Characteristics of women who have abortions between 14 and 16 weeks of pregnancy

This study evaluate the indications, timing, and maternal outcomes of termination of pregnancy (TOP) after 20 weeks of gestation. This single-center retrospective cohort study included all TOP cases performed after 20 weeks between January 2020 and December 2025 in a tertiary referral center. Clinical characteristics, indications, gestational age at diagnosis and termination, time interval between diagnosis and TOP, and delivery methods were analyzed. Cases were stratified into peri-viable (20-24 weeks) and post-viable (>24 weeks) groups. Univariable analyses were used to assess associations with delivery method and gestational age. A total of 116 TOP cases were included. The median gestational age at diagnosis and termination were 22 and 24 weeks, respectively, with a median interval of 11 days. The most common indications were central nervous system, cardiovascular, and genetic abnormalities. Post-viable cases accounted for 30.2% of the cohort and were associated with higher parity and a higher rate of hysterotomy (28.6% vs. 11.1%, P = 0.028). Vaginal delivery was the predominant method (83.6%). Hysterotomy was associated with advanced gestational age, higher birth weight, and prior cesarean section but did not increase transfusion or intensive care unit admission rates despite greater hemoglobin decline. Late TOP is a clinically complex but generally safe procedure with heterogeneous indications. While some cases might reflect delayed care, others are intrinsically late. Hysterotomy was not associated with increased major maternal morbidity in our cohort when clinically indicated.

Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide. Despite medical advances, effective prevention remains challenging. Surgical interventions like total cervix occlusion (TCO) show promise in high-risk groups. This was a retrospective study including patients with singleton pregnancies who had undergone Saling's TCO at the Medical School of Hannover from 2011 to 2021. Data on maternal characteristics, obstetric history, intervention details, and outcomes were collected. Patients were stratified into two groups: classic Saling indication (≥2 late miscarriages or preterm births <32weeks) and extended indication (1 such event). Primary outcomes were live birth and preterm birth after 28+0weeks. The analysis is based on a sample of 99 pregnant women, pregnancy and outcome data was available of 67 patients. The median delivery time was 36weeks. 92.5 % of the neonates were born alive, with 88.1 % of these births occurring after the 28th week of gestation. Patients with extended indication showed longer gestation than those with classic indication. Maternal age, BMI, and conception mode had no impact. Higher parity increased chances of live birth, prior preterm birth lowered it. Previous late abortions raised the risk of delivery before 28weeks. TCO may prolong gestation and improve outcomes, independent of maternal factors. Women with extended indications appear to benefit as well. Given the lack of prospective data and varied international practices, further randomized, multicenter trials are urgently needed to better define indications and assess efficacy.

This review aims to summarize the association between reproductive tract infections and spontaneous abortion, clarify the underlying molecular mechanisms, and provide a scientific basis for clinical screening and targeted interventions. The electronic database PubMed was searched for studies published before April 2026. Keywords included "spontaneous abortion," "Recurrent Spontaneous Abortion," "early spontaneous abortion," "Early Pregnancy Loss," "late spontaneous abortion," "late abortion," "miscarriage," "reproductive tract infections," "bacterial vaginosis," "Chlamydia trachomatis," "Ureaplasma urealyticum," "Ureaplasma parvum," "Human Papillomavirus," "Herpes Simplex Virus," "Cytomegalovirus," "Vulvovaginal Candidiasis," "Trichomonas vaginitis," and "vaginal dysbiosis." Relevant references from retrieved manuscripts and review articles were also searched manually to ensure comprehensive coverage of eligible studies. Reproductive tract infections are key factors for spontaneous abortion, with bacterial vaginosis, Chlamydia trachomatis, Ureaplasma urealyticum, and Ureaplasma parvum showing significant associations. Vaginal dysbiosis interacts with reproductive tract infections, potentially promoting spontaneous abortion through inflammatory responses, disrupted maternal-fetal immune tolerance, and direct placental damage. The association between viruses (e.g., Human Papillomavirus, Herpesvirus infections), Mycoplasma hominis, and Trichomonas vaginalis with spontaneous abortion remains controversial. During pregnancy, maintaining vaginal microbiota balance, routine screening for infections of the reproductive tract, and timely execution of targeted interventions are critical for spontaneous abortion. Future research should focus on large-scale prospective studies to clarify the precise mechanisms of pathogen transmission and to optimize intervention strategies.

