Fetal Abortion Research Articles

Surveillance of congenital rubella and rubella infections in pregnancy in EU/EEA countries, 2012: Current status and future perspective to monitor elimination

IntroductionRubella elimination and congenital rubella syndrome (CRS) prevention are targets for achievement by 2015 in the WHO-EURO Region. This paper describes the existing surveillance systems for CRS and rubella in pregnancy in order to critically interpret the findings in relation to the 2012 WHO-EURO surveillance guidelines. MethodsIn 2012 we conducted a survey to collect information on surveillance of CRS and rubella in pregnancy in 29 EU/EEA countries. Questionnaires explored the characteristics of the surveillance systems, case definition, epidemiological investigation and follow-up of cases, reference laboratories and types of tests performed. ResultsTwenty-eight countries had surveillance systems for CRS, mostly nationwide, mandatory, passive and case-based; 23 collected information on the origin of the infection; 11 reported asymptomatic infections; 6 required zero-reporting. Case definitions varied among countries, although 24 used the EU definition. Laboratories reported cases in 18 countries. Twenty countries collected information on pregnancy within the rubella surveillance system and 5 had specific surveillance for rubella in pregnancy. Two countries did not monitor outcomes of suspected infections in pregnancy; infants with CRS were monitored in all the remaining countries; asymptomatic infected infants in 15; stillbirths and fetal deaths in 13; therapeutic and spontaneous abortions in 8 and 7. Twenty-seven countries had a national reference laboratory for CRS and rubella in pregnancy; genotyping was performed in 15. DiscussionThe current surveillance systems allow adequate CRS monitoring in EU. Further efforts are needed to improve their quality, including uniform case definitions, collection of information on the origin of infection, and promotion of reporting from laboratories. Follow-up of pregnant women with suspected infection should be strengthened because it is an entry point for CRS, including detection of fetal deaths, stillbirths and abortions. Laboratory capacity for confirming congenital rubella infections and infections in pregnancy is good in EU, however the use of genotyping should be encouraged.

Evaluation of Neospora caninum truncated dense granule protein 2 for serodiagnosis by enzyme-linked immunosorbent assay in dogs

Neosporosis is an infectious disease caused by Neospora caninum, and it primarily affects cattle and dogs. An infection by N. caninum causes fetal abortion and neonatal mortality. Previous proteomics and immunoscreening analyses revealed that N. caninum dense granule antigen 2 (NcGRA2) has potential for serodiagnosis of N. caninum. Consequently, we expressed the truncated NcGRA2 (NcGRA2t), which lacks a signal peptide. We compared the serodiagnostic performances of recombinant NcGRA2t with that of truncated surface antigen 1 of N. caninum (NcSAG1t). Specificity testing using sera from mice infected with Toxoplasma gondii indicated that the NcGRA2t recombinant protein does not cross-react with T. gondii. In addition, we detected anti-NcGRA2t antibody at the acute stage in experimentally infected dogs, while detecting anti-NcSAG1t antibody during both the acute and chronic stages. Our results suggest that the levels of anti-NcGRA2 antibody reflect parasite activation in dogs. In conclusion, antibodies against NcGRA2t and NcSAG1t are suitable indicators to distinguish the acute and chronic stages of N. caninum infection.

Reproductive Toxicity of Cassia Absus Seeds in Female Rats: Possible Progesteronic Properties of Chaksine and b-Sitosterol

This study was designed to evaluate the reproductive toxicity of Cassia absus seeds, which have been used in Persian folk medicine. Female rats in treatment groups (N = 5) received C. absus n-hexane fraction (CAF) at oral doses of 100, 200, and 500 mg/kg b.wt./day, once per day on days one to five post-coitum (pc). The control group received 0.2 mL of olive oil (vehicle). Fertility, maternal index, hormone level, and teratogenicity were evaluated. Phytoconstituents of the seeds were detected by HPTLC and GC-MS. The presence of phytoprogesterones was evaluated by docking software. The fertility index and number of fetuses in treated groups decreased significantly. Missed abortion was 50% after administration of 500 mg/kg/day of CAF. The maternal body weight, uterine weight, and levels of FSH, LH, and estradiol exhibited insignificance changes. The serum concentration of progesterone also changed significantly in a dose-dependent manner. No teratogenic effect was found. Oleic acid (35.89%) and linoleic acid (24.22%) were the major constituents of the seed oil. In addition, chaksine and β-sitosterol showed potential phytoprogesteronic properties in docking studies. The reproductive toxicity of C. absus seeds may be related to a hormonal imbalance, a decline in the fertility index, and an increase in the rate of missed abortions of fetuses.

