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[Pathology of developmental defects of the digestive system in human embryos].

Total incidence of the alimentary system defects was 1.05 +/- 0.12% in the non-selected material of medical abortions performed at 5-12 weeks of the intrauterine development. Atresia and stenosis of the duodenum are described for the first time in the embryos of the above age, the possibility of differential diagnosis between physiological and pathological atresia is established. The connection between the ducts of the ring-like head of pancreas and ductus choledochus is observed thus confirming the hypothesis of the additional pancreatic part developing from the ventral anlage. Diagnosis of Mekkel's diverticulum became possible beginning from stage 17. The existence of atresia, stenosis and gastro-intestinal tract doubling in the embryos of the above age indicate that at least some of these defects are not connected with a secondary damage of the intestinal tube due to circulation disturbances, recanalization or inflammation but represent a primary developmental anomaly arising in the early ontogenesis.

Digestive System↗

Ovarian torsion: diagnosis by color Doppler ultrasonography.

BACKGROUND: Ovarian torsion, although a rare gynecologic emergency, is a threat to women of all ages. Traditionally, ultrasonography and laparoscopy facilitated early diagnosis and treatment of this condition. This case report highlights the usefulness of color Doppler ultrasonography in the diagnosis of ovarian torsion. CASE: A 25-year-old patient who conceived after ovulation induction was treated conservatively for mild ovarian hyperstimulation and threatened abortion. She subsequently underwent selective first-trimester multifetal reduction and was admitted and treated for suspected pelvic infection. On the 17th post-procedure morning, ovarian torsion was diagnosed using color Doppler ultrasonography. CONCLUSION: Because gynecologists face serious management dilemmas when confronted with ovarian torsion, this technique of using color Doppler ultrasonography should provide a highly specific finding in complete ovarian torsion, aiding the clinician in prompt diagnosis and treatment.

Adult↗

[Current characteristics associated with a history of induced abortion].

For the purpose of analysing the association between selected current socio-demographic characteristics and the history of induced abortion, 138 students of a Brazilian university, who had been pregnant at least once, were studied. These students were identified from among the 937 who returned, by mail, a self-administered, anonymous questionnaire distributed to all the female undergraduates. The subjects were divided into two groups, those who had and those who did not have a history of induced abortion. It was found that the largest percentage of women who had already had an induced abortion were of less than 24 years of age, were not living in marital union, had no religious affiliation and no living children at the time of the study. Analysis by logistic regression showed that having no living children was the only current characteristic associated with having had an induced abortion.

Abortion, Induced↗

Massive invasion of fetal lymphocytes into the mother's blood at induced abortion.

The proband, a healthy primipara, selected for study after she had asserted that she had not previously been pregnant, gave birth to a healthy girl with the karyotype 46,XX. In the 21st week of gestation, leukoagglutinin-stimulated mitoses from the proband's blood were 99% 46,XX and 1% 46,XY, the Y chromosome being identified by its quinacrine fluorescence. In two samples taken later in pregnancy no XY mitoses were found in the cultures, but on all three occasions brightly fluorescent Y chromatin in a proportion of the uncultured lymphocyte nuclei showed teh presence of XY cells in the proband's blood. High titers of cytotoxic anti-HL-A 3 were detected in the maternal serum before and after delivery. Our tentative interpretation is that the XY cells in the proband's blood emanated from a previous fetus that was legally aborted by curettage on the 10th week of an uneventful pregnancy and which the patient admitted to only after repeated questioning.

Abortion, Induced↗

Abortion requests among adolescents in comparison with young adults in a Swiss region (1990-1998).

AIM: To examine the recent evolution of abortion request rates among adolescents and young adults in the Canton of Vaud (Switzerland) and to describe the circumstances of the abortion requests and sociodemographic characteristics by age subgroups and nationality. METHOD: Data for women aged 14 to 24 y living in Vaud were selected from the 12,358 abortion requests from residents aged 14-49 y between 1990 and 1998. RESULTS: Overall, abortion request rates by age were stable over the study period. However, rates for non-Swiss women were two to three times higher than those for Swiss women, at 4.5 [95% confidence interval [CI]: 3.8-5.2] vs 2.4 [95% CI: 2.1-2.7] per 1000 adolescents below the age of 18, 18.1 [95% CI: 17.2-18.9] vs 8.0 [95% CI: 7.1-8.8] per 1000 women aged 18-19 and 30.5 [95% CI: 29.1-32.0] vs 10.2 [95% CI: 9.6-10.8] per 1000 women aged 20-24. The ratio of abortions to live births was greatest for women under 20 y of age. at 1.9, in comparison with the ratio observed among adult women aged 20-24 (at 0.4). The abortion rate per 1000 conceptions >6 wk remained stable; this rate was 590 per 1000 among 14-19-y-olds in 1997. CONCLUSION: The abortion request rate among youths in this Swiss region has not increased between 1990 and 1998. Efforts must be intensified to ensure universal access to family planning services and contraception, especially for young foreign women and adolescents.