Adding cover crops to crop rotations can improve the sustainability and ecosystem functioning of agroecosystems. Establishing cash crops into a living cover crop, or planting green, in agronomic systems can provide another set of functional benefits, including improved control of weeds and invertebrate pests, potentially reducing the need for preventative pest management strategies. Here, we studied the role of delayed cover-crop termination in managing invertebrate pests through an increase in natural enemies in corn and soybeans. Our work is among the first studies focused on timing of termination of a cover crop and the role that timing has in managing invertebrate pests. In both crops, we found that delaying termination reduces pest incidence and damage without affecting yield. Although crop type influenced predator and pest responses, neither crop experienced an increase in pest pressure or damage with later timing of termination. Regardless of treatment, soybean harbored greater numbers of natural enemies than corn, a result likely influenced by abiotic conditions associated with crop morphology. Our study shows that by delaying cover-crop termination, growers can effectively increase natural-enemy populations and reduce the need for chemical controls. © 2026 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Integrated diagnostic approach for Leptospira spp. detection in SMEDI associated reproductive disease of swine

The aim of this study was to identify maternal and fetal risk factors associated with stillbirth and to differentiate intrauterine fetal death (IUFD) from late termination of pregnancy (TOP). Analyses were performed on births from 2014 to 2024 at Charité Berlin, characterizing the overall cohort, IUFD, and TOP, respectively. Descriptive characterizations and regressions were applied to evaluate the impact of modifiable risk factors and trends within the overall study cohort and 3rd trimester IUFDs. Three hundred and eighty five stillbirths and 58,631 live births were identified (59,016 births, 0.65 % stillbirths). Of these, 177 (46 %) were categorized as IUFD and 208 (54 %) as TOP. The stillbirth rate rose from 0.45 % (2014) to 1.2 % (2024) (odds ratio 1.13, p<0.001). Advanced maternal age, higher maternal BMI before pregnancy, and smoking during pregnancy were associated with stillbirths p<0.01. TOPs and IUFDs differed in their occurrence time (most IUFDs in 28-36+6weeks of pregnancy [44 %], most TOPs 20-27+6weeks [75 %; p<0.001]) and in terms of their risk profiles (IUFDs associated with higher gravity, parity and BMI as well as higher rates of multiple gestations compared to TOPs). Differences in disease burden (WHO ICD-PM criteria) were not significant over the year but formed a distinct contrast between IUFD and TOP. 3rd trimester IUFD was associated with higher parity, gravidity and BMI (p<0.05). IUFD and TOP cohorts naturally represent different risk profiles. As cohort size and power limited analytical possibilities standardized, differentiated recording and data pooling is crucial to advance stillbirth research and develop effective preventive strategies targeting modifiable risk factors.

In 2015, Brazil experienced an epidemic caused by the Zika virus. We use hundreds of millions of administrative records to document household responses to the first public health alert linking the Zika virus to the risk of congenital disease for those in utero. We study two margins of behavior: risk avoidance (avoiding pregnancy), and risk mitigation during pregnancy (ultrasounds and abortions). On risk avoidance, we find a 7% reduction in pregnancies post-alert, a response triggered immediately after the alert. On risk mitigation, we find a 9% increase in the use of ultrasounds in the first trimester of pregnancy, and a 5% rise in abortions, concentrated among late term abortions. We document that post-alert all households - irrespective of race or education for example - were able to reduce risks during pregnancy, in line with preventative measures not being costly. In contrast, the avoidance response is driven by more educated mothers perhaps because such households face lower costs of altering their plans around the timing of fertility. We further discuss consequent impacts on birth outcomes, supply side responses, and how our findings extend to household responses to health alerts related to other viral threats.

Late terminations of pregnancy (after 14 weeks of gestation) can present physicians and other healthcare professionals with complex medical and ethical challenges. In Germany, such terminations require a specific form of medical indication (a danger of grave impairment to the pregnant woman's physical or mental health). Despite these legal provisions, the decision-making process in individual cases often remains characterized by uncertainty, a lack of transparency and insufficient structural support. This article offers recommendations for the development of institutional ethics guidelines that can support responsible, transparent, and legally sound decision-making in cases of requests for a late termination of pregnancy. Based on existing recommendations and experience reports, and on the authors' own reflections, key challenges in decision-making are identified and practical guidance for shaping the decision-making process is derived. Ethical guidelines can help reduce uncertainty, foster interdisciplinary and ethically informed decision-making, and thereby contribute to improving patient care. This requires the development of clear procedures, defined responsibilities, and transparent decision-making frameworks, as well as the promotion of thoughtful engagement with diverse professional perspectives and individual values. The development and implementation of clinical ethics guidelines can offer meaningful structural support for treatment teams in responsibly managing (cases of) late termination of pregnancy.

