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PubMed2003

Induced abortion, miscarriage, and breast cancer risk of young women.

Early studies of breast cancer raised substantial concern regarding risk associated with induced abortion and miscarriage. Literature reviews suggest that study findings depend heavily on the comparison group and that the use of parous women as a reference group for nulliparous women may artificially inflate risk. To examine the individual effects of induced abortion and miscarriage on breast cancer risk of parous and nulliparous women, 744 patients < or =40 years of age and diagnosed from 1983-1988 were matched by parity, age, and race with controls living in the same neighborhood in Los Angeles County. In-person interviews were conducted to obtain a detailed reproductive history. Risk estimates were obtained by conditional logistic regression using nulligravid women as the reference group for nulliparous women with a history of incomplete pregnancy and parous women with no incomplete pregnancies as the reference group for parous women with a history of incomplete pregnancy. Breast cancer risk of parous women was unrelated to a history of miscarriage or induced abortion. Breast cancer risk was reduced among nulliparous women with a history of induced abortion relative to nulligravid women, although the risk estimate was imprecise. Risk declined as the number of induced abortions increased (P = 0.04). Our results do not support the hypothesis that induced abortion or miscarriage increase the breast cancer risk of young women.

Abortion, Induced↗
PubMedDate not supplied

[A retrospective analysis of aborted pregnancy in women engaged in agricultural production in controlled areas of Ukraine].

A retrospective analysis was carried out of failure for a woman to be delivered of a child at the natural time in those female workers engaged in agricultural production in controlled territories of Ukraine (Narodichi and Ovruch districts of Zhytomir Province). Data files were studied of 5371 histories of labor (2440 those before and 2931 after the Chernobyl accident) and 525 records of spontaneous abortion (255 those before and 27 after the ChNPP breakdown). There has been found relationship between the frequency of incomplete pregnancies and density of contamination of soil with cesium-137 in certain settlements.

Abortion, Spontaneous↗
PubMed2001

Aberrant methylation of donor genome in cloned bovine embryos.

Despite recent successes in cloning various animal species, the use of somatic cells as the source of donor nuclei has raised many practically relevant questions such as increased abortion rates, high birth weight and perinatal death. These anomalies may be caused by incomplete epigenetic reprogramming of donor DNA. Genome-wide demethylation occurs during early development, 'erasing' gamete-specific methylation patterns inherited from the parents. This process may be a prerequisite for the formation of pluripotent stem cells that are important for the later development. Here, we provide evidence that cloned bovine embryos may have impaired epigenetic reprogramming capabilities. We found highly aberrant methylation patterns in various genomic regions of cloned embryos. Cloned blastocysts closely resembled donor cells in their overall genomic methylation status, which was very different from that of normal blastocysts produced in vitro or in vivo. We found demethylation of the Bov-B long interspersed nuclear element sequence in normal embryos, but not in cloned embryos, in which the donor-type methylation was simply maintained during preimplantation development. There were also significant variations in the degree of methylation among individual cloned blastocysts. Our findings indicate that the developmental anomalies of cloned embryos could be due to incomplete epigenetic reprogramming of donor genomic DNA.

Animals↗
PubMed1985

[Urethral duplication in the male].

The rare duplications of the male urethra--only 210 cases are described till now--are found as many different variations. Only few of these malformations are symptomatic. The embryology is not always clear. Several classifications have been proposed, often too complicated or incomplete. We think, that our classification avoids these disadvantages. Each duplication is systematically classified in a morphological way according to the type of orifice (epispadiac, normotopic on the glans, hypospadiac, perineo-anal), without urinary transport (distal abortive types) or with urinary transport. The latter type can be complete (if a channel exists between bladder and an external meatus) or incomplete (if a channel exists between bladder and any point of the normal urethra or between the normal urethra and any accessory meatus). Four cases are reported and therapeutical aspects are discussed.

Adult↗
PubMed1987

[Effect of 8-Br-ATP and 8-Oxy-ATP on RNA synthesis by RNA polymerase from Escherichia coli].

The effect of 8-Br-ATP and 8-oxy-ATP on RNA synthesis on calf thymus DNA and on abortive synthesis of di- and trinucleotides on promoter AI of phage T7 delta DIII DNA in the case of an incomplete set of substrates was studied. It was shown that the ATP analogs used inhibit the RNA and di- and trinucleotide synthesis. In all cases, 8-oxy-ATP was a more effective inhibitor than 8-Br-ATP. Both analogs are incapable of being the primer and they do not replace ATP in the course of abortive initiation of pppApU synthesis.

Adenosine Triphosphate↗
PubMed1988

Cervical surgery in infertility.