Reproductive Performances and Management Effects on Productions of Indigenous Dairy Cows Raised at Char Areas in Northern Bangladesh

AbstractThe study was conducted to assess the existing reproductive performances and the effect of nutritional supplementation on productions of indigenous cows in Char areas (remote river Jamuna sand islands) in northern part of Bangladesh from October 2009 to March 2010. The study also projected the frequency and determinants of long calving interval (LCI), retention of foetal membrane (RFM), dystocia (D), and abortion (A) in indigenous cattle and explored production trends. Fifty seven dairy households (average breedable cows = 2, range 1 to 3) were visited and data on reproductive, breeding and management histories were collected and statistically analyzed. Overall, 125 breedable indigenous cows were observed to be alive at different stages. The mean (±SE) calving interval were 492 ± 15days and the interval between calving and the initiation of ovarian activity were 143 ± 6.7 days. Birth rate was 53.7 per 100 cows year, with birth been reported to occur in all over of the year. Of the 87 cows that were reported to have calved more than once in their lifetime, 6(6.9%) and 5(5.7%) were associated with abortion and dystocia, respectively. Eight (9.2%) of the animals suffered RFM. All cows were dewormed and supplemented with vitamin-mineral premixes. The body weight of 125 cows and the milk yield of 71 lactating cows were recorded. The mean (± SD) body weight and daily milk yields of the cows during initial and end of veterinary interventions were 121.1 ± 21.0 kg, 1.5 ± 0.1 litres; 165.0 ± 14.0kg and 2.3 ± 0.02 litres, respectively. After productive veterinary interventions, there was an apparent effect of improved health on body weight gain (80g/cow/day) and the average milk yield increased from 1.5 to 2.3 litre/cow. It was concluded that, the present estimate of LCI, birth rate, prevalence of peripartum disorders attributes as the indicators of poor reproductive performances of cows and the productive veterinary health care services improved the general health and production status of the dairy cows in char areas.

The multiple meanings of 'risk': views on the abortion of non-viable fetuses among Brazilian medical doctors and magistrates

The article seeks to understand the conceptions of 'risk' produced in the medical field as they come to be interpreted in the legal field. It draws on legal decisions concerning authorization for aborting fetuses bearing anomalies incompatible with life, and on non-directive interviews with medical doctors and magistrates. The category of 'risk' was found to be subject to considerable manipulation by both doctors and magistrates in being deployed as moral justification for the abortion of non-viable fetuses. Abortion is thus displaced from the sphere of individual choice to the domain of therapeutic abortion. The article also highlights the polyvalence of risk discourse, since this notion is deployed both to affirm and to deny legal authorizations for abortion, and to attribute responsibility for abortion decisions to doctors.

Assessing bacterial invasion of cardiac cells in culture and heart colonization in infected mice using Listeria monocytogenes.

Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that is capable of causing serious invasive infections in immunocompromised patients, the elderly, and pregnant women. The most common manifestations of listeriosis in humans include meningitis, encephalitis, and fetal abortion. A significant but much less documented sequelae of invasive L. monocytogenes infection involves the heart. The death rate from cardiac illness can be up to 35% despite treatment, however very little is known regarding L. monocytogenes colonization of cardiac tissue and its resultant pathologies. In addition, it has recently become apparent that subpopulations of L. monocytogenes have an enhanced capacity to invade and grow within cardiac tissue. This protocol describes in detail in vitro and in vivo methods that can be used for assessing cardiotropism of L. monocytogenes isolates. Methods are presented for the infection of H9c2 rat cardiac myoblasts in tissue culture as well as for the determination of bacterial colonization of the hearts of infected mice. These methods are useful not only for identifying strains with the potential to colonize cardiac tissue in infected animals, but may also facilitate the identification of bacterial gene products that serve to enhance cardiac cell invasion and/or drive changes in heart pathology. These methods also provide for the direct comparison of cardiotropism between multiple L. monocytogenes strains.

