Frequency Of Abortion Research Articles

Clinical characteristics and outcomes of pregnancy after invasive prenatal testing in women with multiple pregnancy

Retrospective assessment of the obstetric and gynecological history, gravidity, parity and complications of the current pregnancy in women who underwent amniocentesis (AC) and chorionic villus sampling (CVS) are presented. The features of invasive prenatal procedures (IPP), as well as the outcomes of pregnancy and childbirth were studied. The frequency of spontaneous abortion (SA) after AC was 2.90 ± 2.05%, during CVS — 2.80 ± 2.82%, in the comparison group (GC) (1.10 ± 1.07%, p > 0.017). There were no statistically significant differences in invasive prenatal diagnostics in the 1st and 2nd trimesters in multiple and single pregnancies. AC and CVS do not affect the average delivery time (CVS — 37.0 (34.0–38.0) weeks, AC — 36.0 (34.0–38.0) weeks, GS — 36.0 (34.0–37.0) weeks, p > 0.017), weight of newborns (CVH — 2440.0 (1960.0–2845.0) g, AC — 2600.0 (1850.0–2760.0) g, GS — 2325.0 (1800.0–2740.0) g, p > 0.017). IPP do not increase the preterm birth rate at 23–36 weeks' gestation (CVH — 41.40 ± 9.15%, AC — 51.60 ± 6.36%, GS — 54.40 ± 5.19%, p > 0.017) and does not increase perinatal mortality.

Risk of intellectual disability and maternal history of spontaneous abortion: a nationwide cohort study.

To investigate the association between a maternal history of spontaneous abortion and intellectual disability in children. This cohort study included 1778786 children (913 340 males, 865 085 females, 361 missing data; mean age 15y 2mo, SD 8y 11mo, range birth to 40y) born in Denmark between 1977 and 2016. Cox proportional hazard regression was used to estimate the hazard ratios (HRs) of intellectual disability. The overall HR of intellectual disability for children with a maternal history of spontaneous abortion was 1.17 (95% confidence interval [CI] 1.12-1.22) and the risk for multiple spontaneous abortions (HR=1.30, 95% CI 1.20-1.40) was higher than for a single spontaneous abortion (HR=1.13, 95% CI 1.07-1.18). When only cases of inpatient intellectual disability were included, the estimates increased slightly: the overall HR was 1.22 (95% CI 1.12-1.32), the HR for multiple spontaneous abortions was 1.37 (95% CI 1.20-1.58), and the HR for a single spontaneous abortion was 1.17 (95% CI 1.07-1.28). The risks were similar regardless of whether spontaneous abortion occurred before or after the index delivery. Estimates were nearly unchanged after adjusting for preterm birth, low birthweight, or Apgar score. Children born to mothers with spontaneous abortion, especially multiple spontaneous abortions, may be at a higher risk of intellectual disability in later life, regardless of whether spontaneous abortion occurred before or after the index delivery. The findings have clinical implications for targeted early intervention of children with intellectual disability. What this paper adds A maternal history of spontaneous abortion was associated with a risk of intellectual disability in offspring. The risk was higher in children whose mothers previously had multiple spontaneous abortions. Similar risks were observed regardless of whether spontaneous abortion occurred before or after childbirth.

Cervical polyps in early pregnancy are a risk factor for late abortion and spontaneous preterm birth: A retrospective cohort study.

To determine the association between cervical polyps in early pregnancy and late abortion and spontaneous preterm birth (SPTB). We also aimed to explore the relationship between cervical polyps and cervical insufficiency in the second trimester. We conducted a retrospective cohort study of 2941 singleton pregnant women between January 2010 and December 2015. The frequency of late abortion and SPTB (before 28, 34, or 37weeks of pregnancy) was compared between the two groups of 142 (4.8%) patients who had cervical polyps early in the pregnancy (P group) and 2799 who did not (non-P group). Multivariate analysis was performed to identify risk factors for late abortion and SPTB. The incidence of late abortion and SPTB was significantly higher in the P group than in the non-P group. Cervical polyps in early pregnancy were selected as independent risk factors for late abortion and SPTB before 28, 34, or 37weeks of pregnancy. The P group had a significantly higher rate of cases requiring therapeutic cervical cerclage than the non-P group. Cervical polyps in early pregnancy are risk factors for late abortion and SPTB. They are also associated with the occurrence of cervical insufficiency.