We wish to stress three original techniques among the numerous operations which can be performed on the uterine cervix for the treatment of infertility. The first treatment is for cervical dysplasia of the cervix, a conization performed by electrosurgery under local anaesthesia, using a metallic handle of 23 mm, associated with vaporization by a CO2 laser at the edges of the resection. This technique, used for 125 patients, has permitted adequate resection. The rate of incomplete resection is less than 10%. This method has preserved the possibility of pregnancies without abortion. The second technique is the surgical repair of a large post-obstetrical split of the cervix by an abdominal exposure. After dissection of the bladder, the vagina is opened longitudinally, the cervix exposed and repaired carefully. Four patients who had previously had four to six abortions between 4 and 6 months of gestation, succeeded in achieving a full-term pregnancy by this technique. The third technique is the resection of the isthmic septum by microscissors or micro-electrocautery under local or general anaesthesia by hysteroscopy. Twelve cases, five with primary infertility, seven with second infertility and habitual abortions, were operated on by this technique in 1986-87. Four pregnancies have resulted.

Adult↗
PubMed1978

[Pathological and embryological studies on abortion cases related to the Seveso accident].

After the explosion accident on July 10, 1976 in Seveso (Italy), material from 30 interrupted pregnancies and from 4 spontaneous abortions was investigated by embryological and histomorphological studies. No indications of mutagenic, teratogenic or fetotoxic effects of TCDD could be found. The cases of spontaneous abortion, albeit more suspect for dioxin damage, showed different morphological alterations obviously due to a variety of causative factors independent of TCDD. On the other hand it is not possible to exclude entirely an embryotoxic effect of TCDD because in the majority of cases the fetal tissues were incomplete.

Abnormalities, Drug-Induced↗
PubMed1977

Elective abortion. Complications seen in a free-standing clinic.

Experience is reported with the elective first trimester abortion of 16,410 pregnancies during a 31-month period by Reproductive Health Services of St. Louis, a free-standing clinic. Incidence of complications was 1.54%. The most common of these were incomplete evacuation, excessive postabortal bleeding, and uterine perforation. In patients with unquestioned perforation, the use of laparoscopy has been very valuable in ascertaining the exact nature of the perforation, in avoiding unnecessary laparotomy, and in giving intraabdominal visual guidance to concomitant suction evacuation in cases of an incomplete procedure. Aspects of the other complications are also discussed. In general, the findings support the view that even in the first trimester, the earlier in pregnancy that suction abortion is performed, the less likely it is to result in major complications. It is possible to perform first trimester abortions in a free-standing clinic with a satisfactorily low complication rate.

Abortion, Induced↗
PubMed1982

[Comparative morphology of corpus luteum in uterine and tubal pregnancy].

Morphological examinations of a resected yellow body of the ovary in women with uterine (13 observations) and fallopian (74) pregnancies were carried out. In the uterine pregnancy, solid or cystic organization of the yellow body central zone, formation of thecavascular trabeculae and hypertrophy of luteinocytes were found in the presence of a well-developed microcirculatory bed. In fallopian pregnancy, 40 observations presented hypoplastic changes manifested by an incomplete structure-formation process, disturbed vascularization and differentiation of cell layers, immaturity of lutein cells Abortion of the ectopic pregnancy was accompanied by the reduction of the capillary network, arteriolar spasm and dystrophic changes in the parenchymatous layer. The primary structural-functional deficiency of the yellow body of the ovary was found to be possibly one of the main causes of fallopian pregnancy.

Adolescent↗
PubMed1996

Prenatal genetic services for Down's syndrome: access and provision in 1990-1991. Steering Committee of the National Confidential Enquiry into Counselling for Genetic Disorders.

OBJECTIVE: To examine access to and provision of prenatal genetic services relating to Down's syndrome. DESIGN: Retrospective review of obstetric casenotes. SAMPLE: Pregnancies involving Down's syndrome in England and Wales in 1990-1991 in women aged 38 or over. Information was obtained in 430 cases from a questionnaire completed by the obstetric team who were asked to provide details based only on documentation in the antenatal casenotes. The outcome of pregnancy was a termination in 268 (62%) cases, a liveborn child with Down's syndrome in 144 (34%), a stillbirth in 9 (2%), a miscarriage in 8(2%) and in one case was not known. RESULTS: Overall, prenatal diagnosis was not offered in 7% pregnancies (95% CI: 4.4-9.2%) with late booking given as the main reason. Of women offered prenatal diagnosis, 76% accepted (95% CI: 72.3-80.6%). Counselling was documented before prenatal diagnosis in 89% of cases (95% CI: 86.0-92.3%) and after the procedure, to discuss the results, in 73% (95% CI: 67.5-77.7%). In 10% of pregnancies terminated for Down's syndrome, fetal products were not sent to the laboratory. There was no report of a normal fetus having been terminated as a consequences of incorrect prenatal diagnosis. However, in 10% (95% CI: 5.9 to 14.0%) of cases examined in the laboratory the diagnosis of Down's syndrome could not be confirmed. Details of prenatal diagnosis were not provided in five cases where a child with Down's syndrome was born. Of the remaining 139 livebirths, prenatal diagnosis was not offered in 27 (19%) cases, offered and declined in 92 (66%) and accepted in 20 (14%). In two cases a normal fetal karyotype was reported following prenatal diagnosis. CONCLUSIONS: The study has demonstrated that in 1990-1991: 1. There were certain shortcomings in the documentation of antenatal care; 2. Late booking was the main factor precluding the offer of prenatal diagnosis to women aged 38 or over, and 3. The rate of confirmation of Down's syndrome in terminated fetuses was incomplete.

