion were collected and examined by FISH. We analyzed the incidence and type of abnormal cases and sex ratio in the samples. We also analyzed the relationship between the rate of aneuploidy and parental age, the rate of aneuploidy between recurrent abortion and sporadic abortion, the difference in incidence of aneuploidy between samples from previous artificial abortion and those from no previous induced abortion. Results: A total of 832 samples were finally analyzed. 368 (44.23%) were abnormal, in which 84.24% (310/368) were aneuploidies and 15.76% (58/368) were polyploidies. The first was trisomy16 (121/310), followed by trisomy 22, and X monosomy. There was no significant difference in the rate of aneuploidy in the advanced maternal age group (≥35 years old) and young maternal age group (abortion or between the samples from previous artificial abortion and those from no previous artificial abortion. Conclusions: Aneuploidy is a principal factor of miscarriage and total parental age is a risk factor. There is no skewed sex ratio in spontaneous abortion. There is also no difference in the rate of aneuploidy between recurrent abortion and sporadic abortion or between previous artificial abortion and no previous induced abortion. PMID:26481744

  9. Aneuploidy in Early Miscarriage and its Related Factors

    Directory of Open Access Journals (Sweden)

    Chan-Wei Jia

    2015-01-01

    Full Text Available Background: Genetic factors are the main cause of early miscarriage. This study aimed to investigate aneuploidy in spontaneous abortion by fluorescence in situ hybridization (FISH using probes for 13, 16, 18, 21, 22, X and Y chromosomes. Methods: A total of 840 chorionic samples from spontaneous abortion were collected and examined by FISH. We analyzed the incidence and type of abnormal cases and sex ratio in the samples. We also analyzed the relationship between the rate of aneuploidy and parental age, the rate of aneuploidy between recurrent abortion and sporadic abortion, the difference in incidence of aneuploidy between samples from previous artificial abortion and those from no previous induced abortion. Results: A total of 832 samples were finally analyzed. 368 (44.23% were abnormal, in which 84.24% (310/368 were aneuploidies and 15.76% (58/368 were polyploidies. The first was trisomy16 (121/310, followed by trisomy 22, and X monosomy. There was no significant difference in the rate of aneuploidy in the advanced maternal age group (≥35 years old and young maternal age group (<35 years old. However, the rate of trisomy 22 and the total rate of trisomies 21, 13, and 18 (the number of trisomy 21 plus trisomy 13 and trisomy 18 together showed significantly different in two groups. We found no skewed sex ratio. There was no significant difference in the rate of aneuploidy between recurrent miscarriage and sporadic abortion or between the samples from previous artificial abortion and those from no previous artificial abortion. Conclusions: Aneuploidy is a principal factor of miscarriage and total parental age is a risk factor. There is no skewed sex ratio in spontaneous abortion. There is also no difference in the rate of aneuploidy between recurrent abortion and sporadic abortion or between previous artificial abortion and no previous induced abortion.

  10. Diagnostic Value of Elastosonographic Evaluation of Cervix in Idiopathic Recurrent Spontaneous Miscarriage in the First Trimester

    Directory of Open Access Journals (Sweden)

    Doğa Fatma Öcal

    2016-12-01

    Full Text Available Aim: To detect prognostic role of cervical elastosonography (ES among women with a history of idiopathic recurrent spontaneous miscarriage (IRSM in early pregnancy. Methods: There were 40 women enrolled in the study. Of the 40, 20 were women diagnosed with IRSM in the first trimester and 20 were healthy women who had at least one childbirth experience. All patients underwent ES evaluation of the cervix. Strain ratio values of certain cervical tissue were recorded for all women. Results: The results of elastosonographic measures showed that external part of the upper lip of the cervix was significantly softer than the internal part and lower lip in women with IRSM. However, for women who had not experienced miscarriage, the results were not different. There were no significant differences observed between cervical length and elasticity among either group. Conclusion: Although we found that Region A was softer than Region C and D in women with IRSM, we also found similar results for women who have not experienced miscarriage. Our results support that cervical elasticity may not play a central role in the detection of etiopathogenesis of IRSM. Further studies with larger groups are needed.

  11. Evaluation of Some Plasma Coagulation Factors in Women with Spontaneous Miscarriage

    Directory of Open Access Journals (Sweden)

    Mahsa Besharat

    2015-10-01

    Full Text Available Background: It has been reported that 15-20% of parous female have experienced at least one miscarriage, while 3% of them have experienced two miscarriages. The goal of this study was to evaluate the plasma level of coagulation factors in women with a history of spontaneous abortions. Materials and Methods: In this case-control study, 82 women with a history of two or more abortions referred to the six private gynecologic clinics in Gorgan city without any structural abnormality were recruited during 2011-2012. Plasma levels of antithrombin III (ATIII using colorimetric assay, protein C, protein S, factor V Leiden and lupus anticoagulant (LAC using coagulation method were measured. The control group was women with a history of normal delivery and no abortions. Those under anti-coagulant therapy were excluded from the study. Data were entered into the computer using the Statistical Package for the Social Sciences (SPSS, SPSS Inc., Chicago, IL, USA version 16 and analyzed by Chi-square, t test and non-parametric tests. Results: At least one abnormality was reported in 35 cases (42.7%. Among them, protein C deficiency was the most prevalent (30.5%. ATIII was abnormal in 17.1% and lupus anti-coagulant was abnormal in 8.5%. Factor V Leiden was normal in all cases and protein S deficiency was only seen in one case. Conclusion: We suggest to perform these tests in regards to the thrombophilia in cases with spontaneous abortions in order to find an early cure for this treatable disorder.

  12. Consecutive successful pregnancies subsequent to intravenous immunoglobulin therapy in a patient with recurrent spontaneous miscarriage

    Directory of Open Access Journals (Sweden)

    Diejomaoh MF

    2015-12-01

    Full Text Available Michael F Diejomaoh,1,2 Zainab Bello,2 Waleed Al Jassar,1,2 Jiri Jirous,2 Kavitha Karunakaran,2 Asiya T Mohammed11Department of Obstetrics and Gynaecology, Faculty of Medicine, Kuwait University, Safat, 2Maternity Hospital, Shuwaikh, Kuwait Background: Recurrent spontaneous miscarriage (RSM has a multifactorial etiology, mainly due to karyotype abnormalities including balanced translocation, anatomical uterine disorders, and immunological factors, although in 50%–60% the etiology is unexplained. The treatment of RSM remains challenging, and the role of intravenous immunoglobulin (IVIG in RSM is controversial. Case report: Mrs HM, 37 years old, obstetric summary: P0+1+13+1, a known case of hypothyroidism/polycystic ovary syndrome, married to an unrelated 47-year-old man, presented to our RSM clinic in early January 2014 for investigation and treatment. She has had multiple failed in vitro fertilization trials and 13 first-trimester missed miscarriages terminating at 6–7 weeks, all without IVIG therapy. Her tenth pregnancy was spontaneous, managed in London, UK, with multiple supportive therapy and courses of IVIG starting from the third to the 30th week of pregnancy. The pregnancy ended at 36 weeks of gestation with a cesarean section and a live girl baby was delivered. Mrs HM had balanced translocation, 46XX t (7:11 (p10:q10. Preimplantation genetic diagnosis/intracytoplasmic sperm injection/in vitro fertilization was performed with embryo transfer on May 29, 2014, and resulted in a successful pregnancy. She was commenced immediately on metformin, luteal support, and IVIG therapy, started at 6 weeks of gestation and at monthly intervals until 30 weeks of gestation, and also received additional therapy. The pregnancy was monitored with ultrasound, progressed uneventfully until admission at 35 weeks of gestation, with mildly elevated liver enzymes and suspected fetal growth restriction. She was managed conservatively, and in the light of

  13. Expression of Thyroid Hormone Receptors in Villous Trophoblasts and Decidual Tissue at Protein and mRNA Levels Is Downregulated in Spontaneous and Recurrent Miscarriages.

    Science.gov (United States)

    Ziegelmüller, Brigitte; Vattai, Aurelia; Kost, Bernd; Kuhn, Christina; Hofmann, Simone; Bayer, Birgit; Toth, Bettina; Jeschke, Udo; Ditsch, Nina

    2015-07-01

    Thyroid hormones are essential for the maintenance of pregnancy, and a deficiency in maternal thyroid hormones has been associated with early pregnancy losses. The expression of THRα1, THRβ1 and THRα2 increases with gestational age. The aim of this study was the investigation of the protein and mRNA-levels of THR isoforms THRα1, THRα2, THRβ1 and THRβ2 in normal, spontaneous and recurrent miscarriages. The identification of THR-expressing cells in the decidua was done with double immunofluorescence. The nuclear expression of THRα1, THRα2, THRβ1 and THRβ2 is downregulated at protein level in spontaneous and recurrent miscarriages in villous trophoblast tissue. In decidual tissue, we found a significant downregulation only for THRα1 in spontaneous miscarriages. For recurrent miscarriages, THRα1 and THRβ1 were both significantly downregulated in decidual tissue. By applying HLA-G as a trophoblast marker, we found a significant co-expression only for THRβ2. The results of our study show that thyroid hormone receptors THRα1, THRα2, THRβ1 and THRβ2 are downregulated in spontaneous and recurrent miscarriages. The majority of cells expressing the thyroid hormone receptors in the decidua are decidual stromal cells. © The Author(s) 2015.

  14. A practical approach to the prevention of miscarriage: part 5--antiphospholipid syndrome as a cause of spontaneous abortion.

    Science.gov (United States)

    Check, J H

    2011-01-01

    To describe the diagnosis and treatment of antiphospholipid syndrome as it relates to spontaneous abortion. The relative importance of performing tests of antiphospholipid antibodies that prolong the partial thromboplastin time and other autoantibodies against phospholipids measured by ELISA are discussed. The most important diagnostic tests are the lupus anticoagulant, anticardiolipin antibody and antiphosphatidyl serine. Low molecular weight heparin and low dose aspirin are the two most important therapies. Women with recurrent miscarriages or even an unexplained miscarriage especially after ten weeks (but sometimes even early first trimester) or a history of thrombosis or intrauterine growth restriction and maybe preeclampsia are candidates for anticoagulant therapy, especially with the presence of significant levels of the lupus anticoagulant or anticardiolipin or antiphosphatidyl serine antibodies (> 40 pl units/ml).

  15. Consecutive successful pregnancies subsequent to intravenous immunoglobulin therapy in a patient with recurrent spontaneous miscarriage.

    Science.gov (United States)

    Diejomaoh, Michael F; Bello, Zainab; Al Jassar, Waleed; Jirous, Jiri; Karunakaran, Kavitha; Mohammed, Asiya T

    2015-01-01

    Recurrent spontaneous miscarriage (RSM) has a multifactorial etiology, mainly due to karyotype abnormalities including balanced translocation, anatomical uterine disorders, and immunological factors, although in 50%-60% the etiology is unexplained. The treatment of RSM remains challenging, and the role of intravenous immunoglobulin (IVIG) in RSM is controversial. Mrs HM, 37 years old, obstetric summary: P0+1+13+1, a known case of hypothyroidism/polycystic ovary syndrome, married to an unrelated 47-year-old man, presented to our RSM clinic in early January 2014 for investigation and treatment. She has had multiple failed in vitro fertilization trials and 13 first-trimester missed miscarriages terminating at 6-7 weeks, all without IVIG therapy. Her tenth pregnancy was spontaneous, managed in London, UK, with multiple supportive therapy and courses of IVIG starting from the third to the 30th week of pregnancy. The pregnancy ended at 36 weeks of gestation with a cesarean section and a live girl baby was delivered. Mrs HM had balanced translocation, 46XX t (7:11) (p10:q10). Preimplantation genetic diagnosis/intracytoplasmic sperm injection/in vitro fertilization was performed with embryo transfer on May 29, 2014, and resulted in a successful pregnancy. She was commenced immediately on metformin, luteal support, and IVIG therapy, started at 6 weeks of gestation and at monthly intervals until 30 weeks of gestation, and also received additional therapy. The pregnancy was monitored with ultrasound, progressed uneventfully until admission at 35 weeks of gestation, with mildly elevated liver enzymes and suspected fetal growth restriction. She was managed conservatively, and in the light of nonreassuring fetal status, a live female infant weighing 2.29 kg was delivered by emergency cesarean section on January 14, 2015, with an Apgar score of 8 and 9 and mild respiratory distress, and was admitted to the Special Care Baby Unit for intensive therapy. The mother and baby made

  16. Epidemiological Survey and Risk Factor Analysis of Recurrent Spontaneous Miscarriages in Infertile Women at Large Infertility Centers

    Science.gov (United States)

    Wang, Hai-Yan; Qiao, Jie; Sun, Xiao-Xi; Wang, Shu-Yu; Liang, Xiao-Yan; Sun, Yun; Liu, Feng-Hua

    2017-01-01

    Background: A higher frequency of spontaneous miscarriage has been observed in infertile couples, and there is a higher prevalence of infertility among patients with a history of recurrent spontaneous miscarriages (RSMs; ≥2 miscarriages). This study aimed to determine the proportion of infertile patients with RSM and examine risk factors associated in patients with RSM being treated with assisted reproductive technologies. Methods: This cross-sectional observational study was conducted at six reproductive medicine centers in three cities of China. Data of 751 patients with at least one spontaneous miscarriage were analyzed. Demographic data and etiological factors associated with infertility were compiled and compared between patients with a single spontaneous miscarriage (SSM) and those with RSM. Results: Two hundred (26.6%, 95% confidence interval [CI]: 23.50–29.95%) patients experienced RSMs and 551 (73.4%) had a single miscarriage. The odds of RSM increased with increasing age (odds ratio [OR] = 1.06), uterine disorders (OR = 2.09), endocrine disorders (OR = 2.48), and immune disorders (OR = 2.98). Higher education level, masters or above, and a pelvic cavity disorder were associated with lower risk of RSM (OR = 0.27 and 0.46, respectively). Late spontaneous miscarriages were more frequent in patients with RSM than in those with a SSM (31.5% vs. 14.2%, respectively, P < 0.001) and were associated with a history of uterine cavity procedures (OR = 2.095) and cervical factors related to infertility (OR = 4.136, 95% CI: 1.012–16.90). Conclusions: Compared to patients with only a SSM, the conditions of patients with RSM are more complicated. To increase the success rate of assisted reproductive technology, factors including uterus cavity adhesion, cervical relaxation, endocrine disorders, and immune disorders should be treated before assisted reproduction is initiated. These data may provide treatment guidance for infertile patients with a history of RSM. PMID

  17. Identification of key contributory factors responsible for vascular dysfunction in idiopathic recurrent spontaneous miscarriage.

    Directory of Open Access Journals (Sweden)

    Priyanka Banerjee

    Full Text Available Poor endometrial perfusion during implantation window is reported to be one of the possible causes of idiopathic recurrent spontaneous miscarriage (IRSM. We have tested the hypothesis that certain angiogenic and vasoactive factors are associated with vascular dysfunction during implantation window in IRSM and, therefore, could play a contributory role in making the endometrium unreceptive in these women. This is a prospective case-controlled study carried out on 66 women with IRSM and age and BMI matched 50 fertile women serving as controls. Endometrial expression of pro-inflammatory (IL-1β, TNF-α, IFN-γ, TGF-β1, anti-inflammatory (IL-4, -10, angiogenesis-associated cytokines (IL-2, -6, -8, angiogenic and vasoactive factors including prostaglandin E2 (PGE2, vascular endothelial growth factor (VEGF, endothelial nitric oxide synthase (eNOS, nitric oxide (NO and adrenomedullin (ADM were measured during implantation window by ELISA. Subendometrial blood flow (SEBF was assessed by color Doppler ultrasonography. Multivariate analysis was used to identify the significant factor(s responsible for vascular dysfunction in IRSM women during window of implantation and further correlated with vascular dysfunction. Endometrial expression of pro-inflammatory cytokines and PGE2 were up-regulated and anti-inflammatory and angiogenesis-associated cytokines down-regulated in IRSM women as compared with controls. Further, the angiogenic and vasoactive factors including VEGF, eNOS, NO and ADM were found to be down-regulated and SEBF grossly affected in these women. Multivariate analysis identified IL-10, followed by VEGF and eNOS as the major factors contributing towards vascular dysfunction in IRSM women. Moreover, these factors strongly correlated with blood flow impairment. This study provides an understanding that IL-10, VEGF and eNOS are the principal key components having a contributory role in endometrial vascular dysfunction in women with IRSM. Down

  18. Exposure to selective serotonin reuptake inhibitors in early pregnancy and the risk of miscarriage.

    Science.gov (United States)

    Andersen, Jon Trærup; Andersen, Nadia Lyhne; Horwitz, Henrik; Poulsen, Henrik Enghusen; Jimenez-Solem, Espen

    2014-10-01

    To investigate whether exposure to selective serotonin reuptake inhibitors (SSRIs) in early pregnancy is associated with miscarriage. This was a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2010. All births were identified using the Medical Birth Registry, and all records of induced abortion or miscarriage were gathered from the National Hospital Register. Data on SSRI use were gathered from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed to an SSRI in early pregnancy and the hazard of miscarriage in women discontinuing treatment before pregnancy. We identified 1,279,840 pregnancies (911,569 births, 142,093 miscarriages, 226,178 induced abortions). Of the 22,884 exposed to an SSRI during the first 35 days of pregnancy, 12.6% (2,883) ended in miscarriage compared with 11.1% among unexposed. The adjusted hazard ratio of having a miscarriage after exposure to an SSRI was 1.27 (95% confidence interval [CI] 1.22-1.33) compared with unexposed. Women discontinuing SSRI treatment 3-12 months before pregnancy also had an increased hazard ratio of having a miscarriage compared to unexposed (1.24, 95% CI 1.18-1.30). Women exposed to SSRIs during early pregnancy were at increased risk of miscarriage as were women discontinuing SSRI treatment before pregnancy, and these risks were similar. Therefore, treatment with SSRIs during pregnancy should not be discontinued as a result of fear of miscarriage. LEVEL OF EVIEDENCE:: II.

  19. The natural course of spontaneous miscarriage: analysis of signs and symptoms in 188 expectantly managed women

    NARCIS (Netherlands)

    Wieringa-de Waard, Margreet; Ankum, Willem M.; Bonsel, Gouke J.; Vos, Jeroen; Biewenga, Petra; Bindels, Patrick J.

    2003-01-01

    Background: Expectant management is an alternative for curettage in women with a miscarriage Aim: To assess the pattern of vaginal bleeding and pain in expected women with a miscarriage, and to analyse the factantly managed women with a miscarriage, and to analyse the factors predictive of a

  20. Diclofenac/misoprostol during early pregnancy and the risk of miscarriage: a Danish nationwide cohort study.

    Science.gov (United States)

    Andersen, Jon T; Mastrogiannis, Dimitrios; Andersen, Nadia L; Petersen, Morten; Broedbaek, Kasper; Cejvanovic, Vanja; Nielsen, Torben K; Poulsen, Henrik E; Jimenez-Solem, Espen

    2016-08-01

    Misoprostol can be used in the prevention of gastric ulcer in treatment with diclofenac and is used in rheumatic diseases. Since misoprostol causes contractions of the uterus, it can also be used to induce abortions when administrated vaginally. The aim of the study was to investigate if early pregnancy exposure to oral diclofenac/misoprostol was associated with miscarriage. We conducted a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2011. All births were identified using the Medical Birth Registry, and all records of induced abortion and miscarriage were from the National Hospital Register. Data on drug use were from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed to diclofenac/misoprostol in early pregnancy. We identified 1,338,824 pregnancies (970,491 births, 142,147 miscarriages, 226,145 induced abortions). One hundred sixty-six were exposed to diclofenac/misoprostol in the early pregnancy of which 28.3 % (47) ended up in a miscarriage compared to 10.6 % among unexposed. The adjusted hazard ratio of having a miscarriage after exposure to diclofenac/misoprostol in the first trimester was 3.6 (CI 95 % 2.6-4.9). We found an increased risk of miscarriage after exposure to diclofenac/misoprostol during the early pregnancy. Women in the fertile age should not be treated with the combination of diclofenac/misoprostol if other options were available.

  1. Exposure to Selective Serotonin Reuptake Inhibitors in Early Pregnancy and the Risk of Miscarriage

    DEFF Research Database (Denmark)

    Andersen, Jon Thor Trærup; Andersen, Nadia Lyhne; Horwitz, Henrik

    2014-01-01

    OBJECTIVE: To investigate whether exposure to selective serotonin reuptake inhibitors (SSRIs) in early pregnancy is associated with miscarriage. METHODS: This was a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2010. All births were identified using...

  2. Serum periostin levels in early in pregnancy are significantly altered in women with miscarriage.

    Science.gov (United States)

    Freis, A; Schlegel, J; Kuon, R J; Doster, A; Jauckus, J; Strowitzki, T; Germeyer, A

    2017-11-02

    Miscarriage is a common complication in pregnancy and there is still a lack of biomarkers usable in asymptomatic patients before the event occurs. Periostin (PER), whose levels rise particularly during injury or inflammation, has been shown to play an important local role in implantation and early embryonic development. As PER has been described as a biomarker in various medical conditions we intended to evaluate if changes in PER serum levels may help to identify women at risk for spontaneous abortion in the first trimester. Women between 18 and 42 years without confounding comorbidities who conceived by IVF/ICSI and ovarian hyperstimulation were analysed in the study after informed consent. Maternal serum samples from 41 patients were assessed at the time of pregnancy testing (PT) and the following first ultrasound checkup (US). Patients were subsequently divided in two groups: (1) patients with subsequent miscarriage in the first trimester (n = 18) and (2) patients with ongoing pregnancy (n = 23), allowing for statistical analysis and investigating the change of PER levels per individual. PER levels were measured using enzyme-linked immunosorbent assay. Statistical analysis was performed using the Fisher exact and Student's t test. p ≤ 0.05 was considered to be significant. There was no significant difference concerning possible confounders between the two groups. We did not find any significant difference in PER levels at the time point of PT or US. By investigating the interindividual changes of PER between the two time points however, we observed that patients with a following miscarriage showed increasing levels of PER at the time point of PT compared to US in contrast to patients with an ongoing pregnancy who demonstrated a decrease in PER levels. These alterations were significant in the absolute as well as in the relative comparison. The relative expression of PER between PT and US is significantly altered in asymptomatic women with subsequent

  3. Spontaneous abortion and recurrent miscarriage: A comparison of cytogenetic diagnosis in 250 cases.

    Science.gov (United States)

    Choi, Tae Yeong; Lee, Hye Min; Park, Won Kyoung; Jeong, So Yeong; Moon, Hwa Sook

    2014-11-01

    The purpose of this study was to determine the frequency and distribution of cytogenetically abnormal miscarriages in couples with spontaneous abortions (SA) or recurrent miscarriages (RM). Karyotyping of specimens from 164 abortuses with SA and 86 abortuses with RM was successfully performed according to the standard cytogenetic methods using G-banding technique. Among the total 164 cases of SA group, 81 (49.4%) were euploid and the rest (83, 50.6%) showed chromosomal abnormalities. In RM(≥2) and RM(≥3) group, 31 (36.0%)/27 (34.6%) cases were euploid and 55 (64.0%)/51(65.4%) cases were abnormal, respectively. A statistically significant difference was found in the rate of cytogenetic abnormality between SA and RM groups (P<0.05). In all groups, women with advanced maternal age (≥35 years) had a higher rate of chromosome anomalies compared with women younger than age 35 (normal:abnormal = 32.4%:67.6% for ≥35 years and 53.8%:46.2% for <35 years in SA; 19.2%:80.8%/21.7%:78.3% for ≥35 years and 43.3%:56.7%/40.0%:60.0% for <35 years in RM(≥2) and RM(≥3), respectively; P<0.05). In SA group, an increase of normal karyotypes was noted with increased gestational age (<10 week, 38.0%; 10-15 week, 53.5%; 16-20 week, 65.7%). In RM group, most of cases were in <10 week and the frequency of trisomies with chromosomes 1 to 10 were increased compared with that of SA. There was a statistically significant difference in the frequency and distribution of chromosomal abnormalities between SA and RM groups. Our results will provide useful information for diagnosis and genetic counseling of patients with SA or RM.

  4. Diclofenac/misoprostol during early pregnancy and the risk of miscarriage

    DEFF Research Database (Denmark)

    Andersen, Jon T; Mastrogiannis, Dimitrios; Andersen, Nadia L

    2016-01-01

    to diclofenac/misoprostol in the first trimester was 3.6 (CI 95 % 2.6-4.9). CONCLUSION: We found an increased risk of miscarriage after exposure to diclofenac/misoprostol during the early pregnancy. Women in the fertile age should not be treated with the combination of diclofenac/misoprostol if other options...... if early pregnancy exposure to oral diclofenac/misoprostol was associated with miscarriage. METHOD: We conducted a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2011. All births were identified using the Medical Birth Registry, and all records of induced abortion...... and miscarriage were from the National Hospital Register. Data on drug use were from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed to diclofenac/misoprostol in early pregnancy. RESULT: We identified 1...

  5. Genetic heterogeneity of platelet glycoproteins Ia and IIIa and the risk of spontaneous miscarriages.

    Science.gov (United States)

    Vlachadis, Nikolaos; Tsamadias, Vasileios; Vrachnis, Nikolaos; Kaparos, Georgios; Vitoratos, Nikolaos; Kouskouni, Evaggelia; Economou, Emmanuel

    2017-06-01

    The aim of this study was to investigate the association between the genetic heterogeneity of platelet glycoproteins Ia (GpIa-C807T) and IIIa (GpIIIa-PlA1/PlA2) and spontaneous abortions. Two hundred and twenty two women with a history of unexplained spontaneous miscarriages and no successful pregnancy, and 60 fertile women serving as controls were genotyped for the GpIa-C807T and GpIIIa-PlA1/PlA2 polymorphisms by pyrosequencing. In comparison with the common alleles homozygotes, GpIa-807T and GpIIIa-PlA2 carriers had an increased risk of fetal loss (OR = 3.36, 95%CI: 1.85-6.11, p < 0.001, and OR = 2.58, 95%CI: 1.30-5.13, p = 0.006, respectively). For subjects who were combined carriers of the GpIa-807T and GpIIIa-PlA2 alleles, the risk increased further (OR = 9.13, 95%CI: 2.99-27.82, p < 0.001). The above ORs were highest for women who were younger than 30 years of age. The GpIa-C807T and GpIIIa-PlA1/PlA2 polymorphisms and more pronouncedly their combination are associated with increased risk of spontaneous abortions. The correlations were stronger for younger patients. Our results indicate that GpIa-807T and GpIIIa-PlA2 are susceptibility alleles for fetal loss in the Greek population.

  6. Trimethoprim use in early pregnancy and the risk of miscarriage

    DEFF Research Database (Denmark)

    Andersen, J T; Petersen, M; Jimenez-Solem, E

    2013-01-01

    including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox...

  7. Abortamentos espontâneos em portadoras do Traço Falciforme (AS Spontaneous miscarriages among sickle cell trait carriers (AS

    Directory of Open Access Journals (Sweden)

    Antonio S. Ramalho

    2003-01-01

    Full Text Available A study carried out in Salvador, Bahia, Northeastern Brazil, has shown a miscarriage rate significantly higher among AS women than that observed among AA controls. Considering this finding, we investigated the miscarriage rate among women cared for by the hemoglobinopathy program in the city of Araras, São Paulo, Southeastern Brazil. The spontaneous miscarriage rate among 165 AS women (17% was significantly higher than that observed among 500 AA women (10% (p = 0.02. Taking into account only women with ages above 20 years, the miscarriage rate among 112 heterozygous AS (22% greatly differed from that observed among 347 AA women (12.6% (p = 0.01. These results confirm the greater tendency of spontaneous miscarriages among AS women, which might be related to a previously described maternal effect in relation to AS heterozygous women.

  8. Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case-control study.

    Science.gov (United States)

    Toulis, Konstantinos A; Goulis, Dimitrios G; Tsolakidou, Konstantina; Hilidis, Ilias; Fragkos, Marios; Polyzos, Stergios A; Gerofotis, Antonios; Kita, Marina; Bili, Helen; Vavilis, Dimitrios; Daniilidis, Michail; Tarlatzis, Basil C; Papadimas, Ioannis

    2013-08-01

    We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case-control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher's exact test, p value = 1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value = 0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.

  9. Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases.

    Science.gov (United States)

    Tan, Shu-Yin; Hang, Fu; Purvarshi, Gowreesunkur; Li, Min-Qing; Meng, Da-Hua; Huang, Ling-Ling

    2015-10-01

    To evaluate the predictive value of three-dimensional (3D)-power Doppler sonography on recurrent miscarriage. The study patients were divided into a recurrent miscarriage group (30 cases) and a normal pregnancy group (21 cases). Measurement of endometrial thickness was performed using two-dimensional transvaginal ultrasound in the midluteal phase. The endometrial volume, vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) in midluteal and placenta volume, as well as the VI, FI, and VFI of early pregnancy were measured using Virtual Organ Computer-aided Analysis of 3D-power Doppler ultrasound. Endometrial thickness, endometrial volume, endometrial vascular data, VI, FI, and VFI of the midluteal phase were lower in the recurrent miscarriage group compared with the normal pregnancy group (p early pregnancy were lower in the miscarriage group compared with the normal pregnancy group (p early pregnancy (p > 0.05). The predictive accuracy of endometrial thickness, endometrial volume, VI, FI, and VFI in the midluteal phase, and placenta volume, VI, FI, and VFI in early pregnancy as measured by the receiver operating characteristic curve to predict miscarriage before 12 gestational weeks in participants was 0.681, 0.876, 0.770, 0.720, 0.879, 0.771, 0.907, 0.592, respectively. The 3D-power Doppler ultrasound is a more comprehensive and sensitive method for evaluating endometrial receptivity. Endometrial volume, VI, FI, and VFI in the midluteal phase, as well as VI in early pregnancy, can be considered as predictive factors for recurrent miscarriage. Copyright © 2015. Published by Elsevier B.V.

  10. Clarithromycin in early pregnancy and the risk of miscarriage and malformation

    DEFF Research Database (Denmark)

    Andersen, Jon Thor Trærup; Petersen, Morten; Jimenez-Solem, Espen

    2013-01-01

    The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy. The aim of the study was to investigate whether clarithromycin use in early pregnancy was associated...

  11. Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases

    Directory of Open Access Journals (Sweden)

    Shu-Yin Tan

    2015-10-01

    Conclusion: The 3D-power Doppler ultrasound is a more comprehensive and sensitive method for evaluating endometrial receptivity. Endometrial volume, VI, FI, and VFI in the midluteal phase, as well as VI in early pregnancy, can be considered as predictive factors for recurrent miscarriage.

  12. Effects of varicocele repair on spontaneous first trimester miscarriage: a randomized clinical trial.

    Science.gov (United States)

    Mansour Ghanaie, Mandana; Asgari, Seyyed Alaeddin; Dadrass, Nassrin; Allahkhah, Aliakbar; Iran-Pour, Elham; Safarinejad, Mohammad Reza

    2012-01-01

    To evaluate the effects of varicocelectomy on semen parameters, pregnancy rates, and live birth in couples with first term recurrent miscarriage. One hundred and thirty-six women with recurrent miscarriage were recruited into this study. All of the husbands had normal semen parameters according to World Health Organization criteria and clinical varicocele. In order to evaluate the causes of recurrent pregnancy loss, we looked for chromosomal abnormalities and endocrine, chronic inflammatory, and infectious diseases. Both groups were well matched according to male/female age, varicocele grade, and smoking history. These couples were assigned randomly into two groups: group one (n = 68), in which male partners underwent varicocele repair, and group two (n = 68), which underwent expectant therapy. All of the couples were followed up monthly up to 12 months. All of the women who conceived were followed up until delivery. In each 3-month follow-up visits, two semen analyses were performed. Mean sperm concentration, sperm progressive motility, and sperm with normal morphology improved significantly after elapsing 6 months from varicocelectomy by 75.0%, 15.9%, and 14.3%, respectively, versus the expectant group (P Sperm density/mL (r = 0.072; P = .001), time elapsed from varicocelectomy (r = 0.068; P = .001), and female age (r = -0.062; P = .002) were three most significantly related independent factors to pregnancy rate by multiple regression analysis. Varicocelectomy improves semen quality, increases pregnancy rate, and decreases miscarriage rate significantly. Further controlled studies to confirm our results seem warranted.

  13. The frequencies of the presence of embryonic pole and cardiac activity in early miscarriages with abnormal karyotypes.

    Science.gov (United States)

    Liu, Yukun; Liu, Yinglin; Chen, Hui; Du, Tao; Tan, Jianping; Zhang, Jianping

    2015-01-01

    The objective of this study was to compare the frequencies of the presence of an embryonic pole and cardiac activity in miscarriages with normal and abnormal embryonic karyotypes. From January 2008 to December 2012, 405 patients with early miscarriage were evaluated during pregnancy by regular ultrasound, and karyotyping was performed on chorionic villus tissue after curettage. The frequencies of the presence of an embryonic pole and cardiac activity were compared between patients with a normal embryonic karyotype and patients with an abnormal embryonic karyotype. Of the 405 samples, 224 cases (55.3%) had an abnormal karyotype, and 181 cases (44.7%) had a normal karyotype. The frequencies of the presence of an embryonic pole and cardiac activity in miscarriages with normal embryonic chromosomes (71.8% and 57.5%, respectively) were similar to those of miscarriages with abnormal embryonic chromosomes (74.1% and 62.1%, respectively). The frequencies of the presence of an embryonic pole and cardiac activity were higher in miscarriages with viable autosomal trisomies (trisomies 21, 13, and 18), monosomy X, and triploidy than in miscarriages with a normal karyotype or other abnormal karyotypes. The frequencies of the presence of an embryonic pole and cardiac activity are higher in miscarriages with viable autosomal trisomies, monosomy X, and triploidy than in miscarriages with a normal karyotype or other abnormal karyotypes.

  14. Risk of first trimester spontaneous miscarriage among singleton gestations following ICSI and its relation to underlying cause of infertility

    Directory of Open Access Journals (Sweden)

    Wessam Magdi Abuelghar

    2014-06-01

    Results: Two hundred and thirty four pregnant young women were included in the study, 164 (70.9% women miscarried. The causes of infertility among these women were as follows: 41 (25% mild male factor infertility, 40 (24.4% severe male factor infertility, 45 (27.44% tubal factor, 7 (4.27% polycystic ovarian syndrome, 3 (1.83% endometriosis, 20 (12.19% unexplained and 8 (4.87% multifactorial. Stepwise logistic multi-regression analysis showed that both maternal age (>31 years and tubal block were the most sensitive discriminators for the prediction of first trimester spontaneous miscarriage among the study population (P 31 years and/or the presence of tubal block.

  15. A Comparison of Pattern of Pregnancy Loss in Women with Infertility Undergoing IVF and Women with Unexplained Recurrent Miscarriages Who Conceive Spontaneously.

    Science.gov (United States)

    Tamhankar, Vidya A; Liu, Beiyu; Yan, Junhao; Li, Tin-Chiu

    2015-01-01

    Objective. Women with infertility and recurrent miscarriages may have an overlapping etiology. The aim of this study was to compare the pregnancy loss in pregnancies after IVF treatment with spontaneous pregnancies in women with recurrent miscarriages and to assess differences related to cause of infertility. Methods. The outcome from 1220 IVF pregnancies (Group I) was compared with 611 spontaneous pregnancies (Group II) in women with recurrent miscarriages. Subgroup analysis was performed in Group I based on cause of infertility: tubal factor (392 pregnancies); male factor (610 pregnancies); and unexplained infertility (218 pregnancies). Results. The clinical pregnancy loss rate in Group I (14.3%) was significantly lower than that of Group II (25.8%, p cause of infertility. However the timing of pregnancy loss was similar between Groups I and II. The clinical pregnancy loss rate in Group I was similar in different causes of infertility. Conclusions. The clinical pregnancy loss rate following IVF treatment is lower than that of women with unexplained recurrent miscarriages who conceived spontaneously. This difference persists whether the infertility is secondary to tubal factors, male factors, or unexplained cause.

  16. Decidual Macrophages Are Significantly Increased in Spontaneous Miscarriages and Over-Express FasL: A Potential Role for Macrophages in Trophoblast Apoptosis

    Directory of Open Access Journals (Sweden)

    Antonis Makrigiannakis

    2012-07-01

    Full Text Available Decidual macrophages (DM are the second most abundant population in the fetal-maternal interface. Their role has been so far identified as being local immuno-modulators favoring the maternal tolerance to the fetus. Herein we investigated tissue samples from 11 cases of spontaneous miscarriages and from 9 cases of elective terminations of pregnancy. Using immunohistochemistry and dual immunofluorescence we have demonstrated that in spontaneous miscarriages the DM are significantly increased. Additionally, we noted a significant up-regulation of macrophage FasL expression. Our results further support a dual role for DM during pregnancy and miscarriages. We hypothesize that the baseline DM population in normal pregnancy is in line with an M2 phenotype supporting the ongoing gestation. In contrast, during spontaneous miscarriages, the increased FasL-expressing population could be a part of an M1 phenotype participating in Fas/FasL-related apoptosis. Our results highlight a new aspect of macrophage biology in pregnancy physiology and pathophysiology. Further studies with larger samples are needed to verify the current results and evaluate their clinical impact.

  17. A Comparison of Pattern of Pregnancy Loss in Women with Infertility Undergoing IVF and Women with Unexplained Recurrent Miscarriages Who Conceive Spontaneously

    Directory of Open Access Journals (Sweden)

    Vidya A. Tamhankar

    2015-01-01

    Full Text Available Objective. Women with infertility and recurrent miscarriages may have an overlapping etiology. The aim of this study was to compare the pregnancy loss in pregnancies after IVF treatment with spontaneous pregnancies in women with recurrent miscarriages and to assess differences related to cause of infertility. Methods. The outcome from 1220 IVF pregnancies (Group I was compared with 611 spontaneous pregnancies (Group II in women with recurrent miscarriages. Subgroup analysis was performed in Group I based on cause of infertility: tubal factor (392 pregnancies; male factor (610 pregnancies; and unexplained infertility (218 pregnancies. Results. The clinical pregnancy loss rate in Group I (14.3% was significantly lower than that of Group II (25.8%, p<0.001 and this was independent of the cause of infertility. However the timing of pregnancy loss was similar between Groups I and II. The clinical pregnancy loss rate in Group I was similar in different causes of infertility. Conclusions. The clinical pregnancy loss rate following IVF treatment is lower than that of women with unexplained recurrent miscarriages who conceived spontaneously. This difference persists whether the infertility is secondary to tubal factors, male factors, or unexplained cause.

  18. Relationship of karyotype to embryo crown-rump length and maternal serum human chorionic gonadotropin level in early miscarriage.

    Science.gov (United States)

    Liu, Yukun; Liu, Yinglin; Chen, Hui; Li, Qing; Meng, Lili; Chen, Libin; Du, Tao; Zhang, Jianping

    2015-01-01

    The objective of this study was to compare the frequency and distribution of chromosomal abnormalities with different crown-rump length (CRL) and maternal serum human chorionic gonadotropin (HCG) levels in early miscarriages. Pregnancies in which a miscarriage occurred at ≤ 12 weeks' gestation and received karyotyping of chorionic villus after curettage from January 2008 to December 2011 were included in this retrospective study. The frequency and distribution of chromosomal anomalies with different CRLs and HCG levels were compared. A total of 183 miscarriages were included. The mean maternal age was 32.8 ± 4.6 years, and 37.2% of the subjects were ≥ 35 years of age. Among the 183 miscarriages, 74 (40.4%) cases had a normal karyotype, while 109 (59.6%) were abnormal. Maternal age ≥ 35 years, absence of a history of recurrent miscarriage, and CRL ≥ 15 mm were associated with an abnormal karyotype (p abnormalities (11.5%), and a CRL ≥ 15 mm was associated with monosomies (38.7%), triploidies (29%), and viable autosomal trisomies (12.9%). The frequency and distribution of abnormal karyotypes is different when the CRL is ≥ 15 or < 15 mm at the time of miscarriage. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Prototype and Chimera-Type Galectins in Placentas with Spontaneous and Recurrent Miscarriages

    Directory of Open Access Journals (Sweden)

    Laura Unverdorben

    2016-04-01

    Full Text Available Galectins are galactose binding proteins and, in addition, factors for a wide range of pathologies in pregnancy. We have analyzed the expression of prototype (gal-1, -2, -7, -10 and chimera-type (gal-3 galectins in the placenta in cases of spontaneous abortions (SPA and recurrent abortions (RA in the first trimester. Fifteen placental samples from healthy pregnancies were used as a control group. Nine placentas were examined for spontaneous abortions, and 12 placentas for recurrent abortions. For differentiation and evaluation of different cell types of galectin-expression in the decidua, immunofluorescence was used. For all investigated prototype galectins (gal-1, -2, -7, -10 in SPA and RA placenta trophoblast cells the expression is significantly decreased. In the decidua/extravillous trophoblast only gal-2 expression was significantly lowered, which could be connected to its role in angiogenesis. In trophoblasts in first-trimester placentas and in cases of SPA and RA, prototype galectins are altered in the same way. We suspect prototype galectins have a similar function in placental tissue because of their common biochemical structure. Expression of galectin 3 as a chimera type galectin was not found to be significantly altered in abortive placentas.

  20. Positive reproductive family history for spontaneous abortion: predictor for recurrent miscarriage in young couples.

    Science.gov (United States)

    Miskovic, Silvana; Culic, Vida; Konjevoda, Pasko; Pavelic, Jasminka

    2012-04-01

    The etiology of recurrent spontaneous abortions (RSA) in chromosomally normal parents is still unexplained. It is unclear whether or not some factors, such as spontaneous abortions (SA), which occur among extended family members can create a predisposition to RSA. Therefore, this study comprises two parts: (a) an epidemiological part, to evaluate the relationship between RSA in 567 couples and the frequency of SA among their first (I), second (II) and third (III) generation relatives, and (b) a genetic part, investigating whether parental and fetal chromosomal status may predispose to the occurrence of RSA. Couples (567) having one or more SA were analyzed in this retrospective case-control study. The family reproductive history data was collected from their medical charts. The total number of SA found in 567 couples was 1174, and the largest number occurred at 8-10 weeks of gestation. The majority of spouses had normal karyotypes (88.5% and 91%). Of the remainder, 65% of females and 76% of males expressed constitutional chromosomal variation, mostly pericentric inversion of chromosome 9. Cytogenetic analysis of aborted material showed some type of change in 40% of cases. The family reproductive history data indicated that SA among the couples' I, II and III generation relatives happened with a frequency two to three times higher than that of the general population (55.5, 47.6 and 32.6% for female relatives, and 45.8, 44.1 and 15.1% for male relatives). Positive reproductive family history for SA might be the causal factor for RSA and can also predetermine women that are of greater susceptibility to preterm pregnancy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Abortion, Miscarriage, and Breast Cancer Risk

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Abortion, Miscarriage, and Breast Cancer Risk: 2003 Workshop In ... cancer risk, including studies of induced and spontaneous abortions. They concluded that having an abortion or miscarriage ...

  2. Progestogen for treating threatened miscarriage.

    Science.gov (United States)

    Wahabi, Hayfaa A; Fayed, Amel A; Esmaeil, Samia A; Al Zeidan, Rasmieh A

    2011-12-07

    Miscarriage is a common complication encountered during pregnancy. The role of progesterone in preparing the uterus for the implantation of the embryo and its role in maintaining the pregnancy have been known for a long time. Inadequate secretion of progesterone in early pregnancy has been linked to the aetiology of miscarriage and progesterone supplementation has been used as a treatment for threatened miscarriage to prevent spontaneous pregnancy loss. To determine the efficacy and the safety of progestogens in the treatment of threatened miscarriage. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011) and bibliographies of all located articles for any additional studies. Randomised or quasi-randomised controlled trials that compare progestogen with placebo, no treatment or any other treatment given in an effort to treat threatened miscarriage. At least two authors assessed the trials for inclusion in the review, assessed trial quality and extracted the data. Data were checked for accuracy. We included four studies (421 participants) in the meta-analysis. In three studies all the participants met the inclusion criteria and in the fourth study, we included only the subgroup of participants who met the inclusion criteria in the meta-analysis. There was evidence of a reduction in the rate of spontaneous miscarriage with the use of progestogens compared to placebo or no treatment (risk ratio (RR) 0.53; 95% confidence interval (CI) 0.35 to 0.79). There was no increase in the rate of antepartum haemorrhage (RR 0.76; 95% CI 0.30 to 1.94), or pregnancy-induced hypertension (RR 1.00; 95% CI 0.54 to 1.88) for the mother. The rate of congenital abnormalities was no different between the newborns of the mothers who received progestogens and those who did not (RR 0.70; 95% CI 0.10 to 4.82). The data from this review suggest that the use of progestogens is effective in the treatment of threatened miscarriage with no evidence of

  3. [Characteristics of miscarriage and women's rights after pregnancy loss].

    Science.gov (United States)

    Lewicka, Magdalena; Sulima, Magdalena; Pyć, Maria; Stawarz, Barbara

    2013-01-01

    The term "miscarriage" refers to the end of pregnancy before the 22nd week of gestation, or taking into account the criterion of foetal weight (less than 500 g). Approximately 15-20% of recognized pregnancies and miscarriage involve spontaneous expulsion of the blastocyst from the uterine cavity. This constitutes about 80% of miscarriages in the first 12 weeks of gestation. The literature lists a number of factors which cause the loss of pregnancies. The most frequently cited causes of abortion are: genetic, anatomical, immunological and hormonal factors, and infections. A large number of miscarriages remain unexplained (idiopathic miscarriages). Clinical signs of miscarriage include bleeding and pain. Bleeding or spotting is the earliest sign of miscarriage. Data from the patient's history, physical examination, ultrasound examination and tests for hCG level can enable diagnosis of bleeding in early pregnancy, help to assess the degree of risk, and implement an appropriate treatment regimen and care for pregnant women adapted to their needs. Loss of pregnancy is an interdisciplinary problem involving obstetrics, epidemiology, public health, psychology, and other specialities. The role of medical personnel in the care of women after the loss of a child, regardless of the week and therapeutic procedures, as well as for giving adequate information regarding the rights of women after pregnancy loss. The obligation to inform women of their rights concerns medical staff, and it is important to promote knowledge in this field among doctors, nurses and midwives who care for women after miscarriage.

  4. [The trauma of miscarriage--factors influencing the experience of anxiety after early pregnancy loss].

    Science.gov (United States)

    Berth, Hendrik; Puschmann, Anne-Katrin; Dinkel, Andreas; Balck, Friedrich

    2009-08-01

    The experience of miscarriage results in tremendous emotional disturbance for many affected women. Depression, anxiety, (pathological) grief, and posttraumatic stress symptoms are commonly experienced reactions. Several factors influence the level of emotional distress, like age, previous experience of miscarriage, or social support. In this work, we investigated the level of emotional distress after miscarriage using a novel methodological approach. Through the world wide web, N = 500 texts of women who reported freely on their miscarriage were accessed and analyzed using the Dresden Anxiety Dictionary, a German computerized version of the Gottschalk-Gleser speech analysis. The women were 28 years old on average. The texts were written, on average, about 28 days after the miscarriage. Women's pregnancy had lasted between 2 and 40 weeks (M = 12). The scores pertaining to death anxiety and mutilation anxiety were higher than the norm. More than 20 % of the women reported an increased level of anxiety. Variables that influenced the level of anxiety were age, time since miscarriage, duration of pregnancy, previous miscarriage, and social support. The results underscore the need for treatment, at least for sub-groups of affected women who have a higher risk for a complicated course of coping with miscarriage.

  5. Vitamin supplementation for preventing miscarriage.

    Science.gov (United States)

    Balogun, Olukunmi O; da Silva Lopes, Katharina; Ota, Erika; Takemoto, Yo; Rumbold, Alice; Takegata, Mizuki; Mori, Rintaro

    2016-05-06

    Miscarriage is a common complication of pregnancy that can be caused by a wide range of factors. Poor dietary intake of vitamins has been associated with an increased risk of miscarriage, therefore supplementing women with vitamins either prior to or in early pregnancy may help prevent miscarriage. The objectives of this review were to determine the effectiveness and safety of any vitamin supplementation, on the risk of spontaneous miscarriage. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (6 November 2015) and reference lists of retrieved studies. All randomised and quasi-randomised trials comparing supplementation during pregnancy with one or more vitamins with either placebo, other vitamins, no vitamins or other interventions. We have included supplementation that started prior to conception, periconceptionally or in early pregnancy (less than 20 weeks' gestation). Three review authors independently assessed trials for inclusion, extracted data and assessed trial quality. We assessed the quality of the evidence using the GRADE approach. The quality of evidence is included for numerical results of outcomes included in the 'Summary of findings' tables. We included a total of 40 trials (involving 276,820 women and 278,413 pregnancies) assessing supplementation with any vitamin(s) starting prior to 20 weeks' gestation and reporting at least one primary outcome that was eligible for the review. Eight trials were cluster-randomised and contributed data for 217,726 women and 219,267 pregnancies in total.Approximately half of the included trials were assessed to have a low risk of bias for both random sequence generation and adequate concealment of participants to treatment and control groups. Vitamin C supplementation There was no difference in the risk of total fetal loss (risk ratio (RR) 1.14, 95% confidence interval (CI) 0.92 to 1.40, seven trials, 18,949 women; high-quality evidence); early or late miscarriage (RR 0.90, 95% CI 0.65 to 1

  6. Early pregnancy angiogenic markers and spontaneous abortion

    DEFF Research Database (Denmark)

    Andersen, Louise B; Dechend, Ralf; Karumanchi, S Ananth

    2016-01-01

    BACKGROUND: Spontaneous abortion is the most commonly observed adverse pregnancy outcome. The angiogenic factors soluble Fms-like kinase 1 and placental growth factor are critical for normal pregnancy and may be associated to spontaneous abortion. OBJECTIVE: We investigated the association between...... maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor, and subsequent spontaneous abortion. STUDY DESIGN: In the prospective observational Odense Child Cohort, 1676 pregnant women donated serum in early pregnancy, gestational week ..., interquartile range 71-103). Concentrations of soluble Fms-like kinase 1 and placental growth factor were determined with novel automated assays. Spontaneous abortion was defined as complete or incomplete spontaneous abortion, missed abortion, or blighted ovum

  7. Current approaches for assessment and treatment of women with early miscarriage or ectopic pregnancy in Nigeria: a case for dedicated early pregnancy services.

    Science.gov (United States)

    Iyoke, C A; Ugwu, O G; Ezugwu, F O; Onah, H E; Agbata, A T; Ajah, L C

    2014-01-01

    It has been suggested that women with early miscarriage or ectopic pregnancy are best cared for in dedicated units which offer rapid and definitive ultrasonographic and biochemical assessment at the initial review of the patient. To describe the current protocols for the assessment and treatment of women with early miscarriage or ectopic pregnancy as reported by Nigerian Gynecologists, and determine if dedicated early pregnancy services such as Early Pregnancy Assessment Units could be introduced to improve care. A cross-sectional survey of Nigerian Gynecologists attending the 46 th Annual Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria. This was a questionnaire-based study. Data analysis was by descriptive statistics using Statistical Package for the Social Sciences software, version 17.0 for Windows (IBM Corporation, Armonk, NY, USA). A total of 232 gynecologists working in 52 different secondary and tertiary health facilities participated in the survey. The mean age of the respondents was 42.6 ± 9.1 years (range 28-70 years). The proportion of gynecologists reporting that women with early miscarriage or ectopic pregnancy were first managed within the hospital general emergency room was 92%. The mean reported interval between arrival in hospital and first ultrasound scan was 4.9 ± 1.4 hours (range ½-8 hours). Transvaginal scan was stated as the routine initial imaging investigation by only 17.2% of respondents. Approximately 94.8% of respondents felt that dedicated early pregnancy services were feasible and should be introduced to improve the care of women with early miscarriage and ectopic pregnancy. Reported protocols for managing early miscarriage or ectopic pregnancy in many health facilities in Nigeria appear to engender unnecessary delays and avoidable costs, and dedicated early pregnancy services could be both useful and feasible in addressing these shortcomings in the way women with such conditions are currently managed.

  8. Risk of first trimester spontaneous miscarriage among singleton gestations following ICSI and its relation to underlying cause of infertility

    OpenAIRE

    Abuelghar, Wessam Magdi; Elkady, Osama Saleh; Tamara, Tarek Fathi.; Khalil, Mona Hassan

    2014-01-01

    Study objective: To assess the association between the first trimester miscarriage rates among women undergoing intracytoplasmic sperm injection (ICSI) and underlying etiology of infertility. Design: Prospective cohort study. Setting: Ain Shams University maternity hospital. Materials and methods: The study included women who became pregnant with singleton pregnancy following ICSI as a treatment for different causes of infertility. Women were followed up throughout the first trimeste...

  9. Maternal Factors Associated With Early Spontaneous Singleton ...

    African Journals Online (AJOL)

    Background: Knowledge of the maternal factors predisposing to preterm deliveries should affect the anticipatory care of mothers at risk of delivering preterm babies and improve perinatal outcome. Objective: To determine the maternal socio-biological characteristics associated with the delivery of early spontaneous ...

  10. Intraplacental Choriocarcinoma: Rare or Underdiagnosed? Report of 2 Cases Diagnosed after an Incomplete Miscarriage and a Preterm Spontaneous Vaginal Delivery

    Science.gov (United States)

    Oliveira, Paula; Scigliano, Horácio; Nogueira, Rosete; Araújo, Célia; Ferreira, Soledade

    2017-01-01

    Intraplacental choriocarcinoma is a rare malignant tumor diagnosed after an abortion, an ectopic pregnancy, or a term or preterm pregnancy or following the diagnosis of a hydatidiform mole. During pregnancy, it may be more common than reported, as most patients are asymptomatic and placental choriocarcinomas are usually inconspicuous macroscopically and are often mistaken for an infarct. Based upon a case study methodology, we describe 2 cases of intraplacental choriocarcinoma: the first case was identified in the product of a uterine curettage following an incomplete miscarriage and the second in one of the placentas of a bichorionic twin pregnancy. Maternal investigation did not reveal evidence of metastatic disease and neither did the infants' one in the second case. The two cases underwent maternal surveillance with serum hCG and remained disease-free until the present. In conclusion, intraplacental choriocarcinoma is easily underdiagnosed but with current treatment, even in the presence of metastasis, the prognosis is excellent. A routine microscopic examination of all the placentas and products of miscarriage can increase the real incidence of this entity and consequently improve its management. PMID:28567059

  11. Prediction of subsequent miscarriage risk in women who present with a viable pregnancy at the first early pregnancy scan.

    Science.gov (United States)

    Stamatopoulos, Nicole; Lu, Chuan; Casikar, Ishwari; Reid, Shannon; Mongelli, Max; Hardy, Nigel; Condous, George

    2015-10-01

    To generate and evaluate a new prediction model for miscarriage in women who present with a viable intrauterine pregnancy (IUP) at the primary early pregnancy scan and to compare this new model to a previously published model. Data were collected prospectively from women presenting to the early pregnancy unit with a viable IUP between November 2006 and January 2013. More than 30 historical, clinical and ultrasonographic variables were recorded on a standardised datasheet at the first visit. Women were followed until the final outcome was known at the end of the first trimester: viable IUP or miscarriage. A new multinomial logistic regression model was developed retrospectively on training cases and tested prospectively on test cases. The performance of the new prediction model was evaluated using receiver operating characteristic (ROC) curves and compared to a previously published model. After removing cases with missing values for the model of Oates, the area under the ROC curve (AUC) was also calculated for the new model and the Oates model. A total of 1115 consecutive first-trimester women presented to the early pregnancy unit. Eight hundred and sixty-two women with a viable IUP at the first scan whose outcome was known at the end of the first trimester were included in the final analysis. Five hundred and sixty-six women were included in the training set and 296 in the test set. 92.1% were viable and 7.9% had miscarried at the end of the first trimester. The most significant independent prognostic variables for the logistic regression model were as follows: maternal age, embryonic heart rate (EHR), logarithm [gestational sac (GS) volume/crown-rump length (CRL)], CRL and the presence or absence of clots per vagina (PV) at presentation. The performance of the new model compared with the Oates model gave an AUC of 0.870 vs 0.847 for the training set and 0.783 vs 0.744 for the test set. After removing cases with missing values for the model of Oates 2013, the

  12. Placental thrombomodulin expression in recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Turi Angelo

    2010-01-01

    Full Text Available Abstract Background Early pregnancy loss can be associated with trophoblast insufficiency and coagulation defects. Thrombomodulin is an endothelial-associated anticoagulant protein involved in the control of hemostasis and inflammation at the vascular beds and it's also a cofactor of the protein C anticoagulant pathway. Discussion We evaluate the Thrombomodulin expression in placental tissue from spontaneous recurrent miscarriage and voluntary abortion as controls. Thrombomodulin mRNA was determined using real-time quantitative polymerase chain reaction. Reduced expression levels of thrombomodulin were found in recurrent miscarriage group compared to controls (1.82-fold of reduction, that corresponds to a reduction of 45% (from control group Delta CT of thrombomodulin expression in spontaneous miscarriage group respect the control groups. Summary We cannot state at present the exact meaning of a reduced expression of Thrombomodulin in placental tissue. Further studies are needed to elucidate the biological pathway of this important factor in the physiopathology of the trophoblast and in reproductive biology.

  13. Placental apoptosis in recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Tarek A. Atia

    2017-09-01

    Full Text Available Apoptosis is an interactive and dynamic biological process involved in all phases of embryogenesis. We aimed to study the effect of placental apoptosis on recurrent miscarriage (RM. Placental tissue samples were collected from 40 women with RM (study group and 30 women with sporadic spontaneous abortion (control group. Samples were prepared and stained immunohistochemically with markers for both the apoptotic protein (p53 and anti-apoptotic Bcl-2 antibodies. Our results showed that expression of the apoptotic (p53 protein was significantly increased in the placental tissues of the RM group (p = 0.003. By contrast, the expression of anti-apoptotic (Bcl-2 antibodies was significantly increased in the placental tissues of the control group (p = 0.025. We concluded that placental apoptosis plays a crucial role in pregnancy continuation. However, increased p53 expression in placental tissue in early pregnancy could negatively affect pregnancy continuation.

  14. Plasma TNF-α levels are higher in early pregnancy in patients with secondary compared with primary recurrent miscarriage

    DEFF Research Database (Denmark)

    Piosik, Zofia Maria; Goegebeur, Yuri; Klitkou, Louise

    2013-01-01

    Specific pro-inflammatory cytokine profiles in plasma may characterize women with recurrent miscarriage (RM) but the dynamics of the cytokine profiles with progressing pregnancy is largely unknown.......Specific pro-inflammatory cytokine profiles in plasma may characterize women with recurrent miscarriage (RM) but the dynamics of the cytokine profiles with progressing pregnancy is largely unknown....

  15. IGF-1 and IGFBP-1 in peripheral blood and decidua of early miscarriages with euploid embryos: comparison between women with and without PCOS.

    Science.gov (United States)

    Luo, Lu; Wang, Qiong; Chen, Minghui; Yuan, Guangqing; Wang, Zengyan; Zhou, Canquan

    2016-07-01

    This study aims to demonstrate the possible relationship between the insulin-like growth factor (IGF) system and early miscarriage in polycystic ovarian syndrome (PCOS) patients with euploid embryos. 40 pregnant women included. 9 had PCOS and miscarried; 20 had PCOS and a successful ongoing pregnancy; the remaining 11 women did not have PCOS and miscarried. An ultrasound scan was performed to prove clinical pregnancy and a blood sample was taken on day 55 ± 4 of gestation. Serum samples of IGF-1, insulin-like growth factor binding protein-1 (IGFBP-1), total testosterone, serum hormone binding protein (SHBG), leptin and soluble leptin receptor (sOb-R) were obtained. In miscarriages, samples of decidua were obtained during vaccum curettage. Embryonic chromosomes in all miscarriages were proven to be normal. The expression of IGF-1, IGFBP-1, leptin, long-form leptin receptor and androge sOb-R n receptor (AR) were examined in the decidua. We found that miscarried PCOS patients showed significantly increased free androgen index and free IGF index, as well as decreased SHBG and IGFBP-1 than other two groups in peripheral blood. In the decidua, miscarried PCOS patients showed significantly increased expression of IGF-1 and decreased IGFBP-1 when compared with non-PCOS. AR was not expressed in the decidua of either group. Our results suggest that early miscarriage is associated with increased IGF-1 and decreased IGFBP-1 in PCOS patients.

  16. Endocrine dysfunction and recurrent spontaneous abortion: An overview.

    Science.gov (United States)

    Kaur, Ramandeep; Gupta, Kapil

    2016-01-01

    Miscarriage is the spontaneous loss of a fetus before it is viable, occurring at a rate of 15-20%. Recurrent spontaneous abortion (RSA) or habitual miscarriage is defined as repeated occurrence of 3 or more miscarriages before 20(th) week of gestation accounting for the most common complication of early pregnancy in humans. Various etiological factors responsible for recurrent miscarriage are anatomical, genetical, endocrinological, immunological, and infectious. The endocrinological abnormalities may be polycystic ovarian syndrome, hyperprolactinemia, luteal phase defect, thyroid dysfunction, diabetes, or hyperandrogenism contributing to recurrent pregnancy loss. In the present article, the role of endocrinological disorders in patients with RSA has been reviewed. The article search was done using electronic databases, Google scholarly articles, and PubMed based on different key words. We have further combined the searches and made grouping as per various endocrine abnormalities, which might be responsible to cause spontaneous loss of fetus.

  17. Placental expression of CD100, CD72 and CD45 is dysregulated in human miscarriage.

    Science.gov (United States)

    Lorenzi, Teresa; Turi, Angelo; Lorenzi, Maria; Paolinelli, Francesca; Mancioli, Francesca; La Sala, Lucia; Morroni, Manrico; Ciarmela, Pasquapina; Mantovani, Angelo; Tranquilli, Andrea Luigi; Castellucci, Mario; Marzioni, Daniela

    2012-01-01

    The etiology of miscarriage is often multifactorial. One major cause, immunological rejection of the fetus, has not been clearly elucidated. Our aim was to establish whether the semaphorin CD100, its natural receptor CD72, and the glycoprotein CD45, implicated in immune mechanisms, are involved in pregnancy loss by examining their placental expression with real-time PCR, immunohistochemistry and western blotting techniques. Placenta tissue from 72 Caucasian women undergoing surgical uterine evacuation due to early spontaneous pregnancy loss between the 8(th) and 12(th) week of gestation was divided into four groups based on miscarriage number. Gestational age-matched placentas from 18 healthy women without a history of miscarriage undergoing voluntary pregnancy termination were the control group. Placenta from 6 Caesarean deliveries performed at 38-40 weeks of gestation was also studied. CD100, CD72 and CD45 were expressed in placenta and exhibited different mRNA and protein levels in normal pregnancy and miscarriage. In particular, protein levels were highly dysregulated around 10 weeks of gestation in first and second miscarriage placentas. The CD100 soluble form was produced and immediately shed from placental tissue in all samples. Fetal CD100, CD72 and CD45 seem to play a role in miscarriage. The present data support the involvement of the fetal immune system in pregnancy maintenance as well as failure.

