Robertsonian translocations in man: evidence for prezygotic selection.
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Abortion, Spontaneous↗
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Human cytomegalovirus infection and abortion: an immunohistochemical study.
BACKGROUND: Cytomegalovirus (HCMV) has been described in abortion tissues, but seldom associated with inclusion bodies. However, the possible pathogenic role of this virus in abortion is under discussion. We attempted to verify the relationship between HCMV antigens in tissues from first trimester abortions presenting with inflammatory lesions. MATERIAL/METHODS: Sixteen cases of first trimester abortions with inflammatory lesions were selected from 340 cases studied at the Pathology Unit of the University Hospital in Vit ria, Esp rito Santo State, Brazil. Paraffin-embedded sections were subjected to indirect immunofluorescence (IFI) and immunoperoxidase (PAP), using monoclonal antibodies directed against immediate early (IEA) and late antigens (LA) of HCMV. RESULTS: Twelve out of sixteen cases (75%) presented at least one HCMV antigen. Eight cases presented both antigens, three cases only the IEA and one case only the LA. These antigens were present in decidual cells, in stromal cells of chorionic villi and in trophoblastic cells. CONCLUSIONS: The results showed high frequency of HCMV antigens in tissues from first trimester abortion. This frequency, higher than that previously reported, was probably due to the fact that necro-inflammatory lesions were always present in selected cases. The presence of LA in trophoblastic cells is evidence for cell permissiveness to viral replication in vivo. The results showing high presence of HCMV antigens in tissues from abortion with inflammatory lesions suggest a possible relationship of HCMV infection with inflammation and pregnancy loss.
Abortion, Spontaneous↗
The relation between induced abortion and ectopic pregnancy.
OBJECTIVE: To determine whether having had one or more induced abortions increases a woman's risk of having an ectopic pregnancy. METHODS: We conducted a case-control study of all women admitted to a major metropolitan hospital in Georgia with a surgical diagnosis of ectopic pregnancy during the period of October 1988 to August 1990. Controls were randomly selected from women seeking an induced abortion or delivering an infant at the same hospital. After exclusions, this analysis included 182 cases and 1056 controls. Stratified analysis and unconditional logistic regression were used to control for confounding and to estimate the relative risks. RESULTS: Approximately 90% of cases and controls were non-Hispanic, black women; 34% of the cases and 36% of the controls reported a history of induced abortion. The crude odds ratio for having an ectopic pregnancy associated with a history of induced abortion was 0.9 (95% confidence interval 0.6, 1.3). The odds ratio remained the same after adjusting for selected confounding variables and stratifying by the number of induced abortions, gestational age at the time of abortion, place where the abortion was performed, and the woman's report of medical complications of the abortion. CONCLUSION: We found no evidence that having one or more induced abortions increases a woman's risk of having an ectopic pregnancy.
Abortion, Induced↗
Attitudes toward abortion among parents of children with cystic fibrosis.
BACKGROUND: DNA prenatal diagnosis for cystic fibrosis (CF) has been available for parents of affected children since late 1985. METHODS: Using anonymous questionnaires, we surveyed 395 parents of children with CF at 12 New England CF centers with regard to 12 maternal or family situations and 11 fetal characteristics; 271 (68%) responded. RESULTS: The majority supported legal abortion in the first trimester for all 23 situations; 58% would abort for severe mental retardation (MR), 40% would abort for a genetic disorder leading to death before age five years, 41% for a child bedridden for life, 35% for moderate MR, 20% for CF and 17% for a severe incurable disorder starting at age 40 years. Few would abort for a disorder starting at age 60 years, for genetic susceptibility to alcoholism or for sex selection. Variables most strongly related to abortion for CF were attitudes of spouse, respondent's siblings, and CF doctor toward abortion for CF as well as infrequent attendance at religious services. CONCLUSIONS: Prenatal diagnosis may not reduce substantially the number of CF births to parents of CF children because most do not accept abortion for CF.
Abortion, Eugenic↗
Illegal abortion: an attempt to assess its cost to the health services and its incidence in the community.
