Time Of Abortion Research Articles

Baseline Characteristics of Covid-19 Infected Spontaneous Abortion Cases

Background: The COVID-19 pandemic has raised concerns about the potential impact of SARS-CoV-2 infection on pregnancy outcomes. However, there is limited evidence regarding the association between COVID-19 and spontaneous abortion cases, particularly in Bangladesh.Methods: This retrospective observational study investigated the baseline characteristics of 48 cases of spontaneous abortion in pregnant women with laboratory-confirmed COVID-19 infection at Enam Medical College Hospital, Savar, Dhaka, Bangladesh between March and July 2020. Participants were included if they experienced fetal demise at 11 or more weeks of gestation, and potential confounding factors, such as fetal malformations or other obstetric disorders, were excluded. Data on demographic characteristics, gestational age, parity, gravidity, and COVID-19 severity were collected and analyzed.Results: The age distribution of participants ranged from 18 to 33 years, with 50% in the 26-30 year age group. A majority (58.33%) were obese, and 83.33% exhibited mild COVID-19 symptoms, while 16.67% were asymptomatic. Regarding gestational age at the time of spontaneous abortion, 50% were between 11-15 weeks, 41.67% were between 16-20 weeks, and 8.33% were between 21-25 weeks. All participants had at least one previous pregnancy, with 33.33% experiencing their second pregnancy, 41.67% their second pregnancy with a previous live birth, and 25% their third pregnancy with at least one previous live birth.Conclusions: This study provides insights into the baseline characteristics and maternal outcomes of COVID-19 infected spontaneous abortion cases in Bangladesh. The findings suggest that severe COVID-19 illness may not be a prerequisite for adverse pregnancy outcomes and highlight the need for further investigations into the potential mechanisms of intrauterine SARS-CoV-2 transmission and the role of placental factors. Larger-scale studies are warranted to better understand the impact of COVID-19 on pregnancy outcomes and develop appropriate management strategies.

Ralationship between polymorphisms and diplotypes of HLA-G 3’UTR and fetuses with abnormal chromosomes or unexplained pregnancy loss (UPL)

ObjectivesHuman leukocyte antigen G (HLA-G) plays a crucial role in pregnancy. Pregnancy loss (PL) is caused by a variety of causes, such as fetal chromosomal abnormalities, maternal hypertension and diabetes, immune causes, spontaneous immune diseases, infections, unknown causes, etc. This study reports on the association of fetal HLA-G 3’UTR polymorphisms and diplotypes with chromosomally abnormal fetuses (CAF) or unexplained pregnancy loss (UPL).MethodsA total of 552 specimens were collected and grouped by next-generation sequencing technology (NGS) and fetal survival: UPL (112 cases), CAF (170 cases) and control (258 cases). The polymorphisms of HLA-G 3’UTR in all samples were detected by Sanger sequencing. The genotypes, haplotypes and diplotypes of HLA-G 3’UTR were analyzed. The classification and regression tree (CART) analysis was used to evaluate the role of HLA-G diplotypes in predicting fetal outcomes. The correlations between CAF or UPL and maternal age, paternal age, times of miscarrage, times of delivery were analyzed by logistic regression.ResultsThe frequencies of HLA-G + 2960del/del and + 3035CC genotypes were remarkablly increased in CAF than those in control group. The frequencies of HLA-G + 2960ins/del, + 3010CC, + 3035TC, + 3142GG, + 3187AA in CAF were significantly lower than those in normal fetuses. Through genetic models and logistic regression analysis, the dominant model of HLA-G 3’UTR genotypes [such as + 2960 (OR = 1.27, 95% CI = 1.05–1.54, p = 0.016), + 3010 (OR = 0.78, 95% CI = 0.63–0.97, p = 0.026), + 3035 (OR = 1.22, 95% CI = 1.00–1.49, p = 0.047), + 3142 (OR = 0.76, 95% CI = 0.62–0.95, p = 0.014) and + 3187 (OR = 0.80, 95% CI = 0.65–0.99, p = 0.041)] were dramatically associated with CAF. However, the frequencies of HLA-G + 3010GC, + 3142GC and + 3187AG in fetuses with UPL were memorably decreased than those in normal fetuses. No significant difference was found in the frequencies of HLA-G haplotypes in all groups. However, the frequency of UTR-1 positive specimens in CAF was significantly higher than that in UPL and control group. At the same time, the frequency of UTR-1/UTR-3 diplotypes in CAF was observably higher than that in UPL and control group, while the UTR-1/UTR-7 frequency in UPL was signally lower than that in control group. Multivariate logistic regression analysis indicated that positive HLA-G UTR-1 (OR = 1.8, 95% CI = 1.16–2.81, p = 0.009), times of abortion (OR = 1.23, 95% CI = 1.02–1.50, p = 0.035), and times of delivery (OR = 0.31, 95% CI = 0.20–0.48, p < 0.001) were correlated with CAF.ConclusionsThis study suggests that HLA-G 3’UTR polymorphisms and diplotypes play an important role in the process of successful pregnancy of the embryos with abnormal chromosomes after fertilization. At the same time, Different alleles or diplotypes also affect the development of embryos with UPL.