Enemies and turncoats: bovine tuberculosis exposes pathogenic potential of Rift Valley fever virus in a common host, African buffalo (Syncerus caffer).

The ubiquity and importance of parasite co-infections in populations of free-living animals is beginning to be recognized, but few studies have demonstrated differential fitness effects of single infection versus co-infection in free-living populations. We investigated interactions between the emerging bacterial disease bovine tuberculosis (BTB) and the previously existing viral disease Rift Valley fever (RVF) in a competent reservoir host, African buffalo, combining data from a natural outbreak of RVF in captive buffalo at a buffalo breeding facility in 2008 with data collected from a neighbouring free-living herd of African buffalo in Kruger National Park. RVF infection was twice as likely in individual BTB+ buffalo as in BTB- buffalo, which, according to a mathematical model, may increase RVF outbreak size at the population level. In addition, co-infection was associated with a far higher rate of fetal abortion than other infection states. Immune interactions between BTB and RVF may underlie both of these interactions, since animals with BTB had decreased innate immunity and increased pro-inflammatory immune responses. This study is one of the first to demonstrate how the consequences of emerging infections extend beyond direct effects on host health, potentially altering the dynamics and fitness effects of infectious diseases that had previously existed in the ecosystem on free-ranging wildlife populations.

Pregnancy per artificial insemination and pregnancy loss in lactating dairy cows of a single herd following timed artificial insemination or insemination at detected estrus

Thangavelu, G., Gobikrushanth, M., Colazo, M. G. and Ambrose, D. J. 2015. Pregnancy per artificial insemination and pregnancy loss in lactating dairy cows of a single herd following timed artificial insemination or insemination at detected estrus. Can. J. Anim. Sci. 95: 383–388. The objective of this retrospective study was to determine the factors affecting pregnancy per artificial insemination (P/AI) and pregnancy loss in lactating dairy cattle. Breeding records (n=1466) for 5 consecutive years were evaluated from one dairy herd. The effects of type of breeding [timed artificial insemination (TAI; n=1246) vs. insemination at detected estrus (IDE; n=220)], parity (primiparous vs. multiparous), body condition score (BCS; low ≤2.5 vs. high >2.5), year, season (summer vs. other seasons) and fertility group (high fertile <3 vs. low fertile ≥3 inseminations), on P/AI and pregnancy loss (i.e., late embryonic/early fetal loss, abortion and stillbirth) were determined using the GLIMMIX procedures of SAS software. Pregnancy per AI was influenced by type of breeding and season. Pregnancy per AI was lower (P<0.05) in cows that were TAI (28.7%) than IDE (37.1%) and during summer (30.3%) than other seasons of the year (35.5%). Pregnancy loss was higher (P<0.05) in low BCS (9.1%) than in high BCS (1.9%) cows. However, parity, year, and fertility group affected neither P/AI nor pregnancy loss.

Antiphospholipid syndrome

Antiphospholipid syndrome (APS) is characterized by recurrent arterial or venous thromboembolism or pregnancy loss in association with antibodies directed against anionic phospholipids or against plasma proteins bound to anionic phospholipids. It occurs in 15-30 % of patients suffering from systemic lupus erythematosus (secondary APS) but can also occur without an underlying connective tissue disease (primary APS). The reason for the huge variety of clinical manifestations is thromboembolic vaso-occlusive disease and not vasculitis in blood vessels of different sizes and sites (e.g. deep vein thrombosis, pulmonary embolism and cerebrovascular disease). Accordingly, fetal abortion is also caused by infarctions of blood vessels in the placenta typically after the tenth week of gestation. Establishing the correct diagnosis of APS is not easy. Diagnosis should not rely on only slightly or temporarily elevated levels of AP antibodies as thrombosis might occur due to other reasons even in patients with AP antibodies. The estimation of the risk of thrombotic complications as well as the type and intensity of a suitable anticoagulation prophylaxis are challenging in the treatment of patients with APS. Antiplatelet agents (aspirin), heparin and vitamin K antagonists are used for therapy. Immunosuppression is not effective for the prevention of thromboembolic complications; therefore, not only problem issues on laboratory diagnostics but also current therapeutic recommendations are presented.

