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PubMedDate not supplied

The impact of recent policy changes on fertility, abortion, and contraceptive use in Romania.

A national household survey of 4,861 women aged 15-44 on reproductive health issues was conducted in Romania in 1993. The survey provided the opportunity to study the impact of policy changes by comparing selected aspects of fertility, abortion, and contraceptive use before and after the December 1989 revolution, when the laws restricting abortion and contraceptive use were abolished. After abortion became legal, the total fertility rate dropped to below replacement level, while the induced abortion rate doubled. Contraceptive prevalence increased 20 percent, but augmentation of the use of traditional methods, rather than the change in legislation, accounted for 70 percent of the increase. Limited sex education and contraceptive information, mistrust and misinformation about modern methods, a lack of adequately trained providers, and a shortage or uneven distribution of contraceptive supplies are major reasons for the continued high rates of unintended pregnancy.

Abortion, Induced↗
PubMed2003

[Influence of paternal lymphocyte immunization on the selected subpopulations of peripheral blood lymphocytes in women with recurrent spontaneous abortions of unknown etiology].

UNLABELLED: The aim of the study was to evaluate the influence of alloimmunization on the composition of PBL subpopulations in women with recurrent spontaneous abortions (RSA) of unknown etiology. MATERIAL AND METHODS: 25 women with history of 3-6 consecutive RSA were selected for this study. Immunization with paternal lymphocytes, isolated from 100 ml of peripheral blood, was performed two times before conception (4-weeks interval). The following parameters were studied: (%) of peripheral T CD3+, T CD4+, T CD8+, T CD4+/CD45-RO+, T CD4+/CD29+, T CD8+/CD45-RO+, BCD19+ and NK CD16+/CD56+ lymphocytes; (%) of T CD3+ cells with markers of early (CD69+) and late activation (HLA-DR+) and presenting with IL-2 receptors (CD25+); the influence of alloimmunization on the expression of CD69+ receptors on cultured T CD3+ lymphocytes activated by PHA (CD3+/CD69+/FCS). RESULTS: The (%) of T CD3+ (61.0% vs. 68.6%), T CD4+ (37.4% vs. 45.3%) cells as well as T CD4+/T CD8+ ratio (1.3 vs. 1.0) significantly increased, whereas the (%) of T CD8+ (41.3% vs. 32.5%) and NK CD16+/CD56+ cells (23.9% vs. 16.2%) decreased after alloimmunization. The procedure didn't influence the (%) of T CD4+/CD45-RO+, T CD4+/CD29+, T CD8+/CD45-RO+ and BCD19+ lymphocytes. We observed significant increase of the (%) of T CD3+/CD69+ (4.4% vs. 7.3%) and T CD3+/CD25+ (5.8% vs. 10.9%) cells after immunotherapy. Moreover we observed the significant increase of the CD69+ expression on T CD3+ cells activated by PHA (CD3+/CD69+/FCS) (42.1 vs. 47.1%). CONCLUSIONS: Our study suggests that alloimmunization of women with RSA of unknown etiology results in increase of T lymphocytes' activity and a shift of the immune balance towards T helper and T supressor lymphocytes.

Abortion, Habitual↗
PubMed1998

Selection bias in a study on how women experienced induced abortion.

