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At least 109 records · Page 6Linked to original sources
PubMed1998

First trimester pregnancy loss associated with varicella zoster virus infection: histological definition of a case.

Pathological demonstration of varicella infection in first trimester aborted tissue is reported. A 24-year-old primigravida manifested chickenpox infection about 38 days after her last menstrual period or at 24 days age of the embryo. The conceptus survived another 4 to 5 weeks. The macerated embryo and placental tissue revealed nuclear changes consistent with varicella infection. Immunohistochemical stains and electron microscopy were confirmatory.

Adult↗
PubMed1990

Uterine and fetal umbilical artery flow velocity waveforms in normal first trimester pregnancies.

In 85 normal singleton pregnancies between 8 and 13 weeks gestation, Doppler flow velocity waveform recordings were attempted from the left and right uterine artery and fetal umbilical artery. Acceptable waveforms were obtained from the uterine arteries in 83 and from the fetal umbilical artery in 61 of the 85 pregnancies. There was virtually no difference between the left and right uterine artery on average. The marked decrease in pulsatility (PI) and resistance (RI) indices from both uterine arteries reflects the ongoing process of secondary trophoblast invasion into the muscular part of the spiral arteries. Absent end-diastolic velocities were observed in 59 of 61 fetal umbilical artery flow velocity waveform recordings. PI values from the fetal umbilical artery suggest unaltered umbilical placental vascular resistance during the first trimester of pregnancy.

Blood Flow Velocity↗
PubMed1978

Reduced dose of Rh immunoglobulin following first trimester pregnancy termination.

The efficacy and safety of a 50-microgram dose of Rh immune globulin for prevention of Rh isosensitization following first trimester vacuum abortion are evaluated in this study. A total of 1027 women undergoing abortion at three outpatient facilities participated in the study; 755 (73.5%) completed follow-up serologic screening 6 months after termination of pregnancy. None showed serologic evidence of Rh sensitization at the time of followup. No serious adverse reactions to the drug were observed.

Abortion, Induced↗
PubMed2003

A retrospective comparison between lamicel and gemeprost for cervical ripening before surgical interruption of first-trimester pregnancy.

To study the effect and complication rate of lamicel versus gemeprost as pretreatment to vacuum aspiration for the interruption of early pregnancy, the files of 622 medical records of women having a first-trimester abortion at Söder Hospital were studied retrospectively. Group A consisted of 317 women treated with lamicel in 1995 and Group B of 305 women treated with gemeprost in 1996. Complications were more common in Group A than in Group B (55 vs. 22; p < 0.05). Re-admission took place more often in Group A (25) than in Group B (6) (p < 0.05). The complications were more severe in Group A than in Group B. Using multivariate logistic regression analysis, the only impact factor for having a complication was the use of product for cervical priming. Gemeprost for preoperative treatment was found to render a fairly low rate of complications in this study, while complication rate was higher after treatment with lamicel.

Abortion, Induced↗
PubMed2002

First-trimester pregnancy loss and active Chlamydia trachomatis infection: correlation and ultrastructural evidence.

The incidence of Chlamydia trachomatis (Ct) infection and the possible correlation between couples presenting with first-trimester spontaneous abortions and active Ct infection was assessed. Additionally, the ability of Ct to infect zona-free hamster oocytes was explored by incubating the oocytes with spermatozoa from infected patients. A total of 961 women and 750 men consulting our reproductive medicine centre were screened for Ct using direct immunofluorescence. The general incidence of Ct infection was 9.4% in females (90 of 961) and 13.9% in males (104 of 750). In women with spontaneous abortions the incidence of Ct was 21.0% (14 of 66) compared with 8.9% (23 of 59) for women without spontaneous abortions and term pregnancies (chi-square, P < 0.05). When both partners of the couples were considered (one or both partners infected), the incidence rose to 68.8% (22 of 32) (chi-square, P < 0.001). In vitro studies using electron microscopy demonstrated the presence of Ct on the surface of and inside the oocyte. These results indicate a correlation between an active Ct infection and spontaneous abortion. Electron microscopy studies suggested the possibility of direct oocyte infection by Ct. Two models are proposed for the pathogenesis of Ct-related early abortions: (i) direct zygote infection, and (ii) immune response to heat shock proteins expressed by the zygote and triggered by previous Ct infections.