Accuracy of reporting abortions with Down syndrome in England and Wales: a data linkage study

The number of abortions of fetuses with Down syndrome in England and Wales reported by the Department of Health (DH) differs from that reported by the National Down Syndrome Cytogenetic Register (NDSCR). The aim of this study was to investigate the reasons for this. Abortions in 2011 and 2012 from DH were matched to those from NDSCR. The number of cases not reported to either source was estimated. An estimated 2240 abortions of fetuses with Down syndrome occurred in 2011/12; NDSCR estimated 2208 and DH 1100. One thousand and six abortions were identified in both data sets, including 145 (14%) which were not recorded by DH as having Down syndrome. Abortions in NDSCR that were not matched in DH occurred throughout England and Wales and at all gestational ages. An estimated 61 abortions of fetuses with Down syndrome were not reported to DH or NDSCR. The number of abortions of fetuses with Down syndrome reported by the NDSCR is more complete than that reported by the DH. DH data for abortions with other congenital anomalies are also likely to be underestimates, and more accurate estimates are available from BINOCAR regional congenital anomaly registers.

Interferon γ-induced GTPase promotes invasion of Listeria monocytogenes into trophoblast giant cells.

Listeria monocytogenes is well known for having the ability to cross the placental barrier, leading to fetal infections and abortion. However, the mechanisms leading to infectious abortion are poorly understood. In this study, we demonstrate that interferon γ-induced GTPase (IGTP) contributes to the invasion of L. monocytogenes into trophoblast giant (TG) cells, which are placental immune cells. Knockdown of IGTP in TG cells decreased the relative efficiencies of L. monocytogenes invasion. Moreover, IGTP accumulated around infected L. monocytogenes in TG cells. Treatment of TG cells with phosphatidylinositol 3-kinase (PI3K)/Akt inhibitors also reduced bacterial invasion. PI3K/Akt inhibitor or IGTP knockdown reduced the amount of phosphorylated Akt. Monosialotetrahexosylganglioside (GM1) gangliosides, lipid raft markers, accumulated in the membrane of L. monocytogenes-containing vacuoles in TG cells. Furthermore, treatment with a lipid raft inhibitor reduced bacterial invasion. These results suggest that IGTP-induced activation of the PI3K/Akt signaling pathway promotes bacterial invasion into TG cells.

Goat uterine DBA+ leukocytes differentiation and cytokines expression respond differently to cloned versus fertilized embryos.

High rate of fetal mortality in ruminant somatic cell nuclear transfer (SCNT) pregnancies is due, at least in part, to immune-mediated abortion of fetuses. In the present study, goat uterine leukocytes were isolated by Dolichos biflorus agglutinin (DBA) coated magnetic beads, and with majority being were CD56+CD16- in phenotype with low levels of perforin and Granzyme B expression. The responses of the isolated cells to SCNT and in vitro fertilization (IVF) embryos conditioned mediums containing hormone steroids were compared by measuring their phenotype and cytokines expression. The results showed there was a 2-fold increase in the numbers of isolated uterine leukocytes after incubation with different conditioned mediums for 120 h. However, significantly lower percentage and absolute numbers of uterine CD56+CD16- leukocytes incubated with SCNT conditioned mediums were detected as compared with those incubated with IVF conditioned mediums (P < 0.05). The group treated with progesterone (P4) or the combination of P4 and 17β-estradiol (E2) were associated with significantly higher percentage and absolute numbers of CD56+CD16- cells as compared with those treated with E2 alone (P < 0.05). Furthermore, in the presence of steroids, the isolated leukocytes incubated with SCNT conditioned mediums associated with greater levels of IFN-γ secretion and expression, as well as lesser levels of VEGF, as compared with those treated with IVF conditioned mediums (P < 0.05). In conclusion, this study demonstrates that SCNT embryos have a profound effect on the phenotype expression of goat uterine DBA+ leukocytes, as well as the secretion and expression of IFN-γ and VEGF by these cells in vitro.

