Late Abortion Research Articles

Effects of subclinical Theileria orientalis Ikeda genotype infection on average daily gain ratios and a satisfactory rating in the breeding soundness exam in bull test stations in Virginia

Theileria orientalis Ikeda genotype is a tick borne hemoprotozo­an that typically causes economic losses in dairy and beef cattle in Australia, New Zealand and Japan. Acute clinical infections from T. orientalis Ikeda include anemia, icterus, ill-thrift and death. The acute phase of the infection has been associated with decreased libido in dairy bulls, decreased live weight gain in beef bulls and increased mortality in naïve adults and calves. A sequela to acute infections within a herd is persistent sub­clinical infections, which have been associated with decreased mean daily gain in suckling beef calves. In late 2017, T. orienta­lis Ikeda was detected in beef cattle from multiple counties in Virginia and was associated with anemia, weakness, late term abortions and death. As of 2022, T. orientalis Ikeda has been identified in beef cattle in 31 of 95 Virginia counties. Beef pro­duction, typically in naturally bred cow-calf operations, is the second largest agricultural commodity in Virginia. Central bull testing programs for performance evaluation and marketing of beef bulls has existed for over 60 years in Virginia. T. orienta­lis Ikeda was first detected at the Southwest bull test station in 2020 when screened at conclusion of the test. The objective of this study was to determine if subclinical infection with T. ori­entalis Ikeda affected the average daily gain (ADG) ratios of all bulls on test and the achievement of a satisfactory rating of the breeding soundness exam (BSE) for senior bulls.

MBD3 Regulates Male Germ Cell Division and Sperm Fertility in Arabidopsis thaliana.

DNA methylation plays important roles through the methyl-CpG-binding domain (MBD) to realize epigenetic modifications. Thirteen AtMBD proteins have been identified from the Arabidopsis thaliana genome, but the functions of some members are unclear. AtMBD3 was found to be highly expressed in pollen and seeds and it preferably binds methylated CG, CHG, and unmethylated DNA sequences. Then, two mutant alleles at the AtMBD3 locus were obtained in order to further explore its function using CRISPR/Cas9. When compared with 92.17% mature pollen production in the wild type, significantly lower percentages of 84.31% and 78.91% were observed in the mbd3-1 and mbd3-2 mutants, respectively. About 16-21% of pollen from the mbd3 mutants suffered a collapse in reproductive transmission, whereas the other pollen was found to be normal. After pollination, about 16% and 24% of mbd3-1 and mbd3-2 mutant seeds underwent early or late abortion, respectively. Among all the late abortion seeds in mbd3-2 plants, 25% of the abnormal seeds were at the globular stage, 31.25% were at the transition stage, and 43.75% were at the heart stage. A transcriptome analysis of the seeds found 950 upregulated genes and 1128 downregulated genes between wild type and mbd3-2 mutants. Some transcriptional factors involved in embryo development were selected to be expressed, and we found significant differences between wild type and mbd3 mutants, such as WOXs, CUC1, AIB4, and RGL3. Furthermore, we found a gene that is specifically expressed in pollen, named PBL6. PBL6 was found to directly interact with AtMBD3. Our results provide insights into the function of AtMBD3 in plants, especially in sperm fertility.

Genomic evaluation of late-term abortion in cows recorded through Dairy Herd Improvement test plans