Abortion, Spontaneous↗
PubMed1996

Uteroplacental and luteal circulation in normal first-trimester pregnancies: Doppler ultrasonographic and morphologic study.

OBJECTIVE: Our purpose was to establish reference data representative of normal findings at transvaginal color and spectral Doppler ultrasonographic examination of the uteroplacental and luteal circulation in the first trimester and to relate the Doppler findings to morphologic data. STUDY DESIGN: A cross-sectional study was performed of 64 uncomplicated pregnancies of 5 to 11 completed gestational weeks terminated by legal abortion for psychosocial reasons. Doppler examinations of the main uterine arteries, subchorionic arteries, intrachorionic area, and corpus luteum were performed. Abortion material was examined morphologically. RESULTS: In the uterine and subchorionic arteries blood flow velocity increased and pulsatility index values decreased with advancing gestation. Arterial or venous Doppler shift spectra were recorded from the intrachorionic area in 91% (58/64) of the pregnancies. Intrachorionic arterial blood flow velocities and pulsatility index values were low and did not change with advancing gestation; the mean time-averaged maximum velocity, peak systolic velocity, and pulsatility index values were 4.6 cm/sec, 6.0 cm/sec, and 0.47, respectively. Morphologic examination showed trophoblast plugs in the spiral arteries to consistently manifest multiple spaces containing red blood cells at the choriodecidual junction. CONCLUSION: Blood flow velocity in the uteroplacental arteries increases and pulsatility index values decrease with advancing gestation, indicating a steady increase in uterine perfusion during the first trimester. Our findings suggest intervillous flow to be present as early as the first trimester.

Adolescent↗
PubMed1977

Statistical analysis of first-trimester pregnancy terminations in an ambulatory surgical center.

From June, 1973, to December, 1974, 12,219 women requested elective termination of pregnancy at the Concord Medical Center, a private outpatient clinic in Chicago, Illinois. Suction curettage with local anesthesia was performed for 10,890 of the women; the remaining 1,329 (10.9%) women were rejected for the following reasons: not pregnant, 1.9%; estimated duration of pregnancy over 12 weeks, 7.3% medical reasons, 1.6%; and other reasons, 0.1%. For the aborted patients, the immediate complication rate was 6.9 per 1,000. Complication rates were directly associated with length of gestation (whether determined on the basis of the patient-reported last menstrual period (LMP) or on the basis of the physical examination) and with the experience of the physicians. This study adds further evidence that first-trimester termination of pregnancy by suction curettage, with local anesthesia, in a nonhospital setting is a safe procedure when high medical standards are maintained.

Abortion, Legal↗
PubMed2003

A study of co-treatment of nonsteroidal anti-inflammatory drugs (NSAIDs) with misoprostol for cervical priming before suction termination of first trimester pregnancy.

This double-blind randomized control study was conducted to evaluate whether a nonsteroidal anti-inflammatory drug (NSAID) could act as an effective pain control method during first trimester suction abortion, and whether co-treatment of NSAID with misoprostol will decrease the efficacy of the cervical ripening effect of misoprostol. Subjects were randomized to receive misoprostol alone or misoprostol together with diclofenac sodium. Both groups of subjects suffered from similar incidence of preoperative side effects. Co-treatment of NSAID with misoprostol did not attenuate the cervical ripening efficacy of misoprostol. There was no significant pain reduction in the group treated with NSAID, except that a marginal benefit was found in the subgroup of multiparous women. About two thirds of the subjects in both treatment groups found that this was a satisfactory pain relief method during the procedure.

Abortifacient Agents, Nonsteroidal↗
PubMed1985

Plasma prorenin in first-trimester pregnancy: relationship to changes in human chorionic gonadotropin.