  18. Placental Expression of CD100, CD72 and CD45 Is Dysregulated in Human Miscarriage

    Science.gov (United States)

    Lorenzi, Maria; Paolinelli, Francesca; Mancioli, Francesca; La Sala, Lucia; Morroni, Manrico; Ciarmela, Pasquapina; Mantovani, Angelo; Tranquilli, Andrea Luigi; Castellucci, Mario; Marzioni, Daniela

    2012-01-01

    Context and Objective The etiology of miscarriage is often multifactorial. One major cause, immunological rejection of the fetus, has not been clearly elucidated. Our aim was to establish whether the semaphorin CD100, its natural receptor CD72, and the glycoprotein CD45, implicated in immune mechanisms, are involved in pregnancy loss by examining their placental expression with real-time PCR, immunohistochemistry and western blotting techniques. Patients Placenta tissue from 72 Caucasian women undergoing surgical uterine evacuation due to early spontaneous pregnancy loss between the 8th and 12th week of gestation was divided into four groups based on miscarriage number. Gestational age-matched placentas from 18 healthy women without a history of miscarriage undergoing voluntary pregnancy termination were the control group. Placenta from 6 Caesarean deliveries performed at 38–40 weeks of gestation was also studied. Results CD100, CD72 and CD45 were expressed in placenta and exhibited different mRNA and protein levels in normal pregnancy and miscarriage. In particular, protein levels were highly dysregulated around 10 weeks of gestation in first and second miscarriage placentas. The CD100 soluble form was produced and immediately shed from placental tissue in all samples. Conclusions Fetal CD100, CD72 and CD45 seem to play a role in miscarriage. The present data support the involvement of the fetal immune system in pregnancy maintenance as well as failure. PMID:22606231

  19. Placental expression of CD100, CD72 and CD45 is dysregulated in human miscarriage.

    Directory of Open Access Journals (Sweden)

    Teresa Lorenzi

    Full Text Available CONTEXT AND OBJECTIVE: The etiology of miscarriage is often multifactorial. One major cause, immunological rejection of the fetus, has not been clearly elucidated. Our aim was to establish whether the semaphorin CD100, its natural receptor CD72, and the glycoprotein CD45, implicated in immune mechanisms, are involved in pregnancy loss by examining their placental expression with real-time PCR, immunohistochemistry and western blotting techniques. PATIENTS: Placenta tissue from 72 Caucasian women undergoing surgical uterine evacuation due to early spontaneous pregnancy loss between the 8(th and 12(th week of gestation was divided into four groups based on miscarriage number. Gestational age-matched placentas from 18 healthy women without a history of miscarriage undergoing voluntary pregnancy termination were the control group. Placenta from 6 Caesarean deliveries performed at 38-40 weeks of gestation was also studied. RESULTS: CD100, CD72 and CD45 were expressed in placenta and exhibited different mRNA and protein levels in normal pregnancy and miscarriage. In particular, protein levels were highly dysregulated around 10 weeks of gestation in first and second miscarriage placentas. The CD100 soluble form was produced and immediately shed from placental tissue in all samples. CONCLUSIONS: Fetal CD100, CD72 and CD45 seem to play a role in miscarriage. The present data support the involvement of the fetal immune system in pregnancy maintenance as well as failure.

  20. Imaging of early spontaneous osteonecrosis and osteoarthritis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Kusayama, Takeshi; Tomatsu, Taisuke [Tokai Univ. Naka, Kanagawa (Japan). Oiso Hospital

    1999-02-01

    In this paper, the available of MRI in diagnosis on early spontaneous osteonecrosis and osteoarthritis was investigated. Subjects were 5 cases (5 knees) with spontaneous osteonecrosis (stage 1 in Koshino`s classification) and 96 cases (104 knees) in osteoarthritis who were more than 50 years old. Patients with an early spontaneous osteonecrosis were elderly females and had night pain and severe spontaneous pain. On MRI, lesions of all cases were clearly detected in early stage. On the other hand, only 47 of 104 knees (45%) were detected in patients with osteoarthritis, and mirror lesions at shank sides were detected in 45 of 47 knees. These results suggest that it is possible to diagnose early spontaneous osteonecrosis from osteoarthritis by MRI image with the clue to mirror lesion at shank sides, incidence, stage, etc. On the diagnosis of early spontaneous osteonecrosis, MRI image should be performed as soon as possible if a patient was older, had no anamnesis of lesions, and no changes by the X-ray radiography in spite of severe pain of the knee joints. (K.H.)

  1. Pregnancy Loss and Miscarriage

    Science.gov (United States)

    ... Information Find a Study Resources and Publications Pregnancy Loss: Condition Information Skip sharing on social media links Share this: Page Content What is pregnancy loss/miscarriage? A miscarriage, also called pregnancy loss or ...

  2. Progesterone supplementation in women with otherwise unexplained recurrent miscarriages

    Directory of Open Access Journals (Sweden)

    Munawar Hussain

    2012-01-01

    Full Text Available Context: Recurrent miscarriages, the loss of three or more consecutive intrauterine pregnancies before 20 weeks of gestation with the same partner, affect 1%-1.5% of the pregnant population. The inadequate secretion of progesterone in early pregnancy has been proposed as a cause of recurrent miscarriages. Aims: The aim was to investigate the efficacy of progesterone supplementation in patients with unexplained recurrent miscarriages. Settings And Design: This was a 9-year cohort study of women with otherwise unexplained recurrent miscarriages who attended a recurrent miscarriage clinic in a tertiary care university hospital. Subjects and Methods: Women with at least three unexplained recurrent miscarriages were included in the study. They were divided into three groups according to their initial and 48-h repeat progesterone levels. For women with inadequate endogenous progesterone secretion, natural progesterone vaginal pessaries 400 mg 12-hourly were offered until 12 weeks gestation. Statistical Analysis: Proportions and 95% confidence intervals calculated for categorical variables and the chi-square test were used to show statistical significance. Medians and ranges were calculated for noncontinuous variables. Results: Pregnancy cycles (n = 203 were analyzed to examine the miscarriage rate following progesterone supplementation. Overall live birth and miscarriage rates were 63% and 36%, respectively. When analyzed by the number of previous miscarriages there was a reduction in the miscarriage rate following progesterone supplementation in women with 4 previous miscarriages when compared with historical data. Conclusions: Progesterone supplementation may have beneficial effects in women with otherwise unexplained recurrent miscarriages.

  3. Progestagen therapy for recurrent miscarriage

    National Research Council Canada - National Science Library

    Szekeres-Bartho, Julia; Balasch, Juan

    .... METHODS We searched PubMed and the Cochrane database covering the period of 1968-2007. The search terms progestogens and recurrent miscarriage, NK cells and recurrent miscarriage as well as cytokines and recurrent miscarriage were used...

  4. Porque usamos imunoglobulina anti-D em excesso no abortamento precoce? Why do we waste anti-D immunoglobulin in early miscarriage?

    Directory of Open Access Journals (Sweden)

    Eduardo Baiochi

    2004-06-01

    Full Text Available OBJETIVO: avaliação da hemorragia feto-materna (HFM nas pacientes que receberiam profilaxia da aloimunização Rh com emprego de imunoglobulina anti-D (300 mig, pós-aborto precoce. MÉTODO: foram admitidas no estudo pacientes do grupo sanguíneo Rh negativo, com parceiro Rh positivo ou ignorado, com quadro de aborto até 12 semanas de gestação internadas para curetagem uterina. Uma amostra de 5 ml de sangue venoso destas pacientes foi obtida após o procedimento, na qual realizamos o teste qualitativo de roseta para detectar quais casos necessitariam determinação quantitativa do volume de sangue fetal transferido para circulação materna, que foi então apurado pelo teste de Kleihauer-Betke (K-B. RESULTADOS: das 26 pacientes avaliadas, em uma o teste de roseta foi positivo, e o teste de K-B apontou HFM de 1,5 ml. CONCLUSÕES: a dose de imunoglobulina anti-D nos casos de abortamento até a 12ª semana de gestação deveria ser substancialmente reduzida, parecendo-nos oportuna a disponibilização no mercado nacional de apresentação com 50 mig, que representaria além da economia, maior racionalidade.OBJECTIVE: evaluation of fetomaternal hemorrhage (FMH in patients who would need Rh alloimmunization with anti-D immunoglobulin (300 mug prophylaxis after early miscarriage. METHOD: we included in the study Rh (D negative blood group patients with positive or unknown Rh (D partners, who had had a miscarriage up to 12 weeks of gestation, and had been admitted to hospital for uterine curettage. After this procedure 5 ml of venous blood was collected from the patients and the rosette test was applied to screen which patients would need quantitative determination of fetal blood transferred to the maternal circulation, by the Kleihauer-Betke test (K-B. RESULTS: out of 26 patients evaluated the rosette test was positive in one , who showed an FMH of 1.5 ml in the K-B test. CONCLUSIONS: the dose of anti-D immunoglobulin used in cases of miscarriage

  5. Fetal gender ratio in recurrent miscarriages

    Directory of Open Access Journals (Sweden)

    Del Fabro A

    2011-07-01

    Full Text Available Anna Del Fabro1, Lorenza Driul1, Omar Anis1, Ambrogio P Londero1, Serena Bertozzi2, Livio Bortotto3, Diego Marchesoni11Clinic of Obstetrics and Gynecology, 2Clinic of Surgery, 3Unit of Genetics, University Hospital of Udine, Udine, ItalyBackground: The purpose of this study was to evaluate the gender ratio and incidence of chromosomal anomalies in the products of conception (POC from recurrent miscarriages.Methods: We determined the karyotypes of POC from patients with recurrent spontaneous miscarriages between 1999 and 2009.Results: In total, 313 specimens were successfully karyotyped, with a median gestational age of 10 weeks at miscarriage (interquartile range 8–13; 199 (64% were females and 114 (36% were males. In total, 121 (39% had abnormal karyotypes, the most prevalent of which were chromosome 21 and 16 trisomies, triploidy, and monosomy X.Conclusion: Our findings suggest that female POC might be more susceptible to recurrent miscarriages than male ones during embryogenesis, implantation, and initial fetal development.Keywords: fetal gender, recurrent miscarriages, karyotype anomalies

  6. Immunomodulation in Recurrent Miscarriage

    National Research Council Canada - National Science Library

    Kumar, Ashok

    2014-01-01

    ... % of women with recurrent miscarriage (RM). Several studies demonstrated that successful pregnancy is dependant on shifting of maternal immune response from (proinflammatory) Th1 toward (anti-inflammatory) Th2 phenotypes...

  7. Early MR abnormality indicating functional recovery from spontaneous intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Fumeya, Hiroshi; Hideshima, Hiroshi (Hideshima Hospital, Musashino, Tokyo (Japan))

    1991-10-01

    Magnetic resonance (MR) imaging as an indicator of recovery from hemiparesis was evaluated in 60 patients with spontaneous intracerebral hemorrhage. T{sub 2}-weighted MR images revealed early MR abnormality (EMA) of the corticospinal tract within 1 week of ictus. Most patients without EMA recovered beyond Brunnstrom's Recovery Stage 3 while only a few patients with EMA did so. Patients with EMA cannot regain motor function because EMA is almost always followed by complete tract degeneration. EMA in the brainstem and poor motor function recovery are closely correlated. (author).

  8. Early conversational environment enables spontaneous belief attribution in deaf children.

    Science.gov (United States)

    Meristo, Marek; Strid, Karin; Hjelmquist, Erland

    2016-12-01

    Previous research suggests that deaf children who grow up with hearing parents display considerable difficulties in understanding mental states of others, up to their teenage years when explicitly asked in a verbal test situation (Meristo et al., 2007). On the other hand, typically developing pre-verbal infants display evidence of spontaneous false belief attribution when tested in looking-time tasks, although verbal tests are typically not passed before the age of 4years (Onishi & Baillargeon, 2005). The purpose of the present study was to examine whether deaf children of hearing parents are able to demonstrate spontaneous belief attribution in a non-verbal eye-tracking task. Thirty 4- to 8-year-old, deaf and hearing children, completed a non-verbal spontaneous-response false-belief task and a verbal elicited-response false-belief task. The deaf children were either children with cochlear implants or children with hearing aids. Comparative analyses were also carried out with a previous sample of deaf and hearing 2-year-olds (reported in Meristo, Morgan, et al., 2012). We found that in the non-verbal spontaneous-response task typically hearing children, but not deaf children, were able to predict that a person with a false belief about an object's location will search erroneously for the object. However, hearing children and deaf children with implants, but not deaf children with hearing aids, passed the verbal elicited-response task. Language development was significantly correlated with both types of false-belief tasks for the whole sample. Our findings strengthen the hypothesis that the emergence of the ability to recognize others' beliefs needs to be supported initially by very early conversational input in dialogues with caregivers. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH RECURRENT MISCARRIAGE

    Directory of Open Access Journals (Sweden)

    Daniela Mierla

    2012-06-01

    Full Text Available Chromosomal abnormalities are involved in the etiology of recurrent spontaneous pregnancy loss and sub-fertility. The purpose of this study was to determine the frequency and contribution of chromosomal abnormalities in recurrent miscarriages. The results obtained and literature review are helpful in understanding the importance of cytogenetics analysis of female infertility. To investigate the distribution of chromosomal abnormalities in the Romanian population with recurrent miscarriage, karyotype analysis by G-banding was performed from peripheral blood in 967 women infertility. Results: Chromosomal abnormalities were found to 79 women (8,17%. The percentage of chromosomal abnormalities in the studied population correlates with the data in the literature. Chromosomal abnormalities could play the important role in etiology of infertility and are more frequently detected in this group of patients compared to general population. In the infertile couples balanced chromosomal abnormalities are the main cause of spontaneous abortions.

  10. ASSOCIATION BETWEEN CYTOKINE GENE POLYMORPHISMS AND RECURRENT MISCARRIAGE

    Directory of Open Access Journals (Sweden)

    L A. Gordeeva

    2017-01-01

    Full Text Available Associations between IL1B (rs1143634, IL1RN (VNTR, intron 2, IL4 (VNTR, intron 3, TNFA (rs1800629, rs361525, IL6 (rs1800795, and IL10 (rs1800896 genetic polymorphisms in women with recurrent miscarriage (RM were analyzed. We studied DNA samples of 112 women with RM and 267 women with physiological pregnancy. The IL1RN, IL4 genotypes were identified by PCR techniques, the IL1B, IL6 gene polymorphisms were defined by means of RFLP approach. To detect TNFA and IL10 gene polymorphisms, TaqMan real-time PCR was used. The results have shown that polymorphic loci of IL1B, IL1RN, IL10, TNFA genes were not associated with RM, and early spontaneous abortion risk. The 2R allele of IL4 gene was found to be associated with higher RM risk (OR = 1.52; 95% CI = [1.08-2.14]; P-value (cor = 0.05, and G allele of IL6 gene was associated with a risk for > 3 early spontaneous abortions (OR = 2.10; 95% CI = [1.24-3.56]; P-value (cor = 0.05, in an additive inheritance model. Upon evaluation of the data obtained, one may conclude that the IL4 (VNTR intron 3 and IL6 (rs1800795 gene polymorphisms could influence the RM development. These results may be useful for assessment of molecular mechanisms underlying early spontaneous abortion.

  11. Spontaneous chiral symmetry breaking in early molecular networks

    Directory of Open Access Journals (Sweden)

    Markovitch Omer

    2010-05-01

    Full Text Available Abstract Background An important facet of early biological evolution is the selection of chiral enantiomers for molecules such as amino acids and sugars. The origin of this symmetry breaking is a long-standing question in molecular evolution. Previous models addressing this question include particular kinetic properties such as autocatalysis or negative cross catalysis. Results We propose here a more general kinetic formalism for early enantioselection, based on our previously described Graded Autocatalysis Replication Domain (GARD model for prebiotic evolution in molecular assemblies. This model is adapted here to the case of chiral molecules by applying symmetry constraints to mutual molecular recognition within the assembly. The ensuing dynamics shows spontaneous chiral symmetry breaking, with transitions towards stationary compositional states (composomes enriched with one of the two enantiomers for some of the constituent molecule types. Furthermore, one or the other of the two antipodal compositional states of the assembly also shows time-dependent selection. Conclusion It follows that chiral selection may be an emergent consequence of early catalytic molecular networks rather than a prerequisite for the initiation of primeval life processes. Elaborations of this model could help explain the prevalent chiral homogeneity in present-day living cells. Reviewers This article was reviewed by Boris Rubinstein (nominated by Arcady Mushegian, Arcady Mushegian, Meir Lahav (nominated by Yitzhak Pilpel and Sergei Maslov.

  12. Immunomodulators to treat recurrent miscarriage

    NARCIS (Netherlands)

    Prins, Jelmer R.; Kieffer, Tom E.C.; Scherjon, Sicco A.

    2014-01-01

    Recurrent miscarriage is a reproductive disorder affecting many couples. Although several factors are associated with recurrent miscarriage, in more than 50% of the cases the cause is unknown. Maladaptation of the maternal immune system is associated with recurrent miscarriage and could explain part

  13. Relationship between recurrent miscarriage and early preterm delivery and recurrent events in patients with manifest vascular disease : The SMART study

    NARCIS (Netherlands)

    Heida, Karst Y; Koster, Maria PH; Franx, Arie; Veerbeek, Jan HW; Westerink, Jan; Bots, Michiel L; Spiering, Wilko

    BACKGROUND: Women with a complication of pregnancy are at increased risk of cardiovascular morbidity and mortality later in life. Yet, information on risk of recurrent events in women with a previous cardiovascular event is lacking. We aimed to assess the relationship between early preterm delivery,

  14. A Genomewide Association Study of Early Spontaneous Preterm Delivery

    Science.gov (United States)

    Zhang, Heping; Baldwin, Don A.; Bukowski, Radek K.; Parry, Samuel; Xu, Yaji; Song, Chi; Andrews, William W.; Saade, George R.; Esplin, M. Sean; Sadovsky, Yoel; Reddy, Uma M.; Ilekis, John; Varner, Michael; Biggio, Joseph R.

    2015-01-01

    Preterm birth is the leading cause of infant morbidity and mortality. Despite extensive research, the genetic contributions to spontaneous preterm birth (SPTB) are not well understood. Term controls were matched with cases by race/ethnicity, maternal age, and parity prior to recruitment. Genotyping was performed using Affymetrix SNP Array 6.0 assays. Statistical analyses utilized PLINK to compare allele occurrence rates between case and control groups, and incorporated quality control and multiple-testing adjustments. We analyzed DNA samples from mother-infant pairs from early SPTB cases (200/7 to 336/7 weeks, 959 women and 979 neonates) and term delivery controls (390/7 to 416/7 weeks, 960 women and 985 neonates). For validation purposes, we included an independent validation cohort consisting of early SPTB cases (293 mothers and 243 infants) and term controls (200 mothers and 149 infants). Clustering analysis revealed no population stratification. Multiple maternal SNPs were identified with association p-values between 10E-5 and 10E-6. The most significant maternal SNP was rs17053026 on chromosome 3 with an odds ratio (OR) 0.44 with a p-value of 1.0E-06. Two neonatal SNPs reached the genome-wide significance threshold, including rs17527054 on chromosome 6p22 with a p-value of 2.7E-12 and rs3777722 on chromosome 6q27 with a p-value of 1.4E-10. However, we could not replicate these findings after adjusting for multiple comparisons in a validation cohort. This is the first report of a genomewide case-control study to identify single nucleotide polymorphisms (SNPs) that correlate with SPTB. PMID:25599974

  15. Miscarriage and occupational activity

    DEFF Research Database (Denmark)

    Bonde, Jens Peter; Jørgensen, Kristian Tore; Bonzini, Matteo

    2013-01-01

    OBJECTIVE: Previous studies have indicated that shift work, long working hours, and prevalent workplace exposures such as lifting, standing, and physical workload increase the risk of miscarriage, but the evidence is conflicting. We conducted a systematic review of original research reports...... or less likely to be biased. Studies with equivalent measures of exposure were pooled to obtain a weighted common risk estimate. Sensitivity analyses excluded studies most likely to be biased. RESULTS: Working fixed nights was associated with a moderately increased risk of miscarriage (pooled RR 1.51 [95......% confidence interval (95% CI) 1.27-1.78, N=5), while working in 3-shift schedules, working for 40-52 hours weekly, lifting >100 kg/day, standing >6-8 hours/day and physical workload were associated with small risk increments, with the pooled RR ranging from 1.12 (3-shift schedule, N=7) to 1.36 (working hours...

  16. Deciding treatment for miscarriage

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Graungaard, Anette H; Husted, Gitte R

    2015-01-01

    INTRODUCTION: Women experiencing miscarriage are offered a choice of different treatments to terminate their wanted pregnancy at a time when they are often shocked and distressed. Women's and healthcare professionals' experiences of the decision-making process are not well described. We aimed...... to gain insight into this process and the circumstances that may affect it. METHOD: A qualitative study using a grounded theory approach. Data were obtained through semi-structured interviews with six women who had chosen and completed either surgical, medical or expectant treatment for miscarriage......: Despite information and pretreatment counselling, choice of treatment was often determined by unspoken emotional considerations, including fear of seeing the foetus or fear of anaesthesia. These considerations were not discussed during the decision-making process, which was a time when the women were...

  17. Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?

    Science.gov (United States)

    Póvoa, Ana; Matias, Alexandra; Xavier, Pedro; Blickstein, Isaac

    2017-06-20

    To compare first trimester 2D conventional and 3D power Doppler angiography measures in twins and singletons following assisted reproduction. We prospectively evaluated 50 singleton and 47 twin pregnancies that eventually ended in live births. Patients were recruited from a single assisted reproductive technology (ART) center with standard treatment protocols. Obstetric ultrasound was performed at 8-9 weeks +6 days. Intervillous flow, uteroplacental circulation and uterine artery pulsatility (PI) and resistance index (RI) using two-dimensional (2D) ultrasound examination were evaluated. Using three-dimensional (3D) power Doppler angiography, placental volume and the 3D power Doppler indices from the intervillous and uteroplacental circulation were calculated. Demographic and cycle characteristics were similar in mothers of singletons and twins. Placental volume was significantly (1.6-fold) larger in twins. Vascular density and blood perfusion in the intervillous space were lower in twins. The comparison of the other parameters did not show significant differences between singletons and twins. The data confirm the larger placental volume in twins, denoting a probable higher production of placental hormones that would support an early twin pregnancy. The lower vascular density and blood perfusion in the intervillous space in twins may also confer a reproductive advantage to them.

  18. Miscarriage after sonographic confirmation of an ongoing pregnancy in women with moderate and severe obesity.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2012-01-01

    To compare the incidence of spontaneous miscarriage in women with moderate to severe obesity to that in women with a normal BMI after sonographic confirmation of the foetal heart rate in the first trimester.

  19. [First trimester miscarriages: benefits and harms of different management options].

    Science.gov (United States)

    Beucher, G; Dolley, P; Stewart, Z; Carles, G; Dreyfus, M

    2014-09-01

    The objective of this review was to assess early and late benefits and harms of different management options for first-trimester miscarriage. Surgical uterine evacuation remains the most effective and the quickest method of treatment. Depending on the clinical situation, medical treatment using misoprostol (missed miscarriage) or expectative attitude (incomplete miscarriage) does not increase the risk of complications, neither haemorrhagic nor infectious. However, these alternatives generally require longer outpatient follow-up, which leads to more prolonged bleeding and not planned surgical procedures. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Evidence-based interventions of threatened miscarriage

    Directory of Open Access Journals (Sweden)

    Juan Li

    2017-05-01

    Full Text Available Threatened miscarriage is the commonest complication of early pregnancy and affects about 20% of pregnancies. It presents with vaginal bleeding with or without abdominal cramps. Increasing age of women, smoking, obesity or polycystic ovary syndrome (PCOS and a previous history of miscarriage are risk factors for threatened miscarriage. The pathophysiology has been associated with changes in levels of cytokines or maternal immune dysfunction. Clinical history and examination, maternal serum biochemistry and ultrasound findings are important to determine the treatment options and provide valuable information for the prognosis. Bed rest is the commonest advice, but there is little evidence of its value. Other options include progesterone, human chorionic gonadotropin (HCG and muscle relaxants. The complementary and alternative medicine (CAM therapies such as acupuncture and Chinese herbs have also been tried. There is some evidence from clinical studies indicating that CAM therapies may reduce the rate of miscarriage, but the quality of studies is poor. Thus, further double-blind, randomized-controlled trials are necessary to confirm its effectiveness, especially acupuncture and Chinese herbs.

  1. Acupuncture as a therapeutic treatment option for threatened miscarriage

    Directory of Open Access Journals (Sweden)

    Betts Debra

    2012-03-01

    Full Text Available Abstract Background Threatened miscarriage involves vaginal bleeding in a pregnancy that remains viable. This is a common early pregnancy complication with increased risk factors for early pregnancy loss, preterm premature rupture of membranes (PPROM, preterm delivery, low birth weight babies and maternal antepartum haemorrhage. Currently there are no recommended medical treatment options, rather women receive advice that centres on a 'wait and see' approach. For women with a history of unexplained recurrent miscarriage providing supportive care in a subsequent pregnancy improves live birthing outcomes, but the provision of supportive care to women experiencing threatened miscarriage has to date not been examined. Discussion While it is known that 50-70% of miscarriages occur due to chromosomal abnormalities, the potential for therapeutic intervention amongst the remaining percentage of women remains unknown. Complementary and alternative medicine (CAM therapies have the potential to provide supportive care for women presenting with threatened miscarriage. Within fertility research, acupuncture demonstrates beneficial hormonal responses with decreased miscarriage rates, raising the possibility acupuncture may promote specific beneficial effects in early pregnancy. With the lack of current medical options for women presenting with threatened miscarriage it is timely to examine the possible treatment benefits of providing CAM therapies such as acupuncture. Summary Despite vaginal bleeding being a common complication of early pregnancy there is often reluctance from practitioners to discuss with women and medical personal how and why CAM may be beneficial. In this debate article, the physiological processes of early pregnancy together with the concept of providing supportive care and acupuncture are examined. The aim is to raise awareness and promote discussion as to the beneficial role CAM may have for women presenting with threatened miscarriage.

  2. Grief following miscarriage: a comprehensive review of the literature.

    Science.gov (United States)

    Brier, Norman

    2008-04-01

    The literature exploring the relationship between miscarriage and grief is sparse. This paper summarizes the literature on grief subsequent to an early miscarriage to elucidate the nature, incidence, intensity, and duration of grief at this time and to identify potential moderators. An electronic search of the Medline and Psych Info databases was conducted. Studies were selected for inclusion if they related to early miscarriage, used a standardized measure to assess perinatal grief, and specified the assessment intervals employed. Qualitative studies were included when helpful to develop hypotheses. Descriptions of grief following miscarriage are highly variable but tend to match descriptions of grief used to characterize other types of significant losses. A sizable percentage of women seem to experience a grief reaction, with the actual incidence of grief unclear. Suggestively, grief, when present, seems to be similar in intensity to grief after other types of major losses and is significantly less intense by about 6 months. Few conclusions can be drawn in regard to potential moderators of grief following a miscarriage. Although additional research is clearly needed, guidelines for coping with grief following miscarriage can be based on the data available on coping with other significant types of losses. Given the range of potential meanings for this primarily prospective and symbolic loss, practitioners need to encourage patients to articulate the specific nature of their loss and assist in helping them concretize the experience.

  3. An increase in vascular endothelial growth factor (VEGF and VEGF soluble receptor-1 (sFlt-1 are associated with early recurrent spontaneous abortion.

    Directory of Open Access Journals (Sweden)

    Lihong Pang

    Full Text Available Recurrent spontaneous abortion (RSA is a health problem that affects approximately 1% to 5% reproductive age woman. Yet, in around half of these patients, the mechanism for RSA is unexplained. Recent studies have indicated that placental ischemia/hypoxia and endothelial dysfunction are important factors in miscarriage. Other studies have indicated that the level and expression of soluble FMS-like tyrosine kinase-1 (sFlt1 is increased under a hypoxic environment. However, decreased sFlt-1 in the maternal circulation during the first trimester has recently been proposed as a potential marker for identifying risk of pregnancy loss. In this prospective study clinical samples were obtained within a short time after the fetal death, protein expression and maternal serum levels of sFlt1 were assessed and compared to samples taken from those with normal pregnancies. Our results indicate that levels of VEGF and sFlt-1 are both increased in women during early pregnancy compared women that are not pregnant (p<0.05 indicating that VEGF and sFlt-1 are both associated with pregnancy. More importantly, we detected a significant (p<0.05 increase in sFlt1 and VEGF levels and expression in the RSA patients who suffered subsequent miscarriages compare to controls. These results demonstrate that there is likely a relationship between VEGF, sFlt-1 and RSA suggesting that the high levels and over expression of sFlt-1 and VEGF might be associated with the pathogenesis of RSA.

  4. Reproductive outcome and fetal karyotype of couples with recurrent miscarriages.

    Science.gov (United States)

    Zhang, S; Gao, L; Liu, Y; Tan, J; Wang, Y; Zhang, R; Liu, Y; Chen, H; Zhang, J

    2014-01-01

    The purpose of this study was to evaluate the relationship between fetal karyotype and parental chromosomal abnormalities, and assess the long-term reproductive outcomes in couples with recurrent miscarriages (RM). The reproductive outcomes of 34 couples with abnormal karyotypes and RM were investigated. Ultrasound examinations were performed during pregnancy, fetal karyotypes were determined following miscarriages, and successful pregnancy outcomes were recorded. Of the 34 couples, 20 individuals presented with chromosomal abnormalities, specifically in nine females and 11 males (45% vs 55%, chi2 = 0.2833,p > 0.05). Fifteen couples (44.1%) possessed karyotype polymorphisms, of which the most common variant was a long Y chromosome in males. The reproductive outcomes of subsequent pregnancies consisted of 25 live births of phenotypically normal infants (73.5%), one infant with multiple malformations (2.9%), and eight RM (23.6%). With regards to karyotypes, 69.2% (9/13) of couples had inversions and 73.3% (11/15) had karyotype polymorphisms that resulted in live births of phenotypically normal babies. Fetal karyotyping was performed in a total of 29 cases. Normal karyotypes were present in 48.3% (14/29) of cases, whereas 41.4% (12/29) had abnormalities (either numerical or structural), and 10.3% (3/29) has a karyotype polymorphism. There is a positive correlation between chromosomal abnormalities and spontaneous miscarriages. A complete evaluation and special treatment should be provided to couples with a history of recurrent miscarriage(s) during a subsequent pregnancy, particularly when one partner is a carrier of chromosome abnormalities (i.e., inversions of chromosome 9 and long Y chromosome in males). Prenatal diagnosis is necessary in carrier couples suffering from more than two miscarriages.

  5. An Increase in Vascular Endothelial Growth Factor (VEGF) and VEGF Soluble Receptor-1 (sFlt-1) Are Associated with Early Recurrent Spontaneous Abortion

    Science.gov (United States)

    Pang, Lihong; Wei, Zhouling; Li, Ouyang; Huang, Rudian; Qin, Junzhen; Chen, Hongyan; Fan, Xiaojing; Chen, Zi-Jiang

    2013-01-01

    Recurrent spontaneous abortion (RSA) is a health problem that affects approximately 1% to 5% reproductive age woman. Yet, in around half of these patients, the mechanism for RSA is unexplained. Recent studies have indicated that placental ischemia/hypoxia and endothelial dysfunction are important factors in miscarriage. Other studies have indicated that the level and expression of soluble FMS-like tyrosine kinase-1 (sFlt1) is increased under a hypoxic environment. However, decreased sFlt-1 in the maternal circulation during the first trimester has recently been proposed as a potential marker for identifying risk of pregnancy loss. In this prospective study clinical samples were obtained within a short time after the fetal death, protein expression and maternal serum levels of sFlt1 were assessed and compared to samples taken from those with normal pregnancies. Our results indicate that levels of VEGF and sFlt-1 are both increased in women during early pregnancy compared women that are not pregnant (pmiscarriages compare to controls. These results demonstrate that there is likely a relationship between VEGF, sFlt-1 and RSA suggesting that the high levels and over expression of sFlt-1 and VEGF might be associated with the pathogenesis of RSA. PMID:24098721

  6. Miscarriages among female physical therapists who report using radio- and microwave-frequency electromagnetic radiation.

    Science.gov (United States)

    Ouellet-Hellstrom, R; Stewart, W F

    1993-11-15

    Physical therapists are exposed to radio- and microwave-frequency electromagnetic radiation by operating shortwave and microwave diathermy units. Recent studies suggest that use of shortwave diathermy is associated with an excess risk of birth defects, perinatal deaths, and late spontaneous abortions among the offspring of exposed female therapists. To assess the impact of occupational use of microwave and shortwave diathermy at the time of conception, the authors mailed questionnaires to 42,403 physical therapists in 1989. Both occupational and reproductive histories were obtained. Exposures to shortwave and microwave diathermy were both assessed in the same fashion and were examined in relation to early recognized fetal loss in a nested case-control design. A total of 1,753 case pregnancies (miscarriages) were matched to 1,753 incidence density control pregnancies (other pregnancies except ectopic pregnancies). A pregnancy was considered "exposed" if the mother reported using microwave or shortwave diathermy anytime during the 6 months prior to the first trimester or during the first trimester. Pregnancies of mothers reporting microwave use 6 months prior to the pregnancy or during the first trimester were more likely to result in miscarriage (odds ratio (OR) = 1.28, 95% confidence interval (CI) 1.02-1.59). The odds ratio increased with increasing level of exposure (chi 2 = 7.25, p shortwave diathermy equipment (OR = 1.07, 95% CI 0.91-1.24). The odds ratio in the highest exposure group was 0.87.

  7. Thyroid Antibodies and Miscarriage: Where Are We at a Generation Later?

    Directory of Open Access Journals (Sweden)

    Alex Stagnaro-Green

    2011-01-01

    Full Text Available In 1990, an association between thyroid antibody positivity and spontaneous miscarriage was first reported. A generation has passed since the initial observation. Over that time a robust literature has developed which has confirmed the initial finding and expanded upon it. The present paper reviews the literature that has been generated over the last twenty years on the following topics: (1 thyroid antibodies and spontaneous miscarriage, (2 thyroid antibodies and recurrent abortion, (3 etiology of pregnancy loss in thyroid antibody positive women, and (4 discussion of future research directions.

  8. Complications and the effect of varicocelectomy on semen analysis, fertility, early ejaculation and spontaneous abortion

    Directory of Open Access Journals (Sweden)

    Shamsa Ali

    2010-01-01

    Full Text Available Varicocele is still an enigma. Its effects on semen analysis, fertility and, more re-cently, early ejaculation and spontaneous abortion in spouses are not yet fully understood. In this retrospective study, we evaluated these four parameters (semen analysis, fertility, early ejacu-lation and spontaneous abortion among spouses in relation to varicocele and varicocelectomy during a 13-year period. A total of 1,711 patients with varicocele underwent varicocelectomy by high inguinal method (251 cases, subinguinal method (1,375 cases, scrotal method (34 cases, and subinguinal method with local anesthesia (38 cases. Our complication rate was acceptable. Sperm count, motility and morphology increased three months post operation in 55, 51, and 46%, respectively (P value 0.000, 0.000, and 0.015, respectively. Paternity was 56% after one year of post varicocelectomy follow-up. Only 7 out of 82 azoospermic men had sperm in their semen after varicocelectomy and only one of them with mild spermatogenic hypoplasia became a father. The spontaneous abortion rate in the spouses of respondents was 59%. Early ejaculation improved in 75% of the respondents. In conclusion, varicocelectomy does not improve sperm parameters in all men, but it improves pregnancy rate, early ejaculation, and scrotal pain.

  9. Complications and the effect of varicocelectomy on semen analysis, fertility, early ejaculation and spontaneous abortion.

    Science.gov (United States)

    Shamsa, Ali; Nademi, M; Aqaee, M; Fard, A Nouraee; Molaei, Mahmood

    2010-11-01

    Varicocele is still an enigma. Its effects on semen analysis, fertility and, more recently, early ejaculation and spontaneous abortion in spouses are not yet fully understood. In this retrospective study, we evaluated these four parameters (semen analysis, fertility, early ejaculation and spontaneous abortion among spouses) in relation to varicocele and varicocelectomy during a 13-year period. A total of 1,711 patients with varicocele underwent varicocelectomy by high inguinal method (251 cases), subinguinal method (1,375 cases), scrotal method (34 cases), and subinguinal method with local anesthesia (38 cases). Our complication rate was acceptable. Sperm count, motility and morphology increased three months post operation in 55, 51, and 46%, respectively (P value 0.000, 0.000, and 0.015, respectively). Paternity was 56% after one year of post varicocelectomy follow-up. Only 7 out of 82 azoospermic men had sperm in their semen after varicocelectomy and only one of them with mild spermatogenic hypoplasia became a father. The spontaneous abortion rate in the spouses of respondents was 59%. Early ejaculation improved in 75% of the respondents. In conclusion, varicocelectomy does not improve sperm parameters in all men, but it improves pregnancy rate, early ejaculation, and scrotal pain.

  10. The quality of preterm infants' spontaneous movements : an early indicator of intelligence and behaviour at school age

    NARCIS (Netherlands)

    Butcher, Phillipa R.; van Braeckel, Koen; Bouma, Anke; Einspieler, Christa; Stremmelaar, Elisabeth F.; Bos, Arend F.

    Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that

  11. Рroblem of miscarriage in multiple pregnancies

    Directory of Open Access Journals (Sweden)

    A. V. Zharkikh

    2013-08-01

    pregnancy cards (form №113/o, case histories (form №096/o, conclusions of pathohistology research (form №014/o we have done the retrospective analysis of multigestational process and twins labor in 80 women hospitalized and afterwards delivered on the base of the Clinical maternity hospital №5 Zaporozhye for period from 2008 to 2010 years. We analysed labor histories of women with a spontaneous MP. All patients were divided into 2 groups depending on chorionicity: Ist group – 37(46,2% patients with monochorionic diamniotic twins; IInd group – 43(53,8% patients with dichorionic diamniotic twins. Category of pregnancy after IVF – 5 women: 2(MC and 3(DC excluded from research. Results and conclusions Women with a multigestation are included in a high-risk group of development of pregnancy miscarriage. Among complications of gestational process more often meet: premature labor (61,3±21,92%, threat of pregnancy breaking (32,5±38,18%, threat of premature labor (22,5±43,84%, premature rupture of amniotic membranes (20,0±45,25%. Clinical experience shows that monochorionic type of placentation is accompanied by greater frequency of such specific complications multiple pregnancy as discordant fetal growth (18,9±21,21%, fetofetal transfusion syndrome (2,7±5,45%, twin reversed arterial perfusion (2,7±5,45%, fetal growth retardation syndrome (2,7±5,45%. Thus, chorionicity exactly determines the process of multiple pregnancy and its ends. It’s extremely important to use modern uninvasive and safe methods of fetus state function analysis for early diagnostics, prevention of multiple pregnancy miscarriage.

  12. Early severe acute respiratory distress syndrome: What's going on? Part II: controlled vs. spontaneous ventilation?

    Science.gov (United States)

    Petitjeans, Fabrice; Pichot, Cyrille; Ghignone, Marco; Quintin, Luc

    2016-01-01

    The second part of this overview on early severe ARDS delineates the pros and cons of the following: a) controlled mechanical ventilation (CMV: lowered oxygen consumption and perfect patient-to-ventilator synchrony), to be used during acute cardio-ventilatory distress in order to "buy time" and correct circulatory insufficiency and metabolic defects (acidosis, etc.); b) spontaneous ventilation (SV: improved venous return, lowered intrathoracic pressure, absence of muscle atrophy). Given a stabilized early severe ARDS, as soon as the overall clinical situation improves, spontaneous ventilation will be used with the following stringent conditionalities: upfront circulatory optimization, upright positioning, lowered VO2, lowered acidotic and hypercapnic drives, sedation without ventilatory depression and without lowered muscular tone, as well as high PEEP (titrated on transpulmonary pressure, or as a second best: "trial"-PEEP) with spontaneous ventilation + pressure support (or newer modes of ventilation). As these propositions require evidence-based demonstration, the reader is reminded that the accepted practice remains, in 2016, controlled mechanical ventilation, muscle relaxation and prone position.

  13. Recurrence of second trimester miscarriage and extreme preterm delivery at 16 to 27 weeks of gestation with a focus on cervical insufficiency and prophylactic cerclage

    DEFF Research Database (Denmark)

    Sneider, Kirstine; Christiansen, Ole Bjarne; Sundtoft, Iben Blaabjerg

    2016-01-01

    , multiple gestation, uterine anomaly, placental insufficiency, antepartum bleeding, cervical insufficiency, preterm premature rupture of membranes, and intrauterine fetal death. Recurrence rate after a second trimester miscarriage/spontaneous delivery in the period was calculated based on the register data...

  14. Miscarriages

    Science.gov (United States)

    ... previous continue Stillbirths A stillbirth, which many experts define as the death of a baby after the ... in the mother, such as thyroid hormone uncontrolled diabetes exposure to environmental and workplace hazards, such as ...

  15. Miscarriage

    Science.gov (United States)

    ... Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 41. Ellenson LH, Pirog EC. The ... Pathologic Basis of Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 22. Hobel CJ, Williams J. ...

  16. Can Porphyromonas gingivalis be a novel aetiology for recurrent miscarriage?

    Science.gov (United States)

    Ibrahim, Moustafa I; Abdelhafeez, Mohamed A; Ellaithy, Mohamed I; Salama, Ahmed H; Amin, Adel S; Eldakrory, Hesham; Elhadad, Nagwa I

    2015-04-01

    To study the association between Porphyromonas gingivalis (P. gingivalis) infection and recurrent miscarriage. This case control study included women with early pregnancy failure admitted for surgical evacuation of retained products of conception. Cases (group 1) included 50 women with unexplained recurrent early miscarriage whereas the control group (group 2) consisted of 50 women with no such history. The evacuated products of conception, subgingival plaques, cervicovaginal secretions and saliva of all participants were examined to detect P. gingivalis deoxyribonucleic acid (DNA) using a polymerase chain reaction. The prevalence of P. gingivalis DNA in the chorionic villous tissue samples of group 1 was significantly higher than in group 2 (8 [16%] vs. 1 [2%], respectively; p = 0.036, odds ratio [OR]: 9.3, 95% confidence interval [CI]: 1.1-76.9). The prevalence of P. gingivalis DNA was significantly higher in cervicovaginal secretions of group 1 than in group 2 (9 [18%] vs. 1 [2%], respectively; p = 0.02, OR: 10.8, 95% CI: 1.3-88.5). On the contrary, P. gingivalis DNA could not be detected in subgingival plaques and saliva samples of either group. The current study found an association between P. gingivalis infection of the female genital tract and the occurrence of recurrent miscarriage.

  17. Chromosomal anomalies in early spontaneous abortions: interphase FISH analysis on 855 FFPE first trimester abortions.

    Science.gov (United States)

    Russo, Rosa; Sessa, Anna Maria; Fumo, Rosalba; Gaeta, Sara

    2016-02-01

    Cytogenetic analysis of spontaneous abortuses presents at least two main challenges, cell culture failure, and excess of normal female karyotypes related to maternal cell contamination (MCC). Molecular cytogenetic techniques using uncultured cell suspension overcome cell culture failure, but do not resolve MCC at all. The aim of the present study is to demonstrate that interphase fluorescence in situ hybridization (FISH) on routine formalin-fixed paraffin embedded (FFPE) abortive materials is an efficient method to identify chromosomal anomalies in abortuses and to detect MCC. Interphase FISH with a panel of eight probes was applied on 855 FFPE consecutive early spontaneous abortions. Male/female ratio was 0.88 in the complete sample, 0.9 in the group of negative FISH result, and 0.8 in the group with abnormal FISH results, suggesting that no gender predominance was present in our data. The aneuploidy rate was 50.3%. Autosomal trisomies were 60%, polyploidies 23.2%, and X monosomy 14%. Chromosomal mosaicism was discovered in 1.9% with six cases of confined placental mosaicism. FISH on FFPE abortion materials appears to be a successful approach to detect chromosomal anomalies in abortions. Moreover, the preservation of the tissue morphology allows the analysis of only the fetal cells, making the presence of maternal tissues irrelevant. © 2015 John Wiley & Sons, Ltd.

  18. DYZ1 copy number variation, Y chromosome polymorphism and early recurrent spontaneous abortion/early embryo growth arrest.

    Science.gov (United States)

    Yan, Junhao; Fan, Lingling; Zhao, Yueran; You, Li; Wang, Laicheng; Zhao, Han; Li, Yuan; Chen, Zi-Jiang

    2011-12-01

    To find the association between recurrent spontaneous abortion (RSA)/early embryo growth arrest and Y chromosome polymorphism. Peripheral blood samples of the male patients of big Y chromosome, small Y chromosome and other male patients whose partners suffered from unexplained RSA/early embryo growth arrest were collected. PCR and real-time fluorescent quantitative PCR were used to test the deletion and the copy number variation of DYZ1 region in Y chromosome of the patients. A total of 79 big Y chromosome patients (48 of whose partners suffered from RSA or early embryo growth arrest), 7 small Y chromosome patients, 106 other male patients whose partners had suffered from unexplained RSA or early embryo growth arrest, and 100 normal male controls were enrolled. There was no fraction deletion of DYZ1 detected both in big Y patients and in normal men. Of RSA patients, 1 case showed deletion of 266bp from the gene locus 25-290bp, and 2 cases showed deletion of 773bp from 1347 to 2119bp. Of only 7 small Y chromosome patients, 2 cases showed deletion of 266bp from 25 to 290bp, and 4 cases showed deletion of 773bp from 1347 to 2119bp and 275bp from 3128 to 3420bp. The mean of DYZ1 copies was 3900 in normal control men; the mean in big Y patients was 5571, in RSA patients was 2655, and in small Y patients was 1059. All of the others were significantly different (PRSA patients and small Y patients. The integrity and copy number variation of DYZ1 are closely related to the Y chromosome length under microscope. The cause of RSA/early embryo growth arrest in some couples may be the increase (big Y patients) or decrease of DYZ1 copy number in the husbands' Y chromosome. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. High maternal serum ferritin in early pregnancy and risk of spontaneous preterm birth.

    Science.gov (United States)

    Khambalia, Amina Z; Collins, Clare E; Roberts, Christine L; Morris, Jonathan M; Powell, Katie L; Tasevski, Vitomir; Nassar, Natasha

    2015-08-14

    Previous studies have reported inconsistent associations between maternal serum ferritin concentrations and the risk of spontaneous preterm birth (sPTB). The aim of the present study was to examine the association between Fe biomarkers, including serum ferritin concentrations, and the risk of total ( 75th percentile ( ≥ 43 μg/l) (OR 1.49, 95% CI 1.06, 2.10) and >90th percentile ( ≥ 68 μg/l) (OR 1.92, 95% CI 1.25, 2.96). Increased odds of early and moderate-to-late sPTB were associated with ferritin levels >90th percentile (OR 2.50, 95% CI 1.32, 4.73) and >75th percentile (OR 1.56, 95% CI 1.03, 2.37), respectively. No association was found between the risk of sPTB and elevated sTfR levels or Fe deficiency. In conclusion, elevated maternal serum ferritin levels in early pregnancy are associated with an increased risk of sPTB from 34 weeks of gestation. The usefulness of early pregnancy ferritin levels in identifying women at risk of sPTB warrants further investigation.

  20. Metabolite Profile of Cervicovaginal Fluids from Early Pregnancy Is Not Predictive of Spontaneous Preterm Birth

    Directory of Open Access Journals (Sweden)

    Melinda M. Thomas

    2015-11-01

    Full Text Available In our study, we used a mass spectrometry-based metabolomic approach to search for biomarkers that may act as early indicators of spontaneous preterm birth (sPTB. Samples were selected as a nested case-control study from the Screening for Pregnancy Endpoints (SCOPE biobank in Auckland, New Zealand. Cervicovaginal swabs were collected at 20 weeks from women who were originally assessed as being at low risk of sPTB. Samples were analysed using gas chromatography-mass spectrometry (GC-MS. Despite the low amount of biomass (16–23 mg, 112 compounds were detected. Statistical analysis showed no significant correlations with sPTB. Comparison of reported infection and plasma inflammatory markers from early pregnancy showed two inflammatory markers were correlated with reported infection, but no correlation with any compounds in the metabolite profile was observed. We hypothesise that the lack of biomarkers of sPTB in the cervicovaginal fluid metabolome is simply because it lacks such markers in early pregnancy. We propose alternative biofluids be investigated for markers of sPTB. Our results lead us to call for greater scrutiny of previously published metabolomic data relating to biomarkers of sPTB in cervicovaginal fluids, as the use of small, high risk, or late pregnancy cohorts may identify metabolite biomarkers that are irrelevant for predicting risk in normal populations.

  1. FAQs of Pregnancy Loss and Miscarriage

    Science.gov (United States)

    ... the amount in a 12-ounce cup of coffee)5 may increase their risk of miscarriage. The ... M., Finnegan, M., Gerson, A., & Belden, M. (2010). Addiction in pregnancy. Journal of Addictive Diseases , 29(2), ...

  2. Early and late mortality of spontaneous hemorrhagic transformation of ischemic stroke.

    Science.gov (United States)

    D'Amelio, Marco; Terruso, Valeria; Famoso, Giorgia; Di Benedetto, Norma; Realmuto, Sabrina; Valentino, Francesca; Ragonese, Paolo; Savettieri, Giovanni; Aridon, Paolo

    2014-04-01

    Hemorrhagic transformation (HT), a complication of ischemic stroke (IS), might influence patient's prognosis. Our aim is to evaluate, in a hospital-based series of patients not treated with thrombolysis, the relationship between HT and mortality. We compared mortality of individuals with spontaneous HT with that of individuals without. Medical records of patients diagnosed with anterior IS were retrospectively reviewed. Outcome measures were 30- and 90-day survival after IS onset. Kaplan-Meier estimates were used to construct survival curves. Cox proportional hazards model was used to estimate hazard ratio (HR) for the main outcome measure (death). HT was stratified in hemorrhagic infarction and parenchymal hematoma (PH). We also evaluated the relationship between HT and the main mortality risk factors (gender, age, premorbid status, severity of stroke, and radiological features). Thirty days from stroke onset, 8.1% (19 of 233) of patients died. At multivariate analysis, PH (HR: 7.7, 95% confidence interval [CI]: 2.1, 27.8) and low level of consciousness at admission (HR: 5.0, 95% CI: 1.3, 18.6) were significantly associated with death. At 3-month follow-up, mortality rate was 12.1% (28 of 232). At multivariate analysis, large infarct size (HR: 2.7, 95% CI: 1.2, 6.0) and HT (HR: 2.3, 95% CI: 1.0, 5.4) were independent risk factors for mortality. Parenchymal hematoma was, however, the strongest predictor of late mortality (HR: 7.9, 95% CI: 2.9, 21.4). Neurological status and infarct size play a significant role, respectively, in early and late mortality after IS. Parenchymal hematoma independently predicts both early and late mortality. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Spontaneous glial calcium waves in the retina develop over early adulthood.

    Science.gov (United States)

    Kurth-Nelson, Zeb L; Mishra, Anusha; Newman, Eric A

    2009-09-09

    Intercellular glial Ca(2+) waves constitute a signaling pathway between glial cells. Artificial stimuli have previously been used to evoke these waves, and their physiological significance has been questioned. We report here that Ca(2+) waves occur spontaneously in rat retinal glial cells, both in the isolated retina and in vivo. These spontaneous waves are propagated by ATP release. In the isolated retina, suramin (P2 receptor antagonist) reduces the frequency of spontaneous wave generation by 53%, and apyrase (ATP-hydrolyzing enzyme) reduces frequency by 95-100%. Luciferin-luciferase chemiluminescence reveals waves of ATP matching the spontaneous Ca(2+) waves, indicating that ATP release occurs as spontaneous Ca(2+) waves are generated. Wave generation also depends on age. Spontaneous wave frequency rises from 0.27 to 1.0 per minute per mm(2), as rats age from 20 to 120 d. The sensitivity of glia to ATP does not increase with age, but the ATP released by evoked waves is 31% greater in 120-d-old than in 20-d-old rats, suggesting that increased ATP release in older animals could account for the higher frequency of wave generation. Simultaneous imaging of glial Ca(2+) and arterioles in the isolated retina demonstrates that spontaneous waves alter vessel diameter, implying that spontaneous waves may have a significant impact on retinal physiology. Spontaneous intercellular glial Ca(2+) waves also occur in the retina in vivo, with frequency, speed, and diameter similar to the isolated retina. Increased spontaneous wave occurrence with age suggests that wave generation may be related to retinal pathology.

  4. Misoprostol for uterine evacuation during miscarriage: A systematic ...

    African Journals Online (AJOL)

    Miscarriage is an important cause of morbidity and mortality especially in developing countries. Traditionally, miscarriage is treated by surgical curettage. Misoprostol has been introduced in recent years for treatment of miscarriage. In this review, we systematically searched for and combined the evidence from randomized ...

  5. Post Operative Miscarriage Following Ruptured Appendix in ...

    African Journals Online (AJOL)

    Intraoperative findings were purulent peritoneal exudates, ruptured appendix with flakes of necrotic tissues and fecolith. She subsequently had post operative miscarriage 48hours after the surgery which was completed by manual vacuum aspiration. She did remarkably well and was discharged on the 7th post operative ...

  6. New insights into mechanisms behind miscarriage

    DEFF Research Database (Denmark)

    Larsen, Elisabeth Clare; Christiansen, Ole Bjarne; Kolte, Astrid Marie

    2013-01-01

    and changes in sperm DNA integrity. Recent experimental evidence has led to the concept that the decidualized endometrium acts as biosensor of embryo quality, which if disrupted, may lead to implantation of embryos destined to miscarry. These new insights into the mechanisms behind miscarriage offer...

  7. Chromosomal abnormalities in products of conception of first-trimester miscarriages detected by conventional cytogenetic analysis: a review of 1000 cases.

    Science.gov (United States)

    Pylyp, Larysa Y; Spynenko, Lyudmyla O; Verhoglyad, Nataliya V; Mishenko, Anna O; Mykytenko, Dmytro O; Zukin, Valery D

    2017-10-30

    The purpose of this study is to perform a retrospective analysis of types and frequencies of chromosomal abnormalities detected by conventional cytogenetic studies in first-trimester miscarriages after spontaneous conception and IVF. Standard cytogenetic analysis of GTG-banded chromosomes obtained from products of conception (POCs): semi-direct and short-term cultured chorionic villi or long-term cultured fetal mesodermal cells. 50.1% of first-trimester miscarriages in the studied group had chromosomal abnormalities: 59.7% of trisomies, 22% of poliploidies, 7.5% of monosomies, 7% of unbalanced structural abnormalities, and 3.8% of multiple aneuploidies. An increase in the frequency of chromosomally abnormal miscarriages was observed in the group of women above 40 when compared to groups of women under 35 (P < 0.05). No difference in frequencies and types of chromosomal abnormalities in POCs of miscarriages after ICSI and spontaneous conception was observed. Approximately, 50% of first-trimester miscarriages have chromosomal abnormalities which can be detected by conventional cytogenetic analysis. The presence of chromosomal abnormality may explain the cause of miscarriage, improving the reproductive counseling and planning.

  8. Association between single-nucleotide polymorphisms and early spontaneous hepatitis B virus e antigen seroconversion in children.

    Science.gov (United States)

    Komatsu, Haruki; Murakami, Jun; Inui, Ayano; Tsunoda, Tomoyuki; Sogo, Tsuyoshi; Fujisawa, Tomoo

    2014-11-06

    The disease progression following hepatitis B virus (HBV) infection is associated with single-nucleotide polymorphisms (SNPs). However, the role of SNPs in chronic HBV infection in children remains unclear. Here, we investigate the association between SNPs and early spontaneous hepatitis B e antigen (HBeAg) seroconversion in children with chronic hepatitis B infection. This was a retrospective cohort study. We genotyped seven SNPs in the following genes, interleukin (IL)-10 (rs1800871 and rs1800872), human leukocyte antigen (HLA)-DPA1 (rs3077), HLA-DPB1 (rs9277535), HLA-DQB2 (rs7453920), HLA-DQB1 (rs2856718), and IL28B (rs8099917), in patients with chronic HBV infection using PCR and sequencing. These variants were analyzed for an association with early HBeAg seroconversion in children. Of 225 Japanese patients with chronic hepatitis B virus infection (male/female: 105/120, median age at initial visit: 6 years; range 0-44 years), 52 achieved spontaneous HBeAg seroconversion at the age of 10 years or younger (G1: early seroconversion group), and 57 did not achieve spontaneous HBeAg seroconversion under the age of 20 years (G2: late or no seroconversion group). Of the seven SNPs, only the HLA-DPA1 SNP displayed a low p-value (P = 0.070), but not significant, to have early HBeAg seroconversion in the dominant model and in the allele model (P = 0.073) using the chi-square test. The association study found a low p-value, but not significant, to have early HBeAg seroconversion in the dominant model for HLA-DPA1 (genotype TC + TT vs. CC, P = 0.070, odds ratio: 2.016, 95% confidence interval: 0.940-4.323) using a logistic regression model. Although the HLA-DPA1 SNP did not show a statistically significant association with early HBeAg seroconversion in this study, the HLA-DPA1 SNP might increase the likelihood of achieving early spontaneous HBeAg seroconversion in children.

  9. Five cases of early dissociation between the bipolar hip endoprosthesis cup components; either spontaneously or during reduction maneuvers

    Directory of Open Access Journals (Sweden)

    Vedat Uruç

    2017-03-01

    Full Text Available Bipolar hemiarthroplasty is frequently used in the treatment of intracapsular hip fractures. Dissociation of the bipolar components can happen during the hip dislocation, the reduction maneuvers, or spontaneously without any dislocation. Here we report early dissociation between bipolar components in two cases during the attempt of closed reduction maneuvers and three cases with spontaneous dissociation without any trauma. To prevent or minimize this complication; the reduction of dislocated hips must be achieved very gently under general anesthesia with fluoroscopic control. During the initial operation the surgeons must be sure that the bipolar components are locked to each other and after final reduction, especially in osteoarthritic acetabulums, that the cup position is not in varus position.

  10. Five cases of early dissociation between the bipolar hip endoprosthesis cup components; either spontaneously or during reduction maneuvers.

    Science.gov (United States)

    Uruç, Vedat; Özden, Raif; Duman, İbrahim Gökhan; Kalacı, Aydıner

    2017-03-01

    Bipolar hemiarthroplasty is frequently used in the treatment of intracapsular hip fractures. Dissociation of the bipolar components can happen during the hip dislocation, the reduction maneuvers, or spontaneously without any dislocation. Here we report early dissociation between bipolar components in two cases during the attempt of closed reduction maneuvers and three cases with spontaneous dissociation without any trauma. To prevent or minimize this complication; the reduction of dislocated hips must be achieved very gently under general anesthesia with fluoroscopic control. During the initial operation the surgeons must be sure that the bipolar components are locked to each other and after final reduction, especially in osteoarthritic acetabulums, that the cup position is not in varus position. Copyright © 2017. Production and hosting by Elsevier B.V.

  11. Metformin exposure in early pregnancy and spontaneous abortions in women with polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Lauszus, Finn; Viftrup-Lund, Mette; Gade, Melina

    2014-01-01

    Objective: We sought to determine whether metformin affects the rate of first trimester spontaneous abortions and congenital malformations in women with PCOS. Design. Consecutive series of metformin treated women with a questionnaire followup. Setting. Department of Gynecology and Obstetrics at H...

  12. Effect of early amniotomy on the outcome of spontaneous labour: a ...

    African Journals Online (AJOL)

    Edwin Musinguzi

    preventing dystocia in women in spontaneous labour4,5. However, the effectiveness of this intervention in aug- menting ... part of prevention of vertical transmission of ma- ternal infections, the procedure has relative contraindi- ... preeclampsia, and HIV infection. The ethical commit- tee of the hospital approved the study.

  13. Evidence-based management of recurrent miscarriages

    Directory of Open Access Journals (Sweden)

    Yadava B Jeve

    2014-01-01

    Full Text Available Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based.

  14. Miscarriage and recurrent miscarriage in patients with congenital factor V deficiency: a report of six cases in Iran.

    Science.gov (United States)

    Naderi, Majid; Tabibian, Shadi; Shamsizadeh, Morteza; Dorgalaleh, Akbar

    2016-06-01

    Miscarriage and recurrent miscarriage have not been reported in women with congenital factor V (FV) deficiency. Here we describe cases of both miscarriage and recurrent miscarriage in women with congenital FV deficiency (FVD). We investigated six women with FVD from the southeast of Iran who had experienced miscarriage and recurrent miscarriage. Consequent diagnosis was made by routine coagulation tests as well as FV activity and antigen assays. To evaluate the presence of an inhibitor, a mixing study via prothrombin time (PT) assay was performed. All patients were investigated, and found to be negative for antiphospholipid syndrome. Demographic data and clinical presentations were obtained by standard questionnaire. The factor assays determined that all six women were suffering from moderate FVD. One had experienced eight miscarriages, while the others experienced two (two patients), three, and four episodes. Only one patient had a single miscarriage. Three of the women experienced successful delivery without medical intervention. Miscarriage and recurrent miscarriage should be considered as possible presentations of FVD to prevent its life-threatening consequences.

  15. Secondary recurrent miscarriage and H-Y immunity

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre

    2011-01-01

    BACKGROUND Approximately half recurrent miscarriage (RM) cases remain unexplained after standard investigations. Secondary RM (SRM) is, in contrast to primary RM, preceded by a birth, which increases the transfer of fetal cells into the maternal circulation. Mothers of boys are often immunized...... against male-specific minor histocompatibility (H-Y) antigens, and H-Y immunity can cause graft-versus-host disease after stem-cell transplantation. We proposed the H-Y hypothesis that aberrant H-Y immunity is a causal factor for SRM. METHODS This is a critical review of the H-Y hypothesis based on own....... Maternal carriage of HLA-class II alleles presenting H-Y antigens to immune cells is associated with a reduced live birth rate and increased risk of obstetric complications in surviving pregnancies in SRM patients with a firstborn boy. In early pregnancy, both antibodies against HLA and H-Y antigens...

  16. Infectious lesions of placenta as cause of miscarriage

    Directory of Open Access Journals (Sweden)

    A. V. Kolobov

    2015-01-01

    Full Text Available Analysis of the literature demonstratesimportant role played of infections in causes of miscarriage. The paper is based upon retrospective analysis of 12371 screening results of histological and selective immunohistochemical studies of placentas in 2009-12. Preterm births were in 706 cases (5.71%. Infection of the placenta was noted in early preterm labor in all cases (100%, and in premature labor at 28-36 weeks of gestation – in 97.35% of natural delivery cases and in 92.09% when cesarean delivery. Are described the typical structural changes that allow to suspect infections caused by Treponema pallidum, herpes viruses, human immunodeficiency virus, parvovirus with following verification by immunohistochemical study. 

  17. Dust and chemical exposures, and miscarriage risk among women textile workers in Shanghai, China.

    Science.gov (United States)

    Wong, E Y; Ray, R M; Gao, D-L; Wernli, K J; Li, W; Fitzgibbons, E D; Camp, J E; Astrakianakis, G; Heagerty, P J; De Roos, A J; Holt, V L; Thomas, D B; Checkoway, H

    2009-03-01

    To investigate possible associations between miscarriage and occupational exposures in the Shanghai textile industry. A retrospective cohort study of miscarriages among 1752 women in the Shanghai textile industry was conducted. Reproductive history was self-reported by women and occupational work histories were collected from factory personnel records. Occupational exposures were assigned by linking work history information to an industry-specific job-exposure matrix informed by factory-specific textile process information and industrial hygiene assessments. Estimates of cotton dust and endotoxin exposure were also assigned. Odds ratios (OR) and 95% CI were estimated by multivariate logistic regression, with adjustment for age at pregnancy, educational level, smoking status of the woman and her spouse, use of alcohol, and woman's year of birth. An elevation in risk of a spontaneously aborted first pregnancy was associated with exposure to synthetic fibres (OR 1.89, 95% CI 1.20 to 3.00) and mixed synthetic and natural fibres (OR 3.31, 95% CI 1.30 to 8.42). No increased risks were observed for women working with solvents, nor were significant associations observed with quantitative cotton dust or endotoxin exposures. Associations were robust and similar when all pregnancies in a woman's reproductive history were considered. Occupational exposure to synthetic fibres may cause miscarriages, and this possibility should be the subject of further investigation.

  18. How long after a miscarriage should women wait before becoming pregnant again? Multivariate analysis of cohort data from Matlab, Bangladesh

    Science.gov (United States)

    DaVanzo, Julie; Hale, Lauren; Rahman, Mizanur

    2012-01-01

    Objective To determine the optimum interpregnancy interval (IPI) following a miscarriage. Design Multivariate analysis of population-based, prospective data from a demographic surveillance system. Setting Pregnancies in Matlab, Bangladesh, between 1977 and 2008. Participants 9214 women with 10 453 pregnancies that ended in a miscarriage and were followed by another pregnancy outcome. Main outcome measures Outcome of pregnancy following the miscarriage was singleton live birth, stillbirth, miscarriage or induced abortion. For pregnancies that ended in live birth: early neonatal, late neonatal and postneonatal mortality. Results Compared with IPIs of 6–12 months, pregnancies that were conceived ≤3 months after a miscarriage were more likely to result in a live birth and less likely to result in a miscarriage (adjusted relative risk ratio (RRR) 0.70, 95% CI 0.57 to 0.86) or induced abortion (0.50, 0.29 to 0.89). Induced abortions were significantly more likely following IPIs of 18–24 months (2.36, 1.48 to 3.76), 36–48 months (2.73, 1.50 to 4.94), and >48 months (3.32, 1.68 to 2.95), and miscarriages were more likely following IPIs of 12–17 months (1.25, 1.01 to 1.56) and >48 months (1.90, 1.40 to 2.58). No significant effects of IPI duration are seen on the risks of a stillbirth. However, IPIs≤3 months following a miscarriage are associated with significantly higher late neonatal mortality for the infant born at the end of the IPI (adjusted hazard ratio (HR) 1.74, 1.06 to 2.84), and IPIs of 12–18 months are associated with a significantly lower unadjusted risk of postneonatal mortality (0.54, 0.30 to 0.96). Conclusions The shorter the IPI following a miscarriage, the more likely the subsequent pregnancy is to result in a live birth. However, very short IPIs may not be advisable following miscarriages in poor countries like Bangladesh because they are associated with a higher risk of mortality for the infants born after them. PMID

  19. Comparison of Swirl Sign and Black Hole Sign in Predicting Early Hematoma Growth in Patients with Spontaneous Intracerebral Hemorrhage.