New York's Reproductive Health Act 2019 (RHA) reshaped the legal treatment of pregnancy-loss violence by confining homicide to the death of a “person” and removing earlier provisions that integrated certain late-term abortion and abortive offences into the homicide framework. This article traces New York's statutory development from the 1965 Penal Law to the RHA and uses the federal Unborn Victims of Violence Act 2004 (UVVA) as a comparator. It argues that the apparent tension between abortion permissibility and fetal-protection liability is better explained by jurisdictional triggers and consent-based gating than by fetal personhood. After the RHA, New York generally channels pregnancy-loss harm through offences against the mother. In contrast, the UVVA can create a consent-gated two-victim structure for specified federal crimes while exempting consensual abortion and medical treatment. Bioethically, these victim categories function as governance tools protecting women's decisional authority without resolving fetal moral status.

The purpose of the research was to characterize the donor traits of ewes of Romanov breed during embryo transfer. , It should be noted during evaluation the donor traits of the ewes that of the 90 heads which were treated follicle-stimulating hormone (FSH), 80 ewes or 88.8 % gave a positive reaction. The number of donors who gave only high-quality embryos was 55.0 head or 61.1 %, a smaller number of animals reacted with superovulation, but gave some low-quality embryos to 25 sheep or 27.7 %. Among the donors that did not give a positive reaction to the action of FSH animals were found 11.2 %. Upon extraction of the embryos and their morphological evaluation under a microscope, it was found that out of 335 embryos, 177 or 52.8 %, were suitable for transfer compared to 156 or 46.6 % of low-quality embryos. The transfer to recipients was with fresh acquired out embryos. Of 42 transferred embryos 32 recipients or 76.1 % were pregnant. Positive lambing by twins occurred in 31 recipients. In the course of the work, a negative moment was observed in late abortion, which can be explained by a number of individual features of the recipient himself, as well as the influence of paratypical factors. The donor traits of sheep are influenced by many factors (breed, fatness, state of health, feeding and conditions of housing, individual characteristics of the organism). However, the ability of donors to maintain high performance with repeated treatments was confirmed by the obtained repeatability coefficients. Among all treated donors (n=90), the repeatability coefficient between the fi rst and second treatments was not high (rw=0.46), whereas between the second and third treatments, the repeatability coefficient increased to rw=0.68. An increase in the coefficient of repeatability of donor traits was observed in 80 donors with a positive reaction to the action of FSH.

Late pregnancy loss, including stillbirth (following intrauterine fetal death) and termination of pregnancy (TOP), can cause a variety of poor psychiatric outcomes. Knowledge about the effective treatment of psychiatric symptoms following stillbirth and TOP, particularly patterns of psychosocial and pharmacological treatment, remains limited. This study aims to describe treatment practices and outcomes among women following stillbirth and TOP, and to identify factors associated with these outcomes. This retrospective study identified all women who experienced late pregnancy loss (including stillbirth and TOP) at Sheba Medical Center. Data collection included both demographic and clinical variables, which were collected from patient medical records. Treatment modalities, including psychosocial interventions and selective serotonin reuptake inhibitor (SSRI) prescriptions, and clinical outcomes during follow-up were described. Of the 676 women who experienced late pregnancy loss, 146 women (21.6%) contacted the reproductive psychiatry clinic, and 101 women received treatment and were included in the analysis. Most women (60%) were diagnosed with adjustment disorder, with 82% achieving full remission through psychological interventions alone. While 39.6% received a prescription for SSRIs, all of them were diagnosed with a major depressive episode, an adjustment disorder that progressed to depressive episode, or a previous psychiatric disorder with exacerbation. In the multivariate logistic regression model, women diagnosed with an adjustment disorder with grief reaction were significantly more likely to achieve full remission compared with those with a previous psychiatric disorder (OR = 4.9, 95%CI 1.4–17.0). Most women who received only psychotherapy without SSRIs achieved full remission (most of them diagnosed with Adjustment Disorder Grief reaction) (OR = 4.2, 95%CI 1.6–10.9). This study describes mental health care practices and outcomes among women receiving psychiatric treatment following late pregnancy loss in a specialized reproductive psychiatry center. Most women presented with adjustment disorder and received psychosocial interventions, while SSRIs were more commonly prescribed in the context of more severe psychiatric symptoms. These findings highlight real-world clinical practice patterns and the need for prospective studies, randomized, controlled designs with larger and more diverse samples to better inform mental health care and the development of standardized treatment guidelines following late pregnancy loss.