Abortion Trajectory, Timing, and Access Study (ATTAS): study protocol

BackgroundThis study protocol outlines the phased construction of a questionnaire, data collection, and a strategy for analysis within the framework of the ATTAS project. This study has two primary objectives. First, it allows us to map the duration of the various phases of the abortion trajectory for women presenting for abortion in Flanders, Belgium. Second, it identifies barriers that cause delays within these phases.MethodsThe questionnaire was distributed to all women seeking abortion care at one of the five Flemish abortion centers; specifically, the LUNA centers, which are located in Ostend, Ghent, Antwerp, and Hasselt, as is the VUB-Dilemma center in Brussels during the fall and winter of 2023–2024. Ethical clearance for the described research was obtained from the University of Antwerp’s Ethics Committee for the Social Sciences and Humanities (reference numbers: SHW_2023_48_1 and SHW_2023_48_2).DiscussionThe collected data provide a dataset on the abortion trajectories of Flanders women who presented for abortion. This study protocol outlines the ATTAS project’s rationale, phased development, and implementation of the questionnaire, as well as the upcoming data analyses. To our knowledge, this is the first study within the Flemish context to investigate abortion trajectories, timing, and access. Furthermore, this study protocol provides a phased and systematic approach to adapt validated research instruments to fit within diverse legal and cultural contexts. Building on this protocol, future research will seek to advance reproductive justice for all women in Belgium.

Occurrence of Abortion in Different Breeds of Goats Reared under Semi-intensive Farming System at Organized Farms in Semi-arid Region of India

Background: Abortion is a major health problem of animals including goats, which results in significant financial losses for the farmers. The aim of the current study was to determine the occurrence of abortion in different breeds of goats reared under semi-intensive farming system at the organized farms in the semi-arid region of India, and to determine the relationship between the parity, season, and pregnancy stage of the aborted goats with the incidence of abortions. Methods: The data on the caprine abortions was collected and analyzed. The caprine abortions that occurred at the organized farms under a semi-intensive management system were categorized according to the season at the time of abortion, parity and pregnancy stage of the aborted goats. The Chi-Square test and ANOVA methods were used for the statistical analysis of the abortion data. Result: The occurrence of abortion in goats (combined farm) had a significant association with seasons and stages of pregnancy, whereas it was not associated with parities. Barbari, Jakharana and Jamunapari goats individually showed significant differences in abortion rates across various seasons, but did not exhibit significant variation in abortion rates with respect to different stages of pregnancy or parities. In the study, the majority of abortions were found in the winter season, followed by the rainy and summer seasons; similarly, most of the abortions were noticed in the later stage of pregnancy, followed by the mid- and early stages. There was the highest abortion rate in the goats with parity 3 and above, followed by the first and second parities. Further investigation is required to validate the current findings. In conclusion, the study revealed that abortion rates in goats are significantly influenced by seasonal changes and the stages of pregnancy.

The efficacy of mifepristone-misoprostol regimen versus misoprostol-only for medication abortion at 22 + 0/7 to 30 + 0/7weeks' gestation.