Prorenin and human chorionic gonadotropin are both synthesized in chorionic cells. The relationship of changes in maternal plasma prorenin to changes in human chorionic gonadotropin were therefore evaluated during the first trimester. In samples submitted to the routine chemistry laboratory for detection of pregnancy a positive relationship was observed between prorenin and beta human chorionic gonadotropin during the 5 weeks following conception. Subsequently human chorionic gonadotropin continued to rise but prorenin had reached a plateau. Serial studies in one subject demonstrated that prorenin had increased to 65% of maximum by the thirteenth day following conception whereas human chorionic gonadotropin had risen to only 0.2% of maximum. By 3 to 5 days post partum, beta human chorionic gonadotropin had fallen by 98% but prorenin had fallen by only 50%. The early rise in prorenin following conception and the relatively slow fall post partum suggest that pregnancy-related changes in maternal plasma prorenin are of maternal, not fetal, origin.

Chorionic Gonadotropin↗
PubMed1989

Circulating levels of placental protein 12 in complications of first trimester pregnancy.

Serum placental protein 12 (PP12) levels were determined in 34 women with threatened miscarriage in whom a diagnosis of anembryonic pregnancy (n = 19), missed abortion (n = 4), complete or incomplete abortion (n = 5), hydatidiform mole (n = 1) and subsequent abortion of a live fetus (n = 5), was made ultrasonically and confirmed by histological examination. Twenty-four of the 34 patients had one or more levels between the 10th and 90th centiles of the reference range. In 7 of the 19 patients (37%) with anembryonic pregnancy and in 3 of the 4 patients (75%) with a missed abortion, PP12 levels were markedly elevated. However, in cases where serial measurements were available (n = 6), PP12 levels were seen to fall in all cases. It is concluded that pregnancies that have failed or will subsequently fail in the first or second trimester are not associated with depressed maternal PP12 levels, suggesting that the decidual synthesis of this protein is independent of the presence or viability of the fetus.

Abortion, Spontaneous↗
PubMed2001

Comparison of paracervical block techniques during first trimester pregnancy termination.

OBJECTIVES: To determine whether variations in chloroprocaine placement in paracervical blocks influence effectiveness, whether chloroprocaine is superior to saline, and what factors influence pain perception. METHOD: Eighty-two women undergoing first trimester aspiration abortions were randomized to receive 1% chloroprocaine or saline at 3-5-7-9 or 4-8 o'clock positions. Using a 0--10 scale, women rated anxiety, dysmenorrhea, and pain associated with laminaria insertion, paracervical block, and aspiration. RESULTS: All four groups were similar in medical and demographic characteristics. Injection position did not influence pain ratings, but women who received chloroprocaine had less pain than those who received saline (6.3+/-2.3 vs. 7.8+/-2.0, P=0.002). Paracervical pain and dysmenorrhea were independently associated with aspiration pain scores (respective regression coefficients 0.49 and 0.26, P<0.008). CONCLUSIONS: There is no advantage to using a four-site paracervical block over a two-site technique, but chloroprocaine is superior to saline. Paracervical block may not provide adequate anesthesia during first trimester abortion, especially for women with significant dysmenorrhea.

Abortion, Therapeutic↗
PubMed2003

Misoprostol administration in first-trimester pregnancies with embryonic demise reduces uterine arterial blood flow.

OBJECTIVES: This study was designed to evaluate the effect of misoprostol on the blood flow in uterine arteries of pregnant women with first-trimester embryonic demise. METHODS: Transvaginal ultrasonographic Doppler examinations (resistance index, pulsatility index, systolic/diastolic ratio) of the uterine arteries in 61 pregnant women were performed before misoprostol administration and 90 min later. Following baseline Doppler measurements, each woman received 200 microg misoprostol intravaginally and 200 microg misoprostol orally. RESULTS AND CONCLUSION: All Doppler indices increased significantly after misoprostol administration (p < 0.0001), suggesting an increase in flow resistance.

Abortifacient Agents, Nonsteroidal↗
PubMed1976

The use of silastic vaginal device containing (15S)-15 methyl prostaglandin F2 alpha methyl ester for early first trimester pregnancy termination.