Abortion Applicants↗

Immunotherapy for recurrent spontaneous abortions in a Chinese population.

The efficacy of immunotherapy for the treatment of recurrent spontaneous abortions was tested in patients selected from the same ethnically homogeneous population of Chinese in Taiwan in whom the immunogenetics of gestational trophoblastic tumors and of recurrent spontaneous abortion had been studied. The patients, who included both primary and secondary aborters, were randomly assigned to three groups: those who were immunized with their own lymphocytes (controls) (49); those who were immunized with their husbands' lymphocytes (39); and those who were immunized with third party lymphocytes (11). The data were analyzed individually for the primary and secondary aborters and collectively for both groups combined. The number of babies born, the number of current pregnancies, and the number of recurrent abortions were not statistically significantly different between the control and the immunized groups, and a similar small number of congenital abnormalities (4-9%) occurred in both the control and immunized groups. The increase in the blocking effect for the mixed lymphocyte reaction was not related to the success of the postimmunization pregnancies. Thus, this study does not show any significant improvement in the rate of livebirths in women immunized with their husbands' lymphocytes or with third party lymphocytes compared to that in a placebo-controlled group of women.

Abortion, Habitual↗

[Abortion in Korea since 1945].

Since prehistorical era, the human has desired to control reproduction artificially. However, abortion, one of the productive methods has been prohibited to a certain degree by law in some countries, but the operation of abortion has been done in practice. Also, controversial arguments on legitimacy of abortion have been raised. In Korea, physicians operates abortions more than 2 million times each year. In spite of serious social problems, arguments on abortion have not been common yet. The efforts to find a good solution for abortion have not been very sufficient. Therefore, this study is to investigate the concerns for the conditions of abortion since 1945 (this year is the independent one from Japan's government) through a historical perspective and to suggest the efficient direction in policy. Since 1945, many women have had no choice but abortion for their basic life. The Korean government of legislated the Crimes of Abortion in Criminal Law in 1953. However, the number of women who underwent abortion increased since 1962 due to the governmental Family Planning Policy. In addition, the Mother and Fatherless Child Health Act was enacted in 1973 that tolerated abortion to some extent. The disparate treatment of abortion between Criminal Lam and the governmental policy fueled the confusion to potentially pregnant women. The first reason why Korean women choose abortion is wrongful pregnancy. Compared to other counties, in Korea, abortion were operated for sex selection. To conclude, it is important to be implement positive sex education, proper contraception education by government and social publicization of arguments on abortion.

Abortion, Induced↗

Ethical issues in obstetrics.