This study aimed to compare duration of medication abortion after pretreatment with mifepristone versus misoprostol-only regimens at 22 + 0/7 to 30 + 0/7weeks. This retrospective cohort study included patients admitted for medication abortion from 2014 to 2022. Patients underwent feticide due to genetic or anatomical abnormalities at gestational age of 22 + 0/7 to 30 + 0/7weeks. Excluded from this study were patients admitted at gestational age < 22 + 0/7 or > 30 + 0/7weeks, with multiple gestation, with diagnosis of intrauterine fetal demise before feticide, with contraindication for vaginal delivery, and who were administered a medical regimen other than the mifepristone-misoprostol or misoprostol-only protocol. Information collected included patients' demographics, clinical outcomes, additional procedural interventions, and complications. Data of patients treated with mifepristone-misoprostol versus misoprostol-only were compared. The study group included 46 patients in the mifepristone-misoprostol group and 35 in the misoprostol-only group. Median interval from first dose of misoprostol to fetal expulsion was shorter in the mifepristone-misoprostol group (10.6 vs. 15.3h; p = 0.007) with shorter duration of hospitalization (3.5 ± 1.1 vs. 4.1 ± 1.2days; p = 0.013). Study groups did not differ in terms of complications. Patients in the mifepristone-misoprostol group had a younger gestational age (23.8 ± 1.69 vs. 25.37 ± 2.4weeks; p = 0.002). However, multivariable Cox regression found that mifepristone was independently associated with shorter abortion time (OR 1.7, 95% CI 1.03-2.9, p = 0.03). Medication abortion with mifepristone-misoprostol was associated with shorter time to fetal expulsion at gestational ages 22 + 0/7 to 30 + 0/7weeks, compared with misoprostol-only regimen.

Aftercare following second trimester abortion procedures.

The purpose of this review is to examine patient experiences following second-trimester abortion care to identify clinical interventions to improve aftercare. Early validation of a five-question Reproductive Grief Screen suggests that this instrument may be useful for clinicians to identify patients with maladaptive grief responses following a second-trimester abortion. Patients want to talk with their healthcare providers about grief following abortion and desire frequent mental health check-ins. Most people will have breast symptoms following a second-trimester abortion; a one-time dose of cabergoline at time of abortion appears to be an effective intervention to prevent bothersome breast symptoms. As patient desires vary regarding disposition of fetal remains, clinicians should be prepared to discuss donation for research or cremation/ burial as alternatives to routine disposal. With significant variation in availability and cost of ceremonial disposition, clinicians and healthcare systems should identify local resources to facilitate this aspect of aftercare. Clinical practices and healthcare systems should prioritize the aftercare experience including the management of breast symptoms, bereavement, disposition of fetal remains, and follow-up care.

Communication and Counseling Preferences of Women Who Chose Abortion During Adolescence: A Qualitative Study

Study ObjectiveAs part of a larger study about pregnancy options counseling with adolescents, we interviewed women in the United States who chose abortion during adolescence about preferences and experiences regarding communication from healthcare professionals during abortion care. Design, Setting, and ParticipantsWe conducted individual semi-structured interviews with women ages 18-35 years old who were pregnant before age 20 years old and chose abortion. We recruited participants through social media, a research registry, and flyers in healthcare facilities. We recorded and transcribed interviews. Two investigators coded interview transcripts using thematic analysis. ResultsWe conducted interviews with 17 US women (median age 32 years old, range 20-35 years old) from 11/2020-4/2021. The median age at time of abortion was 18 years old (range 14-19 years). The sample was 58% (n = 10) Caucasian and 65% (n = 11) heterosexual. Themes included: 1) Participants perceived options counseling before abortion as important and necessary but did not always feel they personally needed it. 2) Participants reported that clinicians including nurses, physicians, and other staff sometimes had poor bedside manner, which was not aligned with their perceived need for gentleness due to their adolescence. 3) Participants valued nonjudgmental communication including normalization of abortion care. 4) Participants desired privacy and confidentiality throughout their clinic appointment, but clinic logistics led to concerns about limited privacy. 5) Participants appreciated medically accurate information about abortion in plain language balancing safety and risk information for reducing fear before the procedure. ConclusionResponses suggested specific best practices that healthcare providers can adopt to improve care for youth considering abortion.