Late-term abortions cause significant economic loss and are of great concern for dairy herds. Late-term abortions >152 d and <251 d of gestation that terminate a lactation or initiate a new lactation have long been recorded by Dairy Herd Improvement (DHI). For 24.8 million DHI lactations, the average recorded incidence of late-term abortions across all years (2001–2018) was 1.2%. However, the 1.3% incidence of abortions reported in 2012 has declined to <1.0% incidence since 2015. Small adjustments were applied to the 82 million daughter pregnancy rate (DPR), 29 million cow conception rate (CCR), and 9 million heifer conception rate (HCR) records to account for late-term abortions more accurately. Fertility credits for CCR and HCR were changed to treat the last breeding as a failure instead of success if the next calving was coded as a late-term abortion. Similarly, when computing DPR, days open is now set to the maximum value of 250 instead of the reported days open if the next reported calving is an abortion. The test of these changes showed very small changes in standard deviation and high correlations (0.997) of adjusted predicted transmitting abilities (PTA) with official PTA from about 20,000 Holstein bulls born since 2000 with >50% reliability. For late-term abortion as a trait, estimated heritability was only 0.001 and PTA had a standard deviation of only 0.1% for recent sires with high reliability (>75%). Young animal genomic PTA have near 50% reliability but range only from −0.5 to +0.4 because of the low incidence and heritability. Genetic trend was slightly favorable and late-term abortion PTA were correlated favorably by 0.27 with net merit, 0.49 with productive life, 0.33 with livability, 0.23 with CCR, 0.20 with HCR, 0.26 with DPR, −0.31 with somatic cell score, −0.24 with daughter stillbirth, and −0.26 with daughter dystocia. Thus, PTA for late-term abortions should not be needed as a separate fertility trait and instead these minor edit changes should suffice. The PTA for late-term abortions would add little value because national evaluations for current fertility traits already account for those economic losses.

The history of ice-sheet retreat on North America during Termination 5: Implications for the origin of the sea-level highstand during interglacial stage 11

Termination (T) 5, ∼424 ka, involved the biggest deglaciation of land-ice mass during the Quaternary. Warming and ice-sheet retreat during T5 led to an exceptionally long period of interglacial warmth known as Marine Isotope Stage (MIS) 11, ∼424–395 ka. A detailed understanding of the history of continental ice-sheet decay during T5 is required to disentangle regional contributions of ice-sheet retreat to sea-level rise (that range between ∼1 and 13 m above present day) and to correct it for glacio-isostatic adjustments (GIA). Yet little is known about the timing and magnitude of retreat during this time of the volumetrically most important continental ice sheet in the Northern Hemisphere, the Laurentide Ice Sheet (LIS). Here we present new authigenic Fe-Mn oxyhydroxide-derived high-resolution records of Pb isotope data and associated rare earth element profiles for samples spanning T5 from Labrador Sea IODP Site U1302/3. These records feature astronomically-paced radiogenic Pb isotope excursions that track increases in chemical weathering of North American bedrock and freshwater routing to the Labrador Sea via Hudson Straits associated with LIS retreat. Our records show that LIS retreat during T5 began 429. 2 ± 7.9 ka (2σ) and likely occurred over a longer timescale (by ∼10 to 5 kyr) than that observed for T2 and T1. They also show that Hudson Bay Ice Saddle collapse (and therefore LIS break-up) occurred ∼419 ± 4.7 ka (2σ), around the same time as best estimates of southern Greenland deglaciation, but ∼12 kyr before LIS deglaciation and the sea-level high-stand associated with the latter half of MIS 11 likely occurred. Our findings therefore highlight that ice-mass loss on North America likely played an important role in the seemingly protracted nature of T5 sea-level rise. A comparison of the deglaciation histories of the LIS and the southern Greenland Ice Sheet during T5, T2 and T1 also demonstrates that the well-constrained history of regional ice-sheet retreat during T1 is not always applicable as a template for older late Pleistocene terminations in GIA modelling.

Acupuncture benefits to women with recurrent implantation failure: A propensity score-matched cohort study

