Abortion In Early Pregnancy Research Articles

Infection status of human parvovirus B19, cytomegalovirus and herpes simplex Virus-1/2 in women with first-trimester spontaneous abortions in Chongqing, China

BackgroundInfection with Parvovirus B19 (B19V), Cytomegalovirus (CMV) and Herpes Simplex Virus-1/2 (HSV-1/2) may cause fetal loses including spontaneous abortion, intrauterine fetal death and non-immune hydrops fetalis. Few comprehensive studies have investigated first-trimester spontaneous abortions caused by virus infections in Chongqing, China. Our study intends to investigate the infection of B19V, CMV and HSV-1/2 in first-trimester spontaneous abortions and the corresponding immune response.Methods100 abortion patients aged from 17 to 47 years were included in our study. The plasma samples (100) were analyzed qualitatively for specific IgG/IgM for B19V, CMV and HSV-1/2 (Virion\\Serion, Germany) according to the manufacturer’s recommendations. B19V, CMV and HSV-1/2 DNA were quantification by Real-Time PCR.ResultsNo specimens were positive for B19V, CMV, and HSV-1/2 DNA. By serology, 30.0%, 95.0%, 92.0% of patients were positive for B19V, CMV and HSV-1/2 IgG respectively, while 2% and 1% for B19V and HSV-1/2 IgM.ConclusionThe low rate of virus DNA and a high proportion of CMV and HSV-1/2 IgG for most major of abortion patients in this study suggest that B19V, CMV and HSV-1/2 may not be the common factor leading to the spontaneous abortion of early pregnancy.

Prospective study on role of folic acid and vitamin B12 in early pregnancy and spontaneous abortion

Background: Vitamin B12 maintains normal folate metabolism during pregnancy. Maternal folate status has been associated with various adverse pregnancy outcomes. The aim of this study is to predict the risk of abortion in early pregnancy by studying the relation between folate, Vitamin B12 levels, and rate of abortion. This prospective, observational study was carried out on 100 pregnant women with singleton pregnancy of 6–12 weeks of gestation. Methods: The patients were divided into three groups, namely, Group 1 (control group) comprising of 30 normal pregnant women with no history of abortion; Group 2 (control group) comprising of 35 pregnant females with history of previous abortion; and Group 3 (study group) comprising of 35 pregnant women were coming with chief complaint of bleeding per vaginum. About 5 ml blood was taken and serum was separated using centrifugation. Serum folate and Vitamin B12 levels were estimated by chemiluminescence. Data so obtained were computed as mean + standard deviation and SPSS/ANOVA was applied. Results: Serum folate and Serum B12 levels were comparable in all the three groups and the difference was statistically significant. 26.66%, 37.13%, and 31.42% patients had folate deficiency in Groups 1, 2, and 3, respectively. Out of which, 3.33%, 5.71%, and 5.71% patients aborted from folate deficient Groups 1, 2, and 3, respectively. Thus, folate deficiency was not found to be associated with abortion (P = 0.944). Patients with Vitamin B12 deficiency were 73.33%, 82.85%, and 37.13% in Groups 1, 2, and 3, respectively; out of which 3.33% patients from Group 1, 8.57% from Group 2, and 2.85% patients from Group 3 were aborted. Correlation between maternal serum B12 deficiency and abortion was found to be insignificant (P = 0.551). Conclusion: A positive correlation was seen between serum folate and B12 levels. All females planning for conception should be given folate and Vitamin B12 supplementation.