Understanding factors affecting the acceptance of post-abortion contraception: A comprehensive analysis

To assess the proportion of post-abortion contraceptive acceptance and the determinant factors in the utilization of contraception. It is a prospective observational study done on 468 women who presented for abortion care in a tertiary care centre. Data were collected using a pre-structured questionnaire, counselled for contraceptive usage. The family planning method accepted was noted and followed up after one month. Data were analysed using descriptive statistics and expressed in the form of frequency and percentages. In the present study, the magnitude of acceptance of post-abortion contraception was 73.08%. Most women were in the age group 21-30 years (62.82%), the majority belonged to lower socioeconomic status (43.16%), 78.62% were homemakers. Age of the women, education status, and history of the previous usage of contraception showed a positive association with acceptance of post-abortion contraception. The most accepted method was tubectomy (24.35%) followed by barrier contraception (20.51%). During follow-up after 1 month, 69.24% were willing to continue the same method and 5.1% opted for a change in the contraceptive method. The common determinant factors for not opting for post-abortion contraception were due to religious belief, partner opposition, fear of side effects of contraceptive methods and willingness to concieve again shortly. The proportion of post-abortion family planning utilization is good but could be improved. Education before and especially at the time of abortion strongly influenced the usage of family planning services especially in rural areas where the accessibility is comparatively low. Family planning counseling during the time of abortion plays an important role in accepting post-abortion family planning services. At all levels of health care, family planning counseling and services should be provided to those who come for abortion to reduce maternal morbidity and mortality.

The study of vaginal wall thickness in adults based on histopathological measurements

To accurately measure the vaginal mucosa thickness across different age groups using histopathologic techniques and investigate the factors that may influence the thickness changes. This study aims to provide clinicians with objective evidence of variations in vaginal mucosal thickness, facilitating personalized medical decisions for patients. A retrospective analysis was conducted on clinical data from 348 patients who underwent local vaginal wall resection at the West China Second University Hospital, Sichuan University, from January 2021 and May 2022. The thickness of vaginal mucosa, epithelium and lamina propria was measured precisely under the microscope. And the 10th, 25th, 50th, 75th, and 90th percentile values of vaginal mucosa thickness across different age groups were counted and charted a dot-line plot. The percentile values for vaginal mucosa thickness exhibited a decreasing trend with increasing age; vaginal mucosa thickness showed significant correlations with times of delivery (P = 0.031) and age (P < 0.001), both of which were negatively associated. And vaginal mucosa thickness demonstrated no significant correlation with body mass index (BMI) (P = 0.325), times of abortions (P = 0.511), times of gestation (P = 0.101), menstrual cycle (P = 0.533), or types of delivery (P = 0.056); epithelial thickness showed significant associations with age (P < 0.001) and types of delivery (P = 0.017), both of which were negative correlations. Moreover, BMI (P = 0.429), times of abortions (P = 0.764), delivery (P = 0.079), gestation (P = 0.475), and menstrual cycle (P = 0.950) were nonassociated with epithelial thickness; lamina propria thickness displayed a significant correlation only with age (P = 0.002), and there were no obvious correlations observed between lamina propria thickness and BMI (P = 0.374), times of abortion (P = 0.417), delivery (P = 0.053), gestation (P = 0.101), types of delivery (P = 0.132) and menstrual cycle (P = 0.495). Moreover, when the age segmentation was thresholded at 35 and 50 years, both epithelial thickness and vaginal mucosa thickness were significantly correlated with age (P < 0.05). Lamina propria thickness was associated with age when the age threshold was set at 35 years (P = 0.007), whereas it showed no strong link with age when the age threshold was 50 years (P = 0.072). This study has innovatively established percentile reference values for vaginal mucosa thickness based on histopathology, furnishing clinicians with objective evidence of variations in vaginal mucosal thickness to facilitate personalized medical decisions for patients. The findings demonstrated a strong link between vaginal mucosa thickness and age, with epithelium likely playing a predominant role, while the association with lamina propria appeared to be less significant. Further research involving a larger sample size is warranted to elucidate the potential relationship with the lamina propria.

Long Acting Reversible Contraception After Surgical Abortion With High Rate of Continuation and Patients' Satisfaction.

