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Sample records for early pregnancy losses

  1. Early Pregnancy Loss

    MedlinePlus

    ... is called early pregnancy loss , miscarriage , or spontaneous abortion . How common is early pregnancy loss? Early pregnancy ... testes that can fertilize a female egg. Spontaneous Abortion: The medical term for early pregnancy loss. Trimester: ...

  2. Thrombophilia and early pregnancy loss.

    PubMed

    McNamee, Kelly; Dawood, Feroza; Farquharson, Roy G

    2012-02-01

    Early pregnancy loss is the most common pregnancy complication. About 15% of pregnancies result in pregnancy loss and 1% of women experience recurrent miscarriage (more than three consecutive miscarriages). The influence of thrombophilia in pregnancy is a popular research topic in recurrent miscarriage. Both acquired and inherited thrombophilia are associated with a risk of pregnancy failure. Antiphospholipid syndrome is the only thrombophilia known to have a direct adverse effect on pregnancy. Historically, clinical research studying thrombophilia treatment in recurrent miscarriage has been of limited value owing to small participant numbers, poor study design and heterogeneity. The debate on the efficacy of aspirin and heparin has advanced with recently published randomised-controlled trials. Multi-centre collaboration is required to ascertain the effect of thrombophilia on early pregnancy loss and to establish an evidence-based treatment protocol. PMID:22079389

  3. Differential urinary gonadotrophin profiles in early pregnancy and early pregnancy loss.

    PubMed

    O'Connor, J F; Ellish, N; Kakuma, T; Schlatterer, J; Kovalevskaya, G

    1998-12-01

    Early pregnancy loss (EPL), detected by patterns of human chorionic gonadotrophin (hCG) in urine, is the biomarker employed in investigations of the impact of personal, workplace or environmental reproductive toxins on human fertility. An issue central to these studies is what, in terms of urinary hCG expression, constitutes an EPL. This report describes the urinary molecular forms of hCG expressed in menstrual cycles in which a normal pregnancy was conceived, or an EPL occurred, or no apparent conception occurred. Qualitative and significant quantitative differences in the expression of hCG-associated analytes were found between normal pregnancy cycles and EPL cycles. Discriminant analysis calculation based on mole fractions of the different hCG-associated molecules afforded 91 per cent and 80 per cent correct classification of clinical pregnancy cycles and EPL cycles, respectively. Although hCG-associated molecules unique to either EPL or normal pregnancy were not found, what is thought to be an early form of hCG is expressed both at a high frequency and at a significantly higher concentration in early normal pregnancy when compared with EPL. The relative absence of this molecule very early in pregnancy may signal a pregnancy loss. PMID:9885014

  4. Diagnostic Methods of Ectopic Pregnancy and Early Pregnancy Loss: a Review of the Literature

    PubMed Central

    Hamza, A.; Meyberg-Solomayer, G.; Juhasz-Böss, I.; Joukhadar, R.; Takacs, Z.; Solomayer, E.-F.; Baum, S.; Radosa, J.; Mavrova, L.; Herr, D.

    2016-01-01

    This review article presents recent evidence on early pregnancy loss and ectopic pregnancy. In the light of recent evidence, the β-hCG discriminatory zone may be extended in clinically stable cases without evidence of bleeding. A possible cut-off is 4300 mIU/ml, which corresponds to when a sonographer should detect an intrauterine pregnancy. Embryonic demise can be confirmed when a transvaginal ultrasound finding shows no heartbeat in an embryo of more than 7 mm CRL, no embryo in a gestational sac having a mean sac diameter of more than 25 mm, or no appearance of an embryo within 7–10 days after the primary examination. These are considered definitive signs of embryonic demise. Suggestive signs of embryonic demise require closer monitoring of the pregnancy. PMID:27134292

  5. Pregnancy as a reaction to early childhood sibling loss.

    PubMed

    Klyman, C M

    1986-07-01

    Surrogate mothers, illegitimately pregnant teenagers, married women seeking abortions, women convicted of manslaughter, and sister survivors of early childhood sibling loss may share a common conflict. These women may be in a state of incomplete mourning, unconsciously wishing to master a trauma by turning a passive experience into a life event they can control. Pregnancy can function as that life event. Replacement daughters and/or sister survivors can present as our patients with a search for or an avoidance of pregnancy as a crucial though unconscious issue. Literature written about this sequelae of early sibling death is reviewed according to psychosexual and object relationship stages. Common and uncommon consequences are discussed. Vignettes from the course of psychoanalytic therapy with women whose brothers had been accidently killed; whose sibling had died of metabolic disease; and those whose siblings had been relinquished to foster care are used to illustrate the immediate and long-term reactions. The range of these include varieties of separation anxiety as well as learning inhibitions in latency; exaggerated pseudo heterosexuality and other risk taking at puberty; problems in self-esteem regulation relative to either the idealized memory of the missing sibling or the omnipotence connected with survivor guilt. This paper focuses on the choice of a sexual partner and pregnancy issues as symptoms of reworking established conflicts around self-valuation and abandonment by sibling and grieving parents. As the family relationships around the lost sibling become less distorted in her analysis via transference resolution, so do the feelings about contemporary relationships. Becoming pregnant is then not an event burdened by the past. PMID:3744954

  6. Early pregnancy loss and exposure to 50-Hz magnetic fields

    SciTech Connect

    Juutilainen, J.; Matilainen, P.; Saarikoski, S.; Laeaerae Esuo; Suonio, S. )

    1993-01-01

    The possibility of an association of early pregnancy loss (EPL) with residential exposure to ELF magnetic fields was investigated in a case-control study. Eighty-nine cases and 102 controls were obtained from the data of an earlier study aimed at investigating the occurrence of EPL in a group of women attempting to get pregnant. Magnetic-field exposure was characterized by measurements in residences. Strong magnetic fields were measured more often in case than in control residences. In an analysis based on fields measured at the front door, a cutoff score of 0.5 A/m (0.63 microT) resulted in an odds ratio of 5.1 (95% confidence interval 1.0-25). The results should be interpreted cautiously due to the small number of highly exposed subjects and other limitations of the data.

  7. Pregnancy loss.

    PubMed

    Robinson, Gail Erlick

    2014-01-01

    Women who lose desired pregnancies by miscarriage, stillbirth, or genetic termination are at risk of suffering from grief, anxiety, guilt and self-blame that may even present in subsequent pregnancies. It is important to find effective means of helping women deal with these losses. The approach to stillbirth has shifted from immediately removing the child from the mother to encouraging the parents to view and hold the baby. This approach has been questioned as possibly causing persistent anxiety and post-traumatic stress disorder. Women who miscarry are currently encouraged to find ways to memorialise the lost fetus. Couples who decide to terminate a pregnancy after discovering a defect may deal not only with sadness but also guilt. Immediate crisis intervention and follow-up care should be available, recognising that individual women may experience different reactions and their specific post-loss needs must be assessed. PMID:24047642

  8. Poor quality of sperm as it affects repeated early pregnancy loss.

    PubMed

    Gopalkrishnan, K; Padwal, V; Meherji, P K; Gokral, J S; Shah, R; Juneja, H S

    2000-01-01

    A study was carried out to determine whether males contribute to repeated early pregnancy loss. Semen samples were analyzed from proven-fertile men (n = 51 group I) and from men whose partners presented with early pregnancy loss (>3 first trimester abortions, n = 32 group II). Routine analysis, sperm function tests, and ultrastructural studies of sperms were carried out. Female factor could be identified in 25 (78%) couples, and in 7 (22%) no cause either male or female could be identified and the semen analysis was normal. Percent morphologically normal did not differ significantly between the groups, but increased sperm head abnormalities were seen. The functional tests were all normal except for a significant decrease in the capacity of nuclear chromatin to decondense in vitro. The ultrastructural studies showed defects of chromatin condensation and irregular nuclei with vacuoles. This study points to the loss of chromatin integrity as a possible contributing factor from males to early pregnancy loss. PMID:11028929

  9. Natural killer cells and regulatory T cells in early pregnancy loss

    PubMed Central

    SHARMA, SURENDRA

    2015-01-01

    Survival of the allogeneic embryo in the uterus depends on the maintenance of immune tolerance at the maternal-fetal interface. The pregnant uterus is replete with activated maternal immune cells. How this immune tolerance is acquired and maintained has been a topic of intense investigation. The key immune cells that predominantly populate the pregnant uterus are natural killer (NK) cells. In normal pregnancy, these cells are not killers, but rather provide a microenvironment that is pregnancy compatible and supports healthy placentation. In placental mammals, an array of highly orchestrated immune elements to support successful pregnancy outcome has been incorporated. This includes active cooperation between maternal immune cells, particularly NK cells, and trophoblast cells. This intricate process is required for placentation, immune regulation and to remodel the blood supply to the fetus. During the past decade, various types of maternal immune cells have been thought to be involved in cross-talk with trophoblasts and in programming immune tolerance. RegulatoryT cells (Tregs) have attracted a great deal of attention in promoting implantation and immune tolerance beyond implantation. However, what has not been fully addressed is how this immune-trophoblast axis breaks down during adverse pregnancy outcomes, particularly early pregnancy loss, and in response to unscheduled inflammation. Intense research efforts have begun to shed light on the roles of NK cells and Tregs in early pregnancy loss, although much remains to be unraveled in order to fully characterize the mechanisms underlying their detrimental activity. An increased understanding of host-environment interactions that lead to the cytotoxic phenotype of these otherwise pregnancy compatible maternal immune cells is important for prediction, prevention and treatment of pregnancy maladies, particularly recurrent pregnancy loss. In this review, we discuss relevant information from experimental and human

  10. Natural killer cells and regulatory T cells in early pregnancy loss.

    PubMed

    Sharma, Surendra

    2014-01-01

    Survival of the allogeneic embryo in the uterus depends on the maintenance of immune tolerance at the maternal-fetal interface. The pregnant uterus is replete with activated maternal immune cells. How this immune tolerance is acquired and maintained has been a topic of intense investigation. The key immune cells that predominantly populate the pregnant uterus are natural killer (NK) cells. In normal pregnancy, these cells are not killers, but rather provide a microenvironment that is pregnancy compatible and supports healthy placentation. In placental mammals, an array of highly orchestrated immune elements to support successful pregnancy outcome has been incorporated. This includes active cooperation between maternal immune cells, particularly NK cells, and trophoblast cells. This intricate process is required for placentation, immune regulation and to remodel the blood supply to the fetus. During the past decade, various types of maternal immune cells have been thought to be involved in cross-talk with trophoblasts and in programming immune tolerance. Regulatory T cells (Tregs) have attracted a great deal of attention in promoting implantation and immune tolerance beyond implantation. However, what has not been fully addressed is how this immune-trophoblast axis breaks down during adverse pregnancy outcomes, particularly early pregnancy loss, and in response to unscheduled inflammation. Intense research efforts have begun to shed light on the roles of NK cells and Tregs in early pregnancy loss, although much remains to be unraveled in order to fully characterize the mechanisms underlying their detrimental activity. An increased understanding of host-environment interactions that lead to the cytotoxic phenotype of these otherwise pregnancy compatible maternal immune cells is important for prediction, prevention and treatment of pregnancy maladies, particularly recurrent pregnancy loss. In this review, we discuss relevant information from experimental and human

  11. Pregnancy Loss

    MedlinePlus

    ... Pregnancy that ends before 20 weeks is called miscarriage. Miscarriage usually happens because of genetic problems in the ... uterus or cervix might play a role in miscarriage. Health problems, such as polycystic ovary syndrome , might ...

