Termination Of Pregnancy For Reasons Research Articles

Pregnancy termination indications and outcomes before 24 weeks of gestation - a case series.

This study aimed to assess termination of pregnancy (TOP) indications and obstetric outcomes before the 24th gestational week. This is a retrospective study that includes terminations performed in singleton pregnancies between December 2021 and December 2022 in the Perinatology Clinic of Necmettin Erbakan University Meram Medical Faculty. According to the reasons for TOP, all patients were divided into three groups: maternal, fetal, and obstetric reasons. The termination approach and outcomes were evaluated in all cases. A total of 210 patients were included in the study. Considering termination indications, 18 (8.5%) patients had maternal causes, 127 (60.5%) had fetal causes, and 65 (31%) had obstetric causes. Maternal causes were significantly higher in the 1st trimester and fetal causes in the 2nd trimester (P = 0.001). In the maternal group, 77.8% dilatation and curettage were used, 70.1% misoprostol and 29.9% misoprostol + Foley catheter in the fetal group, and 66.2% misoprostol in the obstetric group (P = 0.0001). The length of hospital stay and recurrent revision curettage were not statistically different between the fetal, maternal, and obstetric groups (P = 0.099, P = 0.8, respectively). Termination options should be offered for complicated pregnancies due to fetal, maternal, or obstetric reasons. Pregnancy termination week and indication affect morbidity.

The Most Important Medical Theories and Works of Abu Sahl Masihi, an Iranian Scientist during the Golden Civilization of Islam

Abu Sahl Masihi is a physician, philosopher, mathematician, and famous astronomer of the first half of the 11th century AD. Some scientists have written that Abu Sahl was the master of Avicenna.This study aims to introduce him by using the most important medical theories and works of Abu Sahl Masihi.This library study has been carried out among the most important medical works of Abu Sahl Masihi. Common searches were performed on valid databases and papers. Abu Sahl did not agree with the detailed description of the treatment issues. He focused on the scientific and theoretical part of medicine including General basics and principles of prevention. In his medical works, Abu Sahl has explained the theoretical part in order and simply and the therapeutic part briefly. He has rejected other physicians' opinions that considered menstrual bleeding to be fetal food and thus ending it during menopause as a reason for termination of pregnancy and said that such blood that the body repels cannot be the source of fetal food. He considered the healthy blood of the mother's body as the source of fetal food. Like Aristotle, Abu Sahl has regarded the heart as the life force center, innate heat, and vital spirit. He also had a significant view of the heart structure and the vessels connected to it. We can introduce Abu Sahl as one of the pioneers of the theory of the beginning of digestion of food through the mouth due to being impregnated with saliva by the enzymes in the secretions of the digestive system. Despite the importance of Abu Sahl’s works, his writings have been less considered. It seems that more research on the noteworthy ideas of this great scientist is needed by scholars and researchers.

AN INVESTIGATION INTO THE IMPACT OF CONTINUING OR TERMINATING PREGNANCY ON THE MATERNAL, FETAL AND DISEASE PROGRESSION OUTCOMES IN PREGNANT WOMEN WITH COVID-19

Abstract Introduction: There is limited evidence regarding the potential impact of COVID-19 on pregnancy, fetuses, and its outcomes. Evaluating population-level data on these outcomes as soon as they become available will be crucial for identifying trends related to the COVID-19 pandemic and managing the disease in pregnant women and their offspring. Material and methods: This study employed a descriptive-analytical approach based on the recorded hospital files. All pregnant mothers who presented to the hospitals and tested positive for COVID-19 were included. Data included background and initial information such as age, gender, maternal PCR positivity, COVID-19 vaccination, number of vaccinations, pregnancy count, number of deliveries after 20 weeks of gestation, miscarriage, gestational age at sonography, COVID-19 symptoms, pulmonary involvement, preterm labor, premature rupture of membranes, high blood pressure, preeclampsia, intrauterine fetal demise, deep vein thrombosis/pulmonary embolism, maternal death, pregnancy termination, age at pregnancy termination, reasons for pregnancy termination, method of pregnancy termination, hospitalization duration, maternal recovery, neonatal PCR positivity, Apgar score, neonatal weight, neonatal intensive care unit admission, and neonatal death. Blood factors at admission and discharge were also recorded. Results: A total of 401 pregnant women were enrolled in the study, among whom 282 individuals underwent delivery due to labor pain, previous cesarean section, pain, and labor. Among the pregnant women with COVID-19, 385 (96%) tested positive for PCR. White blood cells, hemoglobin, platelet, alanine aminotransferase, serum ferritin levels, and D-dimer levels showed statistically significant differences before and after discharge. Maternal PCR positivity was significantly associated with first-trimester termination, and the number of COVID-19 vaccinations had a significant relationship with third-trimester termination. In cases of moderate to severe pulmonary involvement, white blood cells, hemoglobin, alanine aminotransferase, aspartate aminotransferase, serum ferritin levels, D-dimer levels, and thrombocytopenia showed a noticeable increase, statistically significant compared to mild cases. Conclusion: This study suggests that the most common time for COVID-19 infection in pregnancy is the first and third trimesters, with clinical symptoms of fever and cough. Pregnancy termination during the inflammatory phase of COVID19 in patients with severe involvement was associated with unfavorable outcomes for both the mother and fetus.