This article describes a study designed to test a method for assessing the cost to the health services of illegally induced abortion and the feasibility of estimating the incidence of induced abortion by a field interviewing approach. The participating centers included three hospitals in Ankara, Turkey; three hospitals in Ibadan, Nigeria; one hospital in Caracas and one in Valencia, Venezuela; and two hospitals in Kuala Lumpur, Malaysia. Hospitalized abortion cases were classified as induced or spontaneous or as "probably induced," "possibly induced," or "unknown" according to a classification scheme comprising certain medical criteria. The sociodemographic characteristics of induced and spontaneous abortion cases were subjected to discriminant function analysis and the discriminating variables best characterizing the induced versus the spontaneous abortion groups were identified for each center. On the basis of this analysis, the "probably" and "possibly" induced and "unknown" categories were further classified as induced or spontaneous abortion, with stated probabilities. Thus an overall estimate is made of the proportion of all hospitalized abortions that can be considered illegally induced outside the hospital. Selected results on costs of induced and spontaneous abortion are shown. The method further tested the feasibility of obtaining valid survey data on abortion from the communities studied by re-interviewing the women hospitalized for induced and spontaneous abortion six months later in their homes. This exercise showed a degree of under-reporting of abortion that varied widely among centers, even among women who had admitted illegal induction at the time of hospitalization. The feasibility of estimating the incidence of illegal abortion by field studies is discussed in the light of these findings.
Abortion, Illegal↗
[Effect of nitrendipine on isolated uterus and other smooth muscles of the rat].
Increasing concentrations of nitrendipine were found to inhibit various types of muscular activation (electrical stimulation, acetylcholine, oxytocin, potassium chloride), as well as the spontaneous rhythmic activity of the isolated rat uterus. The degree of the inhibitory effect of nitrendipine depends on the type of activation. Nitrendipine showed an exceptionally high efficacy in inhibiting contractions induced by electrical stimulation and of spontaneous rhythmic activity. For inhibition of these contractions even osmolar concentrations of nitrendipine were sufficient. The relaxant effect of nitrendipine depended on the concentration of extracellular calcium and the time of incubation of nitrendipine in the bathing medium. Nitrendipine showed high selectivity for the uterine smooth muscle because in a very high concentrations is exerted an insignificant relaxation of the other isolated smooth muscles (oesophagus, urinary bladder). Our experiments indicate that nitrendipine might have a role in therapy of premature delivery and abortion because of its great selectivity for the uterine smooth muscle. Addition of calcium into the medium restores completely all types of muscular activation after the inhibitory action of nitrendipine except its depressive action on the phasic component of oxytocin-induced contractions. These findings that individual types of activation, after inhibitory action of nitrendipine, are reestablished in various degrees by the addition of calcium into the medium, are also an additional confirmation about the existence of various types of calcium channels.
Acetylcholine↗
Quadruplet in vitro fertilization pregnancy complicated by fetal reduction and leiomyoma.
A woman had a quadruplet IVF pregnancy with a leiomyomatous uterus. Pregnancy resulted in the birth of one baby after missed abortion of one fetus and selective reduction of two others. The woman had a left deep calf vein thrombosis in the first half of pregnancy.
Abortion, Missed↗
An epidemiological study of work with video screens and pregnancy outcome: I. A registry study.
Three cohorts of women were identified with the aid of occupational codes in the census, linked to the Medical Birth Registry and an Inpatient Registry, containing information on women hospitalized for spontaneous abortion. The three cohorts were selected from the same socioeconomic stratum but had different probabilities to be exposed for video screen work: high, medium, and low. The total pregnancy outcome of the three groups of women did not differ significantly, but there was a weak trend for more spontaneous abortions and perhaps also for congenital malformations in the group with the highest video screen work exposure; however, the differences could be random. Comparisons of delivery outcomes for these cohorts in 1976-77 with those in 1980-81 did not show any consistent pattern in spite of the heavy computerization of these workplaces which occurred between the two time periods. The second part of this report studies the material in further detail.
Abortion, Spontaneous↗
Liberty, equality, and genetic selection.
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Abortion, Induced↗
Some letters on Jewish Medical Ethics.