OBJECTIVE: One third of the women who had an induced abortion at the department of gynecology and obstetrics in Malmö 1989 refused to participate in an interview a year later to explore their experience and the care they had received. Using data from the mandatory preoperative visit it was then possible to compare participants with non-participants with regard to socio-demographic characteristics. reproductive history and stated reason for abortion. By continued follow-up of medical records it has furthermore been possible to ascertain how many women conceived within a year, and how many of them applied for another abortion and how many elected to continue the pregnancy to term. SETTING: Department of Obstetrics and Gynecology, Lund University, University Hospital, Malmö Sweden. This is the sole referral hospital serving the population of Malmö (approx. 230000). SUBJECTS: All 1285 women who underwent induced abortion at the department in 1989. + STUDY DESIGN: In each case information on socio-demographic characteristics, reproductive history and stated reasons for abortion was collected at the mandatory clinical visit prior to the abortion. This information was used for comparison of participants and non-participants in the planned 1-year follow-up interview. RESULTS: Young, unmarried women of low educational status and without full-time employment or studying were overrepresented in the non-participant group. The proportion of women with children was however smaller in that group. Within 12 months after the abortion, 118 women 66 (7.7%) of the participants in the follow-up interview and 52 (12%) of the non-participants conceived again but elected to continue the pregnancy to term (P<0.05). whereas 124 of the women 80 (9.5%) and 44 (10.2%) of the respective subgroups again applied for abortion within 12 months. CONCLUSION: One third of the women who underwent induced abortion did not wish to be interviewed about their emotional and somatic experience of the abortion 1 year later. Non-participation at the follow-up interview was associated with socio-demographic factors which in studies about other medical problems have been shown to be associated with increased vulnerability and morbidity. Non-participation was also associated with an increased childbirth rate during the following 2 years. The large proportion of non-participants is a matter for concern as to some extent it reflects inability of the health care system to establish trustful relationships with these women. How the participants in the follow-up study experienced this relationship will soon be published in our next paper. Support from the women's surroundings and the adviser the women met at the public health care system clearly influenced the women's psychological reactions after the abortion. It is therefore important to ascertain to what extent the management of abortion applicants in fact fulfils their individual needs and expectations.

Abortion, Induced↗
PubMedDate not supplied

ABH secretion and natural selection.

The secretor gene, which determines secretion of the ABH blood group antigens into saliva and other fluids, has widely varying frequencies in different healthy populations. Its frequency in patients suffering from certain diseases also differs from that in healthy persons. These observations suggest that frequencies of the gene are to some extent the results of natural selection. One means of selection is through haemolytic disease of the newborn. Women, mostly of group O, become immunized to the A or B antigen of a fetus, and this or subsequent fetuses are at risk from haemolytic disease of the newborn. Affected fetuses are preponderantly secretors; this is probably a genetic consequence of all or most immunizing fetuses being secretors. Selection against the secretor factor as well as against blood groups A and B is thus liable to occur. Similar processes of selection seem to operate through fetal loss by early abortion. It is suggested that counter-selection favouring secretors may result from certain epidemic infectious diseases.

ABO Blood-Group System↗
PubMed1999

Protein kinase C-epsilon is responsible for the protection of preconditioning in rabbit cardiomyocytes.

The role of protein kinase C (PKC) in the protection of ischemic preconditioning (PC) is still controversial, partly because of the multiple isozymes of PKC and the inability to directly measure PKC activity in vivo. In this study we have used novel peptide inhibitors which correspond to part of the amino acid sequence from the isozyme-specific RACK-binding site on the PKC molecule. The peptides prevent binding of a specific activated PKC isozyme to its RACK, thus halting isozyme translocation and function. The inhibitor peptides are cross-linked to the membrane-translocating antennapedia homeodomain peptide that allows their entry into cells. The effect of inhibitors of PKC-beta, -delta, -epsilon and -eta were evaluated. Rabbit adult ventricular myocytes were obtained by enzymatic dissociation. Ischemia was simulated by centrifuging the myocytes into an oxygen-free pellet for 180 min. PC was induced by 10 min of pelleting followed by resuspension in oxygenated medium for 15 min. During simulated ischemia cells undergo a predictable increase in osmotic fragility as judged by determination of the number of stained cells following their incubation in hypotonic (85 mOsm) trypan blue. The percentage of cells experiencing membrane rupture, and thus cell staining, was considered to be an index of ischemic injury. PC significantly delayed the progression of osmotic fragility during simulated ischemia (P<0.01). The protection of PC was abolished by the peptide inhibitor of PKC-epsilon but not by the peptide inhibitors selective for PKC-beta, PKC-delta, or PKC-eta; each was applied at 100 n N. Protection could also be induced by the PKC activator oleoylacetyl glycerol, and that protection was aborted by the inhibitor selective for PKC-epsilon, but not by the inhibitor for PKC-delta. None of the above peptide treatments affected the osmotic fragility in non-PC cells during simulated ischemia. Our studies further support PKC as a critical part of the signal transduction pathway in PC and indicate that PKC-epsilon alone is responsible for the early phase of PC's protection in rabbit cardiomyocytes.

Animals↗
PubMed1976

Abortion and family-binding models: fertility limitation in Hungary.