Ethical issues in modern obstetrics commonly relate to a conflict between the rights and possibilities of the fetus versus those of the mother. After delivery, when the fetus by definition is a child, all legal rights are granted to this new individual. Whether any rights should be given or offered to the fetus is dependent on the prevailing situation. General rules are difficult to give due to the rapid evolution of clinical medicine-too firm rules given today could well be an obstacle in the near future. All cultures have well-established opinions regarding issues related to pregnancy and childbirth. Cultural and religious dogmas are often in conflict with modern medical technology and financial issues. In several modern societies, state laws regulate legal abortion and other aspects of termination of pregnancy. Current laws often determine not only decisions but also the minds of doctors, as well as of patients. Advanced medical technology has yielded a possibility of selective feticide. Again our experience with this new technique is limited, and several issues of ethical importance may arise from the use of such techniques. The indications for a selective feticide are dependent upon the benefits and risks of the procedure itself, and also on the selection process of what fetus should be aborted. Clearly, no definitive rules could be given at this stage of development. The advice given to the woman by her doctor is of critical importance for the outcome of the given pregnancy, be it selective feticide or legal abortion. However, the prevailing social welfare system and the support a woman could be given by her society are also factors. Should she give birth to a child with an inborn error of metabolism, or some other chronic illness? Drug abuse, including alcohol and, indeed, also tobacco, constitutes a special problem. In Sweden, drug-addicted pregnant women are hospitalized during their last trimester. This policy results in a drug-free last trimester and a reduction of afflicted newborns. Should a similar approach also be enforced when dealing with abuse of alcohol and tobacco during pregnancy? The improvement of in vitro fertilization techniques has introduced a novel concept, the surrogate mother. In some countries, this is forbidden by law, in others, it is an accepted medical practice, but several medico-legal as well as ethical issues warrant further clarification. What are the legal rights of the surrogate mother? Should there be an age limit for surrogate mothers? Who is responsible for problems in the pregnancy itself? In cases of male infertility, ethical issues may arise. Should the child have a legal right to learn the name of the biological father? Should there be a limit for the use of donor sperm in respect to number of fertility attempts, as well as potential female patients who may use the same sperm donor?

Abortion, Induced↗

Why sex selection should be legal.

Reliable medically assisted sex selection which does not involve abortion or infanticide has recently become available, and has been used for non-medical reasons. This raises questions about the morality of sex selection for non-medical reasons. But reasonable people continue to disagree about the answers to these questions. So another set of questions is about what the law should be on medically assisted sex selection for non-medical reasons in the face of reasonable disagreement about the morality of sex selection. This paper sketches a way of thinking about what the law should be, and concludes, contrary to what the law is in many places, that medically assisted sex selection for non-medical reasons ought to be legal.

Bioethics↗

Association between Coxiella burnetii seropositivity and abortion in dairy cattle of Northern Italy.

Coxiella burnetii, the agent of Q fever in humans, has been associated with abortion in cattle. In this study 650 sera from cattle with abortion and 600 randomly-selected control sera were examined for antibodies to C. burnetii by ELISA. Two hundred and ninety-two (44.9%) out of 650 animals which experienced abortion were seropositive versus 132 (22%) out of 600 of the control group. A statistically significant difference resulted from the comparison of the seroprevalence of aborted cattle with that of controls (p < 0.001). Moreover, a significant higher prevalence was disclosed in cattle which aborted during late gestation (p < 0.002) and in the autumn (p < 0.001).

Abortion, Veterinary↗

Peripheral prostaglandin metabolite levels in women undergoing therapeutic abortions in the first trimester with and without treatment with prostaglandin synthetase inhibitor.

The levels of 11-deoxy-13,14-dihydro-15-keto-11 beta, 16 xi-cyclo prostaglandin E2 (bicyclo PGEM), 13,14-dihydro-15 keto-prostaglandin F2 alpha (PGFM) and prolactin were measured in four serial plasma samples collected from thirty women undergoing therapeutic abortions in the first trimester by a suction curettage procedure. Eleven of these women received a preoperative loading dose of sodium meclofenamate, a PG synthetase inhibitor, before the abortion procedure was started and the rest received this medication after the last blood samples were drawn. Prolactin levels increased significantly during the procedure. Sodium meclofenamate treatment had no effect on this increase. Bicyclo PGEM levels did not increase during the procedure in untreated or treated women, whereas PGFM levels increased but only in untreated women. The lack of increase in treated women apparently was not a treatment effect because PGFM levels in corresponding samples of untreated and treated women were similar. Treatment significantly reduced the bicyclo PGEM levels immediately after completion of the procedure as compared to untreated women. This differential PG response to treatment is unprecedented and may be due to sodium meclofenamate inhibition of PGE2 and not PGF2 alpha synthesis. Nevertheless, these data demonstrate that sodium meclofenamate treatment of patients undergoing first trimester therapeutic abortion to relieve pain involves selective suppression of PGE2 synthesis.

Abortion, Therapeutic↗

Nature of abortive transformation in Saccharomyces cerevisiae.