ObjectivesThe current study aims to assess the effectiveness of acupuncture in improving the live birth rate (LBR), ongoing pregnancy rate (OPR), clinical pregnancy rate (CPR), biochemical pregnancy rate (BPR), and pregnancy loss (early abortion rate, late abortion rate, ectopic pregnancy rate) in patients with recurrent implantation failure (RIF). DesignThis retrospective study compares the outcomes of patients with RIF who underwent frozen embryo transfer (FET) with or without acupuncture. SettingThe medical records of patients diagnosed with RIF and visiting Chengdu Xi'nan Gynecological Hospital between January 2018 and June 2021 were reviewed. The Chengdu Xi'nan Gynecological Hospital Ethics Committee approved this retrospective study (No. 2021–029). ParticipantsA total of 923 patients with RIF who underwent FET were included in this study. The patients were divided into two groups: the Acupuncture (n = 303) and the Non-acupuncture groups (n = 620). ExposureThe Acupuncture group consisted of 303 RIF patients who received acupuncture therapy in addition to standard hormone replacement therapy (HRT)/delayed hormone replacement therapy (d-HRT) for FET. The Non-acupuncture group consisted of 620 RIF patients who received only standard HRT/d-HRT for FET. Primary and secondary outcome measuresThe primary outcome was the LBR. The secondary outcome referred to OPR, CPR, BPR, and pregnancy loss. ResultsThe Acupuncture group had significantly higher BPR (P = 0.08) and CPR (P = 0.049) than the Non-acupuncture group. A potentially higher LBR (P = 0.16) and OPR (P = 0.248) were observed in the Acupuncture group than in the Non-acupuncture group. However, the survival analysis did not show that acupuncture significantly promoted live birth. ConclusionsAcupuncture is an appropriate adjunctive technique in the in vitro fertilization process as it improves biochemical and clinical pregnancies. Therefore, it is necessary to be cautious about the role of acupuncture throughout the whole pregnancy cycle.

O-055 Efficacy of Laparoscopic Abdominal Cerclage in Women With Prior 2nd Trimester Losses/Preterm Birth: Perinatal Outcomes of Case Series

Abstract Study question What is the efficacy of laparoscopic abdominal cerclage (LAC) that placed during periconceptional period in singletons with prior 2nd trimester pregnancy losses/preterm deliveries (PTDs)? Summary answer LAC seems to prolong pregnancy duration and enhance perinatal outcomes in singletons prior 2nd trimester losses/PTDs. What is known already Cervical insufficiency (CI) is defined as the inability of the uterine cervix to retain a pregnancy till term without the signs and symptoms of clinical contractions ,with an incidence up to 1% (Berghella, 2011). Cervical cerclage (CC) has been proposed as an effective treatment for CI in terms of successfully prolonging the pregnancy period and improving the perinatal prognosis. The common clinical approach is transvaginal cervical cerclage (TVC), which is a feasible and relatively easy technique. However, some group of women may experience late abortions and/or PTD and LAC has been proposed to enhance pregnancy outcomes. Study design, size, duration Case series consisting of singletons with at least 2 prior PTDs and managed with LAC was reviewed between January 2019-November 2022. After placement of LAC, reproductive and perinatal outcomes of women were reviewed for 2 years. Participants/materials, setting, methods All women with at least 2 prior 2nd trimester losses and/or PTDs were offered to LAC procedure during the period. After having informed consents, total of 28 LAC procedures were performed. All surgeries were performed by a single experienced laparoscopist in the same center. Non-absorbable mersilene tape was placed during preconceptional period. Reproductive outcomes including spontaneous and assisted conception cycles and perinatal outcomes were reported. Main results and the role of chance A total of 28 LAC proceudres were performed during the period. Mean age of women was 34±2 and mean numbers of previous 2nd trimester losses/PTDs was 2.8±0.8, of which all of them were &amp;lt;24 weeks. Total of 8 women have had gynecologic surgery in their history. Less than 12 months interval, 19 out of 28 women got pregnent; 13/28 conceived spontaneously and 6/28 conceived with after IVF treatment. For the perinatal outcomes; there were no single case of 2nd trimester losses/PTDs &amp;lt;24 weeks in the entire cohort. 15 women delivered &amp;gt;34 weeks and remaining 4 delivered at term (&amp;gt;37 weeks). During the gestation, no additional medication was provided to pregnants such as progesterone treatment. The mean gestational age was 35 4/7 weeks. There were no remarkable adverse events during the pregnancy. All newborns were healthy without remarkable issues, only 2 infants required intensive care for less than 2 weeks. Limitations, reasons for caution Small sample size, lack of a control group and randomization and heterogenious patient population. Wider implications of the findings LAC appears to have favorable pregnancy outcomes in singletons with prior pregnacy losses and/or PTDs. To precisely conclude, randomized controlled trials are needed with different intervention arms in the same population. Trial registration number non applicable

The influence of the introduction of a national prenatal screening program on late termination of pregnancy, a retrospective cohort study.