The influence of Rosenthal effect on the psychological status of pregnant women at risk of miscarriage in early pregnancy

Objective To explore the influence of Rosenthal effect on the psychological status of pregnant women at risk of miscarriage in early pregnancy. Methods From January 2014 to June 2015 151 cases of early pregnancy abortion risk women were set as the control group, and was given conventional psychological intervention. From July 2015 to December 2016 135 cases of early pregnancy abortion risk women were named as the observation group by convenient sampling selection, which was given interventionbased on Rosenthal effect on the basis of routine psychological intervention. The Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) score, the introversion and extroversion scores and the satisfaction degree with intervention were compared between the two groups before and after the intervention. Results There was no significant difference in SDS and SAS scores, inotropic challenge and extroversion challenge between the two groups before treatment (P>0.05). The scores of SDS and SAS, the inotropic challenge and extroversion challenge scores were 41.45 ± 4.26, 40.34 ± 5.82, 4.76 ± 1.03, 5.55 ± 1.26 in the observation group after intervention, and 47.22 ± 3.93,47.18± 7.04,5.39 ± 1.12, 6.43 ± 1.86 respectively in the control group. There were significant difference in scores of SDS and SAS, the inotropic challenge and extroversion challenge (t=2.215-2.573, P<0.05). The satisfaction rates of the observation group and the control group were 93.32% (126/135) and 74.17% (112/151) respectively, the difference was statistically significant (χ2=5.921, P<0.05). Conclusions The intervention based on Rosenthal effect on the basis of conventional psychological intervention for early pregnancy abortion risk women can relieve negative emotions such as anxiety and depression, besides it can also improve satisfaction degree of inpatients with intervention. Key words: Rosenthal effect; Hospitalization; Risk of miscarriage in early pregnancy; Psychological status

Medical Abortion in Early Pregnancy By oral Mifepristone And oral Misoprostol

Medical Abortion in Early Pregnancy By oral Mifepristone And oral Misoprostol

Clinical study on Jianpi-Gushen decoction combined with vitamin E and human chorionic gonadotropin for the patients with threatened abortion in early pregnancy

Objective To evaluate the efficacy of Jianpi-Gushen decoction combined with vitamin E and human chorionic gonadotropin for the patients with threatened abortion in early pregnancy. Methods A total of 154 patients with threatened abortion who met the inclusion criteria were divided into two groups by a random digital table, with 77 patients in each. The control group was treated with intramuscular injection of human chorionic gonadotropin (HCG) combined with vitamin E, while the observation group was treated with Jianpi-Gushen decoction based on the treatment of control group. The levels of serum -HCG were detected by radioimmunoassay before and after treatment, and the levels of progesterone were detected by electrochemiluminescence assay, and the efficacy was evaluated. Results The total effective rate in the observation group was 90.9% (70/77), and control group was 77.9% (60/77). The difference between two groups was significantly different (χ2=4.936, P=0.026). The serum -HCG level (22 383.41 ± 4 387.67 mIU/ml vs. 15 728.66 ± 3 375.93 mIU/ml, t=5.614) and progesterone level (58.53 ± 18.77 nmol/L vs. 43.45 ± 17.46 nmol/L, t=2.674) in the observation group after treatment were higher than those in the control group (P<0.01). Conclusions The Jianpi-Gushen decoction combined with vitamin E and HCG could increase the levels of serum -HCG and progesterone and improve the clinical effect. Key words: Abortion, threatened; Progesterone; Human chorionic gonadotropin, beta subunit, human; Jianpi-Gushen decoction

Роль гематологічних індексів у діагностиці завмерлої на ранніх термінах вагітності

Роль гематологічних індексів у діагностиці завмерлої на ранніх термінах вагітності

Epidemiology and Risk Factors of Functional Constipation in Pregnant Women.

AimTo understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors.MethodsWe searched hospital databases for women who were 37–41 weeks pregnant (1698 cases) from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software.ResultsPregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history.ConclusionThe prevalence rate of functional constipation in pregnant women was significantly higher than in the general population.