In Italy the percentage of repeated abortions is about 24%. Long-acting reversible contraceptive (LARC) methods are currently considered the most effective mode worldwide and are associated with the highest rate of 12-months continuation, with a potential reported reduction of recurrent abortions. The aim of this study was evaluating LARC continuation and the patients' satisfaction at two and twelve months in use. A longitudinal observational study collected women who underwent surgical abortion and placed a LARC method at the time of abortion in our hospital. Totally 828 women underwent surgical abortion during the study period from which 434 choose a LARC method. After two months the rate of continuation of 52mg LNG IUD was 100% in women presenting for follow-up. Continuation rate at one year was approximately 70% for all LARC methods. More than 70% of women declared themselves satisfied or very satisfied with all LARC methods. Despite a high rate of patient loss at follow-up, LARC methods showed a high rate of continuation at two and twelve months, with a high degree of patients' satisfaction.

24-Hour Compared With 12-Hour Mifepristone-Misoprostol Interval for Second-Trimester Abortion: A Randomized Controlled Trial.

To compare 24-hour and 12-hour mifepristone-to-misoprostol intervals for second-trimester medication abortion. We conducted a prospective randomized controlled trial. Participants were allocated to receive mifepristone either 24 hours or 12 hours before misoprostol administration. The primary outcome was the time from the first misoprostol administration to abortion (induction time). Secondary outcomes included the time from mifepristone to abortion (total abortion time); fetal expulsion percentages at 12, 24, and 48 hours after the first misoprostol dose; side effects proportion; and pain and satisfaction scores. A sample size of 40 per group (N=80) was planned to compare the 24- and 12-hour regimens. Eighty patients were enrolled between July 2020 and June 2023, with 40 patients per group. Baseline characteristics were comparable between groups. Median induction time was 9.5 hours (95% CI, 10.3-17.8 hours) and 12.5 hours (95% CI, 13.5-20.2 hours) in the 24- and 12-hour interval arms, respectively ( P =.028). Median total abortion time was 33.0 hours (95% CI, 34.2-41.9 hours) and 24.5 hours (95% CI, 25.7-32.4 hours) in the 24- and 12-hour interval groups, respectively ( P <.001). At 12 hours from misoprostol administration, 25 patients (62.5%) in the 24-hour arm and 18 patients (45.0%) in the 12-hour arm completed abortion ( P =.178). At 24 hours from misoprostol administration, 36 patients (90.0%) in the 24-hour arm and 30 patients (75.0%) in the 12-hour arm had complete abortion ( P =.139). The need for additional medication or surgical treatment for uterine evacuation, pain scores, side effects, and satisfaction levels were not different between groups. A 24-hour mifepristone-to-misoprostol regimen for medication abortion in the second trimester provides a median 3-hour shorter induction time compared with the 12-hour interval. However, the median total abortion time was 8.5-hours longer in the 24-hour interval regimen. These findings can aid in shared decision making before medication abortion in the second trimester. ClinicalTrials.gov, NCT04160221.

Post abortion contraception: A follow up study in women undergoing first and second trimester abortion at a tertiary care centre

: Worldwide 75 million women need post abortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. Majority of them do not wish to conceive in near future and are receptive towards using contraception. Contraceptive counselling and basket of choices should be made available to all women undergoing abortion and her right to decline or postpone this care should be respected while recognizing that each woman has a unique unmet need of contraception.: To compare the acceptance and continuation of various contraceptive choices offered after first and second trimester abortion. : A retrospective study was conducted at a tertiary care hospital in which women who underwent first and second trimester abortion over a period of one year were interviewed regarding their acceptance and continuation of the contraceptive method till six months post abortion.: A total of 378 women underwent first and second trimester abortions over one year, of which 61.3% had resulted from failure of contraception. Women were grouped into Group A for those undergoing first trimester and Group B for women undergoing second trimester abortion for study purpose. Average age of women in group A was 28.9 years and in group B was 26.5 years. Mean period of gestation of pregnancy in group A was 7.5weeks and in group B was 19.5 weeks. In group A 96% parous women had conceived as a result of failure of contraception of which 90% were using natural method (Coitus Interruptus). Group B majority (76.3%) women were nulliparous and early parous (P1, P2) and indication for termination of pregnancy in them were gross congenital anamolies (GCA) in fetus while in rest of multiparous were due to failure of contraception. With group A 53.1% nulliparous women did not opt for any contraception whereas 48.6% primiparous and second parous opted for long acting reversible contraception(LARC) –Intrauterine contraceptive device(IUCD) in contrast to 66% multiparous opting for permanent sterilization at the time of abortion. In group B 45.3% nulliparous and early parous opted for depot medroxy progesterone acetate (DMPA) and 64.2% multigravidas underwent permanent sterilization. : Post abortion care must include counselling and choice of contraceptive basket. Women with future reproductive plans preferred LARC after first trimester abortion whereas DMPA was most acceptable method of contraception after second trimester abortion. Women were most satisfied with LARC and permanent methods compared to methods that required daily intake of pills. There is need of effective contraceptive choices according to the reproductive plans of the women to reduce the burden, morbidity and mortality associated with abortions.