Noninvasive Prenatal Testing: Implications for Muslim Communities

Noninvasive prenatal testing (NIPT), a new technology that uses cell-free fetal DNA in maternal plasma to detect fetal aneuploidies, is currently entering clinical practice. NIPT offers great clinical benefits as it is much more accurate than current screening, allows earlier testing, and eliminates the risk of miscarriage associated with amniocentesis and chorionic villus sampling (CVS). In the future, it may become accurate enough to replace invasive testing. To date, no attention has been given in the literature to the role that earlier testing through NIPT might play in the context of religious traditions with particular attitudes toward abortion, such as in Muslim communities. This article presents some Islamic views regarding fetal development and abortion as well as some recent legislative developments surrounding abortion for fetal conditions, focusing on Iran and Saudi Arabia. It then offers a discussion of possible implications of NIPT for Muslim communities, such as its potential to allow access to diagnostic information before “ensoulment,” the point of fetal development at which the fetus is bestowed the moral status of a human being. The possible impact of early access to information on the evolution of legislation surrounding abortion for fetal conditions is also discussed. Finally, we suggest future research directions based on empirical studies with women, partners, health professionals, and religious authorities in Muslim countries and in countries with a Muslim majority in order to explore their preferences and attitudes regarding the future implementation of NIPT within those communities.

“Let the Children (With Down Syndrome) Come to Me”: God's Shalom and the Radical Hospitality of the Church

This article examines the current selective abortion of fetuses with Down syndrome and understands this phenomenon as a result of late modernity's concept of the good life being grounded in autonomy and a choosing self. In contrast, God's shalom presents a counter-narrative of eschatological hospitality. Ephesians 2:11-22 proclaims a welcome that brings those previously considered outliers into the “new humanity” of the koinonia. This essay argues that the church has an opportunity to witness to society's devaluing of persons with Down syndrome by intentionally seeking to adopt them into their faith communities. This approach not only provides a home for the rejected, but facilitates the church's transformation into a people who personify reconciliation and unity. The communities of L’Arche exist as embodiments of God's eschatological hospitality and potentially stand as mentors for the church in performing this radical act of welcome.

Assessment of Reproductive Performance and Problems in Crossbred (Holstein Friesian X Zebu) Dairy Cattle in and Around Mekelle, Tigray, Ethiopia

A cross sectional study was conducted in and around Mekelle, Tigray, Ethiopia from November 2013 to May 2014 with the aims to assess reproductive performance and prevalence of reproductive problems in crossbred (Holstein Friesian x Zebu) dairy cattle. A questionnaire survey methodology was used. The study sampled 177 randomly selected dairy farms comprising 1013 crossbred dairy cattle (736 cows and 277 heifers). The mean age at first service, age at first calving, first postpartum estrus and calving interval were 24.8 months, 35.3 months, 114.5 days and 401.5 days, respectively. Prevalence rates of reproductive problems recorded in the study area were anestrus (37.8%), repeat-breeding (21.0%), dystocia (11.6%), retained fetal membranes (11.5%), endometritis (6.6%), abortion (6.4%), prolapsed uterus/vagina (2.9%), stillbirth (2.0%) and freemartin (0.2%). Incidence of abortion did not vary with parity and stages of gestation. Breeding and the possible causes of missing insemination/mating while animals were in estrus are problematic. In conclusion, this study has revealed that the reproductive performance of crossbred dairy cattle was not optimal, and anestrus, repeat-breeding, dystocia, retained fetal membranes, endometritis and abortion were the major reproductive problems. More effective breeding and reproductive health management should be considered to improve the fertility of this crossbred cattle herd. Awareness and training should be provided to the farming community to improve the productivity in the region.

Bioethics - should they encourage the killing of unwanted newborn infants?

Bioethics - should they encourage the killing of unwanted newborn infants?