  12. Ultrasonographically documented early pregnancy loss in an Asian elephant (Elephas maximus).

    PubMed

    Lueders, Imke; Drews, Barbara; Niemuller, Cheryl; Gray, Charlie; Rich, Peter; Fickel, Jörns; Wibbelt, Gudrun; Göritz, Frank; Hildebrandt, Thomas B

    2010-01-01

    Early embryonic resorption or fetal loss is known to occur occasionally in captive elephants; however, this has mostly been reported anecdotally. The present study documents the case of a 24-year-old, multiparous Asian elephant cow that suffered embryonic death and resorption at around 18 weeks of gestation. From ovulation onwards, this female was sonographically examined 58 times. Blood was collected twice weekly for progestagen determination via enzyme immunoassay. On Day 42 after ovulation, a small quantity of fluid was detected in the uterine horn, which typically indicates the presence of a developing conceptus. Repeated inspections followed what appeared to be a normal pregnancy until Day 116. However, on Day 124, signs of embryonic life were absent. Progestagen concentrations started declining two weeks later, reaching baseline levels one month after embryonic death. Retrospectively, ultrasound examination revealed several abnormalities in the uterine horn. Besides an existing leiomyoma, multiple small cystic structures had formed in the endometrium at the implantation site and later in the placenta. These pathological findings were considered as possible contributors to the early pregnancy failure. PCR for endotheliotropic elephant herpes virus (EEHV) (which had occurred previously in the herd) as well as serology for other infectious organisms known to cause abortion in domestic animals did not yield any positive results. Although no definitive reason was found for this pregnancy to abort, this ultrasonographically and endocrinologically documented study of an early pregnancy loss provides important insights into the resorption process in Asian elephants. PMID:20797354

  13. Noninvasive Detection of Trophoblast Protein Signatures Linked to Early Pregnancy Loss using TRIC

    PubMed Central

    Fritz, Rani; Kohan-Ghadr, Hamid-Reza; Bolnick, Jay M.; Bolnick, Alan D.; Kilburn, Brian A.; Diamond, Michael P.; Drewlo, Sascha; Armant, D. Randall

    2015-01-01

    Objective To examine the expression pattern of biomarker proteins in extravillous trophoblast (EVT) cells obtained noninvasively by transcervical retrieval and isolation from the cervix (TRIC) in patients with early pregnancy loss, compared to control patients with uncomplicated term delivery. Design Case-control study. Setting Academic medical center. Patients Endocervical specimens were obtained from ongoing pregnancies at gestational ages of 5 to 10 weeks to generate an archive of EVT cells isolated by TRIC. Interventions Medical records were examined to select specimens from patients with either early pregnancy loss (EPL; N=10) or an uncomplicated term delivery (N=10), matched for gestational age at the time of endocervical sampling. Main Outcome Measures Known serum biomarkers for adverse pregnancy outcome that are expressed by EVT cells were evaluated by semi-quantitative immunocytochemistry, using antibodies against endoglin (ENG), FMS-like tyrosine kinase-1 (FLT-1), alpha-fetoprotein (AFP), pregnancy-associated plasma protein-A (PAPPA), galectin-13 (LGALS13), galectin-14 (LGALS14), and placental growth factor (PGF). Results EVT purity was over 95% in all specimens, based on chorionic gonadotropin expression; however, the number of EVT cells obtained was significantly lower in women with EPL than the control group. There was significant elevation of AFP, ENG, and FLT-1, and significant reduction of PAPP-A, LGALS14, and PGF in the EPL group, compared to controls. Conclusions In this pilot study, EVT cells isolated by TRIC early in gestation exhibit altered protein expression patterns prior to EPL, compared to uncomplicated term pregnancies. PMID:26051097

  14. Depression and Anxiety Following Early Pregnancy Loss: Recommendations for Primary Care Providers

    PubMed Central

    Narang, Puneet; Kolikonda, Murali K.; Lippmann, Steven

    2015-01-01

    Early pregnancy loss is a shocking and traumatic event for women and their families. Miscarriage usually induces an intense period of emotional distress. This reaction tends to improve over the following several months, but some residual psychological concerns remain. It is important to screen for depression and anxiety in patients following a miscarriage. Most women in this circumstance do become pregnant again, yet mood disturbances can still coexist. When women are having difficulties at conception, worries may be magnified. Most women and physicians see post-miscarriage intervention as desired, and it is important to provide appropriate treatment. Management of depressive and anxiety symptoms after pregnancy loss can benefit future patient well-being. PMID:26137360

  15. Miscarriage, abortion or criminal feticide: understandings of early pregnancy loss in Britain, 1900-1950.

    PubMed

    Elliot, Rosemary

    2014-09-01

    This paper explores the close links in medical understandings of miscarriage and abortion in the first half of the twentieth century in Britain. In the absence of a clear legal framework for abortion, and the secrecy surrounding the practice, medical literature suggests contradictory and confused views about women presenting with clinical signs of pregnancy loss. On one hand, there was a lack of clarity as to whether pregnancy loss was natural or induced, with a clear tendency to assume that symptoms of miscarriage were the result of criminal interference gone wrong. On the other hand, women who did not present for treatment when miscarriage was underway were accused of neglecting their unborn children. The paper suggests that discourses around pregnancy loss were class-based, distrustful of female patients, and shaped by the wider context of fertility decline and concerns about infant mortality. The close historical connection between miscarriage and abortion offers some insight into why both the pro-life movement and miscarriage support advocates today draw on similar imagery and rhetoric about early fetal loss. PMID:24594057

  16. EFFECT OF METHOXYCHLOR ON OVARIAN STEROIDOGENESIS: ROLE IN EARLY PREGNANCY LOSS

    EPA Science Inventory

    Exposure to methoxychlor (MXC) during early pregnancy impairs implantation and reduces serum levels of progesterone. his study was designed to examine the effect of MXC on ovarian steroido-genesis during early pregnancy. regnant rats were treated with MXC at 0, 25, 50, 100, 250, ...

  17. Maternal antimullerian hormone as a predictor of fetal aneuploidy occurring in an early pregnancy loss

    PubMed Central

    Shim, So Hyun; Ha, Hyeong In; Jung, Yong Wook; Shim, Sung Shin; Cho, Yeon Kyung; Kim, Ji Youn; Lee, Kyoung Jin; Cha, Dong Hyun; Kim, Soo Hyun

    2015-01-01

    Objective The purpose of the study was to examine the relationship between the parameter representing ovarian reserve and the fetal aneuploidy in early spontaneous miscarriage. Methods A multicenter retrospective cohort study was performed in patients who were diagnosed with early pregnancy loss (≤13 gestational weeks) and examined for fetal karyotype at the CHA Gangnam Medical Center, CHA Bundang Medical Center, and CHA Gumi Medical Center between January 2011 and December 2012. Karyotyping was performed by the Genetic Laboratory of the Fertility Center of CHA Gangnam Medical Center. Medical records were reviewed for demographics, karyotype analysis and hormonal assay of ovarian reserve including antimullerian hormone (AMH) and follicle stimulating hormone. Statistical analysis was performed using SPSS software. Results A total 462 patients were included in this study. The mean age of the patients was 35.31±4.12 years and the mean AMH level was 3.88±3.50 ng/mL (n=195). Two hundred eleven conceptuses (45.7%) of patients showed the euploid and 251 (54.3%) showed the aneuploid. There are significant differences in maternal age, AMH and gestational age between fetal euploid and aneuploid groups (34.46±4.35 vs. 36.04±3.78 years, P<0.001; 4.60±3.86 vs. 3.43±3.18 ng/mL, P=0.022; 7.67±1.54 vs. 8.27±1.46 weeks, P<0.001, respectively). Multivariate analysis revealed that low AMH level and early gestational age were maternal age-independent markers for fetal aneuploid (P<0.001 and P=0.045, respectively). Conclusion Low maternal AMH level might be a predicting marker for fetal aneuploid in early pregnancy loss. PMID:26623414

  18. Soluble Flt-1 and PlGF: New Markers of Early Pregnancy Loss?

    PubMed Central

    Muttukrishna, Shanthi; Swer, Michelle; Suri, Sangeeta; Jamil, Amna; Calleja-Agius, Jean; Gangooly, Subrata; Ludlow, Helen; Jurkovic, Davor; Jauniaux, Eric

    2011-01-01

    Recent data have indicated a relationship between placental oxygen and angiogenic protein levels in the first trimester of normal pregnancies. Our objective was to investigate if maternal serum levels of angiogenic factors Soluble vascular endothelial growth factor (VEGF) receptor 1 (sFlt-1), soluble Endoglin and placental growth factor (PlGF) are altered in women with symptoms of threatened miscarriage (TM) and if they are predictive of a subsequent miscarriage. Blood samples were collected at 6–10 weeks from women presenting with TM (n = 40), from asymptomatic controls (n = 32) and from non- pregnant women in their luteal phase (n = 14). All samples were assayed for serum level of sFLT-1, PlGF, sEndoglin and HSP70 using commercial ELISAs. Samples were analysed retrospectively on the basis of pregnancy outcome. TM group included 21 women with a normal pregnancy outcome and 19 with subsequent complete miscarriage. The latter subgroup had significantly lower mean maternal serum (MS) sFlt-1 (83%, P<0.001) and PlGF (44%, P<0.001) compared to those with a normal pregnancy outcome. Asymptomatic control pregnant women had similar MS levels of sFlt-1 and PlGF compared to the TM patients with a normal outcome. The mean MS sFlt-1 (>10 fold) and MS PlGF (∼2 fold) levels were significantly (P<0.001) higher in control pregnant women compared to the non-pregnant group in the luteal phase of the menstrual cycle. Soluble Endoglin was not altered in the normal pregnant women compared to non pregnant women, although lower in the TM subgroup with a subsequent miscarriage (∼25%, P<0.001) compared to TM with a live birth. There was no significant difference in the mean MS HSP 70 levels between the different groups. This study shows that sFlt1 and PlGF MS levels are increased by several folds in early pregnancy and that MS sFlt-1 and MS PlGF are markedly decreased in threatened miscarriage patients who subsequently have a miscarriage suggesting these proteins are