Abortion and its correlates among female fisherfolk along Lake Victoria in Uganda.

Introduction:In Uganda, people living in fishing communities tend to engage in high-risk sexual activity which leads to unintended pregnancies that may end in abortions. Abortion has negative social, psychological, and medical impacts. We determined the frequency of abortion and its correlates among female fisher-folk along Lake Victoria in Uganda.Methods:A cross-sectional survey was conducted among women aged 15– 49 years from Kigungu and Nsazi fishing communities. Data were collected on socio-demographic characteristics, abortion, and family planning use. Associations between abortion and participant characteristics were assessed using logistic regression models.Results:Of the 713 women interviewed, 36, 5% were pregnant and 247, 34.6 % were using contraception. Majority (600, 84.2%) of those interviewed reported ever being pregnant. Approximately 45% of the pregnancies were un-intended while a third of those who had ever been pregnant (195, 32.5%) reported having aborted before. Slightly over a third (247, 34.6%) reported currently using or ever using family planning. Women aged 30+ years were more likely to abort compared to those aged 15-29 years (aOR: 2.7; 95% CI: 1.23-5.91). Women who had living children were less likely to abort compared to those who didn’t have any living child (aOR: 0.06; 95% CI: 0.01 – 0.17).Conclusion:The rate of abortion among female fisher-folk in Uganda is substantial. Family planning use is still low and unintended pregnancies are common. Abortion risk increased with the age of the mother. Continuous behavioral change communication and optimization of family planning use are recommended to reduce abortions.

Pregnancy complications in COVID-19 positive primigravid patients: a comparative study

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of corona virus causing COVID-19. Previous studies suggested that COVID-19 is more likely to affect older males with co-morbidities. But pregnant women are at greater risk of exposure to SARS-CoV-2 infection due to physiological and immunological changes during pregnancy. This study aimed to monitor the pregnancy complications and mode of delivery.
 Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka over from May 2020 to July 2020. A total of 20 primigravid singleton pregnant women of all trimesters having COVID-19 positive reports (mild to moderate) were included in this study. Similar numbers of primigravid singleton pregnant women of all trimester having negative COVID-19 report were included in this study. Women having age between 18 and 40 years were included. Patients with multiple pregnancy, pregnancy with hypertension, heart disease, renal disease and other metabolic diseases were excluded from this study.
 Results: Most of the patients were between 26 and 35 years old. Mean age was 29.25 ± 4.42 years in COVID positive group and 31.10 ± 4.65 years in COVID negative group. In positive cases, most of them had gestational age below 37 weeks but in negative cases, most of them had gestational age e•37 weeks. There was significant difference in gestational age between two groups. Regarding type of delivery, in positive cases most underwent Caesarean section and in negative cases maximum were normal vaginal delivery. Regarding antenatal complication during pregnancy, abortion, premature rupture of membrane and pre term labour was found significantly higher in positive cases than that of negative cases. Respiratory distress and psychological upset were observed significantly higher in positive cases than that of negative cases.
 Conclusion: Regarding antenatal complications and mode of delivery, Frequency of abortion, PROM, preterm labor and LUCS was significantly higher in COVID-19 cases. Respiratory distress and psychological upset was significantly higher in COVID-19 positive cases. COVID-19 Among postnatal complications infection might increase the risk of pregnancy complications and pregnant women could have a severe clinical course of the disease.
 Birdem Med J 2020; 10, COVID Supplement: 71-73

The role of survivin in the pathogenesis of genital endometriosis, current application possibilities (literature review)