To assess the influence of a national prenatal screening program on category 1 (lethal anomalies) late terminations of pregnancy (LTOP). In this population-based retrospective cohort study, we included all category 1 LTOPs from 2004 to 2015 in the Netherlands. The number of LTOPs before and after the introduction of the program was compared as well as the diagnostic process and factors contributing to LTOP. In total, 97 LTOPs were reported. After the introduction of the program, the number of LTOPs decreased from 17 per year to 5 per year on average. The number of cases in which the diagnostic process started with obstetric indications decreased from 55% to 17% (p<0.01) and the number of cases detected by routine screening increased from 11% to 52% (p<0.01). Four factors still contributed to LTOP after the introduction of the screening program: diagnostic or parental delay (40%), absence of screening (24%), false negative results of prior screening (14%) and late onset of disease (12%). The number of LTOPs decreased after the introduction of the screening program. At present, the diagnostic process is mostly screening driven. Parental- and diagnostic delay is still an important factor that contributes to LTOP.

Systemic delays to abortion access undermine the health and rights of abortion seekers across Australia.

Systemic delays to abortion access undermine the health and rights of abortion seekers across Australia.

Detection of Chlamydia and Chlamydia-like organisms in bovine placental tissue.

This study aimed to investigate the presence of Chlamydia spp. and Parachlamydia acanthamoebae in bovine placental tissue originating from abortion and non-abortion cases in Belgium. Placentas of 164 late term bovine abortions (last trimester of gestation) and 41 non-abortion (collected after calving) cases were analysed by PCR for Chlamydia spp., Chlamydia abortus, C. psittaci and P. acanthamoebae. Additionally, a subset of 101 (75 abortion and 26 non-abortion cases) of these placenta samples were also analysed by histopathology to detect possible Chlamydia-induced lesions. In 5.4% (11/205) of the cases, Chlamydia spp. were detected, and three of those cases were positive for C. psittaci. Parachlamydia acanthamoebae was detected in 36% (75/205) of the cases, being 44% (n = 72) in abortions and 7.3% (n = 3) in non-abortions cases (p < .001). None of the cases was positive for C. abortus. Purulent and/or necrotizing placentitis with or without vasculitis was observed in 18.8% (19/101) of the histopathologically analysed placenta samples. In 5.9% (6/101) of the cases, placentitis was observed along with vasculitis. In the abortion cases, 24% (18/75) of the samples showed purulent and/or necrotizing placentitis, while purulent and/or necrotizing placentitis was visible in 3.9% (1/26) of the non-abortion cases. Placental lesions of inflammation and/or necrosis were present in 44% (15/34) of the cases where P. acanthamoebae was detected, while inflammation and/or necrosis was present in 20.9% (14/67) of the negative cases (p < .05). The detection of Chlamydia spp. and especially P. acanthamoebae, in combination with correlated histological lesions such as purulent and/or necrotizing placentitis and/or vasculitis in placental tissue following abortion, suggests a potential role of this pathogen in cases of bovine abortion in Belgium. Further in-depth studies are necessary to unravel the role of these species as abortifacient agents in cattle and to include them in bovine abortion monitoring programmes.

Reproductive and Obstetric Outcomes Following a Natural Cycle vs. Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study.

Background: The proportion of frozen embryo transfer cycles has consistently grown in recent decades. Some adverse obstetric outcomes after frozen embryo transfer could possibly be explained by different approaches in endometrial preparation. The aim of the present study was to investigate reproductive and obstetric outcomes after frozen embryo transfer, comparing different endometrial preparation strategies. Methods: This retrospective study included 317 frozen embryo transfer cycles, of which 239 had a natural or modified natural cycle and 78 underwent artificial endometrial preparation. After excluding late abortion and twin pregnancies, the outcomes of 103 pregnancies were analyzed, 75 of which were achieved after a natural cycle/modified natural cycle, and 28 were achieved after an artificial cycle. Results: The overall clinical pregnancy rate/embryo transfer was 39.7%, the miscarriage rate was 10.1%, and the live birth rate/embryo transfer was 32.8%, without significant differences in reproductive outcomes between natural/modified cycle and artificial cycle groups. The risks of pregnancy-induced hypertension and abnormal placental insertion were significantly increased in pregnancies achieved after the artificial preparation of the endometrium (p = 0.0327 and =0.0191, respectively). Conclusions: Our study encourages the use of a natural cycle or modified natural cycle for endometrial preparation for frozen embryo transfer in order to ensure the presence of a corpus luteum able to orchestrate maternal adaptation to pregnancy.