Diseases caused by defects of energy level and loss of coherence in living cells

Human and animal diseases are brought about by pathological alterations of production, composition, and conformation of macromolecules and structures in cells. Additional contributing factors include changes in physiological states caused by disturbances of energy supply, energy transduction, energy dissipation in moving or oscillating parts, and parasitic energy consumption. Disturbances of energy states may endanger existence of the system. The cell-mediated immunity (CMI) response of T lymphocytes correlating with their adherence properties was examined using antigen prepared from the serum of inbred laboratory mice strain C3H H2k infected with lactate dehydrogenase elevating (LDH) virus. LDH virus is a parasite on the cellular energy system. Significant CMI response was elicited in T lymphocytes prepared from the blood of patients with cancer of different phenotypes, acute myocardial infarctions, schizophrenia, and recurrent spontaneous abortions in early pregnancy from unknown reasons. The CMI response is assumed to monitor transferred information about decreased levels of energy states and decoherence in the cells caused by mitochondrial malfunction, parasitic consumption, production of lactate, and possibly other disturbances. The LDH virus infection or similar pathological processes caused by different agents might be connected with the diseases and monitored by the examined CMI response. A large amount of mitoses with chromosome defects in aborted fetuses suggest increased mutability of genomes caused by defective energy states.

Study on combined detection of serum β-HCG, estradiol, progesterone and antiphospholipid antibodies in predicting the outcome of threatened abortion in early pregnancy

Objective To explore the clinical value of combined detection of serum beta human chorionic gonadotropin(β- hCG), estradiol(E2), progesterone(P)and antiphospholipid antibodies(ACA)in predicting the outcomes of early threatened abortion. Methods 80 pregnant women were chosen from six to eight weeks singleton pregnancies, 50 cases of threatened abortion and 30 cases of normal pregnancy. The serum levels ofβ- HCG, estradiol, progesterone and ACA- IgG,ACA- Ig M and ACA- IgA were detected. The threatened abortion patients were given intramuscular progesterone 20 mg/day/time for 1 week, then, the pregnancy outcomes were analyzed and the serum levels ofβ- HCG,estradiol and progesterone were explored. Results The serum β-HCG, estradiol and progesterone of the threatened abortion group[(5 140.77±2 365.47)IU/L,(680.28±306.06)pg/mL,(15.59±3.65)pg/L]were lower than those of the normal pregnant women[(14 520.4±11 016.24)IU/L,(1 142.81±670.57)pg/mL,(27.6±4.78)pg/L](t= 3.224,P= 0.003;t = 2.43,P= 0.022;t= 7.72,P= 0.001). According to pregnancy outcome,patients with threatened miscarriages were divided into the two groups, including 45 patients with continuing pregnancies and 5 patients with inevitable miscarriages.The serum levels ofβ- HCG, estradiol and progesterone in ongoing pregnancies group[(10 829.42±6 926.28)IU/L,(832.9±397.91)pg/m L,(25.62±4.51)pg/L]were higher than those in inevitable miscarriages[(6 310.14±2 593.19)IU/L,(487.14±275.47)pg/m L,(13.6±4.84)pg/L](P< 0.05); The serum levels of ACA- IgG,ACA- Ig M and ACA- Ig A in 80 cases tested,only 2 cases who appeared in the threatened abortion group were detected with the positive of serum ACA- IgG,accounted for 4% (2/50)(χ2= 68.05,P= 0.000), occurred spontaneous abortion in the end. Conclusion Combined detection of serum ACA,β-HCG, estradiol and progesterone may be helpful for prognosis of threatened abortion. However, the clinical predictive value of ACA needs further study in the early threatened abortion. Key words: Threatened abortion; beta human chorionic gonadotropin(β-hCG); Estradiol; Progester-one; Antiphospholipid antibodies; Pregnancy outcome

A new diagnostic perspective – hyperglycemia in pregnancy – as of the year, 2014

Abstract Gestational Diabetes Mellitus (GDM) is a growing epidemiological problem, and it is currently the most common metabolic disorder in pregnancy, as it affects approximately 2-6% of all pregnant women. In 2014, the Polish Diabetic Association introduced significant changes in the diagnosis of hyperglycemia as first diagnosed in pregnancy, based on the recommendations of the IADPSG of 2010 and WHO of 2013. There are now two categories: diabetes in pregnancy, and GDM. These involve different degrees of severity of metabolic complications for the mother and the growing fetus. Establishing a new diagnostic criterion is significant because of the negative impact of hyperglycemia on the fetus (especially in the first trimester), the increased prevalence of malformations or the possibility of spontaneous abortions in early pregnancy.