In the structure of gynecological diseases, genital endometriosis takes the third place, and its frequency tends to increase. Endometriosis occurs in 510% of women of reproductive age, in 3550% of patients with infertility and in 7080% of women with chronic pelvic pain. The frequency of spontaneous abortion in endometriosis ranges from 10 to 50%. Noteworthy is the fact that the delay in diagnosing and starting treatment is 5 to 10 years. The disadvantages of surgical treatment are the high relapse rate (up to 50% after 5 years from the start of treatment). Hormonal treatments are effective, but they also have serious side effects that limit them in the long run. Naturally, the great practical and social importance of genital endometriosis induced numerous studies on the etiology and pathogenesis, which, however, have not yet been fully elucidated. The widespread prevalence of genital endometriosis necessitates the search and development of new effective methods of diagnosis and treatment. The article presents data on survivin, which is one of the members of the family of apoptosis inhibitors encoded by the BIRC5 gene. Survivin is involved in the pathogenesis of endometriosis and may be one of the early markers of the disease. Apoptosis is an important last step that determines the fate of the cell. Given recent developments in the search for targeted therapy for endometriosis, antagonists of apoptosis inhibitor proteins, including survivin, are considered as a potential target. Influence on the processes of programmed cell death can be a rather promising direction in the treatment of endometriosis. The purpose of this review is to evaluate the significance of surviving expression in the pathogenesis and diagnosis of endometriosis. 43 literature sources (domestic and foreign) were analyzed using various database (PubMed, PubMed central, Google Scholar, UpToDate).

Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin

BackgroundBehavioural and structural factors related to sex work, place female sex workers (FSWs) at high risk of maternal mortality and morbidity (MMM), with a large portion due to unintended pregnancies and abortions. In the African context where MMM is the highest in the world, understanding the frequency and determinants of pregnancy and abortion among FSWs is important in order to meet their sexual and reproductive health needs.MethodsData from two Beninese cross-sectional surveys among FSWs aged 18+ (2013, N = 450; 2016, N = 504) were merged. We first performed exploratory univariate analyses to identify factors associated with pregnancy and abortion (p < 0.20) using Generalized Estimating Equations with Poisson regression and robust variance. Multivariate analyses first included all variables identified in the univariate models and backward selection (p ≤ 0.05) was used to generate the final models.ResultsMedian age was 39 years (N = 866). The proportion of FSWs reporting at least one pregnancy during sex work practice was 16.4%, of whom 42.3% had more than one. Most pregnancies ended with an abortion (67.6%). In multivariate analyses, younger age, longer duration in sex work, previous HIV testing, having a boyfriend and not using condoms with him were significantly (p < 0.05) associated with more pregnancies.ConclusionOne FSW out of five had at least one pregnancy during her sex work practice. Most of those pregnancies, regardless of their origin, ended with an abortion. Improving access to various forms of contraception and safe abortion is the key to reducing unintended pregnancies and consequently, MMM among FSWs in Benin.

Comparison of Pregnancy and Neonatal Outcomes in Frozen and Fresh Embryo Transfer in ART Cycles: A Retrospective Cohort Study

Background & aim: In addition to the benefits of frozen embryo transfer (FET), the key question is whether freezing or melting embryos can cause fetal harm and prenatal complications. This study aimed to assess pregnancy and neonatal outcomes after FET and fresh embryo transfer (ET). Methods: This retrospective cohort study investigated the pregnancy outcomes of infertile women undergoing intracytoplasmic sperm injection with FET and ET in Kowsar Infertility Center of Motahary hospital in Urmia, Iran between March 2014 and March 2016. A questionnaire was completed based on the hospital records of pregnancy or neonatal outcomes. To assess the continuation of pregnancy and delivery, the questionnaires were completed through phone call. The pregnancy and neonatal outcomes were compared between FET (n=96) and fresh ET (n=93) using Student’s t-test, Chi-square, Fisher’s exact tests and multiple logistic regression using SPSS software (version 21.0). Results: The rate of ongoing pregnancy were reported as 60.2% and 76% in the FET and fresh ET groups, respectively. The rate of multiple pregnancy and ongoing pregnancy were lower in FET, compared to those reported for fresh ET (OR=0.38, 95% CI: 0.18-0.79, P=0.01; OR=0.48, 95% CI: 0.25-0.85, P=0.02). The frequency of spontaneous abortion was not different between two groups (P=0.07). The FET and fresh ET increased the odds of lower neonatal weight; however, it was not statistically significant. Conclusion: In this study, a lower rate of ongoing pregnancy was reported in the FET group. It seems that FET can cause damage to the embryo during freezing and melting.

Thyroid peroxidase in human endometrium and placenta: a potential target for anti-TPO antibodies.