Prevalence of Latent Equid Herpesvirus Type 1 in Submandibular Lymph Nodes of Horses in Virginia.

Equine Herpesvirus type 1 (EHV-1) typically causes mild respiratory disease, but it can also cause late-term abortion, neonatal foal death and neurologic disease. Once a horse is infected, the virus concentrates to local lymphoid tissue, where it becomes latent. The virus can be reactivated during times of stress, which can lead to the initiation of devastating outbreaks. Understanding the carriage rate of latent EHV-1 in different geographic regions is essential for managing the disease. The objective of the current study was to estimate the prevalence of latent EHV-1 and compare the frequency of each variant in the submandibular lymph nodes of horses in Virginia. Sixty-three submandibular lymph nodes were collected post-partem from horses submitted to regional labs for necropsy, and qPCR was performed. All samples were negative for the gB gene of EHV-1. The results demonstrated a low apparent prevalence of latent EHV-1 DNA in submandibular lymph nodes in this population of horses in Virginia. Despite this, the mainstay for outbreak prevention and mitigation continues to focus on minimizing risks and using appropriate and diligent biosecurity.

An improved active Kriging method for reliability analysis combining expected improvement and U learning functions

The reliability assessment of structures with multiple failure modes and small failure probability is challenging due to the time-consuming simulations required. Active learning Kriging methods for structural reliability with multiple failure modes have shown high computational efficiency and accuracy. However, selecting the appropriate sample and its failure mode to update the Kriging models remains a key problem. In this paper, we propose a new learning function and stopping criterion to further improve the efficiency of structural system reliability analysis. Firstly, we propose a new learning function that combines the expected improvement function and the U learning function. This function selects the most suitable samples, balancing the degree of expected improvement of samples to the limit state surface and the degree of misclassification probability of samples. Secondly, we propose a new stopping criterion that considers both the accurate construction of limit state surfaces and the probability of accurately predicting the signs of samples. This criterion avoids premature or late termination of the active learning process. Thirdly, the sequential MCS simulation method is employed in the active learning process to efficiently evaluate small failure probability problems. By analyzing four examples, we verify the accuracy and efficiency of the proposed structural reliability analysis method.

Effect of low-molecular-weight heparin in women undergoing frozen-thawed embryo transfer cycles: a retrospective cohort study

BackgroundRecurrent pregnancy loss (RPL) and recurrent implantation failure (RIF) during in vitro fertilization (IVF) treatment are still tough problems without effective treatments; thus, they are important research topics. There is controversy on whether low molecular weight heparin (LMWH) improves pregnancy outcomes in women with unexplained RPL and RIF. Moreover, currently, there is a paucity of reports on the role of LMWH in the entire population undergoing frozen-thawed embryo transfer (FET) cycles. This study aimed to estimate the effects of LMWH on pregnancy outcomes in women undergoing FET cycles.MethodsThere were 1881 female patients included in the study. Of the 1881 patients, 107 underwent preimplantation genetic diagnosis cycles, which were analyzed individually. The patients were divided into two groups: the LMWH group received injections of 4100 IU/d LMWH from the day of transfer until 14 ± 2 days posttransplant, the control group was the comparison group (without LMWH use). The baseline characteristics and reproductive outcomes of the patients were reviewed.ResultsOf the 1774 women with normal FET cycles, no significant differences were found in the number of embryos implanted (1.31 ± 0.02 vs. 1.28 ± 0.02), embryo implantation rate, biochemical pregnancy rate, clinical pregnancy rate, live birth rate, late abortion rate, and ectopic pregnancy rate between the two groups. The LMWH group had a higher early abortion (17.8% [76/427] vs. 12.5% [55/439], p = 0.030). In the sub-group analysis, among the patients who underwent more than four transfers, the LMWH group had a lower late abortion rate (1.7% [1/60] vs. 13.2% [7/53], p = 0.043). Similarly, of the 107 women who underwent preimplantation genetic diagnosis cycles, the reproductive outcomes were comparable between the two groups.ConclusionIn the general population and PGD patients, LMWH did not improve pregnancy outcomes. Therefore, the routine use of LMWH is not recommended for early treatment.