Domestic violence against women working in an institute

Background: Domestic violence is the most common form of violence against women. It affects the life span from sex selective abortion of female foetuses to forced suicide and abuse and isevident to some degreein every society in the world. It is important that studies on domestic violence should be conducted and those women who are found as victims should be counselled to reduce/prevent the health hazards among them. Objective: To study domestic violence against working women. Methods: An institution-based cross-sectional observational study was conducted in Malla Reddy Institute of Medical Sciences and Malla Reddy Hospital for a period of one month. All professionals and working class women including faculty nurses clerks and class-3 and class-4 employees were included. Total women working in Malla Reddy Institute of Medical Sciences and Malla Reddy Hospital were 355. Out of 355 125 women agreed to participate in the study. Results: The prevalence of domestic violence was 23.2%. It was found that slapping was the most common type of physical violence i.e. 20.6%. 11 (37.9%) women out of 29 were facing the economic abuse (violence). 20 (69%) of women out of 29 reported emotional violence. Alcoholic husband was the most common cause in 43.7% of cases. 41.6% of women do not want to report the incidence to anyone. Similar number however has reported to their parents. Conclusion: Thus it can be concluded that the prevalence of domestic violence was very high among the working women.

Incidence of Major Clinical Reproductive Health Problems of Dairy Cows at Bako Livestock Research Farm over a Two-Year Period (September 2008-December 2010)

A prospective follow up study was carried out on 372 dairy cows at Bako Agricultural research center between September 2008 and December 2010 to determine the incidence of reproductive problems and associated risk factors in the cows. The animals were continuously followed from insemination/mating until 45 days postpartum for occurrence of clinical reproductive problems. Data were collected during farm visits by observation and clinical examination of animals. The cumulative incidence of clinically observed major reproductive problems was 35.2% (131/372). No statistically detectable effect (p>0.05) of breed was shown on the occurrence of clinical reproductive problems evaluated. In addition, number of parities, body condition score (BCS), age of dams, calf sex and service type were not found to have a significant influence on the occurrence of reproductive problems in the study farm (p>0.05). The most common reproductive problems recorded in the present study were retained fetal membrane (8.3%), dystocia (6.7%), abortion (5.9%), uterine infections (5.6%) and stillbirths (4.8%). In this study, the incidence of dystocia, uterine infections, stillbirths and repeat breeding were more common in crossbred cows whereas abortion was more common in local cows but the effect of these factors was not significant (p>0.05). This study revealed that nearly one cow out of every three cows encountered at least one type of clinical reproductive problems indicating the widespread occurrence of the problems among dairy cows at Bako Agricultural Research Center. However, considered plausible factors such as breed, parity number, body condition score (BCS), age of dams, calf sex and service type had no significant influence on the occurrence of reproductive problems in the study farm indicating that some other factors are responsible for precipitating the conditions. It is, therefore, recommended that other factors that precipitate the occurrence of the problems in the farm should be investigated and appropriate interventions implemented in order to minimize the occurrence of these problems and associated losses in the farm.

Statistical inferences regarding the genetic determinism of the embryo-fetal losses

The purpose of this study is to examine the way in which embryonic mortality and fetal abortions are inherited from mother to offspring. Â The regression method of offspring on dam was used in order to measure the genetic and environmental relationships among considered characters. The results point that the abortion rate is higher in cows which have already had abortions during their lives. The one-way Anova analysis shows the existence of influence from breeding males as well. In the case of embryonic mortality, a strong genetic determinism (h 2 =0.43) was obtained, while in the case of fetal abortions there was found a low genetic determinism (h 2 =0.35). Heritability was estimated starting from the regression of offspring on parents. Statistic data were obtained using R-statistics soft.

Aberrant expression of Xist in aborted porcine fetuses derived from somatic cell nuclear transfer embryos.

Cloned pigs generated by somatic cell nuclear transfer (SCNT) show a greater ratio of early abortion during mid-gestation than normal controls. X-linked genes have been demonstrated to be important for the development of cloned embryos. To determine the relationship between the expression of X-linked genes and abortion of cloned porcine fetuses, the expression of X-linked genes were investigated by quantitative real-time polymerase chain reaction (q-PCR) and the methylation status of Xist DMR was performed by bisulfate-specific PCR (BSP). q-PCR analysis indicated that there was aberrant expression of X-linked genes, especially the upregulated expression of Xist in both female and male aborted fetuses compared to control fetuses. Results of BSP suggested that hypomethylation of Xist occurred in aborted fetuses, whether male or female. These results suggest that the abnormal expression of Xist may be associated with the abortion of fetuses derived from somatic cell nuclear transfer embryos.