    Science.gov (United States)

    Xiong, Xin; Li, Qi; Yang, Wen-Song; Wei, Xiao; Hu, Xi; Wang, Xing-Chen; Zhu, Dan; Li, Rui; Cao, Du; Xie, Peng

    2018-01-29

    BACKGROUND Early hematoma growth is associated with poor outcome in patients with spontaneous intracerebral hemorrhage (ICH). The swirl sign (SS) and the black hole sign (BHS) are imaging markers in ICH patients. The aim of this study was to compare the predictive value of these 2 signs for early hematoma growth. MATERIAL AND METHODS ICH patients were screened for the appearance of the 2 signs within 6 h after onset of symptoms. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 2 signs in predicting early hematoma growth were assessed. The accuracy of the 2 signs in predicting early hematoma growth was analyzed by receiver-operator analysis. RESULTS A total of 200 patients were enrolled in this study. BHS was found in 30 (15%) patients, and SS was found in 70 (35%) patients. Of the 71 patients with early hematoma growth, BHS was found on initial computed tomography scans in 24 (33.8%) and SS in 33 (46.5%). The sensitivity, specificity, PPV, and NPV of BHS for predicting early hematoma growth were 33.8%, 95.3%, 80.0%, and 72.0%, respectively. The sensitivity, specificity, PPV, and NPV of SS were 46.5%, 71.3%, 47.0%, and 71.0%, respectively. The area under the curve was 0.646 for BHS and 0.589 for SS (P=0.08). Multivariate logistic regression showed that presence of BHS is an independent predictor of early hematoma growth. CONCLUSIONS The Black hole sign seems to be good predictor for hematoma growth. The presence of swirl sign on admission CT does not independently predict hematoma growth in patients with ICH.

  20. Predictive value of serum β-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion.

    Science.gov (United States)

    Liu, Yinglin; Liu, Yukun; Li, Xuejiao; Jiao, Xuedan; Zhang, Rui; Zhang, Jianping

    2016-10-01

    To examine peak serum levels of the β-subunit of human chorionic gonadotropin (β-hCG) for prediction of early pregnancy outcomes among women with recurrent spontaneous abortion (RSA). In a retrospective study, the medical records of pregnant women with a history of RSA treated at Sun Yat-sen Memorial Hospital, China, between January 2011 and July 2013 were reviewed. Serum β-hCG had been measured twice weekly from 5 to 13weeks of pregnancy, and pregnancy was monitored by transvaginal ultrasonography to 13(+6)weeks. Optimal cutoff for peak β-hCG level was determined by receiver operator characteristic curve analysis and Youden index. Women were divided into four groups on the basis of optimal peak β-hCG cutoff and pregnancy outcome (pregnancy at 13weeks or spontaneous abortion). Peak β-hCG levels and length of pregnancy at this peak were examined. Overall, 1240 patients were included. The optimal cutoff value of peak β-hCG was 88 468IU/L, with a sensitivity, specificity, positive predictive value, and negative predictive value for successful pregnancy of 95.6%, 88.0%, 95.6%, and 89.0%, respectively. A faster rise in β-hCG, higher peak β-hCG, and longer pregnancy length at peak β-hCG were associated with successful early pregnancy. A cutoff value of serum β-hCG of 88 000IU/L could be used to predict early pregnancy outcomes for women with a history of RSA. Copyright © 2016. Published by Elsevier Ireland Ltd.

  1. Chromosomal abnormalities and embryo development in recurrent miscarriage couples.

    Science.gov (United States)

    Rubio, C; Simón, C; Vidal, F; Rodrigo, L; Pehlivan, T; Remohí, J; Pellicer, A

    2003-01-01

    Chromosomal abnormalities are an important cause of spontaneous abortion and recurrent miscarriage (RM). Therefore, we have analysed the incidence of chromosomal abnormalities and embryo development in patients with RM. Preimplantation genetic diagnosis (PGD) was performed on 71 couples with RM and 28 couples undergoing PGD for sex-linked diseases (control group). Chromosomes 13, 16, 18, 21, 22, X and Y were analysed by fluorescence in-situ hybridization. The implantation rate in RM patients was 28% and three patients (13%) miscarried. The percentage of abnormal embryos was significantly increased (P abnormal in 19 cycles (22.1%) and repeated PGD cycles yielded similar rates of chromosomal abnormalities in 14 couples. Anomalies for chromosomes 16 and 22 were significantly higher (P abnormal embryos (61.7 versus 24.9%; P chromosomally abnormal embryos, of which some are able to develop to the blastocyst stage. IVF plus PGD is an important step in the management of these couples, but the technique has to move towards a full chromosome analysis.

  2. Effect of the meniscus contact angle during early regimes of spontaneous imbibition in nanochannels

    DEFF Research Database (Denmark)

    Karna, Nabin Kumar; Oyarzua, Elton; Walther, Jens Honore

    2016-01-01

    Nanoscale capillarity has been extensively investigated; nevertheless, many fundamental questions remain open. In spontaneous imbibition, the classical Lucas-Washburn equation predicts a singularity as the fluid enters the channel consisting of an anomalous infinite velocity of the capillary...... meniscus. Bosanquet's equation overcomes this problem by taking into account fluid inertia predicting an initial imbibition regime with constant velocity. Nevertheless, the initial constant velocity as predicted by Bosanquet's equation is much greater than those observed experimentally. In the present...... study, large scale atomistic simulations are conducted to investigate capillary imbibition of water in slit silica nanochannels with heights between 4 and 18 nm. We find that the meniscus contact angle remains constant during the inertial regime and its value depends on the height of the channel. We...

  3. Associations of recurrent miscarriages with chromosomal abnormalities, thrombophilia allelic polymorphisms and/or consanguinity in Saudi Arabia.

    Science.gov (United States)

    Turki, Rola F; Assidi, Mourad; Banni, Huda A; Zahed, Hanan A; Karim, Sajjad; Schulten, Hans-Juergen; Abu-Elmagd, Muhammad; Rouzi, Abdulrahim A; Bajouh, Osama; Jamal, Hassan S; Al-Qahtani, Mohammed H; Abuzenadah, Adel M

    2016-10-10

    Recurrent pregnancy loss (RPL) or recurrent spontaneous abortion is an obstetric complication that affects couples at reproductive age. Previous reports documented a clear relationship between parents with chromosomal abnormalities and both recurrent miscarriages and infertility. However, limited data is available from the Arabian Peninsula which is known by higher rates of consanguineous marriages. The main goal of this study was to determine the prevalence of chromosomal abnormalities and thrombophilic polymorphisms, and to correlate them with RPL and consanguinity in Saudi Arabia. Cytogenetic analysis of 171 consent patients with RPL was performed by the standard method of 72-h lymphocyte culture and GTG banding. Allelic polymorphisms of three thrombophilic genes (Factor V Leiden, Prothrombin A20210G, MTHFR C677T) were performed using PCR-RFLP (restriction fragment length polymorphism) and gel electrophoresis. Data analysis revealed that 7.6 % of patients were carrier of numerical or structural chromosomal abnormalities. A high rate of translocations (46 %) was associated to increased incidence of RPL. A significant correlation between consanguineous RPL patients and chromosomal abnormalities (P prevalence of RPL. This study demonstrated a strong association between RPL and the prevalence of chromosomal abnormalities and inherited thrombophilia. Given the high rate of consanguineous marriages in the Saudi population, these results underline the importance of systematic cytogenetic investigation and genetic counseling preferably at the premarital stage or at least during early pregnancy phase through preimplantation genetic diagnosis (PGD).

  4. Indoor Exposure and Adverse Birth Outcomes Related to Fetal Growth, Miscarriage and Prematurity—A Systematic Review

    Directory of Open Access Journals (Sweden)

    Evridiki Patelarou

    2014-06-01

    Full Text Available The purpose of this review was to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution and all-day personal exposure with adverse birth outcomes including fetal growth, prematurity and miscarriage. We carried out a systematic literature search of MEDLINE and EMBASE databases with the aim of summarizing and evaluating the results of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed indoor air pollution and all-day personal exposure with specific quantitative methods. This comprehensive literature search identified 16 independent studies which were deemed relevant for further review and two additional studies were added through searching the reference lists of all included studies. Two reviewers independently and critically appraised all eligible articles using the Critical Appraisal Skills Programme (CASP tool. Of the 18 selected studies, 14 adopted a prospective cohort design, three were case-controls and one was a retrospective cohort study. In terms of pollutants of interest, seven studies assessed exposure to electro-magnetic fields, four studies assessed exposure to polycyclic aromatic hydrocarbons, four studies assessed PM2.5 exposure and three studies assessed benzene, phthalates and noise exposure respectively. Furthermore, 12 studies examined infant growth as the main birth outcome of interest, six examined spontaneous abortion and three studies assessed gestational age at birth and preterm delivery. This survey demonstrates that there is insufficient research on the possible association of indoor exposure and early life effects and that further research is needed.

  5. Spontaneous transformation of murine epithelial cells requires the early acquisition of specific chromosomal aneuploidies and genomic imbalances.

    Science.gov (United States)

    Padilla-Nash, Hesed M; Hathcock, Karen; McNeil, Nicole E; Mack, David; Hoeppner, Daniel; Ravin, Rea; Knutsen, Turid; Yonescu, Raluca; Wangsa, Danny; Dorritie, Kathleen; Barenboim, Linda; Hu, Yue; Ried, Thomas

    2012-04-01

    Human carcinomas are defined by recurrent chromosomal aneuploidies, which result in a tissue-specific distribution of genomic imbalances. In order to develop models for these genome mutations and to determine their role in tumorigenesis, we generated 45 spontaneously transformed murine cell lines from normal epithelial cells derived from bladder, cervix, colon, kidney, lung, and mammary gland. Phenotypic changes, chromosomal aberrations, centrosome number, and telomerase activity were assayed in control uncultured cells and in three subsequent stages of transformation. Supernumerary centrosomes, binucleate cells, and tetraploidy were observed as early as 48 hr after explantation. In addition, telomerase activity increased throughout progression. Live-cell imaging revealed that failure of cytokinesis, not cell fusion, promoted genome duplication. Spectral karyotyping demonstrated that aneuploidy preceded immortalization, consisting predominantly of whole chromosome losses (4, 9, 12, 13, 16, and Y) and gains (1, 10, 15, and 19). After transformation, focal amplifications of the oncogenes Myc and Mdm2 were frequently detected. Fifty percent of the transformed lines resulted in tumors on injection into immunocompromised mice. The phenotypic and genomic alterations observed in spontaneously transformed murine epithelial cells recapitulated the aberration pattern observed during human carcinogenesis. The dominant aberration of these cell lines was the presence of specific chromosomal aneuploidies. We propose that our newly derived cancer models will be useful tools to dissect the sequential steps of genome mutations during malignant transformation, and also to identify cancer-specific genes, signaling pathways, and the role of chromosomal instability in this process. Copyright © 2011 Wiley Periodicals, Inc.

  6. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial

    Science.gov (United States)

    Mendelow, A David; Gregson, Barbara A; Rowan, Elise N; Murray, Gordon D; Gholkar, Anil; Mitchell, Patrick M

    2013-01-01

    Summary Background The balance of risk and benefit from early neurosurgical intervention for conscious patients with superficial lobar intracerebral haemorrhage of 10–100 mL and no intraventricular haemorrhage admitted within 48 h of ictus is unclear. We therefore tested the hypothesis that early surgery compared with initial conservative treatment could improve outcome in these patients. Methods In this international, parallel-group trial undertaken in 78 centres in 27 countries, we compared early surgical haematoma evacuation within 12 h of randomisation plus medical treatment with initial medical treatment alone (later evacuation was allowed if judged necessary). An automatic telephone and internet-based randomisation service was used to assign patients to surgery and initial conservative treatment in a 1:1 ratio. The trial was not masked. The primary outcome was a prognosis-based dichotomised (favourable or unfavourable) outcome of the 8 point Extended Glasgow Outcome Scale (GOSE) obtained by questionnaires posted to patients at 6 months. Analysis was by intention to treat. This trial is registered, number ISRCTN22153967. Findings 307 of 601 patients were randomly assigned to early surgery and 294 to initial conservative treatment; 298 and 291 were followed up at 6 months, respectively; and 297 and 286 were included in the analysis, respectively. 174 (59%) of 297 patients in the early surgery group had an unfavourable outcome versus 178 (62%) of 286 patients in the initial conservative treatment group (absolute difference 3·7% [95% CI −4·3 to 11·6], odds ratio 0·86 [0·62 to 1·20]; p=0·367). Interpretation The STICH II results confirm that early surgery does not increase the rate of death or disability at 6 months and might have a small but clinically relevant survival advantage for patients with spontaneous superficial intracerebral haemorrhage without intraventricular haemorrhage. Funding UK Medical Research Council. PMID:23726393

  7. Chinese herbal medicines for unexplained recurrent miscarriage.

    Science.gov (United States)

    Li, Lu; Dou, Lixia; Leung, Ping Chung; Chung, Tony Kwok Hung; Wang, Chi Chiu

    2016-01-14

    Recurrent miscarriage affects 1% to 3% of women of reproductive age and mostly occurs before the 10th week of gestation (and around the same gestational week in subsequent miscarriages). Although most pregnant women may not recognise a miscarriage until uterine bleeding and cramping occur, a repeat miscarriage after one or more pregnancy loss and the chance of having a successful pregnancy varies. To date, there is no universally accepted treatment for unexplained recurrent miscarriage. Chinese herbal medicines have been widely used in Asian societies for millennia and have become a popular alternative to Western medicines in recent years. Many clinical studies have reported that Chinese herbal medicines can improve pregnancy outcomes for pregnant women who had previously suffered recurrent miscarriage. This systematic review evaluated the efficacy of Chinese herbal medicines for recurrent miscarriage. To assess the effectiveness and safety of Chinese herbal medicines for the treatment of unexplained recurrent miscarriage. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (01 June 2015), Embase (1980 to 01 June 2015); Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 01 June 2015); Chinese Biomedical Database (CBM) (1978 to 01 June 2015); China Journal Net (CJN) (1915 to 01 June 2015); China Journals Full-text Database (1915 to 01 June 2015); and WanFang Database (Chinese Ministry of Science & Technology) (1980 to 01 June 2015). We also searched reference lists of relevant trials and reviews. We identified and contacted organisations, individual experts working in the field, and medicinal herb manufacturers. Randomised or quasi-randomised controlled trials, including cluster-randomised trials, with or without full text, comparing Chinese herbal medicines (alone or combined with other intervention or other pharmaceuticals) with placebo, no treatment, other intervention (including bed rest and psychological support

  8. Seroprevalence of brucellosis among women with miscarriage at ...

    African Journals Online (AJOL)

    Background: Brucellosis in animals has been identified as a common cause of miscarriage. It is the most common zoonotic disease that leads to considerable morbidity in humans. It is rarely diagnosed in hospitals in Nigeria, and debate exists as to whether it is a more common cause of miscarriage in humans compared to ...

  9. Seroprevalence of brucellosis among women with miscarriage at ...

    African Journals Online (AJOL)

    AbstRACt background: Brucellosis in animals has been identified as a common cause of miscarriage. It is the most common zoonotic disease that leads to considerable morbidity in humans. It is rarely diagnosed in hospitals in Nigeria, and debate exists as to whether it is a more common cause of miscarriage in humans ...

  10. Medical management of first trimester miscarriage according to ultrasonographic findings

    DEFF Research Database (Denmark)

    Vejborg, Thomas; Nilas, Lisbeth; Rørbye, Christina

    2007-01-01

    BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number...... and 3 (43.6%; pmedically-treated first trimester miscarriages varied according to the ultrasonographic definitions...

  11. Risk of miscarriage among users of corticosteroid hormones

    DEFF Research Database (Denmark)

    Bjørn, Anne-Mette B; Nielsen, Rikke B; Nørgaard, Mette

    2013-01-01

    The purpose of this nested case-control study in Denmark was to study the association between use of corticosteroids and risk of miscarriage.......The purpose of this nested case-control study in Denmark was to study the association between use of corticosteroids and risk of miscarriage....

  12. Optimizing quality of care for couples with recurrent miscarriage

    NARCIS (Netherlands)

    van den Boogaard, E.

    2014-01-01

    The first aim of our research was to make a step forwards to decipher the enigma of the definition of recurrent miscarriage. We showed that the risk of underlying antiphospholipid syndrome and carrier status of chromosomal abnormalities in couples with recurrent miscarriage is not related to

  13. Association between formaldehyde exposure and miscarriage in Chinese women.

    Science.gov (United States)

    Xu, Wenjing; Zhang, Weiqiang; Zhang, Xuezhen; Dong, Taowei; Zeng, Huiqian; Fan, Qiyun

    2017-06-01

    The aim of this study was to assess whether higher plasma formaldehyde concentration existed in women diagnosed with miscarriage and whether it contributed to higher risk of miscarriage in Chinese women.A case-control study was conducted in 118 women with a diagnosed miscarriage at the first trimester and 191 healthy women who delivered at term. Plasma levels of formaldehyde were measured by gas chromatography in conjunction with mass spectrometry after derivatization of the formaldehyde to the pentafluorophenylhydrazone and characteristics of the subjects including age, education level, occupation, family income, home decoration status, and exposure to second-hand smoke were recorded. Logistic regression analyses were performed to investigate the relationship between miscarriage and levels of formaldehyde.Women with miscarriage were comparable to controls in terms of age, education level, occupation, family income, and home decoration status. They were, however, more likely to be exposed to second-hand smoke. Plasma levels of formaldehyde were significantly higher in women with miscarriage (0.0944 ± 0.0105 vs. 0.0239 ± 0.0032 μg/mL, P formaldehyde (odds ratio [OR]: 8.06, 95% confidence interval [CI]: 4.96-13.09) and exposure to second-hand smoke (OR: 3.60, 95% CI: 1.58-8.20) were independently and significantly associated with higher risk of miscarriage.Plasma levels of formaldehyde were significantly higher in women who were diagnosed with miscarriage than those who delivered at term and higher levels of formaldehyde was an independent risk factor for miscarriage, with higher levels being associated with higher risk of miscarriage.

  14. Association between formaldehyde exposure and miscarriage in Chinese women

    Science.gov (United States)

    Xu, Wenjing; Zhang, Weiqiang; Zhang, Xuezhen; Dong, Taowei; Zeng, Huiqian; Fan, Qiyun

    2017-01-01

    Abstract The aim of this study was to assess whether higher plasma formaldehyde concentration existed in women diagnosed with miscarriage and whether it contributed to higher risk of miscarriage in Chinese women. A case-control study was conducted in 118 women with a diagnosed miscarriage at the first trimester and 191 healthy women who delivered at term. Plasma levels of formaldehyde were measured by gas chromatography in conjunction with mass spectrometry after derivatization of the formaldehyde to the pentafluorophenylhydrazone and characteristics of the subjects including age, education level, occupation, family income, home decoration status, and exposure to second-hand smoke were recorded. Logistic regression analyses were performed to investigate the relationship between miscarriage and levels of formaldehyde. Women with miscarriage were comparable to controls in terms of age, education level, occupation, family income, and home decoration status. They were, however, more likely to be exposed to second-hand smoke. Plasma levels of formaldehyde were significantly higher in women with miscarriage (0.0944 ± 0.0105 vs. 0.0239 ± 0.0032 μg/mL, P < .001). Multivariate logistic regression showed that higher level of formaldehyde (odds ratio [OR]: 8.06, 95% confidence interval [CI]: 4.96–13.09) and exposure to second-hand smoke (OR: 3.60, 95% CI: 1.58–8.20) were independently and significantly associated with higher risk of miscarriage. Plasma levels of formaldehyde were significantly higher in women who were diagnosed with miscarriage than those who delivered at term and higher levels of formaldehyde was an independent risk factor for miscarriage, with higher levels being associated with higher risk of miscarriage. PMID:28658105

  15. Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death

    NARCIS (Netherlands)

    Benhadi, Nadia; Wiersinga, Wilmar; Reitsma, Johannes; Vrijkotte, Tanja; Bonsel, Gouke

    2009-01-01

    Background: To examine the relationship between maternal TSH and free thyroxine (FT4) concentrations in early pregnancy and the risk of miscarriage. fetal or neonatal death. Method: Cohort study of 2497 Dutch women. TSH, FT4, and thyroid peroxidase antibodies concentrations were determined at first

  16. Time Course of Early Postadmission Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Ovesen, Christian; Christensen, Anders Fogh; Krieger, Derk W

    2014-01-01

    BACKGROUND AND PURPOSE: Early hematoma expansion (EHE) in patients with intracerebral hematoma is a promising treatment target. To date, the time course of EHE has remained poorly described. We prospectively investigated the time course of EHE. METHODS: We included consecutive patients presenting...... occurred within the first 7 to 8 hours after symptom onset. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01472224....

  17. Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses.

    Science.gov (United States)

    Işik, Gözde; Demirezen, Şayeste; Dönmez, Hanife Güler; Beksaç, Mehmet Sinan

    2016-01-01

    Bacterial vaginosis (BV) is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. The study population consisted of 200 fertile women. Sixty one (30.5%) of 200 women had the history of a spontaneous abortion in the last six months (N = 30) and at least three recurrent pregnancy losses (N = 31). BV was diagnosed either by using Papanicolaou staining, Gram staining, or by culturing with BV-associated bacteria, Gardnerella vaginalis. The presence of BV was statistically associated with the history of a spontaneous abortion in the last 6 months (P recurrent pregnancy losses (P > 0.05). These women were also evaluated in view of periods of gestation. Forty-seven (77%) of 61 women had first trimester miscarriage (≤12 weeks) and 14 (23%) of 61 women had second trimester miscarriage (>12 weeks). There was a statistically significant relationship between BV and second trimester miscarriage (P 0.05). BV may contribute to spontaneous abortion and second trimester miscarriage.

  18. Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses

    Directory of Open Access Journals (Sweden)

    Gözde Isik

    2016-01-01

    Full Text Available Context: Bacterial vaginosis (BV is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. Aims: The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. Materials and Methods: The study population consisted of 200 fertile women. Sixty one (30.5% of 200 women had the history of a spontaneous abortion in the last six months (N = 30 and at least three recurrent pregnancy losses (N = 31. BV was diagnosed either by using Papanicolaou staining, Gram staining, or by culturing with BV-associated bacteria, Gardnerella vaginalis. Results: The presence of BV was statistically associated with the history of a spontaneous abortion in the last 6 months (P 0.05. These women were also evaluated in view of periods of gestation. Forty-seven (77% of 61 women had first trimester miscarriage (≤12 weeks and 14 (23% of 61 women had second trimester miscarriage (>12 weeks. There was a statistically significant relationship between BV and second trimester miscarriage (P 0.05. Conclusion: BV may contribute to spontaneous abortion and second trimester miscarriage.

  19. Patients with subclinical hypothyroidism before 20 weeks of pregnancy have a higher risk of miscarriage: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Yibing; Wang, Haoyu; Pan, Xifeng; Teng, Weiping; Shan, Zhongyan

    2017-01-01

    To evaluate the relationship between subclinical hypothyroidism (SCH) and the risk of miscarriage before 20 weeks of pregnancy. Literature databases were searched, including the PubMed, Web of Science, Embase and Cochrane databases, from January 1, 1980, to December 31, 2015. The following search terms were used: subclinical hypothyroidism, hypothyroidism, thyroid dysfunction, thyroid hypofunction, subclinical thyroid disease, thyroid dysfunction, pregnancy loss, abortion and miscarriage. Studies comparing the prevalence of miscarriage in pregnant women with SCH with those who were euthyroid were selected. From the studies matched, the relative risk (RR) and corresponding 95% confidence interval (95% CI) were calculated to yield outcomes. All the statistical analyses were performed using Review Manager (Revman) Version 5.3 and Stata Version 12.0 software. The publication bias of the studies was assessed by forest plot and Begg's test, while the stability of the results was evaluated by sensitivity analysis. Nine articles satisfying the inclusion criteria were analysed. Compared to euthyroid pregnant women, patients with non-treated SCH had a higher prevalence of miscarriage (RR = 1.90, 95% CI1.59-2.27, Ppregnancy, and early treatments can reduce the miscarriage rate. Regardless of the diagnostic criteria used, the miscarriage rate increased as long as a pregnant woman was confirmed to have SCH. The results show that the omission diagnostic rate may increase when the ATA diagnostic criteria are used. In addition, SCH patients with TAI have a higher prevalence of miscarriage, while isolated SCH patients also have a higher miscarriage rate than euthyroid women. Thus, we recommend early treatments to avoid adverse pregnancy outcomes and complications.

  20. Dogs with Cognitive Dysfunction as a Spontaneous Model for Early Alzheimer's Disease: A Translational Study of Neuropathological and Inflammatory Markers.

    Science.gov (United States)

    Schütt, Trine; Helboe, Lone; Pedersen, Lars Østergaard; Waldemar, Gunhild; Berendt, Mette; Pedersen, Jan Torleif

    2016-03-15

    Aged companion dogs with canine cognitive dysfunction (CCD) spontaneously develop varying degrees of progressive cognitive decline and particular neuropathological features correspondent to the changes associated with Alzheimer's disease (AD) in humans. The aim of the present study was to characterize certain aspects of neuropathology and inflammatory markers related to aging and CCD in dogs in comparison with human AD. Fifteen brains from aged dogs with normal cognitive function, mild cognitive impairment, or CCD were investigated and compared with two control brains from young dogs and brain sections from human AD subjects. The neuropathological investigations included evaluation of amyloid-β (Aβ) plaque deposition (N-terminally truncated and pyroglutamyl-modified Aβ included), tau pathology, and inflammatory markers in prefrontal cortex. Cortical Aβ deposition was found to be only of the diffuse subtype as no dense-core or neuritic plaques were found. The Aβ deposition followed a progressive pattern in four maturation stages. Accumulation of the Aβ peptide was also observed in the vessel walls. Both immunohistochemically and biochemically measured levels of Aβ pathology in prefrontal cortex showed a consistent positive correlation to age but not to cognitive deficit severity. No evidence of neurofibrillary tau pathology was found. The level of pro-inflammatory cytokines was generally low and showed no significant association to cognitive status. The findings of the present study support the senescent dog with spontaneous cognitive dysfunction as a valuable non-transgenic model for further investigations of the molecular events involved in the neurodegenerative processes associated with aging and early stage AD, especially the Aβ-related pathology.

  1. Early Spironolactone Treatment Attenuates Heart Failure Development by Improving Myocardial Function and Reducing Fibrosis in Spontaneously Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Marcelo D.M. Cezar

    2015-07-01

    Full Text Available Background: We evaluated the role of the aldosterone blocker spironolactone in attenuating long-term pressure overload-induced cardiac remodeling and heart failure (HF in spontaneously hypertensive rats (SHR. Methods and Results: Thirteen month-old male SHR were assigned to control (SHR-C, n=20 or spironolactone (SHR-SPR, 20 mg/kg/day, n=24 groups for six months. Normotensive Wistar-Kyoto rats (WKY, n=15 were used as controls. Systolic blood pressure was higher in SHR groups and unchanged by spironolactone. Right ventricular hypertrophy, which characterizes HF in SHR, was less frequent in SHR-SPR than SHR-C. Echocardiographic parameters did not differ between SHR groups. Myocardial function was improved in SHR-SPR compared to SHR-C [developed tension: WKY 4.85±0.68; SHR-C 5.22±1.64; SHR-SPR 6.80±1.49 g/mm2; -dT/dt: WKY 18.0 (16.0-19.0; SHR-C 20.8 (18.4-25.1; SHR-SPR 28.9 (24.2-34.6 g/mm2/s]. Cardiomyocyte cross-sectional area and total collagen concentration (WKY 1.06±0.34; SHR-C 1.85±0.63; SHR-SPR 1.28±0.39 µg/mg wet tissue were greater in SHR-C than WKY and SHR-SPR. Type 3 collagen expression was lower in SHR-C than WKY and unchanged by spironolactone. Soluble collagen, type I collagen, and lysyl oxidase did not differ between groups. Conclusion: Early spironolactone treatment decreases heart failure development frequency by improving myocardial systolic and diastolic function and attenuating hypertrophy and fibrosis in spontaneously hypertensive rats.

  2. High incidence and spontaneous resolution of mastoid effusion after craniotomy on early postoperative magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, T.; Saito, N.; Takahashi, A.; Fujimaki, H.; Tosaka, M.; Sasaki, T. [Department of Neurosurgery, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Gunma (Japan); Sato, N. [Department of Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Gunma (Japan)

    2003-07-01

    Mastoid effusion is a poorly understood complication after craniotomy. The incidence and severity of postoperative mastoid effusion were retrospectively examined on postoperative magnetic resonance (MR) images to assess any association with craniotomy procedures, time course, and neuro-otological complications. We evaluated the early postoperative MR images (within 4 days of craniotomy) and medical records of 74 patients who underwent 77 operations for the treatment of various intracranial diseases from January 2000 to December 2001. Mastoid effusion was classified into four grades: none, partial, moderate, and severe diffuse effusion in the mastoid air cells. Thirty-three follow-up MR images from 26 patients were also reviewed. Postoperative mastoid effusion occurred ipsilateral to the craniotomy site in 62 cases and contralateral in 56 cases. Mastoid effusion was significantly more severe ipsilateral than contralateral to craniotomy with exposure of the mastoid air cells (P<0.0001). There was no significant difference in severity between the contralateral and ipsilateral sides after craniotomy without mastoid air cell opening (P=0.437). Mastoid effusion following craniotomy without exposure of mastoid air cells resolved within 3 months. However, otitis media with effusion developed in six patients with severe mastoid effusion ipsilateral to craniotomy with exposure of the mastoid air cells. Mastoid effusion frequently developed on both sides. Any grade of mastoid effusion on the ipsilateral side to craniotomy without exposure of mastoid air cells, or on the contralateral side, was asymptomatic or had a benign course, and disappeared within 3 months. (orig.)

  3. Spontaneous B-L breaking as the origin of the hot early universe

    Energy Technology Data Exchange (ETDEWEB)

    Buchmueller, W.; Domcke, V.; Schmitz, K.

    2012-03-15

    The decay of a false vacuum of unbroken B-L symmetry is an intriguing and testable mechanism to generate the initial conditions of the hot early universe. If B-L is broken at the grand unification scale, the false vacuum phase yields hybrid inflation, ending in tachyonic preheating. The dynamics of the B - L breaking Higgs field and thermal processes produce an abundance of heavy neutrinos whose decays generate entropy, baryon asymmetry and gravitino dark matter. We study the phase transition for the full supersymmetric Abelian Higgs model. For the subsequent reheating process we give a detailed time-resolved description of all particle abundances. The competition of cosmic expansion and entropy production leads to an intermediate period of constant 'reheating' temperature, during which baryon asymmetry and dark matter are produced. Consistency of hybrid inflation, leptogenesis and gravitino dark matter implies relations between neutrino parameters and superparticle masses, in particular a lower bound on the gravitino mass of 10 GeV.

  4. Pregnancy After Miscarriage: What You Need to Know

    Science.gov (United States)

    ... miscarriage in an initial pregnancy lead to adverse obstetric and perinatal outcomes in the next continuing pregnancy? BJOG: An International Journal of Obstetrics and Gynaecology. 2008;115:1623. American College of ...

  5. The Effects of Intravenous Immunoglobulins in Women with Recurrent Miscarriages

    DEFF Research Database (Denmark)

    Egerup, Pia; Lindschou, Jane; Gluud, Christian

    2015-01-01

    BACKGROUND: Immunological disturbances are hypothesised to play a role in recurrent miscarriage (RM) and therefore intravenous immunoglubulins (IVIg) have been tested in RM patients. OBJECTIVES: The objectives were to investigate the benefits and harms of IVIg versus placebo, no intervention...

  6. Selected non-somatic risk factors for pregnancy loss in patients with abnormal early pregnancy

    Directory of Open Access Journals (Sweden)

    Maciej Paszkowski

    2015-12-01

    Full Text Available [b]Introduction and objective. [/b]Spontaneous abortion constitutes one of the most frequent complication of human pregnancy. Despite intensive research efforts undertaken to date, the etiopathogenesis of early pregnancy loss has not been fully elucidated. The objective of this study was to analyze the role of selected non-somatic risk factors for early pregnancy loss in patients with various clinical manifestations of spontaneous abortion. [b]Materials and methods[/b]. The study included 242 women hospitalized between 2001 and 2004 in the 3rd Chair and Department of Gynecology, Medical University of Lublin, Poland (Teaching Hospital No.4 with various clinical categories of spontaneous abortion. Each patient completed a questionnaire assessing her exposure to the examined factors. In patients with threatened abortion dismissed from the hospital with viable gestation, the course of pregnancy was followed-up using questionnaire data and medical records. [b]Results.[/b] In the studied population of women with abnormal early pregnancy course, a significant impact on the risk of miscarriage was observed in case of such factors as: exposure to stress at home and limited number of hours of nightly sleep. Factors such as occupational hazards, diet, stress, heavy housework and use of cigarettes or alcohol did not exert a significant effect on the risk of miscarriage in the studied population. [b]Conclusions.[/b] The results of this study confirm the complexity of the early pregnancy loss etiopatogenesis. Further research need to be conducted in order to identify the non-somatic causative agents of various clinical forms of miscarriage. It may help do select women in reproductive age at high risk of early pregnancy loss and show the ways in which effective preventive measures can be introduced in such population.

  7. Selected non-somatic risk factors for pregnancy loss in patients with abnormal early pregnancy.

    Science.gov (United States)

    Paszkowski, Maciej; Czuczwar, Piotr; Woźniak, Sławomir; Paszkowska, Monika; Szkodziak, Piotr; Patyra, Krzysztof; Paszkowski, Tomasz

    2016-01-01

    Spontaneous abortion constitutes one of the most frequent complication of human pregnancy. Despite intensive research efforts undertaken to date, the etiopathogenesis of early pregnancy loss has not been fully elucidated. The objective of this study was to analyze the role of selected non-somatic risk factors for early pregnancy loss in patients with various clinical manifestations of spontaneous abortion. The study included 242 women hospitalized between 2001 and 2004 in the 3rd Chair and Department of Gynecology, Medical University of Lublin, Poland (Teaching Hospital No.4) with various clinical categories of spontaneous abortion. Each patient completed a questionnaire assessing her exposure to the examined factors. In patients with threatened abortion dismissed from the hospital with viable gestation, the course of pregnancy was followed-up using questionnaire data and medical records. In the studied population of women with abnormal early pregnancy course, a significant impact on the risk of miscarriage was observed in case of such factors as: exposure to stress at home and limited number of hours of nightly sleep. Factors such as occupational hazards, diet, stress, heavy housework and use of cigarettes or alcohol did not exert a significant effect on the risk of miscarriage in the studied population. The results of this study confirm the complexity of the early pregnancy loss etiopatogenesis. Further research need to be conducted in order to identify the non-somatic causative agents of various clinical forms of miscarriage. It may help do select women in reproductive age at high risk of early pregnancy loss and show the ways in which effective preventive measures can be introduced in such population.

  8. Prognosis for live birth in women with recurrent miscarriage

    DEFF Research Database (Denmark)

    Lund, Marie; Kamper-Jørgensen, Mads; Nielsen, Henriette Svarre

    2012-01-01

    To establish a method of estimating the proportion of women with a subsequent live birth after a well-defined time period in an open cohort of women referred to a tertiary recurrent miscarriage clinic.......To establish a method of estimating the proportion of women with a subsequent live birth after a well-defined time period in an open cohort of women referred to a tertiary recurrent miscarriage clinic....

  9. MicroRNA Profiles in Spontaneous Decidualized Menstrual Endometrium and Early Pregnancy Decidua with Successfully Implanted Embryos.

    Directory of Open Access Journals (Sweden)

    Yu Wang

    Full Text Available To comparatively analyze the human microRNA (miRNA profiles between spontaneous decidualized menstrual endometrium and early pregnancy decidua by an in-depth sequencing of miRNAs. The specific miRNAs expressed at conception might be involved in pregnancy establishment and expression of let-7f-5p and let-7g-5p was experimentally up-regulated or inhibited to assess the effect on the expression of IGF2BP-1 and IGF2R in vitro, respectively. Samples of endometria and deciduas were obtained from 25 women who suffered from tubal or male factor subfertility and from 35 early pregnant women who underwent pregnancy termination at 6-8 weeks gestation were irrespectively collected and comparatively analyzed by miRNA sequencing and differential expression of known and novel miRNAs was analyzed using bioinformatics. The 2042 miRNA expression was analyzed in the study and the differential expression of six miRNAs was validated by qRT-PCR. The expression of four miRNAs in decidua samples was down-regulated (miR-34c, miR-92a, miR-181a-5p, and miR-191, whereas the expression of miR-10a-5p and let-7f-5p was significantly up-regulated. The expression of IGF2BP-1 and IGF2R declined and increased with overexpression and inhibition of let-7f-5p and let-7g-5p, respectively. Changes in the expression of particular miRNAs might play a role in the physiology of decidualization following successful embryo implantation, ultimately resulting in continuous decidualization.

  10. A search for hope and understanding: an analysis of threatened miscarriage internet forums.

    Science.gov (United States)

    Betts, Debra; Dahlen, Hannah G; Smith, Caroline A

    2014-06-01

    threatened miscarriage is a common complication of early pregnancy, which increases the risk of miscarriage or pregnancy complications such as premature birth. Currently there is limited evidence to recommend beneficial medical treatments or lifestyle changes, resulting in a 'watchful waiting' approach. The aim of this study was to describe women's experiences of threatened miscarriage through examining postings to Internet discussion forums. a Goggle alert for threatened miscarriage was created with emails containing hyperlinks sent to the first author and collected over a seven month period (April to November 2011). Data was analysed using thematic analysis. one hundred and twenty one discussion threads were collected. The overarching theme that emerged was one of 'a search for hope and understanding'. Within this there were four sub themes that illustrated this search. 'A reason for hope: stories and real life experiences' illustrated how women sought hope for a viable pregnancy through others. 'Becoming the expert,' captures how women gave advice from their own experiences. 'A safe place to share' and 'connecting to empathic support' illustrates how women used this medium for long distance support. internet discussion forums were used by women to seek hope and support they were not receiving from their health professionals. Women urged each other to remain hopeful despite a negative medical prognosis. There was an acceptance of a lay expertise within the forums that was valid enough to challenge medical expertise. health practitioners may need education that helps them balance their delivery of medical information with hope in order to increase feelings of trust. With women seeing the Internet as a useful form of support, it may be relevant for practitioners to consider recommending relevant Internet sites and discuss this with women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Primary Thrombophilia in Mexico XII: Miscarriages Are More Frequent in People with Sticky Platelet Syndrome

    Directory of Open Access Journals (Sweden)

    Guillermo J. Ruiz - Delgado

    2017-09-01

    Full Text Available Objective: Sticky platelet syndrome (SPS is an inherited condition that leads to arterial and venous thrombosis. There is scant information about the association between SPS and obstetric complications. This study aimed to assess the relationship between SPS and fetal loss at a single institution. Materials and Methods: The obstetric histories of all consecutive female patients prospectively studied in a 324-month period at a single institution with a history of thrombosis and a clinical marker of primary thrombophilia were reviewed. Results: Between 1989 and 2016, 268 consecutive patients with a clinical marker of primary thrombophilia and a history of arterial or venous thrombosis were studied; of these, 108 were female patients. Within this subset of thrombophilic females, 77 (71% had been pregnant at some point. Twenty-eight of these 77 patients (37% had had a spontaneous abortion and 24 of those (86% were found to have SPS. On the other hand, in a subset of 73 female patients with SPS who had been pregnant, 32% had miscarriages. These figures are significantly higher than the prevalence of spontaneous abortions in the general Mexican population of pregnant women, which is 12%- 13% (chi-square: 7.47; p=0.0063. Accordingly, the relative risk of having a miscarriage is 2.66 times higher in female patients with SPS than in the general population (p=0.0014. Conclusion: In Mexico, female patients with SPS experience significantly more spontaneous abortions than the general population. Since the treatment of SPS is simple and effective and could in turn prevent adverse obstetric outcomes, its investigation in women treated for obstetric complications may be useful and deserves further research.

  12. Research of the state of the stress-realizing systems in pregnant women with miscarriage

    Directory of Open Access Journals (Sweden)

    V. A. Plotnik

    2013-06-01

    Full Text Available Introduction. Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, within the time limit to 22 weeks. Unfortunately, the incidence of abortion in Ukraine remains quite high and ranges from 15 to 23% of all reported pregnancies, while over 92% of them occurred before 12 weeks (Ventskivskyy BM, 2004, Ginsburg V., 2003, Beetle C.I., 2000. The hypothesis of the development of spontaneous miscarriage as a result of the impact of mental stress factors C.T. Javert first proposed back in 1954. Later it was shown that biochemical substances (epinephrine, norepinephrine, oxytocin, prostaglandins are involved in the processes of influence of stressfactors on pregnant women. The aim of the work was to investigate some stress-realizing systems by adopting an integrated approach in women with threatened abortion for further development of the algorithm of the evaluation and prediction of risk of the miscarriage, which will contribute to the reduction of perinatal losses and improve the reproductive health of women. Materials and methods. Study involved 34 pregnant women with diagnosis of "threatened abortion" gestational age from 7 to20 weeks with a singleton pregnancy. The control group consisted of 15 women with usual pregnancy. Was used an integrated approach, consisting of a set of methods for studying the autonomic nervous system using computer cardiointervalography, rheovasography, research levels of hormones such as cortisol, insulin, dehydroepiandrosteronesulfate, progesterone, estradiol, and clinical and laboratory parameters. Results. According to the gynecological, obstetric and physical anamnesis any significant difference between the women of the 1st and 2nd groups were not found. In the study were found that in the main group cortisol levels were significantly (p ≤ 0,01 elevated and index ratio of cortisol and insulin was higher almost in 2 times

  13. Further Evidence on the Role of Thyroid Autoimmunity in Women with Recurrent Miscarriage

    Directory of Open Access Journals (Sweden)

    Natalia Lazzarin

    2012-01-01

    Full Text Available It has been twenty years since the first paper reporting the association between thyroid antibodies (TAIs and spontaneous miscarriage was published. Following this observation, several studies have clearly demonstrated an increased prevalence of TAI in patients with recurrent miscarriage (RM. However, the exact mechanism underlying this association remains a matter of debate. The aim of the present study was to evaluate the thyroid function, throughout a specific test, in patient with RM and TAI focusing on the hypothesis that TAI should be an indirect sign of a mild thyroid dysfunction. 46 patients with RM and TAI were included in the study. All patients underwent short TRH stimulation test showing an abnormal response in the vast majority of cases (65%. Normal FT4 and FT3 mean values were found whereas TSH values were in the upper normal range (2.64±1.3 mUI/L. Our data support the hypothesis that in patients with RM the presence of TAI is an indirect sign of a subtle thyroid dysfunction detectable by a specific test. This test give the possibility to identify women with RM in which specific therapeutic approaches could effectively improve the possibility for a successful pregnancy.

  14. Effectiveness of Misoprostol for Induction of First-Trimester Miscarriages; Experience at a single tertiary care centre in Oman

    Directory of Open Access Journals (Sweden)

    Qamariya Ambusaidi

    2015-11-01

    Full Text Available Objectives: Non-invasive methods of inducing a miscarriage are now considered an effective alternative to surgical evacuation (dilatation and curettage. This study aimed to evaluate the effectiveness of misoprostol in the termination of first-trimester miscarriages. Methods: This prospective study was conducted between October 2009 and September 2010 and assessed all patients admitted to the Royal Hospital in Muscat, Oman, for the termination of first-trimester miscarriages during the study period. All patients received misoprostol and the rates of successful termination were measured. Patient satisfaction was assessed using a short questionnaire. Results: A total of 290 women were included in the study. Termination with misoprostol was successful in 61.38% of the subjects. Of the remaining subjects requiring additional surgical evacuation (n = 112, 58.93% required evacuation due to failed termination with misoprostol and 65.18% underwent early evacuation (≤24 hours since their last misoprostol dose. The majority of patients experienced no side-effects due to misoprostol (89.66%. Pain was controlled with simple analgesics in 70.00% of the subjects. A high satisfaction rate (94.83% with the misoprostol treatment was reported. Conclusion: Misoprostol was a well-tolerated drug which reduced the rate of surgical evacuation among the study subjects. This medication can therefore be used safely in the management of incomplete miscarriages.

  15. Adenoviral delivery of VEGF121 early in pregnancy prevents spontaneous development of preeclampsia in BPH/5 mice.

    Science.gov (United States)

    Woods, Ashley K; Hoffmann, Darren S; Weydert, Christine J; Butler, Scott D; Zhou, Yi; Sharma, Ram V; Davisson, Robin L

    2011-01-01

    An imbalance in circulating proangiogenic and antiangiogenic factors is postulated to play a causal role in preeclampsia (PE). We have described an inbred mouse strain, BPH/5, which spontaneously develops a PE-like syndrome including late-gestational hypertension, proteinuria, and poor feto-placental outcomes. Here we tested the hypothesis that an angiogenic imbalance during pregnancy in BPH/5 mice leads to the development of PE-like phenotypes in this model. Similar to clinical findings, plasma from pregnant BPH/5 showed reduced levels of free vascular endothelial growth factor (VEGF) and placental growth factor (PGF) compared to C57BL/6 controls. This was paralleled by a marked decrease in VEGF protein and Pgf mRNA in BPH/5 placentae. Surprisingly, antagonism by the soluble form of the FLT1 receptor (sFLT1) did not appear to be the cause of this reduction, as sFLT1 levels were unchanged or even reduced in BPH/5 compared to controls. Adenoviral-mediated delivery of VEGF(121) (Ad-VEGF) via tail vein at embryonic day 7.5 normalized both the plasma-free VEGF levels in BPH/5 and restored the in vitro angiogenic capacity of serum from these mice. Ad-VEGF also reduced the incidence of fetal resorptions and prevented the late-gestational spike in blood pressure and proteinuria observed in BPH/5. These data underscore the importance of dysregulation of angiogenic factors in the pathogenesis of PE and suggest the potential utility of early proangiogenic therapies in treating this disease.

  16. Functional Architecture of Noise Correlations in Human Early Visual Cortex and its Relationship with Coherent Spontaneous Activity

    Directory of Open Access Journals (Sweden)

    Jungwon Ryu

    2012-10-01

    Full Text Available Responses of single sensory neurons to stimuli are ‘noisy’, varying substantially across repeated trials of identical stimulation. Intriguingly, these individual ‘noise responses’ (NR—deviations from their means—are not isolated; rather they are highly correlated, referred to as ‘noise correlation’ (NC. From a computational viewpoint, the presence and nature of NC exert great impacts on the information processing capacity of neurons as they encode sensory events as a population, decode those encoded neural responses, and contribute to perceptual choices for action. Regarding the origin of NR, on the other hand, there has been growing evidence pointing to its tight linkage with ‘spontaneous responses’ (SR—fluctuations of neural activity in the absence of external input or tasks. To investigate the functional structure of NC and its relationship with ‘correlations in SR’ (SC, we defined population receptive fields (pRFs of unit volumes of gray matter (UV in human early visual cortex and computed NRs and SRs using fMRI. NC increased with an increasing degree of similarity in pRF tuning properties such as orientation, spatial frequency, and visuotopic position, particularly between UV pairs close in cortical distance. This ‘like-to-like’ structure of NC remained unaltered across scan runs with different stimuli, even among between-area UV pairs. SC was higher than NC, and its functional and temporal structures were quite similar to those of NC. Furthermore, the partial correlation analysis revealed that NC between a given pair of UVs was best predicted by their SC than by any other factors examined in the current study.

  17. The Impact of Early Versus Late Amniotomy on Duration of Labor, Maternal and Neonatal Outcomes in Iraqi Primigravida with Spontaneous Labor

    OpenAIRE

    Rasheed, Faris Anwer; Ahmed, Alyaa Aziz; Hussain, Saad Abdulrahman

    2015-01-01

    Amniotomy is defined as the artificial rupture of the amniotic membrane for a primary aim to speed up contraction and shorten the length of labor. The present study aims to evaluate the impact of early vs. late amniotomy on duration of labor, neonatal and maternal outcomes in Iraqi primigravida with spontaneous labor. In this randomized, single blinded prospective study, that is carried out in Al-Elweyia Maternity Teaching Hospital from March to December 2011, 210 women admitted for spontaneo...

  18. Heavy metals in miscarriages and stillbirths in developing nations

    Directory of Open Access Journals (Sweden)

    Cecilia Nwadiuto Amadi

    2017-06-01

    Full Text Available Objectives: Cases of miscarriage and stillbirths due to heavy metal poisoning continue to be on the rise in developing nations. In these countries like Nigeria, the menace of miscarriage is not readily linked to heavy metal exposure. This could be as a result of insufficient scientific data available due to poor documentation and inadequate public health education on the consequences of these heavy metals on maternal health. The heavy metals mercury, lead and cadmium are toxicants which have been shown to cross the placental barrier to accumulate in fetal tissues. Methods: For this review, relevant databases were searched for original scientific reports and a total of 100 articles were retained for analysis. Required data was extracted from these studies and their methodology assessed. Results: Miscarriages and stillbirths were observed from exposure to five heavy metals namely; mercury, arsenic, lead, chromium and cadmium. These heavy metals were associated with increased incidence of miscarriages in developing nations. In Nigeria, women with history of miscarriage had blood lead levels >25 µg/dL during pregnancy with approximately 41.61% increase in miscarriage incidence. Cadmium blood level was found to be 85.96 ± 1.09 μg/dl with a 9.50% increase in miscarriage incidence in women exposed to mercury in comparison to the unexposed group. For chromium, a 1.60% increase in the incidence of miscarriage in women exposed to chromium was reported. For cadmium and arsenic, 83.93% and 5.88% increase in incidence were reported respectively. Similar data were obtained for Jamaica (mercury = 7.29 ± 9.10 μg/l, Egypt (Cadmium = 1.17%; Lead = 32.33%. Conclusion: Medical practitioners and Toxicologists involved in women health in sub-Sahara Africa SSA should consider if these heavy metals can become additional biomarkers in the diagnosis of miscarriages and stillbirths.

  19. Seeking Balance in Motion: The Role of Spontaneous Free Play in Promoting Social and Emotional Health in Early Childhood Care and Education

    Directory of Open Access Journals (Sweden)

    Jane Hewes

    2014-10-01

    Full Text Available There is accumulating scientific evidence of the potential of play and playfulness to enhance human capacity to respond to adversity and cope with the stresses of everyday life. In play we build a repertoire of adaptive, flexible responses to unexpected events, in an environment separated from the real consequences of those events. Playfulness helps us maintain social and emotional equilibrium in times of rapid change and stress. Through play, we experience flow—A feeling of being taken to another place, out of time, where we have controlled of the world. This paper argues that spontaneous free play, controlled and directed by children and understood from the child’s perspective, contributes to children’s subjective experience of well-being, building a foundation for life-long social and emotional health. The paradoxical nature of young children’s spontaneous free play is explored. Adaptability, control, flexibility, resilience and balance result from the experience of uncertainty, unpredictability, novelty and non-productivity. These essential dimensions of young children’s spontaneous free play typically produce play which is experienced by adults as chaotic, nonsensical and disruptive. The article concludes with a preliminary discussion of the challenges and possibilities of providing for spontaneous free play indoors, in early childhood care and education programs.

  20. Fertility and Early Pregnancy Outcomes Following Conservative Treatment for Cervical Intraepithelial Neoplasia and Early Cervical Cancer.

    Science.gov (United States)

    Kyrgiou, Maria; Mitra, Anita; Paraskevaidis, Evangelos

    2016-11-01

    Does local conservative treatment for cervical intraepithelial neoplasia and early invasive cervical cancer adversely affect successful conception and early pregnancy outcomes in the first and second trimester (treatment does not adversely affect fertility or first trimester miscarriage, although it is associated with a significant increase in the risk of second trimester miscarriages.

  1. Early enhanced external counter pulsation improves neurological recovery after the return of spontaneous circulation in a mongrel dog cardiac arrest model*.

    Science.gov (United States)

    Hu, Chun-Lin; Liu, Rong; Liao, Xiao-Xing; Wei, Hong-Yan; Li, Xin; Zhan, Hong; Jing, Xiao-Li; Xiong, Yan; Huang, Guo-Qing; Wu, Gui-Fu

    2013-06-01

    The aim of this study was to investigate whether early enhanced external counter pulsation therapy after cardiopulmonary resuscitation improved neurological outcome in a mongrel dog cardiac arrest model. Randomized, animal study. Assisted circulation laboratory. Twenty-four healthy male adult dogs (12-14 kg). After minutes of untreated ventricular fibrillation followed by 2 minutes of cardiopulmonary resuscitation, the dogs were randomized to receive 4 hours of enhanced external counter pulsation therapy, to receive 4 hours of hypertension with over 140 mm Hg or to be a control. Blood pressure and left ventricular ejection fraction were recorded. Cerebral flow was assessed using magnetic resonance imaging. Arterial blood gases and endothelium-derived vasoactive substances were assessed before cardiac arrest and 4 hours after the return of spontaneous circulation. Neurological outcome was assessed by the neurologic deficit score and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining. Enhanced external counter pulsation significantly improved the left ventricular ejection fraction and increased common carotid artery blood flow and shear stress. Enhanced external counter pulsation increased both relative cerebral blood volume (RCBV, p = 0.043) and relative cerebral blood flow (RCBF, p = 0.012) in animals 4 hours after return of spontaneous circulation. Enhanced external counter pulsation therapy promoted the production of nitric oxide and tissue plasminogen activator and decreased the release of endothelin-1 (p = 0.013) after return of spontaneous circulation. Treatment with norepinephrine in the high mean artery pressure also increased common carotid artery blood flow and shear stress. However, no effects on the left ventricular ejection fraction, the production of nitric oxide and tissue plasminogen activator, or the release of endothelin-1 were found. The neurologic deficit scores of the animals were significantly lower at 24, 48, 72

  2. Aspirin or anticoagulants for treating recurrent miscarriage in women without antiphospholipid syndrome

    NARCIS (Netherlands)

    Kaandorp, Stef; Di Nisio, Marcello; Goddijn, Mariette; Middeldorp, Saskia

    2009-01-01

    Background Since hypercoagulability might result in recurrent miscarriage, anticoagulant agents could potentially increase the live-birth rate in subsequent pregnancies in women with either inherited thrombophilia or unexplained recurrent miscarriage. Objectives To evaluate the efficacy and safety

  3. Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia

    NARCIS (Netherlands)

    de Jong, Paulien G.; Kaandorp, Stef; Di Nisio, Marcello; Goddijn, Mariette; Middeldorp, Saskia

    2014-01-01

    Since hypercoagulability might result in recurrent miscarriage, anticoagulant agents could potentially increase the chance of live birth in subsequent pregnancies in women with unexplained recurrent miscarriage, with or without inherited thrombophilia. To evaluate the efficacy and safety of

  4. Feasibility of guidelines for the management of threatened miscarriage in general practice/family medicine.

    NARCIS (Netherlands)

    Fleuren, M.; Wijkel, D.; Haan, M. de; Grol, R.; Sips, F.

    1998-01-01

    Objective: to determine the feasiblity in daily practice of guidelines on threatened miscarriage for general practice. The guidelines on threatened miscarriage were issued in 1989 by the Dutch College of General Practitioners. Methods: prospective recording of appointments by 86 general

  5. Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again.

    LENUS (Irish Health Repository)

    Dempsey, Mark Anthony

    2015-05-01

    This study was designed to evaluate platelet aggregation in pregnant women with a history of unexplained recurrent miscarriage (RM) and to compare platelet function in such patients who go on to have either another subsequent miscarriage or a successful pregnancy.

  6. Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats

    National Research Council Canada - National Science Library

    Mencl, Stine; Garz, Cornelia; Niklass, Solveig; Braun, Holger; Göb, Eva; Homola, György; Heinze, Hans-Jochen; Reymann, Klaus G; Kleinschnitz, Christoph; Schreiber, Stefanie

    2013-01-01

    .... In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood-brain barrier...

  7. Early Coronary Reperfusion Facilitates Return of Spontaneous Circulation and Improves Cardiovascular Outcomes After Ischemic Cardiac Arrest and Extracorporeal Resuscitation in Pigs.

    Science.gov (United States)

    Hutin, Alice; Lamhaut, Lionel; Lidouren, Fanny; Kohlhauer, Matthias; Mongardon, Nicolas; Carli, Pierre; Berdeaux, Alain; Ghaleh, Bijan; Tissier, Renaud

    2016-12-22

    Extracorporeal cardiopulmonary resuscitation (ECPR) is widely proposed for the treatment of refractory cardiac arrest. It should be associated with coronary angiography if coronary artery disease is suspected. However, the prioritization of care remains unclear in this situation. Our goal was to determine whether coronary reperfusion should be instituted as soon as possible in such situations in a pig model. Anesthetized pigs were instrumented and submitted to coronary artery occlusion and ventricular fibrillation. After 5 minutes of untreated cardiac arrest, conventional cardiopulmonary resuscitation (CPR) was started. Fifteen minutes later, ECPR was initiated for a total duration of 240 minutes. Animals randomly underwent either early or late coronary reperfusion at 20 or 120 minutes of ECPR, respectively. This timing was adapted to the kinetic of infarct extension in pigs. Return of spontaneous circulation was determined as organized electrocardiogram rhythm with systolic arterial pressure above 80 mm Hg. During conventional CPR, hemodynamic parameters were not different between groups. Carotid blood flow then increased by 70% after the onset of ECPR in both groups. No animal (0 of 7) elicited return of spontaneous circulation after late reperfusion versus 4 of 7 after early reperfusion (P=0.025). The hemodynamic parameters, such as carotid blood flow, were also improved in early versus late reperfusion groups (113±20 vs 43±17 mL/min after 240 minutes of ECPR, respectively; P=0.030), along with infarct size decrease (71±4% vs 84±2% of the risk zone, respectively; P=0.013). Early reperfusion improved hemodynamic status and facilitated return of spontaneous circulation in a porcine model of ischemic cardiac arrest treated by ECPR. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  8. Stress and anxiety-depression levels following first-trimester miscarriage: a comparison between women who conceived naturally and women who conceived with assisted reproduction.

    Science.gov (United States)

    Cheung, C S; Chan, C H; Ng, E H

    2013-08-01

    To compare the psychological impact following early miscarriage between women who conceived naturally and women who conceived following assisted reproduction. Prospective cohort study. Assisted reproduction clinic and general gynaecological unit in a university-affiliated, tertiary referral hospital. A cohort of 150 women (75 after natural conception; 75 after assisted reproduction). Completed semi-structured interviews using two standard questionnaires [the 12-item General Health Questionnaire (GHQ-12) and the 22-item Revised Impact of Events Scale (IES-R)], at 1, 4, and 12 weeks after a diagnosis of first-trimester miscarriage. The GHQ-12 and IES-R scores for the two groups of women. The GHQ-12 and IES-R scores were significantly higher in the assisted reproduction group than the scores in the natural conception group, at 4 weeks and 12 weeks after miscarriage. Further breakdown of the scores revealed significantly higher hyperarousal symptoms at 4 and 12 weeks in the assisted reproduction group, indicating the traumatic effect of miscarriage to these women. Following first-trimester miscarriage, subfertile women who conceived after assisted reproduction had higher stress and anxiety-depression levels, and experienced more traumatic impact from the event, than those after natural conception. A timely support and psychological intervention would be beneficial in the management of this group of women. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

  9. [Echographic diagnosis of missed early miscarriage: Assessment of image quality].

    Science.gov (United States)

    Barthes, C; Mezan De Malartic, C; Baumann, C; Rousseaux, H; Morel, O

    2018-02-01

    Ultrasound examination plays a central role in case of suspected non-viable pregnancy. A wrong diagnosis might have major consequence in terms of inadequate care, especially in cases of false positive non-viable pregnancy diagnosis. Ultrasound criterions are today well defined. Our objective was to evaluate the feasibility and reproducibility of a novel image-quoting method of first-trimester non-viable pregnancy. Thirty images of non-viable pregnancy were twice evaluated with blinded proofreading. Two quotations were evaluated: the first for the images of gestational sacs without embryo (gestational sac score), the second for the images with embryo (embryo score). The ICC (interclass correlation coefficient) was>0.75 for inter- and intra-observer reproducibility both for the quotations of the gestational sac and for the embryo with a low variability. Reproducibility of quoting crown rump length measurements 0.75. The inter- and intra-observer reproducibility of our quoting methods is high with a low variability. They might be a useful tool in current practice in the future. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Maternal underweight and the risk of spontaneous abortion

    DEFF Research Database (Denmark)

    Helgstrand, Stine; Andersen, Anne-Marie Nybo

    2005-01-01

    BACKGROUND: To evaluate the risk of spontaneous abortion in relation to maternal pre-pregnant underweight. METHODS: The study was designed as a cohort study within the framework of the Danish National Birth Cohort (DNBC). The participants were a total of 23 821 women recruited consecutively...... spontaneous abortion. Relative risk of spontaneous abortion was calculated as Hazard Ratios using Cox regression with delayed entry. RESULTS: The outcome measure was spontaneous abortion. The hazard ratio for spontaneous abortion in women with a pre-pregnant body mass index (BMI) below 18.5 was 1.24 (95......% confidence limits 0.95-1.63) compared to women with pre-pregnant BMI 18.5-24.9. Women with a BMI of 25 or more had a smaller increase in risk of spontaneous abortion. Adjustment for maternal age, parity, previous miscarriages, and lifestyle factors did not affect the estimates substantially, neither did...

  11. Future directions of failed implantation and recurrent miscarriage research

    DEFF Research Database (Denmark)

    Christiansen, Ole B; Nielsen, Henriette Svarre; Kolte, Astrid M

    2006-01-01

    Recurrent implantation failure is today the major reason for women completing several IVF/intracytoplasmic sperm injection attempts without having achieved a child, and is probably also the explanation for many cases of unexplained infertility. Most causes of recurrent miscarriage are still poorl...

  12. A Randomized Trial of Progesterone in Women with Recurrent Miscarriages

    NARCIS (Netherlands)

    Coomarasamy, Arri; Williams, Helen; Truchanowicz, Ewa; Seed, Paul T; Small, Rachel; Quenby, Siobhan; Gupta, Pratima; Dawood, Feroza; Koot, Yvonne E M; Bender Atik, Ruth; Bloemenkamp, Kitty W M; Brady, Rebecca; Briley, Annette L; Cavallaro, Rebecca; Cheong, Ying C; Chu, Justin J; Eapen, Abey; Ewies, Ayman; Hoek, Annemieke; Kaaijk, Eugenie M; Koks, Carolien A M; Li, Tin-Chiu; MacLean, Marjory; Mol, Ben W; Moore, Judith; Ross, Jackie A; Sharpe, Lisa; Stewart, Jane; Vaithilingam, Nirmala; Farquharson, Roy G; Kilby, Mark D; Khalaf, Yacoub; Goddijn, Mariette; Regan, Lesley; Rai, Rajendra

    2015-01-01

    BACKGROUND: Progesterone is essential for the maintenance of pregnancy. However, whether progesterone supplementation in the first trimester of pregnancy would increase the rate of live births among women with a history of unexplained recurrent miscarriages is uncertain. METHODS: We conducted a

  13. Intravenous immunoglobulin in the prevention of recurrent miscarriage

    DEFF Research Database (Denmark)

    Christiansen, Ole B; Nielsen, Henriette Svarre

    2005-01-01

    Immunological disturbances play a role in the majority of patients with recurrent miscarriage (RM) and therefore treatment with intravenous immunoglobulin (IvIg) has been tested in patients with RM in several trials. Seven placebo-controlled trials that were extremely heterogeneous with respect t...

  14. Pregnancy After Miscarriage: What You Need to Know

    Science.gov (United States)

    ... Tulandi T, et al. Management of couples with recurrent pregnancy loss. http://www.uptodate.com/home. Accessed Feb. 9, 2016. Swanson KM, et al. Resolution of depression and grief during the first year after miscarriage: A randomized controlled clinical trial of couples-focused ...

  15. Recurrent miscarriage and antiphospholipid antibodies: prognosis of subsequent pregnancy.

    NARCIS (Netherlands)

    Cohn, D.M.; Goddijn, M.; Middeldorp, S.; Korevaar, J.C.; Dawood, F.; Farquharson, R.G.