Could the contraceptive counselling improve contraceptive choice after abortion? A multicentric study to evaluate patients’ perception

Introduction24 % of abortion in Italy are repeated procedure. The cause of repeated abortion can be traced back to the inadequacy of the contraceptive counseling during the previous admission or to the adoption of an ineffective contraception method.This study aims to evaluate the Italian situation on the perceived quality of contraceptive counselling by patients undergoing abortion. The second aim is to verify if the chosen methods were available for immediate start. Study designMulticentric, prospective, non-interventional, non-randomized, non-pharmacological clinical observational study. We analyzed anonymous questionnaires on contraceptive counseling and LARC (Long Acting Reversable Contraceptives) availability and SARC (Short Acting Reversable Contraceptives) prescription at hospital discharge, distributed to women who requested abortion. Results1074 participants on 15 hospitals through Italy. 82 % of the interviewees reported that they had received correct information regarding contraception. 74 % of the patients who chose LARC methods reported to have them inserted at the time of abortion. 73 % of women who had chosen a SARC method stated that they had received the prescription before discharge. After contraceptive counselling, we reported a significative reduction of “none or natural methods use” and a significant increase of SARC and LARC use compared to before the abortion. ConclusionContraceptive counselling could allow a better contraceptive choice in patient who required abortion and we hope that future strategies will implement LARC choice. We think that a greater availability of LARC at an affordable price at the time of abortion could improve LARC choice. In case of SARC choice, we have to implement the prescription at hospital discharged.

Вплив артифіційних абортів на стан репродуктивного здоров’я жінок фертильного віку. Результати когортного дослідження

Data on the negative impact of artificial abortions in the early stages on a woman's reproductive health are contradictory. Variables that may affect the results include study design, gestational age at the time of abortion, duration of follow-up, and procedure’s type. Aim - to analyze the impact of early artificial abortions on the reproductive womenʼs health. Materials and methods. A retrospective cohort study was conducted, which included 549 consecutively recruited women, of which: 119 respondents with a history of induced abortions made up the experimental group, 430 without artificial termination of pregnancy - the comparison group. An analysis of the gynecological and obstetrical anamnesis was carried out. Statistical data processing was carried out using the SPSS 21 program. Results. It was established that the presence of artificial abortions in the anamnesis is associated with an increase in the frequency of infertility, colpitis, cervix dysplasia, salpingo-oophoritis, uterus inflammatory diseases, habitual miscarriage, and also increase in the obstetric complications frequency (spontaneous miscarriages at an early stage, the threat of termination of pregnancy, premature births, abdominal surgical delivery, placental complications). Conclusions. Analysis of the artificial abortions consequences indicates the presence of various disorders in reproductive system of fertile women. This study did not involve any experiments on animals or humans. No conflict of interests was declared by the authors.

The Risk of Cervical Cancer in Women Among Han, Bai, Dai and Hani Ethnic Minorities in Yunnan Province of China.