Predictive value of fetal fibronectin on the embryonic loss of patients with recurrent spontaneous abortion in early pregnancy

Objective: This work aims to investigate the predictive value of fetal fibronectin (fFN) in embryonic loss of patients with recurrent spontaneous abortion (RSA) in early pregnancy. Materials and Methods: Eighty-four patients with RSA in early pregnancy were selected as the test group and 31 healthy women in early pregnancy were selected as the control group. The ages and number of previous abortions, along with other information, were recorded. These patients underwent a fFN test, and their pregnancy outcome was followed up until 14 weeks. Results: The incidence of spontaneous abortion was 20.24% in the test group and 9.68% in the control group. The positive fFN [fFN (+)] rate was 57.14% in the test group and 12.90% in the control group, indicating a statistically significant difference (p p 2 = 5.53). The sensitivity, specificity, and positive and negative predictive values in the prediction of abortion in fFN (+) patients of the test group were 82.35%, 49.25%, 29.17%, and 91.67%, respectively. Conclusion: If detected at an early stage of pregnancy, fFN in patients with RSA is largely related to the prediction of abortion and facilitates the evaluation of pregnancy outcomes.

Spontaneous abortion is associated with elevated systemic C5a and reduced mRNA of complement inhibitory proteins in placenta.

Spontaneous abortion in early pregnancy due to unknown reasons is a common problem. The excess complement activation and consequent placental inflammation and anti-angiogenic milieu is emerging as an important associated factor in many pregnancy-related complications. In the present study we sought to examine the expression of complement inhibitory proteins at the feto-maternal interface and levels of complement split products in the circulation to understand their role in spontaneous abortion. Consenting pregnant women who either underwent elective abortion due to non-clinical reasons (n = 13) or suffered miscarriage (n = 14) were recruited for the study. Systemic levels of complement factors C3a and C5a were measured by enzyme-linked immunosorbent assay (ELISA). Plasma C5 and C3 protein levels were examined by Western blot. Expressions of complement regulatory proteins such as CD46 and CD55 in the decidua were investigated by quantitative polymerase chain reaction (PCR) and Western blot. The median of plasma C3a level was 82·83 ng/ml and 66·17 ng/ml in elective and spontaneous abortion patients, respectively. Medians of plasma C5a levels in elective and spontaneous abortion patients were 0·96 ng/ml and 1·14 ng/ml, respectively. Only plasma C5a levels but not C3a levels showed significant elevation in spontaneous abortion patients compared to elective abortion patients. Further, there was a threefold decrease in the mRNA expressions of complement inhibitory proteins CD46 and CD55 in the decidua obtained from spontaneous abortion patients compared to that of elective abortion patients. These data suggested that dysregulated complement cascade may be associated with spontaneous abortion.

Inter-relations between habitual abortion and lead levels in venous blood, abortuses, and drinking water in Egyptian women

In Egypt, one of the main sources of lead exposure is a network of lead pipes used for water supply. Adverse effects of high lead exposure are well known. Many studies have focused on the health effects of low blood lead levels after sharp decline of its exposure levels. Currently, there is a growing concern about threats posed on pregnancy outcomes among women with low to moderate blood lead levels. Aim of the work This study was conducted to evaluate the role of contaminated water as one source of multifactorial lead exposure chain, and to be acquainted if the currently observed lead levels are associated with increased risk of spontaneous abortion in pregnant women in Egypt. Patients and Methods This study was conducted at Obstetrics and Gynecology Department, Tanta University Hospital from January to September 2012. The participants were 26 pregnant female with history of habitual abortion in early pregnancy (8-14 weeks) who presented by dilated cervix with bleeding, non-pulsating fetal node on ultrasound, and/or decreasing beta-HCG level. ResultsThe results of this study revealed significant positive correlations between drinking-water lead with both blood lead and abortus lead levels in cases of abortion. Each woman with unexplained spontaneous abortion should be subjected to blood lead estimation. Primary prevention by removing lead from the environment is the only pathway to avoid threats posed on pregnancy outcome since there is no effective remedy to remove lead from the body at levels below 30 μg/dl.