Autoimmune thyroid disease is the most common endocrine disorder during pregnancy. Thyroid autoantibodies (TAs) have been suggested to serve a role in implantation failure and spontaneous abortion. Until now, there are no data on the potential interaction of TAs with human reproductive organs. Here, we set out for the first time to test this hypothesis by studying the expression of thyroid peroxidase (TPO) at gene and protein level in human reproductive organs. Endometrial samples were taken from normal women, and placenta tissues were collected after full-term caesarian section. Expression of TPO messenger RNA (mRNA) was investigated by qRT-PCR. In addition, polyclonal anti-TPO antibodies were produced and the expression of TPO protein in mentioned tissues was evaluated by immunohistochemistry and Western blot analysis. The reactivity of anti-TPO antibody in human embryos was evaluated by immunofluorescent staining. For the first time, our study showed that TPO is expressed at gene and protein levels in endometrium and placenta. TPO expression was mainly localized to glandular and luminal epithelial cells in the endometrium. In placenta, the syncytiotrophoblasts and invasive trophoblast cells were the main cell types that expressed TPO protein. Specific band of approximately 110kDa was observed in all endometrial and placental tissues by Western blot analysis. However, no expression of TPO protein was observed in human embryo. TPO expression in endometrium and placenta may explain higher frequency of abortion and infertility in patients with thyroid autoimmunity.

Comparing the Effectiveness of Doing Intra-uterine Insemination 36 and 42 Hours After Human Chorionic Gonadotropin (HCG) Injection on Pregnancy Rate: A Randomized Clinical Trial.

Objective: Intrauterine insemination (IUI) is an assisted conception technique that involves the deposition of a processed semen sample in the upper uterine cavity, overcoming natural barriers to sperm ascent in the female reproductive tract. Hence, we compared the results of doing intra-uterine insemination 36 and 42 hours after human chorionic gonadotropin (hCG) hormone injection to achieve clinical and chemical pregnancy rates. Materials and methods: One hundred and sixty infertile women with unexplained infertility participated in this clinical trial. They were divided into two groups: those who underwent IUI 36 hours after hCG injection (control group), and those who underwent IUI 42 hours after hCG injection (case group). Statistical analyses were done using IBM-SPSS 25.0. and Chi-square test were used for data analysis. Results: The percentages of clinical and chemical pregnancies were significantly higher in the 42h group compared to the other group (P = 0.038 vs. P = 0.009, respectively). There was no significant difference regarding frequency of abortion, twin and ectopic pregnancies between the two groups (P > 0.05). Conclusion: Doing IUI 42 hours after hCG injection can significantly increase chances of fertility compared to doing it 36 hours after hCG injection.

Cytomegalovirus UL83 Gene as Diagnostic Marker for Preliminary Infection in Pregnant Women in AL-Najaf City

The case-control diagnostic study was developed to evaluate the prevalence of Human cytomegalovirus (HCMV) among the population of pregnant women (160 women of ages ranging from 15 -45 years old who were attended to get medical diagnosis at Al-Najaf public health laboratory, during a period extending from 15th January - 15th August 2019), and also 50 healthy pregnant women were included as a control group. Data about frequency of abortion, age, and residency were recorded. Diagnosis was firstly depending on Enzyme immunoassay (EIA) for the evaluation of the prevalence of anti- HCMV IgM and IgG antibodies in sera of pregnant women, then confirmed by the quantitative real-time PCR(qRT-PCR), using specific primers targeting of UL83 gene of HCMV. Results presented in this study showed that the overall prevalence of HCMV infection was 97:160 (60.63%) and among women of mean ages± Standard deviation (SD) equal to 26.243± 6.485. Out of 160 participant women; 95(59.38%) of cases had chronic HCMV infection while only 2 cases (1.25%) had acute HCMV infection. Results were revealing that 52:160 (32.5%) of HCMV infected cases were related to women of 16-25 years age group followed by those related to 26-35 years age group with a prevalence of 21.88%. Eight cases (5%) were related to 36-45 years age group, while only 2 cases (1.25%) had 15 years old age. Current results were also revealed that 35:59 (59.3%) from rural area, while 62:101 (61.4%) were from urban areas in Al-Najaf.Recurrent abortion (two or more frequency) was recorded to 17:97 (17.53%) of HCMV seropositivity cases with significant correlation. Results of HCMV UL83 gene amplification by qRT-PCR were showing that the overall prevalence of HCMV UL83 gene was 85% (136:160) of the total diagnostic group, and also positive in 25:50 (50%) of healthy pregnant women, with significant statistically differences. The HCMV positive threshold cycle (CT) of UL83 gene was revealing mean ± SD of 19.0537±6.64501, and 4 fold ratio as compared with that detected in asymptomatic cases by the method of 2^-∆∆CT. The interassay coefficient of variation (CV) of HCMV UL83 gene amplification CT was 34.88%. The qRT-PCR of HCMV UL83 amplification was revealing sensitivity, specificity and diagnostic accuracy of 100%, 96% and 99.4% respectively. While positive predictive and negative predictive values were equal to 99.3% and 100% respectively. We concluded that UL83 gene detection was successful, confirmatory to EIA and more precised for HCMV isolated from serum samples.