Abortion, Induced↗
PubMed2000

Management of side effects and complications in medical abortion.

Side effects are an expected part of medical abortion; some, such as pain and bleeding, result from the abortion process itself and are generally managed with orally administered analgesics and counseling. True medication side effects most commonly include nausea, vomiting, diarrhea, and warmth or chills. Complications of medical abortion usually represent an extreme or severe side effect. Large series have reported transfusion rates of <1%. Because of the infrequency of uterine instrumentation, postabortal endometritis appears to be rare with medical abortion. As with early surgical abortion, the clinician must remain aware of the possibility for ectopic pregnancy. Overall approximately 2% to 10% of patients will require surgical intervention for control of bleeding, resolution of incomplete expulsion, or termination of a continuing pregnancy. Understanding the types of side effects and complications that can occur will enable the clinician to counsel patients properly as well as to understand when medical intervention is necessary during the medical abortion process.

Abortifacient Agents↗
PubMed1988

Toxoplasmosis in sheep III. Further evaluation of the ability of a live Toxoplasma gondii vaccine to prevent lamb losses and reduce congenital infection following experimental oral challenge.

The aim of this study was to compare the ability of a live incomplete strain (Strain 48) and a live complete strain (Strain 89) of Toxoplasma gondii to protect against abortion and congenital infection following an oral challenge of T. gondii oocysts. Sixty-nine two-tooth ewes were immunised pre-tupping with live Strain 48 of T. gondii tachyzoites and seventy ewes were immunised with Strain 89. Eighty-two serologically negative ewes served as controls. At mid-pregnancy half of the ewes were challenged orally with T. gondii oocysts (2x10(5)/ewe). The ewes vaccinated with Strain 48 were significantly (p<0.05) protected against the effects of experimental challenge and the rate of congenital infection was also significantly (p<0.15) reduced. The ewes vaccinated with Strain 89 were also significantly (p<0.05) protected. The serological response to challenge as measured by both the Dye test and the Indirect Haemagglutination test varied considerably between the two vaccinated groups.

Journal Article↗
PubMed1990

The genic nature of gamete eliminator in rice.

The two cultivated rice species, Oryza sativa and Oryza glaberrima, are morphologically alike but are reproductively isolated from each other by hybrid sterility. The hybrid is male sterile but partially female fertile. Backcross experiments were conducted to introduce an alien factor controlling hybrid sterility from O. glaberrima (W025) into O. sativa (T65wx) and examine the genetic basis. An extracted sterility factor, closely linked to the wx locus, induced gametic abortion due to allelic interaction and was tentatively designated as S(t). The segregation patterns for infertility was explained by assuming that W025 and T65wx carried S(t) and S(t)a, respectively, and gametes with S(t)a aborted only in the heterozygote (S(t)/S(t)a) although the elimination of female gametes was incomplete. Thus, S(t) seemed to be intermediate between a gamete eliminator and pollen killer. However, S(t) was proven to be likely the same as S1 which was formerly reported as gamete eliminator in a different genetic background of O. sativa. In addition, a chromosomal segment containing S1 (or S(t] caused a marked suppression of crossing over around it, suggesting the presence of an inversion. Further, female transmission of S1a increased as the segment containing S1 became small by recombination. After S1 was further purified by successive backcrosses up to the BC15 generation, it became pollen killer. The present results give evidence that a profound sterility gene such as gamete eliminator can be made from accumulation of pollen killer and its modifier(s) when pollen killer and modifier(s) are linked, they behave as a gene complex in the hybrid.

Alleles↗
PubMed2002

[Ultrasound screening in pregnancy: evidence and maternity care reality].