Drug exposure during pregnancy in primary care: an algorithm and observational study from SIDIAP database, Catalunya, Spain

ObjectivesTo develop an algorithm to identify pregnancy episodes in women at childbearing age using SIDIAP (Information System for the Improvement of Research in Primary Care) data (Catalunya, Spain).To describe drugs...

Comparison of Inflammatory Factors of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Maternal Platelet Count in Patients with and Without Chorioamnionitis and with Premature Preterm Rupture of Membrane

Background: The present study aimed to compare inflammatory markers of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and maternal platelet count in patients with and without chorioamnionitis with premature preterm rupture of membrane (PPROM). Methods: Women with PPROM and gestational age less than 34 weeks were enrolled in this cohort study. PPROM was confirmed with sterile speculum examination or the AmniSure test. A blood sample was drawn from mothers for complete blood count (CBC) and differential count (Diff) before administering antibiotics and corticosteroids. Another blood sample was drawn for CBC-Diff tests at the time of pregnancy termination. The status of mothers and fetuses was carefully monitored during hospitalization through the following indicators: Vital signs, daily abdominal examination, uterus discharge, daily non-stress test, and weekly ultrasonography. All samples were collected in one year. Results: A total of 110 patients were examined. The reason for pregnancy termination was gestational age of 34 weeks in 30 patients (27.3%), chorioamnionitis in 19 cases (17.3%), pain and dilation in 32 cases (29.1%), and miscellaneous in 29 cases (26.4%). Among the study parameters, only NLR was significantly different between groups, and the order of values from highest to lowest was in the chorioamnionitis, pain and dilatation, miscellaneous, and gestational age of 34 weeks groups. We found that NLR at a cut-off point of 3.2 - 3.5 had an acceptable sensitivity and low specificity to detect the cases of chorioamnionitis. Raised NLR was associated with (95% CI) histological chorioamnionitis with a sensitivity of 86% and a specificity of 43%. Conclusions: According to the findings of our study, NLR can be a suitable indicator for predicting chorioamnionitis in women who deliver preterm without clinical signs and symptoms of infection. It can be used for expectant management for PPROM after 34 weeks.

Patients' experiences of termination of pregnancy at a regional hospital in Durban, South Africa.

Safe and effective termination of pregnancy (ToP) services have helped to resolve the uncertainty that surrounds unwantedpregnancies globally and in South Africa (SA). It is important to determine the demographic profile of women requesting ToP and to assessthe reasons for ToP and the beliefs and experiences of women seeking these services in order to improve service delivery. To determine the sociodemographic profile and emotional and psychological experiences of women undergoing ToP at aregional hospital in Durban, SA. The study population consisted of women seeking either medical or surgical ToP at the Addington Hospital ToP clinic from Juneto August 2021. The participants were requested to complete a structured self-reporting questionnaire on their sociodemographics, theirawareness of, attitude to and knowledge of ToP, and their reasons for seeking ToP services, as well as contraception method and use. Thequestionnaire also captured their experience after the ToP was completed. Of the 246 participants, the majority (92.3%) were aged 16 - 35 years, with 62.6% having little or no income and dependent ontheir family or partner for financial support. Most of the participants (73.2%) were parous and had secondary education and above (94.3%).Furthermore, 59.0% of the participants indicated they were not on any form of contraception before becoming pregnant, even though 70.3%of them were single. The most cited reasons for ToP were lack of finance (37.5%), schooling (33.9%), and not feeling ready to be a parent(20.0%). Although some participants (35.7%) were fearful of ToP, most of them (78.0%) reported feeling relieved after the procedure. Unemployment and financial dependency appeared to be common reasons for seeking ToP in our study population. Most ofthe women were single and many had not used any contraception prior to the pregnancy.