Pregnancy termination at viable stage in daily clinical practice: A nationwide mortality follow-back study in Flanders, Belgium.

Congenital malformations are frequently diagnosed prenatally, even at viable stage. No adequate registration of incidence and characteristics of late termination of pregnancy (TOP) or abortion for medical reasons in Flanders exists. Nationwide mortality follow-back survey, sent to physicians signing death certificates of all stillbirths from 22 weeks gestation onward (September 2016 - December 20217) in Flanders, Belgium. Questions measured whether late TOP preceded stillbirth, and which clinical and sociodemographic characteristics were indicated. Questionnaire data were linked with sociodemographic information from death certificates. Response rate was 56% (203/366). 38% of stillbirths (77/203) concerned late TOP. In 88.3% of late TOPs, physicians classified congenital anomalies of the foetus as serious or very serious (incompatibility with life outside the womb or severe neurological or physical impairment). In 26% of cases, late TOP was first suggested by the physician rather than spontaneously requested by parents (73%). 88% of late TOPs was discussed in open team meetings. 2/5 stillbirths were preceded by late TOP, indicating severe underreportation by existing registrations and a dire need for adequate registration methods. Although late TOP was most often explicitly requested by parents, in ¼ cases termination was suggested first by physicians. Parents are sometimes hesitant to bring up late TOP themselves, indicating that TOP should always be counseled as an equivalent option. This article is protected by copyright. All rights reserved.

Sequential application of copy number variation sequencing and quantitative fluorescence polymerase chain reaction in genetic analysis of miscarriage and stillbirth.

Copy number variation sequencing (CNV-seq) could detect most chromosomal abnormalities except polyploidy, and quantitative fluorescence polymerase chain reaction (QF-PCR) is a supplementary method to CNV-seq in triploid detection. This study aimed to evaluate the feasibility of sequential application of CNV-seq and QF-PCR in genetic analysis of miscarriage and stillbirth. A total of 261 fetal specimens were analyzed by CNV-seq, and QF-PCR was only further performed for samples with normal female karyotype identified by CNV-seq. Cost and turnaround time (TAT) was analyzed for sequential detection strategy. Subgroup analysis and logistic regression were carried out to evaluate the relationship between clinical characteristics (maternal age, gestational age, and number of pregnancy losses) and the occurrence of chromosomal abnormalities. Abnormal results were obtained in 120 of 261 (45.98%) cases. Aneuploidy was the most common abnormality (37.55%), followed by triploidy (4.98%) and pathogenic copy number variations (pCNVs) (3.45%). CNV-seq could detect the triploidy with male karyotype, and QF-PCR could further identify the remaining triploidy with female karyotype. In this study, we found more male triploidies than female triploidies. With the same ability in chromosomal abnormalities detection, the cost of sequential strategy decreased by 17.35% compared with combined strategy. In subgroup analysis, significant difference was found in the frequency of total chromosomal abnormalities between early abortion group and late abortion group. Results of logistic regression showed a trend that pregnant women with advanced age, first-time abortion, and abortion earlier than 12 weeks were more likely to detect chromosomal aberrations in their products of conception. Sequential application of CNV-seq and QF-PCR is an economic and practical strategy to identify chromosomal abnormalities in fetal tissue.