Research on the risk factors for cervical cancer in Yunnan Province's four characteristic ethnic groups (Han, Bai, Dai, and Hani) is lacking. To study the risk factors of cervical cancer in four ethnic women in Yunnan Province, and to provide evidence for its prevention. The cervical cancer patients of Han, Bai, Dai and Hani ethnic groups in Yunnan Province who were first diagnosed in the Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center) from January 2011 to December 2020 were selected as the research objects. The 1:1 matched case-control study method was used, and single factor and conditional logistic regression were used for statistical analysis. HPV types 16, 18 and 58 are mostly related with cervical cancer, the younger the age of the last pregnancy, the more times of pregnancy, childbirth and abortion, especially the younger the first marriage age of Bai and Dai, are the risk factors of cervical cancer; the infection of genital tract bacteria, mycoplasma and chlamydia is closely related to the incidence of cervical cancer in four ethnicities. Multifactorial analysis showed that demographic characteristics and environment/behavior were not included in the influencing factors of cervical cancer; among Han, Bai, Dai and Hani ethnic minorities, contraception (OR=0.29, OR=0.03, OR=0.09, OR=0.16, P<0.05) was positive factor, HPV infection (OR=64.77, OR=128.71, OR=71.89, OR=40.07, P<0.01) was a causative factor of cervical cancer. Risk of high parity with cervical cancer could be due to a complex interplay of factors, it is very important to formulate prevention strategies and measures in line with the cervical cancer of Han, Bai, Dai and Hani ethnic groups women in Yunnan Province.

The Effect of Uterocervical Angle on Treatment Efficacy in First-Trimester Pregnancy Terminations

Aim: We aimed to evaluate the effectiveness and usability of the uterocervical angle, which we examined ultrasonographically before misoprostol treatment, which we used in first-trimester pregnancy terminations, and its relationship with the abortion time.&#x0D; Material and Method: This prospective study includes 207 pregnant women diagnosed with an ex-fetus in utero hospitalized for medical termination in a single center. These patients were divided into two groups patients whose treatment was completed in the first cycle and who needed additional cycles. The characteristics of all pregnant women, abortion times, and misoprostol doses used were compared with uterocervical angle and cervical length and analyzed between groups.&#x0D; Results: The mean age of the patients in the entire study group was 30.1±6.3, the median uterocervical angle was 112 degrees, and the cervical length was 36 mm. Increasing cesarean number and increasing uterocervical angle degree were positively correlated with increasing abortion time. The number of cesarean sections and the degree of uterocervical angle differ significantly between the group whose treatment was completed in the first cycle and the groups that needed additional cycles. In the treatment groups with elevated uterocervical angle degrees, the first cycle was higher than the successful group. Additional dose and cycle requirements arise if the uterocervical angle is &gt;110 degrees.&#x0D; Conclusion: Evaluation of the uterocervical angle in first-trimester medical terminations may guide the clinician in the early completion of treatment. With this evaluation before medical treatment, the duration of hospitalization can be shortened, and the need for surgical intervention for patients can be reduced.

Baseline Characteristics of Covid-19 Infected Spontaneous Abortion Cases

Background: The COVID-19 pandemic has raised concerns about the potential impact of SARS-CoV-2 infection on pregnancy outcomes. However, there is limited evidence regarding the association between COVID-19 and spontaneous abortion cases, particularly in Bangladesh. Methods: This retrospective observational study investigated the baseline characteristics of 48 cases of spontaneous abortion in pregnant women with laboratory-confirmed COVID-19 infection at Enam Medical College Hospital, Savar, Dhaka, Bangladesh between March and July 2020. Participants were included if they experienced fetal demise at 11 or more weeks of gestation, and potential confounding factors, such as fetal malformations or other obstetric disorders, were excluded. Data on demographic characteristics, gestational age, parity, gravidity, and COVID-19 severity were collected and analyzed. Results: The age distribution of participants ranged from 18 to 33 years, with 50% in the 26-30 year age group. A majority (58.33%) were obese, and 83.33% exhibited mild COVID-19 symptoms, while 16.67% were asymptomatic. Regarding gestational age at the time of spontaneous abortion, 50% were between 11-15 weeks, 41.67% were between 16-20 weeks, and 8.33% were between 21-25 weeks. All participants had at least one previous pregnancy, with 33.33% experiencing their second pregnancy, 41.67% their second pregnancy with a previous live birth, and 25% their third pregnancy with at least one previous live birth. Conclusions: This study provides insights into the baseline characteristics and maternal outcomes of COVID-19 infected spontaneous abortion cases in Bangladesh. The findings suggest that severe COVID-19 illness may not be a prerequisite for adverse pregnancy outcomes and highlight the need for further investigations into the potential mechanisms of intrauterine SARS-CoV-2 transmission and the role of placental factors. Larger-scale studies are warranted to better understand the impact of COVID-19 on pregnancy outcomes and develop appropriate management strategies.