  19. Early pregnancy assessment in multiple pregnancies.

    PubMed

    D'Antonio, Francesco; Bhide, Amar

    2014-02-01

    Early ultrasound assessment and accurate determination of chorionicity is crucial so that appropriate care of multiple pregnancy can be provided. It is best achieved in the first trimester of pregnancy using the Lambda 'λ' and 'T' signs. Accurate labelling of the twins is needed to ensure that the same individual fetus is measured through the pregnancy so that the longitudinal growth pattern can be correctly assessed. Discrepancy in crown-rump length indicates a possibility for future development of selective intrauterine growth restriction. Careful early ultrasound assessment is needed to identify structural and chromosomal anomalies, as twin pregnancies are at increased risk. Twin-to-twin transfusion syndrome, selective intrauterine growth restriction and congenital abnormalities represent the major determinants of perinatal loss in monochorionic pregnancies, and diagnosis and prognosis are discussed in detail. Treatment of twin reverse arterial perfusion sequence is more effective in early pregnancy, so early identification is needed. Outcome of conjoined twins is guarded, and is dependent on the extent of fusion, degree of sharing of organs, associated anomalies, and presence of cardiac failure in utero. PMID:24355992

  20. Adolescent pregnancy and loss.

    PubMed

    Bright, P D

    1987-01-01

    Adolescents have a perinatal and infant mortality rate two times as high as that found in the adult population, and yet few have investigated the characteristics of adolescent grief over pregnancy loss. The mourning response of adolescents appears to differ from that of older females: adult signs of depression are either nonexistent or fleeting. Adolescents who are having difficulties moving away from dependence on their mothers may become pregnant in order to demonstrate a semblance of adulthood and also to circumvent the depression common to this phase of development. When reproductive loss occurs, two outcomes often are seen: mother-daughter conflict concerning independence accelerates, which, in turn, provides the impetus for re-impregnation soon afterward. Since pregnancy interferes with mourning, the adolescent may not be able to bond with subsequent children, thus continuing the mother-child conflict into another generation. PMID:3649521

  1. Low aneuploidy rate in early pregnancy loss abortuses from patients with polycystic ovary syndrome.

    PubMed

    Wang, Qiong; Luo, Lu; Lei, Qiong; Lin, Ming-Mei; Huang, Xuan; Chen, Ming-Hui; Zeng, Yan-Hong; Zhou, Can-Quan

    2016-07-01

    A prospective cohort study was conducted to determine whether chromosome aneuploidy increases the risk of early spontaneous abortions in patients with polycystic ovary syndrome (PCOS). A total of 1461 patients who conceived after IVF and embryo transfer were followed; 100 patients who had experienced clinical spontaneous abortion were recruited, 32 with PCOS and 68 without PCOS. Before 2013, genetic analysis comprised conventional cultured villus chromosome karyotyping and a multiplex ligation-dependent probe amplification subtelomere assay combined with fluorescence in-situ hybridization; since 2013, array-based comparative genomic hybridization technique combined with chromosome karyotyping has been used. Age, BMI, pregnancy history, gestational age and total gonadotrophin dosage did not differ significantly between the PCOS and non-PCOS groups. In the PCOS group, 28.1% of abortuses demonstrated aneuploidy, which was significantly lower (P = 0.001) than in the non-PCOS group (72.1%). Further statistical analyses controlling for maternal age demonstrated that abortuses of women with PCOS were significantly less (P = 0.001) likely to have chromosome aneuploidy. Embryonic aneuploidy does not play a vital role in early spontaneous abortion in women with PCOS. Maternal factors resulting in endometrial disorders are more likely to be responsible for the increased risk of early spontaneous abortion in patients with PCOS. PMID:27157933

  2. Early pregnancy loss in sows after low dose, deep uterine artificial insemination with sex-sorted, frozen-thawed sperm.

    PubMed

    Bathgate, R; Grossfeld, R; Susetio, D; Ruckholdt, M; Heasman, K; Rath, D; Evans, G; Maxwell, W M C

    2008-03-01

    Recent developments in reproductive technologies have enabled the production of piglets of a predetermined sex via non-surgical, low dose artificial insemination. The practical application of sex-sorting technology to the pig is made challenging by the large numbers of sperm required for successful insemination of sows. One way of overcoming the time required for sex-sorting may be to create a bank of cryopreserved, sex-sorted sperm, thus making available appropriate doses as sows require insemination. To date, little success has been achieved with non-surgical inseminations of sex-sorted boar sperm. This study attempted to achieve litters of a predetermined sex after a double insemination of sows with 160x10(6) sex-sorted, frozen-thawed sperm. Sows were synchronised and sperm were non-surgically inseminated into the proximal third of the uterine horn at 36 and 42 h after hCG administration. Sows inseminated with sex-sorted sperm achieved similar pregnancy rates to those receiving an equal dose of unsorted, frozen-thawed sperm. However, all sows conceiving after insemination with sex-sorted sperm returned to oestrus within 57 days of insemination. This was a higher rate of pregnancy loss than observed for sows inseminated with unsorted sperm (37.5%; P=0.031). A combination of low sperm numbers and potentially compromised developmental capability of embryos derived from sex-sorted sperm may have resulted in this early stage loss of pregnancy. PMID:17689209

  3. Prepregnancy Nutrition and Early Pregnancy Outcomes

    PubMed Central

    Gaskins, Audrey J.; Toth, Thomas L.; Chavarro, Jorge E.

    2015-01-01

    Implantation failure and pregnancy loss are estimated to affect up to 75% of fertilized ova; however as of yet there is limited empirical evidence, particularly at the population level, for understanding the environmental determinants of these losses. The purpose of this review is to summarize the current knowledge on prepregnancy nutrition and early pregnancy outcomes with particular focus on the outcome of spontaneous abortion among pregnancies conceived naturally and early pregnancy end points among pregnancies conceived through in vitro fertilization. To date, there is limited evidence to support associations of prepregnancy vitamin D and caffeine intake with pregnancy loss. There is suggestive data supporting a link between a healthy diet and lower risk of pregnancy loss. High folate and minimal to no alcohol intake prior to conception have the most consistent evidence supporting an association with lower risk of pregnancy loss. PMID:26457232

  4. Development of an assay for a biomarker of pregnancy and early fetal loss

    SciTech Connect

    Canfield, R.E.; O'Connor, J.F.; Birken, S.; Krichevsky, A.; Wilcox, A.J.

    1987-10-01

    Human chorionic gonadotropin (hCG) is a glycoprotein hormone, secreted by the syncytiotrophoblast cells of the fertilized ovum, that enters the maternal circulation at the time of endometrial implantation. It is composed of two nonidentical subunits; ..cap alpha.. and ..beta.., with molecular weights of 14 kD and 23 kD, respectively. Human chorionic gonadotropin binds to the same receptor as hLH and displays the same biological response, namely, to stimulate the declining function of the corpus luteum to produce progestins and estrogen late in the menstrual cycle. The differences in the structures of hCG and hLH have been exploited to develop antibodies that can measure hCG specifically in the presence of hLH. Two-site antibody binding assays have been developed, based on a surface immunological concept of hCG epitopes, that involve four distinct regions to which antibodies against hCG can bind simultaneously. Antibody cooperative effects, in conjunction with kinetic advantages derived from the concentration factors by use of the sandwich assay technique (immunoradiometric assay, IRMA), have enabled development of extremely sensitive and specific measurement protocols for urinary hCG. The assay described herein permits the detection of pregnancy on an average 25.4 days after the first day of the preceding menses, as opposed to 29.5 days for conventional radioimmunoassay techniques. In addition, the greater sensitivity and specificity of this assay method has permitted the detection of episodes of fetal loss not detected by radioimmunoassay of urine specimens. A large scale epidemiological study is in progress using this assay technique as a way to identify pregnancies that are lost before becoming clinically apparent.

  5. Fetal loss in mice exposed to magnetic fields during early pregnancy

    SciTech Connect

    Svedenstaal, B.M.; Johanson, K.J.

    1995-12-01

    The effects of low-frequency magnetic fields (MFs) on early pregnancy were studied in CBA/S mice. The magnetic field was a 20 kHz, 15 {micro}T sawtooth. Pregnant females were divided into four groups, two control groups and two exposed groups. One group was exposed to MFs continuously from day 1 postconception (pc) until day 5.5 pc, and the other group was exposed continuously until day 7 pc. All animals were sacrificed on day 19 pc, the day before partus, and their uterine contents were analyzed. No significant increase in the resorption (early fetal death) rate was found in the exposed animals compared to the sham controls. In the group exposed during days 1.0--5.5 pc, the body weight and length of the living fetuses were significantly decreased. Except on day 3 pc (progesterone) and day 13 pc (calcium) in the treated groups, there were no significant differences in progesterone and calcium levels in peripheral blood. Implantation occurred on the same day in MF-treated and control animals.

  6. "These are not good things for other people to know": how rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality.

    PubMed

    Haws, Rachel A; Mashasi, Irene; Mrisho, Mwifadhi; Schellenberg, Joanna Armstrong; Darmstadt, Gary L; Winch, Peter J

    2010-11-01

    Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events. PMID:20541305

  7. Evaluation of the role of exogenous pathogens on the incidence of embryo loss during early pregnancy in mice.

    PubMed

    Baines, M G; Billingsley, K A; De Fougerolles, A R; Duclos, A J; Olney, H J; Pomerantz, D K; Gendron, R L

    1994-01-01

    The mating of CBA/j female mice (H2k) by DBA/2j male mice (H2d) typically results in an elevated incidence of spontaneous embryo loss thus providing an ideal genetically controlled laboratory model for the study of the factors causing early embryo loss during pregnancy. There is now considerable data on the cells and factors involved in fetal resorption but little is known about the events which activate this process. While the activation of the maternal response to the fetal implant could have endogenous or genetic origins, a role for exogenous factors including microbial pathogens could also be involved. In order to investigate these possibilities, the reproductive success of CBA/j female x DBA/2j male matings in a conventional animal care facility were compared with matings in a specific pathogen free (SPF) animal facility. All animals housed under these conditions were routinely screened by immunoassay and culture, for the presence of a number of viral and bacterial pathogens of mice. The incidence of spontaneous embryo loss in specific pathogen free CBA female mice mated by DBA and other male strains was found to be virtually identical to that of CBA female mice infected with multiple viral pathogens and housed under otherwise identical conditions (non-SPF). However, the numbers of implantation per pregnancy was significantly greater in an SPF facility. Therefore, exposure of mating mice to exogenous viral and bacterial pathogens did not appear to alter the overall incidence of spontaneous embryo resorption. It was concluded that the immunomodulatory effects of infection by common murine pathogens neither augmented nor reduced post-implantation embryo losses. PMID:8040834

  8. USE OF BROMOERGOCRYPTINE IN THE VALIDATION OF PROTOCOLS FOR THE ASSESSMENT OF MECHANISMS OF EARLY PREGNANCY LOSS IN THE RAT

    EPA Science Inventory

    Validated protocols for evaluating maternally mediated mechanisms of early pregnancy failure in rodents are needed for use in the risk assessment process. To supplement previous efforts in the validation of a panel of protocols assembled for this purpose, bromoergocryptine (BEC) ...

  9. Marriage season, promptness of successful pregnancy and first-born sex ratio in a historical natural fertility population - evidence for sex-dependent early pregnancy loss?