Since 1980 maternity care in Germany has included ultrasound screening. The aim of this review is (1) to assess the benefit of ultrasound screening on the basis of randomised, controlled trials in accordance with the criteria of evidence-based medicine, (2) to examine current screening practice and the quality of German maternity care in everyday clinical practice, and (3) to indicate priorities for further screening developments. We reviewed Cochrane reviews, health technology assessment reports and relevant individual studies. The three essential effects that may be achieved by ultrasound screening include: (1) earlier detection of multiple pregnancies, (2) better dating of pregnancy and reduction in induced labour by 40%, and (3) more frequent and earlier detection of foetal malformations including the option for an abortion. Yet, early detection does not increase the rate of successful pregnancies. The effects mentioned are only incompletely achieved with standard maternity care in Germany. For example, there is no evidence for an essential reduction of the frequency with which labour is induced. Detection rates in routine preventive care are markedly lower than described for trial conditions. Only multiple pregnancies can be identified more or less completely; detecting other target diagnoses remains unsatisfactory: placenta praevia 57% (without signs of bleeding 14%), postmaturity 46%, malformations 30-40% and intrauterine growth retardation 30%. Also, high rates of false positive findings can be observed that might lead to follow-up examinations and unnecessary treatment procedures. Quality of maternity screening is low and is not subjected to substantial quality assurance. We suggest the following priority measures: (1) to improve the quality of screening by modifying the previous three-step concept with the aim of promoting accessibility of highly qualified examiners for all pregnant women, (2) to strengthen quality assurance, (3) to assist the pregnant woman with her informed decision by offering independent and non-directional counselling concerning the advantages and disadvantages of screening and (4) to focus maternity care on effective interventions according to the criteria of evidence-based medicine.

Evidence-Based Medicine↗
PubMed1994

Pregnancy outcome after hydatidiform mole, initial and recurrent.

Pregnancy outcome after complete and partial hydatidiform mole was evaluated in 170 patients. Of the 170 patients, 143 became pregnant a total of 250 times. Patients with incomplete hydatidiform mole had 232 subsequent pregnancies that resulted in 169 (72.8%) term deliveries, 30 (12.9%) spontaneous abortions, 7 (3.0%) induced abortions, 6 (2.6%) stillbirths, 13 (5.6%) preterm deliveries, 6 (2.6%) recurrent moles and one (0.4%) ectopic pregnancy. Of the subsequent pregnancies in patients with partial hydatidiform mole, full-term delivery, spontaneous abortion and recurrent mole occurred in 10 (55.6%), 5 (27.8%) and 3 (16.7%) of the patients, respectively. Among the 9 patients with recurrent hydatidiform mole, viable term pregnancy was achieved in 4. Even patients with recurrent hydatidiform mole can be assured that they can have a normal subsequent pregnancy.

Adult↗
PubMed1977

Limitations of visualization of the entire fetus by means of second-trimester fetoscopy.

Fetoscopy with rigid fiber optics was performed under general anesthesia in 9 patients scheduled for therapeutic abortion by hysterotomy with a duration of pregnancy between 12 and 18 weeks. Visualization of fetus and placenta was found to be at random chance and incomplete, and could not be improved by internal or external manipulation. Skin biopsies were obtained in 5 cases. The cord could be recognized in all cases. It is concluded that the haphazard and incomplete visualization of the uterine contents at present precludes the application of second-trimester fetoscopy for early detection of visible congenital fetal abnormalities.

Abortion, Therapeutic↗
PubMed2003

Studying parents and grandparents to assess genetic contributions to early-onset disease.

Suppose DNA is available from affected individuals, their parents, and their grandparents. Particularly for early-onset diseases, maternally mediated genetic effects can play a role, because the mother determines the prenatal environment. The proposed maximum-likelihood approach for the detection of apparent transmission distortion treats the triad consisting of the affected individual and his or her two parents as the outcome, conditioning on grandparental mating types. Under a null model in which the allele under study does not confer susceptibility, either through linkage or directly, and when there are no maternally mediated genetic effects, conditional probabilities for specific triads are easily derived. A log-linear model permits a likelihood-ratio test (LRT) and allows the estimation of relative penetrances. The proposed approach is robust against genetic population stratification. Missing-data methods permit the inclusion of incomplete families, even if the missing person is the affected grandchild, as is the case when an induced abortion has followed the detection of a malformation. When screening multiple markers, one can begin by genotyping only the grandparents and the affected grandchildren. LRTs based on conditioning on grandparental mating types (i.e., ignoring the parents) have asymptotic relative efficiencies that are typically >150% (per family), compared with tests based on parents. A test for asymmetry in the number of copies carried by maternal versus paternal grandparents yields an LRT specific to maternal effects. One can then genotype the parents for only the genes that passed the initial screen. Conditioning on both the grandparents' and the affected grandchild's genotypes, a third log-linear model captures the remaining information, in an independent LRT for maternal effects.

Age of Onset↗