    2010-01-01

    Background: Although women with antiphospholipid antibodies (APLAs) are at increased risk of recurrent miscarriage, the outcome of a subsequent pregnancy is not clearly elucidated. Objectives: To assess the pregnancy outcome of a subsequent pregnancy in women with APLAs and compare this outcome with

  16. Cesarean section and rate of subsequent stillbirth, miscarriage, and ectopic pregnancy: a Danish register-based cohort study.

    Science.gov (United States)

    O'Neill, Sinéad M; Agerbo, Esben; Kenny, Louise C; Henriksen, Tine B; Kearney, Patricia M; Greene, Richard A; Mortensen, Preben Bo; Khashan, Ali S

    2014-07-01

    With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of stillbirth, and maternally requested

  17. Population-based estimates of still birth, induced abortion and miscarriage in the Indian state of Bihar.

    Science.gov (United States)

    Kochar, Priyanka S; Dandona, Rakhi; Kumar, G Anil; Dandona, Lalit

    2014-12-17

    We report population-based data on still birth, induced abortion and miscarriage from the Indian state of Bihar to assess the magnitude of the problem and to inform corrective action. A representative sample of women from all districts of Bihar with a pregnancy outcome in the last 12 months was obtained through multistage sampling in early 2012. Still birth rate was calculated as fetuses born with no sign of life at 7 or more months of gestation per 1,000 births. Induced abortion and miscarriage rates were defined as expulsion of dead fetuses at less than 7 months of gestation induced by any means or without inducement, respectively, per 1000 pregnancies that had an outcome. Multiple regression models were used to explore possible associations with stillbirths, induced abortions and miscarriages. Multi-level models were developed for the relatively less developed north zone and for the south zone of Bihar to examine contextual factors associated with still births, induced abortions and miscarriages. Still birth rate was estimated as 20 per 1,000 births (95% CI 15.6-24.5), and induced abortion and miscarriage rates as 8.6 (6.6-10.6), and 46 (40.8-51.3) per 1,000 pregnancies with outcome, respectively. The odds of induced abortion and miscarriage were significantly higher in the south zone (odds ratio 2.53 [95% CI 1.79-3.57] and 1.27 [95% CI 1.10-1.47], respectively). In the multi-level model for the north zone, the odds of induced abortion were higher for women with husband's having mean years of education higher than the state mean (2.62; 95% CI 1.47-4.69). Among the nine divisions of Bihar, comprising of groups of districts, higher induced abortion rate was associated with lower neonatal mortality rate (R(2) = 0.68, p = 0.01). These population-based data show a significant burden of still births in Bihar, suggesting that addressing these must become an important part of maternal and child health initiatives. The higher induced abortion in the more

  18. The use of power Doppler colour scoring to predict successful expectant management in women with an incomplete miscarriage.

    Science.gov (United States)

    Casikar, Ishwari; Lu, Chuan; Oates, Jennifer; Bignardi, Tommaso; Alhamdan, Dalya; Condous, George

    2012-03-01

    To evaluate whether the use of power Doppler to confirm the presence or absence of blood flow within retained products of conception (RPC) in women with an incomplete miscarriage can predict subsequent successful expectant management. Prospective observational study in the Acute Gynaecology and Early Pregnancy Unit (AGEPU) at Nepean Hospital from November 2006 to February 2009. Incomplete miscarriage was defined by the presence of a measurable focus of hyperechoeic material, in three planes, within the endometrial cavity using two-dimensional greyscale transvaginal ultrasound (TVS). Subjective qualitative power Doppler colour scoring (PDCS) of the RPC was performed. The vascularization of the RPC was scored using the colour scoring system of the International Ovarian Tumour Analysis (IOTA) group. PDCS 1 meant absence of vascularity, PCDS 2 represented minimal vascularity, PDCS 3 rather strong vascularity and PDCS 4 very strong vascularity. The correlation between the PDCS and successful expectant management of miscarriage was analysed. The volume of RPC was calculated using the ellipsoid formula and then compared with both the PDCS and the outcome of expectant management. Successful expectant management was defined as the resolution of symptoms and the absence of RPC on follow-up TVS. A total of 1395 consecutive pregnant women underwent TVS. Of them, 198 women were diagnosed with an incomplete miscarriage; 172 were managed expectantly. Complete data were available on 158 cases. In total 84.8% (134/158) were managed successfully whilst 15.2% (24/158) failed expectant management. Of the total, 89% (121/136) of women with a PDCS 1 had successful expectant management compared with 57.1 (8/14) with PDCS 2 and 62.5% (5/8) with PDCS 3. Comparing absence of flow (PDCS 1) to presence of flow (PDCS 2 or more), the rate of success was significantly higher in the first group (89 versus 60.9%, Fisher's exact test P= 0.00136). In the prediction of success, the absence of flow

  19. Worldwide Survey of the "Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment" (ABCDEF) Bundle.

    Science.gov (United States)

    Morandi, Alessandro; Piva, Simone; Ely, E Wesley; Myatra, Sheila Nainan; Salluh, Jorge I F; Amare, Dawit; Azoulay, Elie; Bellelli, Giuseppe; Csomos, Akos; Fan, Eddy; Fagoni, Nazzareno; Girard, Timothy D; Heras La Calle, Gabriel; Inoue, Shigeaki; Lim, Chae-Man; Kaps, Rafael; Kotfis, Katarzyna; Koh, Younsuck; Misango, David; Pandharipande, Pratik P; Permpikul, Chairat; Cheng Tan, Cheng; Wang, Dong-Xin; Sharshar, Tarek; Shehabi, Yahya; Skrobik, Yoanna; Singh, Jeffrey M; Slooter, Arjen; Smith, Martin; Tsuruta, Ryosuke; Latronico, Nicola

    2017-11-01

    To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines. Worldwide online survey. Intensive care. A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle. There were 1,521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. Spontaneous awakening trials and spontaneous breathing trials are performed in 66% and 67% of the responder ICUs, respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was "prescribed" by most, but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU-acquired weakness. Family members were actively involved in 67% of ICUs; however, only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hr/d for family visits. The current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines.

  20. Use of inhaled and oral corticosteroids in pregnancy and the risk of malformations or miscarriage.

    Science.gov (United States)

    Bjørn, Anne-Mette Bay; Ehrenstein, Vera; Nohr, Ellen Aagaard; Nørgaard, Mette

    2015-04-01

    Corticosteroids are potent anti-inflammatory and immunosuppressive drugs, which sometimes must be given to pregnant women. Corticosteroids have been suspected to be teratogenic for many years; however, there is conflicting evidence regarding the association. Based on a literature review of three databases, this MiniReview provides an overview of inhaled and oral corticosteroid use in pregnancy with specific emphasis on the association between use of corticosteroids during pregnancy and risk of miscarriage and congenital malformations in offspring. The use of corticosteroids among pregnant women ranged from 0.2% to 10% and increased nearly two times in recent years. Taken together, the evidence suggests that the use of corticosteroids in early pregnancy is not associated with an increased risk of congenital malformations overall or oral clefts in offspring; at the same time, published estimates are inconsistent. The use of inhaled corticosteroids was associated with a slightly increased risk of miscarriage, whereas the use of oral corticosteroids was not; however, confounding by indication could not be ruled out. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  1. Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death.

    Science.gov (United States)

    Benhadi, N; Wiersinga, W M; Reitsma, J B; Vrijkotte, T G M; Bonsel, G J

    2009-06-01

    To examine the relationship between maternal TSH and free thyroxine (FT(4)) concentrations in early pregnancy and the risk of miscarriage, fetal or neonatal death. Cohort study of 2497 Dutch women. TSH, FT(4), and thyroid peroxidase antibodies concentrations were determined at first booking. Child loss was operationalized as miscarriage, fetal or neonatal death. Women with overt thyroid dysfunction were excluded. Twenty-seven cases of child loss were observed. The mean TSH and FT(4) level in the women with child loss was 1.48 mU/l and 9.82 pmol/l compared with 1.11 mU/l and 9.58 pmol/l in women without child loss. The incidence of child loss increased by 60% (OR=1.60 (95% confidence interval (CI): 1.04-2.47)) for every doubling in TSH concentration. This association remained after adjustment for smoking, age, parity, diabetes mellitus, hypertension, previous preterm deliveries, and previous preterm stillbirth/miscarriage (adjusted odds ratio=1.80 (95% CI: 1.07-3.03)). This was not true for FT(4) concentrations (OR=1.41 (95% CI: 0.21-9.40); P=0.724). In a cohort of pregnant women without overt thyroid dysfunction, the risk of child loss increased with higher levels of maternal TSH. Maternal FT(4) concentrations and child loss were not associated.

  2. Risk factors for first trimester miscarriage--results from a UK-population-based case-control study.

    Science.gov (United States)

    Maconochie, N; Doyle, P; Prior, S; Simmons, R

    2007-02-01

    The aim of this study was to examine the association between biological, behavioural and lifestyle risk factors and risk of miscarriage. Population-based case-control study. Case-control study nested within a population-based, two-stage postal survey of reproductive histories of women randomly sampled from the UK electoral register. Six hundred and three women aged 18-55 years whose most recent pregnancy had ended in first trimester miscarriage (traumatic events); high paternal age and changing partner. Previous live birth, nausea, vitamin supplementation and eating fresh fruits and vegetables daily were associated with reduced risk, as were feeling well enough to fly or to have sex. After adjustment for nausea, we did not confirm an association with caffeine consumption, smoking or moderate or occasional alcohol consumption; nor did we find an association with educational level, socio-economic circumstances or working during pregnancy. The results confirm that advice to encourage a healthy diet, reduce stress and promote emotional wellbeing might help women in early pregnancy (or planning a pregnancy) reduce their risk of miscarriage. Findings of increased risk associated with previous termination, stress, change of partner and low pre-pregnancy weight are noteworthy, and we recommend further work to confirm these findings in other study populations.

  3. [Psychopathology of miscarriages and psychic disorders following fertility treatments].

    Science.gov (United States)

    Leal Herrero, Fernando

    2009-01-01

    This paper deals with the psychic disorders that frequently follow miscarriages. We specify the clinical forms under which such disorders appear and argue in favour of establishing a "Post-Abortion Syndrome" which would include the symptoms that form the basis of the psychopathological reactions that follow miscarriages. We will also study the psychological and psychopathological reactions to be found in couples -in both men and women-, who undergo fertility treatments, offering a brief description of the psychodynamic aspects that affect the couple. Furthermore, we will stress the biological and psychological risks that appear as a consequence of fertility treatments and offer an ethical evaluation of these risks, warning of the long-term consequences of human reproductive techniques.

  4. The Gulf oil spill, miscarriage, and infertility: the GROWH study.

    Science.gov (United States)

    Harville, Emily W; Shankar, Arti; Zilversmit, Leah; Buekens, Pierre

    2018-01-01

    To examine whether reported exposure to the Gulf oil spill (2010) was related to reproductive reported miscarriage or infertility. 1524 women aged 18-45 recruited through prenatal and Women, Infant, and Children (WIC) clinics, and community events were interviewed about their experience of the oil spill and reproductive history. 1434 women had information on outcomes of at least one pregnancy, and 633 on a pregnancy both before and after the spill. Generalized estimating equations were used to examine the relationship between contact with oil and economic and social consequences of the spill with postponement of pregnancy, miscarriage, and infertility (time to pregnancy >12 months or reported fertility issues), with adjustment for age, race, BMI, smoking, and socioeconomic status. Results were compared for pregnancies occurring prior to and after the oil spill. 77 (5.1%) women reported postponing pregnancy due to the oil spill, which was more common in those with high contact with oil or overall high exposure (aOR 2.92, 95% CI 1.31-6.51). An increased risk of miscarriage was found with any exposure to the oil spill (aOR, 1.54, 95% CI 1.17-2.02). Fertility issues were more common in the overall most highly exposed women (aOR 1.88, 1.19-2.95), when the data were limited to those with pregnancies before and after. However, no particular aspect of oil spill exposure was strongly associated with the outcomes, and effects were almost as strong for pregnancies prior to the oil spill. The oil spill appears to have affected reproductive decision-making. The evidence is not strong that exposure to the oil spill was associated with miscarriage or infertility.

  5. Ultrasound diagnostics of miscarriage in the first trimester of pregnancy

    Directory of Open Access Journals (Sweden)

    Chekhonatskaya M.L.

    2013-12-01

    Full Text Available On the basis of the analysis of Russian and foreign literature the modern aspects of ultrasonic diagnostics of miscarriage in the first trimester of pregnancy have been examined. The attention is focused on the assessment of the extraembryonic structures and provisional organs. The features of Doppler imaging in the assessment of the course of pregnancy in the first trimester have been highlighted.

  6. Early endogenous activation of CB1 and CB2 receptors after spinal cord injury is a protective response involved in spontaneous recovery.

    Directory of Open Access Journals (Sweden)

    Angel Arevalo-Martin

    Full Text Available Spinal cord injury (SCI induces a cascade of processes that may further expand the damage (secondary injury or, alternatively, may be part of a safeguard response. Here we show that after a moderate-severe contusive SCI in rats there is a significant and very early increase in the spinal cord content of the endocannabinoids 2-arachidonoylglycerol (2-AG and arachidonoyl ethanolamide (anandamide, AEA. Since 2-AG and AEA act through CB1 and CB2 cannabinoid receptors, we administered at 20 minutes after lesion a single injection of their respective antagonists AM281 and AM630 alone or in combination to block the effects of this early endocannabinoid accumulation. We observed that AM281, AM630 or AM281 plus AM630 administration impairs the spontaneous motor recovery of rats according to the Basso-Beattie-Bresnahan (BBB locomotor scale. However, blockade of CB1, CB2 or both receptors produced different effects at the histopathological level. Thus, AM630 administration results at 90 days after lesion in increased MHC-II expression by spinal cord microglia/monocytes and reduced number of serotoninergic fibres in lumbar spinal cord (below the lesion. AM281 exerted the same effects but also increased oedema volume estimated by MRI. Co-administration of AM281 and AM630 produced the effects observed with the administration of either AM281 or AM630 and also reduced white matter and myelin preservation and enhanced microgliosis in the epicentre. Overall, our results suggest that the endocannabinoids acting through CB1 and CB2 receptors are part of an early neuroprotective response triggered after SCI that is involved in the spontaneous recovery after an incomplete lesion.

  7. Non-visualized pregnancy losses are prognostically important for unexplained recurrent miscarriage

    DEFF Research Database (Denmark)

    Kolte, A M; van Oppenraaij, R H; Quenby, S

    2014-01-01

    miscarriage. Among women with ≥2 clinical miscarriages, a reduced RR for live birth was also shown: 0.82 (95% CI 0.74; 0.92) for each clinical miscarriage and 0.89 (95% CI 0.80; 0.98) for each non-visualized pregnancy loss, respectively. Surgically treated ectopic pregnancies (EPs) were significantly more...... common for women with primary RM and no confirmed clinical miscarriages, compared with women with primary RM and ≥1 clinical miscarriage (22 versus 6%, difference 16% (95% CI 9.1%; 28.7%); RR for ectopic pregnancy was 4.0 (95% CI 1.92; 8.20). LIMITATIONS, REASONS FOR CAUTION: RM was defined as ≥3......STUDY QUESTION: Are non-visualized pregnancy losses (biochemical pregnancy loss and failed pregnancy of unknown location combined) in the reproductive history of women with unexplained recurrent miscarriage (RM) negatively associated with the chance of live birth in a subsequent pregnancy? SUMMARY...

  8. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study.

    Science.gov (United States)

    Farren, Jessica; Jalmbrant, Maria; Ameye, Lieveke; Joash, Karen; Mitchell-Jones, Nicola; Tapp, Sophie; Timmerman, Dirk; Bourne, Tom

    2016-11-02

    This is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with a control group with ongoing pregnancies. The secondary aim was to assess whether miscarriage or ectopic pregnancy impacted differently on the type and severity of psychological morbidity. This was a prospective survey study. Consecutive women were recruited between January 2012 and July 2013. We emailed women a link to a survey 1, 3 and 9 months after a diagnosis of EPL, and 1 month after the diagnosis of a viable ongoing pregnancy. The Early Pregnancy Assessment Unit (EPAU) of a central London teaching hospital. We recruited 186 women. 128 had a diagnosis of EPL, and 58 of ongoing pregnancies. 11 withdrew consent, and 11 provided an illegible or invalid email address. Post-traumatic stress disorder (PTSD) was measured using the Post-traumatic Diagnostic Scale (PDS), and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Response rates were 69/114 at 1 month and 44/68 at 3 months in the EPL group, and 20/50 in controls. Psychological morbidity was higher in the EPL group with 28% meeting the criteria for probable PTSD, 32% for anxiety and 16% for depression at 1 month and 38%, 20% and 5%, respectively, at 3 months. In the control group, no women met criteria for PTSD and 10% met criteria for anxiety and depression. There was little difference in type or severity of distress following ectopic pregnancy or miscarriage. We have shown a large number of women having experienced a miscarriage or ectopic pregnancy fulfil the diagnostic criteria for probable PTSD. Many suffer from moderate-to-severe anxiety, and a lesser number depression. Psychological morbidity, and in particular PTSD symptoms, persists at least 3 months following pregnancy loss. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Decreased Ovarian Reserve Predicts Inexplicability of Recurrent Miscarriage? A Retrospective Analysis

    OpenAIRE

    Pils, Sophie; Promberger, Regina; Springer, Stephanie; Joura, Elmar; Ott, Johannes

    2016-01-01

    Objective To evaluate anti-Mullerian hormone, basal follicle stimulating hormone, luteinizing hormone, estradiol, and female age in women with recurrent miscarriage and to compare women with explained and idiopathic recurrent miscarriage. Design Retrospective cohort study. Setting University hospital, tertiary care center. Patients Women with recurrent miscarriage (78 explained, 66 idiopathic). Intervention(s) None. Main Outcome Measures(s) Anti-Mullerian hormone, basal follicle stimulating h...

  10. Vascular endothelial growth factor (VEGF) and the VEGF soluble receptor-1 (sFlt-1) in chorionic villus tissue from Chinese women with early recurrent spontaneous abortion.

    Science.gov (United States)

    Pang, L-H; Li, M-J; Li, M-Q; Yang, D-M; Shi, L

    2011-01-01

    This case-control study explored the relationship between early recurrent spontaneous abortion (RSA) and the expression of two genes: VEGFA, the gene encoding vascular endothelial growth factor (VEGF); and fms-related tyrosine kinase 1 (FLT1), the gene encoding the soluble VEGF receptor-1 (sFlt-1). Women experiencing RSA or undergoing induced abortions in the early stage of normal pregnancy were recruited to the study (n = 30 per group). There were no significant between-group differences in maternal age or duration of pregnancy. The levels of VEGF and sFlt-1 mRNA in chorionic villus tissue samples were examined by quanti tative reverse transcription-polymerase chain reaction. Levels of sFlt-1 and VEGF mRNA in the chorionic villus tissue of women with RSA were significantly higher than levels in the control group. This study demonstrated that there is a relationship between early RSA and VEGF and sFlt-1 levels, suggesting that over-expression of the FLT1 and VEGFA genes may be associated with the pathogenesis of RSA.

  11. Adult height after spontaneous pubertal growth or GnRH analog treatment in girls with early puberty: a meta-analysis.

    Science.gov (United States)

    Bertelloni, Silvano; Massart, Francesco; Miccoli, Mario; Baroncelli, Giampiero I

    2017-06-01

    Early puberty (EP) has been defined as the onset of puberty in the low-normal range; it may be a cause for concern regarding a possible impairment of adult height (AH). This paper meta-analysed data on AH after spontaneous growth or after gonadotropin-releasing hormone (GnRH) analog treatment in girls with EP. A computerized literature search was conducted from 1980 to June 30, 2016. Only published studies in English were considered. Eight papers were selected (483 cases). In untreated girls (n = 300), predicted adult height (PAH) at start of follow-up (-0.559 SDS (95%CI -1.110 to 0.001); P = 0.050) was close to mid-parental height (MPH) (-0.557 SDS (95%CI -0.736 to -0.419); P puberty represents a main cause of consultation in paediatric endocrinology offices due to concerns of both practitioners and parents. • Treatment with GnRH analogs is sometimes attempted with the aim to improve adult height. What is New: • Untreated and GnRH analog treated girls with early puberty reached similar adult height. • Adult height was consistent with mid-parental height in both untreated and GnRH analog treated girls with early puberty.

  12. Early, middle, or late administration of zoledronate alleviates spontaneous nociceptive behavior and restores functional outcomes in a mouse model of CFA-induced arthritis.

    Science.gov (United States)

    Morado-Urbina, Carlos Eduardo; Alvarado-Vázquez, Perla Abigail; Montiel-Ruiz, Rosa Mariana; Acosta-González, Rosa Issel; Castañeda-Corral, Gabriela; Jiménez-Andrade, Juan Miguel

    2014-11-01

    This study was performed to evaluate whether early, middle, or late treatment of zoledronate, an approved bisphosphonate that blocks bone resorption, can reduce nociceptive behaviors in a mouse arthritis model. Arthritis was produced by repeated intra-articular knee injections of complete Freund's adjuvant (CFA). A dose-response curve with zoledronate (3, 30, 100, and 300 μg/kg, i.p., day 4 to day 25, twice weekly for 3 weeks) was performed, and the most effective dose of zoledronate (100 μg/kg, i.p.) was initially administered at different times of disease progression: day 4 (early), day 15 (middle), or day 21 (late) and continued until day 25 after the first CFA injection. Flinching of the injected extremity (spontaneous nociceptive behavior), vertical rearings and horizontal activity (functional outcomes), and knee edema were assessed. Zoledronate improved both functional outcomes and reduced flinching behavior. At day 25, the effect of zoledronate on flinching behavior and vertical rearings was greater in magnitude when it was given early or middle rather than late in the treatment regimen. Chronic zoledronate did not reduce knee edema in CFA-injected mice nor functional outcomes in naïve mice by itself. These results suggest that zoledronate may have a positive effect on arthritis-induced nociception and functional disabilities. © 2014 Wiley Periodicals, Inc.

  13. The Liver X Receptor in Correlation with Other Nuclear Receptors in Spontaneous and Recurrent Abortions

    Science.gov (United States)

    Knabl, Julia; Pestka, Aurelia; Hüttenbrenner, Rebecca; Plösch, Torsten; Welbergen, Lena; Günthner-Biller, Maria

    2013-01-01

    The liver X receptors (LXRs) have been shown to be crucially involved in maternal-fetal cholesterol transport and placentation. The aim of this study was to investigate the expression pattern and frequency of LXR under normal physiological circumstances and in spontaneous abortion and/or recurrent miscarriage. A total of 29 (12 physiologic pregnancies/10 spontaneous abortions/7 recurrent miscarriages) human pregnancies in first trimester were analysed for LXR expression. Expression changes were evaluated by immunohistochemistry for receptor and quantitative RT-PCR (TaqMan) was performed to determine the level of LXR mRNA expression. We also stained for RXRα and PPARγ as possible heterodimers of LXR. LXR expression was downregulated in the syncytiotrophoblast of spontaneous abortion placentas compared to normal pregnancy. In recurrent miscarriage there was a trend for a downregulation. Decidua showed an even stronger downregulation in both groups. In the syncytiotrophoblast we found a positive correlation for the combination of LXR/PPARγ in abortions and a negative correlation for LXR/RXRα. In addition, double-immunofluorescence staining showed that LXR as well as RXRα and PPARγ are expressed by the extravillous trophoblast. Finally, RXRα and LXR showed coexpression in the same extravillous trophoblast cells. To conclude, our data show that LXR expression is decreased in miscarriage. PMID:23690759

  14. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care.

    Science.gov (United States)

    Wei, Shuqin; Wo, Bi Lan; Qi, Hui-Ping; Xu, Hairong; Luo, Zhong-Cheng; Roy, Chantal; Fraser, William D

    2013-08-07

    Caesarean section rates are over 20% in many developed countries. The main diagnosis contributing to the high rate in nulliparae is dystocia or prolonged labour. The present review assesses the effects of a policy of early amniotomy with early oxytocin administration for the prevention of, or the therapy for, delay in labour progress. To estimate the effects of early augmentation with amniotomy and oxytocin for prevention of, or therapy for, delay in labour progress on the caesarean birth rate and on indicators of maternal and neonatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2013), MEDLINE (1966 to 4 July 2013), Embase (1980 to 4 July 2013), CINAHL (1982 to 4 July 2013), MIDIRS (1985 to 4 July 2013) and contacted authors for data from unpublished trials. Randomized and quasi-randomized controlled trials that compared oxytocin and amniotomy with expectant management. Three review authors extracted data independently. We stratified the analyses into 'Prevention Trials' and 'Therapy Trials' according to the status of the woman at the time of randomization. Participants in the 'Prevention Trials' were unselected women, without slow progress in labour, who were randomized to a policy of early augmentation or to routine care. In 'Treatment Trials' women were eligible if they had an established delay in labour progress. For the 2013 update, we identified and excluded one new clinical trial. This updated review includes 14 trials, randomizing a total of 8033 women. The unstratified analysis found early intervention with amniotomy and oxytocin to be associated with a modest reduction in the risk of caesarean section; however, the confidence interval (CI) included the null effect (risk ratio (RR) 0.89; 95% CI 0.79 to 1.01; 14 trials; 8033 women). In prevention trials, early augmentation was associated with a modest reduction in the number of caesarean births (RR 0.87; 95% CI 0.77 to 0.99; 11 trials; 7753). A policy of

  15. Abnormal embryonic karyotype is the most frequent cause of recurrent miscarriage.

    Science.gov (United States)

    Sugiura-Ogasawara, Mayumi; Ozaki, Yasuhiko; Katano, Kinue; Suzumori, Nobuhiro; Kitaori, Tamao; Mizutani, Eita

    2012-08-01

    We previously found that a normal karyotype in a previous miscarriage is a predictor of subsequent miscarriage. However, the prevalence of recurrent miscarriage caused by an abnormal embryonic karyotype has not yet been reported, since embryonic karyotype is not typically analyzed during conventional examinations. A total of 482 patients who underwent both embryonic karyotype determination and conventional examinations for recurrent miscarriage were enrolled in this study. The distribution of the causes and the live birth rate for each cause were examined. The total percentage of subjects in whom conventional causes of recurrent miscarriage could be detected was 29.5%. The prevalence of the abnormal embryonic karyotype was 41.1% in the subjects in whom no conventional causes of miscarriage could be identified. The prevalence of recurrent miscarriage of truly unexplained cause, that is, of subjects without conventional causes in whom the embryonic karyotype was ascertained to be normal, was 24.5%. Among the patients in whom the first determination revealed an abnormal embryonic karyotype, 76.2% (32/42) showed an abnormal embryonic karyotype in the repeat determination as well. The cumulative live birth rate (71.9%) in women with recurrent miscarriages caused by the abnormal embryonic karyotype was significantly higher than that (44.7%) in women with recurrent miscarriages associated with the embryonal euploidy. An abnormal embryonic karyotype was found to represent the commonest cause of recurrent miscarriage, and the percentage of cases with recurrent miscarriage of truly unexplained cause was limited to 24.5%.The two groups should be distinguished for both clinical and research purposes.

  16. Recurrent miscarriage is a useful and valid clinical concept

    DEFF Research Database (Denmark)

    Christiansen, Ole B

    2014-01-01

    favorable. Believers of the latter hypothesis think that treatments aimed at the woman may improve pregnancy outcome, but that testing of such treatments in randomized controlled trials is needed. In this article in favor of RM being a specific and useful clinical concept, arguments are advanced......Although epidemiological, clinical and biochemical risk factors are known for recurrent miscarriage (RM), the etiology is mainly unknown. Two main hypotheses dominate: that RM is mainly caused by aneuploid conceptions and other conception errors and that the recurrence rate is explained...

  17. A Decrease of Brain MicroRNA-122 Level Is an Early Marker of Cerebrovascular Disease in the Stroke-Prone Spontaneously Hypertensive Rat

    Directory of Open Access Journals (Sweden)

    Rosita Stanzione

    2017-01-01

    Full Text Available Based on preliminary evidence that highlights microRNA-122 as a contributing factor to stroke pathogenesis, we aimed at assessing its expression level, along with the presence of early signs of cerebrovascular disease, in the brain of stroke-prone spontaneously hypertensive rat (SHRSP, a suitable model of human disease that accelerates stroke occurrence under a high sodium/low potassium (Japanese-style diet (JD. After one month of JD, before stroke occurrence, brain microRNA-122 level was significantly decreased in SHRSP as compared to the stroke-resistant SHR (SHRSR. At this time, levels of markers of oxidative stress and inflammation, as well as of endothelial integrity and function, apoptosis and necrosis were differently modulated in the brains of JD-fed SHRSP as compared to SHRSR, pointing to a significant activation of all deleterious mechanisms underlying subsequent stroke development in SHRSP. We also showed that miR-122 improved survival of rat endothelial cerebral cells upon stress stimuli (excess NaCl, hydrogen peroxide. Our data suggest that a decrease of brain microRNA-122 level is deleterious and can be considered as an early marker of stroke in the SHRSP. Understanding the mechanisms by which microRNA-122 protects vascular cells from stress stimuli may provide a useful approach to improve preventive and treatment strategies against stroke.

  18. Trends in ectopic pregnancy, hydatidiform mole and miscarriage in the largest obstetrics and gynaecology hospital in China from 2003 to 2013.

    Science.gov (United States)

    Li, Xue-Lian; Du, Dan-Feng; Chen, Shang-Jie; Zheng, Sai-Hua; Lee, Arier C; Chen, Qi

    2016-05-20

    Ectopic pregnancies, miscarriages and hydatidiform moles are the major types of pathological pregnancies in the early gestations of pregnancy and constitute an important public health problem. The trends and incidences of these pathological pregnancies may vary by ethnicity and geographical regions. This has not been fully investigated in the Chinese population. In this study we retrospectively report the trends of pathological pregnancies in Chinese population. Data on 22,511 women with ectopic pregnancy, hydatidiform mole and miscarriage were collected from the largest obstetrics and gynaecology hospital in China from 2003 to 2013. Data included age at diagnosis and the annual number of women with diagnosed ectopic pregnancy, hydatidiform mole and miscarriage. The total number of ectopic pregnancy, hydatidiform mole and miscarriage was increased 3.5folds in 2013 compared to 2003. Ectopic pregnancy is the leading pathological pregnancy and miscarriage is increasing at a greater rate among the pathological pregnancies. The median age of women with hydatidiform mole at diagnosis significantly increased from 25.5 years to 29 years (p = 0.002), however the median age for other pathological pregnancies was not different between 2003 and 2013. The number of women with hydatidiform mole at diagnosis who were over 40 years old has increased. The mean maternal age is increased from 28.1 years old in 2003 to 29.4 years old in 2013 in this hospital. We speculate that the increased maternal age may contribute to the increase in these pathological pregnancies between 2003 and 2013 in China.

  19. PROBLEMS OF THE ORGANIZATION OF PREGRAVID PREPARATION AND MANAGEMENT OF PREGNANCY IN WOMEN WITH RECURRENT MISCARRIAGE IN THE STRUCTURE OF PRIMARY HEALTH CARE

    Directory of Open Access Journals (Sweden)

    E. A. Vartanyan

    2016-01-01

    Full Text Available Purpose. Assessment of the scope and coverage of the surveys of patients with recurrent pregnancy losses in primary care of Zelenograd administrative district of Moscow.Materials and methods. Comparison of the frequency of occurrence of miscarriage in Europe, USA, Russia and in Moscow has been held. They performed a retrospective analysis of 221 history for the period 2013–2015 in patients with a history of 2 or more cases of miscarriage. The selection criteria for the study were: completion of pregnancy at term of gestation from 22 to 37 weeks, presence of a diagnosis of “habitual miscarriage” at statement on the account of pregnancy.Results. The factors predisposing to miscarriage are described, the coverage of the primary care of these patients, timeliness of registration of pregnancy, the completeness of the survey related professionals if patients ‘ comorbidity are estimated. The estimation of the frequency of occurrence of extragenital somatic pathology in patients with HM and the impact of this disease on pregnancy is held. The influence of previously deferred inflammatory diseases of the pelvic organs on a probable miscarriage is estimated, the evaluation of the quality of diagnosis of such diseases at an early stage of monitoring in primary care is held. It is established that pregravid preparation of patients with HM in 80% can be made in surveys provided by the territorial program of medical service. They evaluated the role of costly research conducted in the framework of pregravid training in patients with HM and the feasibility of conducting of these studies.Conclusion. The recommendations for the prevention of a probable miscarriage and the principles of monitoring of these patients in primary care on the example of Zelenograd administrative district basis are developed, the proposal for the introduction of these techniques in primary health care is formulated.

  20. Early Oral Ovalbumin Exposure during Maternal Milk Feeding Prevents Spontaneous Allergic Sensitization in Allergy-Prone Rat Pups

    Directory of Open Access Journals (Sweden)

    Adaweyah El-Merhibi

    2012-01-01

    Full Text Available There are conflicting data to support the practice of delaying the introduction of allergenic foods into the infant diet to prevent allergy development. This study investigated immune response development after early oral egg antigen (Ovalbumin; OVA exposure in a rat pup model. Brown Norway (BN rat pups were randomly allocated into groups: dam reared (DR, DR pups challenged daily (days 4–13 with oral OVA (DR + OVAc, DR pups challenged intermittently (on day 4, 10, 12, and 13 with oral OVA (DR + OVAi, formula-fed pups (FF, and FF pups challenged daily with oral OVA (FF + OVA. Immune parameters assessed included OVA-specific serum IgE, IgG1, and IgA. Ileal and splenic messenger ribonucleic acid (mRNA expression of transforming growth factor-beta (TGF-β1, mothers against decapentaplegic (Smad 2/4/7, and forkhead box P3 (Foxp3 were determined. Ileum was stained for TGF-β1 and Smad4. Results. Feeding OVA daily to DR pups maintained systemic and local gut antibody and immunoregulatory marker mRNA responses. Systemic TGF-β1 was lower in DR + OVAi pups compared to DR and DR + OVAc pups. Feeding OVA to FF pups resulted in significantly greater OVA-specific IgE and IgG1, and lower IgA and TGF-β1 and Smad expression compared to DR pups. Conclusions. Early daily OVA exposure in the presence of maternal milk maintains immune markers associated with a regulated immune response, preventing early allergic sensitization.

  1. Symptoms of an imminent miscarriage. A prospective study by general practitioners and midwives

    NARCIS (Netherlands)

    Fleuren, M.A.H.; Van Der Meulen, J.M.; Wijkel, D.

    2000-01-01

    Objective: In 1989 the Dutch College of General Practitioners drew up national guidelines relative to imminent miscarriage. These guidelines are also used by midwives. A prospective recording study was carried out among primary health care patients to determine the course of imminent miscarriage

  2. Confronting the Inevitable: A Conceptual Model of Miscarriage for Use in Clinical Practice and Research

    Science.gov (United States)

    Wojnar, Danuta M.; Swanson, Kristen M.; Adolfsson, Ann-Sofie

    2011-01-01

    In spite of scientific evidence that miscarriage has negative psychological consequences for many individuals and couples, silence and dismissal continue to surround this invisible loss in North American culture and beyond. The grief and sorrow of miscarriage has important implications for clinical practice. It indicates a need for therapeutic…

  3. Multifactorial etiology of recurrent miscarriage and its scientific and clinical implications

    DEFF Research Database (Denmark)

    Steffensen, R.; Nielsen, H.S.; Varming, K.

    2008-01-01

    A considerable proportion of recurrent miscarriage (RM) cases are caused by recurrent chromosomally abnormal conceptions. However, in younger patients and patients with multiple miscarriages, maternal causes seem to dominate. No single biomarker with a high predictive value of maternally caused R...

  4. Exploring a self-help coping intervention for pregnant women with a miscarriage history

    NARCIS (Netherlands)

    Ockhuijsen, Henrietta D L; van den Hoogen, Agnes; Boivin, Jacky; Macklon, Nicholas S.; de Boer, Fijgje

    2015-01-01

    Pregnant women with a history of miscarriages experience symptoms of anxiety and depression in a subsequent pregnancy and are in need of support in the period after miscarriage, when trying to get pregnant again and during the first phase of pregnancy.The aim of this study was to investigate whether

  5. Previous miscarriages and GLI2 are associated with anorectal malformations in offspring

    NARCIS (Netherlands)

    van de Putte, Romy; Wijers, Charlotte H. W.; de Blaauw, Ivo; Marcelis, Carlo L. M.; Sloots, Cornelius E. J.; Brooks, Alice S.; Broens, Paul M. A.; Roeleveld, Nel; van der Zanden, Loes F. M.; van Rooij, Iris A. L. M.

    2017-01-01

    STUDY QUESTION: Are anorectal malformations (ARMs) associated with previous miscarriages or single nucleotide polymorphisms (SNPs) in the Bone Morphogenetic Protein 4 (BMP4) and GLI family zinc finger 2 (GLI2) genes? SUMMARY ANSWER: The SNP rs3738880 in GLI2 and miscarriages were associated with

  6. PPO.46 Risk of Miscarriage associated with Maternal and Paternal Smoking

    NARCIS (Netherlands)

    Meaney, S.; Corcoran, P.; Lutomski, J.E.; Spillane, N.; O'Donoghue, K.

    2014-01-01

    OBJECTIVE: Maternal smoking has been associated with increased risk of miscarriage. However little is known about the influence of paternal smoking. The study aimed to examine maternal and paternal smoking as risk factors for miscarriage. STUDY DESIGN: A cohort study was conducted in a large,

  7. Frequency and impact of obstetric complications prior and subsequent to unexplained secondary recurrent miscarriage

    DEFF Research Database (Denmark)

    Nielsen, H S; Steffensen, R; Lund, M

    2010-01-01

    The chance of a live birth after a diagnosis of secondary recurrent miscarriage (SRM) is reduced in patients who, prior to the miscarriages, gave birth to a boy and carry HLA class II alleles that efficiently present male-specific (H-Y) antigens to the immune system. Information about obstetric...

  8. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care

    Science.gov (United States)

    Wei, Shuqin; Wo, Bi Lan; Qi, Hui-Ping; Xu, Hairong; Luo, Zhong-Cheng; Roy, Chantal; Fraser, William D

    2014-01-01

    Background Caesarean section rates are over 20% in many developed countries. The main diagnosis contributing to the high rate in nulliparae is dystocia or prolonged labour. The present review assesses the effects of a policy of early amniotomy with early oxytocin administration for the prevention of, or the therapy for, delay in labour progress. Objectives To estimate the effects of early augmentation with amniotomy and oxytocin for prevention of, or therapy for, delay in labour progress on the caesarean birth rate and on indicators of maternal and neonatal morbidity. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (15 February 2012), MEDLINE (1966 to 15 February 2012), EMBASE (1980 to 15 February 2012), CINAHL (1982 to 15 February 2012), MIDIRS (1985 to February 2012) and contacted authors for data from unpublished trials. Selection criteria Randomized and quasi-randomized controlled trials that compared oxytocin and amniotomy with expectant management. Data collection and analysis Three review authors extracted data independently. We stratified the analyses into ’Prevention Trials’ and ’Therapy Trials’ according to the status of the woman at the time of randomization. Participants in the ’Prevention Trials’ were unselected women, without slow progress in labour, who were randomized to a policy of early augmentation or to routine care. In ’Treatment Trials’ women were eligible if they had an established delay in labour progress. Main results For this update, we have included a further two new clinical trials. This updated review includes 14 trials, randomizing a total of 8033 women. The unstratified analysis found early intervention with amniotomy and oxytocin to be associated with a modest reduction in the risk of caesarean section; however, the confidence interval (CI) included the null effect (risk ratio (RR) 0.89; 95% CI 0.79 to 1.01; 14 trials; 8033 women). In prevention trials, early augmentation was

  9. HLA-C antibodies in women with recurrent miscarriage suggests that antibody mediated rejection is one of the mechanisms leading to recurrent miscarriage.

    Science.gov (United States)

    Meuleman, T; van Beelen, E; Kaaja, R J; van Lith, J M M; Claas, F H J; Bloemenkamp, K W M

    2016-08-01

    HLA-C is the only polymorphic classical HLA I antigen expressed on trophoblast cells. It is known that higher incidence of C4d deposition on trophoblast cells is present in women with recurrent miscarriage. C4d is a footprint of antibody-mediated classical complement activation. Therefore, this study hypothesize that antibodies against HLA-C may play a role in the occurrence of unexplained consecutive recurrent miscarriage. Present case control study compared the incidence of HLA-C specific antibodies in 95 women with at least three consecutive miscarriages and 105 women with uneventful pregnancy. In the first trimester of the next pregnancy, presence and specificity of HLA antibodies were determined and their complement fixing ability. The incidence of HLA antibodies was compared with uni- and multivariate logistic regression models adjusting for possible confounders. Although in general a higher incidence of HLA antibodies was found in women with recurrent miscarriage 31.6% vs. in control subjects 9.5% (adjusted OR 4.3, 95% CI 2.0-9.5), the contribution of antibodies against HLA-C was significantly higher in women with recurrent miscarriage (9.5%) compared to women with uneventful pregnancy (1%) (adjusted OR 11.0, 95% CI 1.3-89.0). In contrast to the control group, HLA-C antibodies in the recurrent miscarriage group were more often able to bind complement. The higher incidence of antibodies specific for HLA-C in women with recurrent miscarriage suggests that HLA-C antibodies may be involved in the aetiology of unexplained consecutive recurrent miscarriage. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Recurrent miscarriage and micro-RNA among north Indian women.

    Science.gov (United States)

    Parveen, Farah; Agrawal, Suraksha

    2015-04-01

    Micro-RNAs (miRNAs) regulate diverse cellular processes such as cell differentiation, proliferation and apoptosis. Mutation in miRNAs results in various pathological conditions such as inflammation, viral infections, neurodegeneration, autoimmunity, and so on. We have evaluated the association of miR-146aC > G (rs2910164), miR-149T > C (rs2292832), miR-196a2T > C (rs11614913), and miR-499A > G (rs3746444) among patients with recurrent miscarriage (RM) and controls from North India. All the 200 patients with RM reported to experience at least 3 unexplained miscarriages before 20th week of gestation. Three hundred fertile women with no history of RMs were taken as controls. Both patients and controls were genotyped by the polymerase chain reaction amplification followed by restriction fragment length polymorphism. Variant alleles and genotypes of miR-499 A > G (Single Nucleotide Polymorphism Database [dbSNP] ID rs3746444) were found to be significant risks associated with patients having RM (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.40-2.81; P value = .0001) and controls (OR = 3.64; 95% CI = 1.33-9.94; P value = .0109). A significant susceptible effect was found at allelic level in miR-196aT > C (dbSNP ID rs11614913) and miR-499 A > G (dbSNP ID rs3746444). © The Author(s) 2014.

  11. Genetics of recurrent miscarriage: challenges, current knowledge, future directions.

    Directory of Open Access Journals (Sweden)

    Kristiina eRull

    2012-03-01

    Full Text Available Recurrent miscarriage (RM occurs in 1-3% of couples aiming at childbirth. Due to multifactorial etiology the clinical diagnosis of RM varies. The design of genetic/’omics’ studies to identify genes and biological mechanisms involved in pathogenesis of RM has challenges as there are several options in defining the study subjects (female patient and/or couple with miscarriages, fetus/placenta and controls. An ideal study would attempt a trio-design focusing on both partners as well as pregnancies of the couple. Application of genetic association studies focusing on pre-selected candidate genes with potential pathological effect in RM show limitations. Polymorphisms in ~100 genes have been investigated and association with RM is often inconclusive or negative. Also, implication of prognostic molecular diagnostic tests in clinical practice exhibits uncertainties. Future directions in investigating biomolecular risk factors for RM rely on integrating alternative approaches (SNPs, CNVs, gene/protein expression, epigenetic regulation in studies of single genes as well as whole-genome analysis. This would be enhanced by collaborative network between research centers and RM clinics.

  12. Spontaneous deregulation

    NARCIS (Netherlands)

    Edelman, Benjamin; Geradin, Damien

    Platform businesses such as Airbnb and Uber have risen to success partly by sidestepping laws and regulations that encumber their traditional competitors. Such rule flouting is what the authors call “spontaneous private deregulation,” and it’s happening in a growing number of industries. The authors

  13. Association between HLA-DR1 and -DR3 antigens and unexplained repeated miscarriage

    DEFF Research Database (Denmark)

    Christiansen, O B; Ring, Mette; Rosgaard, A

    1999-01-01

    Few, mostly small, studies have investigated the distribution of HLA class II antigens among women with unexplained recurrent miscarriage. Although some studies have reported statistically significant associations between this syndrome and certain HLA-DR antigens--especially the -DR1 and -DR3...... antigens--other studies have been unable to demonstrate such associations. For the present meta-analysis, 18 cross-sectional or case-control studies (published or unpublished) reporting on frequencies of HLA-DR1 and -DR3 antigens among Caucasian women with unexplained repeated miscarriage were identified...... and because patients with only two miscarriages were included in many studies; this is defined as repeated miscarriage. The odds ratios of repeated miscarriage for the HLA-DR1 and -DR3 antigens were calculated for the individual studies and subsequently the pooled odds ratios for the studies were calculated...

  14. NSAIDs and spontaneous abortions - true effect or an indication bias?

    Science.gov (United States)

    Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Levy, Amalia

    2015-10-01

    The aim of the study was to characterize the extent of indication bias resulting from the excessive use of NSAIDs on the days preceding a spontaneous abortion to relieve pain. We used data from a retrospective cohort study assessing the risk for spontaneous abortions following exposure to NSAIDs. Three definitions of exposure for cases of spontaneous abortions were compared, from the first day of pregnancy until the day of spontaneous abortion and until 3 and 2 days before a spontaneous abortion. Statistical analysis was performed using multivariate time programmed Cox regression. A sharp increase was observed in the dispensation of indomethacin, diclofenac and naproxen, and a milder increase was found in the use of ibuprofen during the week before a spontaneous abortion. Non- selective COX inhibitors in general and specifically diclofenac and indomethacin were found to be associated with spontaneous abortions when the exposure period was defined until the day of spontaneous abortion (hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.04, 1.28; HR 1.31, 95% CI 1.08, 1.59 and HR 3.33, 95% CI 2.09, 5.29, respectively). The effect disappears by excluding exposures occurring on the day before the spontaneous abortion for non-selective COX inhibitors and on the last week before the spontaneous abortion for indomethacin. In general, decreasing HRs were found with the exclusion of exposures occurring on the days immediately before the spontaneous abortion. The increased use of NSAIDs during the last few days that preceded a spontaneous abortion to relieve pain associated with the miscarriage could bias studies assessing the association between exposure to NSAIDs and spontaneous abortions. © 2015 The British Pharmacological Society.

  15. Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study

    Science.gov (United States)

    O'Neill, Sinéad M.; Agerbo, Esben; Kenny, Louise C.; Henriksen, Tine B.; Kearney, Patricia M.; Greene, Richard A.; Mortensen, Preben Bo; Khashan, Ali S.

    2014-01-01

    Background With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of

  16. Cesarean section and rate of subsequent stillbirth, miscarriage, and ectopic pregnancy: a Danish register-based cohort study.

    Directory of Open Access Journals (Sweden)

    Sinéad M O'Neill

    2014-07-01

    Full Text Available BACKGROUND: With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. METHODS AND FINDINGS: We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996, with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28 was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI of 0.03% for stillbirth, and a number needed to harm (NNH of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31 and elective cesarean (HR 1.11, 95% CI 0.91, 1.35, although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15 and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21, yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85. Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment

  17. Active or passive immunization in unexplained recurrent miscarriage

    DEFF Research Database (Denmark)

    Christiansen, Ole B; Nielsen, Henriette Svarre; Pedersen, Bjorn

    2004-01-01

    carried out as Cochrane reviews have concluded than none of the different forms of immunotherapy has proved effective in the total RM population. However, the included trials have generally been small and very heterogenous with respect to the clinical histories of patients and the immunization protocols......Controversy exists as to whether active immunotherapy with allogeneic lymphocyte transfusions (ALT) or passive immunotherapy with intravenous immunoglobulin (IvIg) improve the chance of live birth in women with unexplained recurrent miscarriages (RM). Meta-analyses of the placebo-controlled trials....... Thus, other meta-analyses which have looked at the efficacy in subgroups of RM patients have reported that ALT and IvIg may be effective in women with primary RM and secondary RM, respectively. In RM clinics in Denmark, ALT with donor lymphocytes or IvIg immunotherapy have been tested in several...

  18. Structural genomic variation as risk factor for idiopathic recurrent miscarriage

    DEFF Research Database (Denmark)

    Nagirnaja, Liina; Palta, Priit; Kasak, Laura

    2014-01-01

    Recurrent miscarriage (RM) is a multifactorial disorder with acknowledged genetic heritability that affects ∼3% of couples aiming at childbirth. As copy number variants (CNVs) have been shown to contribute to reproductive disease susceptibility, we aimed to describe genome-wide profile of CNVs...... and identify common rearrangements modulating risk to RM. Genome-wide screening of Estonian RM patients and fertile controls identified excessive cumulative burden of CNVs (5.4 and 6.1 Mb per genome) in two RM cases possibly increasing their individual disease risk. Functional profiling of all rearranged genes...... and Denmark (meta-analysis, n = 309/205, odds ratio = 4.82, P = 0.012). Comparison to Estonian population-based cohort (total, n = 1000) confirmed the risk for Estonian female cases (P = 7.9 × 10(-4) ). Datasets of four cohorts from the Database of Genomic Variants (total, n = 5,846 subjects) exhibited...

  19. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2012-01-31

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  20. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2011-01-01

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  1. Recurrent early pregnancy loss and consanguinity in Omani couples.

    Science.gov (United States)

    Gowri, Vaidyanathan; Udayakumar, Achandira Muthappa; Bsiso, Wafa; Al Farsi, Yahaya; Rao, Kuntal

    2011-10-01

    Consanguinity is common in Arab countries. The Sultanate of Oman has a relatively small population with a high prevalence of consanguineous marriages. This is a retrospective study of women who had three or more consecutive miscarriages between January 2002 and December 2008, investigated in the non-pregnant state. Age, parity, menstrual history, number of miscarriages, personal and family history, history of consanguinity and investigations were collected for 141 patients. The mean number of miscarriages was 3.4; 53% of the women had a consanguineous marriage, 42% were non-consanguineous and in 5% the marital interrelationship was unknown. There was no significant difference in the prevalence of parental karyotype abnormalities, anticardiolipin antibodies, antinuclear antibodies, thyroid disorders, or lupus between the consanguineous and non-consanguineous couples. Consanguinity appeared not to play a significant role in the etiology of recurrent spontaneous miscarriage. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. Maternal use of selective serotonin reuptake inhibitors and risk of miscarriage

    DEFF Research Database (Denmark)

    Johansen, Rie Laurine Rosenthal; Mortensen, Laust Hvas; Andersen, Anne-Marie Nybo

    2015-01-01

    BACKGROUND: The use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy has been associated with miscarriage, but the association may be biased by maternal mental illness, lifestyle and exposure misclassification. METHODS: A register study on all pregnancies in Denmark between 1996....... No difference was observed for second trimester miscarriage. SSRI-exposed pregnancies without a maternal depression/anxiety diagnosis from a psychiatric department were less likely to result in first trimester miscarriage than unexposed pregnancies with a diagnosis, HR=0.85 [95% CI 0.76, 0.95]. SSRI...

  3. Screening for coeliac disease in women with a history of recurrent miscarriage or infertility.

    Science.gov (United States)

    Kolho, K L; Tiitinen, A; Tulppala, M; Unkila-Kallio, L; Savilahti, E

    1999-02-01

    Because subclinical coeliac disease may decrease fertility or complicate pregnancy, we screened women with recurrent miscarriage of unknown aetiology (n = 63), unexplained infertility (n = 47) and infertility with a known cause (n = 82), for anti-endomysium antibodies in serum to find undiagnosed coeliac disease. One woman (1-6%) with recurrent miscarriage, another woman (2.1%) with unexplained infertility and one woman (2.0%) in the control group (n = 51), were considered to have coeliac disease. We could not demonstrate a higher frequency of coeliac disease in women with infertility or recurrent miscarriage, but suggest that undiagnosed coeliac disease is common in women.

  4. Uterine artery Doppler and subendometrial blood flow in patients with unexplained recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Hala Abdel Wahab

    2011-09-01

    Conclusion: The presence of good uterine and endometrial blood flow is an important prerequisite for successful implantation and continuation of pregnancy as shown by higher uterine artery blood flow resistance and lower endometrial blood flow in recurrent miscarriage cases and those patients with unexplained RPL may have abnormalities in the uterine and endometrial blood flow. Despite these findings we could not find any cut off values that could predict the occurrence of miscarriage which may be attributed to small sample size and short period of follow up so larger prospective studies are needed aiming to confirm such results and reaching values that can accurately predict the occurrence of miscarriage.

  5. Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats

    OpenAIRE

    Kleinschnitz, Christoph; Mencl, Stine; Garz, Cornelia; Niklass, Solveig; Braun, Holger; Göb, Eva; Homola, György; Heinze, Hans-Jochen; Reymann, Klaus G; Schreiber, Stefanie

    2013-01-01

    Background Human cerebral small vessel disease (CSVD) has distinct histopathologic and imaging findings in its advanced stages. In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood–brain barrier and an activated coagulatory state resulting in capillary and arteriolar erythrocyte accumulations (stases). In ...

  6. Increased Miscarriage Rate in Female Farmers Working in Saffron Fields: A Possible Effect of Saffron Toxicity

    Directory of Open Access Journals (Sweden)

    Mahmoud Ajam

    2014-06-01

    Conclusion: Exposure to saffron may increase the risk of miscarriage. Hence, it is suggested that pregnant women avoid contact with considerable amounts of saffron especially for female farmers working in saffron fields.

  7. Prognostic impact of anticardiolipin antibodies in women with recurrent miscarriage negative for the lupus anticoagulant

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Christiansen, Ole Bjarne

    2005-01-01

    BACKGROUND: Anticardiolipin antibodies (ACA) are found with increased prevalence in women with unexplained recurrent miscarriage (RM) but their impact on future pregnancy outcome in lupus anticoagulant (LAC) negative patients needs better quantification. METHODS: The impact of a repeatedly positive...

  8. Inflammatory cytokines in maternal circulation and placenta of chromosomally abnormal first trimester miscarriages.

    Science.gov (United States)

    Calleja-Agius, Jean; Jauniaux, Eric; Muttukrishna, Shanthi

    2012-01-01

    The impact of abnormal placental karyotype on the inflammatory response within the villous tissue and peripheral circulation of women with miscarriage was evaluated. Villous (n = 38) and venous blood samples (n = 26) were obtained from women with missed miscarriage. Tissue chromosome analysis indicated 23 abnormal and 15 normal karyotypes. Concentration of tumour necrosis factor alpha (TNFα), TNF-R1 and TNF-R2, and interleukin (IL)-10 were measured using flowcytometric bead array in fresh villous homogenate, cultured villous extracts, culture medium, maternal whole blood, and plasma. Plasma TNFα/IL-10 ratios were significantly (P abnormal karyotype. In the abnormal karyotype group, there were significantly higher levels of TNFα (P karyotype group. In miscarriage with abnormal karyotype, there is an exacerbated placental inflammatory response, in contrast to miscarriage of normal karyotype where maternal systemic response is increased.

  9. Inflammatory Cytokines in Maternal Circulation and Placenta of Chromosomally Abnormal First Trimester Miscarriages

    OpenAIRE

    Jean Calleja-Agius; Eric Jauniaux; Shanthi Muttukrishna

    2012-01-01

    The impact of abnormal placental karyotype on the inflammatory response within the villous tissue and peripheral circulation of women with miscarriage was evaluated. Villous ( = 3 8 ) and venous blood samples ( = 2 6 ) were obtained from women with missed miscarriage. Tissue chromosome analysis indicated 23 abnormal and 15 normal karyotypes. Concentration of tumour necrosis factor alpha (TNF ), TNF-R1 and TNF-R2, and interleukin (IL)-10 were measured using flowcytometric bead array in f...

  10. The effect of body mass index on the outcome of pregnancy in women with recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Winnie Lo

    2012-01-01

    Full Text Available Background: Maternal obesity is associated with menstrual disorders, infertility and sporadic miscarriages. Recurrent miscarriage (RM affects at least 1% of couples trying to conceive. In over 50% of cases, the cause of the loss of pregnancy remains unexplained. The aim of this study was to determine the relationship between maternal Body Mass Index (BMI and future outcomes of pregnancy in couples with "unexplained" RM. Methods and Results: All couples referred to the specialist recurrent miscarriage clinic at St. Mary′s Hospital, London, were investigated for an underlying cause. Those with unexplained RM were eligible. Demographic and clinical data were retrieved from a computerised database and medical records. The World Health Organisation (WHO classification of BMI was used. Univariate analysis demonstrated that BMI, maternal age, number of previous miscarriages and ethnicity were significantly associated with pregnancy outcome. Logistic regression demonstrated that maternal obesity (BMI ≥ 30 kg/m 2 significantly increased the risk of miscarriage in couples with unexplained RM (OR 1.73; 95% CI 1.06 - 2.83. Asian women with a BMI similar to Caucasian women had a higher risk of a further miscarriage (OR 2.87, 95% CI, 1.52 - 5.39. Conclusions: Maternal obesity is an independent factor associated with an increased risk of miscarriage in couples with RM. All women with RM should have their BMI recorded at their first clinic visit. The potential effect of weight loss on the outcome of subsequent pregnancies should be assessed in future studies. The increased risk of miscarriage in Asian women needs to be explored further.

  11. Spontaneous hemoperitoneum.

    Science.gov (United States)

    Lucha, P A

    1996-06-01

    Massive hemoperitoneum seen without an obvious precipitating event is rare. A 21-year-old man was seen with diffuse abdominal pain of 48 hours' duration. He had no fever, nausea, or vomiting, and most laboratory values were normal. Exploration of the abdomen revealed free intraperitoneal blood with clotting but failed to reveal a source. The patient could recall no trauma or other inciting event. The only abnormalities found during laparotomy were multiple adhesions of the omentum to the lateral abdominal wall and localization of most of the clot within the greater omentum. The author cautions that a high index of suspicion followed by laparotomy are the management tools for controlling spontaneous hemoperitoneum. Conservative management produces a high mortality rate.

  12. Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Carol Coughlan

    2015-01-01

    Full Text Available Evidence is increasing that the integrity of sperm DNA may also be related to implantation failure and recurrent miscarriage (RM. To investigate this, the sperm DNA fragmentation in partners of 35 women with recurrent implantation failure (RIF following in vitro fertilization, 16 women diagnosed with RM and seven recent fathers (control were examined. Sperm were examined pre- and post-density centrifugation by the sperm chromatin dispersion (SCD test and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL assay. There were no significant differences in the age of either partner or sperm concentration, motility or morphology between three groups. Moreover, there were no obvious differences in sperm DNA fragmentation measured by either test. However, whilst on average sperm DNA fragmentation in all groups was statistically lower in prepared sperm when measured by the SCD test, this was not seen with the results from the TUNEL assay. These results do not support the hypothesis that sperm DNA fragmentation is an important cause of RIF or RM, or that sperm DNA integrity testing has value in such patients. It also highlights significant differences between test methodologies and sperm preparation methods in interpreting the data from sperm DNA fragmentation tests.

  13. Effects of Single and Combined Losartan and Tempol Treatments on Oxidative Stress, Kidney Structure and Function in Spontaneously Hypertensive Rats with Early Course of Proteinuric Nephropathy.

    Science.gov (United States)

    Karanovic, Danijela; Grujic-Milanovic, Jelica; Miloradovic, Zoran; Ivanov, Milan; Jovovic, Djurdjica; Vajic, Una-Jovana; Zivotic, Maja; Markovic-Lipkovski, Jasmina; Mihailovic-Stanojevic, Nevena

    2016-01-01

    Oxidative stress has been widely implicated in both hypertension and chronic kidney disease (CKD). Hypertension is a major risk factor for CKD progression. In the present study we have investigated the effects of chronic single tempol (membrane-permeable radical scavenger) or losartan (angiotensin II type 1 receptor blocker) treatment, and their combination on systemic oxidative status (plasma thiobarbituric acid-reactive substances (pTBARS) production, plasma antioxidant capacity (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid, pABTS), erythrocyte antioxidant enzymes activities) and kidney oxidative stress (kTBARS, kABTS, kidney antioxidant enzymes activities), kidney function and structure in spontaneously hypertensive rats (SHR) with the early course of adriamycin-induced nephropathy. Adult SHR were divided into five groups. The control group received vehicle, while the other groups received adriamycin (2 mg/kg, i.v.) twice in a 21-day interval, followed by vehicle, losartan (L,10 mg/kg/day), tempol (T,100 mg/kg/day) or combined T+L treatment (by gavage) during a six-week period. Adriamycin significantly increased proteinuria, plasma lipid peroxidation, kidney protein oxidation, nitrite excretion, matrix metalloproteinase-1 (MMP-1) protein expression and nestin immunostaining in the kidney. Also, it decreased kidney antioxidant defense, kidney NADPH oxidase 4 (kNox4) protein expression and abolished anti-inflammatory response due to significant reduction of kidney NADPH oxidase 2 (kNox2) protein expression in SHR. All treatments reduced protein-to-creatinine ratio (marker of proteinuria), pTBARS production, kidney protein carbonylation, nitrite excretion, increased antioxidant capacity and restored kidney nestin expression similar to control. Both single treatments significantly improved systemic and kidney antioxidant defense, bioavailability of renal nitric oxide, reduced kMMP-1 protein expression and renal injury, thus retarded CKD progression

  14. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study)

    DEFF Research Database (Denmark)

    Vissenberg, R; van Dijk, M M; Fliers, E

    2015-01-01

    BACKGROUND: Thyroid peroxidase antibodies (TPO-Ab) in euthyroid women are associated with recurrent miscarriage (RM) and other pregnancy complications such as preterm birth. It is unclear if treatment with levothyroxine improves pregnancy outcome. Aim To determine the effect of levothyroxine...... administration on live birth rate in euthyroid TPO-Ab positive women with recurrent miscarriage. METHODS: /Design We will perform a multicenter, placebo controlled randomized trial in euthyroid women with recurrent miscarriage and TPO-Ab. Recurrent miscarriage is defined as two or more miscarriages before the 20...... we discuss the rationale and design of the T4-LIFE study, an international multi-center randomized, double blind placebo controlled, clinical trial aimed to assess the effectiveness of levothyroxine in women with recurrent miscarriage and TPO-Ab....

  15. The effects of immunotherapy with intravenous immunoglobulins versus no intervention, placebo, or usual care in patients with recurrent miscarriages

    DEFF Research Database (Denmark)

    Egerup, Pia; Lindschou, Jane; Gluud, Christian

    2014-01-01

    BACKGROUND: Recurrent miscarriage is generally defined as three or more miscarriages before gestational week 20. Recurrent miscarriage affects 1% of all women and the condition can only be explained by parental chromosome abnormalities, uterine malformations, or endocrine or thrombophilic...... disturbances to a limited extent. Immunological disturbances are hypothesised to play an important role in recurrent miscarriage and, therefore, various types of immunologically-based therapies have been tested in recurrent miscarriage patients including intravenous immunoglobulins. So far, at least eight...... randomised placebo-controlled trials, with opposing results, investigating intravenous immunoglobulins with a total of 324 recurrent miscarriage patients have been published. METHODS: We will include randomised clinical trials irrespective of publication date, publication type, publication language...

  16. HLA-C antibodies in women with recurrent miscarriage suggests that antibody mediated rejection is one of the mechanisms leading to recurrent miscarriage

    NARCIS (Netherlands)

    Meuleman, T.; van Beelen, E.; Kaaja, R. J.; van Lith, J. M. M.; Claas, F. H. J.; Bloemenkamp, K. W. M.

    2016-01-01

    HLA-C is the only polymorphic classical HLA I antigen expressed on trophoblast cells. It is known that higher incidence of C4d deposition on trophoblast cells is present in women with recurrent miscarriage. C4d is a footprint of antibody-mediated classical complement activation. Therefore, this

  17. HLA-C antibodies in women with recurrent miscarriage suggests that antibody mediated rejection is one of the mechanisms leading to recurrent miscarriage

    NARCIS (Netherlands)

    Meuleman, T; van Beelen, E; Kaaja, R J; van Lith, J M M; Claas, F H J; Bloemenkamp, K W M

    HLA-C is the only polymorphic classical HLA I antigen expressed on trophoblast cells. It is known that higher incidence of C4d deposition on trophoblast cells is present in women with recurrent miscarriage. C4d is a footprint of antibody-mediated classical complement activation. Therefore, this

  18. [Relationship between IL-18 gene polymorphism and unexplained recurrent spontaneous abortion].