    NASA Astrophysics Data System (ADS)

    Nonaka, K.; Desjardins, Bertrand; Charbonneau, Hubert; Légaré, Jacques; Miura, Teiji

    We investigated population-based vital records of the seventeenth and eighteenth century French Canadian population to assess the effects of marriage season on the outcome of the first births under natural fertility conditions (n=21,698 marriages). Promptness of the first successful conception after marriage differed according to marriage season; the proportion of marriages with a marriage-first birth interval of 8.0-10.0 months was lowest (34%) for marriages in August-October (P=0.001). Although the male/female sex ratio of the babies born with an interval of 8.0-10.0 months was generally higher (1.10) than those with an interval of 10.0-24.0 months (1.05), the marriages in August-October resulted in a significantly reduced sex ratio (0.96) among only the prompt conceptions (P=0.026). We discuss whether this seasonal reduction of the sex ratio could be partly explained by a clustered pregnancy loss of male zygotes in early pregnancy.

  10. Genetic Causes of Recurrent Pregnancy Loss.

    PubMed

    Page, Jessica M; Silver, Robert M

    2016-09-01

    Pregnancy loss is one of the most common obstetric complications, affecting over 30% of conceptions. A considerable proportion of losses are due to genetic abnormalities. Indeed, over 50% of early pregnancy losses have been associated with chromosomal abnormalities. Most are due to de novo nondisjunctional events but balanced parental translocations are responsible for a small but important percentage of genetic abnormalities in couples with recurrent pregnancy loss. In the past, assessment of genetic abnormalities was limited to karyotype performed on placental or fetal tissue. However, advances in molecular genetic technology now provide rich genetic information about additional genetic causes of and risk factors for pregnancy loss. In addition, the use of preimplantation genetic testing in couples undergoing in vitro fertilization has the potential to decrease the risk of pregnancy loss from genetic abnormalities. To date, efficacy is uncertain but considerable potential remains. This chapter will review what is known about genetic causes of recurrent pregnancy loss with a focus on novel causes and potential treatments. Remaining knowledge gaps will be highlighted. PMID:27414972

  11. Urinary Concentrations of Phthalate Metabolites and Bisphenol A and Associations with Follicular-Phase Length, Luteal-Phase Length, Fecundability, and Early Pregnancy Loss

    PubMed Central

    Jukic, Anne Marie; Calafat, Antonia M.; McConnaughey, D. Robert; Longnecker, Matthew P.; Hoppin, Jane A.; Weinberg, Clarice R.; Wilcox, Allen J.; Baird, Donna D.; Calafat, Antonia M.; McConnaughey, D. Robert; Longnecker, Matthew P.; Hoppin, Jane A.; Weinberg, Clarice R.; Wilcox, Allen J.; Baird, Donna D.

    2015-01-01

    Background Certain phthalates and bisphenol A (BPA) show reproductive effects in animal studies and potentially affect human ovulation, conception, and pregnancy loss. Objectives We investigated these chemicals in relation to follicular- and luteal-phase lengths, time to pregnancy, and early pregnancy loss (within 6 weeks of the last menstrual period) among women attempting pregnancy. Methods Women discontinuing contraception provided daily first-morning urine specimens and recorded days with vaginal bleeding for up to 6 months. Specimens had previously been analyzed for estrogen and progesterone metabolites and human chorionic gonadotropin. A total of 221 participants contributed 706 menstrual cycles. We measured 11 phthalate metabolites and BPA in pooled urine from three specimens spaced throughout each menstrual cycle. We analyzed associations between chemical concentrations and outcomes using linear mixed models for follicular- and luteal-phase lengths, discrete-time fecundability models for time to pregnancy, and logistic regression for early pregnancy loss. Results Higher concentrations of monocarboxyoctyl phthalate (MCOP) were associated with shorter luteal phase [2nd tertile vs. 1st tertile: –0.5 days (95% CI: –0.9, –0.1), 3rd vs. 1st: –0.4 days (95% CI: –0.8, 0.01), p = 0.04]. BPA was also associated with shorter luteal phase [2nd vs. 1st: –0.8 days (95% CI: –1.2, –0.4), 3rd vs. 1st: –0.4 days (95% CI: –0.8, 0.02), p = 0.001]. Conclusions BPA and MCOP (or its precursors) were associated with shorter luteal phase. Menstrual cycle–specific estimates of urinary BPA and phthalate metabolites were not associated with detrimental alterations in follicular-phase length, time to pregnancy, or early pregnancy loss, and in fact, DEHP [di(2-ethylhexyl) phthalate] metabolites {MEOHP [mono(2-ethyl-5-oxohexyl) phthalate] and ΣDEHP} were associated with reduced early loss. These findings should be confirmed in future human studies. Citation Jukic

  12. [The trauma of miscarriage--factors influencing the experience of anxiety after early pregnancy loss].

    PubMed

    Berth, Hendrik; Puschmann, Anne-Katrin; Dinkel, Andreas; Balck, Friedrich

    2009-08-01

    The experience of miscarriage results in tremendous emotional disturbance for many affected women. Depression, anxiety, (pathological) grief, and posttraumatic stress symptoms are commonly experienced reactions. Several factors influence the level of emotional distress, like age, previous experience of miscarriage, or social support. In this work, we investigated the level of emotional distress after miscarriage using a novel methodological approach. Through the world wide web, N = 500 texts of women who reported freely on their miscarriage were accessed and analyzed using the Dresden Anxiety Dictionary, a German computerized version of the Gottschalk-Gleser speech analysis. The women were 28 years old on average. The texts were written, on average, about 28 days after the miscarriage. Women's pregnancy had lasted between 2 and 40 weeks (M = 12). The scores pertaining to death anxiety and mutilation anxiety were higher than the norm. More than 20 % of the women reported an increased level of anxiety. Variables that influenced the level of anxiety were age, time since miscarriage, duration of pregnancy, previous miscarriage, and social support. The results underscore the need for treatment, at least for sub-groups of affected women who have a higher risk for a complicated course of coping with miscarriage. PMID:18821478

  13. Evolutionary forward genomics reveals novel insights into the genes and pathways dysregulated in recurrent early pregnancy loss

    PubMed Central

    Kosova, Gülüm; Stephenson, Mary D.; Lynch, Vincent J.; Ober, Carole

    2015-01-01

    STUDY QUESTION Are the genes that gained novel expression in the endometria of Eutherian (placental) mammals more likely to be dysregulated in patients with endometrial-associated recurrent early pregnancy loss (REPL)? SUMMARY ANSWER There was a significant enrichment of genes dysregulated in REPL patients among the Eutherian-specific endometrial genes. WHAT IS KNOWN ALREADY Pregnancy loss is the most common complication of human pregnancy. REPL has multiple etiologies, including dysregulation of endometrial function, leading to ‘suboptimal’ implantation. Although the implantation process is tightly regulated in Eutherian (placental) mammals, the molecular factors contributing to dysregulated endometrial gene expression patterns in women with REPL are largely unknown. STUDY DESIGN, SIZE, DURATION Endometrial biopsies were obtained from 32 REPL patients during the mid-luteal phase, and evaluated for glandular development arrest based on elevated nuclear cyclin E levels in gland cells, and for out-of-phase endometrial development based on histology. Gene expression levels were measured using Illumina Human HT-12v4 BeadChip arrays. PARTICIPANTS/MATERIALS, SETTING, METHODS Differentially expressed genes were identified between patients with (i) out-of-phase (n = 10) versus normal (n = 22) histological dating and (ii) abnormally elevated (n = 9) versus normal (n = 23) cyclin E levels in the nuclei of endometrial glands, using a likelihood ratio test. Enrichment of dysregulated genes in REPL endometria among Eutherian-specific genes was tested by permutation. Gene ontology and pathway enrichment analyses were carried out for the dysregulated genes. MAIN RESULTS AND THE ROLE OF CHANCE Fifty-eight and eighty-one genes were identified as differentially expressed at P < 0.001 in women with out-of-phase histological dating and abnormally elevated glandular cyclin E levels, respectively. Genes that were recruited into endometrial expression during the evolution of

  14. Hyperhomocysteinemia in women with unexplained sterility or recurrent early pregnancy loss from Southern Italy: a preliminary report

    PubMed Central

    D'Uva, Maristella; Di Micco, Pierpaolo; Strina, Ida; Alviggi, Carlo; Iannuzzo, Mariateresa; Ranieri, Antonio; Mollo, Antonio; De Placido, Giuseppe

    2007-01-01

    Background Hyperhomocysteinemia has been described as a risk factor for unexplained recurrent pregnancy loss. Increased levels of homocysteine may be due to inadequate dietary intake of folate and vitamin B12 and inherited defects within the methionine-homocysteine pathway such as MTHFR C677T gene polymorphism. However, the association between hyperhomocysteinemia and sterility problems have been underlined only for recurrent pregnancy loss while a relationship between hyperhomocysteinemia and female sterility is still matter of discussion. Aim This study sought to find out a possible relationship between sterility (primary sterility or secondary sterility due to recurrent pregnancy loss) and homocysteine metabolism. Patients and Methods We selected 20 patients with recurrent pregnancy loss, 20 patients with unexplained female sterility and 20 healthy women as control group. Several whole blood samples were collected by venipuncture. Firstly homocysteinemia and other related variables were tested (i.e. folate and vitamin B12 levels); thereafter DNA was extracted by a further whole blood sample collected in EDTA in order to screen MTHFR C677T gene polymorphism. Statistical analysis was performed by chi square test; differences were considered to be significant if p < 0.05. Results The median fasting total plasma homocysteine concentration was 19.2 ± 6.14 μM for patients with recurrent pregnancy loss, while was 21.05 ± 8.78 μM for patients with unexplained sterility, vs 7.85 ± 3.31 μM of control group (p < 0.05). Fifteen patients with unexplained female sterility showed MTHFR C677T homozigosity vs 17 with recurrent pregnancy loss and 3 in the control group (p < 0.05). On the other hand no significant differences were found in the levels of vitamin B 12 in the three groups, while reduced folate concentrations were found in women with unexplained female sterility and recurrent pregnancy loss (p < 0.05 vs control group. Discussion MTHFR C677T gene polymorphism is

  15. Association of Maternal Antiangiogenic Profile at Birth With Early Postnatal Loss of Microvascular Density in Offspring of Hypertensive Pregnancies.