Specializing in Jewish Medical Ethics--a term, I believe, first used as the title of my doctor's thesis (1955) subsequently condensed and revised in book form (1959)--I frequently receive inquiries from individuals and organizations seeking guidance on the Jewish attitude to moral issues in medicine. After a review of my voluminous correspondence on many phases of this subject, I have made a small selection on a variety of topics. The correspondence on the last of the four topics, 'Medical Experimentation on Animals', is the longest, because it contains an element of polemics. Since this might make it of special interest to the Journal's readers, and since this subject is infrequently discussed in the literature of Medical Ethics, I decided to include it in this brief selection.
Abortion, Induced↗
[Epidemiology of induced abortion and contraception].
This article describes prevalence and distribution patterns of induced abortion and contraception in various regions of the USSR. Selective studies have elucidated a spectrum of factors of abortion and contraception prevalence, their roles in birth control and priorities in implementation of updated methods of induced abortion prevention.
Abortion, Induced↗
Minnesota court overturns ban on Medicaid coverage for abortion.
Hennipin County District Court Judge William Posten issued a decision on June 16 striking down Minnesota's near ban on abortion coverage for low-income women. Ruling in Women of the State of Minnesota vs. Haas-Steffen, Judge Posten found that the state Constitution's rights of privacy and equality are more protective of women's reproductive choices than the corresponding federal rights. Holding that "the state's selective funding of childbirth over abortion impinges on an indigent woman's fundamental right to decide for herself whether to continue or terminate her pregnancy," the state district court permanently enjoined enforcement of the measure. Minnesota must now cover all medically necessary abortions for women receiving Medicaid. For more than 15 years, the statutes and regulations invalidated by Judge Posten have limited abortion coverage to cases of life endangerment or reported rape or incest. State officials have indicated that they will seek a stay and expedited review of Judge Posten's decision from the Minnesota Supreme Court. Filed on March 8, 1993, the Minnesota case is one of 5 such lawsuits brought by CRLP. Last December, in a similar case, the West Virginia Supreme Court struck down that state's ban on Medicaid coverage for abortions. Similar CRLP cases are still pending in Florida, Texas, and Montana. Plaintiffs--a class of Minnesota Medicaid-eligible women seeking abortions, Dr. Jane Hodgson, Pro-Choice Resources, Women's Health Center, Midwest Health Center for Women, and Meadowbrook Women's Clinic, on behalf of themselves and the women they serve--are represented by CRLP's Simon Heller, Janet Benshoof, and Lenora Lapidus, along with Minnesota attorney Linda Ojala.
Abortion, Induced↗
An association exists between bovine herpesvirus-4 seropositivity and abortion in cows.
The prevalence of cattle seropositive to bovine herpesvirus-4 (BHV-4) is high in Belgium. In Belgian farms, clinical signs associated with BHV-4 infection essentially involve the genital tract and consist mainly of postpartum metritis or metroperitonitis. The role of BHV-4 in abortion has not been definitively demonstrated but epidemiological and experimental facts suggest its involvement. A seroepidemiological investigation was therefore conducted as a case-control study to compare the seroprevalences of BHV-4 infections in the aborted-cow population and in a randomly selected control group in the province of Liège (Belgium). The seroprevalence (17.2%) in aborted cows was significantly higher than that of the control group (10.0%). The odds ratio (OR) was 1.87 (1.06 < 3.30). BHV-4 infection is therefore considered as a risk factor for abortion in cows.
Abortion, Veterinary↗
Effect of nicardipine on the isolated uterus and other smooth muscles of the rat.
Increasing concentrations of nicardipine were found to inhibit various types of muscular activation (electrical stimulation, acetylcholine, oxytocin, potassium chloride), as well as the spontaneous rhythmic activity of the isolated rat uterus. The degree of the inhibitory effect of nicardipine depends on the type of activation. Nicardipine showed an exceptionally high efficacy in inhibiting contractions induced by electrical stimulation and of spontaneous rhythmic activity. For inhibition of these contractions, even femtomolar concentrations of nicardipine were sufficient. The relaxant effect of nicardipine depends on the concentration of extracellular calcium and the temperature of the medium. Nicardipine shows high selectivity for the uterine smooth muscle because even in very high concentrations it exerts an insignificant relaxation of the other isolated smooth muscles (oesophagus, bladder, colon descendens) as well as of the isolated intercostal muscle of the rat. Our experiments indicate that nicardipine might have a role in the therapy of premature delivery and abortion because of its great selectivity for the uterine smooth muscle. Nicardipine causes a stronger inhibition of the tonic than of the phasic component of contraction induced by potassium chloride and oxytocin. These findings suggest that potassium chloride and oxytocin act through various populations of calcium channels.