    Science.gov (United States)

    Wang, Dan; Wang, Chen; Zheng, Ling-zhi; Zhu, Min; Zhu, Yi-min

    2014-07-01

    To investigate the association between IL-18 polymorphisms and the risk of unexplained recurrent spontaneous abortion (URSA). The polymorphism of rs187238, rs360718 and rs360717 in IL-18 was determined by PCR in combination with DNA sequencing in 207 patients with URSA and 144 women with normal pregnancy. The frequency of gene types GG, GC+CC of rs187238 (-137 G/C) in URSA group and control group was 77.3%, 22.7%, and 95.8%, 4.2%, respectively (χ²=22.767, Precurrent spontaneous miscarriage. Rs360718 and rs360717 in IL-18 may not be associated with URSA.

  19. The influence of socio-demographic factors on miscarriage incidence among Italian and immigrant women: a critical analysis from Italy.

    Science.gov (United States)

    Caserta, Donatella; Ralli, Eleonora; Matteucci, Eleonora; Bordi, Giulia; Soave, Ilaria; Marci, Roberto; Moscarini, Flaviano

    2015-06-01

    Miscarriage is one of the most relevant adverse events in women's reproductive life. The purpose of the study was to describe miscarriage trend in Italy during the last years among Italian and immigrant women, to compare miscarriage rates of the two groups and to evaluate the effect of age, nationality and educational level on the incidence of having a miscarriage. Then, a brief critical review of other miscarriage risk factors was performed. This study is based on ISTAT database. All data were analyzed through the statistical software SPSS and the following analytical techniques were used: multivariate logistic regression, factorial analysis of variance and Chi square test. Immigrant miscarriage rates resulted higher than Italian ones and they decreased from 2003 to 2009 unlike Italian ones, which remained unchanged. The effect of maternal age on the miscarriage incidence resulted different, depending on the nationality; for Italian women it increased with increasing of age and for immigrant women the opposite trend was found. Moreover, miscarriage incidence resulted significantly different depending on the maternal educational level. Whereas immigrant women considered did not belong to the same ethnic group, biological or genetic factors underlying these differences were excluded and a socioeconomic explanation was provided. Finally, in order to provide more complete information, other miscarriage risk factors were discussed through a brief review of the literature.

  20. Cytogenetic analysis in couples with recurrent miscarriages: a ...

    Indian Academy of Sciences (India)

    adding to the aetiology. The spontaneous abortion in the first trimester is due to chromosomal anomalies, skewed X- chromosome inactivation, genomic imprinting, single gene mutation, chromosomal instability and sperm chromosomal abnormalities, which explain idiopathic reproductive loss. (Dutta et al. 2011). Our study ...

  1. Cytogenetic analysis in couples with recurrent miscarriages: a ...

    Indian Academy of Sciences (India)

    NEHA SUDHIR

    orders, immunological disorders and environmental factors adding to the aetiology. The spontaneous abortion in the first trimester is due to chromosomal anomalies, skewed X- chromosome inactivation, genomic imprinting, single gene mutation, chromosomal instability and sperm chromosomal abnormalities, which explain ...

  2. Prediction of Spontaneous Preterm Birth

    NARCIS (Netherlands)

    Dijkstra, Karolien

    2002-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. It is a major goal in obstetrics to lower the incidence of spontaneous preterm birth (SPB) and related neonatal morbidity and mortality. One of the principal objectives is to discover early markers that would allow us to identify

  3. Decidual natural killer cells in recurrent spontaneous abortions

    Directory of Open Access Journals (Sweden)

    Radović-Janošević Dragana

    2011-01-01

    Full Text Available Background/Aim. A repeated or habitual miscarriage (PSP is defined as three or more consecutive losses of pregnancy. In the first three months of pregnancy, habitual miscarriages occur in about 1% of pregnant women, out of which 50% are of an unknown etiology. It is believed that among them, the greatest number is the consequence of an inadequate alloimmune response of a women to the pregnancy. The endocrine and immune systems are in a close interaction during the implantation and maintaining of pregnancy. This communication is the most obvious on endometrium of pregnancy decidua. The aim of the study was to identify the number and the subpopulation distribution of the decidual NK cells in the decidua by using an immunohistochemical method. Methods. The research included a group of 30 women who had had two spontaneous miscarriages consecutively in the first three months of their pregnancy, while the curettage after the third spontaneous abortion was histopathologically and immunohistochemically analyzed. The control group consisted of 20 women without a problematic reproductive anamnesis, who had had their pregnancy terminated for social reasons. The criteria for the eliminating from the research were the diagnosed uterus anomalies, positive screening on thrombophilia, as well as women suffering from diabetes melitus and the ones with the thyroid gland function disorder. Results. The number and the phenotype structure of the uterus NK cells were significantly different between the decidua of a normal pregnancy and that in PSP. In the decidua in PSP, there were much more NK cells with the phenotype of the peripheral circulation CD57 and CD56dim, while in the decidua of the control group the dominant cells were the typical uNK cell subpopulation CD56bright. Conclusion. The above mentioned results show that the disregulation of the immunocompetent cells of the decidua, by creating an inadequate cytokine milieu, is one of the mechanism of rejecting

  4. Acute Nicotine Enhances Spontaneous Recovery of Contextual Fear and Changes "c-fos" Early Gene Expression in Infralimbic Cortex, Hippocampus, and Amygdala

    Science.gov (United States)

    Kutlu, Munir G.; Tumolo, Jessica M.; Holliday, Erica; Garrett, Brendan; Gould, Thomas J.

    2016-01-01

    Exposure therapy, which focuses on extinguishing fear-triggering cues and contexts, is widely used to treat post-traumatic stress disorder (PTSD). Yet, PTSD patients who received successful exposure therapy are vulnerable to relapse of fear response after a period of time, a phenomenon known as spontaneous recovery (SR). Increasing evidence…

  5. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis.

    Science.gov (United States)

    Robinson, Lynne; Gallos, Ioannis D; Conner, Sarah J; Rajkhowa, Madhurima; Miller, David; Lewis, Sheena; Kirkman-Brown, Jackson; Coomarasamy, Arri

    2012-10-01

    Is there an association between high levels of sperm DNA damage and miscarriage? Miscarriage rates are positively correlated with sperm DNA damage levels. Most ejaculates contain a subpopulation of sperm with DNA damage, also referred to as DNA fragmentation, in the form of double or single-strand breaks which have been induced in the DNA prior to or following ejaculation. This DNA damage may be particularly elevated in some subfertile men, hence several studies have examined the link between sperm DNA damage levels and conception and miscarriage rates. A systematic review and meta-analysis of studies which examined the effect of sperm DNA damage on miscarriage rates was performed. Searches were conducted on MEDLINE, EMBASE and the Cochrane Library without any language restrictions from database inception to January 2012. We used the terms 'DNA damage' or 'DNA fragmentation' combined with 'miscarriage', 'abortion' or 'pregnancy' to generate a set of relevant citations. Data extraction was performed by two reviewers. Study quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis of relative risks of miscarriage was performed with a random effects model. Subgroup analyses were performed by the type of DNA damage test, whether the sperm examined were prepared or from raw semen and for pregnancies resulting from IVF or ICSI treatment. We identified 16 cohort studies (2969 couples), 14 of which were prospective. Eight studies used acridine orange-based assays, six the TUNEL assay and two the COMET assay. Meta-analysis showed a significant increase in miscarriage in patients with high DNA damage compared with those with low DNA damage [risk ratio (RR) = 2.16 (1.54, 3.03), P < 0.00001)]. A subgroup analysis showed that the miscarriage association is strongest for the TUNEL assay (RR = 3.94 (2.45, 6.32), P < 0.00001). There is some variation in study characteristics, including the use of different assays and different thresholds for DNA damage and the

  6. Inflammatory Cytokines in Maternal Circulation and Placenta of Chromosomally Abnormal First Trimester Miscarriages

    Directory of Open Access Journals (Sweden)

    Jean Calleja-Agius

    2012-01-01

    Full Text Available The impact of abnormal placental karyotype on the inflammatory response within the villous tissue and peripheral circulation of women with miscarriage was evaluated. Villous (=38 and venous blood samples (=26 were obtained from women with missed miscarriage. Tissue chromosome analysis indicated 23 abnormal and 15 normal karyotypes. Concentration of tumour necrosis factor alpha (TNF, TNF-R1 and TNF-R2, and interleukin (IL-10 were measured using flowcytometric bead array in fresh villous homogenate, cultured villous extracts, culture medium, maternal whole blood, and plasma. Plasma TNF/IL-10 ratios were significantly (<0.05 lower in miscarriages with abnormal karyotype. In the abnormal karyotype group, there were significantly higher levels of TNF (<0.01, IL-10 (<0.01, TNF-R1 (<0.001, and TNF-R2 (<0.001 in the villous extracts and culture-conditioned medium compared to normal karyotype group. In miscarriage with abnormal karyotype, there is an exacerbated placental inflammatory response, in contrast to miscarriage of normal karyotype where maternal systemic response is increased.

  7. Correlation of the sperm penetration assay (SPA and miscarriage after assisted reproduction: The potential use of spa as a new criterion for preimplantation genetic diagnosis

    Directory of Open Access Journals (Sweden)

    Gradistanac Jelena

    2011-01-01

    Full Text Available We analyzed 93 couples undergoing male screening with the Sperm Penetration Assay (SPA before in vitro fertilization and intracytoplasmic sperm injection (ICSI, to determine the accuracy of SPA for subsequent embryonic development, incidence of pregnancy and miscarriage rates (SAB. ICSI patients with the lowest SPA scores had significantly higher incidences of Sthan did patients in the other SPA groups. Sperm quality is higher with better SPA scores. Poor sperm quality has increased incidence of chromosomal abnormalities and is associated with early fetal loss. Couples with negative SPA are candidates for preimplantation genetic diagnosis, to reduce the incidence of SAB.

  8. Grieving after early pregnancy loss--a common reality.

    LENUS (Irish Health Repository)

    Purandare, N

    2013-05-24

    A miscarriage can be very traumatic for a couple and their immediate family. The aim of this study was to assess, using the Perinatal Grief Scale (PGS), whether the type of early pregnancy loss influences the severity of grief and whether the presence of living children influences the severity of grief. Over a period of 6 months in 2008, seventy five patients were recruited for the study, of which 7 (9.3%) had molar pregnancies, 20 (26.7%) had ectopic pregnancies, 43 (573%) had a miscarriage and 5 (6.7%) had recurrent miscarriages. In this study there was no significant difference in severity of grief, between women that had a miscarriage and ectopic pregnancy (p = 0.14) or, between women that had a miscarriage and a molar pregnancy (p = 0.85). Women who had experienced a ectopic pregnancy did not have a higher grief intensity than the women that had a molar pregnancy (p = 0.75). However, for women with a child, the grief intensity significantly increases with the number of miscarriages (p = 0.015). Women with no children with an ectopic pregnancy grieve significantly more than those with a child (p = 0.019). An appointment for the \\'Miscarriage Clinic\\' should be offered to all of these women but special attention should be paid to those in the categories most at risk

  9. Spontaneous Pneumothorax

    Directory of Open Access Journals (Sweden)

    John Costumbrado

    2017-09-01

    Full Text Available History of present illness: A 16-year-old male with asthma was brought to the emergency department by his parents for increasing right-sided chest pain associated with cough and mild dyspnea over the past week. Albuterol inhaler did not provide relief. He denied recent trauma, fever, sweats, and chills. The patient’s vitals and oxygen saturations were stable. Physical exam revealed a tall, slender body habitus with no signs of chest wall injuries. Bilateral breath sounds were present, but slightly diminished on the right. A chest radiograph was ordered to determine the etiology of the patient’s symptoms. Significant findings: Initial chest radiograph showed a 50% right-sided pneumothorax with no mediastinal shift, which can be identified by the sharp line representing the pleural lung edge (see arrows and lack of peripheral lung markings extending to the chest wall. While difficult to accurately estimate volume from a two-dimensional image, a 2 cm pneumothorax seen on chest radiograph correlates to approximately 50% volume.1 The patient underwent insertion of a pigtail pleural drain on the right and repeat chest radiograph showed resolution of previously seen pneumothorax. Ultimately the pigtail drain was removed and chest radiograph showed clear lung fields without evidence of residual pneumothorax or pleural effusion. Discussion: Pneumothorax is characterized by air between the lungs and the chest wall.2 Spontaneous pneumothorax (SP occurs when the pneumothorax is not due to trauma or any discernable etiology. 3 SP is multifactorial and may be associated with subpleural blebs, bullae, and other connective tissue changes that predispose the lungs to leak air into the pleural space.4 SP can be further subdivided into primary (no history of underlying lung disease or secondary (history of chronic obstructive pulmonary disease, tuberculosis, cystic fibrosis, lung malignancy, etc..2 It is estimated that the incidence of SP among US pediatric

  10. Cognitive behavior therapy for psychological distress in patients with recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Nakano Y

    2013-07-01

    Full Text Available Yumi Nakano,1 Tatsuo Akechi,2 Toshiaki A Furukawa,3 Mayumi Sugiura-Ogasawara4 1Department of Psychology, School of Human Sciences, Sugiyama Jogakuen University, Nisshin, Aichi, Japan; 2Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan; 3Department of Health Promotion and Human Behavior (Cognitive-Behavioral Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; 4Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan Objective: To examine the reduction of psychiatric symptoms using individual cognitive behavior therapy (CBT for women who suffer from recurrent miscarriage (RM and depression and/or anxiety. Methods: Patients with RM and a score of five or higher for K6, a self-report screening scale for depression/anxiety, were interviewed to find information about stressful situations, thoughts, and consequent behaviors that are common and potential causes of psychological distress among RM patients. We then performed individual CBT on 14 patients with RM and depression/anxiety, referring to a list from the interviews, and examined the effects of CBT by a paired t-test. Results: Fourteen women received CBT. The mean number of intervention times was 8.9 sessions (standard deviation [SD], 4.6 sessions. The average Beck Depression Inventory-Second Edition and State–Trait Anxiety Inventory–state anxiety scores, self-report screening scales for depression/anxiety, decreased from 13.6 (SD, 8.2 and 49.0 (SD, 7.1 at baseline to 5.2 (SD, 4.4 and 38.0 (SD, 10.2 posttherapy, respectively. These changes were statistically significant. Conclusion: The current preliminary open study confirmed that individual CBT was potentially useful for women with RM and depression and/or anxiety. This finding is the first step towards creating a comprehensive psychological support system for women with RM

  11. Patient-centered early pregnancy care: a systematic review of quantitative and qualitative studies on the perspectives of women and their partners

    NARCIS (Netherlands)

    van den Berg, M. M. J.; Dancet, E. A. F.; Erlikh, T.; van der Veen, F.; Goddijn, M.; Hajenius, P. J.

    2018-01-01

    Early pregnancy complications, defined as miscarriage, recurrent miscarriage or ectopic pregnancy, affect the physical and psychological well-being of intended parents. Research in this field so far has focused mainly on improving accuracy of diagnostic tests and safety and effectiveness of

  12. The impact of supportive counselling on women's psychological wellbeing after miscarriage--a randomised controlled trial.

    Science.gov (United States)

    Kong, G W S; Chung, T K H; Lok, I H

    2014-09-01

    To assess the effectiveness of supportive counselling after miscarriage. Randomised controlled trial. University hospital. Two hundred and eighty women with miscarriage. Women were randomised to receive supportive counselling from a nurse (at diagnosis and 2 weeks later) or routine care. Psychological wellbeing was measured with the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI). Primary outcome measured the proportion of women suffering psychological distress (GHQ-12 score ≥4) at 3 months after miscarriage. Secondary outcomes were GHQ-12 and BDI scores at 6 weeks, 3 and 6 months. There was no difference in the proportion of women suffering psychological distress at 3 months after miscarriage (17.1% in counselling group versus 24.4% in control group; 95% CI -0.034 to 0.177; P = 0.19). However, for the subgroup of women (n = 152) with high baseline GHQ-12 scores, the median GHQ-12 score in the counselling group was significantly lower than the control group at 6 weeks (median score 3 versus 4.5 in counselling and control groups; P = 0.04) and 3 months (median score 1 versus 2.5 in counselling and control groups; P = 0.03). Similarly, for women with high baseline BDI scores (BDI > 12), the proportion for women continuing to score high was significantly lower in the counselling group 6 weeks after miscarriage (33.3 versus 61.1% in counselling group and control group; P = 0.03). Although the results of current study do not justify routine counselling of all women following miscarriage, a supportive counselling programme for selected women with high levels of psychological distress is promising and merits further investigation. © 2014 Royal College of Obstetricians and Gynaecologists.

  13. High Prevalence and Clinical/Sociodemographic Correlates of Miscarriages Among Flight Attendants.

    Science.gov (United States)

    Heidecker, Bettina; Spencer, Rachel Maureen; Hayes, Victoria; Hall, Sarah; Parikh, Nisha; Stock, Eveline Oestreicher; Redberg, Rita

    2017-12-01

    There are many occupational health hazards associated with long hours of air travel, including cosmic radiation exposure, circadian rhythm disruptions, prior and secondhand smoke exposure, for flight attendants who flew before smoking bans were initiated in the 1990s. Previous studies in flight attendants have found increased incidence of breast cancer and melanoma. However, there is little information on the relationship of airline travel and reproductive health in flight attendants. Secondhand smoke exposure has numerous negative health effects, such as increased cardiac events and respiratory infections, but its effect on reproductive health is not known. This study seeks to examine the role of secondhand smoke exposure on the miscarriage rate in flight attendants who flew before the smoking ban. Flight attendants who flew before the smoking ban and participating in a study of health effects of secondhand smoke were asked to complete a reproductive health survey. We compared miscarriage rates of flight attendants to the general population using 2010 data from the Centers for Disease Control and Prevention. In our cohort of 145 female flight attendants exposed to secondhand smoke, there were 45 miscarriages (26%), compared with a 17.1% rate in the Centers for Disease Control and Prevention report (P = .002). There was no difference in secondhand smoke exposure between the flight attendants with miscarriage and the group without miscarriage (P = .93). This study found an increased incidence of miscarriage in flight attendants, which was unrelated to secondhand smoke exposure. Other factors, such as circadian rhythm disruption and radiation, may be related to these reproductive health findings and require further investigation. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Witvliet, Marian D; Steffensen, Rudi

    2010-01-01

    Anti-paternal HLA-antibodies are considered a harmless phenomenon during most pregnancies, whereas their role in recurrent miscarriage (RM) patients is disputed. In contrast to primary RM, patients with secondary RM have carried a fetus to term pregnancy prior to a series of miscarriages, which i...

  15. A firstborn boy is suggestive of a strong prognostic factor in secondary recurrent miscarriage: a confirmatory study

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Andersen, Anne-Marie Nybo; Kolte, Astrid Marie

    2008-01-01

    To test our previously generated hypothesis that women with secondary recurrent miscarriages with a firstborn boy have a poorer pregnancy prognosis than those with a firstborn girl.......To test our previously generated hypothesis that women with secondary recurrent miscarriages with a firstborn boy have a poorer pregnancy prognosis than those with a firstborn girl....

  16. Association between HLA-DR1 and -DR3 antigens and unexplained repeated miscarriage

    DEFF Research Database (Denmark)

    Christiansen, O B; Ring, Mette; Rosgaard, A

    1999-01-01

    Few, mostly small, studies have investigated the distribution of HLA class II antigens among women with unexplained recurrent miscarriage. Although some studies have reported statistically significant associations between this syndrome and certain HLA-DR antigens--especially the -DR1 and -DR3...... antigens--other studies have been unable to demonstrate such associations. For the present meta-analysis, 18 cross-sectional or case-control studies (published or unpublished) reporting on frequencies of HLA-DR1 and -DR3 antigens among Caucasian women with unexplained repeated miscarriage were identified...

  17. Association between the plasma/whole blood lead ratio and history of spontaneous abortion: a nested cross-sectional study

    Directory of Open Access Journals (Sweden)

    Smith Donald

    2007-09-01

    Full Text Available Abstract Background Blood lead has been associated with an elevated risk of miscarriage. The plasmatic fraction of lead represents the toxicologically active fraction of lead. Women with a tendency to have a higher plasma/whole blood Pb ratio could tend towards an elevated risk of miscarriage due to a higher plasma Pb for a given whole blood Pb and would consequently have a history of spontaneous abortion. Methods We studied 207 pregnant Mexico City residents during the 1st trimester of pregnancy, originally recruited for two cohorts between 1997 and 2004. Criteria for inclusion in this study were having had at least one previous pregnancy, and having valid plasma and blood Pb measurements. Pb was measured in whole blood and plasma by inductively coupled plasma mass spectrometry using ultra-clean techniques. History of miscarriage in previous pregnancies was obtained by interview. The incidence rate of spontaneous abortion was defined as the proportion of previous pregnancies that resulted in miscarriage. Data were analyzed by means of Poisson regression models featuring the incidence rate of spontaneous abortion as the outcome and continuous or categorized plasma/blood Pb ratios as predictor variables. All models were adjusted for age and schooling. Additionally, logistic regression models featuring inclusion in the study sample as the outcome were fitted to assess potential selection bias. Results The mean number of miscarriages was 0.42 (range 0 to 4; mean Pb concentrations were 62.4 and 0.14 μg/L in whole blood and plasma respectively. Mean plasma/blood Pb ratio was 0.22%. We estimated that a 0.1% increment in the plasma/blood Pb ratio lead was associated to a 12% greater incidence of spontaneous abortion (p = 0.02. Women in the upper tertile of the plasma/blood Pb ratio had twice the incidence rate of those in the lower tertile (p = 0.02. Conditional on recruitment cohort, inclusion in the study sample was unrelated to observable

  18. Perinatal outcomes in a subsequent pregnancy among women who have experienced recurrent miscarriage: a retrospective cohort study.

    Science.gov (United States)

    Field, K; Murphy, D J

    2015-05-01

    Is a history of three or more miscarriages associated with adverse perinatal outcomes in a subsequent pregnancy? Recurrent miscarriage is associated with an increased risk of adverse perinatal outcomes, including preterm birth, very preterm birth and perinatal death, in a subsequent pregnancy. Published data are conflicting with some studies reporting an increase in adverse perinatal outcomes in association with prior recurrent miscarriage while others report little or no increase. Large-scale population-based studies have been lacking. We performed a retrospective cohort study of 30 053 women with a singleton pregnancy who booked for antenatal care and delivery between January 2008 and July 2011. All women who attended a university affiliated hospital in Ireland had a detailed obstetric history taken, recording the outcome of all previous pregnancies. We compared the obstetric and perinatal outcomes of 2030 women (6.8%) who had a history of three or more miscarriages (recurrent miscarriage) with the outcomes of 28 023 women (93.2%) who did not. Logistic regression analyses were performed, adjusting for potential confounding factors. Women with a history of recurrent miscarriage were more likely to be obese, to have undergone assisted conception, to have had a previous perinatal death, and to be delivered by scheduled Caesarean section. Recurrent miscarriage was associated with an increased incidence of preterm birth (perinatal death (1.2 versus 0.5%, adjOR 2.66; 95% CI 1.70-4.14). The results were similar for both primary and secondary recurrent miscarriage. This is a retrospective cohort study and while regression analyses adjusted for potential confounding factors, residual confounding may persist. The strict definition of recurrent miscarriage is three consecutive miscarriages and while each woman in the study group had three or more miscarriages, they were only confirmed to be consecutive in the primary RM group. The affected women have not been categorized

  19. Traditional Camel Veterinary Treatment Among the Bedouins of Sultanate of Oman: A Case of Recurrent Miscarriages

    Directory of Open Access Journals (Sweden)

    Ali Tigani ElMahi

    2014-01-01

    Full Text Available In Oman, Bedouins have developed their own ways of providing medical care for their camels. This indigenous knowledge must have evolved sometime after the domestication of camels around 3000 BC. This paper documents a case of treating a female camel suffering from recurrent miscarriages in al Naffas at al Mudaibi area in the interior of Oman.

  20. Does surgery improve live birth rates in patients with recurrent miscarriage caused by uterine anomalies?

    Science.gov (United States)

    Sugiura-Ogasawara, M; Lin, B L; Aoki, K; Maruyama, T; Nakatsuka, M; Ozawa, N; Sugi, T; Takeshita, T; Nishida, M

    2015-02-01

    We found that congenital uterine anomalies have a negative impact on reproductive outcome in recurrent-miscarriage couples, being associated with further miscarriage with a normal embryonic karyotype. There has been no study comparing live birth rates between patients with and without surgery. We conducted a prospective study to prove that surgery for a bicornuate or septate uterus might improve the live birth rate. A total of 170 patients with congenital uterine anomalies suffering two or more miscarriages were examined. The live birth rate after ascertainment of anomalies, cumulative live birth rate and infertility rate, were compared between patients with and without surgery. In patients with a septate uterus, the live birth rate (81.3%) at the first pregnancy after ascertainment of anomalies with surgery tended to be higher than that (61.5%) in those without surgery. The infertility rates were similar in both groups, while the cumulative live birth rate (76.1%) tended to be higher than without surgery (60.0%). Surgery showed no benefit in patients with a bicornuate uterus for having a baby, but tended to decrease the preterm birth rate and the low birth weight. The possibility that surgery has benefits for having a baby in patients with a septate uterus suffering recurrent miscarriage could not be excluded.

  1. Increased complement C4d deposition at the maternal-fetal interface in unexplained recurrent miscarriage

    NARCIS (Netherlands)

    Meuleman, Tess; Cohen, Danielle; Swings, Godelieve M J S; Veraar, Kimberly; Claas, Frans H J; Bloemenkamp, Kitty W M

    2015-01-01

    C4d is a footprint of antibody-mediated classical complement activation, and has evolved as a useful diagnostic marker of antibody-mediated rejection. It is unknown if complement activation, as reflected by C4d deposition plays a role in unexplained recurrent miscarriage. In a case-control study

  2. Aspirin plus Heparin or Aspirin Alone in Women with Recurrent Miscarriage

    NARCIS (Netherlands)

    Kaandorp, Stef P.; Goddijn, Mariette; van der Post, Joris A. M.; Hutten, Barbara A.; Verhoeve, Harold R.; Hamulyak, Karly; Mol, Ben Willem; Folkeringa, Nienke; Nahuis, Marleen; Papatsonis, Dimitri N. M.; Buller, Harry R.; van der Veen, Fulco; Middeldorp, Saskia

    2010-01-01

    BACKGROUND Aspirin and low-molecular-weight heparin are prescribed for women with unexplained recurrent miscarriage, with the goal of improving the rate of live births, but limited data from randomized, controlled trials are available to support the use of these drugs. METHODS In this randomized

  3. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage

    NARCIS (Netherlands)

    Kaandorp, Stef P.; Goddijn, Mariëtte; van der Post, Joris A. M.; Hutten, Barbara A.; Verhoeve, Harold R.; Hamulyák, Karly; Mol, Ben Willem; Folkeringa, Nienke; Nahuis, Marleen; Papatsonis, Dimitri N. M.; Büller, Harry R.; van der Veen, Fulco; Middeldorp, Saskia

    2010-01-01

    Aspirin and low-molecular-weight heparin are prescribed for women with unexplained recurrent miscarriage, with the goal of improving the rate of live births, but limited data from randomized, controlled trials are available to support the use of these drugs. In this randomized trial, we enrolled 364

  4. Role of 1,25-dihydroxyvitamin D (vitamin D3 as immunomodulator in recurrent missed miscarriage

    Directory of Open Access Journals (Sweden)

    Zakia Mahdy Ibrahim

    2013-09-01

    Conclusion: Although statistically insignificant, vitamin D3 oral supplementation has resulted in reducing risk of pregnancy loss up to 15% among women with recurrent miscarriage so it is a matter that is worth more attention and large scale studies with larger sample size may result in more significant results.

  5. An altered endometrial CD8 tissue resident memory T cell population in recurrent miscarriage.

    Science.gov (United States)

    Southcombe, J H; Mounce, G; McGee, K; Elghajiji, A; Brosens, J; Quenby, S; Child, T; Granne, I

    2017-01-23

    When trying to conceive 1% of couples have recurrent miscarriages, defined as three or more consecutive pregnancy losses. This is not accounted for by the known incidence of chromosomal aneuploidy in miscarriage, and it has been suggested that there is an immunological aetiology. The endometrial mucosa is populated by a variety of immune cells which in addition to providing host pathogen immunity must facilitate pregnancy. Here we characterise the endometrial CD8-T cell population during the embryonic window of implantation and find that the majority of cells are tissue resident memory T cells with high levels of CD69 and CD103 expression, proteins that prevent cells egress. We demonstrate that unexplained recurrent miscarriage is associated with significantly decreased expression of the T-cell co-receptor CD8 and tissue residency marker CD69. These cells differ from those found in control women, with less expression of CD127 indicating a lack of homeostatic cell control through IL-7 signalling. Nevertheless this population is resident in the endometrium of women who have RM, more than three months after the last miscarriage, indicating that the memory CD8-T cell population is altered in RM patients. This is the first evidence of a differing pre-pregnancy phenotype in endometrial immune cells in RM.

  6. ANIMAL MODELS FOR STUDYING MISCARRIAGE: ILLUSTRATION WITH STUDY OF DRINKING WATER DISINFECTION BY-PRODUCTS

    Science.gov (United States)

    Animal models for studying miscarriage: Illustration with study of drinking water disinfection by-productsAuthors & affiliations:Narotsky1, M.G. and S. Bielmeier Laffan2.1Reproductive Toxicology Division, NHEERL, ORD, U.S. Environmental Protection Agency, Research Tri...

  7. Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage.

    Science.gov (United States)

    Leach, Mikaela; Aitken, Robert J; Sacks, Gavin

    2015-08-01

    Previous studies have described an association between sperm with DNA damage and a history of recurrent miscarriage (RM), although it is not clear whether there is benefit in screening for sperm DNA fragmentation and to what extent DNA fragmentation impacts upon RM. To identify what proportion of couples experiencing RM are affected by DNA fragmentation abnormalities. In this retrospective study, between 2008 and 2013, couples with a history of recurrent miscarriage (≥3 first trimester miscarriages) were investigated comprehensively for known causes (karyotype, uterine, antiphospholipid syndrome, thrombophilia) and also by semen analysis, including DNA fragmentation [sperm chromatin structure analysis (SCSA)]. Statistical analysis was performed on SPSS software with significance taken as P fragmentation index (DFI) of 9.50%. Normal levels were found in 70.5% of men (DFI 30%). Couples with otherwise unexplained recurrent miscarriage had significantly higher DFI than those with other causes identified on routine screening (P = 0.012). In couples experiencing RM, 30% (32/108) of men had sperm with high levels of DNA fragmentation (DFI > 15%). This may be a contributing factor to the clinical syndrome of RM, and future clinical trials of therapies for these couples are warranted. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  8. HLA associations and HLA sharing in recurrent miscarriage : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Meuleman, Tess; Lashley, Lisa E L O; Dekkers, Olaf M.; van Lith, Jan M M; Claas, Frans H J; Bloemenkamp, Kitty W M

    2015-01-01

    Problem: The aim of this meta-analysis was to evaluate whether specific maternal HLA alleles and HLA sharing of couples are associated with the occurrence of recurrent miscarriage (RM). Method of study: A systematic literature search was performed for studies that evaluated the association between

  9. Implications of sperm chromosome abnormalities in recurrent miscarriage.

    Science.gov (United States)

    Rubio, C; Simón, C; Blanco, J; Vidal, F; Mínguez, Y; Egozcue, J; Crespo, J; Remohí, J; Pellicer, A

    1999-05-01

    Our purpose was to assess the existence of sperm chromosome abnormalities in recurrent pregnancy loss in an assisted reproduction program. In this prospective study, 12 sperm samples from couples undergoing in vitro fertilization with two or more first-trimester spontaneous abortions were analyzed. Diploidy and disomy in decondensed sperm nuclei were assessed for chromosomes 13, 18, 21, X, and Y using two- and three-color fluorescence in situ hybridization. Sex chromosome disomy in sperm samples from recurrent abortion couples was significantly increased compared to that from internal controls (0.84% vs 0.37%). In a subpopulation of seven couples who underwent oocyte donation, mean frequencies for sex chromosome disomy (1%) were even higher and diploidy (0.43%) was also significantly increased. These results suggest an implication of sperm chromosome abnormalities in some cases of recurrent pregnancy loss.

  10. Exploring risk perception and attitudes to miscarriage and congenital anomaly in rural Western Kenya.

    Directory of Open Access Journals (Sweden)

    Stephanie Dellicour

    Full Text Available Understanding the socio-cultural context and perceptions of adverse pregnancy outcomes is important for informing the best approaches for public health programs. This article describes the perceptions, beliefs and health-seeking behaviours of women from rural western Kenya regarding congenital anomalies and miscarriages.Ten focus group discussions (FGDs were undertaken in a rural district in western Kenya in September 2010. The FGDs included separate groups consisting of adult women of childbearing age, adolescent girls, recently pregnant women, traditional birth attendants and mothers of children with a birth defect. Participants were selected purposively. A deductive thematic framework approach using the questions from the FGD guides was used to analyse the transcripts.There was substantial overlap between perceived causes of miscarriages and congenital anomalies and these were broadly categorized into two groups: biomedical and cultural. The biomedical causes included medications, illnesses, physical and emotional stresses, as well as hereditary causes. Cultural beliefs mostly related to the breaking of a taboo or not following cultural norms. Mothers were often stigmatised and blamed following miscarriage, or the birth of a child with a congenital anomaly. Often, women did not seek care following miscarriage unless there was a complication. Most reported that children with a congenital anomaly were neglected either because of lack of knowledge of where care could be sought or because these children brought shame to the family and were hidden from society.The local explanatory model of miscarriage and congenital anomalies covered many perceived causes within biomedical and cultural beliefs. Some of these fuelled stigmatisation and blame of the mother. Understanding of these beliefs, improving access to information about the possible causes of adverse outcomes, and greater collaboration between traditional healers and healthcare providers may

  11. Is ambient heat exposure levels associated with miscarriage or stillbirths in hot regions? A cross-sectional study using survey data from the Ghana Maternal Health Survey 2007

    Science.gov (United States)

    Asamoah, Benedict; Kjellstrom, Tord; Östergren, Per-Olof

    2017-07-01

    It is well established that high ambient heat could cause congenital abnormalities resulting in miscarriage or stillbirth among certain species of mammals. However, this has not been systematically studied in real field settings among humans, despite the potential value of such knowledge for estimating the impact of global warming on the human species. This study sought to test the hypothesis that maternal heat exposure during pregnancy in hot regions is associated with increased prevalence of spontaneous abortions or stillbirths and to develop an analytical strategy to use existing data from maternal health surveys and existing data on historical heat levels at a geographic grid cell level. A subsample of the Ghana Maternal Health Survey 2007 was used in this study. This study sample consisted of 1136 women with pregnancy experiences between 2004 and 2007, out of which 141 women had a pregnancy that terminated in miscarriage or stillbirth. Induced-abortion cases were excluded. The linkage between ambient heat exposure and pregnancy outcome followed the epidemiological time-place-person principle, by linking timing of pregnancy outcome with historical data of local area heat levels for each month, as estimated in an international database. Maternal heat exposure level was estimated using calculated levels of the wet-bulb globe temperature (WBGT), which takes into account temperature, humidity, heat radiation, and air movement over the skin (wind speed). The values we used applied to exposure in the shade or in buildings without cooling (no solar heat radiation) and a standard air movement of 1 m/s. We applied two exposure durations: yearly average and monthly average for second month of pregnancy. In one analysis, we restricted the sample to four regions with time-homogeneous ambient heat. Analysis was made using logistic regression. About 12% of the latest pregnancies ended in either miscarriage (9.6%) or stillbirth (2.8%). The odds ratios indicated 12 to 15

  12. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study).

    Science.gov (United States)

    Vissenberg, R; van Dijk, M M; Fliers, E; van der Post, J A M; van Wely, M; Bloemenkamp, K W M; Hoek, A; Kuchenbecker, W K; Verhoeve, H R; Scheepers, H C J; Rombout-de Weerd, S; Koks, C; Zwart, J J; Broekmans, F; Verpoest, W; Christiansen, O B; Post, M; Papatsonis, D N M; Verberg, M F G; Sikkema, J; Mol, B W; Bisschop, P H; Goddijn, M

    2015-09-01

    Thyroid peroxidase antibodies (TPO-Ab) in euthyroid women are associated with recurrent miscarriage (RM) and other pregnancy complications such as preterm birth. It is unclear if treatment with levothyroxine improves pregnancy outcome. The aim of this study is to determine the effect of levothyroxine administration on live birth rate in euthyroid TPO-Ab positive women with recurrent miscarriage. We will perform a multicenter, placebo controlled randomized trial in euthyroid women with recurrent miscarriage and TPO-Ab. Recurrent miscarriage is defined as two or more miscarriages before the 20th week of gestation. The primary outcome is live birth, defined as the birth of a living fetus beyond 24weeks of gestation. Secondary outcomes are ongoing pregnancy at 12weeks, miscarriage, preterm birth, (serious) adverse events, time to pregnancy and survival at 28days of neonatal life. The analysis will be performed according to the intention to treat principle. We need to randomize 240 women (120 per group) to demonstrate an improvement in live birth rate from 55% in the placebo group to 75% in the levothyroxine treatment group. This trial is a registered trial (NTR 3364, March 2012). Here we discuss the rationale and design of the T4-LIFE study, an international multicenter randomized, double blind placebo controlled, clinical trial aimed to assess the effectiveness of levothyroxine in women with recurrent miscarriage and TPO-Ab. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Onset of coeliac disease after a spontaneous miscarriage during a holiday in Australia: coincidence or causal relationship?

    NARCIS (Netherlands)

    Dondorp, A. M.; de Groot, G. H.

    1998-01-01

    Diarrhoea contracted whilst travelling in a (sub)tropical country often has an infectious cause. However, dietary changes can also be of importance. We describe the case of a 28-year-old woman, who developed severe coeliac disease during a trip in the Australian outback. The nutritional history

  14. Influences of prior miscarriage and weight status on perinatal psychological well-being, exercise motivation and behavior.

    Science.gov (United States)

    Devlin, Courtenay A; Huberty, Jennifer; Downs, Danielle Symons

    2016-12-01

    women who have experienced miscarriage may be at increased risk for elevated depressive and anxiety symptoms in subsequent pregnancies. Exercise may be a useful strategy for coping with these symptoms. Little is known about how miscarriage influences prenatal exercise behavior. The study purpose was to examine the influences of miscarriage history and prepregnancy weight status on pregnant women's psychological health, exercise motivation, and behavior using the Theory of Planned Behavior. Pregnant women (N=203; 41 with prior miscarriage; 72 overweight/obese; BMI > 25.0) in the northeast United States. Women prospectively reported their depressive/anxiety symptoms and exercise motivation/behavior in the 1st, 2nd, and 3rd trimesters via mailed surveys. Group differences in depressive/anxiety symptoms, exercise behavior, and its motivational determinants were examined using Chi Square analyses and Univariate and Multivariate Analyses of Covariance. Women with a history of miscarriage had higher 1st and 2nd trimester depressive/anxiety symptoms and lower 1st trimester attitudes about exercise and 1st and 2nd trimester perceived behavior control than women without a history of miscarriage. Overweight/obese women had higher 1st and 2nd trimester pregnancy depressive/anxiety symptoms, engaged in less prepregnancy exercise, and had lower levels of exercise intention, attitude, and perceived behavior control throughout pregnancy than normal weight women. Women with a history of miscarriage and overweight/obese women have poorer psychological health and lower motivation to exercise during pregnancy than women without a history of miscarriage and normal weight women. Interventions and healthcare provider communications aimed at promoting perinatal exercise behavior and psychological health should take into account pre-pregnancy weight status and pregnancy history to identify strategies to help women, particularly overweight/obese women with a history of miscarriage, to

  15. Frequency of recurrent spontaneous abortion and its influence on further marital relationship and illness: the Okazaki Cohort Study in Japan.

    Science.gov (United States)

    Sugiura-Ogasawara, Mayumi; Suzuki, Sadao; Ozaki, Yasuhiko; Katano, Kinue; Suzumori, Nobuhiro; Kitaori, Tamao

    2013-01-01

    The aim of this study was to examine the influence of recurrent spontaneous abortion (RSA) on marital relationships, and the association between past/present illness and RSA. A total of 2733 Japanese women who underwent a medical examination responded to the questionnaire. The frequency of recurrent miscarriage and two or more consecutive RSA were 0.88% and 4.2%, respectively. Women with a history of miscarriages (hazard ratio: 1.596) and RSA (hazard ratio: 3.103) were at a higher risk of their relationships ending as compared with the women without a history of miscarriage. Existence of a relation was seen between a history of RSA and the occurrence of gastric ulcer, gastritis, fatty liver, and atopic dermatitis. Overall, 89.5% of the women with RSA experienced cumulative live births.  Miscarriage was found to be a severe life event with an influence on marital relationships, and to be associated with an elevated risk of gastric disease or atopic dermatitis. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  16. Glycogen Storage Disease Type IV and Early Implantation Defect: Early Trophoblastic Involvement Associated with a New GBE1 Mutation.

    Science.gov (United States)

    Dainese, Linda; Adam, Nicolas; Boudjemaa, Sabah; Hadid, Kamel; Rosenblatt, Jonathan; Jouannic, Jean-Marie; Heron, Delphine; Froissart, Roseline; Coulomb, Aurore

    A 29-year-old primigravida presented with a spontaneous miscarriage at 8 weeks of gestation. There was no consanguinity in the family. Aspiration was performed. Pathological examination showed immature villi with numerous slightly yellow intracytoplasmic inclusions within the early implantation stage cytotrophoblastic cells. Inclusions were periodic acid-Schiff and Alcian blue positive and partially positive with periodic acid-Schiff with amylase. Diagnosis of Glycogen storage disease type IV (GSD IV) was made. Genetic analysis of glycogen branching enzyme 1 gene (GBE1) was performed in parents and showed a novel deletion of 1 nucleotide, c.1937delT, affecting the mother and a mutation affecting a consensus splice site, c.691+2T>C, in the father. At time of subsequent pregnancy, genetic counseling with GBE1 gene analysis was performed on throphoblastic biopsy and showed a mutated allele, c.1937delT, inherited from the mother. The mother gave birth to a healthy, unaffected female newborn. Our findings demonstrate that GSD IV may affect early pregnancies, leading to trophoblastic damage and early fetal loss. Diagnosis can accurately be made on pathological examination and should be further documented by genetic analysis.

  17. Presence of antibodies against Coxiella burnetii and risk of spontaneous abortion: a nested case-control study.

    Directory of Open Access Journals (Sweden)

    Stine Yde Nielsen

    Full Text Available BACKGROUND AND AIMS: Q fever is a bacterial zoonosis caused by infection with Coxiella burnetii. It is well established that Q fever causes fetal loss in small ruminants. The suspicion has been raised that pregnant women may also experience adverse pregnancy outcome when the infection is acquired or reactivated during pregnancy. The purpose of this study was to assess the potential association between serologic markers of infection with C. burnetii and spontaneous abortion. METHODS: A nested case-control study within the Danish National Birth Cohort, a cohort of 100,418 pregnancies recruited from 1996-2002. Women were recruited in first trimester of pregnancy and followed prospectively. Median gestational age at enrolment was 8 weeks (25 and 75 percentiles: 7 weeks; 10 weeks. During pregnancy, a blood sample was collected at gestational week 6-12 and stored in a bio bank. For this study, a case sample of 218 pregnancies was drawn randomly among the pregnancies in the cohort which ended with a miscarriage before 22 gestational weeks, and a reference group of 482 pregnancies was selected in a random fashion among all pregnancies in the cohort. From these pregnancies, serum samples were screened for antibodies against C. burnetii in a commercial enzyme-linked immunosorbent assay (ELISA. Samples that proved IgG or IgM antibody positive were subsequently confirmatory tested by an immunofluorescence (IFA test. RESULTS: Among cases, 11 (5% were C. burnetii positive in ELISA of which one was confirmed in the IFA assay compared to 29 (6% ELISA positive and 3 IFA confirmed in the random sample. CONCLUSIONS: We found no evidence of a higher prevalence of C. burnetii antibodies in serum samples from women who later miscarried and the present study does not indicate a major association between Q fever infection and spontaneous abortion in humans. Very early first trimester abortions were, however, not included in the study.

  18. Spontaneous EEG activity and spontaneous emotion regulation.

    Science.gov (United States)

    Tortella-Feliu, M; Morillas-Romero, A; Balle, M; Llabrés, J; Bornas, X; Putman, P

    2014-12-01

    Variability in both frontal and parietal spontaneous EEG activity, using α and β band power and θ/β and δ/β ratios, was explored in a sample of 96 healthy volunteers as a potential correlate of individual differences in spontaneous emotion regulation (SER). Following a baseline EEG recording, participants were asked to continuously rate their discomfort while looking at affective pictures, as well as for a period of time after exposure. Greater spontaneous β band power in parietal locations, lower frontal and parietal δ/β ratios, and lower parietal θ/β ratio were associated with lower ratings of discomfort after the offset of unpleasant pictures. Moreover, lower parietal δ/β ratio was also related to less time needed to recover from discomfort after exposure to aversive pictures, while only a greater frontal and parietal α band power appeared to be associated with faster recovery from discomfort induced by normative-neutral pictures. However, parietal δ/β ratio was the only predictor of both minimum discomfort ratings and time needed to downregulate following exposure to unpleasant pictures, and frontal α band power the only spontaneous EEG index that predicted variability in spontaneous down-regulation after the exposure to normative-neutral pictures. Results are discussed focusing on the utility of diverse spontaneous EEG measures in several cortical regions when capturing trait-like individual differences in emotion regulation capabilities and processes. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Single point biochemical measurement algorithm for early diagnosis of ectopic pregnancy.

    Science.gov (United States)

    Butler, Stephen A; Abban, Thomas K A; Borrelli, Paola T A; Luttoo, Jameel M; Kemp, Bryn; Iles, Ray K

    2013-09-01

    Tubal rupture as a result of an ectopic pregnancy is the leading cause of first trimester maternal mortality. Currently, the diagnosis of ectopic pregnancy depends on transvaginal ultrasound and serial serum measurements of human chorionic gonadotrophin (hCG), which requires follow up. The objective of this study was to examine whether single point measurements at presentation could distinguish between women with ectopic pregnancy, viable pregnancy, and spontaneous miscarriage. Serum total hCG (hCGt), hyperglycosylated hCG (hCGh), free beta subunit of hCG (hCGβ), progesterone (P), and CA-125 were measured by chemiluminescence immunoassay over a 3 month period in 441 women presenting at the emergency room with abdominal pain and a positive pregnancy test. Patient outcomes were followed and confirmed by histology. 65 samples were excluded due to poor sample storage, or lost to follow up. The pregnancy outcomes were 175 viable pregnancies, 175 spontaneous miscarriages, and 26 ectopic pregnancies. A serum hCGt ectopic pregnancy from viable pregnancy; but did not differentiate spontaneous miscarriage. Serum CA125 ectopic pregnancy from spontaneous miscarriage. Sequential application of hCGt and CA-125 cut off followed by ultrasound could detect 100% of ectopic pregnancies with 87% specificity for all intrauterine pregnancies. The combination of serum hCGt ectopic pregnancy at initial presentation. © 2013.

  20. Plasminogen activator inhibitor-1 5G/5G genotype is associated with early spontaneous recanalization of the infarct-related artery in patients presenting with acute ST-elevation myocardial infarction.

    Science.gov (United States)

    Cagliyan, Caglar E; Yuregir, Ozge O; Balli, Mehmet; Tekin, Kamuran; Akilli, Rabia E; Bozdogan, Sevcan T; Turkmen, Serdar; Deniz, Ali; Baykan, Oytun A; Aslan, Huseyin; Cayli, Murat

    2013-05-01

    We aimed to examine the association between plasminogen activator inhibitor-1 (PAI-1) genetic polymorphism and early spontaneous recanalization in patients presenting with acute ST-elevation myocardial infarction. Patients admitted to our emergency department with ST-elevation myocardial infarction in the first 6 h of symptom onset were included. An immediate primary percutaneous coronary intervention was performed. Patients were grouped according to the initial patency of the infarct-related artery (IRA) as follows: total occlusion (TO) group [Thrombolysis in Myocardial Infarction (TIMI) 0-1 flow in the IRA], partial recanalization group (TIMI 2 flow in the IRA), and complete recanalization (CR) group (TIMI 3 flow in the IRA). PAI-1 4G/5G polymorphism was detected using the real-time PCR method. There were 107 patients in the TO group, 30 patients in the partial recanalization group, and 45 patients in the CR group. When we evaluated degrees of patency according to the PAI-1 genotype, TO of the IRA was the highest in patients with the PAI 4G/4G genotype (PAI-1 4G/4G: 66.7%, PAI-1 4G/5G: 65.9%, PAI-1 5G/5G: 40.4%) and CR of the IRA was the highest in patients with the PAI 5G/5G genotype (PAI-1 5G/5G: 38.5%, PAI-1 4G/5G: 19.8%, PAI-1 4G/4G: 17.9%). The distribution of genotypes in different degrees of patency of IRA was statistically significant (P=0.029). In logistic regression analysis, the PAI-1 5G/5G genotype was associated independently with the spontaneous CR of the IRA (odds ratio: 2.875, 95% confidence interval [1.059-7.086], P=0.038). Patients with the PAI-1 5G/5G genotype seem to be luckier than others in terms of early spontaneous recanalization of the IRA. Further prospective studies with large patient populations are required for more precise results.

  1. Effect of early amniotomy on the outcome of spontaneous labour: a randomized controlled trial of pregnant women in Enugu, South-east Nigeria.

    Science.gov (United States)

    Onah, Livinus N; Dim, Cyril C; Nwagha, Uchenna I; Ozumba, Benjamin C

    2015-12-01

    Early amniotomy is common in obstetric practice but, its effectiveness has not been proven. To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal outcomes of uncomplicated pregnancies in Enugu, South-east Nigeria. A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved. Mean duration of labour for the amniotomy group (279.4 ± 53.7 minutes) was significantly lower than that of control group (354.4 ± 67.5 minutes), (t = -8.988, p amniotomy group needed oxytocin augmentation as against 21 (19.6%) women in the control group RR = 0.14, (CI 95%: 0.04 - 0.46), NNT = 16. The two groups did not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission. Early amniotomy when compared to fetal membrane conservation reduced the duration of labour and need for oxytocin augmentation among term singleton pregnant women in Enugu, Nigeria. Its routine use in well selected cases may reduce prolonged labour and its complications.

  2. Recurrent miscarriage in translocation carriers : no differences in clinical characteristics between couples who accept and couples who decline PGD

    NARCIS (Netherlands)

    De Krom, G.; Arens, Y. H. J. M.; Coonen, E.; Van Ravenswaaij-Arts, C. M. A.; Meijer-Hoogeveen, M.; Evers, J. L. H.; Van Golde, R. J. T.; De Die-Smulders, C. E. M.

    STUDY QUESTION: Do clinical characteristics of recurrent miscarriage couples with a chromosomal abnormality and who opt for PGD differ from couples that decline PGD after extensive genetic counselling? SUMMARY ANSWER: No differences in clinical characteristics are identified between recurrent

  3. Recurrent miscarriage in translocation carriers : No differences in clinical characteristics between couples who accept and couples who decline PGD

    NARCIS (Netherlands)

    De Krom, G.; Arens, Y. H J M; Coonen, E.; Van Ravenswaaij-Arts, C. M A; Meijer-Hoogeveen, M.; Evers, J. L H; van Golde, Ron J T; de Die-Smulders, Christine E M

    2015-01-01

    Study question: Doclinical characteristics of recurrent miscarriage couples with a chromosomal abnormality and who opt for PGD differ from couples that decline PGD after extensive genetic counselling? Summary answer: No differences in clinical characteristics are identified between recurrent

  4. Frequency of Low-level Mosaicism in X-Cromosome in Couples with Antecedent of Recurrent Miscarriages

    OpenAIRE

    Forero C., Maribel; Lucena Q, Elkin; Esteban Pérez, Clara

    2010-01-01

    Recurrent miscarriage occurs in around 1 to 7 percent of couples. The etiology involves genetic, immunologic, anatomic, hormonal, metabolic, thrombophilic and infectious factors. With the aim of establishing the frequency of low-level mosaicism in the X-chromosome, in a population of couples with prior recurrent miscarriages, a prospective case-control cytogenetic study took place on 20 couples, at the biogenetic laboratory in CECOLFES (Colombian Center of Fertility and Sterility). Clinical p...

  5. Frequency of Low-level Mosaicism in X-Cromosome in Couples with Antecedent of Recurrent Miscarriages

    OpenAIRE

    Maribel Forero C.., Elkin Lucena Q. M.D., PhD., Clara Esteban Pérez BSc., MSc; Elkin Lucena Q.; Clara Esteban Pérez

    2006-01-01

    Recurrent miscarriage occurs in around 1 to 7percent of couples. The etiology involves genetic,immunologic, anatomic, hormonal, metabolic,thrombophilic and infectious factors. With theaim of establishing the frequency of low-level mosaicism in the X-chromosome, in a populationof couples with prior recurrent miscarriages, aprospective case-control cytogenetic study tookplace on 20 couples, at the biogenetic laboratoryin CECOLFES (Colombian Center of Fertility andSterility). Clinical pathologic...

  6. Maternal KIR haplotype influences live birth rate after double embryo transfer in IVF cycles in patients with recurrent miscarriages and implantation failure.

    Science.gov (United States)

    Alecsandru, D; Garrido, N; Vicario, J L; Barrio, A; Aparicio, P; Requena, A; García-Velasco, J A

    2014-12-01

    In patients with recurrent miscarriages (RM) or recurrent implantation failure (RIF), does the maternal killer immunoglobulin-like receptor (KIR) haplotype have an impact on live birth rates per cycle after embryo transfer with the patient's own or donated oocytes? After double embryo transfer (DET) in patients with the maternal KIR AA haplotype, a significantly increased early miscarriage rate was observed when the patient's own oocytes were used, and a significantly decreased live birth rate per cycle after embryo transfer was observed when donated oocytes were used. Interactions between fetal HLA-C and maternal KIR influence placentation during human pregnancy. There is an increased risk of RM, pre-eclampsia or fetal growth restriction in mothers with the KIR AA haplotype when the fetus has more HLA-C2 genes than the mother. Between 2010 and 2014, we performed a retrospective study that included 291 women, with RM or RIF, who had a total of 1304 assisted reproductive cycles. Pregnancy, miscarriage and live birth rates per cycle after single or DET, categorized by the origin of the oocytes and the presence of maternal KIR haplotypes, were studied. KIR haplotype regions were defined by the presence of the following KIR genes: Cen-A/2DL3; Tel-A/3DL1 and 2DS4; Cen-B/2DL2 and 2DS2; as well as Tel-B/2DS1 and 3DS1. Higher rates of early miscarriage per cycle after DET with the patient's own oocytes in mothers with the KIR AA haplotype (22.8%) followed by those with the KIR AB haplotype (16.7%) compared with mothers with the KIR BB haplotype (11.1%) were observed (P = 0.03). Significantly decreased live birth rates per cycle were observed after DET of donated oocytes in mothers with the KIR AA haplotype (7.5%) compared with those with the KIR AB (26.4%) and KIR BB (21.5%) haplotypes (P = 0.006). No statistically significant differences were observed for pregnancy, miscarriage and live birth rates per cycle among those with maternal KIR AA, AB and BB haplotypes after

  7. Natality Decline and Miscarriages Associated With the 1918 Influenza Pandemic: The Scandinavian and United States Experiences

    DEFF Research Database (Denmark)

    Bloom-Feshbach, Kimberly; Simonsen, Lone; Viboud, Cecile

    2011-01-01

    Background. Although pregnancy is a recognized risk factor for severe influenza infection, the effect of influenza on miscarriages and births remains unclear. We examined the relationship between influenza and birth rates during the 1918 pandemic in the United States, Denmark, Sweden, and Norway....... Methods. We compiled monthly birth rates from 1911 through 1930 in 3 Scandinavian countries and the United States, identified periods of unusually low or high birth rates, and quantified births as “missing” or “in excess” of the normal expectation. Using monthly influenza data, we correlated the timing...... of peak pandemic exposure and depressions in birth rates, and identified pregnancy stages at risk of influenza-related miscarriage. Results. Birth rates declined in all study populations in spring 1919 by a mean of 2.2 births per 1000 persons, representing a 5%–15% drop below baseline levels (P

  8. A genome-wide scan in affected sibling pairs with idiopathic recurrent miscarriage suggests genetic linkage

    DEFF Research Database (Denmark)

    Kolte, Astrid Marie; Nielsen, H S; Moltke, Ida

    2011-01-01

    I platform and non-parametric linkage analysis was performed via the software package Merlin. We find that siblings of IRM patients exhibit a higher frequency of miscarriage than population controls regardless of age at the time of pregnancy. We identify chromosomal regions with LOD scores between 2.5 and 3.......0 in subgroups of affected sibling pairs. Maximum LOD scores were identified in four occurrences: for rs10514716 (3p14.2) when analyzing sister-pairs only; for rs10511668 (9p22.1) and rs341048 (11q13.4) when only analyzing families where the probands have had four or more miscarriages; and for rs10485275 (6q16...

  9. Use of Inhaled and Oral Corticosteroids in Pregnancy and the Risk of Malformations or Miscarriage

    DEFF Research Database (Denmark)

    Bjørn, Anne-Mette Bay; Ehrenstein, Vera; Nohr, Ellen Aagaard

    2014-01-01

    Corticosteroids are potent anti-inflammatory and immunosuppressive drugs, which sometimes must be given to pregnant women. Corticosteroids have been suspected to be teratogenic for many years; however, there is conflicting evidence regarding the association. Based on a literature review of three...... databases, this MiniReview provides an overview of inhaled and oral corticosteroid use in pregnancy with specific emphasis on the association between use of corticosteroids during pregnancy and risk of miscarriage and congenital malformations in offspring. Use of corticosteroids among pregnant women ranged...... are inconsistent. Use of inhaled corticosteroids was associated with a slightly increased the risk of miscarriage, whereas use of oral corticosteroids was not; however, confounding by indication could not be ruled out. This article is protected by copyright. All rights reserved....

  10. Peritonitis - spontaneous bacterial

    Science.gov (United States)

    Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis ... who are on peritoneal dialysis for kidney failure. Peritonitis may have other causes . These include infection from ...

  11. Psychotherapeutic correction and rehabilitation of mental disorders in pregnant women with threatened miscarriage

    Directory of Open Access Journals (Sweden)

    I. E. Kupriyanova

    2014-01-01

    Full Text Available Objective: to study the efficiency of psychotherapeutic correction of mental disorders in pregnant women with threatened miscarriage.Patients and methods. Psychotherapy for mental disorders and prenosological conditions was performed in 84 pregnant women aged 18 to 41 years with threatened miscarriage. The efficiency of performed measures was evaluated using the quality of life questionnaire, Spielberger–Hanin’s scale, and a therapy efficiency assessment scale in patients with borderline states. Delivery outcomes were analyzed in relation to management tactics in this cohort of pregnant women. The health status of newborn infants was assessed by the neonatologists of maternity hospitals.Results and discussion. After psychotherapeutic correction, the quality-of-life indicators in the pregnant women with threatened miscarriage from the study group were significantly higher than in those from the comparison group. The level of reactive and personality anxiety significantly decreased in the pregnant women in the study group. The pregnant women with the asthenic variant of prenosological conditions and those who had ICD-10 diagnoses F40-48 were most successful in the context of psychotherapeutic rehabilitation. Sporadic cases of incomplete recovery were noted when psychotherapeutical support was got. In the study group, pregnancy resulted in full-term babies in 100% of the women. In the pregnant women with prenosological conditions and mental disorders from the study group, parturition proceeded significantlymore rapidly than in those from the comparison study. Significantly higher physical quotients were found in the newborn babies from the study group parturients. The psychotherapy that supplements the complex system of therapeutic measures has been shown to be highly effective in the women with threatened miscarriage accompanied by mental disorders.

  12. Higher levels of procoagulant microparticles in women with recurrent miscarriage are not associated with antiphospholipid antibodies.

    Science.gov (United States)

    Martínez-Zamora, M A; Tàssies, D; Creus, M; Reverter, J C; Puerto, B; Monteagudo, J; Carmona, F; Balasch, J

    2016-01-01

    Are the levels of circulating cell-derived microparticles (cMPs) in patients with recurrent miscarriage (RM) associated with the antiphospholipid syndrome (APS)? cMPs in women with RM are not associated with antiphospholipid antibodies (aPLs). Previous studies have focused on cMP levels in RM patients. Most studies have shown higher levels of cMPs in RM patients whereas others have reported lower levels. Data regarding cMPs in patients with the APS are scanty in the literature. A case-control study including three groups of patients. A total of 154 women were prospectively recruited from September 2009 to October 2013. Four patients refused to participate. The APS group consisted of 50 women that had been previously diagnosed with primary APS and had had ≥3 consecutive first trimester miscarriages. The uRM group included 52 couples with ≥3 consecutive first trimester miscarriages of unknown etiology. The fertile control (FER) group was composed of 52 healthy fertile women with no history of pregnancy losses. Miscarriage was defined as intrauterine pregnancy loss at Plan Nacional de I+D+I' and co-funded by the 'ISCIII-Subdirección General de Evaluación' and the 'Fondo Europeo de Desarrollo Regional (FEDER)'. The authors have no competing interests to disclose. Not applicable. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Association between Perfluorinated Compound Exposure and Miscarriage in Danish Pregnant Women

    Science.gov (United States)

    Jensen, Tina Kold; Andersen, Louise Bjørkholt; Kyhl, Henriette Boye; Nielsen, Flemming; Christesen, Henrik Thybo; Grandjean, Philippe

    2015-01-01

    Perfluorinated alkylated substances (PFAS) have been extensively used in consumer products and humans are widely exposed to these persistent compounds. A recent study found no association between exposure to perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) and miscarriage, but no studies have examined adverse effect of the more recently introduced PFASs. We therefore conducted a case-control study within a population-based, prospective cohort during 2010-2012. Newly pregnant women residing in the Municipality of Odense, Denmark were invited to enroll in the Odense Child Cohort at their first antenatal visit before pregnancy week 12. Among a total of 2,874 participating women, 88 suffered a miscarriage and 59 had stored serum samples, of which 56 occurred before gestational week 12. They were compared to a random sample (N=336) of delivering women, who had also donated serum samples before week 12. Using a case-control design, 51 of the women suffering a miscarriage were matched on parity and gestational day of serum sampling with 204 delivering women. In a multiple logistic regression with adjustment for age, BMI, parity and gestational age at serum sampling, women with the highest tertile of exposure to perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) in pregnancy had odds ratios for miscarriage of 16.5 (95% CI 7.4-36.6-36.5) and 2.67 (1.31-5.44), respectively, as compared to the lowest tertile. In the matched data set, the OR were 37.9 (9.9-145.2) and 3.71 (1.60-8.60), respectively. The association with perfluorohexane sulfonic acid (PFHxS) was in the same direction, but not statistically significant, while no association was found with PFOA and PFOS. Our findings require confirmation due to the possible public health importance, given that all pregnant women are exposed to these widely used compounds. PMID:25848775

  14. Preimplantation Genetic Screening: An Effective Testing for Infertile and Repeated Miscarriage Patients?

    OpenAIRE

    Wang, Ning; Zheng, Ying-Ming; Li, Lei; Jin, Fan

    2010-01-01

    Aneuploidy in pregnancy is known to increase with advanced maternal age (AMA) and associate with repeated implantation failure (RIF), and repeated miscarriage (RM). Preimplantation genetic screening (PGS) has been introduced into clinical practice, screening, and eliminating aneuploidy embryos, which can improve the chance of conceptions for infertility cases with poor prognosis. These patients are a good target group to assess the possible benefit of aneuploidy screening. Although practiced ...

  15. Association between perfluorinated compound exposure and miscarriage in Danish pregnant women.

    Directory of Open Access Journals (Sweden)

    Tina Kold Jensen

    Full Text Available Perfluorinated alkylated substances (PFAS have been extensively used in consumer products and humans are widely exposed to these persistent compounds. A recent study found no association between exposure to perfluorooctanoic acid (PFOA and perfluorooctanesulfonic acid (PFOS and miscarriage, but no studies have examined adverse effect of the more recently introduced PFASs. We therefore conducted a case-control study within a population-based, prospective cohort during 2010-2012. Newly pregnant women residing in the Municipality of Odense, Denmark were invited to enroll in the Odense Child Cohort at their first antenatal visit before pregnancy week 12. Among a total of 2,874 participating women, 88 suffered a miscarriage and 59 had stored serum samples, of which 56 occurred before gestational week 12. They were compared to a random sample (N=336 of delivering women, who had also donated serum samples before week 12. Using a case-control design, 51 of the women suffering a miscarriage were matched on parity and gestational day of serum sampling with 204 delivering women. In a multiple logistic regression with adjustment for age, BMI, parity and gestational age at serum sampling, women with the highest tertile of exposure to perfluorononanoic acid (PFNA and perfluorodecanoic acid (PFDA in pregnancy had odds ratios for miscarriage of 16.5 (95% CI 7.4-36.6-36.5 and 2.67 (1.31-5.44, respectively, as compared to the lowest tertile. In the matched data set, the OR were 37.9 (9.9-145.2 and 3.71 (1.60-8.60, respectively. The association with perfluorohexane sulfonic acid (PFHxS was in the same direction, but not statistically significant, while no association was found with PFOA and PFOS. Our findings require confirmation due to the possible public health importance, given that all pregnant women are exposed to these widely used compounds.