Reproductive Health Practices in Spanish Women Who Underwent Voluntary Termination of Pregnancy.

Background: The incidence of Voluntary Termination of Pregnancy (VTP) is an important indicator of unplanned pregnancies and the differences in the functioning of contraceptive services and the effectiveness of their use. Its analysis is essential for monitoring the well-being of women and their partners. Our aim was to analyse the socio-demographic profile of women who request voluntary termination of pregnancy in the province of Salamanca, as well as their satisfaction with the intervention and its influence on their contraceptive methods. Methods: An intervention study (before-after) designed without a control group, including all women requesting a voluntary termination of pregnancy through the Salamanca Public Health System. Socio-demographic and reproductive health variables were used. After the termination of pregnancy, a satisfaction survey and analysis of consequences were carried out. Results: A total of 176 surveys were obtained. Women who underwent VTP in Salamanca were between 20 and 25 years old, had secondary education but were still studying or working, lived alone and had no children. The most commonly used contraceptive method was the condom (55%), followed by the pill (25%). The most frequent reason for termination of pregnancy was economic (47.7%). The abortion entailed a significant change in contraception. Whereas before the abortion only 34% used a hormonal method, 66% were willing to use one afterwards (p = 0.006). Conclusion: Reproductive health education needs to be improved so that couples use reliable contraceptive methods appropriately. Although women are generally satisfied with the care received during abortion, they would prefer better accessibility to the procedure and more comprehensive information about the process from a neutral stance.

Risk factors for gestational trophoblastic neoplasia development of singleton normal fetus with partial hydatidiform mole pregnancy: A retrospective cohort and literature review.

Singleton normal fetus with partial hydatidiform mole (PHM) pregnancy is a rare phenomenon. No previous reports have investigated the risk factors of gestational trophoblastic neoplasia (GTN) progression following this condition. We retrospectively enrolled cases of singleton normal fetuses with PHM pregnancies at West China Second University Hospital, Sichuan University, from 2005 to 2017. Other cases were identified from PubMed databases during 1975 to 2021 for the cohort study. Cox proportional hazards models were applied to evaluate risk factors for GTN progression based on the patient's clinical characteristics. Overall, 36 cases of singleton normal fetuses with PHM pregnancies were enrolled. After a median follow-up of 4.0 (0.8-12.0) months, nine (25.0%) patients progressed to GTN. Gestational age at pregnancy termination (hazard ratio [HR] 0.88; 95% confidence interval [CI] 0.78-0.99, p=0.032), hyperthyroidism (HR 5.75; 95% CI, 1.16-28.50, p=0.032), and reasons for pregnancy termination (medical indications vs. patients' choice; HR 0.25; 95% CI, 0.06-0.99, p=0.049) were significantly correlated with GTN progression. Area under the receiver operating characteristic curve (AUC) of gestational age at pregnancy termination to predict non-progression to GTN was 0.784 (95% CI, 0.615-0.903, p < 0.001). A clinically significant cutoff value, that is, gestational age of 24 weeks, was determined by comprehensively considering the cutoff values of AUC and clinical significance of gestational age. Compared to gestational age of pregnancy termination <24 weeks, ≥24 weeks was a protective factor for GTN. Therefore, there is enough evidence to continue pregnancy, except for uncontrolled severe complications, without increasing the risk of GTN progression.

Profiles of women presenting for abortions in Singapore at the National University Hospital: focus on married women.