The influence of polycystic ovary syndrome on abortion rate after in vitro fertilization/intracytoplasmic sperm injection fresh cycle pregnancy

There are many reports on clinical pregnancy outcomes in polycystic ovary syndrome (PCOS) patients receiving vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), but little research about abortion has been done and there is a debate on whether the abortion risk increases in PCOS patients receiving IVF/ICSI. Therefore, the aim of this study was to investigated the abortion in PCOS patients. Clinical data of 12055 IVF/ICSI fresh cycles performed in our hospital from January 2015 to December 2020 were collected. Based on the Rotterdam diagnostic criteria of PCOS and after propensity score matching (PSM) for baseline data of clinical pregnancy cycles, matched 599 PCOS (PCOS group) and Non-PCOS (non-PCOS group) cycles were obtained. Abortion and abortion-related outcomes were compared between the two groups. Risk factors for late abortion in twins were analyzed using binary Logistics regression. Post-PSM data showed that the late abortion rate was significantly higher in the PCOS group than in the non-PCOS group only in twin pregnancy (9.50% vs. 3.96%, OR: 2.55, 95%CI 1.10–5.89). There were no statistical differences in other pregnancy outcomes. The etiological distribution for late abortion were not statistically different between the two groups in both singletons and twins. Logistics regression indicated that PCOS and obesity [pregnancy-assisted body mass index (BMI) ≥ 28] were risk factors for late abortion in twin pregnancy. In twin pregnancy, PCOS and obese patients are more likely to have late abortion. In twin pregnancy, the late abortion risk significantly increased in the PCOS patients as compared with non-PCOS patients (OR: 2.59, 95%CI 1.11–6.03, P < 0.05), as well as in the patients with obesity (BMI ≥ 28) as compared with the patients with normal BMI (OR: 4.17, 95%CI 1.59–10.90, P < 0.05). PCOS does not significantly affect early and overall late abortion rates after IVF/ICSI fresh cycle pregnancy.

Pregnancy and perinatal outcomes of early vs late selective termination in dichorionic twin pregnancy: systematic review and meta-analysis.

To evaluate outcomes of dichorionic twin pregnancies undergoing early vs late selective termination of pregnancy (ST). MEDLINE, EMBASE, CINAHL and the Web of Science databases were searched electronically up to March 2022. The primary outcome of this study was pregnancy loss prior to 24 weeks' gestation. The secondary outcomes included preterm birth (PTB) before 37, 34, and 32 weeks, preterm prelabor rupture of membranes (PPROM), gestational age (GA) at delivery, Cesarean delivery, mean birth weight, 5-min Apgar score < 7, overall neonatal morbidity and neonatal survival. Only prospective or retrospective studies reporting data on the outcome of early (before 18 weeks) vs late (at or after 18 weeks) ST in dichorionic twin pregnancies were considered suitable for inclusion. Quality assessment of the included studies was performed using the Newcastle-Ottawa scale for cohort studies. Random-effects head-to-head meta-analysis was used to analyze the data. Seven studies reporting on 649 dichorionic twin pregnancies were included in this systematic review. The risk of pregnancy loss prior to 24 weeks was significantly lower in dichorionic twin pregnancies undergoing early compared with late ST (1% vs 8%; odds ratio (OR), 0.25 (95% CI, 0.10-0.65); P = 0.004). The risk of PTB was significantly lower in dichorionic twin pregnancies undergoing early compared with late ST when considering PTB before 37 weeks (19% vs 45%; OR, 0.36 (95% CI, 0.23-0.57); P < 0.00001), before 34 weeks (4% vs 19%; OR, 0.24 (95% CI, 0.11-0.54); P = 0.0005) and before 32 weeks (4% vs 20%; OR, 0.21 (95% CI, 0.05-0.85); P = 0.03). The mean birth weight was significantly greater in the early-ST group (mean difference (MD), 392.2 g (95% CI, 59.1-726.7 g); P = 0.02), as was the mean GA at delivery (MD, 2.47 weeks (95% CI, 0.04-4.91 weeks); P = 0.049). There was no significant difference between dichorionic twin pregnancies undergoing early compared with late ST in terms of PPROM (P = 0.27), Cesarean delivery (P = 0.38), 5-min Apgar score < 7 (P = 0.35) and neonatal survival of the non-reduced twin (P = 0.54). The risk of pregnancy loss prior to 24 weeks and the rate of PTB before 37, 34 and 32 weeks were significantly higher in dichorionic twin pregnancies undergoing late vs early ST, thus highlighting the importance of early diagnosis of fetal anomalies in twin pregnancies. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