    PubMed

    Yu, Grace Z; Aye, Christina Y L; Lewandowski, Adam J; Davis, Esther F; Khoo, Cheen P; Newton, Laura; Yang, Cheng T; Al Haj Zen, Ayman; Simpson, Lisa J; O'Brien, Kathryn; Cook, David A; Granne, Ingrid; Kyriakou, Theodosios; Channon, Keith M; Watt, Suzanne M; Leeson, Paul

    2016-09-01

    Offspring of hypertensive pregnancies are more likely to have microvascular rarefaction and increased blood pressure in later life. We tested the hypothesis that maternal angiogenic profile during a hypertensive pregnancy is associated with fetal vasculogenic capacity and abnormal postnatal microvascular remodeling. Infants (n=255) born after either hypertensive or normotensive pregnancies were recruited for quantification of postnatal dermal microvascular structure at birth and 3 months of age. Vasculogenic cell potential was assessed in umbilical vein endothelial cells from 55 offspring based on in vitro microvessel tube formation and proliferation assays. Maternal angiogenic profile (soluble fms-like tyrosine kinase-1, soluble endoglin, vascular endothelial growth factor, and placental growth factor) was measured from postpartum plasma samples to characterize severity of pregnancy disorder. At birth, offspring born after hypertensive pregnancy had similar microvessel density to those born after a normotensive pregnancy, but during the first 3 postnatal months, they had an almost 2-fold greater reduction in total vessel density (-17.7±16.4% versus -9.9±18.7%; P=0.002). This postnatal loss varied according to the vasculogenic capacity of the endothelial cells of the infant at birth (r=0.49; P=0.02). The degree of reduction in both in vitro and postnatal in vivo vascular development was proportional to levels of antiangiogenic factors in the maternal circulation. In conclusion, our data indicate that offspring born to hypertensive pregnancies have reduced vasculogenic capacity at birth that predicts microvessel density loss over the first 3 postnatal months. Degree of postnatal microvessel reduction is proportional to levels of antiangiogenic factors in the maternal circulation at birth. PMID:27456522

  16. Association of Maternal Antiangiogenic Profile at Birth With Early Postnatal Loss of Microvascular Density in Offspring of Hypertensive Pregnancies

    PubMed Central

    Yu, Grace Z.; Aye, Christina Y.L.; Lewandowski, Adam J.; Davis, Esther F.; Khoo, Cheen P.; Newton, Laura; Yang, Cheng T.; Al Haj Zen, Ayman; Simpson, Lisa J.; O’Brien, Kathryn; Cook, David A.; Granne, Ingrid; Kyriakou, Theodosios; Channon, Keith M.; Watt, Suzanne M.

    2016-01-01

    Offspring of hypertensive pregnancies are more likely to have microvascular rarefaction and increased blood pressure in later life. We tested the hypothesis that maternal angiogenic profile during a hypertensive pregnancy is associated with fetal vasculogenic capacity and abnormal postnatal microvascular remodeling. Infants (n=255) born after either hypertensive or normotensive pregnancies were recruited for quantification of postnatal dermal microvascular structure at birth and 3 months of age. Vasculogenic cell potential was assessed in umbilical vein endothelial cells from 55 offspring based on in vitro microvessel tube formation and proliferation assays. Maternal angiogenic profile (soluble fms-like tyrosine kinase-1, soluble endoglin, vascular endothelial growth factor, and placental growth factor) was measured from postpartum plasma samples to characterize severity of pregnancy disorder. At birth, offspring born after hypertensive pregnancy had similar microvessel density to those born after a normotensive pregnancy, but during the first 3 postnatal months, they had an almost 2-fold greater reduction in total vessel density (−17.7±16.4% versus −9.9±18.7%; P=0.002). This postnatal loss varied according to the vasculogenic capacity of the endothelial cells of the infant at birth (r=0.49; P=0.02). The degree of reduction in both in vitro and postnatal in vivo vascular development was proportional to levels of antiangiogenic factors in the maternal circulation. In conclusion, our data indicate that offspring born to hypertensive pregnancies have reduced vasculogenic capacity at birth that predicts microvessel density loss over the first 3 postnatal months. Degree of postnatal microvessel reduction is proportional to levels of antiangiogenic factors in the maternal circulation at birth. PMID:27456522

  17. Factors affecting pregnancy loss for single and twin pregnancies in a high-producing dairy herd.

    PubMed

    Silva-Del-Río, N; Colloton, J D; Fricke, P M

    2009-06-01

    Our objective was to determine the magnitude of, and factors affecting, pregnancy loss for lactating Holstein cows on a commercial dairy farm when diagnosed with twin (n=98) or single (n=518) pregnancies using transrectal ultrasonography. Pregnancy losses were assessed with records of non-viable embryos at first pregnancy examination and embryo losses between the first (25-40 d after AI) and second (48 and 82 d after AI) post-breeding pregnancy examinations. Among cows diagnosed with single pregnancies, 3.7% were diagnosed with a non-viable embryo at first pregnancy examination, and 4.6% of those diagnosed with a viable embryo underwent pregnancy loss by the second examination. A total of 11.2% of cows diagnosed with twins experienced a single embryo reduction, whereas 13.3% lost both embryos. Overall, the total proportion of cows experiencing pregnancy loss or experiencing embryo reduction was greater for cows diagnosed with twin than single pregnancies (odds ratio; OR=3.6), resulting in an embryo survival rate of 91.9% for cows diagnosed with single compared to 75.5% for cows diagnosed with twin pregnancies. Season of breeding and milk production were associated with pregnancy loss for single pregnancies, whereas CL number was associated negatively with embryo reduction and pregnancy loss for twin pregnancies. The risk of twinning and double ovulation among pregnant cows increased with days in milk (DIM), and the risk of double ovulation was greater for cows diagnosed with ovarian cysts and lacking a CL at initiation of an Ovsynch protocol. We concluded that in this herd, embryo reduction and pregnancy loss during early gestation was greater for lactating Holstein cows diagnosed with twin compared to single pregnancies. In addition, cows diagnosed with ovarian cysts and lacking a CL had an increased risk for double ovulation. PMID:19269023

  18. [Annexins and recurrent pregnancy loss].

    PubMed

    Udry, Sebastián; Aranda, Federico; Latino, Omar; Larrañaga, Gabriela de

    2013-01-01

    Recurrent Pregnancy Loss (RPL) affects public health and directly compromises the quality of life of hundreds of women, with a detrimental effect on their physical and mental health. Approximately 50% of RPL are not associated to any of the currently known etiology and will be considered idiopathic. Recently, it has been demonstrated that the expression of annexin 5 (ANXA5), a protein found on the trophoblastic surface, plays a fundamental role in the development of pregnancy due to its immunomodulator and anticoagulant function at the placentary level. Some genetic haplotypes of ANXA5 are associated to alterations in the expression of this gene, such as haplotype M2 which is associated to a decrease in the expression of ANXA5. The presence of this haplotype is related to the following conditions occurring during pregnancy: RPL, foetal intrauterine growth restriction, low child weight at birth, preeclampsia and maternal pulmonary thromboembolism. This review describes the structure, function and genetic expression of ANXA5, as well as its possible implication in RPL. PMID:24152411

  19. Pregnancy loss: French clinical practice guidelines.

    PubMed

    Huchon, C; Deffieux, X; Beucher, G; Capmas, P; Carcopino, X; Costedoat-Chalumeau, N; Delabaere, A; Gallot, V; Iraola, E; Lavoue, V; Legendre, G; Lejeune-Saada, V; Leveque, J; Nedellec, S; Nizard, J; Quibel, T; Subtil, D; Vialard, F; Lemery, D

    2016-06-01

    In intrauterine pregnancies of uncertain viability with a gestational sac without a yolk sac (with a mean of three orthogonal transvaginal ultrasound measurements <25mm), the suspected pregnancy loss should only be confirmed after a follow-up scan at least 14 days later shows no embryo with cardiac activity (Grade C). In intrauterine pregnancies of uncertain viability with an embryo <7mm on transvaginal ultrasound, the suspected pregnancy loss should only be confirmed after a follow-up scan at least 7 days later (Grade C). In pregnancies of unknown location after transvaginal ultrasound (i.e. not visible in the uterus), a threshold of at least 3510IU/l for the serum human chorionic gonadotrophin assay is recommended; above that level, a viable intrauterine pregnancy can be ruled out (Grade C). Postponing conception after an early miscarriage in women who want a new pregnancy is not recommended (Grade A). A work-up for women with recurrent pregnancy loss should include the following: diabetes (Grade A), antiphospholipid syndrome (Grade A), hypothyroidism with anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies (Grade A), vitamin deficiencies (B9, B12) (Grade C), hyperhomocysteinaemia (Grade C), hyperprolactinaemia (Grade B), diminished ovarian reserve (Grade C), and a uterine malformation or an acquired uterine abnormality amenable to surgical treatment (Grade C). The treatment options recommended for women with a missed early miscarriage are vacuum aspiration (Grade A) or misoprostol (Grade B); and the treatment options recommended for women with an incomplete early miscarriage are vacuum aspiration (Grade A) or expectant management (Grade A). In the absence of both chorioamnionitis and rupture of the membranes, women with a threatened late miscarriage and an open cervix, with or without protrusion of the amniotic sac into the vagina, should receive McDonald cerclage, tocolysis with indomethacin, and antibiotics (Grade C). Among women

  20. Lipopolysaccharide-induced modulation in the expression of progesterone receptor and estradiol receptor leads to early pregnancy loss in mouse.

    PubMed

    Agrawal, Varkha; Jaiswal, Mukesh Kumar; Jaiswal, Yogesh Kumar

    2013-11-01

    The objective of the present study was to investigate the effect of Gram-negative bacteria infection on ovarian steroid receptors, i.e. progesterone receptor (PR) and estradiol receptor (ER) during preimplantation days of pregnancy. A well established mouse model of Gram-negative bacteria infection was used to test this objective. Mice were treated with normal saline or lipopolysaccharide (LPS) on day 0.5 of pregnancy and used to collect embryos and uterine horns on day 1.5 to day 4.42 preimplantation day of pregnancy. Total RNA was extracted and reverse-transcription polymerase chain reaction (PCR) was performed to check the expression of PR and ER genes. The mRNA expression of PR and ER was altered in embryos and uterus of LPS-treated animals during preimplantation days of pregnancy studied. These results suggest that PR and ER play an important role in Gram-negative bacteria infection and induced implantation failure in mouse. PMID:22809764

  1. [Characteristics of miscarriage and women's rights after pregnancy loss].

    PubMed

    Lewicka, Magdalena; Sulima, Magdalena; Pyć, Maria; Stawarz, Barbara

    2013-01-01

    The term "miscarriage" refers to the end of pregnancy before the 22nd week of gestation, or taking into account the criterion of foetal weight (less than 500 g). Approximately 15-20% of recognized pregnancies and miscarriage involve spontaneous expulsion of the blastocyst from the uterine cavity. This constitutes about 80% of miscarriages in the first 12 weeks of gestation. The literature lists a number of factors which cause the loss of pregnancies. The most frequently cited causes of abortion are: genetic, anatomical, immunological and hormonal factors, and infections. A large number of miscarriages remain unexplained (idiopathic miscarriages). Clinical signs of miscarriage include bleeding and pain. Bleeding or spotting is the earliest sign of miscarriage. Data from the patient's history, physical examination, ultrasound examination and tests for hCG level can enable diagnosis of bleeding in early pregnancy, help to assess the degree of risk, and implement an appropriate treatment regimen and care for pregnant women adapted to their needs. Loss of pregnancy is an interdisciplinary problem involving obstetrics, epidemiology, public health, psychology, and other specialities. The role of medical personnel in the care of women after the loss of a child, regardless of the week and therapeutic procedures, as well as for giving adequate information regarding the rights of women after pregnancy loss. The obligation to inform women of their rights concerns medical staff, and it is important to promote knowledge in this field among doctors, nurses and midwives who care for women after miscarriage. PMID:24734346

  2. Stepping Back to Gain Perspective: Pregnancy Loss History, Depression, and Parenting Capacity in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B)

    ERIC Educational Resources Information Center

    Price, Sarah Kye

    2008-01-01

    Previous empirical studies of pregnancy loss have predominantly focused on complex grief response and emergent problems associated with future parenting in self-selected samples of bereaved women. This article presents findings from a retrospective secondary data analysis conducted with a racially and ethnically diverse sample of currently…

  3. Immunization with BLS-Stx2B chimera totally protects dams from early pregnancy loss induced by Shiga toxin type 2 (Stx2) and confers anti-Stx2 immunity to the offspring.