The aim of this study is to present the medical indications, diagnostic procedures, fetal pathologies, and timing of abortions for medical reasons after the 12+0 week of pregnancy (p.c.) as well as to examine the influence of the introduction of NIPT on the timing and pattern of indications. Retrospective analysis of 561 abortions from the 12+0 week of pregnancy at a university hospital between 2008 and 2024. Diagnoses are based on ultrasound examinations, invasive prenatal diagnostic procedures, and molecular genetic analyses. Statistical evaluations were performed descriptively and inferentially. The most common indications were chromosomal abnormalities (38.1%), followed by malformations of the CNS (22.4%) and multiple malformations (17.0%). Terminations of pregnancy before the 24+0 week of gestation occurred significantly earlier and more frequently in cases of chromosomal abnormalities, while malformations of the CNS dominated after the 24+0 week of gestation. Complications in the mother were rare overall (4%), no maternal deaths. The introduction of NIPT led to an earlier diagnosis of chromosomal abnormalities. Medically indicated abortions are safe and have a low complication rate in mothers. The most common indications relate to chromosomal abnormalities and malformations of the central nervous system. The introduction of NIPT tends to enable earlier diagnosis of fetal chromosomal abnormalities. Further long-term observations are necessary to fully assess the impact of NIPT.

Nitrogen (N) management remains a primary challenge in organic grain systems, particularly in rotations where heavy N-consuming crops, such as corn and wheat, follow one another. Daikon radish (Raphanus sativus L.) is widely adopted for its ability to scavenge residual soil nitrate between cash crops; yet the subsequent availability of scavenged N to the following crop is inconsistent and often negligible. This 4-year field study (2014–2017) at the University of Minnesota Southwest Research and Outreach Center evaluated whether planting daikon radish in polyculture with berseem clover, and either annual oats or winter rye could improve N retention and timed release compared to daikon radish monoculture. Three cover crop treatments were tested across three common organic management systems: no manure with no tillage, manure with tillage, and manure plus shallow tillage incorporation before cover crop seeding. Polycultures, especially those including winter rye, produced significantly more fall biomass (up to 6435 kg ha−1) than daikon radish monoculture (573–1272 kg ha−1). Manure incorporation consistently increased total and daikon radish biomass, as well as the percent living cover. Despite substantial biomass differences, mid-season and fall soil inorganic N, potentially mineralizable N, permanganate-oxidizable C, and enzyme activities showed few consistent treatment effects. Corn grain yield was highest following manure with tillage incorporation but was significantly reduced after the winter rye polyculture in all years, likely due to N immobilization and delayed corn planting caused by late rye termination under wet spring conditions. Results indicate that while polycultures with winter rye maximize biomass and soil cover, they do not reliably enhance N recycling to the subsequent organic corn crop and can reduce yield.

A frequently cited benefit of the first-trimester anomaly scan (FTAS) is that it reduces psychological impact by enabling earlier termination of pregnancy (TOP). However, the impact of early versus late TOP due to fetal anomalies remains unclear. This study evaluates the psychological impact and perspectives associated with early versus late TOP. A prospective mixed methods study was conducted. The early group (TOP <18 weeks) included women with an abnormal FTAS; the late group (TOP 20-24 weeks) included women with an abnormal second-trimester scan (SAS), abnormal FTAS, or normal FTAS followed by abnormal SAS. Women completed questionnaires 2 (T1) and 6 months (T2) postpartum addressing psychological impact using validated scales (State-Trait Anxiety Inventory, Edinburgh Depression Scale, Impact of Event Scale, Perinatal Grief Scale) and study-specific questions. Semi-structured interviews were conducted with women and their partners 3-6 months after termination. 149 women with early TOP (15 + 2 weeks, range 14 + 4-16 + 1) and 129 with late TOP (22 + 0, 21 + 0-23 + 1) completed T1. In both groups, the majority had clinically relevant anxiety at T1 and T2 and moderate/severe distress at T1. The late TOP group had higher median depression and mean grief scores at T1 (5.0, range 3.0-8.0 vs. 4.0, range 2.0-7.0, p = 0.004) (85.9 ± 21.0 vs. 76.5 ± 22.4, p < 0.001) and at T2 (4.0, 1.0-7.0 vs. 3.0, 1.0-6.0, p = 0.043) (81.3 ± 22.9 vs. 70.8 ± 22.6, p < 0.001), respectively, and higher mean distress scores at T1 (33.8 ± 13.3 vs. 30.2 ± 14.7, p = 0.034). Of 51 interviews with women and partners (22 early, 29 late TOP), four themes were identified: fetal attachment, time pressure, grief, and reflections on gestational age. Most late TOP participants expressed strong fetal attachment; for early TOP participants, the experiences were more variable. Half of the late TOP participants reported time pressure due to the legal limit. Perceived grief and impact were substantial in both groups. Our findings suggest that early TOP is associated with lower psychological impact compared to late TOP, mainly in the first months postpartum. This may reflect less intense fetal attachment and more time for reproductive decision-making for some parents, supporting the presumed benefit of earlier intervention. Nevertheless, TOP causes a significant emotional impact at any gestational age.