Disruption mutagenesis by homologous recombination in Saccharomyces cerevisiae is carried out by transforming-DNA fragments containing the target gene disrupted by a selectable marker. A large number of transient (abortive) transformants are often formed that may hinder the isolation of integrants containing the gene disruption. We show that abortive transformants result from re-circularization of the linear transforming-DNA in vivo. Their number was greatly reduced when the cut DNA could not readily re-ligate, either by digestions that gave non-compatible or blunt ends, or by de-phosphorylation. In addition, true integrants could be readily distinguished from abortive transformants through replica plating onto selective media. Enhanced disruption-mutagenesis was also observed when non-compatible ends were generated in an ARS-containing insertion vector.

Aldose-Ketose Isomerases↗

The effect of prenatal care on birthweight: a full-information maximum likelihood approach.

This paper uses a full-information maximum likelihood estimation procedure, the Discrete Factor Method, to estimate the relationship between birthweight and prenatal care. This technique controls for the potential biases surrounding both the sample selection of the pregnancy-resolution decision and the endogeneity of prenatal care. In addition, we use the actual number of prenatal care visits; other studies have normally measured prenatal care as the month care is initiated. We estimate a birthweight production function using 1993 data from the US state of Texas. The results underscore the importance of correcting for estimation problems. Specifically, a model that does not control for sample selection and endogeneity overestimates the benefit of an additional visit for women who have relatively few visits. This overestimation may indicate 'positive fetal selection,' i.e., women who did not abort may have healthier babies. Also, a model that does not control for self-selection and endogenity predicts that past 17 visits, an additional visit leads to lower birthweight, while a model that corrects for these estimation problems predicts a positive effect for additional visits. This result shows the effect of mothers with less healthy fetuses making more prenatal care visits, known as 'adverse selection' in prenatal care.

Birth Weight↗

Healthy worker effect and pregnancy: role of adverse obstetric history and social characteristics.

Data from a survey conducted in 1981 on a national sample of 5508 births in France were used to analyse the role of a history of previous adverse pregnancy outcome (spontaneous abortion, perinatal death or adverse fetal condition) in the selection mechanisms of women with regard to occupational activity, and the impact on the relation between work and preterm delivery. The study, carried out separately in each parity group, showed that occupational activity was associated with a more favourable outcome for women of parity one: the preterm delivery rate was significantly higher among women who had never worked than among those who continued working during pregnancy. However, the hypothesis of a "healthy worker effect" linked to a history of adverse obstetric outcome was not confirmed in this study. A selection effect of women from a history of spontaneous abortions was observed, but these were not linked to preterm delivery. Among multiparous women, a history of perinatal death or adverse fetal condition did not seem to modify women's behaviour towards their work. Selection mechanisms of women towards occupational activity according to sociodemographic factors were also analysed and showed that the higher percentage of younger women among those who had never worked explained the higher rate of preterm delivery in that group.

Age Factors↗

Contraceptive usage among abortion seekers in Nigeria.

A study on contraceptive usage among abortion seekers in 150 randomly selected health institutions in the most and the least urbanized states of the health zone B representing the South Western states of Nigeria was conducted over a period of 2 months. There were 1839 abortion seekers during the period. About 30.4% (559) of the respondents admitted to ever used any form of contraceptive methods. Most of the respondents who admitted to ever used any form of contraceptives i.e. 81.2% (454/559) were not using the contraceptive methods regularly and this cut across all the methods. Oral contraceptive pill was the commonest method used, though not on regular basis. The most frequent reason for not ever used contraceptive methods was ignorance. There is a need for intensification of strategies for promotion of use of family planning methods, which can be achieved through good counselling, sexuality education, and availability of cheap, and affordable contraceptive methods and services.

Abortion Applicants↗

[Abortion induced by prostaglandin F 2 alpha in risk patients].

For 245 cases of risk the intermittend extraamnial Prostaglandin F 2 alpha application was used for medicamentous dilatation of the cervix when carrying out the legal abortion in the I. trimenon. The low morbidity rate of 3% in cases of legal abortion as well as the preventive method of dilatation are able to prevent disturbances of fertility. Especially for all the young primigravidae we hope for a diminution of the cervix insufficiencies in the following desired gravidity.--In contrast to this, the danger of bacterial contamination as well as the burden onto the cervix' holding and supporting function up to the complete abortion are much higher with Prostaglandininductions.--The low doses of 3 mg Prostaglandin F 2 alpha for medicamentous dilatation of the cervix and economical advantages let this method be recommended as a method of selection for cases of legal abortion with risk.

Abortion, Induced↗