  16. Is subclinical hypothyroidism associated with lower live birth rates in women who have experienced unexplained recurrent miscarriage?

    Science.gov (United States)

    van Dijk, Myrthe M; Vissenberg, Rosa; Bisschop, Peter H; Dawood, Feroza; van Wely, Madelon; Goddijn, Mariëtte; Farquharson, Roy G

    2016-12-01

    Thyroid disorders have been associated with recurrent miscarriage. Little evidence is available on the influence of subclinical hypothyroidism on live birth rates. In this cohort study, women who had experienced miscarriage and subclinical hypothyroidism (defined as thyroid-stimulating hormone >97.5th percentile mU/l with a normal thyroxine level) were investigated; the control group included women who had experienced recurrent miscarriage and normal thyroid function. Multivariable logistic regression was used to investigate the association of subclinical hypothyroidism. Data were available for 848 women; 20 (2.4%) had subclinical hypothyroidism; 818 women (96%) had euthyroidism; and 10 (1.2%) had overt hypothyroidism. The live birth rate was 45% in women with subclinical hypothyroidism and 52% in euthyroid women (OR 0.69, 95% CI 0.28 to 1.71). The ongoing pregnancy rate was 65% versus 69% (OR 0.82, 95% CI 0.32 to 2.10) and the miscarriage rate was 35% versus 28% (OR 1.43, 95% CI 0.56 to 3.68), respectively. No differences were found when thyroid stimulating hormone 2.5 mU/l was used as cut-off level to define subclinical hypothyroidism. In women with unexplained miscarriage, no differences were found in live birth, ongoing pregnancy and miscarriage rates between women with subclinical hypothyroidism and euthyroid women. Copyright © 2016. Published by Elsevier Ltd.

  17. Abortamento na adolescência: um estudo epidemiológico Abortion and miscarriage in adolescence: an epidemiological study

    Directory of Open Access Journals (Sweden)

    Leila Maria Vieira

    2007-10-01

    Full Text Available O presente trabalho foi desenvolvido no Hospital Maternidade Santa Izabel da cidade de Bauru, São Paulo, Brasil, e teve como objetivo investigar o abortamento na adolescência e compará-lo com o das mulheres adultas. Os indicadores buscaram traçar o perfil epidemiológico das mulheres internadas, por meio de dados coletados em prontuários, entre aquelas com diagnóstico de aborto, independente da forma clínica, entre os anos de 2000 a 2003. O total de abortamentos registrados foi de 2.286, sendo 459 (20,08% na faixa etária da adolescência e a forma completa foi significativamente maior nas adolescentes quando comparada às das mulheres adultas; segundo o ano de análise, constatou-se decréscimo de ocorrência entre as adolescentes, com maior incidência em 2000 (30,50%, seguida dos anos de 2001 (25,05%, 2002 (23,53% e 2003 (20,92%, sendo que as adolescentes apresentaram tendência a permanecer dois ou mais dias hospitalizadas. Enfatiza-se a implementação de políticas e programas direcionados à saúde sexual e reprodutiva e suas co-morbidades.This study was conducted at the Santa Izabel Maternity Hospital in the town of Bauru, São Paulo State, Brazil, in order to investigate abortions and miscarriages in adolescence, comparing them to terminations among adult women. The indicators are used to draw up an epidemiological profile of hospitalized women through data collected from documents on women with diagnoses of abortion or miscarriage from 2000 to 2003, regardless of their clinical form. The total number of registered early terminations of pregnancy reached 2,286, with 459 (20.08% during adolescence, with the complete form being significantly higher among teenagers than adults; a decrease in the occurrence among adolescents was noted, dropping from 30.5% in 2000 to 25.05% in 2001, 23.53% in 2002 and 20.92% in 2003; with adolescents tending to remain in hospital for two or more days. The implementation is stressed of policies and

  18. NLRP7 or KHDC3L genes and the etiology of molar pregnancies and recurrent miscarriage

    DEFF Research Database (Denmark)

    Andreasen, L; Christiansen, O B; Niemann, I

    2013-01-01

    Women with mutation in both alleles of the NLRP7 or C6orf221/KHDC3L genes are predisposed to diploid biparental moles, but it has also been suggested that mutation in these genes can predispose to diploid androgenetic or triploid moles and to other kinds of reproductive wastage. We have investiga......Women with mutation in both alleles of the NLRP7 or C6orf221/KHDC3L genes are predisposed to diploid biparental moles, but it has also been suggested that mutation in these genes can predispose to diploid androgenetic or triploid moles and to other kinds of reproductive wastage. We have...... investigated the association between molar pregnancy and recurrent miscarriages regarding changes in the NLRP7 and C6orf221/KHDC3L genes. Our study group can be divided into three sub-cohorts: (i) women having had at least one molar pregnancy and at least two non-mole miscarriages, (ii) women having had...... that indubitably have a pathogenic effect on the affected woman) in NLRP7 or C6orf221/KHDC3L in any of the women in the study group. This indicates that recurrent miscarriages plus hydatidiform mole, recurrent androgenetic hydatidiform moles and familial androgenetic hydatidiform moles in general do not have...

  19. Spontaneous acute tumor lysis syndrome as a cause of early deaths in short-term carcinogenicity studies using p53 +/- mice.

    Science.gov (United States)

    Vogel, P; Pletcher, J M; Liang, Y

    2010-07-01

    Acute tumor lysis syndrome (ATLS) is a potentially lethal condition precipitated by the massive release of intracellular components such as nucleic acids, potassium, and phosphorus, following a rapid and widespread lysis of tumor cells. Herein, the authors describe the high incidence and characteristic histopathologic lesions of acute ATLS in p53-deficient mice used in 2 short-term carcinogenicity studies. ATLS was a frequent cause of early death in p53 (+/-) mice in these studies and was consistently associated with the presence of disseminated lymphoma and leukemia. Although a heavy tumor burden and leukemia were present in all affected mice, the absence of ATLS in other mice with equally severe lymphoma and leukemia indicates that these tumor burdens are necessary but insufficient to cause ATLS in mice. The hallmark histopathologic findings of ATLS in mice are the disseminated microemboli composed of nuclear and cytoplasmic debris derived from lysed tumor cells. The mechanical obstruction of capillary beds by these microemboli appeared to be the proximate cause of the early deaths of mice in these studies. Microemboli may contribute to the pathogenesis of acute renal failure and other clinical signs associated with ATLS in other species. Recognition of ATLS in laboratory animals is critical in studies intended to evaluate the efficacy and/or toxicity of anticancer treatments, where early deaths due to ATLS might otherwise be attributed to test article toxicity. Further studies on the role of microemboli in the pathogenesis of ATLS may elucidate pathogenetic mechanisms and lead to improved approaches to clinical management and treatment of this potentially lethal condition.

  20. The maternal immune response to fetal platelet GPIbα causes frequent miscarriage in mice that can be prevented by intravenous IgG and anti-FcRn therapies.

    Science.gov (United States)

    Li, Conglei; Piran, Siavash; Chen, Pingguo; Lang, Sean; Zarpellon, Alessandro; Jin, Joseph W; Zhu, Guangheng; Reheman, Adili; van der Wal, Dianne E; Simpson, Elisa K; Ni, Ran; Gross, Peter L; Ware, Jerry; Ruggeri, Zaverio M; Freedman, John; Ni, Heyu

    2011-11-01

    Fetal and neonatal immune thrombocytopenia (FNIT) is a severe bleeding disorder caused by maternal antibody-mediated destruction of fetal/neonatal platelets. It is the most common cause of severe thrombocytopenia in neonates, but the frequency of FNIT-related miscarriage is unknown, and the mechanism(s) underlying fetal mortality have not been explored. Furthermore, although platelet αIIbβ3 integrin and GPIbα are the major antibody targets in immune thrombocytopenia, the reported incidence of anti-GPIbα-mediated FNIT is rare. Here, we developed mouse models of FNIT mediated by antibodies specific for GPIbα and β3 integrin and compared their pathogenesis. We found, unexpectedly, that miscarriage occurred in the majority of pregnancies in our model of anti-GPIbα-mediated FNIT, which was far more frequent than in anti-β3-mediated FNIT. Dams with anti-GPIbα antibodies exhibited extensive fibrin deposition and apoptosis/necrosis in their placentas, which severely impaired placental function. Furthermore, anti-GPIbα (but not anti-β3) antiserum activated platelets and enhanced fibrin formation in vitro and thrombus formation in vivo. Importantly, treatment with either intravenous IgG or a monoclonal antibody specific for the neonatal Fc receptor efficiently prevented anti-GPIbα-mediated FNIT. Thus, the maternal immune response to fetal GPIbα causes what we believe to be a previously unidentified, nonclassical FNIT (i.e., spontaneous miscarriage but not neonatal bleeding) in mice. These results suggest that a similar pathology may have masked the severity and frequency of human anti-GPIbα-mediated FNIT, but also point to possible therapeutic interventions.

  1. Relationship between Helicobacter pylori infection and spontaneous abortion

    Directory of Open Access Journals (Sweden)

    Sariyeh Golmahammadlou

    2015-07-01

    Conclusion: According to the result of this study there was not any association between HP infection and miscarriage. We recommend more studies with larger sample size for determining the effect of CagA positive strains on miscarriage.

  2. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  3. Controlling spontaneous emission

    DEFF Research Database (Denmark)

    Lodahl, Peter

    Control over spontaneous emission of light is of great importance in quantum optics. It is essential for diverse applications such as miniature lasers, light-emitting diodes, and single-photon sources for quantum information. We present experimental studies on spontaneous emission of CdSe quantum...

  4. Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta.

    Science.gov (United States)

    Guenot, Cécile; Robyr, Romaine; Jastrow, Nicole; Vial, Yvan; Raio, Luigi; Baud, David

    2016-04-01

    Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks' gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable.

  5. Neonatal mucolipidosis 2. The spontaneous evolution of early bone lesions and the effect of vitamin D treatment. Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Pazzaglia, U.E.; Zatti, G. (Pavia Univ. (Italy). Clinica Ortopedica); Beluffi, G. (Policlinico San Matteo, Pavia (Italy). Servizio di Radiodiagnostica); Danesino, C. (Sassari Univ. (Italy). Cattedra di Genetica Umana); Frediani, P.V. (Ospedale dei Bambini Umberto I, Brescia (Italy)); Pagani, G. (Ospedale Santa Anna, Como (Italy). Div. di Patologia Neonatale)

    1989-11-01

    Evolution of the early bone lesions in two children with mucolipidosis 2 was followed from birth. The progression of the bone changes did not differ from healing of rickets. Low levels of 1,25-OH{sub 2}-D3 were found in one child and he was treated with vitamin D; resolution of the rachitic changes was more rapid than in the untreated child. It is suggested that in mucolipidosis 2 bone reacts to two independent factors, one controlling calcium metabolism, the other depending on the primary lysosomal enzyme defect. Since ricket-like features are not present in the other mucolipidoses or mucopolysaccharidoses, the defect of calcium metabolism seems to be related to the specific enzyme defect of mucolipidosis 2. (orig.).

  6. Miscarriage with a History of Elective Abortion: A Comparison Study of the Miscarriage Experience - Women with a History of Elective Abortion Versus Women Without a History of Elective Abortion

    Science.gov (United States)

    1990-01-01

    Recent studies have begun to recognize the impact that this early pregnancy loss, medically known as spontaneous abortion , can have on a woman’s life ...Code) 10. SOURCE OF FUNDING NUMBERS PROGRAM PROJECT TASK WORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification...Instrument 22 Human Subjects Protection 23 Data Analysis 23 Chapter 4: Findings 24 Characteristics of Sample 24 Comparison of Scores 26 Chapter 5

  7. Increased C4d and Bb immunoreactivity and decreased MBL immunoreactivity characterise first-time pathologic first-trimester miscarriage: a case-control study.

    Science.gov (United States)

    Canda, M Tunc; Caglayan, Latife Doganay; Demir, Namik; Ortaç, Ragıp

    2018-01-01

    The role of the complement system in first-time pathologic first-trimester miscarriage was investigated. In this case-control study, tissue samples of 126 women with pathologic miscarriage and termination of normal pregnancies were assessed. The pathologic pregnancy group consisted of 40 women with missed miscarriage, 13 women with incomplete miscarriage and 10 women with a blighted ovum. The control group consisted of 63 normal-appearing pregnancies. Immunoreactivity for C4d, Bb and MBL was evaluated in the deciduas and villous trophoblasts separately using a semi-quantitative histological scoring system (H-score). C4d and Bb H-scores were higher and MBL H-score was reduced in the deciduas and villous tissues from pathologic miscarriage compared to termination of pregnancies (p = .003 and p = .001; p = .011 and p < .001; p < .001 and p < .001, respectively). C4d and Bb activities were increased and MBL activity was decreased in human first-time pathologic first-trimester miscarriage. We suggest that three complement pathways may play a role in human first-time pathologic first-trimester miscarriage. Impact statement Previous studies focussed on complement proteins related to a single complement pathway in cases often associated with antiphospholipid syndrome (APS) or recurrent miscarriage. In APS-related cases, the classical pathway is activated. In antibody-dependent and in antibody-independent mouse models of foetal loss, classical and alternative pathways are activated, respectively. Lectin pathway deficiency has been reported in some recurrent miscarriage. The complement pathway or pathways, which have a role in human pathologic miscarriage was the starting point of this study. There has been no study done till now reporting the role of the three complement pathways in human pathologic miscarriage. In this study, we found increased classical and alternative complement pathway activities and decreased lectin pathway activity in tissues

  8. Processing Demands Impact 3-Year-Olds’ Performance in a Spontaneous-Response Task: New Evidence for the Processing-Load Account of Early False-Belief Understanding

    Science.gov (United States)

    Scott, Rose M.; Roby, Erin

    2015-01-01

    Prior to age four, children succeed in non-elicited-response false-belief tasks but fail elicited-response false-belief tasks. To explain this discrepancy, the processing-load account argues that the capacity to represent beliefs emerges in infancy, as indicated by early success on non-elicited-response tasks, but that children’s ability to demonstrate this capacity depends on the processing demands of the task and children’s processing skills. When processing demands exceed young children’s processing abilities, such as in standard elicited-response tasks, children fail despite their capacity to represent beliefs. Support for this account comes from recent evidence that reducing processing demands improves young children’s performance: when demands are sufficiently reduced, 2.5-year-olds succeed in elicited-response tasks. Here we sought complementary evidence for the processing-load account by examining whether increasing processing demands impeded children’s performance in a non-elicited-response task. 3-year-olds were tested in a preferential-looking task in which they heard a change-of-location false-belief story accompanied by a picture book; across children, we manipulated the amount of linguistic ambiguity in the story. The final page of the book showed two images: one that was consistent with the main character’s false belief and one that was consistent with reality. When the story was relatively unambiguous, children looked reliably longer at the false-belief-consistent image, successfully demonstrating their false-belief understanding. When the story was ambiguous, however, this undermined children’s performance: looking times to the belief-consistent image were correlated with verbal ability, and only children with verbal skills in the upper quartile of the sample demonstrated a significant preference for the belief-consistent image. These results support the processing-load account by demonstrating that regardless of whether a task

  9. Processing Demands Impact 3-Year-Olds' Performance in a Spontaneous-Response Task: New Evidence for the Processing-Load Account of Early False-Belief Understanding.

    Science.gov (United States)

    Scott, Rose M; Roby, Erin

    2015-01-01

    Prior to age four, children succeed in non-elicited-response false-belief tasks but fail elicited-response false-belief tasks. To explain this discrepancy, the processing-load account argues that the capacity to represent beliefs emerges in infancy, as indicated by early success on non-elicited-response tasks, but that children's ability to demonstrate this capacity depends on the processing demands of the task and children's processing skills. When processing demands exceed young children's processing abilities, such as in standard elicited-response tasks, children fail despite their capacity to represent beliefs. Support for this account comes from recent evidence that reducing processing demands improves young children's performance: when demands are sufficiently reduced, 2.5-year-olds succeed in elicited-response tasks. Here we sought complementary evidence for the processing-load account by examining whether increasing processing demands impeded children's performance in a non-elicited-response task. 3-year-olds were tested in a preferential-looking task in which they heard a change-of-location false-belief story accompanied by a picture book; across children, we manipulated the amount of linguistic ambiguity in the story. The final page of the book showed two images: one that was consistent with the main character's false belief and one that was consistent with reality. When the story was relatively unambiguous, children looked reliably longer at the false-belief-consistent image, successfully demonstrating their false-belief understanding. When the story was ambiguous, however, this undermined children's performance: looking times to the belief-consistent image were correlated with verbal ability, and only children with verbal skills in the upper quartile of the sample demonstrated a significant preference for the belief-consistent image. These results support the processing-load account by demonstrating that regardless of whether a task involves an elicited

  10. The effect of early life experience, environment, and genetic factors on spontaneous home-cage aggression-related wounding in male C57BL/6 mice.

    Science.gov (United States)

    Gaskill, Brianna N; Stottler, Aurora M; Garner, Joseph P; Winnicker, Christina W; Mulder, Guy B; Pritchett-Corning, Kathleen R

    2017-03-22

    Aggression is a major welfare issue in mice, particularly when mice unfamiliar to each other are first placed in cages, as happens on receipt from a vendor, and following cage cleaning. Injuries from aggression are the second leading cause of unplanned euthanasia in mice, following ulcerative dermatitis. Commonly employed strategies for reducing aggression-related injury are largely anecdotal, and may even be counterproductive. Here we report a series of experiments testing potential explanations and interventions for post-shipping aggression-related injuries in C57BL/6 mice. First, we examined the effects of weaning: testing whether manipulating weaning age reduced aggression-related injuries, and if repeated mixing of weaned mice before shipping increased these injuries. Contrary to our predictions, repeated mixing did not increase post-shipping injurious aggression, and early weaning reduced aggression-related injuries. Second, we examined potential post-shipping interventions: testing whether lavender essential oil applied to the cage reduced aggression-related injuries, and whether a variety of enrichments decreased injurious aggression. Again, contrary to predictions, lavender increased wounding, and none of the enrichments reduced it. However, consistent with the effects of weaning age in the first experiment, cages with higher mean body weight showed elevated levels of aggression-related wounding. Finally, we tested whether C57BL/6 substrains and identification methods affected levels of intra-cage wounding from aggression. We found no effect of strain, but cages where mice were ear-notched for identification showed higher levels of wounding than cages where mice were tail-tattooed. Overall, these results emphasize the multifactorial nature of home-cage injurious aggression, and the importance of testing received wisdom when it comes to managing complex behavioral and welfare problems. In terms of practical recommendations to reduce aggressive wounding in

  11. Spontaneous Resolution of Massive Spontaneous Tubercular Pneumothorax

    Science.gov (United States)

    Kant, Surya; Saheer, S.; Hassan, G.; Parengal, Jabeed

    2011-01-01

    A 29-year-old female presented with complaints of fever and productive cough of three weeks duration. Pulmonary tuberculosis was diagnosed bacteriologically and she was prescribed antituberculosis drugs. During follow-up she developed massive pneumothorax, for which patient refused surgical management and was managed conservatively. After six months there was complete spontaneous resolution of pneumothorax. The unusual presentation and unexpected outcome prompted us to report this case. PMID:22937428

  12. Spontaneous fertility and in vitro fertilization outcome: new evidence of human papillomavirus sperm infection.

    Science.gov (United States)

    Garolla, Andrea; Engl, Bruno; Pizzol, Damiano; Ghezzi, Marco; Bertoldo, Alessandro; Bottacin, Alberto; Noventa, Marco; Foresta, Carlo

    2016-01-01

    To evaluate the reproductive outcome of infertile couples undergoing assisted reproduction techniques (ART) with or without human papillomavirus (HPV) semen infection. Cross-sectional clinical study. Units of andrology, reproductive medicine, and gynecology. A total of 226 infertile couples. Male partners were evaluated by means of fluorescence in situ hybridization (FISH) for HPV on semen. After a diagnostic period, female partners underwent intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI). Seminal parameters and FISH analysis for HPV in sperm head. Spontaneous or assisted pregnancies, live births, and miscarriages were recorded. Statistical analysis included unpaired Student t test and chi-square test. Fifty-four male partners (23.9%) had HPV semen infection confined to sperm, confined to exfoliated cells, or in both cells. During the diagnostic period, noninfected couples showed spontaneous pregnancies. IUI and ICSI treatments were performed in, respectively, 60 and 98 noninfected and in 21 and 33 infected couples, with 38.4% and 14.2% cumulative pregnancy rates, respectively. The follow-up of pregnancies showed a higher miscarriage rate in infected couples (62.5% vs. 16.7%). Ongoing pregnancies of the latter group were characterized by HPV infection confined to exfoliated cells. A reduction in natural and assisted cumulative pregnancy rate and an increase in miscarriage rate are related to the presence of HPV at sperm level. Although the exact mechanism by which sperm infection is able to impair fertility remains unclear, this aspect is worthy of further investigations. If confirmed, these results could change the clinical and diagnostic approach to infertile couples. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Metroplasty for AFS Class V and VI septate uterus in patients with infertility or miscarriage: reproductive outcomes study.

    Science.gov (United States)

    Bendifallah, Sofiane; Faivre, Erika; Legendre, Guillaume; Deffieux, Xavier; Fernandez, Hervé

    2013-01-01

    To assess reproductive outcomes in patients after surgical correction of septate uterus. Observational retrospective study (Canadian Task Force classification II-2). Two university hospitals. One hundred twenty-eight patients with primary infertility or recurrent miscarriage with partial (American Fertility Society [AFS] class Va), complete (AFS class Vb), or fundic (AFS class VI) septate uterus. Metroplasty is the current method of choice for surgically correcting septate uterus. The procedure and its indications are a matter of debate. Metroplasty via hysteroscopy. Outcomes including the numbers of pregnancies, first live births (FLBs), and miscarriages were determined. After metroplasty, 78 women (60.9%) became pregnant, and 70 live neonates were delivered. The FLB rate in infertile women was 53.1%. Of the 25 pregnancies, 13 (52%) resulted from assisted reproductive technology. In women who experienced recurrent miscarriage, the miscarriage rate was significantly improved. Outcomes (miscarriages and FLBs) differed significantly according to anatomical type of septum after surgery. Hysteroscopic septum resection is accompanied by safe improvement in reproductive performance in patients with symptoms of AFS class V/VI septate uterus. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  14. Spontaneous rupture of pyometra

    National Research Council Canada - National Science Library

    Mallah, Fatemeh; Eftekhar, Tahere; Naghavi-Behzad, Mohammad

    2013-01-01

    Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen...

  15. Motion under graviditeten og risikoen for spontan abort--sekundaerpublikation

    DEFF Research Database (Denmark)

    Madsen, Mia; Jørgensen, Tina; Jensen, Mette Lundsby

    2008-01-01

    We investigated the association between exercise during pregnancy and risk of miscarriage among more than 90,000 pregnant women. Information on exposures was obtained by means of computer-assisted telephone interviews. A relation was found between the amount of exercise and the risk of miscarriage...... with the risk of miscarriage rising stepwise by the amount of exercise performed. Particularly "high impact exercise" was associated with an increased risk of miscarriage. No association was seen between exercise and risk of miscarriage after 18 weeks of gestation. Udgivelsesdato: 2008-Sep-1...

  16. Motion under graviditeten og risikoen for spontan abort

    DEFF Research Database (Denmark)

    Madsen, Mia; Jørgensen, Tina; Jensen, Mette Lundsby

    2008-01-01

    We investigated the association between exercise during pregnancy and risk of miscarriage among more than 90,000 pregnant women. Information on exposures was obtained by means of computer-assisted telephone interviews. A relation was found between the amount of exercise and the risk of miscarriage...... with the risk of miscarriage rising stepwise by the amount of exercise performed. Particularly "high impact exercise" was associated with an increased risk of miscarriage. No association was seen between exercise and risk of miscarriage after 18 weeks of gestation....

  17. Comparaing the causes of abortion in patients with two or more than two consecutive miscarriages

    Directory of Open Access Journals (Sweden)

    Azam Azargoon MD. A

    2011-07-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Recurrent miscarriage is defined as the loss of three or more pregnancies. Recurrent Pregnancy Loss (RPL is traditionally investigated after three or more consecutive losses. Although some believe that the investigation must be launched after two miscarriages, there is not enough compelling evidence to draw conclusion. "n"nMethods : In this cross-sectional study, we studied 58 women with two or more consecutive abortions (37 women with two and 21 women with three or more miscarriages from 2005 to 2009. The following risk factors were analyzed and compared between the two groups: endocrine dysfunctions, genetic abnormalities, uterine anomalies, infections, thrombophilia, polycystic ovary syndrome, autoimmune disorders, sperm characteristics, and advanced maternal age."n"nResults : We did not find any known factor for pregnancy losses in 18 (31.03% patients but in the rest, the most common cause of Recurrent pregnancy loss was endocrine disorders (41.4%. The other causes were uterine abnormalities (12.1%, infections (12.1%, maternal age more than 35 years (12.1%, thrombophilia (8.6%, abnormal semen analysis (8.6%, genetic defects (6.9% and autoimmune disorders (1.7%. There were no significant differences between the two groups in regards with the causes of abortion except uterine abnormality (P=0.039 which was more frequent in women with three or more three miscarriages (23.8% relative to women with two abortions (5.4%."n"nConclusion: There were no significant differences between women

  18. Association between Perfluorinated Compound Exposure and Miscarriage in Danish Pregnant Women

    DEFF Research Database (Denmark)

    Jensen, Tina Kold; Andersen, Louise Bjørkholt; Kyhl, Henriette Boye

    2015-01-01

    Perfluorinated alkylated substances (PFAS) have been extensively used in consumer products and humans are widely exposed to these persistent compounds. A recent study found no association between exposure to perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) and miscarriage.......60-8.60), respectively. The association with perfluorohexane sulfonic acid (PFHxS) was in the same direction, but not statistically significant, while no association was found with PFOA and PFOS. Our findings require confirmation due to the possible public health importance, given that all pregnant women are exposed...

  19. Sera of patients with recurrent miscarriages containing anti-trophoblast antibodies (ATAB) reduce hCG and progesterone production in trophoblast cells in vitro.

    Science.gov (United States)

    von Schönfeldt, Viktoria; Rogenhofer, Nina; Ruf, Katharina; Thaler, Christian J; Jeschke, Udo

    2016-09-01

    Reproductive failure including RM has been suggested to correlate with antibodies that cross react with HLA-negative syncytiotrophoblasts and we have reported that 17% of women with 2 or more miscarriages and 34% of women with 3 or more miscarriages express anti-trophoblast antibodies (ATAB). Until now, the mechanism, how ATAB interfere with pregnancy success is not known. HCG and progesterone both play fundamental roles in supporting human pregnancy. Therefore we investigated the effects of sera of RM patients containing ATAB on the hCG and progesterone production of cells of the choriocarcinoma cell line JEG-3. In vitro study to investigate effects of patient sera with and without ATAB on hCG and progesterone secretion of JEG-3 cells. The presence of ATAB was detected as described earlier. Effects of sera from ATAB positive and ATAB negative RM patients on hCG and progesterone secretion by JEG-3 cells were analysed 12 and 24h after plating. Sera of women without pregnancy pathologies served as controls. Sera of ATAB-positive RM patients significantly inhibit hCG secretion of JEG-3 cells for 12h after plating compared to sera of healthy controls (p=0.019) and significantly reduce progesterone production for 12h (p=0.046) and 24h (p=0.027) of co-culture. Sera of ATAB-negative RM patient show no significant effect on progesterone secretion. Inhibition of hCG and progesterone production might point to a mechanism, how ATAB interfere with early pregnancies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Spontaneous symmetry breaking in gauge theories.

    Science.gov (United States)

    Kibble, T W B

    2015-01-13

    The aim of this historical article is to describe the development of the idea of spontaneous symmetry breaking in gauge theories as seen from my perspective as a member of Abdus Salam's group at Imperial College London, UK. Beginning with an account of particle physics in the years after the Second World War, I describe early attempts at constructing a unified theory of weak and electromagnetic interactions, the obstacles encountered and how they were eventually overcome with the mass-generating mechanism incorporating the idea of spontaneous symmetry breaking, one of whose features is the now-famous Higgs boson.

  1. Spontaneous subdural hematoma associated to Duret hemorrhage

    Directory of Open Access Journals (Sweden)

    William Alves Martins, MD

    2015-03-01

    Full Text Available Subdural hematoma (SH is a neurosurgical emergency, usually caused by head trauma. Non-traumatic causes include aneurysm or arterial–venous malformation rupture, coagulopathy and others. We report the case of a 66 year-old man who developed apparently unprovoked signs of increased intracranial pressure. Brain computed tomography scan showed an acute spontaneous SH, surgically treated. Throughout surgery, a ruptured cortical artery with intensive bleeding appeared and was cauterized. After surgery, patient remained comatose and a new CT demonstrated Duret hemorrhage at the brainstem. Acute spontaneous SH of arterial origin is rare and highly lethal, in which a good prognosis relies on early diagnosis and treatment.

  2. ALIFE2 study: low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia - study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Jong, P.G. de; Quenby, S.; Bloemenkamp, K.W.; Braams-Lisman, B.A.; Bruin, J.P. de; Coomarasamy, A.; David, M.; DeSancho, M.T.; Heijden, O.W.H. van der; Hoek, A.; Hutten, B.A.; Jochmans, K.; Koks, C.A.; Kuchenbecker, W.; Mol, B.W.; Torrance, H.L.; Scheepers, H.C.; Stephenson, M.D.; Verhoeve, H.R.; Visser, J.; Vries, J.I. de; Goddijn, M.; Middeldorp, S.

    2015-01-01

    BACKGROUND: A large number of studies have shown an association between inherited thrombophilia and recurrent miscarriage. It has been hypothesized that anticoagulant therapy might reduce the number of miscarriages and stillbirth in these women. In the absence of randomized controlled trials

  3. ALIFE2 study: : low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia - study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Jong, Paulien G.; Quenby, Siobhan; Bloemenkamp, Kitty W. M.; Braams-Lisman, Babette A. M.; de Bruin, Jan Peter; Coomarasamy, Arri; David, Michele; DeSancho, Maria T.; van der Heijden, Olivier W. H.; Hoek, Annemieke; Hutten, Barbara A.; Jochmans, Kristin; Koks, Carolien A. M.; Kuchenbecker, Walter K. H.; Mol, Ben Willem J.; Torrance, Helen L.; Scheepers, Hubertina C. J.; Stephenson, Mary D.; Verhoeve, Harold R.; Visser, Jantien; de Vries, Johanna I. P.; Goddijn, Mariette; Middeldorp, Saskia

    2015-01-01

    Background: A large number of studies have shown an association between inherited thrombophilia and recurrent miscarriage. It has been hypothesized that anticoagulant therapy might reduce the number of miscarriages and stillbirth in these women. In the absence of randomized controlled trials

  4. ALIFE2 study: low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia--study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Jong, Paulien G.; Quenby, Siobhan; Bloemenkamp, Kitty W. M.; Braams-Lisman, Babette A. M.; de Bruin, Jan Peter; Coomarasamy, Arri; David, Michele; DeSancho, Maria T.; van der Heijden, Olivier W. H.; Hoek, Annemieke; Hutten, Barbara A.; Jochmans, Kristin; Koks, Carolien A. M.; Kuchenbecker, Walter K. M.; Mol, Ben Willem J.; Torrance, Helen L.; Scheepers, Hubertina C. J.; Stephenson, Mary D.; Verhoeve, Harold R.; Visser, Jantien; de Vries, Johanna I. P.; Goddijn, Mariëtte; Middeldorp, Saskia

    2015-01-01

    A large number of studies have shown an association between inherited thrombophilia and recurrent miscarriage. It has been hypothesized that anticoagulant therapy might reduce the number of miscarriages and stillbirth in these women. In the absence of randomized controlled trials evaluating the

  5. [The practice guideline 'Miscarriage' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Lagro-Janssen, A.L.M.

    2005-01-01

    The practice guideline 'Miscarriage' has been reviewed for the second time in fifteen years. It provides the practitioner with distinct diagnostic tools for vaginal bleeding in the first sixteen weeks of pregnancy and a clear management algorithm. The management of miscarriage is based on a joint

  6. Chromosomal abnormalities in spontaneous abortion after assisted reproductive treatment

    Directory of Open Access Journals (Sweden)

    Kim You

    2010-11-01

    Full Text Available Abstract Background We evaluated cytogenetic results occurring with first trimester pregnancy loss, and assessed the type and frequency of chromosomal abnormalities after assisted reproductive treatment (ART and compared them with a control group. We also compared the rate of chromosomal abnormalities according to infertility causes in ICSI group. Methods A retrospective cohort analysis was made of all patients who were referred to the Genetics Laboratory of Fertility Center of CHA Gangnam Medical Center from 2005 to 2009 because of clinical abortion with a subsequent dilation and evacuation (D&E performed, and patients were grouped by type of conception as follows: conventional IVF (in vitro fertilization (n = 114, ICSI (intracytoplasmic sperm injection (n = 140, and control (natural conception or intrauterine insemination [IUI] (n = 128. Statistical analysis was performed using SPSS software. Results A total 406 specimens were referred to laboratory, ten abortuses were excluded, and in 14 cases, we did not get any spontaneous metaphase, chromosomal constitutions of 382 specimens were successfully obtained with conventional cytogenetic methods. Overall, 52.62% of the miscarriages were found to be cytogenetically abnormal among all patients, the frequency was 48.4% in the control group, 54.3% of miscarriages after ICSI and 55.3% after conventional IVF (p = 0.503. The most prevalent abnormalities were autosomal trisomy, however, nine (11.69% sex chromosome aneuploidy were noted in the ICSI group vs. four (6.45% and two (3.23% cases in the conventional IVF group and control group. We compared chromosomal abnormalities of miscarriages after ICSI according to infertility factor. 55.71% underwent ICSI due to male factors, 44.29% due to non-male factors. ICSI group having male factors showed significantly higher risk of chromosomal abnormalities than ICSI group having non-male factors (65.8% vs. 34.2%, p = 0.009, odds ratio = 1.529, 95% CI = 1

  7. The loss of self: The effect of miscarriage, stillbirth, and child death on maternal self-esteem.

    Science.gov (United States)

    Wonch Hill, Patricia; Cacciatore, Joanne; Shreffler, Karina M; Pritchard, Kayla M

    2017-04-01

    A child's death augments how grieving parents view the world, the family, and the self. Using a representative sample of women ages 25-45 who have ever given birth, we assessed whether miscarriage, stillbirth, and child death impact self-esteem and whether this loss is moderated by maternal identity. We found that stillbirth and child death, but not miscarriage, negatively impacted self-esteem. For those who experienced a loss, the impact on self-esteem was moderated by maternal identity. Women who experienced a stillbirth were the only group who had significantly lower self-esteem after controlling for background characteristics and maternal identity variables.

  8. The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Witvliet, Marian D; Steffensen, Rudi

    2010-01-01

    Anti-paternal HLA-antibodies are considered a harmless phenomenon during most pregnancies, whereas their role in recurrent miscarriage (RM) patients is disputed. In contrast to primary RM, patients with secondary RM have carried a fetus to term pregnancy prior to a series of miscarriages, which....... Sera from women with secondary RM (n=56), primary RM (n=13) and parous controls (n=24) were tested for HLA-antibodies using an ELISA assay and complement dependent cytotoxicity. Samples were taken at gestational week 4-5 in 62 (90%) of the patients. HLA-antibodies were significantly more frequent...

  9. Core Outcome Sets in Miscarriage Trials (COSMisT) study: a study protocol.

    Science.gov (United States)

    Smith, Paul; Cooper, Natalie; Dhillon-Smith, Rima; O'Toole, Emily; Clark, T Justin; Coomarasamy, Arri

    2017-11-16

    'Core outcome sets' are an agreed, standardised set of outcomes based on what key stakeholders (clinicians, patients, their partners, researchers, service developers, funding organisations and so on) consider the important outcomes in the management or prevention of a condition. This paper describes the rationale and design for the development of Core Outcome Sets for Miscarriage Trials. Systematic reviews, interviews and focus groups with patients and their partners will be conducted to identify potential core outcomes that will be introduced into a modified Delphi survey. To ensure all key stakeholders are included, patients, partners, clinicians, charities and researchers will be invited to take part in the modified Delphi survey. There will be three rounds of scoring and rescoring during the Delphi survey to reach consensus regarding outcomes to be included in the core set, which will be subsequently refined through face-to-face consensus discussions. The use of core outcome sets allows results from different studies to be compared and combined, thereby reducing inconsistency and aiding interpretation of study findings. It also means research is more likely to report relevant outcomes and so can reduce reporting bias. Understanding which outcomes are important to patients has the potential to act as a driver to improve both the quality and cost-effectiveness of miscarriage services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Repeated Miscarriage

    Science.gov (United States)

    ... to the woman’s uterus to achieve a pregnancy. Pelvic Exam: A physical examination of a woman’s reproductive organs. Polycystic Ovary Syndrome: ... produced in the testes that can fertilize a female egg. Translocation: An error in chromosome structure in ...

  11. Miscarriage - threatened

    Science.gov (United States)

    ... Blood tests done may include: Beta HCG (quantitative) test (pregnancy test) over a period of days or weeks to confirm whether the pregnancy is continuing Complete blood count (CBC) to determine ...

  12. Association of HY-restricting HLA class II alleles with pregnancy outcome in patients with recurrent miscarriage subsequent to a firstborn boy

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Steffensen, Rudi; Varming, Kim

    2009-01-01

    Healthy females, pregnant with a boy, generate immune responses against male-specific minor histocompatibility (HY) antigens. The clinical importance of these responses is evident in stem cell transplantation. Birth of a boy prior to a series of miscarriages reduces the chance of a subsequent live...... birth. This study explores the putative impact of known HY-presenting HLA alleles on future pregnancy outcome in women with at least three consecutive miscarriages following a birth [secondary recurrent miscarriage (SRM)]. HLA-A, -B, -DRB1, DRB3-5 and DQB1 genotyping was performed in 358 SRM patients...... and in 203 of their children born prior to the miscarriages. The subsequent live birth in women with boys prior to the miscarriages compared with girls is lower in women with HY-restricting HLA class II alleles [odds ratio (OR): 0.17 (0.1-0.4), P = 0.0001]. One HY-restricting HLA class II allele in women...

  13. Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats.

    Science.gov (United States)

    Mencl, Stine; Garz, Cornelia; Niklass, Solveig; Braun, Holger; Göb, Eva; Homola, György; Heinze, Hans-Jochen; Reymann, Klaus G; Kleinschnitz, Christoph; Schreiber, Stefanie

    2013-01-01

    Human cerebral small vessel disease (CSVD) has distinct histopathologic and imaging findings in its advanced stages. In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood-brain barrier and an activated coagulatory state resulting in capillary and arteriolar erythrocyte accumulations (stases). In the present study, we investigated whether initial microvascular dysfunction and other stages of the pathologic CSVD cascade can be detected by serial magnetic resonance imaging (MRI). Fourteen SHRSP and three control (Wistar) rats (aged 26-44 weeks) were investigated biweekly by 3.0 Tesla (3 T) MRI. After perfusion, brains were stained with hematoxylin-eosin and histology was correlated with MRI data. Three SHRSP developed terminal CSVD stages including cortical, hippocampal, and striatal infarcts and macrohemorrhages, which could be detected consistently by MRI. Corresponding histology showed small vessel thromboses and increased numbers of small perivascular bleeds in the infarcted areas. However, 3 T MRI failed to visualize intravascular erythrocyte accumulations, even in those brain regions with the highest densities of affected vessels and the largest vessels affected by stases, as well as failing to detect small perivascular bleeds. Serial MRI at a field strength of 3 T failed to detect the initial microvascular dysfunction and subsequent small perivascular bleeds in SHRSP; only terminal stages of cerebral microangiopathy were reliably detected. Further investigations at higher magnetic field strengths (7 T) using blood- and flow-sensitive sequences are currently underway.

  14. Retrospective Methods Analysis of Semiautomated Intracerebral Hemorrhage Volume Quantification From a Selection of the STICH II Cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas).

    Science.gov (United States)

    Haley, Mark D; Gregson, Barbara A; Mould, W Andrew; Hanley, Daniel F; Mendelow, Alexander David

    2018-02-01

    The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective analysis of a selection of the STICH II cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas). From 390 patients, 739 scans were selected from the STICH II image archive based on the availability of a CT scan compatible with OsiriX DICOM viewer. ICH volumes were calculated by the reference standard semiautomatic segmentation in OsiriX software and compared with calculated arithmetic methods (ABC/2, ABC/2.4, ABC/3, and 2/3SC) volumes. Volumes were compared by difference plots for specific groups: randomization ICH (n=374), 3- to 7-day postsurgical ICH (n=206), antithrombotic-associated ICH (n=79), irregular-shape ICH (n=703) and irregular-density ICH (n=650). Density and shape were measured by the Barras ordinal shape and density groups (1-5). The ABC/2.4 method had the closest agreement to the semiautomatic segmentation volume in all groups, except for the 3- to 7-day postsurgical ICH group where the ABC/3 method was superior. Although the ABC/2 formula for calculating elliptical ICH is well validated, it must be used with caution in ICH scans where the elliptical shape of ICH is a false assumption. We validated the adjustment of the ABC/2.4 method in randomization, antithrombotic-associated, heterogeneous-density, and irregular-shape ICH. URL: http://www.isrctn.com/ISRCTN22153967. Unique identifier: ISRCTN22153967. © 2018 American Heart Association, Inc.

  15. Spontaneous Perforation of Pyometra

    Directory of Open Access Journals (Sweden)

    Begüm Yildizhan

    2006-01-01

    Full Text Available Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01–0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy. Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.

  16. Spontaneous renal artery dissection.

    Science.gov (United States)

    John, Santhosh G; Pillai, Unnikrishnan; Vaidyan, Philip B; Ishiyama, Takaaki

    2010-01-01

    Isolated spontaneous dissection of renal arteries or its branches are extremely rare. Most cases of renal artery dissection are associated with underlying pathology of the renal arteries. We report a case of spontaneous dissection of the left main renal artery and infarction of the left kidney with positive antiphospholipid antibody. Extensive work up of the patient including imaging studies confirmed the diagnosis of SRAD. Antiphospholipid antibodies may have a role in the pathogenesis of arterial dissection by causing endothelial dysfunction. This is a first literature report.

  17. Spontaneous Atraumatic Mediastinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Morkos Iskander BSc, BMBS, MRCS, PGCertMedEd

    2013-04-01

    Full Text Available Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.

  18. Spontaneous closure of muscular ventricular septal defects

    Directory of Open Access Journals (Sweden)

    Pejčić Ljiljana

    2017-01-01

    Full Text Available Introduction/Objective. Ventricular septal defect (VSD is the most frequently diagnosed congenital heart anomaly. The prognosis is usually good as it has spontaneous closure evolution, especially small muscular VSDs. The aim of this study was to determine the natural history of isolated muscular VSDs including the frequency of spontaneous closure in relation to location in the muscular septum and the age at the time of closure. Methods. The study included 96 children (52 girls and 44 boys with isolated muscular VSD diagnosed during the first month of life. We analyzed the tendency of spontaneous closure of these defects for the duration of childhood during a follow-up period of 16 years. Two-dimensional color Doppler echocardiography was performed to detect muscular VSD as a primary cardiac lesion. There was significant prevalence of small apical versus trabecular defects and their outcomes were evaluated. Results. Our study evaluated 91 children, 49 (53.8% girls and 42 (46.2% boys who did not undergo surgery. Apically located VSD was diagnosed in 68 (74.7%, while trabecular defects were found in 23 (25.3% children. Spontaneous closure occurred in 56 out of 91 cases (61.5%. The time of spontaneous closure was most commonly recorded during the first six months after birth (46.4%. The overall rate of spontaneous closure was 81.3% by the end of the first year. Apically located ventricular defects underwent spontaneous closure in the majority of patients, in comparison to trabecular ventricular defects (χ2 = 12.581; p < 0.001. Kaplan–Meier analysis demonstrated a significant difference in the average time required for spontaneous closure between the analyzed patient groups (log-rank = 9.64, p = 0.002. Conclusion. The frequency of spontaneous closure of muscular VSDs, especially apically located, is very high in the first six months, especially within the first year of life. It is advisable to detect them early on using color flow imaging and to

  19. Spontaneous Biliary Peritonitis in Children

    Directory of Open Access Journals (Sweden)

    Supreethi Kohli

    2013-01-01

    Full Text Available Pediatric Spontaneous Bile duct perforation is a rare clinical condition with only around 150 cases reported worldwide. Early management gives excellent prognosis but the condition often presents a diagnostic dilemma. Hepato-biliary Technetium-99m-iminodiacetic acid scintiscan is the diagnostic investigation of choice but its availability in third world countries is limited. We present two cases of spontaneous biliary peritonitis in children, which were diagnosed without scintiscanning. The first case was a one-and -a half-year-old child, who was diagnosed with biliary peritonitis without pneumoperitoneum by a combination of Ultrasound (USG, Contrast enhanced computed tomography (CECT, and Magnetic Resonance Imaging (MRI. The child underwent USG-guided drainage and subsequent cholecystectomy with hepatico-jejunostomy. The second child also had biliary peritonitis without pneumoperitoneum, which was initially suspected on USG. CECT revealed dilated gall bladder and fluid collection in sub-hepatic space and pelvis. Abdominal paracentesis revealed presence of bile. The child responded to conservative therapy. Both are doing well on two-year follow-up. In a patient with jaundice, biliary tract abnormalities and/or free fluid, either generalized or localized to peri-cholecystic/sub-hepatic space on USG/CT/MRI, in the absence of pneumoperitoneum, suggest a diagnosis of biliary perforation even in the absence of scintiscanning.

  20. Methodology in Aristotle's Theory of Spontaneous Generation.

    Science.gov (United States)

    Zwier, Karen R

    2017-10-10

    Aristotle's theory of spontaneous generation offers many puzzles to those who wish to understand his theory both within the context of his biology and within the context of his more general philosophy of nature. In this paper, I approach the difficult and vague elements of Aristotle's account of spontaneous generation not as weaknesses, but as opportunities for an interesting glimpse into the thought of an early scientist struggling to reconcile evidence and theory. The paper has two goals: (1) to give as charitable and full an account as possible of what Aristotle's theory of spontaneous generation was, and to examine some of its consequences; and (2) to reflect on Aristotle as a scientist, and what his comments reveal about how he approached a difficult problem. In particular, I propose that the well-recognized problem of the incompatibility between Aristotle's concept of spontaneity and his theory of spontaneous generation presents an opportunity for insight into his scientific methodology when approaching ill-understood phenomena.

  1. Spontaneous uterine rupture

    African Journals Online (AJOL)

    had had hysteroscopy and repeated curettage7, but it happened during labor and not before labor as in our case. Diagnosis of spontaneous uterine rupture during pregnancy occuring on a scarred uterus can be made by ultrasound scan in which case there can be protrusion of membranes at the site of the scar8. If possible ...

  2. Spontaneous Appendicocutaneous Fistula I

    African Journals Online (AJOL)

    M T0k0de* MB, BS and. Dr 0. A. AWOj0bi+ FMCS (Nig). ABSTRACT. Ruptured appendicitis is not a common cause of spontaneous enterocutaneous fistula. A case of ruptured retrocaecal appendicitis presenting as an enterocutaneous fistula in a Nigerian woman is presented. The literature on this disorder is also reviewed.

  3. Spontaneous Grammar Explanations.

    Science.gov (United States)

    Tjoo, Hong Sing; Lewis, Marilyn

    1998-01-01

    Describes one New Zealand university language teacher's reflection on her own grammar explanations to university-level students of Bahasa Indonesian. Examines form-focused instruction through the teacher's spontaneous answers to students' questions about the form of the language they are studying. The teacher's experiences show that it takes time…

  4. Spontaneous rib fractures.

    Science.gov (United States)

    Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber

    2015-07-01

    Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.

  5. [Spontaneous bacterial peritonitis].

    Science.gov (United States)

    Velkey, Bálint; Vitális, Eszter; Vitális, Zsuzsanna

    2017-01-01

    Spontaneous bacterial peritonitis occurs most commonly in cirrhotic patients with ascites. Pathogens get into the circulation by intestinal translocation and colonize in peritoneal fluid. Diagnosis of spontaneous bacterial peritonitis is based on elevated polymorphonuclear leukocyte count in the ascites (>0,25 G/L). Ascites culture is often negative but aids to get information about antibiotic sensitivity in positive cases. Treatment in stable patient can be intravenous then orally administrated ciprofloxacin or amoxicillin/clavulanic acid, while in severe cases intravenous III. generation cephalosporin. Nosocomial spontaneous bacterial peritonitis often caused by Gram-positive bacteria and multi-resistant pathogens can also be expected thus carbapenem should be the choice of the empiric treatment. Antibiotic prophylaxis should be considered. Norfloxacin is used most commonly, but changes are expected due to increase in quinolone resistance. As a primary prophylaxis, a short-term antibiotic treatment is recommended after gastrointestinal bleeding for 5 days, while long-term prophylaxis is for patients with low ascites protein, and advanced disease (400 mg/day). Secondary prophylaxis is recommended for all patients recovered from spontaneous bacterial peritonitis. Due to increasing antibiotic use of antibiotics prophylaxis is debated to some degree. Orv. Hetil., 2017, 158(2), 50-57.

  6. Knowledge and perceived risks in couples undergoing genetic testing after recurrent miscarriage or for poor semen quality

    NARCIS (Netherlands)

    Vansenne, F.; Goddijn, M.; Redeker, B.; Snijder, S.; Gerssen-Schoorl, K.; Lemmink, H.; Leschot, N. J.; van der Veen, F.; Bossuyt, P. M. M.; de Borgie, C. A. J. M.

    2011-01-01

    Couples with recurrent miscarriage (RM) and men with poor semen quality may undergo genetic testing as part of the diagnostic work-up. This study explored their knowledge and perception of genetic testing, evaluated psychological wellbeing and identified associated variables. A prospective

  7. Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Madsen, M; Jørgensen, T; Jensen, M L

    2007-01-01

    OBJECTIVE: To examine the association between leisure time physical exercise during pregnancy and the risk of miscarriage. DESIGN: Prospective study with elements of retrospective data collection. SETTING: Denmark 1996-2002. POPULATION: A total of 92,671 pregnant women enrolled in the Danish...

  8. Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort

    DEFF Research Database (Denmark)

    Andersen, Louise B; Jørgensen, Jan S; Jensen, Tina K

    2015-01-01

    BACKGROUND: Miscarriage is the most common negative outcome of pregnancy, and identification of modifiable risk factors is potentially of great importance for public health. Low vitamin D concentrations in pregnancy are widespread worldwide, and vitamin D deficiency is implicated in immune cell r...

  9. Intimate Partner Violence and Miscarriage: Examination of the Role of Physical and Psychological Abuse and Posttraumatic Stress Disorder

    Science.gov (United States)

    Morland, Leslie A.; Leskin, Gregory A.; Block, Carolyn Rebecca; Campbell, Jacquelyn C.; Friedman, Matthew J.

    2008-01-01

    Despite research documenting high rates of violence during pregnancy, few studies have examined the impact of physical abuse, psychological abuse, and posttraumatic stress disorder (PTSD) on miscarriage. Secondary analysis of data collected by the Chicago Women's Health Risk Study permitted an exploration of the relationships among physical abuse,…

  10. A modest but significant effect of CGB5 gene promoter polymorphisms in modulating the risk of recurrent miscarriage

    DEFF Research Database (Denmark)

    Rull, Kristiina; Christiansen, Ole Bjarne; Nagirnaja, Liina

    2013-01-01

    To confirm the effect of single nucleotide polymorphisms (SNPs) in chorionic gonadotropin beta (CGB) genes in modulating the susceptibility to recurrent miscarriage (RM) in Danes and in a meta-analysis across Danes and the discovery samples from Estonia and Finland....

  11. Lack of Association between Angiotensin Converting Enzyme I/D Polymorphism and Unexplained Recurrent Miscarriage in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Mukaynizi Fatimah Basil

    2016-04-01

    Full Text Available Background: An insertion/deletion (I/D polymorphism in the angiotensin converting enzyme (ACE gene has been associated with recurrent miscarriage (RM in several populations. We initiated this study to determine the association, if any, between the I/D polymorphism of ACE gene and RM in Saudi females.

  12. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study)

    NARCIS (Netherlands)

    Vissenberg, R.; van Dijk, M. M.; Fliers, E.; van der Post, J. A. M.; van Wely, M.; Bloemenkamp, K. W. M.; Hoek, A.; Kuchenbecker, W. K.; Verhoeve, H. R.; Scheepers, H. C. J.; Rombout-de Weerd, S.; Koks, C.; Zwart, J. J.; Broekmans, F.; Verpoest, W.; Christiansen, O. B.; Post, M.; Papatsonis, D. N. M.; Verberg, M. F. G.; Sikkema, J.; Mol, B. W.; Bisschop, P. H.; Goddijn, M.

    Background: Thyroid peroxidase antibodies (TPO-Ab) in euthyroid women are associated with recurrent miscarriage (RM) and other pregnancy complications such as preterm birth. It is unclear if treatment with levothyroxine improves pregnancy outcome. Aim: The aim of this study is to determine the

  13. Misoprostol for miscarriage management in a woman with previous five cesarean deliveries: a case report and literature review

    Directory of Open Access Journals (Sweden)

    AlSaad D

    2017-05-01

    Full Text Available Doua AlSaad,1,2 Sawsan Alobaidly,3 Palli Abdulrouf,1 Binny Thomas,4,5 Afif Ahmed,1 Moza AlHail1 1Department of Pharmacy, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar; 2Public Health Program, London School of Hygiene and Tropical Medicine, University of London, UK; 3Department of Obstetrics and Gynecology, Women’s Hospital, 4Clinical Support Service Unit, Hamad Medical Corporation, Doha, Qatar; 5Pharmacy and Life Sciences Research Institute, Robert Gordon University, Aberdeen, Scotland Background: Misoprostol is an effective medical method for the management of pregnancy loss. However, data on its efficacy and safety in women with previous cesarean deliveries are limited.Case presentation: We report a 36-year-old patient, gravida 11 para 6, with a diagnosis of missed miscarriage at 15 weeks of gestation. The patient had a significant obstetric history of previous five cesarean deliveries and uterine rupture. Following patient counseling about the medical and surgical options of managing her miscarriage, the patient opted for medical method. Low-dose misoprostol of 100 µg was inserted vaginally and repeated again after 6 hours. The patient had an uneventful complete miscarriage following the second dose of misoprostol. No uterine rupture, no extra vaginal bleeding, and no blood transfusion were observed.Conclusion: We conclude that adopting a low-dose misoprostol protocol could be potentially safe and effective in managing second trimester missed miscarriage in women with repeated cesarean deliveries and/or uterine rupture history. Further studies are needed to confirm these results. Keywords: cesarean section, uterine rupture, prostaglandin E1, misoprostol, second trimester, miscarriage, abortion

  14. Preimplantation Genetic Screening: An Effective Testing for Infertile and Repeated Miscarriage Patients?

    Directory of Open Access Journals (Sweden)

    Ning Wang

    2010-01-01

    Full Text Available Aneuploidy in pregnancy is known to increase with advanced maternal age (AMA and associate with repeated implantation failure (RIF, and repeated miscarriage (RM. Preimplantation genetic screening (PGS has been introduced into clinical practice, screening, and eliminating aneuploidy embryos, which can improve the chance of conceptions for infertility cases with poor prognosis. These patients are a good target group to assess the possible benefit of aneuploidy screening. Although practiced widely throughout the world, there still exist some doubts about the efficacy of this technique. Recent randomized trials were not as desirable as we expected, suggesting that PGS needs to be reconsidered. The aim of this review is to discuss the efficacy of PGS.

  15. Fetal exposure to nonsteroidal anti-inflammatory drugs and spontaneous abortions

    Science.gov (United States)

    Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Bilenko, Natalya; Ratzon, Ronit; Levy, Amalia

    2014-01-01

    Background: Spontaneous abortion is the most common complication of pregnancy. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used during pregnancy. Published data are inconsistent regarding the risk of spontaneous abortion following exposure to NSAIDs. Methods: We performed a historical cohort study involving all women who conceived between January 2003 and December 2009 and who were admitted for delivery or spontaneous abortion at Soroka Medical Center, Clalit Health Services, Israel. A computerized database of medication dispensation was linked with 2 computerized databases containing information on births and spontaneous abortions. We constructed time-varying Cox regression models and adjusted for maternal age, diabetes mellitus, hypothyroidism, obesity, hypercoagulation or inflammatory conditions, recurrent miscarriage, in vitro fertilization of the current pregnancy, intrauterine contraceptive device, ethnic background, tobacco use and year of admission. Results: The cohort included 65 457 women who conceived during the study period; of these, 58 949 (90.1%) were admitted for a birth and 6508 (9.9%) for spontaneous abortion. A total of 4495 (6.9%) pregnant women were exposed to NSAIDs during the study period. Exposure to NSAIDs was not an independent risk factor for spontaneous abortion (nonselective cyclooxygenase [COX] inhibitors: adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 0.99–1.22; selective COX-2 inhibitors: adjusted HR 1.43, 95% CI 0.79–2.59). There was no increased risk for specific NSAID drugs, except for a significantly increased risk with exposure to indomethacin (adjusted HR 2.8, 95% CI 1.70–4.69). We found no dose–response effect. Interpretation: We found no increased risk of spontaneous abortion following exposure to NSAIDs. Further research is needed to assess the risk following exposure to selective COX-2 inhibitors. PMID:24491470

  16. Fetal exposure to nonsteroidal anti-inflammatory drugs and spontaneous abortions.

    Science.gov (United States)

    Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Bilenko, Natalya; Ratzon, Ronit; Levy, Amalia

    2014-03-18

    Spontaneous abortion is the most common complication of pregnancy. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used during pregnancy. Published data are inconsistent regarding the risk of spontaneous abortion following exposure to NSAIDs. We performed a historical cohort study involving all women who conceived between January 2003 and December 2009 and who were admitted for delivery or spontaneous abortion at Soroka Medical Center, Clalit Health Services, Israel. A computerized database of medication dispensation was linked with 2 computerized databases containing information on births and spontaneous abortions. We constructed time-varying Cox regression models and adjusted for maternal age, diabetes mellitus, hypothyroidism, obesity, hypercoagulation or inflammatory conditions, recurrent miscarriage, in vitro fertilization of the current pregnancy, intrauterine contraceptive device, ethnic background, tobacco use and year of admission. The cohort included 65,457 women who conceived during the study period; of these, 58,949 (90.1%) were admitted for a birth and 6508 (9.9%) for spontaneous abortion. A total of 4495 (6.9%) pregnant women were exposed to NSAIDs during the study period. Exposure to NSAIDs was not an independent risk factor for spontaneous abortion (nonselective cyclooxygenase [COX] inhibitors: adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 0.99-1.22; selective COX-2 inhibitors: adjusted HR 1.43, 95% CI 0.79-2.59). There was no increased risk for specific NSAID drugs, except for a significantly increased risk with exposure to indomethacin (adjusted HR 2.8, 95% CI 1.70-4.69). We found no dose-response effect. We found no increased risk of spontaneous abortion following exposure to NSAIDs. Further research is needed to assess the risk following exposure to selective COX-2 inhibitors.

  17. [Augmented spontaneous breathing].

    Science.gov (United States)

    Hachenberg, T

    1996-09-01

    Impaired pulmonary gas exchange can result from lung parenchymal failure inducing oxygenation deficiency and fatigue of the respiratory muscles, which is characterized by hypercapnia or a combination of both mechanisms. Contractility of and coordination between the diaphragm and the thoracoabdominal respiratory muscles predominantly determine the efficiency of spontaneous breathing. Sepsis, cardiac failure, malnutrition or acute changes of the load conditions may induce fatigue of the respiratory muscles. Augmentation of spontaneous breathing is not only achieved by the application of different technical principles or devices; it also has to improve perfusion, metabolism, load conditions and contractility of the respiratory muscles. Intermittent mandatory ventilation (IMV) allows spontaneous breathing of the patient and augments alveolar ventilation by periodically applying positive airway pressure tidal volumes, which are generated by the respirator. Potential advantages include lower mean airway pressure (PAW), as compared with controlled mechanical ventilation, and improved haemodynamics. Suboptimal IMV systems may impose increased work and oxygen cost of breathing, fatigue of the respiratory muscles and CO2 retention. During pressure support ventilation (PSV), inspiratory alterations of PAW or gas flow (trigger) are detected by the respirator, which delivers a gas flow to maintain PAW at a fixed value (usually 5-20 cm H2O) during inspiration. PSV may be combined with other modalities of respiratory therapy such as IMV or CPAP. Claimed advantages of PSV include decreased effort of breathing, reduced systemic and respiratory muscle consumption of oxygen, prophylaxis of diaphragmatic fatigue and an improved extubation rate after prolonged periods of mechanical ventilation. Minimum alveolar ventilation is not guaranteed during PSV; thus, close observation of the patient is mandatory to avoid serious respiratory complications. Continuous positive airway pressure

  18. Spontaneous recovery from acalculia.

    Science.gov (United States)

    Basso, Anna; Caporali, Alessandra; Faglioni, Pietro

    2005-01-01

    A topic much considered in research on acalculia was its relationship with aphasia. Far less attention has been given to the natural course of acalculia. In this retrospective study, we examined the relationship between aphasia and acalculia in an unselected series of 98 left-brain-damaged patients and the spontaneous recovery from acalculia in 92 acalculic patients with follow-up. There was a significant association between aphasia and acalculia although 19 participants exhibited aphasia with no acalculia and six acalculia with no aphasia. We observed significant improvement between a first examination carried out between 1 and 5 months post-onset and a second examination carried out between 3 and 11 months later (mean: 5 months). The mechanisms of spontaneous recovery are discussed.

  19. Spontaneous Rupture of Pyometra

    Directory of Open Access Journals (Sweden)

    Fatemeh Mallah

    2013-01-01

    Full Text Available Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. In most cases, a correct and definite diagnosis can be made only by laparotomy. We report two cases of diffuse peritonitis caused by spontaneous perforated pyometra. The first case is a 78-year-old woman with abdominal pain for which laparotomy was performed because of suspected incarcerated hernia. The second case is a 61-year-old woman with abdominal pain for which laparotomy was performed because of symptoms of peritonitis. At laparotomy of both cases, 1 liter of pus with the source of uterine was found in the abdominal cavity. The ruptured uterine is also detected. More investigations revealed no malignancy as the reason of the pyometra.

  20. [Spontaneous pneumothorax in children].

    Science.gov (United States)

    Michel, J L

    2000-03-01

    Spontaneous pneumothorax is rare in childhood. Before 12 years of age the main underlying pathologies are asthma, cystic malformations, post infectious bullae, and infectious pneumoniae. After 12 years of age it is mainly associated with cystic fibrosis and constitutional slim morphology. Symptoms vary according to the extent of lung collapse and the diagnosis is confirmed on chest X rays. In mildly symptomatic pneumothorax, spontaneous resolution is achieved within few days. When cardiorespiratory difficulties are present, mechanical evacuation of air from the pleural cavity is necessary through a tube drainage maintained until complete pulmonary reexpansion. Surgical treatment is indicated in case of persisting air leakage after one week of efficient drainage, large cystic malformation or post infectious bullae, recurring or bilateral pneumothorax.

  1. [Spontaneous bilateral Petit hernia].

    Science.gov (United States)

    Fontoura, Rodrigo Dias; Araújo, Emerson Silveira de; Oliveira, Gustavo Alves de; Sarmenghi Filho, Deolindo; Kalil, Mitre

    2011-01-01

    Petit's lumbar hernia is an uncommon defect of the posterior abdominal wall that represents less than 1% of all abdominal wall hernias. It is more often unilateral and founded in young females, rarely containing a real herniated sac. There are two different approaches to repair: laparoscopy and open surgery. The goal of this article is to report one case of spontaneous bilateral lumbar Petit's hernia treated with open surgery.