In this study, we aimed to identify the differences in sociodemographic variables and reasons for termination of pregnancy (TOP) between married women and single/divorced women. We hope that this study can guide future policies and interventions to reduce the incidence of unsupported pregnancies in this profile group of women. We retrospectively evaluated the sociodemographic data of 802 women who underwent an abortion for social reasons at our institution in Singapore from January 2016 to September 2018. We compared the sociodemographic variables, reasons for and methods of TOP between married and single/divorced women. We analysed data from 524 married women (65.3%) and 278 single/divorced women (34.7%). Married women were more likely to be of older age (29.5 years vs. 24.5 years, P < 0.001), had more living children and higher educational qualifications. The top two cited reason for abortions among married women were having enough children (42.0%) and the inability to afford another child (18.7%). Multivariate analysis showed that women aged >19 years and having more living children were independently associated with recurrent TOPs. Having a tertiary education was noted to be associated with less recurrent TOPs. The most common reasons married women cited for having TOP include having enough children and the lack of financial capacity to afford another child. Recommendations to support women ought to be personalised and comprehensive in addressing their needs rather than offering a standardised support method. Greater emphasis should be placed on post-TOP family planning counselling to reduce repeated TOP.

Profile of abortion seekers in the tertiary center of northern hills with review of medical termination of pregnancy act in India

The aim of the present study was to investigate the socio-demographic and obstetric profile of pregnant women, seeking medical termination of pregnancy in accordance with the Medical Termination of Pregnancy (MTP) Act and the reasons for undergoing termination of pregnancy in the tertiary care center of the hilly region of Northern India and to further review the amendments in the Medical Termination of Pregnancy Act 1971 along with its future implications in legalizing abortions in India.&#x0D; Materials and Methods: A registry-based retrospective study was carried out among pregnant women, attending the gynecologic outpatient department for termination of pregnancy at the tertiary care teaching hospital and the referral center for Himalayan foothills in Northern India. The records of women, seeking termination of pregnancy during a 1-year period between October 2020 and September 2021, were reviewed and information on their demographic and obstetric profile, reason for undergoing termination of pregnancy, and acceptance of contraception, following termination of pregnancy was recorded in the data sheet. The information obtained was analyzed using SPSS version 20 (IBM, Chicago, USA) for descriptive statistics.&#x0D; Results: A total of 400 pregnant women underwent Medical Termination of Pregnancy between October 2020 and September 2021. 30.5 % (122/400) women between 26–30 years of age underwent termination of pregnancy, followed by 27.3 % women aged between 31–35 years. Social reasons for termination of pregnancy were more evident in women aged 26 years and above. 84.09 % pregnancies were terminated in the second trimester (&gt;12 weeks) on eugenic ground, while 65.01 % pregnancies were terminated in the first trimester (6–12 weeks) on social grounds. Only 7.75 % (31/400) women opted for sterilization or family planning after MTP, out of which the majority opted for temporary methods of contraception.&#x0D; Conclusion: We conclude from the results of the present study that women in the peak reproductive age (26–30 years) are more likely to seek pregnancy termination and this group of women needs to be the focus of contraceptive counseling and family planning services. Timely ultrasound scans by an expert sonologist may be a step forward towards lowering the rates of late pregnancy termination. There is a need to educate women to avail and use contraceptive methods in an effective manner and to make them aware of utilizing sterilization services, once they complete their families to avoid unwanted pregnancies.

Clinical analysis of pregnancy termination in 167 pregnant women with cardiovascular disease during the first and second trimester