FETAL ANOMALIES RESULTING IN TERMINATION OF PREGNANCY IN CONSANGUINEOUS MARRIAGE - AN EXPERIENCE IN TERTIARY CARE

Objectives: To know the Fetal anomalies resulting in termination of pregnancy in consanguineous marriage. Material and Methods: Source of Data This study was performed in the department of radio-diagnosis Basaweshwara Teaching and General Hospital, on patients referred from Obstetrics and Gynaecology Department from September 2021-April 2022. 1. Sample size: Twenty Cases. 2. Type of study: Prospective Study. 3. Inclusion Criteria: All Patients were with 18-20 weeks of gestation. Retrieved data was tabulated and fed in SPSS 20 for analysis. Results: 1. Data of 20 patients who came for anomaly scans were monitored. Mean age of patient was (Min 19 and Max 35). Mean gestational age at which Anomaly scan was carried out was 18-22 weeks (Min 17 weeks and max 24 week). 2. Early termination was performed in 80 % (10 out of 20) cases and late termination was done in 20 % (5 out of 20) cases. 3. Analysis of fetal anomalies showed that CNS anomalies 50% (9 out of 20), and multiple anomalies 10% (4 out of 20). 4. Further analysis showed that CNS anomalies for which PT was carried out includes hydrocephalus 40% (9 out of 20).Enteric system (4 out of 20) MSK (2 out of 20). Conclusion: CNS abnormalities are the top reason to terminate pregnancy, followed by cases with multiple abnormalities and renal anomalies.

Information Gathering about Pregnancy, Birth, and Puerperium—Good and Fake Information

A total of 249 women were included in this study and recruited over a period of one month at the University Hospital of Zurich (USZ). Exclusion criteria included cases of fetal demise and late abortions. The survey on information-gathering processes was divided into three stages: pregnancy, birth, and puerperium. The different sources of information were compared based on women's characteristics. The response rate was 78% (n = 197). The main findings include a significant difference in information gathering based on varying levels of education, with women at the lowest educational level using the Internet the least during pregnancy (p = 0.029). During puerperium, significant differences could be observed in the involvement of the gynecologist. Primipara women as well as women of lower educational levels contacted their gynecologist less in contrast to multipara women (p = 0.006) and women of higher educational levels (p = 0.011). Overall, health professionals were considered to be the most important source of information. This study demonstrates that parity and educational level influence the information-gathering process. As the most important source for information gathering, health professionals must use this advantage to better assist their patients in accessing reliable information.

Medical tourism for late abortion: Women’s profile and circumstances. A quantitative study among women who travelled within Europe for late abortion

BackgroundIn France, women seeking abortion must do so before the maximum legal limit of 12 weeks of pregnancy (14 Gestational Weeks). Women seeking abortion after the 12-week limit tend to travel to the Netherlands, where the maximum legal limit is 22 weeks of pregnancy. The purpose of this study was to identify the profile and circumstances of women who travel from France to the Netherlands for a late abortion. MethodsA descriptive, monocentric study was conducted in a Dutch abortion clinic, where a standardized, anonymous questionnaire was administered to women from France, holding an appointment for late abortion. Data was collected from July 2020 to December 2020. Data analysis was performed with R 4.0.3 software. ResultsThirty-seven women participated in the study. Most of the women were young (15–25 y. o.), without any prior pregnancy, single, in paid employment, with an educational level less than or equal to a high school degree. Most of the women had regular gynaecological follow-up, used contraception, mostly birth control pills, and had already discussed emergency contraception or abortion with a healthcare professional. The women had delayed awareness of their pregnancy and visited the clinic at 18 weeks of pregnancy or later, beyond the 12-week French legal limit for abortion. ConclusionRisk factors likely to lead to medical tourism for late abortion include young age (15–25 y. o.), first pregnancy, being insufficiently informed about available contraceptive methods.