This paper demonstrates how family-building models can be used for checking the quality of abortion data. A family-building model, called FERMODA, is presented and used to check whether the available data on abortion for Hungary are consistent with Hungarian data on other aspects of family building. Model cohorts are generated, using in FERMODA the proportions of women married and the birth and abortion rates of two selected Hungarian cohorts. The estimates obtained from the simulated cohorts concerning use of contraception are compared with the information available on contraception, and, on the basis of this comparison, a judgment is made about the quality of abortion data for Hungary.

Abortion, Induced↗
PubMedDate not supplied

The outcome of pregnancies subsequent to induced and spontaneous abortion.

A study was made of 8982 women who were admitted for delivery over a four-year period to the University of Benin Teaching Hospital, Benin City, Nigeria. Of the 5682 women who had had more than one pregnancy, 14.5% admitted a history of one or more abortions (spontaneous or induced). Of the whole series, 8.8% admitted having had one or more induced abortions. Patients with prior abortions were compared with selected controls, and maternal characteristics were standardized between the two groups. Undesirable outcomes of subsequent pregnancy, such as low birth weight, premature delivery, stillbirth, neonatal death, miscarriage or congenital malformation, did not seem to increase in patients with histories of abortions.

Abortion, Induced↗
PubMedDate not supplied

[Clinical and immunologic results of immunotherapy with pooled buffy coat transfusions in females with habitual abortion].

In a multicenter study we have evaluated the effect of immunotherapy with pooled buffy coats on women with habitual abortions. 21 women were selected under the same criteria with respect to clinical, immunological and blood banking conditions. All women have had at least two miscarriages with the same partner and no living child (except one case). Additionally, all well-known reasons for abortions were excluded. The couples were tested for HLA-A, B and C antigens as well as for the presence of HLA-antibodies. The couples with recurrent spontaneous abortions suggested a significantly higher compatibility in two or more antigens in comparison to the control couples with children and without any abortion. Before treatment there was no case with cytotoxic HLA antibodies. 10 women received each two pooled buffy coats intravenously before pregnancy at time intervals of 3 weeks. 15 women were treated in early pregnancy until the 28th week of gestation at the same application intervals. In the meantime 10 of 15 women have delivered at term a healthy and mature child with normal weight. Four of 15 are still pregnant in the third trimester of pregnancy. In one case the pregnancy resulted in an abortion. The buffy coat transfusions were well tolerated and led in no case to the formation of antierythrocytic antibodies. 12 of 21 women treated developed HLA antibodies at various time intervals during immunotherapy, mainly with a low titre. In 7 of 10 cases the antibodies occurred in the treatment period before pregnancy, in 5 of 15 cases during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗
PubMed1976

Depressed mixed lymphocyte culture reactivity in mothers with recurrent spontaneous abortion.

One-way mixed wife-husband lymphocyte culture (MLC) reaction as well as human lymphocyte antigen (HLA) typing were performed on 29 couples, most of whom were infertile because of recurrent spontaneous abortion, and compared with 35 fertile couples with no abortion history. The 29 couples had been selected from 280 couples with a karyotyped spontaneous abortion. A significantly depressed MLD response (P=0.04) was observed in mothers of karyotypically normal abortuses when stimulated by the fathers but not when they were stimulated by males from the fertile couples. No significant difference in the frequency of HLA-A-and HLA-B-incompatible matings, respectively, was found between the abortion and the fertile couples. It is concluded that depressed maternal cellular response to paternal stimulation can be explained as a consequence of recurrent spontaneous abortion and that it is uncertain whether this depressed response plays a role in the etiology of recurrent abortion.

Abortion, Habitual↗
PubMed1989

Uterine unification procedures: post-operative obstetrical outcome.

Seventeen patients with different uterine anomalies underwent unification procedures for various indications. Preoperative obstetrical performance segregated them into three main groups: seven patients had only first trimester abortion (group A), seven patients had second trimester abortion with or without first trimester abortion (group B) and three patients were infertile (group C). Postoperatively, all seven patients in group A became pregnant with 100% viable pregnancy rate. Six patients in group B became pregnant (85.7%) and five (57%) had living children. All three patients with primary infertility (group C) became pregnant and two had living babies. The overall pregnancy rate was 94.1% and the viable pregnancy rate was 76.5%. Uterine unification procedures are recommended for patients with repeated first trimester abortions as well as for selected patients with infertility.

Abortion, Spontaneous↗