    PubMed

    Sacerdoti, Flavia; Mejías, María P; Bruballa, Andrea C; Alvarez, Romina Soledad; Amaral, María M; Palermo, Marina S; Ibarra, Cristina

    2016-09-01

    Shiga toxin producing Escherichia coli (STEC) are bacterial pathogens involved in food-borne diseases. Shiga toxin (Stx) is the main virulence factor of STEC and is responsible for systemic complications including Hemolytic Uremic Syndrome (HUS). It has been previously demonstrated that Shiga toxin type 2 (Stx2) induces pregnancy loss in rats in early stage of pregnancy. The main purpose of this study was to determine if an active immunization prevents Stx2 mediated pregnancy loss and confers passive protective immunity to the offspring. For that purpose Sprague Dawley female rats were immunized with the chimera based on the enzyme lumazine synthase from Brucella spp. (BLS) and the B subunit of Shiga toxin 2 (Stx2B) named BLS-Stx2B. After immunization females were mated with males. At day 8 of gestation, dams were challenged intraperitoneally with a sublethal and abortifacient dose of Stx2. The immunization induced high anti-Stx2B-specific antibody titers in sera and most important, prevented pregnancy loss. Pups born and breastfeed by immunized dams had high anti-Stx2B-specific antibody titers in sera. Cross-fostering experiments indicated that passive protective immunity against Stx2 was transmitted through lactation. These results indicate that immunization of adult female rats with BLS-Stx2B prevents Stx2-induced pregnancy loss and confers anti Stx2 protective immunity to the offspring. PMID:27527816

  4. Hereditary Thrombophilia and Recurrent Pregnancy Loss.

    PubMed

    Pritchard, Ashley M; Hendrix, Paul W; Paidas, Michael J

    2016-09-01

    The challenging nature of recurrent pregnancy loss (RPL) is multifactorial, but largely begins with determining who meets diagnostic criteria for RPL as definitions vary and frequently change. Many patients seek obstetrical intervention after losses, even if they do not meet the criteria for RPL, and even those strictly meeting criteria often present a conundrum as to the etiology of their condition. The contribution of hereditary thrombophilia to RPL, the impact of each disorder on the clotting cascade, available evidence regarding pregnancy outcomes, and current recommendations for evaluation and treatment is presented. PMID:27427827

  5. Immunogenetic contributions to recurrent pregnancy loss.

    PubMed

    Grimstad, Frances; Krieg, Sacha

    2016-07-01

    While sporadic pregnancy loss is common, occurring in 15 % of pregnancies, recurrent pregnancy loss (RPL) impacts approximately 5 % of couples. Though multiple causes are known (including structural, hormonal, infectious, autoimmune, and thrombophilic causes), after evaluation, roughly half of all cases remain unexplained. The idiopathic RPL cases pose a challenging therapeutic dilemma in addition to incurring much physical and emotional morbidity. Immunogenetic causes have been postulated to contribute to these cases of RPL. Natural Killer cell, T cell expression pattern changes in the endometrium have both been shown in patients with RPL. Human leukocyte antigen (HLA) and cytokine allelic variations have also been studied as etiologies for RPL. Some of the results have been promising, however the studies are small and have not yet put forth outcomes that would change our current diagnosis and management of RPL. Larger database studies are needed with stricter control criteria before reasonable conclusions can be drawn. PMID:27169601

  6. Reproductive Endocrinology in Recurrent Pregnancy Loss.

    PubMed

    Krog, Maria C; Nielsen, Henriette Svarre; Christiansen, Ole B; Kolte, Astrid M

    2016-09-01

    Endocrine disruptions may be important in patients experiencing recurrent pregnancy loss (RPL). This review focuses on data available on RPL and the endocrine system to investigate relevant, and perhaps modifiable, endocrine factors of importance for the disorder. Evidence indicates that some hormones may be important as immune modulators and a better understanding of this interplay has potential for improving pregnancy outcome in RPL. To date there is a lack of consensus on the effect of endocrine treatment options in RPL and there is a strong need for large randomized-controlled trials. PMID:27403585

  7. Patterns of grief reaction after pregnancy loss.

    PubMed

    Lin, S X; Lasker, J N

    1996-04-01

    Analysis of three waves of Perinatal Grief Scale scores for 194 bereaved subjects over the course of two years revealed patterns of change different from those commonly noted in the literature. Less than half the sample matched the "normal" model; the rest exhibited non-normal patterns that did not fit the alternative psychological models. Demographic variables and pregnancy history, both before and after the loss, help explain some of the differences in direction of the grief response. PMID:9173804

  8. Ultrasound for fetal assessment in early pregnancy

    PubMed Central

    Whitworth, Melissa; Bricker, Leanne; Neilson, James P; Dowswell, Therese

    2014-01-01

    Background Diagnostic ultrasound is a sophisticated electronic technology, which utilises pulses of high frequency sound to produce an image. Diagnostic ultrasound examination may be employed in a variety of specific circumstances during pregnancy such as after clinical complications, or where there are concerns about fetal growth. Because adverse outcomes may also occur in pregnancies without clear risk factors, assumptions have been made that routine ultrasound in all pregnancies will prove beneficial by enabling earlier detection and improved management of pregnancy complications. Routine screening may be planned for early pregnancy, late gestation, or both. The focus of this review is routine early pregnancy ultrasound. Objectives To assess whether routine early pregnancy ultrasound for fetal assessment (i.e. its use as a screening technique) influences the diagnosis of fetal malformations, multiple pregnancies, the rate of clinical interventions, and the incidence of adverse fetal outcome when compared with the selective use of early pregnancy ultrasound (for specific indications). Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (September 2009). Selection criteria Published, unpublished, and ongoing randomised controlled trials that compared outcomes in women who experienced routine versus selective early pregnancy ultrasound (i.e. less than 24 weeks’ gestation). We have included quasi-randomised trials. Data collection and analysis Two review authors independently extracted data for each included study. We used the Review Manager software to enter and analyse data. Main results Routine/revealed ultrasound versus selective ultrasound/concealed: 11 trials including 37505 women. Ultrasound for fetal assessment in early pregnancy reduces the failure to detect multiple pregnancy by 24 weeks’ gestation (risk ratio (RR) 0.07, 95% confidence interval (CI) 0.03 to 0.17). Routine scan is associated with a reduction in

  9. Loss of Endometrial Plasticity in Recurrent Pregnancy Loss.

    PubMed

    Lucas, Emma S; Dyer, Nigel P; Murakami, Keisuke; Lee, Yie Hou; Chan, Yi-Wah; Grimaldi, Giulia; Muter, Joanne; Brighton, Paul J; Moore, Jonathan D; Patel, Gnyaneshwari; Chan, Jerry K Y; Takeda, Satoru; Lam, Eric W-F; Quenby, Siobhan; Ott, Sascha; Brosens, Jan J

    2016-02-01

    Menstruation drives cyclic activation of endometrial progenitor cells, tissue regeneration, and maturation of stromal cells, which differentiate into specialized decidual cells prior to and during pregnancy. Aberrant responsiveness of human endometrial stromal cells (HESCs) to deciduogenic cues is strongly associated with recurrent pregnancy loss (RPL), suggesting a defect in cellular maturation. MeDIP-seq analysis of HESCs did not reveal gross perturbations in CpG methylation in RPL cultures, although quantitative differences were observed in or near genes that are frequently deregulated in vivo. However, RPL was associated with a marked reduction in methylation of defined CA-rich motifs located throughout the genome but enriched near telomeres. Non-CpG methylation is a hallmark of cellular multipotency. Congruently, we demonstrate that RPL is associated with a deficiency in endometrial clonogenic cell populations. Loss of epigenetic stemness features also correlated with intragenic CpG hypomethylation and reduced expression of HMGB2, coding high mobility group protein 2. We show that knockdown of this sequence-independent chromatin protein in HESCs promotes senescence and impairs decidualization, exemplified by blunted time-dependent secretome changes. Our findings indicate that stem cell deficiency and accelerated stromal senescence limit the differentiation capacity of the endometrium and predispose for pregnancy failure. PMID:26418742

  10. Managing miscarriage in early pregnancy assessment units.

    PubMed

    Bradley, E; Hamilton-Fairley, D

    1998-06-01

    For most women, pregnancy is a significant life event and the prospect of losing a baby causes anxiety, stress and grief. Modern treatment of miscarriage should provide rapid sympathetic diagnosis and adequate counselling. Early pregnancy assessment units benefit patients, staff and the NHS. Many clinicians use medical treatment or expectant management, rather than standard surgical evacuation of the uterus. PMID:9775272

  11. Marriage and Cohabitation Outcomes After Pregnancy Loss

    PubMed Central

    Gold, Katherine J.; Sen, Ananda; Hayward, Rodney A.

    2010-01-01

    OBJECTIVE The goal was to evaluate marriage and cohabitation outcomes for couples who experienced a live birth or fetal death at any gestational age. METHODS For married and cohabitating women who experienced live births, miscarriages, or stillbirths, we conducted a survival analysis (median follow-up period: 7.8 years), by using data from the National Survey of Family Growth, to examine the association between birth outcomes and subsequent relationship survival. The Cox proportional-hazards models controlled for multiple independent risk factors known to affect relationship outcomes. The main outcome measure was the proportion of intact marriages or cohabitations over time. RESULTS Of 7770 eligible pregnancies, 82% ended in live births, 16% in miscarriages, and 2% in stillbirths. With controlling for known risk factors, women who experienced miscarriages (hazard ratio: 1.22 [95% confidence interval: 1.08–1.38]; P = .001) or stillbirths (hazard ratio: 1.40 [95% confidence interval: 1.10–1.79]; P = .007) had a significantly greater hazard of their relationship ending, compared with women whose pregnancies ended in live births. CONCLUSIONS This is the first national study to establish that parental relationships have a higher risk of dissolving after miscarriage or stillbirth, compared with live birth. Given the frequency of pregnancy loss, these findings might have significant societal implications if causally related. PMID:20368319

  12. The effect of a very short interpregnancy interval and pregnancy outcomes following a previous pregnancy loss

    PubMed Central

    WONG, Luchin F.; SCHLIEP, Karen C.; SILVER, Robert M.; MUMFORD, Sunni L.; PERKINS, Neil J.; YE, Aijun; GALAI, Noya; WACTAWSKI-WENDE, Jean; LYNCH, Anne M.; TOWNSEND, Janet M.; FARAGGI, David; SCHISTERMAN, Enrique F.