Abstract Adoption of cover crops in corn-producing regions of the United States (U.S.) has progressed at an uneven pace. Since corn is a nitrogen (N) demanding crop, a limited understanding of N fertilizer management for corn following cover crops is among the major barriers to widespread adoption of cover crops. To address this critical knowledge gap, we conducted the first meta-analysis to systematically examine the impacts of N fertilization on corn yield and N content following cover crops, considering various agronomic practices and soil conditions. Studies comparing corn production with and without cover crops were selected for analysis, with 392 and 228 individual observations included for corn yield and N content, respectively. Results depicted that the integration of cover crops tends to boost corn yield and N content by 11% and 22%, respectively. The type of cover crop species impacts corn performance, with legumes improving yield by more than 50% in the subsequent non-fertilized corn. Grass and brassica cover crops require nearly 200 kg N ha −1 to achieve yield comparable to fallow systems, due to N immobilization by cover crop residues. The timing of cover crop termination also plays a critical role in yield outcomes, with late termination (within 1 week of corn planting) producing higher corn yields than early termination. Additionally, manure and ammonium-based fertilizers perform better than urea-based fertilizers in systems involving cover crops. Key considerations include the selection of cover crop species and N fertilizer types to maximize the agronomic, environmental, and economic benefits. These findings suggest that a well-managed corn cropping system has the potential to effectively integrate cover crops while achieving yield goals.

The Termination of pregnancy in the late second and third trimester poses deep medical, legal, and ethical issues. In India, the Medical Termination of Pregnancy (MTP) Amendment Act 2021 extends abortion access to 24 weeks for specific cases such as rape survivors and fetal abnormality and allows medical boards to approve termination beyond that point if the mother’s life is at risk or for severe fetal anomalies. However, there are chances of inadvertent neonatal survival. To avoid this, making a feticide procedure, usually intracardiac potassium chloride injection, antecedent to induction of labor and prior to the termination procedure has been advised by the Ministry of Health and Family Welfare (MoHFW) (2017, 2018) as well as medical boards of top institutions such as AIIMS. Although these steps are taken in an attempt to prevent legal as well as administrative issues, they put the physicians into ethical dilemma, undermining the Hippocratic oath of saving life. This article discusses India’s complex legal and ethical issues regarding late-term abortion. It highlights an ethical problem: whether to perform feticide or not, as it conflicts with the core medical principle of preserving life.

An outbreak of bovine viral diarrhea virus (BVDV) in a herd of 218 beef cattle resulted in 15 late-term abortions and the birth of two weak calves. Neonate 1, at 28 days of age, exhibited ataxia and paresis, while Neonate 2, at one day of age, was underdeveloped. Neonate 1 presented with cerebellar hypoplasia, hydrocephalus, and porencephalic cysts. Histological examination revealed foliar dysgenesis and ectopic Purkinje neurons. Neonate 2, weighing 7kg at birth, showed no histologic lesions. A single fetus at six months was necropsied and showed no gross lesions. However, histopathology revealed multifocal lymphoplasmacytic inflammation. Tissue samples from the neonates and fetus were tested for BVDV by RT-PCR, yielding negative results. Brain tissue was tested by RT-PCR for Simbu serogroup viruses and by PCR for Neospora caninum and Toxoplasma gondii, all of which returned negative results. The entire herd was subjected to serum sampling for BVDV testing by RT-PCR. Six calves tested positive in all three consecutive rounds of testing, while one calf tested positive only once. Sera from the seven RT-PCR positive calves were subsequently tested by ELISA for antigen detection, with six testing positive. They were also tested by ELISA for antibody detection, with two calves showing seropositivity. Amplification products from three samples were submitted for Sanger sequencing and phylogenetic analysis, which identified BVDV-1b with 100% homology among the three sequences and a high similarity to Chinese strains. This study reports an outbreak of persistent infection by BVDV-1b in southern Brazil, with associated congenital malformations and reproductive losses.

Nitrous oxide emissions and emission factors in hairy vetch-maize sequences: The role of vetch termination timing on nitrogen synchronization

Evaluation of pathogenicity of a Korean NADC34-like Porcine reproductive and respiratory syndrome virus strain in pregnant gilts.