(15 S) - 15 methyl prostaglandin F2 alpha methyl ester in a silastic vaginal device was administered to 9 gravid women in the first 7 weeks of gestation for elective termination of pregnancy. Continuous intrauterine pressure recording was carried out in one case. Prompt initiation of uterine activity and vaginal bleeding was seen and expulsion of products of conception occurred in under 24 hours in all cases. There were no serious complications and side effects were considered acceptable. Two patients have required subsequent curettage for removal of retained placental tissue. This incidence of failure to complete expulsion, if confirmed in a larger series, is considered to render this technique without modification unacceptable as a routine method for early pregnancy termination.

Abortion, Induced↗
PubMed2006

Placenta percreta diagnosed after first-trimester pregnancy termination: a case report.

BACKGROUND: Placenta percreta in early pregnancy has been documented in only a few cases. This is the first report of placenta percreta diagnosed after an extended period from pregnancy termination. CASE: A woman with a history of a previous cesarean section presented with heavy and irregular vaginal bleeding beginning immediately after pregnancy termination at 7 weeks' gestation. Failed response to hormonal treatment and curettage necessitated hysterectomy. Histologic examination revealed a placenta percreta. CONCLUSION: Although placenta percreta is an uncommon occurrence, clinicians should consider it in patients who have a uterotomy scar and complain of long-term metrorrhagia following pregnancy termination.

Abortion, Induced↗
PubMed2003

Apoptosis of extravillous trophoblast cells limits the trophoblast invasion in uterine but not in tubal pregnancy during first trimester.

During the first trimester of pregnancy extravillous trophoblast cells (EVT) invade the maternal decidua. Invasion normally is reduced from the second trimester onwards and stops in the inner third of the myometrium. By contrast, in extrauterine tubal pregnancy, trophoblast invasion may even penetrate the tubal wall, which ultimately leads to the rupture of the fallopian tube. Induction of apoptosis of EVT cells, by maternal immune competent cells, may be an important mechanism to limit EVT invasion in uterine pregnancy. Tissue specimens from first and second trimester uterine pregnancy and first trimester tubal pregnancy were analyzed for apoptosis by TUNEL- and M30-staining. By immunohistochemical double labelling, maternal leukocyte subtypes were co-localized to apoptotic cells and in this context, the number of CD56(+)NK cells was analyzed. Our data show that apoptosis is confined to the decidua basalis. Most apoptotic cells are single cytokeratin-positive epithelial cells residing in the stromal compartment. Consequently these cells can only be EVT cells. Maternal leukocytes are not apoptotic. They are located in close contact to apoptotic cells. The number of apoptotic cells in the second trimester (1.8+/-0.7 per cent) is reduced compared to first trimester (5.6+/-0.7 per cent) of uterine pregnancy. In parallel, the number of NK cells declines from first (24.4+/-2.9) to second (12.4+/-1.8) trimester. Furthermore, apoptosis is significantly reduced in ectopic (0.9+/-0.3 per cent) compared to eutopic first trimester pregnancies. Consequently, we suggest that in first trimester uterine pregnancy, induction of EVT cell apoptosis by the maternal immune system is one mechanism to limit EVT invasion. During the second trimester, in parallel to declining numbers of NK cells, the mechanism changes. However, in tubal pregnancy due to differing immunological microenvironments at the ectopic implantation site, apoptosis induction fails, which deleteriously may result in uncontrolled invasion and penetration of the tubal wall.

Apoptosis↗
PubMed1996

Chorion villosum does not express progesterone and estrogen receptors during the first trimester of pregnancy.

First-trimester chorion villosum plays the key role in the development of human placenta and secretes a large number of hormones and hormone-related substances. To test whether progesterone and estrogen could have regulatory effects on first-trimester chorion villosum functions, we investigated the presence of progesterone receptor (PR) and estrogen receptor (ER) in 47 chorion villosum samples from patients who underwent abortion during the first trimester of pregnancy. The study was carried out using immunohistochemical methods. No ER and PR positivity was evidenced in the 47 chorion villosum samples examined. The possibility that progesterone and estrogen play a role in the regulation of chorion villosum functions should therefore be excluded.

Antibodies, Monoclonal↗