Effect of adjunctive vaginal progesterone after McDonald cerclage on the rate of second-trimester abortion in singleton pregnancy: a randomized controlled trial.

To evaluate the effect of adjunctive use of vaginal progesterone after McDonald cerclage on the rate of second-trimester abortion in singleton pregnancy. A randomized controlled trial at Woman's Health Hospital, Assiut University, Egypt, between April 2017 and March 2019 enrolled women eligible for McDonald cerclage. After cerclage, participants were randomly assigned to receive progesterone (400mg pessary) once daily until 37weeks or no progesterone. The primary outcome was rate of abortion before 28weeks. Secondary outcomes included gestational age at delivery, preterm delivery, mean birthweight, Apgar score, and admission to the neonatal intensive care unit (NICU). The rate of spontaneous abortion was higher in the no-progesterone group (P=0.016). Mean gestational age and mean birthweight was higher in the progesterone group (P<0.001 and P=0.002, respectively). The frequency of preterm neonates, neonates with Apgar score less than 7, and admission to NICU was higher in the progesterone group than in the no-progesterone group (P=0.005, P=0.008, and P=0.044, respectively). Adjunctive use of vaginal progesterone after McDonald cerclage was found to decrease the frequency of second-trimester abortion and to improve perinatal outcomes in singleton pregnancy. Clinicaltrials.gov: NCT02846909.

Pathogenetically differentiated management of pregnancy in patients with retrochorial hematoma

Introduction. Intrauterine hematomas commonly found in routine ultrasound examinations represent one of causes resulting in early pregnancy loss. The most common is retrochorial hematoma resulting from fetal egg detachment from the uterine wall. Retrochorial hematoma often leads to pregnancy complications and affects gestational process. Aim: to develop a personalized approach to the diagnosis, prevention and management of pregnancy with retrochorial hematomas in the early stages. Materials and methods. A prospective examination of 70 females, aged 22 to 37 years old, with retrochorial hematoma was performed at gestational age ranging from 5 to 12 weeks. Here, we examined serum level for lupus anticoagulant, antiphospholipid antibodies (AFA), antibodies to cardiolipin, fi2-glycoprotein I, to annexin V and prothrombin, and ADAMTS-13. All women were examined for genetic mutations linked to high thrombogenic risk and low thrombogenic risk polymorphisms. Patients were also examined for urinary tract infections. Results. It was found that 43 (61 %) females had aggravated obstetric anamnesis (non-developing pregnancy, spontaneous miscarriage in early stages, antenatal fetal death), whereas 13 (18.5 %) subjects had burdened familial thrombotic history (heart attack, stroke, and thrombosis occurred before the age of 55 years in first-line relatives). In addition, 22 (31.4 %) females were found to have genetic and acquired forms of thrombophilia; 6 (8.5 %) were detected to have circulatory ADAMTS-13 inhibitor; 5 females were confirmed to have decreased blood coagulation factor activity; and 38 (54.2 %) had vaginal dysbiosis. Conclusion. Our work demonstrates that a personified and pathogenetically differentiated algorithm for diagnostics and management of pregnant women with chorionic detachments in early stages allows to lower frequency of early abortions and increases the therapeutic effectiveness.