Objective: To study the risk assessment, method selection and clinical management of pregnancy termination during the first and second trimester of pregnant women with cardiovascular disease. Methods: This study focused on pregnant women with cardiovascular diseases who were admitted to Beijing Anzhen Hospital during the first and second trimester of pregnancy from January 2016 to September 2019, to summarize their clinical characteristics, reasons and methods of pregnancy termination, management and outcomes. Results: Among 167 pregnant women, 119 cases (71.3%, 119/167) were in early pregnancy and 48 cases (28.7%, 48/167) were in middle pregnancy. The reasons for termination of pregnancy were cardiovascular disease (109 cases; 65.3%, 109/167), unwanted pregnancy (54 cases; 32.3%, 54/167) and other reasons (4 cases). Vacuum aspiration was performed in 98 cases and forceps curettage was performed in 19 cases, medical abortion was performed in 2 cases in early pregnancy. There was no change in cardiac function after pregnancy termination and all survived in early pregnancy. In the second trimester, 16 cases were induced by intraamniotic injection of ethacridine, 2 cases by water balloon, 1 case by oxytocin intravenous drip, and 29 cases by hysterotomy delivery. The ratio of patients with hysterotomy delivery with cardiac function grade Ⅲ-Ⅳ was significantly higher than that in the patients with vaginal labor induction in the second trimester [79% (23/29) vs 4/19; P<0.01]; the ratio of pregnancy risk grade Ⅳ-Ⅴ was also significantly higher [100% (29/29) vs 14/19; P=0.007]. The mean length of hospital stay of patients with hysterotomy delivery was significantly longer than that in the patients with vaginal labor induction [(7.1±3.4) vs (2.4±1.8) days; P<0.01]. Cardiac function was improved in 4 patients induced by ethacridine and rapid recovery without serious complications. Cardiac function decreased in 5 cases and 1 case died on the first day after hysterotomy delivery. Conclusions: Pregnancy risk assessment should be conducted as early as possible in patients with cardiovascular disease. If it is not suitable to continue the pregnancy, terminate pregnancy as early as possible to reduce the risk. Pregnancy termination methods and analgesic methods should be selected according to different gestational age and complications. The indications for hysterotomy delivery should not be relaxed at will, so as to minimize trauma and hemodynamic changes. After the termination of pregnancy, contraceptive measures should be implemented and the next treatment plan should be guided.

Reasons for termination of pregnancy in mid-trimester: A single-centre experience

Reasons for termination of pregnancy in mid-trimester: A single-centre experience

Safe abortion services during the COVID -19 pandemic: a cross-sectional study from a tertiary center in Nepal

Background: Abortion is an essential service, the need for which has increased during the coronavirus disease 2019 (COVID-19) pandemic. Because of the lockdowns at several periods, these services were hampered. This study analyzed the pattern of Safe Abortion Services (SAS) at a tertiary healthcare center during the first six months of the COVID-19 pandemic in Nepal. Methods: This is a cross-sectional analytical study. We compared the pattern of safe abortion services between the first three months of the pandemic when a lockdown was implemented and the second three months when the lockdown was eased. Demographic and obstetric profile of women, their abortion choices, method of termination, difficulty in accessibility, and level of psychological distress were studied. Results: A total of 52 women were provided SAS during the study period. The number of women coming for SAS during lockdown was 47.1% less than that after easing of the lockdown. During the lockdown, women came at a later period of gestation with a mean of 9.5 weeks compared to 7.5 weeks in the later three months. Because of fear of COVID-19, 19.2% (n=10) women opted for termination of pregnancy. Increased need of contraception was felt but 40% (n=12) had problems of accessibility. More women had probable serious mental illness during the lockdown period (p=0.008). Conclusion: Lockdown during the pandemic decreased the number of women coming for SAS due to barriers in accessibility. Contraceptive needs are also increased but access is difficult. The need for safe abortion services and contraception has increased during the pandemic but the lockdown caused inaccessibility. Psychological distress is prevalent, and fear of COVID-19 has become a common reason for termination of pregnancy. This pandemic can be taken as an opportunity to provide and improve contraception and abortion accessibility, and quality with integration of mental health support.

Safe abortion services during the COVID -19 pandemic: a cross-sectional study from a tertiary center in Nepal.

Background: Abortion is an essential service, the need for which has increased during the coronavirus disease 2019 (COVID-19) pandemic. Because of the lockdowns at several periods, these services were hampered. This study analyzed the pattern of Safe Abortion Services (SAS) at a tertiary healthcare center during the first six months of the COVID-19 pandemic in Nepal. Methods: This is a cross-sectional analytical study. We compared the pattern of safe abortion services between the first three months of the pandemic when a lockdown was implemented and the second three months when the lockdown was eased. Demographic and obstetric profile of women, their abortion choices, method of termination, difficulty in accessibility, and level of psychological distress were studied. Results: A total of 52 women were provided SAS during the study period. The number of women coming for SAS during lockdown was 47.1% less than that after easing of the lockdown. During the lockdown, women came at a later period of gestation with a mean of 9.5 weeks compared to 7.5 weeks in the later three months. Because of fear of COVID-19, 19.2% (n=10) women opted for termination of pregnancy. Increased need of contraception was felt but 40% (n=12) had problems of accessibility. More women had probable serious mental illness during the lockdown period (p=0.008). Conclusion:Lockdown during the pandemic decreased the number of women coming for SAS due to barriers in accessibility. Contraceptive needs are also increased but access is difficult. The need for safe abortion services and contraception has increased during the pandemic but the lockdown caused inaccessibility. Psychological distress is prevalent, and fear of COVID-19 has become a common reason for termination of pregnancy. This pandemic can be taken as an opportunity to provide and improve contraception and abortion accessibility, and quality with integration of mental health support.