Influence of genes and the environment in familial congenital heart defects

The present study aimed to investigate genetic and environmental factors involved in the pathogenesis of congenital heart disease (CHD). A total of 61 familial pedigrees with CHD were analyzed, and 134 patients out of 761 family members had a diagnosis of CHD confirmed. The present study revealed that the prevalence of CHD in first‑degree relatives (55/249, 22.0%) was significantly higher than that in second‑degree relatives (18/526, 3.4%). Additionally, the recurrence rate of CHD in families in which the patient's mother (12/61) or sister (15/61) had CHD were significantly higher than in cases with the father (6/61) or brother (4/61) having CHD. The subtypes of CHD with increased risk of recurrence were ventricle septal defect (VSD) and atrial septal defect (ASD), followed by patent ductus arteriosus and tetralogy of fallot (TOF). In the 21 sets of twins among the 61 familial pedigrees analyzed, the concordance of both twins affected by CHD in identical and dizygotic twins was 94.4% (17/18) and 33.3% (1/3), respectively. Identical subtypes of CHD were identified in 10 out of 21 sets of twins. Of note, the following pattern was identified in three sets of the twins: One twin had TOF, while the other one had VSD. A risk factor survey revealed that threatened abortion in early pregnancy was associated with familial CHD. In conclusion, genetic factors may have important roles in the development of CHD, and TOF and VSD may have similar molecular mechanisms. Threatened abortion in early pregnancy is a novel environmental factor that may be specific in Chinese females with CHD.

Recurrent spontaneous abortions, Hashimoto thyroiditis and alopecia totalis: response to anticoagulation and intravenous immunoglobulin therapy

Introduction: Although numerous studies indicated a link between antithyroid antibodies and recurrent spontaneous abortions (RSA), consensus on the treatment of this condition is still lacking.Case report: We present a case of a 35-year-old pregnant woman (gestation week 4) with primary hypothyroidism, total alopecia, high level of positive antithyroid antibodies, and history of two recurrent spontaneous abortions in early pregnancy. Along with L-thyroxin substitution, intravenous human immunoglobulin (IVIg) combined with anticoagulation and antiaggregation therapy was introduced. During pregnancy her scalp hair completely re-grew, and following gestation week 39 she delivered healthy female child.Conclusion: Thyroid antibodies could contribute to previous recurrent abortions in our patient. It is suggested that in older primiparas with Hashimoto thyroiditis and history of RSA, a combined treatment with IVIg, anticoagulation and antiaggregation therapy should be considered.

Primary biliary cirrhosis associated to anti-phospholipid syndrome: About one observation

Introduction: Primary biliary cirrhosis (PBC) is a chronic disease of autoimmune origin. Sicca syndrome is observed in 60–80% of cases, thyroid disease, arthralgia, Raynaud's phenomenon, and sclerodactyly in 10–20% of cases. Other associated diseases are rare. In this regard, we report a case of PBC associated with systemic lupus erythematosus (SLE) with anti-phospholipid syndrome (APS). Observation: A. M is a 33year old woman. She has the history of five early pregnancy abortions and one fetal death in utero consults for chronic non-erosive polyarthritis of large and small joints.

Misoprostol Abortion: Ultrasonography versus Beta-hCG testing for verification of effectiveness

Miscarriage is a common complication of early pregnancy with medical and psychological consequences. Dilation and Curettage are considered as two standard caring ways for early pregnancy failure. Alternatively misoprostol has been used as a single agent for termination of early pregnancy. Aim of the present study was to compare the usefulness of serum β-hCG measurement and ultrasound examination to predict complete abortion after medical induction. There were one hundred and thirty three patients experiencing missed abortion or blighted ovum. Ultrasound examination and serum β-hCG test were performed before treatment and during follow-up in all these patients. Treatment was successful without any need for surgical intervention in 92.4% of the cases. Both methods could verify the complete abortion among all the patients at the end of the study (4(th) week). Kappa agreement coefficient for the two methods of diagnosis was 0.327 (P < 0.5). Based on our results, β- hCG is as effective as ultrasound in confirming a successful medically induced abortion in early pregnancy, but it should be used as supplements to clinical assessments.