  2. Spontaneous spinal epidural abscess.

    LENUS (Irish Health Repository)

    Ellanti, P

    2011-10-01

    Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.

  3. Spontaneous Perforation of Pyometra

    OpenAIRE

    Sharma, Nalini; Singh, Ahanthem Santa; Bhaphiralyne, Wankhar

    2016-01-01

    Pyometra is collection of purulent material which occurs when there is interference with its normal drainage. It is an uncommon condition with incidence of 0.1 to 0.5% of all gynecological patients. Spontaneous rupture of uterus is an extremely rare complication of pyometra. A 65-year-old lady presented with pain abdomen and purulent vaginal discharge. Preoperative diagnosis of pyometra was made by magnetic resonance imaging (MRI). Laparotomy followed by peritoneal lavage and repair of perfor...

  4. Spontaneous Achilles tendon rupture in alkaptonuria

    Science.gov (United States)

    Alajoulin, Omar A.; Alsbou, Mohammed S.; Ja’afreh, Somayya O.; Kalbouneh, Heba M.

    2015-01-01

    Alkaptonuria (AKU) is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA). Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis), early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations. PMID:26620992

  5. Geological and mining factors affecting spontaneous heating of coal

    Energy Technology Data Exchange (ETDEWEB)

    Morris, R.; Atkinson, T.

    1986-04-01

    The authors define the phenomenon of spontaneous heating in underground coal mines as a combination of seam factor, geological factor and mining factor. These latter two factors are discussed in a practical manner from the early work of Fayol in 1879 through to the findings of modern day researchers. The paper assesses the significance of all relevant aspects affecting spontaneous heating of coal, and provides the basis for a better understanding of its complex causes. 7 figs., 24 refs.

  6. Sperm macrocephaly syndrome in a patient without AURKC mutations and with a history of recurrent miscarriage.

    Science.gov (United States)

    Molinari, Emanuela; Mirabelli, Marzia; Raimondo, Stefania; Brussino, Alessandro; Gennarelli, Gianluca; Bongioanni, Francesca; Revelli, Alberto

    2013-02-01

    This paper reports a case of recurrent miscarriage in a patient affected by a variant phenotype of sperm macrocephaly syndrome (SMS). SMS is usually related to specific sperm characteristics (large head, multiple tail) and homozygous mutations in the aurora kinase C gene (AURKC). However, the present case observed large-headed spermatozoa with no flagellar abnormalities and no mutations detectable by AURKC sequencing. Furthermore, the patient had repeatedly conceived by intracytoplasmic sperm injection, but pregnancy always aborted. This study performed morphological analysis (Papanicolau staining), annexin V/propidium iodide staining, sperm chromatin structure assay (SCSA), fluorescence in-situ hybridization (FISH) and transmission electron microscopy. This study observed large-headed, mono-tailed, mono-centriolar spermatozoa characterized by abnormal chromatin and swollen mitochondria. SCSA revealed a high ratio of late apoptotic cells with fairly intact amount of DNA. The FISH analysis showed 100% disomy rate. As far as is known, this is the first study to include gene sequencing, TEM, cytogenetic analysis and sperm DNA fragmentation in a case of SMS and also to report recurrent miscarriage related to this specific condition. SMS may be associated with important abnormalities of the sperm subcellular structure and with disomy even in the absence of mutations in the AURKC coding sequence. Sperm macrocephaly syndrome (SMS) is a rare condition that affects spermatozoa and is related to infertility. It is characterized by a specific phenotype of large-headed, multi-tailed spermatozoa with an abnormal chromosomal status. A very few pregnancies have been obtained so far in SMS patients by means of IVF procedures. We present a case of SMS that differs from the classical syndrome as we observed large-headed spermatozoa without tail abnormalities. The affected patient had achieved three pregnancies following IVF, but all aborted. We carried out a detailed examination of

  7. Spontaneous Thigh Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Khan, Sameer K

    2011-02-01

    Full Text Available A young man presented with a painful and swollen thigh, without any history of trauma, illness, coagulopathic medication or recent exertional exercise. Preliminary imaging delineated a haematoma in the anterior thigh, without any fractures or muscle trauma. Emergent fasciotomies were performed. No pathology could be identified intra-operatively, or on follow-up imaging. A review of thigh compartment syndromes described in literature is presented in a table. Emergency physicians and traumatologists should be cognisant of spontaneous atraumatic presentations of thigh compartment syndrome, to ensure prompt referral and definitive management of this limb-threatening condition. [West J Emerg Med. 2011;12(1:134-138].

  8. A Previous Miscarriage and a Previous Successful Pregnancy Have a Different Impact on HLA Antibody Formation during a Subsequent Successful Pregnancy

    OpenAIRE

    Kirsten Geneugelijk; Gideon Hönger; Hanneke Wilhelmina Maria van Deutekom; Irene Mathilde Hoesli; Stefan Schaub; Eric Spierings

    2016-01-01

    Inherited paternal HLA antigens from the semi-allogeneic fetus may trigger maternal immune responses during pregnancy, leading to the production of child-specific HLA antibodies. The prevalence of these HLA antibodies increases with the number of successful pregnancies. In the present study, we investigated the effect of a single prior miscarriage on HLA antibody formation during a subsequent successful pregnancy. Women with a successful pregnancy with one or more prior miscarriages (n = 229)...

  9. Intervillous and uteroplacental circulation in normal early pregnancy and early pregnancy loss assessed by 3-dimensional power Doppler angiography.

    Science.gov (United States)

    Mercé, Luis T; Barco, María J; Alcázar, Juan L; Sabatel, Rosa; Troyano, Juan

    2009-03-01

    To assess intervillous and uteroplacental circulation in early normal pregnancies and miscarriages. One hundred normal pregnancies and 46 delayed miscarriages were evaluated by 3-dimensional vaginal ultrasound and power Doppler angiography. Volumes of the early placenta and the subplacental area were obtained between 5 and 12.6 weeks' gestation. The placental volume, vascularization index, flow index, and vascularization flow index was calculated. Intraclass correlation coefficients ranged from 0.961 for placental volume to 0.885 for intervillous flow index. Intervillous power Doppler signals were not detected before the sixth week. Placental volume (R(2) = 0.68), intervillous vascularization index (R(2) = 0.30), flow index (R(2) = 0.33) and vascularization flow index (R(2) = 0.35), uteroplacental flow index (R(2) = 0.34), and vascularization flow index (R(2) = 0.17) increase significantly (P < .001) throughout the first trimester of normal pregnancies. Uteroplacental vascularization index was not significantly related to gestational age. Intervillous vasculariztion index, flow index, and vascularization flow index were significantly raised in miscarriages, but there were no significant differences for uteroplacental vascularization index, flow index, or vascularization flow index. Intervillous and uteroplacental blood flow increases throughout the first trimester of normal pregnancies. Intervillous circulation is abnormally increased when a miscarriage is diagnosed.

  10. Early fetal reduction to twin versus prophylactic cervical cerclage for triplet pregnancies conceived with assisted reproductive techniques

    Directory of Open Access Journals (Sweden)

    Mohamed Sayed Abdelhafez

    2018-02-01

    Conclusion: Early transvaginal reduction of triplets to twins leads to improved obstetric outcomes as it decreases prematurity and its related neonatal morbidities and mortality without increase in the miscarriage rate. Early fetal reduction seems to be better than continuation of triplet pregnancies with prophylactic placement of cervical cerclage.

  11. The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism.

    Science.gov (United States)

    Cetin, Orkun; Karaman, Erbil; Cim, Numan; Dirik, Deniz; Sahin, Hanim Guler; Kara, Erdal; Esen, Ramazan

    2017-01-01

    The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively. From among them, 68 patients were treated only with folic acid and iron. The remaining 53 patients were treated with folic acid, iron and prophylactic doses of low molecular weight heparin. The subsequent pregnancy outcomes of these patients were noted. The live birth rate was higher in patients with anticoagulant therapy than in patients without anticoagulant therapy (48.5% vs. 69.8%, respectively, p: 0.015) and the congenital anomaly rate was lower in anticoagulant therapy group (17.6% vs. 3.8%, respectively, p: 0.022). The other obstetric outcomes were found to be similar between the two groups. The current study demonstrated that low molecular weight heparin improved the live birth rates among unex-plained recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphisms. How-ever, the routine use of low molecular weight heparin did not improve the late pregnancy complications in these selected patients in the eastern region of our country. Further studies are needed to discriminate the effect of anticoagulation on the live birth rate of each of methylenetetrahydrofolate reductase gene polymorphism type.

  12. Association of tumor necrosis factor-alpha 308G/A polymorphism with recurrent miscarriages in women

    Directory of Open Access Journals (Sweden)

    Neha Sudhir

    2016-01-01

    Full Text Available BACKGROUND: Recurrent miscarriage (RM is the most common pregnancy loss in the first trimester affecting approximately 0.5–2% of women. It is a heterogeneous condition and remains an enigma as the underlying cause is still difficult to track down. AIM: This study was aimed to investigate the distribution of tumor necrosis factor-alpha (TNF-α 308G/A polymorphism and its association with RM in females. The comparative picture was also demonstrated by comparing genotyping results with healthy control women having no history of miscarriage. METHODS: This clinical study was conducted among 115 women aged 21–44 years with history of recurrence of miscarriage. The samples were collected from women attending the outpatient departments of various hospitals, nursing homes, and infertility clinics of this region. In the present study, 111 fertile healthy women aged 24–46 years with at least one live birth and no history of miscarriage were also included. RESULTS: Mean age of women with RM was found to be 28 ± 5.6 years by recall method, whereas it was found to be 30 ± 7.4 in context to healthy women with no history of pregnancy loss. In the present study, 66% of women with RM had homozygous wild type genotype (GG while 30% and 4% of women had heterozygous (GA and homozygous mutant genotype (AA, respectively. Among control group, 79%, 16%, and 5% of women showed GG, GA, and AA genotype, respectively. CONCLUSION: The current study supports the concept of TNF-α 308G/A variant in particular with reproductive failure, GG and GA alleles showing 1-fold risk association with RM (odds ratio: 1.86 and 1.43, respectively.

  13. A Previous Miscarriage and a Previous Successful Pregnancy Have a Different Impact on HLA Antibody Formation during a Subsequent Successful Pregnancy.

    Science.gov (United States)

    Geneugelijk, Kirsten; Hönger, Gideon; van Deutekom, Hanneke Wilhelmina Maria; Hösli, Irene Mathilde; Schaub, Stefan; Spierings, Eric

    2016-01-01

    Inherited paternal HLA antigens from the semi-allogeneic fetus may trigger maternal immune responses during pregnancy, leading to the production of child-specific HLA antibodies. The prevalence of these HLA antibodies increases with the number of successful pregnancies. In the present study, we investigated the effect of a single prior miscarriage on HLA antibody formation during a subsequent successful pregnancy. Women with a successful pregnancy with one or more prior miscarriages (n = 229) and women with a successful pregnancy without a prior miscarriage (n = 58), and their children were HLA typed. HLA antibody analyses were performed in these women to identify whether HLA antibodies were formed against mismatched HLA class-I antigens of the last child. The percentage of immunogenic antigens was significantly lower after a single successful pregnancy that was preceded by a single miscarriage (n = 18 women) compared to a successful pregnancy that was preceded by a first successful pregnancy (n = 62 women). Thus, our data suggest that a previous miscarriage has a different impact on child-specific HLA antibody formation during a subsequent successful pregnancy than a previous successful pregnancy. The lower immunogenicity in these women cannot be explained by reduced numbers of immunogenic B-cell and T-cell epitopes. In conclusion, our observations indicate that increasing gravidity is not related to an increased prevalence of HLA antibodies in a single successful pregnancy that was preceded by a single prior miscarriage.

  14. Frequency of Miscarriage/Stillbirth and Terminations of Pregnancy Among Women With Congenital Heart Disease in Germany, Hungary and Japan.

    Science.gov (United States)

    Koerten, Marc-André; Niwa, Koichiro; Szatmári, András; Hajnalka, Balint; Ruzsa, Zoltán; Nagdyman, Nicole; Niggemeyer, Eva; Peters, Brigitte; Schneider, Karl-Theodor M; Kuschel, Bettina; Mizuno, Yoshiko; Berger, Felix; Kaemmerer, Harald; Bauer, Ulrike M M

    2016-07-25

    The 2011 guidelines of the European Society of Cardiology (ESC) on the management of cardiovascular diseases during pregnancy define the maternal predictors for neonatal complications. The aim of this study was to determine whether these are associated with an increased number of miscarriages/stillbirths and terminations of pregnancy (TOPs) also in patients with congenital heart defects (CHD). The 634 women from Germany, Hungary and Japan were surveyed concerning the issues of sexuality and reproductive health, as well as their general life situation and medical care. 25% of the recorded pregnancies in women with CHD resulted in miscarriage, stillbirth or TOP. Affecting 16.8% of all recorded pregnancies, miscarriages or stillbirths occurred more frequently than in the general population and more than previously recorded for patients with CHD. TOP occurred in 8% of the surveyed pregnancies. Underlying maternal predictors for neonatal events had an influence on the number of TOP; among those with underlying predictors, TOP was recorded 3-fold more than in those without such predictors (15.6% vs. 5.5%). Remarkably, a significant deficit regarding the level of information on potential pregnancy-associated risks was observed in all 3 participating countries. Pregnant women with CHD should always be treated and counseled individually by cardiologists, gynecologists, obstetricians and anesthetists with appropriate expert knowledge. (Circ J 2016; 80: 1846-1851).

  15. Altered Endometrial Expression of Endothelial Nitric oxide Synthase (eNOS) in women with Unexplained Recurrent Miscarriage and Infertility

    Science.gov (United States)

    Najafi, Tohid; Novin, Marefat Ghaffari; Ghazi, Reza; Khorram, Omid

    2012-01-01

    Background Endothelial nitric oxide synthase (eNOS) has diverse roles in the female reproductive system including a role in blastocyst implantation. Aberrant expression of eNOS could therefore be significant in the pathogenesis of disorders of implantation Materials and Methods eNOS protein and mRNA levels in the endometrium of women with recurrent miscarriages, unexplained infertility, and a control group was determined by compartmental quantitative immunohistochemistry and real time RT-PCR Results eNOS was immunolocalized to all layers of the endometrium and the vascular endothelium. eNOS protein expression was higher in glandular epithelium (P=0.004) and luminal epithelium (P=0.002) but not vascular endothelium and stroma (P=0.14) in women with recurrent miscarriage. Similarly, in women with unexplained infertility eNOS expression was significantly higher (Pinfertility compared with controls Conclusion Increased expression of eNOS in glandular and luminal epithelium of the endometrium in women with recurrent miscarriages and unexplained infertility suggests a detrimental effect of excess nitric oxide in endometrial receptivity and implantation PMID:22877939

  16. Miscarriage history and Toxoplasma gondii infection: A cross-sectional study in women in Durango City, Mexico.

    Science.gov (United States)

    Alvarado-Esquivel, C; Pacheco-Vega, S J; Hernández-Tinoco, J; Centeno-Tinoco, M M; Beristain-García, I; Sánchez-Anguiano, L F; Liesenfeld, O; Rábago-Sánchez, E; Berumen-Segovia, L O

    2014-06-01

    Through a cross-sectional study design, 326 women with a history of miscarriage were examined for anti-Toxoplasma gondii IgG and IgM antibodies in Durango City, Mexico. Prevalence association with sociodemographic, clinical, and behavioral characteristics in women with miscarriage was also investigated. Twenty-two (6.7%) of the 326 women studied had anti-T. gondii IgG antibodies and two (0.6%) were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection was not influenced by age, birth place, occupation, educational level, or socioeconomic status. In contrast, logistic regression showed that T. gondii exposure was associated with consumption of raw or undercooked meat (OR = 6.84; 95% CI: 1.04-44.95; P = 0.04) and consumption of chicken brains (OR = 18.48; 95% CI: 1.26-269.43; P = 0.03). This is the first study on the seroepidemiology of T. gondii infection in women with a history of miscarriage in Northern Mexico. Of interest, we also observed an association of T. gondii exposure with consumption of chicken brains. Contributing factors for T. gondii exposure found in the present study should be taken into consideration for public health measures to avoid infection with T. gondii and its sequelae.

  17. Frequency of Low-level Mosaicism in X-Cromosome in Couples with Antecedent of Recurrent Miscarriages

    Directory of Open Access Journals (Sweden)

    Maribel Forero C.., Elkin Lucena Q. M.D., PhD., Clara Esteban Pérez BSc., MSc

    2006-12-01

    Full Text Available Recurrent miscarriage occurs in around 1 to 7percent of couples. The etiology involves genetic,immunologic, anatomic, hormonal, metabolic,thrombophilic and infectious factors. With theaim of establishing the frequency of low-level mosaicism in the X-chromosome, in a populationof couples with prior recurrent miscarriages, aprospective case-control cytogenetic study tookplace on 20 couples, at the biogenetic laboratoryin CECOLFES (Colombian Center of Fertility andSterility. Clinical pathologic evaluation, anatomic,hormonal, infectious, andrologic and geneticstudies were performed. As a conventionalmethod in cytogenetic techniques, banding GTGwas used for the study of structural and numericchromosomal abnormalities whereas the molecularmethod of Fluorescence In Situ Hybridization(FISH was used to confirm the mosaicismin sexual chromosomes. According to paraclinicresults from the participating couples, diagnosisshowed immunologic (75%, anatomic (30%,hormonal (25%, male (25%, infectious (25%,genetic (15% and idiophatic factors (10%.Results from the cytogenetic analysis, were 10%of low-level mosaicism in the X-chromosome intwo women whose final diagnosis includedgenetic and infectious factors for one and geneticand immunologic factors for the other. Only 10% of the total miscarriages from the couples wereevaluated. Conclusions include aspects such asmultifactorial evidence of pathogenesis in recurrentmiscarriage, the sub-diagnosis of geneticfactors and the need to focus future investigationson cytogenetic interpretation and the clinicalpathologicalassociation between low-level mosaicismin the X-cromosome and recurrentmiscarriage.

  18. Spontaneous abortion and physical strain around implantation

    DEFF Research Database (Denmark)

    Hjøllund, Niels Henrik Ingvar; Jensen, T.K.; Bonde, J.P.

    2000-01-01

    Existing studies of physical strain and spontaneous abortion are mainly retrospective or based only on pregnancies that have survived the first trimester. Furthermore, almost all studies have relied on averaged measures of physical strain, which tend to blur an effect if peak values during short...... time periods are the relevant measure. We followed a cohort of first pregnancy planners from termination of birth control until pregnancy for a maximum of six menstrual cycles. The analyses include 181 pregnancies, of which 32 were subclinical pregnancies detected by hCG analysis only. During early...... pregnancy the women recorded physical strain prospectively in a structured diary. Physical strain around the time of implantation was associated with later spontaneous abortion. The adjusted risk ratio for women who reported physical strain higher than average at day 6 to 9 after the estimated date...

  19. Spontaneous stress fractures of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Dorne, H.L.; Lander, P.H.

    1985-02-01

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head.

  20. KDR gene polymorphisms and idiopathic recurrent spontaneous abortion.

    Science.gov (United States)

    Honarvar, Negar; Sheikhha, Mohammad Hasan; Farashahi Yazd, Ehsan; Pashaiefar, Hossein; Mohtaram, Shirin; Sazegari, Ali; Feizollahi, Zahra; Ghasemi, Nasrin

    2016-11-01

    Process of angiogenesis is essential for successful gestation. Disruption in this pathway leads to various undesirable consequences in pregnancy such as recurrent spontaneous abortion (RSA). One of the most important genes involved in angiogenesis is kinase-insert domain-containing receptor (KDR). This study aimed to investigate the associations between two single-nucleotide polymorphisms (SNPs) of KDR gene, 1719A > T and 1192G > A, with idiopathic RSA in south-east Iran. A total of 230 women, including 110 women with a history of at least two consecutive spontaneous miscarriages and 120 healthy women were recruited in this study. Genomic DNA was extracted from peripheral blood samples of participants using the Salting out method. The KDR 1719A > T and 1192G > A polymorphisms were genotyped by the standard amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) technique. For the case group, frequencies of 2.73%, 30% and 67.27% were observed for AA, AT and TT genotypes in1719A > T SNP, respectively, and the genotype frequencies for controls were equal to AA = 3.33%, AT = 32.5% and TT = 64.17%. Distribution of genotypes in 1192G > A SNP in the case group was 79.1%, 19.1% and 1.8% for GG, AG and AA, respectively, whereas the corresponding values for the controls were GG  =  80%, AG  =  20% and AA  =  0. No significant difference was found between the case and control groups based on the frequency of KDR gene polymorphisms with the susceptibility to RSA. There is no association between these two SNPs of KDR gene and the susceptibility to RSA in women from south-east Iran.

  1. Cognitive behavior therapy for psychological distress in patients with recurrent miscarriage.

    Science.gov (United States)

    Nakano, Yumi; Akechi, Tatsuo; Furukawa, Toshiaki A; Sugiura-Ogasawara, Mayumi

    2013-01-01

    To examine the reduction of psychiatric symptoms using individual cognitive behavior therapy (CBT) for women who suffer from recurrent miscarriage (RM) and depression and/or anxiety. Patients with RM and a score of five or higher for K6, a self-report screening scale for depression/anxiety, were interviewed to find information about stressful situations, thoughts, and consequent behaviors that are common and potential causes of psychological distress among RM patients. We then performed individual CBT on 14 patients with RM and depression/anxiety, referring to a list from the interviews, and examined the effects of CBT by a paired t-test. Fourteen women received CBT. The mean number of intervention times was 8.9 sessions (standard deviation [SD], 4.6 sessions). The average Beck Depression Inventory-Second Edition and State-Trait Anxiety Inventory-state anxiety scores, self-report screening scales for depression/anxiety, decreased from 13.6 (SD, 8.2) and 49.0 (SD, 7.1) at baseline to 5.2 (SD, 4.4) and 38.0 (SD, 10.2) posttherapy, respectively. These changes were statistically significant. The current preliminary open study confirmed that individual CBT was potentially useful for women with RM and depression and/or anxiety. This finding is the first step towards creating a comprehensive psychological support system for women with RM.

  2. Live-birth rate in euthyroid women with recurrent miscarriage and thyroid peroxidase antibodies.

    Science.gov (United States)

    Vissenberg, Rosa; Fliers, Eric; van der Post, Joris A M; van Wely, Madelon; Bisschop, Peter H; Goddijn, Mariette

    2016-01-01

    Thyroid autoimmunity with normal thyroid function is associated with recurrent miscarriage (RM), but the association with live birth is less clear. Therefore, we determined the association between thyroid peroxidase antibodies (TPO-Ab) and live-birth rate (LBR) in a retrospective cohort of euthyroid women with unexplained RM. We included 202 women of which 28 were TPO-Ab positive (13.9%) and 174 were TPO-Ab negative. TPO-Ab positive women (n = 10) without levothyroxine treatment had a lower LBR (29%) compared to TPO-Ab negative women (51%) (HR 0.23, 0.07-0.72, p = 0.012). The LBR in women with TPO-Ab receiving levothyroxine was not different compared women without TPO-Ab (60% versus 51%, p = 0.50). In conclusion, TPO-Ab are associated with a lower LBR in euthyroid women with unexplained RM and these women may benefit from treatment with levothyroxine.

  3. Prevalence and associated risk factors for syphilis in women with recurrent miscarriages

    Science.gov (United States)

    Hussain Laghari, Arshad; Sultana, Viqar; Hussain Samoo, Akhtar; Makhija, Pirbhomal; Ara, Jehan; Hira

    2014-01-01

    Objective: A Cross Sectional population based serological studies was conducted to determine the prevalence and associated risk factors for syphilis women with recurrent miscarriages. Methods: Patient’s 5ml whole blood was collected through venepuncture technique. Data were collected by all women answered a questionnaire and by investigating blood sample VDRL test and FTA-ABS test. The study was conducted in a confidential manner and numbers were used to identify the participant. Results: Total 256 women were included in the present study. Mean age of women was 29.4 years while range was 21 to 38 years (206/256). Out of the 256 samples, 05 (1.9%) were positive for active syphilis. Majority belonged to low socioeconomic group, uneducated and had previous congenital anomaly. Conclusion: Active infection with Treponema pallidum (T.P) in women belonging to low socioeconomic level were disquieting. This is probably due to illiteracy and high proportion of unsafe sexual behavior. It is also suggestive that seropositive status is often discovered in routine serological studies during pregnancy. PMID:24772130

  4. Perinatal outcomes of women with a prior history of unexplained recurrent miscarriage.

    LENUS (Irish Health Repository)

    Dempsey, Mark

    2014-05-14

    Abstract Objective: We sought to determine subsequent pregnancy outcomes in a cohort of women with a history of unexplained RM who were not receiving medical treatment. Study Design: This was a prospective cohort study, of women with a history of three unexplained consecutive first trimester losses, who were recruited and followed in their subsequent pregnancy. Control patients were healthy pregnant patients with no previous adverse perinatal outcome. Results: A total of 42 patients with a history of unexplained RM were recruited to the study. 9 (21.4%) experienced a further first trimester miscarriage, 1 case of ectopic and 1 case of partial molar pregnancy. 74% (23\\/31) of the RM cohort had a vaginal delivery. There was one case of severe pre-eclampsia. The RM group delivered at a mean gestational age of 38+2 weeks and with a mean birth-weight of 3.23kg. None of the neonates were under the 10(th) centile for gestational age. Overall, there was no significant difference in pregnancy outcomes between the two cohorts. Conclusion: Our study confirms the reassuring prognosis for achieving a live birth in the unexplained RM population with a very low incidence of adverse events with the majority delivering appropriately grown fetuses at term.

  5. Spying on spontaneous combustion

    Energy Technology Data Exchange (ETDEWEB)

    1994-11-01

    The British Coal Technical Services and Research Executive (TSRE) has carried out a project to investigate potential applications of fibre optic based distributed temperature sensing (DTS) technology within a mining environment. The objective was to determine whether DTS could identify and locate spontaneous combustion earlier than conventional systems. The trials took place in a British mine from April to September 1992 and from August to November 1993 using a commercially available system from York Sensors Ltd. Results indicate that DTS is capable of very sensitive temperature monitoring, revealing sub-degree thermal trends resulting from various activities and local heatings. DTS has several prospective mining applications, e.g. monitoring known hot spots, investigating ventilation and heat flow through mine workings. The trials show that the system can be installed, calibrated, operated and maintained by relatively inexperienced personnel. 1 photo.

  6. [Recurrent early pregnancy loss: What the life-birth chances are? A 10-years retrospective study].

    Science.gov (United States)

    Bonne, S; Sananes, N; Rongières, C

    2015-05-01

    Recurrent miscarriages are a current consultation pattern. Etiologic evaluation is classically proposed and preventive therapy should be discussed. We wanted to study our University Hospital pregnancies outcomes, following 3 repetitive early miscarriages, and how those patients are managed. A 10-years retrospective study has been performed in our center, with 296 patients found having a three-repetitive miscarriage experience. Information about diagnostic evaluation following miscarriages, preventive therapy initiation, and next pregnancy outcome has been provided. Around 62.5% of the patients experienced a life-birth. When investigations were done (n=148), a 64.9% part of the patients had abnormal results. Life-birth rate was more important when there were normal karyotypes or no thrombophilia found (respectively p equal 0.30 and 0.45). We noticed a better prognostic in the group of patients with normal investigations results who had a preventive therapy (n=20, 85% of life-birth, P=0.19). When done, investigations for recurrent miscarriages, allow the finding of an abnormality in two thirds of cases. Wonderingly, outcomes are very encouraging since that almost two thirds of the patients experienced life-birth. Investigations indications, results interpretations, and consecutive therapy should be well thought but preventive therapy seems to be efficient in the normal results patient group. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Incarcerated small bowel within a spontaneous lumbar hernia.

    Science.gov (United States)

    Teo, K A T; Burns, E; Garcea, G; Abela, J E; McKay, C J

    2010-10-01

    Lumbar hernias are rare, resulting from protrusion through the posterior abdominal wall that may be congenital, acquired or spontaneous. They very rarely present with acute bowel obstruction. We present a case of incarcerated small bowel within a spontaneous inferior (Petit's) lumbar hernia, treated by early open repair with mesh insertion. This case highlights the importance of thorough clinical examination and a high index of suspicion, even in the absence of previous surgery around the anatomical site of the suspected hernia, in order to effect an early repair before the onset of ischaemia in incarcerated contents.

  8. Early pregnancy care over time: should we promote an early pregnancy assessment unit?

    Science.gov (United States)

    van den Berg, Merel M J; Goddijn, Mariette; Ankum, Willem M; van Woerden, Emmy E; van der Veen, Fulco; van Wely, Madelon; Hajenius, Petra J

    2015-08-01

    In this observational study, the effect of the introduction of the first Early Pregnancy Assessment Unit (EPAU) in a university hospital in The Netherlands in 2008 on early pregnancy care is analysed. Derivatives of quality of care were measured before and after the establishment of the EPAU, with the aim of reducing unnecessary care. Care within three time periods was measured: 2006, 2009 and 2012. In 2006, 14% of women who had experienced a miscarriage were admitted to the hospital, whereas in 2009 and 2012 no women were admitted. The surgical management rate for miscarriage decreased from 79% (2006) to 6% (2009) and 28% (2012). Karyotyping of couples who had experienced recurrent miscarriage decreased from 100% (2006) to 17% (2009) and 33% (2012). The surgical management rate for ectopic pregnancy decreased from 50% (2006) to 25% (2009) and 29% (2012). The mean total cost per woman treated in 2006 was €1111 (95% CI €808 to 1426), €436 (95% CI €307 to 590) in 2009 and €633 (95% CI €586 to 788) in 2012. We can therefore conclude that an EPAU results in higher quality and cost-effective care, and has a positive effect on early pregnancy care. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  9. Decidual vascularization and the expression of angiogenic growth factors and proteases in first trimester spontaneous abortions

    NARCIS (Netherlands)

    Plaisier, M.; Dennert, I.; Rost, E.; Koolwijk, P.; Hinsbergh, V.W.M. van; Helmerhorst, F.M.

    2009-01-01

    BACKGROUND : Decidual vascular development is important for implantation. This study analysed decidual vascular adaptation to implantation in correlation with miscarriage in decidual secretory endometrium (DSE), decidua parietalis (DP) and decidua basalis (DB) of miscarriage patients and matched

  10. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  11. Genetic Variant in Interleukin-18 Is Associated with Idiopathic Recurrent Miscarriage in Chinese Han Population

    Directory of Open Access Journals (Sweden)

    Jun Yue

    2015-02-01

    Full Text Available Levels of IL-18 were significantly lower in women with recurrent miscarriage (RM than those without idiopathic RM. IL-18 promoter single nucleotide polymorphisms were previously identified to have an impact on IL18 gene transcription activity and influence the level of IL-18 protein production. The aim of this study was to evaluate whether IL-18 gene polymorphisms are risk factors for idiopathic RM in Chinese Han population. Study subjects comprised of 484 idiopathic RM patients and 468 controls. Three polymorphisms (rs360717, rs187238, rs1946518 in IL-18 gene and serum IL-18 concentrations were assessed. rs187238 variant exhibits significant association with RM in additive and recessive genetic model (additive model p = 1.05 × 10−4, dominant model p = 0.025, recessive model p = 2.43 × 10−5. In contrast, rs360717 and rs1946518 are not significantly associated with RM. Serum IL-18 levels are significantly lower in RM cases than in control (111.98 ± 93.13 versus 148.74 ± 130.51 pg/mL, p = 7.42 × 10−7. There are lower levels of serum IL-18 in rs187238 homozygous mutant (CC than homozygous wild-type (GG in this study population, including cases and control groups (98.31 ± 86.46 versus 131.87 ± 115.02 pg/mL, p = 0.015. These results suggest that reduced IL-18 levels and rs187238 variant may contribute to pathogenesis of idiopathic RM in Chinese Han population.

  12. Cardiovascular function in women with recurrent miscarriage, pre-eclampsia and/or intrauterine growth restriction.

    Science.gov (United States)

    Mahendru, Amita A; Everett, Thomas R; McEniery, Carmel M; Wilkinson, Ian B; Lees, Christoph C

    2013-03-01

    To investigate prepregnancy cardiovascular function and risk factors in women with previous pregnancy complications. Thirty-four women with previous normal pregnancy (controls), 26 with unexplained recurrent miscarriage (RM) and 14 with pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR), planning to conceive were recruited. Brachial and central blood pressures (BP), cardiac output (CO), peripheral vascular resistance (PVR), aortic stiffness, blood biochemistry and platelet aggregation were assessed. Women with previous PE/IUGR had higher brachial diastolic BP (78 ± 9 vs 71 ± 7 mmHg; p = 0.03), central systolic BP (107 ± 10 vs 99 ± 8 mmHg; p = 0.03), mean arterial pressure (92 ± 10 vs 84 ± 8 mmHg; p = 0.01) and PVR (1499 ± 300 vs 1250 ± 220 dynes.s(-1) cm(-5); p = 0.005), than the controls. No differences were observed in either cardiovascular function or blood biochemistry in women with unexplained RM compared with the controls. Women with previous PE/IUGR though not with RM had a stronger family history of cardiovascular disease (CVD) than controls. Women with previous PE and/or IUGR had higher BP and PVR compared with controls, which may predispose them to CVD later in life. However, in the absence of underlying vascular pathology, women with unexplained RM did not have abnormal cardiovascular function. Prepregnancy period provides an opportunity to identify cardiovascular risks in relation to previous obstetric history.

  13. [Bacterial vaginosis and spontaneous preterm birth].

    Science.gov (United States)

    Brabant, G

    2016-12-01

    To determine if bacterial vaginosis is a marker for risk of spontaneous preterm delivery and if its detection and treatment can reduce this risk. Consultation of the database Pubmed/Medline, Science Direct, and international guidelines of medical societies. Bacterial vaginosis (BV) is a dysbiosis resulting in an imbalance in the vaginal flora through the multiplication of anaerobic bacteria and jointly of a disappearance of well-known protective Lactobacilli. His diagnosis is based on clinical Amsel criteria and/or a Gram stain with establishment of the Nugent score. The prevalence of the BV extraordinarily varies according to ethnic and/or geographical origin (4-58 %), in France, it is close to 7 % in the first trimester of pregnancy (EL2). The link between BV and spontaneous premature delivery is low with an odds ratio between 1.5 and 2 in the most recent studies (EL3). Metronidazole or clindamycin is effective to treat BV (EL3). It is recommended to prescribe one of these antibiotics in the case of symptomatic BV (Professional Consensus). The testing associated with the treatment of BV in the global population showed no benefit in the prevention of the risk of spontaneous preterm delivery (EL2). Concerning low-risk asymptomatic population (defined by the absence of antecedent of premature delivery), it has been failed profit to track and treat the BV in the prevention of the risk of spontaneous preterm delivery (EL1). Concerning the high-risk population (defined by a history of preterm delivery), it has been failed profit to track and treat the VB in the prevention of the risk of spontaneous preterm delivery (EL3). However, in the sub population of patients with a history of preterm delivery occurred in a context of materno-fetal bacterial infection, there may be a benefit to detect and treat early and systematically genital infection, and in particular the BV (Professional Consensus). The screening and treatment of BV during pregnancy in asymptomatic low

  14. Spontaneous intracranial hypotension

    Energy Technology Data Exchange (ETDEWEB)

    Haritanti, A. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Karacostas, D. [Department of Neurology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)], E-mail: bneurol@med.auth.gr; Drevelengas, A. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Kanellopoulos, V. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)], E-mail: vasikanel@hotmail.com; Paraskevopoulou, E. [Department of Neurology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Lefkopoulos, A.; Economou, I.; Dimitriadis, A.S. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)

    2009-02-15

    Spontaneous intracranial hypotension (SIH) is an uncommon but increasingly recognized syndrome. Orthostatic headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delayed diagnosis of this condition may subject patients to unnecessary procedures and prolong morbidity. We describe six patients with SIH and outline the important clinical and neuroimaging findings. They were all relatively young, 20-54 years old, with clearly orthostatic headache, minimal neurological signs (only abducent nerve paresis in two) and diffuse pachymeningeal gadolinium enhancement on brain MRI, while two of them presented subdural hygromas. Spinal MRI was helpful in detecting a cervical cerebrospinal fluid leak in three patients and dilatation of the vertebral venous plexus with extradural fluid collection in another. Conservative management resulted in rapid resolution of symptoms in five patients (10 days-3 weeks) and in one who developed cerebral venous sinus thrombosis, the condition resolved in 2 months. However, this rapid clinical improvement was not accompanied by an analogous regression of the brain MR findings that persisted on a longer follow-up. Along with recent literature data, our patients further point out that SIH, to be correctly diagnosed, necessitates increased alertness by the attending physician, in the evaluation of headaches.

  15. Spontaneous Intracapsular Tonsillar Hemorrhage

    Directory of Open Access Journals (Sweden)

    Güçlü Beriat

    2012-07-01

    Full Text Available In this case report, we discussed a case of spontaneous intracapsular tonsillar haemorrhage appearing as a tumor medial to the left palatine tonsil and clinging to the tonsillar tissue with a pedicle. The patient was a 30 years old healthy pregnant woman. She had a growing sensation of a lump in her oropharynx and dysphagia in the past three months. She had no history of acute and chronic tonsillitis or trauma. On examination, a mobile brown mass with a 2 cm diameter having a small pedicle at the upper pole of the left palatine tonsil was seen. Other laboratory results were normal. The mass was excised under general anesthesia. Histological evaluation revealed tonsillar intracapsular bleeding with lymphoepi-thelial tissue and acute hemorrhagic fields bounded by a capsule. A postpartum tonsillectomy was planned for our patient. Tonsillectomy must be performed to patients followed up with this diagnosis in order to differentiate between dyspha-gia, risks of bleeding and aspiration, and malignant tumors.

  16. [Results of spontaneous NBT-test in influenza patients].

    Science.gov (United States)

    Nagoev, B S; Orazaev, N G

    2000-01-01

    Assessment of leukocyte activity with spontaneous NBT-test in influenza patients regarding the disease stage, severity, complication and concomitant diseases. 107 influenza patients aged 16-84 years were studied. 70 patients had no complications, 11 patients had early influenzal pneumonia, 26 patients had late viral-bacterial infection. Chronic concomitant diseases were diagnosed in 23 cases. Cytochemical examination of leukocyte activity was made in all the patients using spontaneous NBT-test. In mild influenza NBT-test results were within upper limits of normal value. In alleviation of the symptoms NBT-test parameters were low. In early influenzal and viral-bacterial pneumonia leukocyte activity was high and lowered to normal in late convalescence. Parameters of spontaneous NBT-test in influenzal patients were elevated depending on influenza stage, severity and complications. This fact is of differential-diagnostic importance.

  17. Peripheral Dendritic Cells and CD4+CD25+Foxp3+ Regulatory T Cells in the First Trimester of Normal Pregnancy and in Women with Recurrent Miscarriage.

    Directory of Open Access Journals (Sweden)

    Maciej Kwiatek

    Full Text Available The development of pregnancy is possible due to initiation of immune response in the body of the mother resulting in immune tolerance. Miscarriage may be caused by the impaired maternal immune response to paternal alloantigens located on the surface of trophoblast and fetal cells. The aim of the study was to compare the population of circulating dendritic cells (DCs and CD4+CD25+Foxp3+ regulatory T cells (TREGs in the first trimester of a normal pregnancy and in women with recurrent miscarriage and an attempt to determine the relationship between these cells and the role they may play in human reproductive failures. The study was conducted in a group of 33 first trimester pregnant women with recurrent miscarriage and in a group of 20 healthy pregnant women in the first trimester of normal pregnancy. Among mononuclear cells isolated from peripheral blood, the populations of DCs and TREGs were assessed by flow cytometry. The percentage of myeloid DCs and lymphoid DCs showed no significant difference between study and control group. Older maternal age and obesity significantly reduced the pool of circulating myeloid and lymphoid DCs (R=-0.39, p=0.02. In miscarriages the percentage of circulating TREGs was significantly lower compared to normal pregnancies (p=0.003. Among the analysed factors the percentage of TREGs was the most sensitive and the most specific parameter which correlated with the pregnancy loss. The reduction in the population of circulating TREGs suggests immunoregulatory mechanisms disorder in a pregnancy complicated by miscarriage.

  18. Robertsonian translocation between chromosomes (no.21/14) in relation to the history of spontaneous abortion in a family.

    Science.gov (United States)

    Hasanzadeh-NazarAbadi, Mohammad; Baghbani, Fatemeh; Namazi, Iman; Mirzaee, Salmeh

    2014-08-01

    Approximately 205 million pregnancies occur each year in the worldwide. On the other hand, Spontaneous abortion has been reported in 15-20% of all diagnosed pregnancies. The most common cause of spontaneous abortion is chromosomal abnormalities of the embryo. Robertsonian translocation carriers specially 21-14 are the most common balanced rearrangement among the carrier couples with the history of spontaneous abortion. In order to search for balanced chromosomal rearrangement and cytogenetic disorders, 10 members of related family with consanguinity marriage with the history of recurrent miscarriage were assessed. Cytogenetic evaluation on the basis G-banding technique at high resolution was performed in 3 couples and their related family with the history of idiopathic RSA in order to postulate any balanced chromosomal rearrangement. six members of them appeared with robertsonian balanced translocation between chromosome No.21 to No. 14 with the karyotype of 45, XX, t (14, 21) and 45, XY, t (14, 21), which this results are in agreement with several similar works which claimed that the risk of spontaneous abortion in couples with balanced chromosomal rearrangements is higher compared with general population. Considering to results of present study, it seems as if the cytogenetic analysis of couples with the history of recurrent abortions should be suggested compulsory to estimate the probable presence of any chromosomal rearrangement. This offer wills valuable information for genetic consulting.

  19. Ziprasidone-induced spontaneous orgasm.

    Science.gov (United States)

    Boora, K; Chiappone, K; Dubovsky, S; Xu, J

    2010-06-01

    Neuroleptic treatment in schizophrenic patients has been associated with sexual dysfunction, including impotence and decreased libido. Spontaneous ejaculation without sexual arousal during typical antipsychotic treatment is a rare condition that has been described with zuclopentixol, trifluoperazine, and thiothixene. Here, we are reporting a case of spontaneous orgasm with ziprasidone in a bipolar patient. This patient began to repeatedly experience spontaneous sexual arousal and orgasm, which she had never experienced in the past. Ziprasidone might be causing an increase in sexual orgasm by 5-HT2 receptor antagonism, which preclinical evidence suggests that it facilitates dopamine release in the cortex.

  20. The role of ultrasound imaging in diagnosing and investigating early pregnancy failure.

    Science.gov (United States)

    Jauniaux, E; Johns, J; Burton, G J

    2005-06-01

    The advent of high-resolution transvaginal ultrasound (TVS) has revolutionized our understanding of the pathophysiology and the management of early pregnancy failure. Knowledge of the ultrasound appearances of normal early pregnancy development and a good understanding of its pitfalls are essential for the diagnosis and management of early pregnancy failure. Ultrasound imaging has rapidly replaced all other techniques used to study normal human development in the first trimester, and ultrasound features of the early gestational sac have corroborated anatomical studies showing that the first structures to appear are the celomic cavity and the secondary yolk sac. No single ultrasound measurement of the different anatomical features in the first trimester has been shown to have a high predictive value for determining early pregnancy outcome. Similarly, Doppler studies have failed to demonstrate abnormal blood flow indices in the first-trimester uteroplacental circulation of pregnancies that subsequently end in miscarriage. Ultrasound parameters combined with maternal serum hormone levels, maternal age, smoking habits, obstetric history and the occurrence of vaginal bleeding have all been combined in multivariate analyses, with mixed results. Combined ultrasound and in-vitro experiments have demonstrated that the maternal circulation inside the placenta starts at the periphery at around 9 weeks of gestation and that this is associated with a physiological oxidative stress which could be the trigger for the formation of the placental membranes. Abnormal development of these membranes can result in subchorionic hemorrhage and threatened miscarriage with subsequent long-term consequences such as preterm rupture of the membranes and preterm labor, irrespective of the finding of a hematoma on ultrasound. In both euploid and aneuploid missed miscarriages there is clear ultrasound evidence for excessive entry of maternal blood at a very early stage inside the developing

  1. Kinematic assessment of stereotypy in spontaneous movements in infants

    NARCIS (Netherlands)

    Karch, Dominik; Kang, Keun-Sun; Wochner, Katarzyna; Philippi, Heike; Hadders-Algra, Mijna; Pietz, Joachim; Dickhaus, Hartmut

    Movement variation constitutes a crucial feature of infant motor development. Reduced variation of spontaneous infant movements, i.e. stereotyped movements, may indicate severe neurological deficit at an early stage. Hitherto evaluation of movement variation has been mainly restricted to subjective

  2. Male-mediated spontaneous abortion among spouses of stainless steel welders

    DEFF Research Database (Denmark)

    Hjollund, N H; Bonde, J P; Jensen, T K

    2000-01-01

    Male-mediated spontaneous abortion has never been documented for humans. The welding of stainless steel is associated with the pulmonary absorption of hexavalent chromium, which has genotoxic effects on germ cells in rodents. Clinical and early subclinical spontaneous abortions were examined among...

  3. Male-mediated spontaneous abortion among spouses of stainless steel welders

    DEFF Research Database (Denmark)

    Hjollund, N H; Bonde, Jens Peter; Jensen, Tina Kold

    2000-01-01

    Male-mediated spontaneous abortion has never been documented for humans. The welding of stainless steel is associated with the pulmonary absorption of hexavalent chromium, which has genotoxic effects on germ cells in rodents. Clinical and early subclinical spontaneous abortions were examined among...... spouses of stainless-steel welders....

  4. HLA sharing and history of miscarriage among women with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, P. [Univ. of Manchester Medical School (United Kingdom)

    1997-03-01

    An increased frequency of recurrent spontaneous abortions (RSA), defined as three or more pregnancy losses without an identifiable cause, has been reported among women who share HLA alleles with their partner. A similar association has also been reported for women who have decreased fecundity. No specific HLA alleles have been identified as being the important etiological factor, raising the possibility that the observed sharing may represent a marker for sharing of other closely linked susceptibility genes. 12 refs., 1 tab.

  5. Spontaneous intraorbital hematoma: case report

    Directory of Open Access Journals (Sweden)

    Vinodan Paramanathan

    2010-12-01

    Full Text Available Vinodan Paramanathan, Ardalan ZolnourianQueen's Hospital NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, UKAbstract: Spontaneous intraorbital hematoma is an uncommon clinical entity seen in ophthalmology practice. It is poorly represented in the literature. Current evidence attributes it to orbital trauma, neoplasm, vascular malformations, acute sinusitis, and systemic abnormalities. A 65-year-old female presented with spontaneous intraorbital hematoma manifesting as severe ocular pains, eyelid edema, proptosis, and diplopia, without a history of trauma. Computer tomography demonstrated a fairly well defined extraconal lesion with opacification of the paranasal sinuses. The principal differential based on all findings was that of a spreading sinus infection and an extraconal tumor. An unprecedented finding of a spontaneous orbital hematoma was discovered when the patient was taken to theater. We discuss the rarity of this condition and its management.Keywords: hemorrhage, ophthalmology, spontaneous, intra-orbital, hematoma

  6. Spontaneous creation of the universe from nothing

    CERN Document Server

    He, Dongshan; Cai, Qing-yu

    2014-01-01

    An interesting idea is that the universe could be spontaneously created from nothing, but no rigorous proof has been given. In this paper, we present such a proof based on the analytic solutions of the Wheeler-DeWitt equation (WDWE). Explicit solutions of the WDWE for the special operator ordering factor p=-2 (or 4) show that, once a small true vacuum bubble is created by quantum fluctuations of the metastable false vacuum, it can expand exponentially no matter whether the bubble is closed, flat or open. The exponential expansion will end when the bubble becomes large and thus the early universe appears. With the de Broglie-Bohm quantum trajectory theory, we show explicitly that it is the quantum potential that plays the role of the cosmological constant and provides the power for the exponential expansion of the true vacuum bubble. So it is clear that the birth of the early universe completely depends on the quantum nature of the theory.

  7. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  8.  The Use of Total Cervical Occlusion along with McDonald Cerclage in Patientswith Recurrent Miscarriage or Preterm Deliveries

    Directory of Open Access Journals (Sweden)

    Sanusi R. Suhyb

    2012-01-01

    Full Text Available  Objectives: To study the fetal outcome with the use of McDonaldcerclage and total cervical occlusion in women with recurrentmid-trimester miscarriages or preterm deliveries, as well ascomplications of total cervical occlusion in the women.Methods: Prospective descriptive observational study on patientswith two or more mid-trimester miscarriages, deliveries before 36weeks, or patients who have experienced failure of transvaginalcerclage.Results: Twenty-six women were studied. Of these, 92�0deliveredat term. Two women delivered at 33 and 35 weeks, respectively.There was one neonatal death. Take home baby rate was 96.2�here was no serious maternal morbidity among the patients.Conclusion: The addition of external cervical OS occlusion toMcDonald cerclage could improve fetal outcome in women withrecurrent mid-trimester miscarriages and preterm deliveries.

  9. Motion under graviditeten og risikoen for spontan abort--sekundærpublikation

    DEFF Research Database (Denmark)

    Madsen, Mia; Jørgensen, Tina; Jensen, Mette Lundsby

    2008-01-01

    We investigated the association between exercise during pregnancy and risk of miscarriage among more than 90,000 pregnant women. Information on exposures was obtained by means of computer-assisted telephone interviews. A relation was found between the amount of exercise and the risk of miscarriage...... with the risk of miscarriage rising stepwise by the amount of exercise performed. Particularly "high impact exercise" was associated with an increased risk of miscarriage. No association was seen between exercise and risk of miscarriage after 18 weeks of gestation. Udgivelsesdato: 2008-Sep-1...

  10. Motion under graviditeten og risikoen for spontan abort. Sekundærpublikation

    DEFF Research Database (Denmark)

    Madsen, Mia; Jørgensen, Tina; Jensen, Mette Lundsby

    2008-01-01

    We investigated the association between exercise during pregnancy and risk of miscarriage among more than 90,000 pregnant women. Information on exposures was obtained by means of computer-assisted telephone interviews. A relation was found between the amount of exercise and the risk of miscarriage...... with the risk of miscarriage rising stepwise by the amount of exercise performed. Particularly "high impact exercise" was associated with an increased risk of miscarriage. No association was seen between exercise and risk of miscarriage after 18 weeks of gestation. Udgivelsesdato: 2008-Sep-1...

  11. The impact of miscarriage on women's pregnancy-specific anxiety and feelings of prenatal maternal-fetal attachment during the course of a subsequent pregnancy: an exploratory follow-up study.

    Science.gov (United States)

    Tsartsara, Eirini; Johnson, Martin P

    2006-09-01

    This study assesses the implications a miscarriage history has on women's pregnancy-specific anxiety and feelings of prenatal maternal-fetal attachment during the 1st and 3rd trimesters of a subsequent pregnancy. Thirty-five pregnant women (N = 10 with a history of miscarriage) volunteered participation completing the Pregnancy Outcome Questionnaire (POQ), the Maternal Antenatal Attachment Scale (MAAS and a demographic/reproductive history questionnaire during the first trimester of pregnancy. Of these, 24 participants completed the measures again during the third trimester of pregnancy. Women with a miscarriage history reported significantly higher pregnancy-specific anxiety at trimester 1 than women with no miscarriage history; even when the effects of parity were controlled. All expectant mothers, irrespective of miscarriage history, scored similarly at trimester 1 on the MAAS scales. By the 3rd trimester, pregnancy-specific anxiety had significantly decreased for women with a miscarriage history whose mean scores on the POQ were now similar to women with no history of miscarriage. Maternal-fetal attachment had significantly risen by the 3rd trimester for all women. These findings suggest that having a miscarriage history may not have a long-lasting adverse effect on woman's psychological adaptation during the course of a subsequent pregnancy.

  12. Leiomyomas in Pregnancy and Spontaneous Abortion: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Sundermann, Alexandra C; Velez Edwards, Digna R; Bray, Michael J; Jones, Sarah H; Latham, Sanura M; Hartmann, Katherine E

    2017-10-06

    To systematically review studies reporting the risk of spontaneous abortion among pregnant women of typical reproductive potential with and without uterine leiomyomas. We searched PubMed, EMBASE, Web of Science, and ClinicalTrials.gov for publications from January 1970 to December 2016. We excluded studies that did not use imaging to uniformly document leiomyoma status of all participants, did not have a comparison group without leiomyomas, or primarily included women seeking care for recurrent miscarriage, infertility care, or assisted reproductive technologies. Two authors independently reviewed eligibility, extracted data, and assigned overall quality ratings based on predetermined criteria. Of 1,469 articles identified, nine were eligible. Five enrolled general obstetric populations and four included women undergoing amniocentesis. In five studies in general obstetric populations that included 21,829 pregnancies (1,394 women with leiomyomas and 20,435 without), only one adjusted for potential confounders. This meta-analysis revealed no increase in risk of spontaneous abortion among those with leiomyomas compared with those without (11.5% compared with 8.0%; risk ratio 1.16, 95% CI 0.80-1.52). When bias from confounding was estimated for nonadjusted studies, the aggregate calculated risk ratio was 0.83 (95% CI 0.68-0.98). Leiomyoma presence was not associated with increased risk of spontaneous abortion in an analysis of more than 20,000 pregnant women. Failure of prior studies to adjust for confounders may have led to the common clinical belief that leiomyomas are a risk factor for spontaneous abortion.

  13. Retinoid X receptor α and retinoids are key regulators in apoptosis of trophoblasts of patients with recurrent miscarriages.

    Science.gov (United States)

    Pestka, A; Toth, B; Kuhn, C; Hofmann, S; Wiest, I; Wypior, G; Friese, K; Jeschke, U

    2011-10-01

    The retinoid X receptor α (RXRα) is a nuclear hormone receptor that is able to bind other nuclear receptors in a heterodimeric complex, thereby activating gene transcription. Recently, we identified enhanced expression of RXRα in extravillous trophoblasts (EVT) and villous trophoblasts (VT) of miscarried placentas. In addition, an increased number of apoptotic EVT was present in miscarried placentas. In this study, on the basis of immunocytochemical analysis, western blots, and quantitative real-time reverse transcription PCR, we could demonstrate a reduced expression of RXRα in choriocarcinoma cell lines and in human VTs after stimulation with the retinoids 9-cis-retinoic acid and all-trans-retinoic acid and the prostaglandin 15-deoxy-Δ(12,14)-prostaglandin J(2). Furthermore, a simultaneous expression of RXRα and the apoptotic marker M30 CytoDEATH in EVT of miscarried placentas from the first trimester was shown. In EVT of control placentas from legal termination of pregnancies, no co-expression of RXRα and M30 could be detected. A likely conclusion is that RXRα plays an important role in the induction of apoptosis. Downregulation of RXRα, as observed in the tested choriocarcinoma cells and trophoblasts, might serve as a protection against apoptosis and miscarriage. In conclusion, RXRα represents a potential target in the treatment of recurrent miscarriages.

  14. Molecular analysis of miscarriage products using multiplex ligation-dependent probe amplification (MLPA): alternative to conventional karyotype analysis.

    Science.gov (United States)

    Kim, Ji Won; Lyu, Sang Woo; Sung, Se Ra; Sung, Sae Ra; Park, Ji Eun; Cha, Dong Hyun; Yoon, Tae Ki; Ko, Jung Jae; Shim, Sung Han

    2015-02-01

    The present study aims to evaluate whether multiplex ligation-dependent probe amplification (MLPA) technique with subtelomeric probes is to be an alternative method of routine G-banding chromosome analysis from pregnancy loss. A review of 5 years (from 2005 to 2009) of karyotype for products of conception (POCs) was carried out. From June 2010 to June 2012, MLPA was performed in parallel with karyotype analysis on 347 miscarriages. Karyotyped miscarriages served as controls in this blinded study. Abnormal results were confirmed by fluorescence in situ hybridization. A review of 5 years of karyotype results for POCs indicated that 11.46 % of cases failed to karyotyping. In the study periods, MLPA results were successfully obtained from all cases including 51 (14.7 %) culture failed cases, chromosomal abnormalities were detected in 27 (52.9 %) of cases which failed to grow or could not be cultivated. It took 3 weeks by conventional karyotyping, but it required at least 24 h and at most a week by MLPA from tissue sampling to final reporting. 47 cases showed discordant results between karyotyping and MLPA because of maternal cell contamination, polyploidy, mosaicism, or balanced translocation. MLPA technique is relatively low cost, less labor intensive and reduces waiting time with high accuracy compared with conventional cytogenetic analysis. Therefore, MLPA can be the first approach for chromosome analysis from pregnancy loss.

  15. Multi-functional optical coherence tomography imaging of spontaneous neovascularization in the mouse retina

    Science.gov (United States)

    Augustin, Marco; Wechdorn, Matthias; Pfeiffenberger, Ulrike; Fialová, Stanislava; Werkmeister, René M.; Hitzenberger, Christoph K.; Baumann, Bernhard

    2017-07-01

    A multi-functional OCT approach is used to identify different tissue types during the early development of spontaneous neovascularizations in the mouse retina based on their intrinsic optical properties.

  16. The Relationship among Spontaneity, Impulsivity, and Creativity

    Science.gov (United States)

    Kipper, David A.; Green, Doreen J.; Prorak, Amanda

    2010-01-01

    The present study was designed to investigate two characteristics of spontaneity, its relationship to creativity and to impulsivity. We hypothesized a positive relationship between spontaneity and creativity, consistent with Moreno, 1953 "canon of spontaneity-creativity." We also predicted a negative relationship between spontaneity and…

  17. Optical antenna enhanced spontaneous emission.

    Science.gov (United States)

    Eggleston, Michael S; Messer, Kevin; Zhang, Liming; Yablonovitch, Eli; Wu, Ming C

    2015-02-10

    Atoms and molecules are too small to act as efficient antennas for their own emission wavelengths. By providing an external optical antenna, the balance can be shifted; spontaneous emission could become faster than stimulated emission, which is handicapped by practically achievable pump intensities. In our experiments, InGaAsP nanorods emitting at ∼ 200 THz optical frequency show a spontaneous emission intensity enhancement of 35 × corresponding to a spontaneous emission rate speedup ∼ 115 ×, for antenna gap spacing, d = 40 nm. Classical antenna theory predicts ∼ 2,500 × spontaneous emission speedup at d ∼ 10 nm, proportional to 1/d(2). Unfortunately, at d < 10 nm, antenna efficiency drops below 50%, owing to optical spreading resistance, exacerbated by the anomalous skin effect (electron surface collisions). Quantum dipole oscillations in the emitter excited state produce an optical ac equivalent circuit current, I(o) = qω|x(o)|/d, feeding the antenna-enhanced spontaneous emission, where q|x(o)| is the dipole matrix element. Despite the quantum-mechanical origin of the drive current, antenna theory makes no reference to the Purcell effect nor to local density of states models. Moreover, plasmonic effects are minor at 200 THz, producing only a small shift of antenna resonance frequency.

  18. Bacterial vaginosis in early pregnancy is associated with low birth weight and small for gestational age, but not with spontaneous preterm birth: A population-based study on Danish women

    DEFF Research Database (Denmark)

    Thorsen, Poul; Vogel, Ida; Olsen, Jørn

    2006-01-01

    Objective. To analyze the association between bacterial vaginosis (BV) in early pregnancy and preterm birth, low birth weight (LBW) and small for gestational age (SGA) in a Danish population. Methods. A geographically defined population-based prospective study of Danish-speaking pregnant women over...

  19. Alcohol consumption at the time of conception and spontaneous abortion

    DEFF Research Database (Denmark)

    Henriksen, Tine Brink; Hjollund, Niels Henrik; Jensen, Tina Kold

    2004-01-01

    The authors studied the association between female and male alcohol intakes at the time of conception and the risk of spontaneous abortion, including early pregnancy loss detected by urinary human chorionic gonadotropin. After a nationwide mailing to about 50,000 members of four trade unions....... Women collected morning urine for 10 days from the first day of vaginal bleeding in each cycle. The authors detected 186 pregnancies: 131 resulted in childbirth, and 55 resulted in spontaneous abortion (34 detected by urinary human chorionic gonadotropin). Depending on the intake in the cycle...... of conception and the adjustment factors, female alcohol intake was associated with 2-3 times the adjusted risk of spontaneous abortion compared with no intake, and male alcohol intake was associated with 2-5 times the adjusted risk. Only the adjusted relative risks for 10 or more drinks/week compared...

  20. Spontaneous methicillin-resistant Staphylococcus aureus epidural abscess in pregnancy.

    Science.gov (United States)

    Connealy, Brendan D; Lovgren, Todd R; Tomich, Paul G; Smith, Carl V; Berg, Teresa G

    2010-08-01

    Epidural abscess is a rare complication of regional anesthesia, and spontaneous formation is even more uncommon. Diabetes mellitus, concomitant infection, intravenous drug use, and immune suppression are risk factors for spontaneous epidural abscess. A 29-year-old white woman presented at 28 weeks of estimated gestational age reporting an intermittent headache. She had Horner syndrome and was hospitalized. A cervicothoracic epidural abscess was diagnosed. Surgical decompression and parenteral antibiotics resulted in complete resolution of neurologic symptoms. Cultures were positive for methicillin-resistant Staphylococcus aureous. Spontaneous epidural abscess is a rare condition and diagnosis is often delayed. The finding of Horner syndrome led to imaging of the cervical spine and diagnosis of epidural abscess. Early intervention resulted in resolution of neurologic symptoms and a successful pregnancy outcome.

  1. Pseudoarachnoiditis in Spontaneous Intracranial Hypotension

    Directory of Open Access Journals (Sweden)

    Özlem Alkan

    2011-03-01

    Full Text Available Spontaneous intracranial hypotension is an important cause of new daily persistent headaches in young and middle-aged individuals. The diagnosis is made based on low cerebrospinal fluid pressure with characteristic findings upon brain and spinal magnetic resonance imaging (MRI. We present the case of a 15-year-old boy with spontaneous intracranial hypotension. Although his brain MRI was normal, his lumbar spinal MRI showed clustering of the nerve roots characteristic of arachnoiditis. Radionuclide cisternography revealed an epidural leak, which was treated with an epidural blood patch. The patient reached a near-full recovery within 24 h, and the lumbar spinal MRI findings mimicking arachnoiditis disappeared.

  2. Spontaneous waves in muscle fibres

    Energy Technology Data Exchange (ETDEWEB)

    Guenther, Stefan; Kruse, Karsten [Department of Theoretical Physics, Saarland University, 66041 Saarbruecken (Germany); Max Planck Institute for the Physics of Complex Systems, Noethnitzer Street 38, 01187 Dresden (Germany)

    2007-11-15

    Mechanical oscillations are important for many cellular processes, e.g. the beating of cilia and flagella or the sensation of sound by hair cells. These dynamic states originate from spontaneous oscillations of molecular motors. A particularly clear example of such oscillations has been observed in muscle fibers under non-physiological conditions. In that case, motor oscillations lead to contraction waves along the fiber. By a macroscopic analysis of muscle fiber dynamics we find that the spontaneous waves involve non-hydrodynamic modes. A simple microscopic model of sarcomere dynamics highlights mechanical aspects of the motor dynamics and fits with the experimental observations.

  3. Spontaneous isolated celiac artery dissection

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk

    2011-01-01

    Full Text Available Dyspepsia with mild, stabbing epigastric discomfort without history of trauma is a very common symptom that emergency physicians see in their daily practice. Vascular emergencies, mostly the aortic dissection and aneurysm, are always described in the differential diagnosis with persistent symptoms. Isolated celiac artery dissection occurring spontaneously is a very rare diagnosis. The involvement of branch vessels is generally observed and patients show various clinical signs and symptoms according to the involved branch vessel. Here we are presenting a case with spontaneous isolated celiac artery dissection, without any branch vessel involvement or visceral damage, detected by computed tomography scans taken on admission.

  4. Fertility and obstetric outcomes after curettage versus expectant management in randomised and non-randomised women with an incomplete evacuation of the uterus after misoprostol treatment for miscarriage

    NARCIS (Netherlands)

    Lemmers, M.; Verschoor, M. A. C.; Overwater, K.; Bossuyt, P. M.; Hendriks, D.; Hemelaar, M.; Schutte, J. M.; Adriaanse, A. H.; Ankum, W. M.; Huirne, J. A. F.; Mol, B. W. J.