Maternal heart disease and pregnancy outcome: Experience of a single unit in a tertiary care hospital in Sri Lanka

Introduction: Heart disease complicating pregnancy is a leading cause of maternal morbidity and mortality in Sri Lanka. Understanding the pattern and outcomes of heart disease complicating pregnancy will help to optimise the care. Objective: Describe maternal and fetal outcomes of heart disease complicating pregnancy in a tertiary care unit from 2013 to 2017. To compare the pattern of heart disease complicating pregnancy over the years from the same unit to assess whether there is a change in the pattern of cases presenting in pregnancy. To study the reasons for termination of pregnancy in patients with cardiac disease during the study period Method: Retrospective analysis of secondary data collected from clinical notes of pregnancies complicated with heart disease. Results: A total of 248 cases with diagnosis of cardiac disease complicating pregnancy were included in the study.15 patients had termination of pregnancy in the first trimester due to severe heart disease. Two hundred thirty three (233) patients continued the pregnancy until the delivery. Out of these 233, heart disease was diagnosed during the index pregnancy in 18.9% (n-44) of the patients. Heart disease was categorised as acquired (47.2%), congenital (28.2%), mitral valve prolapse (15%), cardiac arrhythmias (9.4%). Among acquired heart disease 89% was rheumatic in origin. Mitral valve (89.7%) was the commonest valve affected amongst women with rheumatic carditis (n=98). Cardiac decompensation at delivery occurred in 7.7%. Pulmonary hypertension was present in 22.9% with acquired heart disease and 31.7% with congenital heart disease. Three intra uterine fetal demise and two maternal deaths occurred during this period. Conclusion: Rheumatic heart disease remains the commonest heart disease in pregnant women in Sri Lanka. There is an increase proportion of women with congenital heart disease. A significant number required therapeutic termination which highlights the need for improved pre-pregnancy preparation.

Sperm DNA fragmentation is a necessity for modern clinical practice

According to world statistics, 15 % of married couples do not reach pregnancy within one year and seek medical help. At the same time, an important component of the complex problem of infertility, in addition to not getting pregnant, are also pregnancy losses. According to modern ideas, one of the reasons for termination of pregnancy is sperm DNA fragmentation (SDF). According to the European Association of Urology guidelines on male infertility, SDF reduces the chances of natural conception and increases the risk of pregnancy loss. In the European Society of Human Reproduction and Embryology guideline on the management of recurrent pregnancy loss, the definition of SDF is recommended in the algorithm for examining a couple after a single episode of miscarriage. The causes, mechanisms and approaches to correcting increased SDF are the subject of active research; according to PubMed, more than 2,500 papers have been published on this problem to date. Given the huge amount of factual material, the purpose of this review is to highlight the key points of etiology, pathogenesis and approaches to the correction of increased levels of SDF

Socio-demographic Profile of Abortion Cases attending at a Tertiary Level Hospital

Introduction: Abortion in Bangladesh is illegal under most situations, but menstrual regulation is often used as a substitute. Abortion can be legally performed by a physician in a hospital if it is necessary to save the life of the mother. A person, who performs an abortion under any other circumstances, including a woman who self-aborts, can be punished by a fine and imprisonment.&#x0D; Objective: To assess the socio-demographic profile of abortion cases attending a tertiary level hospital of Bangladesh.&#x0D; Materials and Methods: This cross-sectional descriptive type of study was carried out among 80 patients at the Gynae ward and out patient department of Dhaka Medical College Hospital from March 2012 to June 2012. The study population was women attending the selected hospital for an abortion or abortion-related complications.&#x0D; Results: Most of the respondents 35(43.8%) were below 25 years of age and all patients were housewives. The maximum number of patients 63(78.8%) had spontaneous abortion, low socio-economic status and majority were multigravidas. It was also found that patients with abortion were mostly in their second (43.8%) and third (21.3%) decade of life.&#x0D; Conclusion: In this study, the commonest reason for termination of pregnancy was unplanned pregnancy. Creating awareness and timely intervention might decrease the number of abortion cases.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 200-202