Animals↗
[Coping behavior in women with miscarriage or spontaneous abortion and recurrent spontaneous abortion].
In a pilot study about medical, psychological and psychosocial factors in spontaneous and recurrent spontaneous abortions, coping strategies of 83 women were investigated and compared with a control group (n = 69). Two further subgroups were selected (31 women with recurrent spontaneous abortions and 30 without pregnancy complications). A modified form of a stress-investigation-scale (SVF from Janke et al.) was used. The results indicated that women with spontaneous abortions had increased depressive and lowered positive and cognitive coping modes. According to the hypothesis most psychological disturbances and depressive coping strategies were found in recurrent spontaneous abortions. In pregnancy depressive withdrawal, need of social support and information seeking was further increased, but emotional self-control lowered. A connection between psychological disturbances and negative coping strategies was shown. After pregnancy loss psychological support and building up positive and efficient coping strategies are therefore indicated.
Abortion, Habitual↗
Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome.
Nurses working in selected departments of general hospitals in Finland were collected from a central register on health personnel in Finland. Using the Hospital Discharge Register and the Register of Congenital Malformations, case nurses were selected who had had a spontaneous abortion (N = 217) or a malformed child (N = 46) between the years 1973 and 1979. Controls consisted of three nurses who had had a normal birth; the control nurses were matched for age and hospital of employment. Information on exposure in the first trimester of pregnancy was sought through the head nurses of the hospitals. No significant increase in risk of spontaneous abortion or of malformation was observed after exposure to anaesthetic gases (odds ratio for spontaneous abortion 1.2), sterilising gases and soaps, or x-rays. Handling of cytostatic drugs did not affect the frequency of spontaneous abortion but was associated with malformations in the offspring. The odds ratio, based on eight cases, was 4.7 (p = 0.02) when the logistic model was adopted. The results suggest that the exposures investigated, other than cytostatic drugs, do not cause a strong reproductive risk. Further studies are needed, particularly on cytostatic drugs.
Abnormalities, Drug-Induced↗
Spontaneous abortions and congenital malformations among women exposed to tetrachloroethylene in dry cleaning.
STUDY OBJECTIVE: The aim of the study was to determine whether exposure to tetrachloroethylene during the first trimester of pregnancy has harmful effects on pregnancy outcome. DESIGN: The study used record linkage identification of cases and case-control comparison. SETTING: The study involved dry cleaner and laundry workers throughout Finland who had become pregnant during the study period. Controls were age matched but otherwise unselected women giving birth to normal babies in the study period. SUBJECTS: Cases were defined as women who had been treated for spontaneous abortion or had delivered a malformed child. Out of 5700 workers nearly half had been pregnant during the study period. One pregnancy only was randomly selected for study per worker, and the final study population was 247 women with spontaneous abortions and 33 with malformed infants. Three age matched controls were selected for each abortion case and five for each malformation case. MEASUREMENTS AND MAIN RESULTS: Three women out of four had worked in early pregnancy. Exposure information was collected from 1108 women by mailed questionnaires, with a 77% response, and was partly confirmed by biological monitoring data. Exposure to tetrachloroethylene was found to be significantly associated with spontaneous abortions (odds ratio 3.6, p less than 0.05). CONCLUSION: The findings, together with other available data, indicate that exposure of pregnant women to tetrachloroethylene needs to be minimised.
Abnormalities, Drug-Induced↗
On the scientific and ethical issues of fetal somatic gene therapy.
Fetal somatic gene therapy is often seen as an ethically particularly controversial field of gene therapy. This review outlines the hypothesis and scientific background of in utero gene therapy and addresses some of the frequently raised questions and concerns in relation to this still experimental, potentially preventive gene therapy approach. We discuss here the choice of vectors, of animal models and routes of administration to the fetus. We address the relation of fetal gene therapy to abortion, to post-implantation selection and postnatal gene therapy and the concerns of inadvertent germ-line modification. Our views on the specific risks of prenatal gene therapy and on the particular prerequisites that have to be met before human application can be considered are presented.
Abortion, Therapeutic↗