Trust in provider and stigma during second-trimester abortion

ObjectiveTo determine whether trust in the provider and sociodemographics are associated with individual-level abortion stigma. MethodsWe performed a cross sectional and exploratory study design using secondary analysis of a randomized trial that enrolled participants undergoing second trimester abortion. We collected baseline survey data from 70 trial participants to assess stigma (Individual Level of Abortion Stigma scale, ILAS; range 0–4), trust in provider (Trust in Physician scale; range 1–5), anxiety, depression, and sociodemographics. We performed multiple linear regression, for which ILAS score was the outcome of interest. Univariate associations were used to inform the regression model. ResultsThe mean abortion stigma score was at the low end of the ILAS at 1.21 (range 0.2–2.8, SD 0.66). Age, race, income, BMI, parity, gestational age at time of abortion, and reasons for ending the pregnancy were not significantly associated with the ILAS score. Higher trust in provider scores were (m 4.0, SD 0.49) and inversely related to the ILAS score, even after adjustment for confounders (β −0.02, CI −0.03 to −0.004, p = 0.013). Screening positive for anxiety or depression was associated with a higher ILAS score ((β 0.48, CI 0.10, 0.90, p = 0.015); (β = 0.27 CI −0.097, 0.643)), while cohabitation was associated with lower ILAS score (β −0.44, CI −0.82 to −0.57, p = 0.025). ConclusionsTrust in an abortion provider, anxiety, depression, and cohabitation are associated with abortion stigma among people seeking second trimester abortion care. Interventions that improve trust in a provider may be an area of focus for addressing abortion stigma. Future research should confirm these findings in larger populations and across diverse locations and demographics and to conduct qualitative research to understand what patients perceive as trust-promoting behaviors and words during abortion encounters.

Intracardiac KCl Injection in Cesarean Scar Pregnancy: A Review Article

Embryo implantation in a previous caesarean scar (CS) resulting in a caesarean scar pregnancy (CSP) is another rare but potentially catastrophic complication of a previous caesarean birth. CSP can be detected between days 33 and 94 of pregnancy. Methotrexate and potassium chloride (KCl) are the most common feticidal agents used. intracardiac KCl causes feticide and reduces the uteroplacental blood flow, thereby decreasing the rate of hemorrhage due to placenta previa, caesarian scar pregnancy and in cases of fibroids; it is easy to evacuate the macerated fetus. Intracardiac KCl causes feticide and reduces the uteroplacental blood flow, thereby decreasing the rate of hemorrhage and abortion time before termination of pregnancy (TOP) leading to an easy evacuation of the macerated fetus. In conclusion, feticide with intracardiac KCl is a safe procedure.

Reproduction and Productivity in Dairy Cattle after Abortions Both Related and Unrelated to Coxiella burnetii.

C. burnetii is a widespread pathogen, causing abortions and reproductive disorders in ruminants. The study aimed to evaluate animal reproductive capacity and productivity after abortion, related and unrelated to C. burnetii. We compared data about the abortion time, the outcome of the animals after an abortion, further reproduction, and productivity for C. burnetii-positive (n = 148) and C. burnetii-negative (n = 149) aborted dairy cows and heifers. C. burnetii-positive animals had a positive serological response or presence of C. burnetii DNA at the time of abortion. C. burnetii-positive animals had a significantly higher number of lactations at the time of abortion. However, in the other indicators, we observed no significant differences between the groups. Comparing indicators of all the aborted animals, we found that if animals started a new lactation after abortion, they had a significantly lower milk yield, lower fat, protein, and somatic cell counts (SCCs) in milk during the standard lactation for both primiparous and multiparous cows compared to herd averages in each group. Lower SCCs can be due to animals with a high SCC being culled earlier. We found an economic disadvantage to aborting, not only because of the loss of offspring, but also because of the high culling rate and lower productivity in both primiparous and multiparous cows.