Termination of pregnancy in women with epilepsy — A retrospective single center study

Antiepileptic drugs (AEDs) are commonly prescribed to women of childbearing age. As 0.3%–0.7% of all pregnancies occur in women with epilepsy (WWE), the effect of recurrent seizures and teratogenicity on pregnancy outcome and the fetus have been widely studied. Most of these studies have focused on live births. A significant number of terminated pregnancies in WWE were ignored in past studies, thus reducing the calculated incidence of congenital malformations and possible influence of AED exposure. We scrutinized the medical records at our medical center for termination of pregnancy (TOP) in WWE for the years 2004–2016. Fifty-eight TOPs occurred in WWE during these years. Reasons for TOP included spontaneous abortions necessitating medical intervention (46.6%), patient's request (31.0%), medically recommended (10.3%), and unknown (12.1%).

LIGHT AND PREGNANCY: THE RESULTS OF EXPERIMENT

Objective – to establish the presence of interrelation between the functioning of the pineal gland, immune system and progress of pregnancy.Material and methods. The study was conducted on 20 sexually mature nonlinear female white rats Rattus Norvegicus Wistar, which had not given birth (study group). The control group consisted of 16 female rats with the same parameters. After pregnancy occurrence the animals of the study group were exposed to light in regimen 24 hours by halogenic lamps of “white” light; the rats of control group were kept in regimen “12 hours of light/12 hours of darkness”. In 21 days after confirmation of pregnancy the rats were slayed. The concentrations of melatonin and interleukines in the blood of animals were studied. The uteruses of the slayed animals were histologically examined. Results. The termination of pregnancy was found at histological examination in all rats of study group, whereas in the control group the pregnancies were developed normally. The significant decreasing of the melatonin concentration was found in the blood of the rats of the group under study, comparing to the control (74,79±14,51 pg/ml, in the control group 245,00±32,26 pg/ml, p<0,01), as well as the increasing of the level of IL-6 (5,59±1,02 pg/ml, in control group 1,28±0,54 pg/ml, p<0,05).Conclusions. The depression of the functioning of the pineal gland, caused by light, has the direct influence on pregnancy process, and may even be a reason for pregnancy termination; the activation of pro-inflammatory immunity has been noticed in this case.

SCUBA Diving in Pregnancy.

Obstetrical care providers may occasionally encounter women with questions about the safety of Self-Contained Underwater Breathing Apparatus (SCUBA) diving in pregnancy. This article provides an overview of safety issues associated with basic SCUBA diving and offers guidance to practitioners about how to evaluate and counsel pregnant women about the associated maternal and fetal risks. Basic diving physiology is reviewed and the implications of SCUBA diving during pregnancy are discussed. A literature review examined available animal and human data about the potential adverse effects of the physiological changes of pregnancy on divers, the impact of pressure changes during diving, and possible consequences of hyperbaric gas exposure and rapid decompression on mother and fetus. Studies were found by searching the terms "scuba diving," "pregnancy," "fetus," "decompression illness," "hyperbaric medicine," and "animal studies" in the databases Medline, Pubmed, and Embase. Reference lists from existing articles and reports from identified diving magazines were also reviewed. Studies were limited to the English language and included publications until 2016. All relevant human studies were selected. Five retrospective studies and one prospective study assessing the antenatal and postnatal outcomes of women who participated in SCUBA diving while pregnant were reviewed. Published data was limited in both quantity and quality. The authors' experience with SCUBA diving together with a background in obstetrics allowed themes to be explored and recommendations developed. In addition to established risks of SCUBA diving, pregnant women are at increased risk due to changes in body habitus (affecting equipment fitting and balance). Animal data suggest possible adverse fetal effects due to fetal decompression illness (DCI) and hyperbaric oxygen exposure. Human data, though generally reassuring, are of poor quality and thus do not completely exclude adverse outcomes. In general, women should be cautioned to avoid diving during pregnancy, but inadvertent exposure to recreational diving in early pregnancy is not a reason for pregnancy termination.