    2014-01-01

    Objective We sought to assess the relationship between a short interpregnancy interval (IPI) following a pregnancy loss and subsequent live birth and pregnancy outcomes. Study Design A secondary analysis of women enrolled in the Effects of Aspirin in Gestation and Reproduction trial with an hCG-positive pregnancy test and whose last reproductive outcome was a loss were included in this analysis (n=677). IPI was defined as the time between last pregnancy loss and last menstrual period of the current pregnancy and categorized by 3-month intervals. Pregnancy outcomes include live birth, pregnancy loss, and any pregnancy complications. These were compared between IPI groups using multivariate relative risk estimation by Poisson regression. Results Demographic characteristics were similar between IPI groups. The mean gestational age of prior pregnancy loss was 8.6 ± 2.8 weeks. The overall live birth rate was 76.5%, with similar live birth rates between those with IPI ≤ 3 months as compared to IPI > 3 months, aRR=1.07 (95% CI 0.98–1.16). Rates were also similar for peri-implantation loss (aRR=0.95; 95% CI 0.51–1.80), clinically confirmed loss, (aRR=0.75; 95% CI 0.51–1.10), and any pregnancy complication (aRR=0.88; 95% CI 0.71–1.09) for those with IPI ≤ 3 months as compared to IPI > 3 months. Conclusion Live birth rates and adverse pregnancy outcomes, including pregnancy loss, were not associated with a very short IPI after a prior pregnancy loss. The traditional recommendation to wait at least 3 months after a pregnancy loss before attempting a new pregnancy may not be warranted. PMID:25246378

  13. FAQs of Pregnancy Loss and Miscarriage

    MedlinePlus

    ... for miscarriage in a subsequent pregnancy? Is there anything a woman can do to prevent a pregnancy ... Most of the time, a woman cannot do anything to prevent a miscarriage. Getting preconception care and ...

  14. Adolescent pregnancy loss. A school-based program.

    PubMed

    Shaefer, S J

    1992-04-01

    A school-based program is proposed for meeting the needs of teenagers who experience a pregnancy loss or infant death. School nurses are well situated in the school setting to provide support to the bereaved teenage mother. The pregnancy is considered in the context of developmental task achievement, and the effects thereon of loss of the pregnancy or infant death. Adolescent grief reactions are discussed, with an emphasis on the tasks of grief. PMID:1568078

  15. Pregnancy after miscarriage: balancing between loss of control and searching for control.

    PubMed

    Ockhuijsen, Henrietta D L; van den Hoogen, Agnes; Boivin, Jacky; Macklon, Nicholas S; de Boer, Fijgje

    2014-08-01

    Pregnant women who have had miscarriages face challenges in responding to the loss of the previous pregnancy and the uncertainties of the early pregnancy that follows. The research question in this qualitative study was: How do women experience miscarriage, conception, and the early pregnancy waiting period, and what types of coping strategies do they use during these periods? Twenty-four women were interviewed in a subsequent pregnancy after having a miscarriage. Data analyses resulted in an overarching theme described as "balancing between loss of control and searching for control." Although women realized there was little they could do to influence the outcome, they searched for strategies to increase the feeling of control in each period of waiting. The results of this study may contribute to interventions to support women during miscarriage and subsequent conception and pregnancy. PMID:24974799

  16. Pregnancy losses in cattle: potential for improvement.

    PubMed

    Diskin, M G; Waters, S M; Parr, M H; Kenny, D A

    2015-02-01

    For heifers, beef and moderate-yielding dairy cows, it appears that the fertilisation rate generally lies between 90% and 100%. For high-producing dairy cows, there is a less substantive body of literature, but it would appear that the fertilisation rate is somewhat lower and possibly more variable. In cattle, the major component of embryo loss occurs in the first 16 days following breeding (Day 0), with emerging evidence of greater losses before Day 8 in high-producing dairy cows. In cattle, late embryo mortality causes serious economic losses because it is often recognised too late to rebreed females. Systemic concentrations of progesterone during both the cycle preceding and following insemination affect embryo survival, with evidence of either excessive or insufficient concentrations being negatively associated with survival rate. The application of direct progesterone supplementation or treatments to increase endogenous output of progesterone to increase embryo survival cannot be recommended at this time. Energy balance and dry matter intake during the first 4 weeks after calving are critically important in determining pregnancies per AI when cows are inseminated at 70-100 days after calving. Level of concentrate supplementation of cows at pasture during the breeding period has minimal effects on conception rates, although sudden reductions in dietary intake should be avoided. For all systems of milk production, more balanced breeding strategies with greater emphasis on fertility and feed intake and/or energy must be developed. There is genetic variability within the Holstein breed for fertility traits, which can be exploited. Genomic technology will not only provide scientists with an improved understanding of the underlying biological processes involved in fertilisation and the establishment of pregnancy, but also, in the future, could identify genes responsible for improved embryo survival. Such information could be incorporated into breeding objectives in

  17. Pivotal periods for pregnancy loss during the first trimester of gestation in lactating dairy cows.

    PubMed

    Wiltbank, Milo C; Baez, Giovanni M; Garcia-Guerra, Alvaro; Toledo, Mateus Z; Monteiro, Pedro L J; Melo, Leonardo F; Ochoa, Julian C; Santos, José E P; Sartori, Roberto

    2016-07-01

    Loss of pregnancy can occur at many different stages of gestation and for a variety of causes but clearly produces a negative impact for reproductive and economic performances of dairy herds. This review describes four pivotal periods for pregnancy loss during the first trimester of gestation and discusses possible causes for pregnancy failure during these periods. The first period occurs during the first week after breeding with lack of fertilization and death of the early embryo producing major losses in pregnancy, particularly under specific environmental and hormonal conditions. In general, 20%-50% of high-producing lactating dairy cows have already experienced pregnancy loss during the first week of gestation with methods to decrease pregnancy loss during this period targeting improved oocyte quality by alleviating heat stress, inflammatory diseases, and body condition loss, and by increasing progesterone concentrations during preovulatory follicle development. The second pivotal period, from Days 8 to 27, encompasses embryo elongation and the classical "maternal recognition of pregnancy" period with losses averaging ∼30% but with surprising variation between farms (25%-41%). Maintenance of the CL of pregnancy is produced by the embryonic signal interferon-tau and alteration in uterine secretory patterns of prostaglandins F2α, E1, and E2. Failures or delays in trophoblast elongation and/or embryonic development result in loss of pregnancy during the second pivotal period possibly due to suboptimal histotroph. The third pivotal period is during the second month of pregnancy, Days 28 to 60, with losses of ∼12% based on a summary of published results from more than 20,000 pregnancies in high-producing dairy cows. Delays or defects in development of the chorioallantoic placentomes or embryo result in CL regression or embryo death during this pivotal period. Finally, a fourth period during the third month of pregnancy has reduced pregnancy losses (∼2

  18. The epidemiology of recurrent pregnancy loss.

    PubMed

    Cramer, D W; Wise, L A

    2000-01-01

    In reviewing the epidemiology of recurrent abortion (RAB), we believe it is necessary to consider the epidemiology of spontaneous abortion (SAB) as well, since it is clear that even a single pregnancy loss increases the risk for a subsequent abortion. In addition, any attempt to identify epidemiologic risk factors for SAB or RAB must deal with the fact that at least 50% of SABs are associated with genetic abnormalities. Given that most epidemiologic studies have not distinguished karyotypically abnormal abortuses, risk factors are likely to be underestimated. Nevertheless, there is fair agreement that a variety of factors may increase risk for SAB or RAB, including advanced maternal age, single gene mutations such as PKU or G6PD deficiency, structural abnormalities of the uterus, poorly controlled diabetes, antiphospholipid syndrome, and smoking. More controversial is the role of luteal phase defect or hyperandrogenism, alloimmune factors, genital infections, caffeine or alcohol use, and trace element or chemical exposure from tap water or in the workplace. Besides better designed epidemiologic studies to detect modifiable risk factors for SAB or RAB, there is a clear need for clinical trials of therapy for RAB which meet minimum epidemiologic standards including randomization, double-blinded (when possible), and placebo-controlled (when ethical). PMID:11355791

  19. Anti-early pregnancy by PDT

    NASA Astrophysics Data System (ADS)

    Ding, Ai-Hua; Chen, Hui-Ling

    1993-03-01

    The effect of laser on anti-early pregnancy in rabbits showed that laser in combination with HPD could induce necrosis of blastocysts and complete absorption. The anti-fertility efficiency of the combined treatment was more effective than that of the He-Ne laser or the HPD treatment alone. The fluorescence spectrum of HPD determined by PNQ3 showed that its affinity to embryonic tissue was about 4 times greater than that to uterine tissue. This may underlie the mechanisms of anti-early pregnancy of the laser. The operation of artificial abortion is a routine method to terminate early pregnancy. Though it is simple and easy, its syndrome and complications can not be absolutely avoided. Many antifertility drugs have been reported, however, they often bring in general reaction. Our present work is to explore a new way of anti-early pregnancy in rabbits by means of the light inhibitory and light sensitive effects of laser. It is a quite safe and painless treatment without expanding and scraping of the uterus.

  20. [Technical research on termination of early pregnancy].

    PubMed

    Hu, C P; Qi, M K; Xiu, Y G; An, Y X; Jin, Z S

    1983-02-01

    The research on contraceptives for embryogenesis and pregnancy termination by applying prostaglandins and Chinese medicinal herbs has now achieved great acclaim both at home and abroad. However, these achievements cannot be considered satisfactory as of yet because the time necessary for abortion is great, and the embryo cannot be evacuated so completely. In particular, during the early stages of pregnancy, menstrual induction and pregnancy termination with drugs cannot be considered ideal. However, when utilizing a capillary mechanical method, a simple sweeping and absorbing operation is performed in the uterine cavity 2-10 days after menstruation. The uterus internal membrane can be peeled off, thus physiologically interrupting the pregnancy. The embryo can thus be eliminated at the earliest stage and the induction of menstruation and cessation of pregnancy can be brought about quickly. From the clinical observations made on 200 cases selected at random out of 1400 cases and controls, it is shown that abortion time is shortened, and that the embryo is eliminated thorougly. This occurs faster, results in less bleeding, and less discomfort, and without side effects. Therefore, it may be regarded as a safe, reliable new technology for the earliest pregnancy termination. (author's modified) PMID:12339178

  1. [Preplacentation pregnancy loss in cases of angiotensin-converting enzyme insertion/deletion polymorphism].