    2017-01-01

    To assess fertility and obstetric outcomes in women treated with curettage or undergoing expectant management for an incomplete miscarriage after misoprostol treatment. Between June 2012 and July 2014, we conducted a multicentre randomised clinical trial (RCT) with a parallel cohort study for

  5. MisoREST : surgical versus expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for miscarriage: a randomized controlled trial

    NARCIS (Netherlands)

    Lemmers, M; Verschoor, M A C; Oude Rengerink, K; Naaktgeboren, C; Opmeer, B C; Bossuyt, P M; Huirne, J A F; Janssen, C A H; Radder, C; Klinkert, E R; Langenveld, J; Catshoek, R; Van der Voet, L; Siemens, F; Geomini, P; Van Hooff, M H; Van der Ploeg, J M; Coppus, S F P J; Ankum, W M; Mol, B W J

    2016-01-01

    STUDY QUESTION: Is curettage more effective than expectant management in case of an incomplete evacuation after misoprostol treatment for first trimester miscarriage? SUMMARY ANSWER: Curettage leads to a higher chance of complete evacuation but expectant management is successful in at least 76% of

  6. MisoREST : surgical versus expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for miscarriage: a randomized controlled trial

    NARCIS (Netherlands)

    Lemmers, M.; Verschoor, M. A. C.; Rengerink, K. Oude; Naaktgeboren, C.; Opmeer, B. C.; Bossuyt, P. M.; Huirne, J. A. F.; Janssen, C. A. H.; Radder, C.; Klinkert, E. R.; Langenveld, J.; Catshoek, R.; Van der Voet, L.; Siemens, F.; Geomini, P.; Van Hooff, M. H.; Van der Ploeg, J. M.; Coppus, S. F. P. J.; Ankum, W. M.; Mol, B. W. J.

    2016-01-01

    Is curettage more effective than expectant management in case of an incomplete evacuation after misoprostol treatment for first trimester miscarriage? Curettage leads to a higher chance of complete evacuation but expectant management is successful in at least 76% of women with an incomplete

  7. IMMEDIATE MENTAL CONSEQUENCES OF THE GREAT EAST JAPAN EARTHQUAKE AND FUKUSHIMA NUCLEAR POWER PLANT ACCIDENT ON MOTHERS EXPERIENCING MISCARRIAGE, ABORTION, AND STILLBIRTH: THE FUKUSHIMA HEALTH MANAGEMENT SURVEY.

    Science.gov (United States)

    Yoshida-Komiya, Hiromi; Goto, Aya; Yasumura, Seiji; Fujimori, Keiya; Abe, Masafumi

    2015-01-01

    The Fukushima Pregnancy and Birth Survey was launched to monitor pregnant mothers' health after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant (NPP) accident. Several lines of investigations have indicated that a disaster impacts maternal mental health with childbirth. However, there is no research regarding mental health of mothers with fetal loss after a disaster. In this report, we focus on those women immediately after the Great East Japan Earthquake and Fukushima NPP accident and discuss their support needs. Data regarding 61 miscarriages, 5 abortions, and 22 stillbirths were analyzed among the women who were pregnant at the time of the accident in the present study. We used a two-item case-finding instrument for depression screening, and compared the childbirth group with the fetal loss groups. We also analyzed mothers' opinions written as free-form text. Among the three fetal loss groups, the proportion of positive depression screens was significantly higher in the miscarriage and stillbirth group than in the childbirth group. Mothers' opinions were grouped into six categories, with pregnancy-related items being most common, especially in the miscarriage and stillbirth groups. A higher proportion of Fukushima mothers with fetal loss, especially those with miscarriage and stillbirth, had depressive symptoms compared to those who experienced childbirth. Health care providers need to pay close attention to this vulnerable group and respond to their concerns regarding the effects on their fertility.

  8. H-Y antibody titers are increased in unexplained secondary recurrent miscarriage patients and associated with low male : female ratio in subsequent live births

    DEFF Research Database (Denmark)

    Nielsen, H S; Wu, F; Aghai, Z

    2010-01-01

    The birth of a boy is significantly more common than a girl prior to secondary recurrent miscarriage (SRM) and is associated with a poorer chance of a subsequent live birth. Children born after SRM are more likely to be girls. High-titer antisera specific for male antigens (H-Y) have been shown...

  9. "These are not good things for other people to know": how rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality.

    Science.gov (United States)

    Haws, Rachel A; Mashasi, Irene; Mrisho, Mwifadhi; Schellenberg, Joanna Armstrong; Darmstadt, Gary L; Winch, Peter J

    2010-11-01

    Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Spontaneous closure of midline diastema following frenectomy.

    Science.gov (United States)

    Koora, Kiran; Muthu, M S; Rathna, Prabhu V

    2007-03-01

    Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies) and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

  11. Spontaneous closure of midline diastema following frenectomy

    Directory of Open Access Journals (Sweden)

    Koora Kiran

    2007-03-01

    Full Text Available Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

  12. Biomarkers of spontaneous preterm birth

    DEFF Research Database (Denmark)

    Polettini, Jossimara; Cobo, Teresa; Kacerovsky, Marian

    2017-01-01

    Despite decades of research on risk indicators of spontaneous preterm birth (PTB), reliable biomarkers are still not available to screen or diagnose high-risk pregnancies. Several biomarkers in maternal and fetal compartments have been mechanistically linked to PTB, but none of them are reliable...

  13. THE RATE OF SPONTANEOUS MUTATION

    Indian Academy of Sciences (India)

    The Rate of Spontaneous Mutation of a Human Gene. (Published on 1935 J. Genet. 31, 317-326). J. B. S. Haldane. J. Genet. Classic Volume 83 Issue 3 December 2004 pp 235-244. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/jgen/083/03/0235-0244. Author Affiliations.

  14. Spontaneously disappearing lumbar disc protrusion

    OpenAIRE

    Ushewokunze, Shungu; Abbas, Naeem; Dardis, Ronan; Killeen, Ian

    2008-01-01

    Spontaneous disappearance of a herniated lumbar disc is known to occur. This case study describes a 45-year-old patient whose symptoms of lumbar radiculopathy resolved and follow-up imaging showed complete disappearance of the disc prolapse. This phenomenon strengthens the role of conservative treatment in the management of lumbar disc protrusions.

  15. Spontaneous fission of superheavy nuclei

    Indian Academy of Sciences (India)

    and penetrability for binary nuclear configurations typical for fission processes. The deformed two- ... Finally, the WKB method is used to calculate penetrabilities and spontaneous fission half-lives. Calculations ... the mass tensor components contain binary character of the process, because the pairing. Pramana – J. Phys.

  16. Shell theorem for spontaneous emission

    DEFF Research Database (Denmark)

    Kristensen, Philip Trøst; Mortensen, Jakob Egeberg; Lodahl, Peter

    2013-01-01

    and therefore is given exactly by the dipole approximation theory. This surprising result is a spontaneous emission counterpart to the shell theorems of classical mechanics and electrostatics and provides insights into the physics of mesoscopic emitters as well as great simplifications in practical calculations....

  17. Spontaneous complete chorioamniotic membrane separation ...

    African Journals Online (AJOL)

    Apart from the association with Down syndrome, other complications include preterm labour, premature rupture of membranes, IUGR, fetal malformation and fetal death. Such pregnancies require close fetal surveillance and occasionally inpatient management. Case: We present a case of spontaneous complete CAS and ...

  18. Silicosis with bilateral spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Fotedar Sanjay

    2010-01-01

    Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  19. Early pregnancy angiogenic proteins levels and pregnancy related hypertensive disorders.

    Science.gov (United States)

    Jakovljevic, Ana; Bogavac, Mirjana; Lozanov-Crvenkovic, Zagorka; Milosević-Tosic, Mirjana; Nikolic, Aleksandra; Mitic, Gorana

    2017-03-01

    Normal placental vascular development depends on multiple interactions of many regulatory molecules including pro and antiangiogenic proteins. It is considered that these vascular modulators might be one of the factors responsible for development hypertensive disorders in pregnancy. To evaluate and compare the early pregnancy (11-14 week of gestation) serum level of angiogenic proteins sFlt1, VEGF i PIGF between different types of pregnancy related hypertensive disorders. The study included 177 pregnant women between 11 and 14 weeks of gestation, divided into four study subgroups (preeclampsia group-41, gestational hypertension group-31, chronic hypertension group-32 and miscarriage group-19) and control group-54. Blood samples (serum) were taken for measuring sFlt1, VEGF i PIGF by a quantitative ELISA technique and measuring other biochemical and hematological parameters. Significantly higher levels of sFlt1 were in the subgroups with preeclampsia and miscarriages, significantly lower level of VEGF in the all study subgroups and lover level of PIGF were in miscarriage group. In the groups with chronic and gestational hypertension there were higher level of sFlt1 and lover level of VEGF than in the control group, but the differences did not reach statistical significance. Early pregnancy imbalance between antiangiogenic protein sFlt1 and proangiogenic molecules VEGF and PIGF could have impact on pathophysiology of placental disorders which leads to development of pregnancy related hypertensive disorders.

  20. Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry

    Directory of Open Access Journals (Sweden)

    Anjala Chelvanathan

    2016-01-01

    Full Text Available Objective. Out of hospital cardiac arrest (OHCA patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C and without catheterization (MTH + NC between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C and 110 patients did not undergo cardiac catheterization (MTH + NC. Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, and p = 0.009. Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA.

  1. Spontaneous Retropharyngeal Emphysema: A Case Report | Chi ...

    African Journals Online (AJOL)

    ... is a rare clinical condition in pediatric otolaryngology. The predominant symptoms are sore throat, odynophagia, dysphagia, and neck pain. Here, we report a case of spontaneous retropharyngeal emphysema. Keywords: Iatrogenic injury, retropharyngeal emphysema, spontaneous retropharyngeal emphysem, trauma ...

  2. Lunar Cycle Influences Spontaneous Delivery in Cows

    OpenAIRE

    Yonezawa, Tomohiro; Uchida, Mona; Tomioka, Michiko; Matsuki, Naoaki

    2016-01-01

    There is a popular belief that the lunar cycle influences spontaneous delivery in both humans and cattle. To assess this relationship, we investigated the synodic distribution of spontaneous deliveries in domestic Holstein cows. We used retrospective data from 428 spontaneous, full-term deliveries within a three-year period derived from the calving records of a private farm in Hokkaido, Japan. Spontaneous birth frequency increased uniformly from the new moon to the full moon phase and decreas...

  3. The moral significance of spontaneous abortion.

    OpenAIRE

    Murphy, T F

    1985-01-01

    Spontaneous abortion is rarely addressed in moral evaluations of abortion. Indeed, 'abortion' is virtually always taken to mean only induced abortion. After a brief review of medical aspects of spontaneous abortion, I attempt to articulate the moral implications of spontaneous abortion for the two poles of the abortion debate, the strong pro-abortion and the strong anti-abortion positions. I claim that spontaneous abortion has no moral relevance for strict pro-abortion positions but that the ...

  4. Association of the +49 A/G Polymorphism of CTLA4 Gene with Idiopathic Recurrent Spontaneous Abortion in Women in Southwest of Iran.

    Science.gov (United States)

    Rasti, Zarnegar; Nasiri, Mahboobeh

    2016-01-01

    Survival of the semi-allograft fetus during pregnancy opens a new area for the immunological based causes of recurrent spontaneous abortion (RSA). Cytotoxic T lymphocyte-associated antigen 4 (CTLA4) is a negative regulator of the T-cell activation, which may modulate peripheral self-tolerance of the allogeneic fetus. The present study aimed to investigate the +49 A/G CTLA4 genetic polymorphism and predisposition to RSA. The total participants were 120 women with at least two miscarriages and 120 healthy post-menopausal women as the control group. The +49 A/G polymorphism was genotyped using PCR-RFLP method. Required demographic information was collected through filling out a questionnaire. The obtained data were fed into SPSS software version 16. The results showed a significant association between the minor alleles (G) with the decreased risk of the RSA. The frequency of the G allele in controls and patients was 25% and 12%, respectively. A GG genotype in the co-dominance model (OR: 0.25, 95%CI: 0.09-0.66) and in the dominant model for allele G (GG+AG vs. AA) (OR: 0.84, 95%CI: 0.8-0.87) showed significant association with RSA by imposing the protective role. The frequency of miscarriage is significantly (p=0.04) higher among the relatives of RSA women (33.3%) in comparison with the women in the control group (21.7%). It can be concluded that +49G allele may act as a dominant allele and reduce the risk of RSA. Family history of miscarriage increased the risk of RSA among women.

  5. Spontaneous Photon Emission in Cavities

    Directory of Open Access Journals (Sweden)

    Alber G.

    2014-01-01

    Full Text Available We investigate spontaneous photon emission processes of two-level atoms in parabolic and ellipsoidal cavities thereby taking into account the full multimode scenario. In particular, we calculate the excitation probabilities of the atoms and the energy density of the resulting few-photon electromagnetic radiation field by using semiclassical methods for the description of the multimode scenario. Based on this approach photon path representations are developed for relevant transition probability amplitudes which are valid in the optical frequency regime where the dipole and the rotating-wave approximations apply. Comparisons with numerical results demonstrate the quality of these semiclassical results even in cases in which the wave length of a spontaneously emitted photon becomes comparable or even larger than characteristic length scales of the cavity. This is the dynamical regime in which diffraction effects become important so that geometric optical considerations are typically not applicable.

  6. Spontaneous rupture of the ureter

    Science.gov (United States)

    Eken, Alper; Akbas, Tugana; Arpaci, Taner

    2015-01-01

    Spontaneous rupture of the ureter is a very rare condition and usually results from ureteral obstruction by a calculus. Only theoretical mecha­nisms have been proposed and no possible explanation has yet been reported in the literature. Intravenous contrast-enhanced computed tomography is the most informative study with high sensitivity. Treatment should be individualised, and depends on the state of the patient. Minimally invasive endourological procedures with double-J catheter placement and percutaneous drainage offer excellent results. Conservative management with analgesics and antibiotic coverage may be an alternative to surgery. Herein, we present a case of spontaneous rupture of the proximal ureter with no evidence of an underlying pathological condition. PMID:25715862

  7. Spontaneous regression of colon cancer.

    Science.gov (United States)

    Kihara, Kyoichi; Fujita, Shin; Ohshiro, Taihei; Yamamoto, Seiichiro; Sekine, Shigeki

    2015-01-01

    A case of spontaneous regression of transverse colon cancer is reported. A 64-year-old man was diagnosed as having cancer of the transverse colon at a local hospital. Initial and second colonoscopy examinations revealed a typical cancer of the transverse colon, which was diagnosed as moderately differentiated adenocarcinoma. The patient underwent right hemicolectomy 6 weeks after the initial colonoscopy. The resected specimen showed only a scar at the tumor site, and no cancerous tissue was proven histologically. The patient is alive with no evidence of recurrence 1 year after surgery. Although an antitumor immune response is the most likely explanation, the exact nature of the phenomenon was unclear. We describe this rare case and review the literature pertaining to spontaneous regression of colorectal cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Spontaneous Rotational Inversion in Phycomyces

    KAUST Repository

    Goriely, Alain

    2011-03-01

    The filamentary fungus Phycomyces blakesleeanus undergoes a series of remarkable transitions during aerial growth. During what is known as the stagea IV growth phase, the fungus extends while rotating in a counterclockwise manner when viewed from above (stagea IVa) and then, while continuing to grow, spontaneously reverses to a clockwise rotation (stagea IVb). This phase lasts for 24-48Ah and is sometimes followed by yet another reversal (stageAIVc) before the overall growth ends. Here, we propose a continuum mechanical model of this entire process using nonlinear, anisotropic, elasticity and show how helical anisotropy associated with the cell wall structure can induce spontaneous rotation and, under appropriate circumstances, the observed reversal of rotational handedness. © 2011 American Physical Society.

  9. Spontaneous Perforation of Rectosigmoid Colon

    Directory of Open Access Journals (Sweden)

    Farhad Haj Sheikholeslami

    2010-12-01

    Full Text Available Spontaneous perforation of the sigmoid colon or rectom is definedas a sudden perforation of the colon in the absence of diseasessuch as tumors, diverticulosis or external injury. It is avery rare finding, and if neglected, results in severe peritonitisand high mortality. The causes of this rare condition are numerous,and in this case it might be due to the chronic constipationinduced by an anticholinergic antipsychotic.Iran J Med Sci 2010; 35(4: 339-341.

  10. Spontaneous esophageal-pleural fistula

    Directory of Open Access Journals (Sweden)

    Sameer Vyas

    2011-01-01

    Full Text Available Spontaneous esophageal-pleural fistula (EPF is a rare entity. We describe a case in a middle-aged female who presented with severe retrosternal chest pain and shortness of breadth. Chest computed tomography showed right EPF and hydropneumothorax. She was managed conservatively keeping the chest tube drainage and performing feeding jejunostomy. A brief review of the imaging finding and management of EPF is discussed.

  11. Spontaneous Splenic Rupture in Melanoma

    Directory of Open Access Journals (Sweden)

    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  12. Spontaneous abortion: a prospective cohort study of younger women from the general population in Denmark. Validation, occurrence and risk determinants

    DEFF Research Database (Denmark)

    Buss, L; Tolstrup, J; Munk, C

    2006-01-01

    , and may be early, nonhospitalized abortions. We confirm that number of previous spontaneous abortions is a strong determinant, and our data may also indicate a role of previous contraceptive habits. A role of the length of interpregnancy interval in the risk of spontaneous abortion cannot be ruled out....

  13. Aspirin and low-molecular weight heparin combination therapy effectively prevents recurrent miscarriage in hyperhomocysteinemic women.

    Directory of Open Access Journals (Sweden)

    Pratip Chakraborty

    Full Text Available The management of recurrent pregnancy loss (RPL still remains a great challenge, and women with polycystic ovarian syndrome (PCOS are at a greater risk for spontaneous abortion. Treatment with low-molecular-weight heparin (LMWH has become an accepted treatment option for women with RPL; however, the subgroup of women, who are likely to respond to LMWH, has not been precisely identified. The present study evaluated the efficacy of LMWH with reference to PCOS and associated metabolic phenotypes including hyperhomocysteinemia (HHcy, insulin resistance (IR and obesity. This prospective observational study was conducted at Institute of Reproductive Medicine, Kolkata, India. A total of 967 women with history of 2 or more consecutive first trimester abortions were screened and 336 were selected for the study. The selected patients were initially divided on the basis of presence or absence of PCOS, while subsequent stratification was based on HHcy, IR and/or obesity. The subjects had treatment with aspirin during one conception cycle and aspirin-LMWH combined anticoagulant therapy for the immediate next conception cycle, if the first treated cycle was unsuccessful. Pregnancy salvage was the sole outcome measure. The overall rate of pregnancy salvage following aspirin therapy was 43.15%, which was mostly represented by normohomocysteinemic women, while the salvage rate was lower in the HHcy populations irrespective of the presence or absence of PCOS, IR, or obesity. By contrast, aspirin-LMWH combined therapy could rescue 66.84% pregnancies in the aspirin-failed cases. Logistic regression analyses showed that HHcy remained a significant factor in predicting salvage rates in the PCOS, IR, and obese subpopulations controlled for other confounding factors. With regard to pregnancy salvage, combined anticoagulant therapy with aspirin and LMWH conferred added benefit to those with HHcy phenotype.

  14. Role of serum biomarkers in the prediction of outcome in women with threatened miscarriage: a systematic review and diagnostic accuracy meta-analysis.

    Science.gov (United States)

    Pillai, Rekha N; Konje, Justin C; Tincello, Douglas G; Potdar, Neelam

    2016-01-01

    Threatened miscarriage affects one in five women and is associated with significant emotional distress. The uncertainty around the prognosis of threatened miscarriage makes it equally challenging to the healthcare professionals. Various biochemical markers have been investigated in the past to predict the outcome of threatened miscarriage; however, the results have been conflicting. Therefore, we have conducted a systematic review and meta-analysis to determine the diagnostic accuracy of biochemical markers in predicting the outcome in women presenting with threatened miscarriage. This is a systematic review and meta-analysis of prospective studies that investigated biochemical markers to determine outcomes for women with threatened miscarriage at 5-23 weeks gestational age. Electronic databases were searched up to June 2015 and study quality assessment was performed using QUADAS-2 (Quality Assessment for Diagnostic Accuracy Studies-2: A Revised Tool) for evaluating the diagnostic accuracy studies. Statistical analysis was performed using the Cochrane systematic review software. A total of 19 studies were included in the qualitative data synthesis of which 15 (including 1263 women) were eligible for the meta-analysis. The review highlights the role of biochemical markers serum progesterone, hCG, pregnancy associated plasma protein A, estradiol and cancer antigen 125 (CA 125) in the prediction of outcome in women with threatened miscarriage. Interestingly, serum CA 125 appears to be the most promising marker (n = 648 women in seven studies), whereas serum progesterone and hCG are less useful once fetal viability is established. The summary receiver operating characteristics for CA 125 showed a sensitivity of 90% (95% confidence interval (CI) 83-94%), specificity of 88% (95% CI 79-93%), positive likelihood ratio of 7.86 (95% CI 4.23-14.60) and negative likelihood ratio of 0.10 (95% CI 0.06-0.20). The inverse of negative likelihood ratio was 9.31 (95% CI 5

  15. Predicting adverse obstetric outcome after early pregnancy events and complications: a review

    DEFF Research Database (Denmark)

    van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B

    2009-01-01

    BACKGROUND The aim was to evaluate the impact of early pregnancy events and complications as predictors of adverse obstetric outcome. METHODS We conducted a literature review on the impact of first trimester complications in previous and index pregnancies using Medline and Cochrane databases......) after two or more miscarriages, the risk of placenta praevia, premature preterm rupture of membranes, VPTD and low birthweight (LBW) after recurrent miscarriage and the risk of VPTD after two or more termination of pregnancy. Clinically relevant associations of adverse obstetric outcome in the ongoing...... hyperemesis gravidarum. CONCLUSIONS Data from our literature review indicate, by finding significant associations, that specific early pregnancy events and complications are predictors for subsequent adverse obstetric and perinatal outcome. Though, some of these associations are based on limited or small...

  16. Treatment of Chronic Spontaneous Urticaria

    Science.gov (United States)

    2012-01-01

    Chronic spontaneous urticaria is defined as persistent symptoms of urticaria for 6 weeks or more. It is associated with autoimmunity in approximately 45 percent of patients. Therapy is often difficult however the initial approach should employ high-dose non-sedating antihistamines; 4-6 tablets/day may be necessary. It has been shown that the response to 4 tablets/day exceeds 3, and exceeds 2, which exceeds 1. However the dose that corresponds to the maximal dose of first generation antihistamines (hydroxyzine, diphenhydramine) used previously, is 6/day. Yet over half the patients are refractory to antihistamines and other agents should be tried next. Whereas current guidelines (published) often add leukotriene antagonists and/or H2 receptor antogonists next, these are of little utility. Likewise drugs effective for urticarial vasculitis (colchicine, dapsone, sulfasalazine, hydroxychloroquine) are effective in a small percentage of patients and no study suggests that the response rate of any of them exceeds the 30% placebo responses seen in most double-blind, placebo controlled studies. The drugs that are effective for antihistamine-resistant chronic spontaneous urticaria are corticosteroids, cyclosporine, and Omalizumab. Use of steroids is limited by toxicity. If used at all, a dose of no more than 10 mg/day should be employed with a weekly reduction of 1 mg. The response rates to cyclosporine and Omalizumab are each close to 75%. Cyclosporine can be used effectively if care is taken to monitor blood pressure, urine protein, blood urea nitrogen, and creatinine, every 6 weeks. Omalizumab has the best profile in terms of efficacy/toxicity and, once approved by federal agencies for use in chronic spontaneous urticaria, a dramatic change in the treatment paradigm, whether associated with autoimmunity or not, is predicted. A phase 3 trial is currently in place. Refractoriness to both Omalizumab and cyclosporine is expected to be less than 5 percent of patients. Other

  17. Maternal factor V Leiden and prothrombin mutations do not seem to contribute to the occurrence of two or more than two consecutive miscarriages in Caucasian patients.

    Science.gov (United States)

    Baumann, Kristin; Beuter-Winkler, Petra; Hackethal, Andreas; Strowitzki, Thomas; Toth, Bettina; Bohlmann, Michael K

    2013-12-01

    We analysed the prevalence of the most common hereditary thrombophilia (hTP) - factor V Leiden (FVL) mutation, prothrombin 20210 G>A substitution (PT) - and the 677 C>T replacement in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene in Caucasian patients with a history of two and more consecutive recurrent miscarriages (RMs) as compared to healthy controls with an identical ethnic background and at least one live birth. A multicenter analysis of three hTP was performed in 641 RM patients identically screened at specialized university centres. The study groups consisted of 240 patients with 2 (1) and 401 patients with >2 miscarriages (2) and were compared with 157 controls. There was no significant difference in the prevalence of the hTP between RM patients and controls nor within the two study groups. Subgroup analysis showed that the homozygous MTHFR polymorphism was significantly more prevalent in the study group 2 as compared to study group 1 (13.9 versus 7.9%, P = 0.02). In Caucasians, maternal FVL or PT mutations do not seem to contribute to the pathophysiology of RM, irrespective of the number of miscarriages. However, the role of the homozygous MTHFR polymorphism merits further investigation. © 2013 John Wiley & Sons Ltd.

  18. A Case of Multiple Spontaneous Keloid Scars

    Directory of Open Access Journals (Sweden)

    Abdulhadi Jfri

    2015-07-01

    Full Text Available Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body.

  19. Women’s well-being improves after missed miscarriage with more active support and application of Swanson’s Caring Theory

    Directory of Open Access Journals (Sweden)

    Annsofie Adolfsson

    2010-12-01

    Full Text Available Annsofie Adolfsson1,21Department of Obstetrics and Gynecology, Skaraborgs Sjukhus, Skövde, Sweden; 2School of Life Sciences, The University of Skövde, SwedenPurpose: The purpose of this study was to provide better organization and more efficient use of resources within the health care system in order to identify women with nonviable pregnancy earlier in their gestation terms and also to identify those women who experience severe grief reaction after the miscarriage. The proposed solution is to offer an appointment with a gynecologist during regular office hours after consultation with the patient’s midwife to women experiencing symptoms and who are concerned with the viability of their pregnancy. Unnecessary contact with the emergency room by the patients would be reduced as a result of this improvement in organization. The aim of the study was to give the women experiencing missed miscarriage an increased sense of well-being by applying Swanson’s Caring Theory to their recovery, in addition to the better organization and more efficient use of resources.Method: Both the original study from 2002 to 2003 and the later study from 2004 to 2005 applied Swanson’s Caring Theory in the follow-up care management of the women, but only the later study was influenced by the changes made in the health care system. In the past, diagnosis of missed miscarriage was delayed because women experiencing minor symptoms were not highly prioritized in the health care system. More active support was introduced in order to get the proper information to the patient throughout the health care system. The size of the original study database was n = 43, compared with the later study database, which was n = 56. All of the women answered the Perinatal Grief Scale (PGS questions twice, 1 month and 4 months after their diagnosis. Some additional questions about their circumstances unrelated to the PGS were also mailed to the women 4 months after their diagnosis

  20. Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Daniel Cabezalí Barbancho

    2013-01-01

    Full Text Available Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

  1. Lyme Disease Presenting as a Spontaneous Knee Effusion.

    Science.gov (United States)

    Matzkin, Elizabeth; Suslavich, Kaytelin; Curry, Emily J

    2015-11-01

    Musculoskeletal complaints, which are frequently associated with Lyme disease, often prompt patients to see a physician. In particular, transient episodes of spontaneous knee effusion are common early in the progression of Lyme disease, and, if left untreated, 60% of patients diagnosed with the disease develop Lyme arthritis. This disease is easily treated with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease. However, the time required to receive test results and the inconsistencies between serum and synovial tests can complicate diagnosis of the disease. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  2. Three cases of spontaneous lumbar artery rupture in hemodialysis patients.

    Science.gov (United States)

    Hwang, Na Kyoung; Rhee, Harin; Kim, Il Young; Seong, Eun Young; Lee, Dong Won; Lee, Soo Bong; Kwak, Ihm Soo; Kim, Chang Won; Song, Sang Heon

    2017-01-01

    We encountered three cases of retroperitoneal hematoma caused by spontaneous lumbar artery rupture, a rare vascular complication. At the time of retroperitoneal hematoma, two patients were on anticoagulant/antiplatelet therapy. One patient was not taking any anticoagulant/antiplatelet agents but was receiving hemodialysis treatment with heparin. Lumbar artery rupture was successfully controlled by transcatheter arterial embolization in all patients, but one patient developed multiple organ failure and died. We suggest that spontaneous lumbar artery rupture may occur in patients being treated with maintenance hemodialysis or anticoagulant/antiplatelet therapy. Therefore, clinicians should suspect lumbar artery rupture in patients with unstable vital signs and rapid onset of anemia because early diagnosis and appropriate intervention are necessary to decrease the risks of morbidity and mortality. © 2016 International Society for Hemodialysis.

  3. Regulatory T cells, maternal-foetal immune tolerance and recurrent miscarriage: new therapeutic challenging opportunities.

    Science.gov (United States)

    Alijotas-Reig, Jaume; Melnychuk, Taisiia; Gris, Josep Maria

    2015-03-15

    Because maternal alloreactive lymphocytes are not depleted during pregnancy, local and/or systemic mechanisms have to play a key role in altering the maternal immune response. Peripheral T regulatory cells (pTregs) at the maternal-foetal interface are necessary in situ to prevent early abortion, but only those pTregs that have been previously exposed to paternal alloantigens. It has been showed that pregnancy selectively stimulates the accumulation of maternal Foxp3(+)CD4(+)CD25(+) (Foxp3Tregs) cells with foetal specificity. Interestingly, after delivery, foetal-specific pTregs persist at elevated levels, maintain tolerance to pre-existing foetal antigen, and rapidly re-accumulate during subsequent pregnancy. pTreg up-regulation could be hypothesized as a possible future therapeutic strategy in humans. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. [Spontaneous hepatic hematoma in twin pregnancy].

    Science.gov (United States)

    Quesnel, Carlos; Weber, Alejandro; Mendoza, Dalila; Garteiz, Denzil

    2012-02-01

    The hepatic hematoma or rupture appear in 1 of every 100,000 pregnancies. The most common causes of hepatic hematoma in pregnancy are severe preeclampsia and HELLP syndrome; some predisposing factors are seizures, vomiting, labor, preexistent hepatic disease and trauma. A 33 year old primigravid with a normal 33 week twin pregnancy presented abdominal pain and hypovolemic shock due to spontaneous subcapsular hepatic hematoma; laparoscopy was performed to evaluate the possibility of rupture, which was not found, later emergency cesarean section was carried out followed by hepatic hematoma drainage and abdominal packaging by laparoscopy. After surgery the flow through drainage was too high additionally hemodynamic instability and consumption coagulopathy. Abdominal panangiography was performed without identifying bleeding areas. Intesive care was given to the patient evolving satisfactorily, was discharged 19 days after the event. Seven months later she had laparoscopic cholecystectomy due to acute litiasic colecistitis. We found 5 cases in literatura about hepatic hematoma during pregnancy no related to hypertensive disorders of pregnancy; these were related to hepatoma, amebian hepatic abscess, falciform cell anemia, cocaine consumption and molar pregnancy. Hepatics hematomas have high morbidity and mortality so is significant early diagnosis and multidisciplinary approach.

  5. Spontaneous germinal centers and autoimmunity.

    Science.gov (United States)

    Domeier, Phillip P; Schell, Stephanie L; Rahman, Ziaur S M

    2017-02-01

    Germinal centers (GCs) are dynamic microenvironments that form in the secondary lymphoid organs and generate somatically mutated high-affinity antibodies necessary to establish an effective humoral immune response. Tight regulation of GC responses is critical for maintaining self-tolerance. GCs can arise in the absence of purposeful immunization or overt infection (called spontaneous GCs, Spt-GCs). In autoimmune-prone mice and patients with autoimmune disease, aberrant regulation of Spt-GCs is thought to promote the development of somatically mutated pathogenic autoantibodies and the subsequent development of autoimmunity. The mechanisms that control the formation of Spt-GCs and promote systemic autoimmune diseases remain an open question and the focus of ongoing studies. Here, we discuss the most current studies on the role of Spt-GCs in autoimmunity.

  6. Detailed description of spontaneous emission

    Science.gov (United States)

    Guryev, M. V.

    2012-08-01

    The wave side of wave-photon duality, describing light as an electromagnetic field (EMF), is used in this article. The EMF of spontaneous light emission (SE) of a laser-excited atom is calculated from first principles for the first time. This calculation is done using the simple method of atomic quantum electrodynamics. The EMF of SE is also calculated for three types of polyatomic light sources excited by a laser. It is shown that light radiated by such sources can be coherent, which explains recent experiments on SE of laser-excited atoms. Small sources of SE can be superradiant, which also conforms to experiment. Thus, SE is shown not to be a random event itself. Random properties of natural light are simply explained as a result of thermal excitation randomness without additional hypotheses. The EMF of SE is described by simple complex functions, but not real ones.

  7. Infertility and recurrent miscarriage with complex II deficiency-dependent mitochondrial oxidative stress in animal models.

    Science.gov (United States)

    Ishii, Takamasa; Yasuda, Kayo; Miyazawa, Masaki; Mitsushita, Junji; Johnson, Thomas E; Hartman, Phil S; Ishii, Naoaki

    2016-04-01

    Oxidative stress is associated with some forms of both male and female infertility. However, there is insufficient knowledge of the influence of oxidative stress on the maintenance of a viable pregnancy, including pregnancy complications and fetal development. There are a number of animal models for understanding age-dependent decrease of reproductive ability and diabetic embryopathy, especially abnormal spermatogenesis, oogenesis and embryogenesis with mitochondrial dysfunctions. Several important processes occur in mitochondria, including ATP synthesis, calcium ion storage, induction of apoptosis and production of reactive oxygen species (ROS). These events have different effects on the several aspects of reproductive function. Tet-mev-1 conditional transgenic mice, developed after studies with the mev-1 mutant of the nematode C. elegans, offer the ability to carefully regulate expression of doxycycline-induced mutated SDHC(V69E) levels and hence modulate endogenous oxidative stress. The mev-1 models have served to illuminate the effects of complex II deficiency-dependent mitochondrial ROS production, although interestingly they maintain normal mitochondrial and intracellular ATP levels. In this review, the reproductive dysfunctions are presented focusing on fertility potentials in each gamete, early embryogenesis, maternal conditions with placental function and neonatal development. Copyright © 2016. Published by Elsevier Ireland Ltd.

  8. Crows spontaneously exhibit analogical reasoning.

    Science.gov (United States)

    Smirnova, Anna; Zorina, Zoya; Obozova, Tanya; Wasserman, Edward

    2015-01-19

    Analogical reasoning is vital to advanced cognition and behavioral adaptation. Many theorists deem analogical thinking to be uniquely human and to be foundational to categorization, creative problem solving, and scientific discovery. Comparative psychologists have long been interested in the species generality of analogical reasoning, but they initially found it difficult to obtain empirical support for such thinking in nonhuman animals (for pioneering efforts, see [2, 3]). Researchers have since mustered considerable evidence and argument that relational matching-to-sample (RMTS) effectively captures the essence of analogy, in which the relevant logical arguments are presented visually. In RMTS, choice of test pair BB would be correct if the sample pair were AA, whereas choice of test pair EF would be correct if the sample pair were CD. Critically, no items in the correct test pair physically match items in the sample pair, thus demanding that only relational sameness or differentness is available to support accurate choice responding. Initial evidence suggested that only humans and apes can successfully learn RMTS with pairs of sample and test items; however, monkeys have subsequently done so. Here, we report that crows too exhibit relational matching behavior. Even more importantly, crows spontaneously display relational responding without ever having been trained on RMTS; they had only been trained on identity matching-to-sample (IMTS). Such robust and uninstructed relational matching behavior represents the most convincing evidence yet of analogical reasoning in a nonprimate species, as apes alone have spontaneously exhibited RMTS behavior after only IMTS training. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Placenta percreta with spontaneous rupture of an unscarred uterus in the second trimester.

    Science.gov (United States)

    LeMaire, W J; Louisy, C; Dalessandri, K; Muschenheim, F

    2001-11-01

    Rupture of a pregnant uterus occurs most often in a scarred uterus, and spontaneous rupture of a non-scarred uterus in the early second trimester is rare. A woman with two previous normal vaginal deliveries and no prior trauma to the uterus presented at 16 weeks' gestation with an acute abdomen due to intraperitoneal hemorrhage. A large rupture of the fundus of the uterus was found. A supracervical hysterectomy was carried out, with subsequent good recovery. The specimen showed placenta percreta. Spontaneous rupture of an unscarred uterus, due to placenta percreta, should be considered in cases of acute intraperitoneal hemorrhage, even in early pregnancy.

  10. [Misoprostol: off-label use in the first trimester of pregnancy (spontaneous abortion, and voluntary medical termination of pregnancy)].

    Science.gov (United States)

    Beucher, G; Dolley, P; Carles, G; Salaun, F; Asselin, I; Dreyfus, M

    2014-02-01

    State of knowledge about misoprostol's use out of its marketing authorization during the first trimester of pregnancy, in early miscarriage or to induce abortion or medical termination of pregnancy. French and English publications were searched using PubMed, Cochrane Library and international learned societies recommendations. Cervical ripening prior to surgical uterine evacuation during the first trimester of pregnancy facilitates cervical dilatation and reduces operative time and uterine retention risk. Misoprostol, mifepristone and osmotic cervical dilators are equally efficient. Concerning first trimester miscarriage, surgical uterine evacuation remains the most effective and the quickest method of treatment (EL 1). Depending on the clinical situation, medical treatment using misoprostol (missed miscarriage) or expectative attitude (incomplete miscarriage) does not increase the risk of complications, neither haemorrhagic nor infectious (EL 1). However, these alternatives generally require longer outpatient follow-up, which leads to more consultations, prolonged bleeding and not planned surgical procedures (EL 1). Concerning missed miscarriage, a vaginal dose of 800 μg of misoprostol, possibly repeated 24 to 48 hours later, seems to offer the best efficiency/tolerance ratio (EL 2). Concerning early abortion, medical method is a safe and efficient alternative to surgery (EL 2). Success rates are inversely proportional to gestational age (EL 2). According to the modalities of its marketing authorization, 400 μg of misoprostol can only be given by oral route, for less than 7 weeks of amenorrhea (WA) pregnancies and after 36 to 48 hours following 600 mg of mifepristone (EL 1). However, 200mg of mifepristone is as efficient as 600 mg (EL 1). Beyond 7WA, misoprostol buccal dissolution (sublingual or prejugal) or vaginal administration are more efficient and better tolerated than oral ingestion (EL 1). Between 7 and 9WA, the best protocol in terms of efficiency and

  11. Preconception and early pregnancy maternal haemodynamic changes in healthy women in relation to pregnancy viability.

    Science.gov (United States)

    Foo, F L; Collins, A; McEniery, C M; Bennett, P R; Wilkinson, I B; Lees, C C

    2017-05-01

    . Similarly, between the groups, there were no differences in pregnancy adaptation with similar trends in cardiovascular function changes from pre-pregnancy to 6 weeks gestation. Whilst this is the first study to investigate preconception and early pregnancy haemodynamic and arterial function in relation to viability, the relatively modest number of miscarriages may not be sufficient to show subtle differences in haemodynamic changes if these were present. This study suggests that pre-pregnancy haemodynamic and arterial function is unlikely to be the causal link between miscarriages and future cardiovascular disease. Our findings suggests that factors other than the presence of a viable embryo drive cardiovascular changes in early pregnancy. This study raises new questions about miscarriages as an independent risk event which predisposes women to increased cardiovascular risk later in life. The investigators are funded by NIHR Imperial BRC, NIHR Cambridge BRC, Action Medical Research, Imperial College Healthcare Charity and Tommy's Charity. We acknowledge the loan of ultrasound equipment from Samsung Medison (South Korea)/MIS Ltd and provision of fertility monitors from SPD Development Company Ltd (Bedford, UK). There are no competing interests. C.C.L. is supported by the UK National Institute for Health Research Biomedical Research Centre based at Imperial College Healthcare National Health Service Trust and Imperial College London. N/A.

  12. The ADA*2 Allele of the Adenosine Deaminase Gene and Recurrent Spontaneous Abortions in Northwest of Iran

    Directory of Open Access Journals (Sweden)

    M Bonyadi

    2015-06-01

    Full Text Available Background & objectives: Recurrent spontaneous abortion (RSA is defined by two or more consecutive miscarriages before 20 weeks of gestation. Adenosine deaminase (ADA is an enzyme of purine salvage pathway and has two important isoenzymes ADA1 and ADA2. The adenosine deaminase G22A polymorphism (ADA*2 increases the level of adenosine. Adenosine may play a protective role against recurrent spontaneous abortions, since it regulates blood flow into the uterus and placenta. In consideration of the effect of decreased enzymatic activity of adenosine deaminase G22A polymorphism on adenosine levels we evaluated the protective effect of ADA*2 allele against recurrent spontaneous abortions in north-west of Iran.  Methods: A total of 100 women were recruited to form two groups. First one, with a history of recurrent spontaneous abortions (N=50, and the second one, without a history of abortions (N=50. Genomic DNA was extracted from peripheral blood with a commercial kit and PCR-RFLP analysis was used to identify the G22A genetic polymorphism. Fisher's exact test and odds ratio values were used to compare the proportions of adenosine deaminase genotypes and alleles between women with and without a history of recurrent spontaneous abortion (p<0.05.  Results: The frequency of homozygotes (AA was 2% in control group, whereas no homozygote (AA was found in the case group. The frequency of heterozygotes (AG was 20% in control group and 8% in the case group (p<0.05. The frequency of homozygotes (GG was 78% in control group and 92% in the case group (p<0. 05. A significant increase in the frequency of AG genotype in controls (p=0.014, OR=0.348 relative to women with the history of RSA demonstrates the protective effect of AG genotype in controls. Conclusion: The data suggest that women carrying the G22A polymorphism (ADA*2 allele and AG genotype which is associated with the lower enzymatic activity are better protected against recurrent spontaneous abortions.

  13. Children's Spontaneous Vocalisations during Play: Aesthetic Dimensions

    Science.gov (United States)

    Countryman, June; Gabriel, Martha; Thompson, Katherine

    2016-01-01

    This paper explores the phenomenon of spontaneous vocalisations in the self-chosen, unstructured outdoor play of children aged 3-12. Spontaneous vocalisations encompass the whole range of children's unprompted, natural, expressive vocal soundings beyond spoken language. Non-participant observations at childcare centres and on elementary school…

  14. The spontaneous in the therapeutic theater

    OpenAIRE

    Silva, Marisa Schmidt

    2012-01-01

    The author makes considerations about the historic influences on the creation of Spontaneous theater by Jacob Levy Moreno and the psychotherapy conditions of this theater, nowadays revigoratade in whole world. The author consider the specific way to deal with Spontaneous theater of "Troupe de Psicodramatores" in Curitiba, Parana.

  15. A new class of spontaneously polarized materials

    DEFF Research Database (Denmark)

    Field, David; Plekan, Oksana; Cassidy, Andrew

    2011-01-01

    Very large electric fields form spontaneously within films of seemingly prosaic chemicals such as nitrous oxide or propane.We describe how the discovery of this unexpected phenomenon took place and how we attempt to understand the nature of the new class of spontaneously polarized materials...

  16. Spontaneous Achilles tendon rupture in alkaptonuria | Mohammed ...

    African Journals Online (AJOL)

    Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs.

  17. Mathematical models of spontaneous symmetry breaking

    OpenAIRE

    Sardanashvily, G.

    2008-01-01

    The Higgs mechanism of mass generation is the main ingredient in the contemporary Standard Model and its various generalizations. However, there is no comprehensive theory of spontaneous symmetry breaking. We summarize the relevant mathematical results characterizing spontaneous symmetry breaking phenomena in algebraic quantum theory, axiomatic quantum field theory, group theory, and classical gauge theory.

  18. Spontaneous CP violation and CPT violation

    OpenAIRE

    Qian, Yu Kun

    2011-01-01

    At first we give a little formalism to show some features of spontaneous CP violation theory. Then we give a convincing argument show that Cronin etc's experiment is a evidence of CPT violation and spontaneous CP violation is absolutely necessary. Final we discuss some possible CPT violation mechanism.

  19. Spontaneous emission in nanoscopic dielectric particles.

    Science.gov (United States)

    Rogobete, Lavinia; Schniepp, Hannes; Sandoghdar, Vahid; Henkel, Carsten

    2003-10-01

    We report on theoretical studies of the inhibition of the spontaneous emission process in subwavelength dielectric media. We discuss the modification of the spontaneous emission rate as a function of the size and shape of the medium as well as the position of the emitter in it.

  20. Spontaneity and Equilibrium II: Multireaction Systems

    Science.gov (United States)

    Raff, Lionel M.

    2014-01-01

    The thermodynamic criteria for spontaneity and equilibrium in multireaction systems are developed and discussed. When N reactions are occurring simultaneously, it is shown that G and A will depend upon N independent reaction coordinates, ?a (a = 1,2, ..., N), in addition to T and p for G or T and V for A. The general criteria for spontaneity and…

  1. Spontaneous Retroperitoneal Hematoma: A Rare Devastating ...

    African Journals Online (AJOL)

    Spontaneous Retroperitoneal Hematoma: A Rare Devastating. Clinical Entity of a Pleiada of Less Common Origins. Definition of Wunderlich syndrome, also known as spontaneous retroperitoneal hemorrhage. (SRH), was first given in 1700 by ... of SRH as a complication of tumors, however, is low. In renal cell carcinoma, ...

  2. Spontaneous rupture of choledochal cyst: case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    2002-11-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued.

  3. Spontaneous pneumomediastinum after bench press training.

    Science.gov (United States)

    Nishino, Tomoya

    2017-04-01

    Spontaneous pneumomediastinum is often associated with asthma and mainly affects adolescent males with a tall, thin body habitus. A 17-year-old man complained of chest and pharyngeal pain after bench press training and spontaneous pneumomediastinum was diagnosed. It should be considered in the differential diagnosis of chest pain of uncertain cause.

  4. The (perceived) meaning of spontaneous thoughts.

    Science.gov (United States)

    Morewedge, Carey K; Giblin, Colleen E; Norton, Michael I

    2014-08-01

    Spontaneous thoughts, the output of a broad category of uncontrolled and inaccessible higher order mental processes, arise frequently in everyday life. The seeming randomness by which spontaneous thoughts arise might give people good reason to dismiss them as meaningless. We suggest that it is precisely the lack of control over and access to the processes by which they arise that leads people to perceive spontaneous thoughts as revealing meaningful self-insight. Consequently, spontaneous thoughts potently influence judgment. A series of experiments provides evidence supporting two hypotheses. First, we hypothesize that the more a thought is perceived to be spontaneous, the more it is perceived to provide meaningful self-insight. Participants perceived more spontaneous kinds of thought (e.g., intuition) to reveal greater self-insight than did more controlled kinds of thought in Study 1 (e.g., deliberation). In Studies 2 and 3, participants perceived thoughts with the same content and target to reveal greater self-insight when spontaneously rather than deliberately generated (i.e., childhood memories and impressions formed). Second, we hypothesize that the greater self-insight attributed to thoughts that are (perceived to be) spontaneous leads those thoughts to more potently influence judgment. Participants felt more sexually attracted to an attractive person whom they thought of spontaneously than deliberately in Study 4, and reported their commitment to a current romantic relationship would be more affected by the spontaneous rather than deliberate recollection of a good or bad experience with their romantic partner in Study 5. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  5. Spontaneous hemopneumothorax: our experience with surgical management.

    Science.gov (United States)

    Tay, Cheong Kiat Julian; Yee, Yong Chen; Asmat, Atasha

    2015-03-01

    Spontaneous hemopneumothorax is rare, accounting for only 1%-12% of patients presenting with spontaneous pneumothorax. The optimal management of these patients remains controversial with no definitive guidelines on patient selection and timing of surgery. The aim of this study was to review our institution's surgical experience in the management of patients with spontaneous hemopneumothorax. We performed a retrospective review of all patients with spontaneous hemopneumothorax who underwent surgery from January 2000 to June 2013. Patient data were obtained from our institution's primary spontaneous pneumothorax database. Of 510 patients who underwent surgery for spontaneous pneumothorax, 33 (6.4%) developed spontaneous hemopneumothorax. The mean age was 24.0 years (range 16-40 years). In 30 (90.9%) patients, it was their first presentation of pneumothorax. There were 25 (75.8%) patients with Vanderschueren stage III spontaneous pneumothorax. Blood loss ranged from 250 to 3000 mL (mean 1280 mL). In 28 patients, a torn adhesion band was the source of bleeding. Thoracotomy was the surgical approach in 9 (27.3%) patients, and video-assisted thoracic surgery was used in 24 (72.7%). One patient required reoperation for retained clots. There was no mortality. Our results suggest that surgical management of spontaneous hemopneumothorax can be undertaken with minimal morbidity and mortality. With the increasing use of video-assisted thoracic surgery, definitive surgical management of spontaneous hemopneumothorax can be instituted earlier. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. [Abnormal Early Pregnancy: What Matters for Practice].

    Science.gov (United States)

    Birindelli, Esther; Fink, Daniel

    2015-06-03

    The first trim ester is referred to as early pregnancy and comprehends the lapse of time between conception and the end of the 12th week of gestation with embryo nic implantation and organogenesis. A pathological early gestation takes place when the embryo does not correctly implant in the cavity of the uterus (extrauterine pregnancy), when th ere is no growth of the embryo (missed abortion) or the embryo is not developing at all (blighted ovum) and sooner or later there is a miscarriage. A special case of missed abortion is the so called vanishing twin, when during a twin gestation, one embryo stops to grow. Rarely gestational trophoblastic disorders as the complete mole (without fetal tissue) or incomplete mole (with fetal tissue) and the invasive mole as villous trophoblastic diseases as well as the non-villous trophoblastic diseases with the extremely rare chorioniccarcinoma are detected.

  7. Patterns of Spontaneous Local Network Activity in Developing Cerebral Cortex: Relationship to Adult Cognitive Function.

    Science.gov (United States)

    Peinado, Alejandro; Abrams, Charles K

    2015-01-01

    Detecting neurodevelopμental disorders of cognition at the earliest possible stages could assist in understanding them mechanistically and ultimately in treating them. Finding early physiological predictors that could be visualized with functional neuroimaging would represent an important advance in this regard. We hypothesized that one potential source of physiological predictors is the spontaneous local network activity prominent during specific periods in development. To test this we used calcium imaging in brain slices and analyzed variations in the frequency and intensity of this early activity in one area, the entorhinal cortex (EC), in order to correlate early activity with level of cognitive function later in life. We focused on EC because of its known role in different types of cognitive processes and because it is an area where spontaneous activity is prominent during early postnatal development in rodent models of cortical development. Using rat strains (Long-Evans, Wistar, Sprague-Dawley and Brattleboro) known to differ in cognitive performance in adulthood we asked whether neonatal animals exhibit corresponding strain-related differences in EC spontaneous activity. Our results show significant differences in this activity between strains: compared to a high cognitive-performing strain, we consistently found an increase in frequency and decrease in intensity in neonates from three lower performing strains. Activity was most different in one strain considered a model of schizophrenia-like psychopathology. While we cannot necessarily infer a causal relationship between early activity and adult cognition our findings suggest that the pattern of spontaneous activity in development could be an early predictor of a developmental trajectory advancing toward sub-optimal cognitive performance in adulthood. Our results further suggest that the strength of dopaminergic signaling, by setting the balance between excitation and inhibition, is a potential underlying

  8. Increased MMA concentration and body mass index are associated with spontaneous abortion in Brazilian women: a pilot study.

    Science.gov (United States)

    Guerra-Shinohara, Elvira M; Pereira, Perla M; Kubota, Ananka M; Silva, Thaiomara A; Reis, Jucilene L; Miyashita, Gerson S; D'Almeida, Vânia; Allen, Robert H; Stabler, Sally P

    2010-03-01

    The pathophysiology of spontaneous abortion is complex and may involve the interaction of genetic and environmental factors. We evaluated the predictors of spontaneous abortion in Brazilian pregnant women. The effects of age, gestational age, body mass index (BMI), cigarette smoking, alcohol ingestion, use of multivitamins and concentrations of vitamins (folate, cobalamin and vitamin B6) and vitamin-dependent metabolites were analyzed. Study population included 100 healthy women that attended pre-natal care in 2 health centers of Sao Paulo, Brazil, and in whom pregnancy outcome was known. Folate and cobalamin status was measured in blood specimens collected between 4 and 16 weeks. The genotypes for 8 gene polymorphisms were evaluated by PCR-RFLP. Eighty-eight women had normal pregnancy outcome (Group 1), while 12 experienced a miscarriage after blood collection (Group 2). Increased methylmalonic acid (MMA) concentrations were found in Group 2 (median [25th-75th percentile]=274 [149-425] nmol/l) relative to Group 1 (138 [98-185]) (PMMA, cystathionine, body mass index (BMI), cigarette smoking, alcohol ingestion and use of multivitamins the risk of abortion was significantly associated with MMA (OR [95% CI]=3.80 [1.36, 10.62] per quartile increase in MMA), BMI (OR [95% CI]=5.49 [1.29, 23.39] per quartile) and gestational age (OR [95% CI]=0.10 [0.01, 0.77] per increase of interval in gestational age). Increased serum MMA and BMI concentrations are associated with spontaneous abortion in Brazilian women. Copyright 2009 Elsevier B.V. All rights reserved.

  9. Cosmological constraints on spontaneous R-symmetry breaking models

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, Yuta; Kobayashi, Tatsuo [Kyoto Univ. (Japan). Dept. of Physics; Kamada, Kohei [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Ookouchi, Yutaka [Kyoto Univ. (Japan). Dept. of Physics; Kyoto Univ. (Japan). The Hakubi Center for Advanced Research and Dept. of Physics

    2012-11-15

    We study general constraints on spontaneous R-symmetry breaking models coming from the cosmological effects of the pseudo Nambu-Goldstone bosons, R-axions. They are substantially produced in the early Universe and may cause several cosmological problems. We focus on relatively long-lived R-axions and find that in a wide range of parameter space, models are severely constrained. In particular, R-axions with mass less than 1 MeV are generally ruled out for relatively high reheating temperature, T{sub R}>10 GeV.

  10. Spontaneous rupture of the esophagus: report of two cases

    Directory of Open Access Journals (Sweden)

    Ali Said Esgaib

    Full Text Available OBJECTIVE - To study the diagnosis, prognosis and management of spontaneous rupture of the esophagus. DESIGN: This is a retrospective study through the analysis of two cases with delayed diagnosis and subsequent treatment at the Track Surgery Service. LOCALE: The study was performed at the Thoracic Surgery Unit of the Hospital do Servidor Público Estadual Francisco Morato de Oliveira in the city of São Paulo. This is a specialized service. PARTICIPANTS: The two patients reported on had suffered spontaneous rupture of the esophagus. They were transferred to the Thoracic Surgery Unit because of the worsening of their condition in the previous institution which they had been admitted into. MEASUREMENT: The two patients with esophagus pleural fistula received similar treatment, initially advocated by Kanashin in Russia and Hauer-Santos in the United States, which consists of washing the fistula and using continuous pleural aspiration. RESULTS: Although both patients had to spend a long period of time in hospital, their evolution was satisfactory with the treatment adopted, and the fistula closed. CONCLUSION: The authors conclude that the method of lavage of the mediastinum and continuous pleural aspiration, in patients who after spontaneous rupture of the esophagus developed a pleural esophagus fistula due to belated diagnosis, is an alternative and satisfactory therapy. Furthermore, in order to have the best outcome, an early diagnosis is recommended and thoracostomy as the surgical procedure, with primary suture.

  11. Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Toshihiro Kitai

    2014-01-01

    Full Text Available Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts.

  12. Spontaneous splenic rupture in Waldenstrom's macroglobulinemia: a case report

    Directory of Open Access Journals (Sweden)

    Charakidis Michail

    2010-09-01

    Full Text Available Abstract Introduction We report the case of a patient with Waldenstrom's macroglobulinemia complicated by spontaneous splenic rupture. Case presentation A 49-year-old Caucasian woman was referred to our emergency department by her general practitioner following a three-week history of malaise, night sweats, six kilograms of weight loss, intermittent nausea and vomiting, progressive upper abdominal pain and easy bruising. On the fourth day following her admission, she had a rapid clinical deterioration, with subsequent radiological investigations revealing a splenic rupture. Her morphology, biochemistry, flow cytometry and histology were strongly suggestive of Waldenstrom's macroglobulinemia. Conclusions Spontaneous splenic rupture is not an expected complication of low-grade lymphoplasmacytic lymphomas, such as Waldenstrom's macroglobulinemia. To the best of our knowledge, this is the only reported case of early spontaneous splenic rupture due to Waldenstrom's macroglobulinemia. Our case highlights that despite the typical disease course of low-grade hematological malignancies, signs and symptoms of imminent splenic rupture should be considered when formulating a clinical assessment.

  13. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  14. Spontaneous prosocial choice by chimpanzees.

    Science.gov (United States)

    Horner, Victoria; Carter, J Devyn; Suchak, Malini; de Waal, Frans B M

    2011-08-16

    The study of human and primate altruism faces an evolutionary anomaly: There is ample evidence for altruistic preferences in our own species and growing evidence in monkeys, but one of our closest relatives, the chimpanzee (Pan troglodytes), is viewed as a reluctant altruist, acting only in response to pressure and solicitation. Although chimpanzee prosocial behavior has been reported both in observational captive studies and in the wild, thus far Prosocial Choice Tests have failed to produce evidence. However, methodologies of previous Prosocial Choice Tests may have handicapped the apes unintentionally. Here we present findings of a paradigm in which chimpanzees chose between two differently colored tokens: one "selfish" token resulting in a reward for the actor only (1/0), and the other "prosocial" token rewarding both the actor and a partner (1/1). Seven female chimpanzees, each tested with three different partners, showed a significant bias for the prosocial option. Prosocial choices occurred both in response to solicitation by the partner and spontaneously without solicitation. However, directed requests and pressure by the partner reduced the actor's prosocial tendency. These results draw into question previous conclusions indicating that chimpanzees have a limited sensitivity to the needs of others and behave prosocially only in response to significant prompting.

  15. Etiology of hypercoagulable state in women with recurrent fetal loss without other causes of miscarriage from Southern Italy: new clinical target for antithrombotic therapy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2008-10-01

    Full Text Available Maristella D’Uva1, Pierpaolo Di Micco2, Ida Strina1, Antonio Ranieri1, Carlo Alviggi1, Antonio Mollo1, Francesca Fabozzi1, Lucia Cacciapuoti1, Maria Teresa Scotto di Frega1, Mariateresa Iannuzzo2, Giuseppe De Placido11Dipartimento Universitario di Scienze Ostetriche Ginecologiche e Medicina della Riproduzione, Area Funzionale di Medicina della Riproduzione ed Endoscopia Ginecologica, Università degli Studi di Napoli Federico II, via Pansini 5 Building 9, 80131, Naples, Italy; 2Internal Medicine Division, Fatebenefratelli Hospital of Naples, Naples, ItalyBackground: Recurrent fetal loss (RPL is one of the most common cause of sterility. Several studies identified thrombophilia as the principal cause of recurrent pregnancy loss. However, reported studies often do not evaluate other causes of miscarriages in their inclusion and exclusion criteria. So the aim of our study was to investigate the role of inherited thrombophilia in patients with RPL and without other causes of RPL.Patients and methods: Patients with 2 or more first trimester abortion or with 1 or more late pregnancy loss were considered for this study. In order to evaluate the causes of RPL we looked for chromosomal, endocrine, chronic inflammatory, and infectious alterations. 90 patients affected by unexplained RPL were enrolled and tested for hemostatic alterations. These women were tested for inherited and/or acquired thrombophilia by MTHFR C677T gene polymorphism, factor V Leiden gene polymorphism, PTHRA20210G gene polymorphism, protein S deficiency, protein C deficiency, antithrombin III deficiency, lupus anticoagulant, and anticardiolipin antibodies Ig G and Ig M.Results: Acquired and/or inherited thrombophilia are strongly associated with RPL when other common causes of miscarriage were excluded. 78% of tested women showed hemostatic abnormalities. Several women with combined thrombophilic defects were also identified by our data.Conclusion: After a thorough evaluation of

  16. Predictive value of serum progesterone level on β-hCG check day in women with previous repeated miscarriages after in vitro fertilization.

    Science.gov (United States)

    Kim, Yong Jin; Shin, Jung Ho; Hur, Jun Yong; Kim, Hoon; Ku, Seung-Yup; Suh, Chang Suk

    2017-01-01

    To evaluate the predictive value of the progesterone level at the beta-human chorionic gonadotropin (β-hCG) check day for ongoing pregnancy maintenance in in vitro fertilization (IVF) cycles in women with previous unexplained repeated miscarriages. One hundred and forty-eight women, with visible gestational sac after IVF, were recruited in this observational study. All subjects had unexplained recurrent miscarriages in more than two previous IVF cycles. The progesterone level at the β-hCG check day (i.e. 14 days after oocyte retrieval) was assessed. The area under the curve (AUC) of the progesterone level was evaluated to predict the ongoing pregnancy or miscarriage outcomes. The overall ongoing pregnancy rate was 60.8% (90/148). The cut-off value with β-hCG levels higher than 126.5 mIU/mL and with progesterone levels higher than 25.2 ng/mL could be the predictive factors for ongoing pregnancy maintenance (AUC = 0.788 and 0.826; sensitivity = 0.788 and 0.723; specificity = 0.689 and 0.833; P 126.5 mIU/mL and 13.0% (10/77) in those with > 25.2 ng/mL. In the comparison of the ROC curves between both values, a similar significance was found. The subjects with β-hCG > 126.5 mIU/mL and progesterone > 25.2 ng/mL showed higher ongoing pregnancy rates [98.0% (49/50) vs. 41.8% (41/98)] than those with β-hCG ≤ 126.5 mIU/mL or progesterone ≤ 25.2 ng/mL. The progesterone level at 14 days after oocyte retrieval can be a good predictive marker for ongoing pregnancy maintenance in women with repeated IVF failure with miscarriage, together with the β-hCG level. The combined cut-off value of progesterone > 25.2 ng/mL and β-hCG > 126.5 mIU/mL may suggest a good prognosis.

  17. STUDENTS’ SPONTANEOUS SMILE IN EFL CLASSROOM

    Directory of Open Access Journals (Sweden)

    Daniela Gomes de Araújo Nóbrega

    2012-12-01

    Full Text Available This article discusses the importance of the students’ spontaneous smile in EFL classroom interaction, and its implication to their oral production. Findings proved that the students’ spontaneous smile served as a fundamental interactive nonverbal sign for it not only favors a closer relation among students, but also helps them in the co-construction of oral activities in group works. In sum, the students’ spontaneous smile appeared to be a nonverbal indicative of proximity and of increasing oral interaction among them.

  18. Herpetic viruses and spontaneous recovery in melanoma.

    Science.gov (United States)

    Motofei, I G

    1996-08-01

    The malignant melanoma may display extremely variable forms of development, from clinical forms with a lethal course to the unforeseeable situations of spontaneous cures. The basic immunotherapeutic procedures, as well as hypotheses regarding the mechanisms involved in courses towards spontaneous regressions, are presented. Since viruses of the herpes genus are involved in the mechanisms assumed to be at the basis of spontaneous regressions, it is suggested that these viruses (selected strains) be used in the clinic, in order to check the advanced hypothesis, an opportunity which could permit to study also the very probable therapeutic alternative offered by this virus, namely the association of the well-known immunotherapeutic methods.

  19. Clock frequency estimation under spontaneous emission

    Science.gov (United States)

    Qin, Xi-Zhou; Huang, Jia-Hao; Zhong, Hong-Hua; Lee, Chaohong

    2018-02-01

    We investigate the quantum dynamics of a driven two-level system under spontaneous emission and its application in clock frequency estimation. By using the Lindblad equation to describe the system, we analytically obtain its exact solutions, which show three different regimes: Rabi oscillation, damped oscillation, and overdamped decay. From the analytical solutions, we explore how the spontaneous emission affects the clock frequency estimation. We find that under a moderate spontaneous emission rate, the transition frequency can still be inferred from the Rabi oscillation. Our results enable potential practical applications in frequency measurement and quantum control under decoherence.

  20. Spontaneous emission from active dielectric microstructures

    DEFF Research Database (Denmark)

    Søndergaard, Thomas; Tromborg, Bjarne

    2001-01-01

    Spontaneous emission is one of the key factors that determine the noise properties of photonic devices and the pump power threshold of lasers. The spontaneous emission in dielectric microstructures (micro-cavities, photonic crystals, optical waveguides, etc.) can to some extend be controlled...... and engineered due to the dependence of the emission rate on the location and polarisation of the emitters in the structure. This paper addresses the methods of quantum electrodynamics of dielectric media which enable calculation of the local rate of spontaneous emission in active microstructures....