The Dysfunction of CD4+CD25+ Regulatory T Cells Contributes to the Abortion of Mice Caused by Toxoplasma gondii Excreted-Secreted Antigens in Early Pregnancy

Toxoplasma gondii is an opportunistic intracellular parasite that is highly prevalent in human and warm-blooded animals throughout the world, leading to potentially severe congenital infections. Although the abortion caused by T. gondii is believed to be dependent on the timing of maternal infection during pregnancy, the mechanism remains unclear. This study was focused on the effects of T. gondii excreted-secreted antigens on pregnant outcomes and CD4+CD25+ Foxp3+ regulatory T cells at different stages of pregnancy. The results showed that in mice the frequency and suppressive function of CD4+CD25+ regulatory cells were diminished after injection of T. gondii excreted-secreted antigens at early and intermediate stages of pregnancy. The abortion caused by T. gondii excreted-secreted antigens at early pregnancy could be partly prevented by adoptively transferring of CD4+CD25+ cells from the mice injected with T. gondii excreted-secreted antigens at late pregnancy, but not from the mice with the same treatment at early pregnancy. Furthermore, T. gondii excreted-secreted antigens induced apoptosis of CD4+CD25+ regulatory cells of mice in early and intermediate stages of pregnancy by down-regulating their Bcl-2 expressions and Bcl-2/Bax ratio. This study provides new insights into the mechanism that T. gondii infection is the high risk factor for abortion in early pregnancy.

Familial congenital heart disease: data collection and preliminary analysis

The aim of this study was to explore genetic mechanisms of congenital heart disease by analysing family data. Families with two or more affected members were studied, and information on family history and risk factors was collected. A total of 25 families with congenital heart disease were identified, and among them the condition was confirmed in 57. The prevalence of congenital heart disease in first-degree relatives was 43.0%, that is 46 out of 107, significantly higher than that in second-degree relatives, that is, 4.4%, 11 out of 252) (χ2 = 83.897, P < 0.01). The prevalence difference between twins (90%) and siblings (62.2%) (χ2 = 4.983, P < 0.05) was also significant among first-degree relatives. Eleven families were found to have the same phenotype (44%), including ventricular septal defect in six families, atrial septal defect in two families, conotruncal defects in two families, and hypoplastic left heart syndrome in one family. Both twins were diagnosed with congenital heart disease in 8 out of 10 twin families - all eight twins were monozygotic. The cardiac phenotype of the twins was consistent in three families (37.5%). The cardiac phenotype of first- and second-degree relatives was not fully consistent with their probands. There was an increased incidence of threatened abortion in early pregnancy in patients with familial congenital heart disease when compared with sporadic congenital heart disease (χ2 = 8.704, P < 0.05). Morbidity in relatives was related to blood relationship, with a closer relationship increasing the risk of congenital heart disease. Genetic factors appear to play an important role in congenital heart disease.

Bilateral ovarian vein thrombosis after abortion: A case report

The frequency of thromboembolism is 0.3–1.2% in pregnant women, in most cases occur in veins. Especially, ovarian vein thromboses present rarely that occur in 0.02–0.18% of pregnancy. Ovarian vein thromboses are diagnosed mainly on right side, rarely bilateral or left side involvement. Ovarian vein thromboses are caused by physiologic hypercoagulability, endothelial injury, and compression of uterus during pregnancy. Mostly it occurs at postpartum. In the cases of ovarian vein thrombosis after abortion, it is very rarely reported in domestic and foreign. We report the case of bilateral ovarian vein thrombosis that was presented after abortion in early pregnancy with brief review of literature.