Outcome of Septic Abortion –Experience from a Tertiary Referral Hospital

Objective: Septic abortion is a life threatening complication of induced abortion. Being a tertiary referral hospital in Bangladesh, Sir Salimullah Medical College and Mitford Hospital often deals with such cases of septic abortion. This research work was conducted with the aim of evaluation of frequency, complications and outcome of septic abortion in this institute.&#x0D; Method: A cross sectional observational study was conducted from January 2016 to December 2016 in the department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Bangladesh. All cases of septic abortion admitted in the department were included in the study.&#x0D; Results: During one-year period total number of Gynaecological admission cases were 11,351, of which 1065 were abortion cases, among them 28 cases were diagnosed as septic abortion. The frequency of septic abortion thus was 2.6% of the abortion admitted cases. Age range of the patients was between 15 to 45years. Majority (60.71%) of the cases were grand multigravida, belonging to poor socioeconomic group (71%). Most of the patients (68%) came with haemorrhage. The most frequent method (50%) used for termination of pregnancy in this study was Menstrual Regulation (MR) in unhygienic environment. Mostly (57.14%) the patients were managed by evacuation and curettage. Laparotomy was also needed for the definitive management of two patients. Maternal mortality in this study group was one out of 28(3.7%).&#x0D; Conclusion: Septic abortion contributes significantly to maternal morbidity and mortality. Proper use of contraceptives, avoidance of induced abortion in unhygienic condition can reduce the moribund consequences. In this study one maternal death among 28 septic abortion cases indicate proper standard of care of the hospital.&#x0D; Bangladesh J Obstet Gynaecol, 2020; Vol. 35(1): 3-6

Association of Autoimmunity and Parvovirus B19 Infection among Spontaneous Miscarriage Women in Erbil / Iraq

The study was conducted from January 2016 to January 2017 at Maternity Teaching Hospital in Erbil city/ Iraq. One hundred and forty women who experienced spontaneous abortions were selected according to inclusion and exclusion criteria and forty normal pregnant women as a control group. Serum from patients and control group subjected for assessment of anticardiolipin IgM, antiphospholipid IgM, Parvovirus B19 IgG and IgM using enzyme linked immune-sorbent assay technique. Prevalence of positive Parvovirus B19 IgG and IgM, anticardiolipin IgM and antiphospholipid IgM, in aborted women was higher than that observed in non-aborted women (control group). Women with the highest frequency of spontaneous abortion found at age group 27–34 year. More frequent of previous spontaneous abortion was 1-2 abortion at the 1st trimester of gestational period. Anticardiolipin antibody and antiphospholipid antibody production trigged by viral infection, and have role in spontaneous abortion in pregnant women.

The discussion of abortion in US political debates: A study in occasioned semantics

This article deals with the discussion of abortion in a number of US presidential and vice-presidential debates, from a scaling perspective. The interest in scales, as (co)constructed and negotiated by participants in the course of interaction, is a component of occasioned semantics. I found that, in the political debates that I examined, there are a number of different scales anchored by the contrast between ‘pro-life’ and ‘pro-choice’ positions. These are as follows: (1) Stage of pregnancy, (2) Prescribed action, (3) Special circumstances, (4) Locus of enforcement and (5) Frequency. These scales are manipulated in various ways by the candidates to make their own stances seem reasonable and moral and their opponents’ unreasonable and immoral. A position may be made to appear more moderate by adding a more extreme alternative to the scale, which is then rejected (‘negative upgrading’). Also, common goals (in particular, reduction of abortion frequency) may be emphasized. The debaters also use ‘negative downgrading’ – rejection of a more moderate position – to suggest an opponent’s unreasonableness. It is noted that the availability of several scales affords various ways of formulating the reasonableness or unreasonableness of a particular position. The article continues with a close examination of an extended debate sequence, illustrating the crucial role of implicature in the manipulation of scales, the attribution of attitude, and the practice of argumentation, and the possibility of dealing with implicature within a conversation analytic framework. The discussion is, at all points, grounded in and illustrated by the actual talk of the political candidates. It is suggested that viewing specific occasions of interaction in terms of the creation and negotiation of scales can yield a unique and revealing perspective on what is taking place.

Association between fetal chromosomal abnormalities and the frequency of spontaneous abortions.

Fetal chromosomal abnormalities are a common cause of spontaneous abortion. The present study investigated the association between fetal chromosomal abnormalities and the frequency of spontaneous abortions to enable clinicians to provide more informed genetic counseling. A total of 182 patients with a history of spontaneous abortions were recruited from July 2015 to August 2017. G-banding cytogenetic analysis and novel high-throughput ligation-dependent probe amplification (HLPA) techniques were performed on conception in all 182 patients to detect chromosomal abnormalities. Low-coverage whole-genome sequencing (WGS) was performed in 74 patients to detect copy number variations (CNVs). There were no significant differences in the incidence of karyotype abnormalities between patients with sporadic miscarriages (48.0%; SM group) and patients suffering recurrent spontaneous abortions (44.8%; RSA group). The maternal age was markedly higher in patients with 3 miscarriages. WGS indicated that the incidence of pathogenic CNVs in the RSA group was higher than that in the SM group, but the difference was not significant. In conclusion, a high incidence of karyotype abnormalities and pathogenic CNVs was observed in patients with spontaneous abortion. However, no association between fetal chromosomal abnormalities and the number of spontaneous abortions was observed. HLPA assays may be used as an alternative method for fetal karyotype analysis and determination of CNVs in patients with SM and RSA.

The Actual Practice of Breast Self-Examination among Sample of Iraqi Patients with Breast Cancer

Background : To assess the actual practice of breast self-examination (BSE), as an early detection tool for breast cancer, among a sample of patients affected with breast cancer in Iraq.Methods: A random sample of 200 female patients with breast cancer was analyzed to evaluate the extent of their actual practice of breast self-examination before the diagnosis of the disease. The examined variables included the age of the patients, marital status, education, occupation, smoking habit, family history of cancer, frequency of gravidity, parity and abortions. Results: The age of patients ranged from (24-70) years with a mean age of 48 years. The highest frequency of the examined sample (24%) was noted in the age group (50-54) years. The majority of the patients (89%) were married, 33% had university degree and 57% were employed. While 46% of the patients had a family history of cancer, in 33.5% the breast was involved. Only 5.5% of the total number of patients had practiced BSE regularly before the diagnosis of breast cancer, 57.5% had carried out the procedure randomly while 37% did not perform BSE at all during their lives. The study illustrated that the level of education, occupation and family history of cancer had significant roles in the practice of BSE. Conclusions: The findings of this study emphasize the urgent need for promoting screening in our society through strengthening practical policy decisions to raise the level of public awareness among the Iraqi women towards the adoption of simple approaches for early detection of breast cancer.

Management in cases of large uterine myomas in pregnancy

Abstract Objectives Uterine fibroids are the most common benign tumors in women of procreative age. The effects of their occurrence affect the course of pregnancy by increasing the frequency of abortions, premature delivery or premature abruption of the placenta. Medical treatment includes clinical observation, pharmacological pain control, myomectomy during pregnancy or perinatal hysterectomy. Case presentation We present a survey of literature and the case of a pregnant woman with an enormous uterine fibroid 23×13×16 cm on the basis of which a diagnostic-therapeutic scheme for tumors of the reproductive organs during pregnancy has been developed. Conclusions The study presents improved recommendations for management the pregnancies in presence of the uterine myomas based on clinical practice.

Actual aspects of vaginal progesterone use to prevent reproductive losses and optimize perinatal outcomes

Miscarriage is a complex socio-medical problem, the relevance of which throughout the world is determined by the stable frequency of spontaneous abortions and premature births for half a century. Premature termination of pregnancy as a typical multifactorial disease regardless of the term has a universal pathogenetic mechanism of realization, which is progesterone deficiency. This justifies the need for subsidies with progesterone drugs for women at the real risk of miscarriage and preterm pregnancy.The aim of the review is to summarize the information of relevant scientific publications with a high level of evidence on the effectiveness of progesterone drugs to prevent early spontaneous termination of pregnancy and an adverse perinatal outcome. To understand the features of micronized progesterone preparations that guarantee maximum effectiveness, to clarify the points of its application in connection with the risk of prematurity and perinatal outcome have been carried out studies in the world: PROMIS, TRISTAN-1, TRISTAN-2, OPPTIMUM, PRISM.It is proved that the target groups for progesterone drugs are women with the threat of miscarriage in the early stages, patients with habitual miscarriage. Progesterone preparations (micronized progesterone) are aimed not only at prolonging pregnancy, but also at preventing late complications. To date, strong evidence has been obtained (PRISM, 2019) that vaginal micronized progesterone provides better results: live birth value in the general population of women with bloody discharge in the early period (4153 observations) is 3% more than placebo, best effect obtained women with a history of three or more miscarriages who have a 28% higher chance of a live baby (up to 34 weeks). A change in the system of views on assessing progestogen effectiveness in the treatment of miscarriage (its criterion is a live birth), the best prospects for viability, which is provided by proven safety and a positive effect on perinatal outcomes was noted.