    PubMed

    Ivanov, P; Konova, E; Komsa-Penkova, R; Kovacheva, K; Nikolov, N; Simeonova, M; Tanchev, St

    2014-01-01

    The balance between coagulation and fibrinolysis processes is critical for establishment and development of early pregnancy. Angiotensin-converting enzyme (ACE) is related with plasminogen activator inhibitor-1 activity which is a key regulator in embryo implantation. Therefor polymorphisms in ACE gene and variation in ACE activity could be associated with an early pregnancy wastage risk. This study investigated carrier status for insertion/deletion (I/D) polymorphism in introne 16 of ACE gene in 71 women with two or more pregnancy loss in preplacentation period (between 10 and 14 weeks of gestation) and 75 women without pregnancy complications. DD genotype for I/D polymorphism was found respectively in 31% and 24% in patients and controls. Heterozygosity of D allele was found correspondingly in 47.9% and 54.7%. The dominant genetic model was used for allele prevalence comparison. D allele in DD genotype was not significantly prevalent in women with early pregnancy wastage compared with the control subjects, OR = 1.42, 95% CI (0.64-3.15). The study found a weak association between I/D polymorphism and preplacentation pregnancy loss. The additive effect over the pregnancy loss risk of I/D polymorphism could be supposed in a presence of other inherited or acquired factors connected with endometrial receptivity and implantation process. PMID:25510065

  2. Maternal disturbance in activated sphingolipid metabolism causes pregnancy loss in mice

    PubMed Central

    Mizugishi, Kiyomi; Li, Cuiling; Olivera, Ana; Bielawski, Jacek; Bielawska, Alicja; Deng, Chu-Xia; Proia, Richard L.

    2007-01-01

    Uterine decidualization, a process that occurs in response to embryo implantation, is critical for embryonic survival and thus is a key event for successful pregnancy. Here we show that the sphingolipid metabolic pathway is highly activated in the deciduum during pregnancy and disturbance of the pathway by disruption of sphingosine kinase (Sphk) genes causes defective decidualization with severely compromised uterine blood vessels, leading to early pregnancy loss. Sphk-deficient female mice (Sphk1–/–Sphk2+/–) exhibited both an enormous accumulation of dihydrosphingosine and sphingosine and a reduction in phosphatidylethanolamine levels in pregnant uteri. These mice also revealed increased cell death in decidual cells, decreased cell proliferation in undifferentiated stromal cells, and massive breakage of decidual blood vessels, leading to uterine hemorrhage and early embryonic lethality. Thus, sphingolipid metabolism regulates proper uterine decidualization and blood vessel stability. Our findings also suggest that disturbance in sphingolipid metabolism may be considered as a cause of pregnancy loss in humans. PMID:17885683

  3. How Do Health Care Providers Diagnose Pregnancy Loss or Miscarriage?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pregnancy loss or miscarriage? Skip sharing ... light spotting, or bleeding, she should contact her health care provider immediately. For diagnosis, the woman may need ...

  4. Systems biology approach to understanding uterine receptivity and pregnancy loss

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Infertility and subfertility represent major problems in domestic animals and humans. The majority of embryonic loss in those species occurs during the first month of gestation when pregnancy recognition and conceptus (embryo and associated extraembryonic membranes) implantation are obligatory. The ...

  5. Pregnancy and Infant Loss: Supporting Parents and Their Children

    ERIC Educational Resources Information Center

    O'Leary, Joann M.

    2007-01-01

    The loss of a child during pregnancy or infancy raises challenging questions about how to communicate with very young siblings about the family's loss. What to say and how to say it varies with the developmental level of the child and the circumstances of the loss, as well as the family's culture, values, and beliefs. Children need open and honest…

  6. Systematic Review of Chinese Medicine for Miscarriage during Early Pregnancy

    PubMed Central

    Leung, Ping Chung; Chung, Tony Kwok Hung; Wang, Chi Chiu

    2014-01-01

    Background. Miscarriage is a very common complication during early pregnancy. So far, clinical therapies have limitation in preventing the early pregnancy loss. Chinese Medicine, regarded as gentle, effective, and safe, has become popular and common as a complementary and alternative treatment for miscarriages. However, the evidence to support its therapeutic efficacy and safety is still very limited. Objectives and Methods. To summarize the clinical application of Chinese Medicine for pregnancy and provide scientific evidence on the efficacy and safety of Chinese medicines for miscarriage, we located all the relevant pieces of literature on the clinical applications of Chinese Medicine for miscarriage and worked out this systematic review. Results. 339,792 pieces of literature were identified, but no placebo was included and only few studies were selected for systematic review and conducted for meta-analysis. A combination of Chinese medicines and Western medicines was more effective than Chinese medicines alone. No specific safety problem was reported, but potential adverse events by certain medicines were identified. Conclusions. Studies vary considerably in design, interventions, and outcome measures; therefore conclusive results remain elusive. Large scales of randomized controlled trials and more scientific evidences are still necessary to confirm the efficacy and safety of Chinese medicines during early pregnancy. PMID:24648851

  7. Medical approaches to termination of early pregnancy.

    PubMed Central

    Van Look, P. F.; Bygdeman, M.

    1989-01-01

    Termination of early pregnancy by vacuum aspiration is a well-established technique. The procedure is highly effective and has a low complication rate, particularly when performed during the first few weeks after missed menses. However, this parasurgical method requires skilled health care personnel, and attempts have therefore been made to find medical alternatives. Prostaglandins were the first agents to be used successfully for this purpose, but the high incidence of mainly gastrointestinal side-effects has limited their widespread use. More recently, attention has focused on antiprogestational steroids, i.e., compounds that prevent the action of progesterone either by inhibiting its biosynthesis or by preventing it from binding to the cellular receptors in target organs. Current experience indicates that these compounds, particularly when used in combination with a low dose of a synthetic prostaglandin analogue, have the potential to become a safe, effective, and acceptable medical method for the termination of early pregnancy. PMID:2692870

  8. An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

    PubMed Central

    Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

    2014-01-01

    Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

  9. Recurrent spontaneous intracranial hypotension in early pregnancy.

    PubMed

    McGrath, Emer; Monaghan, Thomas S; Alexander, Michael; Hennessy, Michal J

    2010-01-01

    Spontaneous intracranial hypotension (SIH) is an uncommon condition characterised by postural headache secondary to low cerebrospinal fluid pressure. Here we present a case of recurrence of SIH in early pregnancy in a 26-year-old woman. She first presented at the age of 21 years at 15 weeks' gestation with a history of headache, nausea, vomiting, neck stiffness and photophobia. Findings from a MRI brain scan led to a diagnosis of SIH. She was treated with autologous epidural blood patching and remained asymptomatic until her second pregnancy 5 years later, when she re-presented at 16 weeks' gestation with similar symptoms. She was again diagnosed with SIH and required a repeat treatment of autologous epidural blood patching. She subsequently remained symptom free and delivered a healthy boy at term. PMID:22791729

  10. Clinical B12 deficiency in one case of recurrent spontaneous pregnancy loss.

    PubMed

    Candito, Mirande; Magnaldo, Sarah; Bayle, Jacques; Dor, Jean-François; Gillet, Yves; Bongain, André; Van Obberghen, Emmanuel

    2003-08-01

    Moderate hyperhomocysteinaemia (HHcy) and the homozygous mutation C677T in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene are associated with increased risk of recurrent pregnancy loss. This HHcy is currently reported as a consequence of folate rather than of vitamin B12-deficient status. We describe one case of recurrent early pregnancy loss with HHcy caused by B12 deficiency. A 38-year old woman had four episodes of early spontaneous pregnancy loss. Biological data: no haemostasis disorders, HHcy (25.9 micromol/l), normal folate (5 ng/ml), B12 deficiency (< 150 pg/ml) and the MTHFR C677T homozygote genotype. A bone marrow biopsy gave evidence of moderate megaloblastosis. Parenteral B12 therapy led to normal homocysteine level within 2 months and to a successful pregnancy. In conclusion, vitamin B12 deficiency is one of the causes of recurrent pregnancy loss associated with HHcy, and serum B12 should be measured systematically in this circumstance. PMID:12964808

  11. Pregnancy loss in lesbian and bisexual women: an online survey of experiences

    PubMed Central

    Peel, Elizabeth

    2010-01-01

    BACKGROUND Although pregnancy loss is a distressing health event for many women, research typically equates women's experiences of pregnancy loss to ‘married heterosexual women's experiences of pregnancy loss’. The objective of this study was to explore lesbian and bisexual women's experiences of miscarriage, stillbirth and neonatal death. METHODS This study analysed predominantly qualitative online survey data from 60 non-heterosexual, mostly lesbian, women from the UK, USA, Canada and Australia. All but one of the pregnancies was planned. Most respondents had physically experienced one early miscarriage during their first pregnancy, although a third had experienced multiple losses. RESULTS The analysis highlights three themes: processes and practices for conception; amplification of loss; and health care and heterosexism. Of the respondents, 84% conceived using donor sperm; most used various resources to plan conception and engaged in preconception health care. The experience of loss was amplified due to contextual factors and the investment respondents reported making in impending motherhood. Most felt that their loss(es) had made a ‘significant’/‘very significant’ impact on their lives. Many respondents experienced health care during their loss. Although the majority rated the overall standard of care as ‘good’/‘very good’/‘outstanding’, a minority reported experiencing heterosexism from health professionals. CONCLUSIONS The implications for policy and practice are outlined. The main limitation was that the inflexibility of the methodology did not allow the specificities of women's experiences to be probed further. It is suggested that both coupled and single non-heterosexual women should be made more visible in reproductive health and pregnancy loss research. PMID:20023293

  12. Alkaline Phosphatase Protects Lipopolysaccharide-Induced Early Pregnancy Defects in Mice

    PubMed Central

    Lei, Wei; Ni, Hua; Herington, Jennifer; Reese, Jeff; Paria, Bibhash C.

    2015-01-01

    Excessive cytokine inflammatory response due to chronic or superphysiological level of microbial infection during pregnancy leads to pregnancy complications such as early pregnancy defects/loss and preterm birth. Bacterial toxin lipopolysaccharide (LPS), long recognized as a potent proinflammatory mediator, has been identified as a risk factor for pregnancy complications. Alkaline phosphatase (AP) isozymes have been shown to detoxify LPS by dephosphorylation. In this study, we examined the role of alkaline phosphatase (AP) in mitigating LPS-induced early pregnancy complications in mice. We found that 1) the uterus prior to implantation and implantation sites following embryo implantation produce LPS recognition and dephosphorylation molecules TLR4 and tissue non-specific AP (TNAP) isozyme, respectively; 2) uterine TNAP isozyme dephosphorylates LPS at its sites of production; 3) while LPS administration following embryo implantation elicits proinflammatory cytokine mRNA levels at the embryo implantation sites (EISs) and causes early pregnancy loss, dephosphorylated LPS neither triggers proinflammatory cytokine mRNA levels at the EISs nor induces pregnancy complications; 4) AP isozyme supplementation to accelerate LPS detoxification attenuates LPS-induced pregnancy complications following embryo implantation. These findings suggest that a LPS dephosphorylation strategy using AP isozyme may have a unique therapeutic potential to mitigate LPS- or Gram-negative bacteria-induced pregnancy complications in at-risk women. PMID:25910276

  13. Possible Early Warning of Pregnancy Abnormalities

    MedlinePlus

    ... pregnancies are ectopic. Another condition, known as “blighted ovum,” the fertilized egg also fails to develop into ... genetic factors involved in ectopic pregnancy and blighted ovum. In healthy pregnancies, the fertilized egg develops into ...

  14. [Support for teenage pregnancies and early emotional deprivation].

    PubMed

    Andro, Gwénäelle

    2016-01-01

    The perinatal psychology and psychiatry unit of Caen university hospital has put in place two systematic intervention protocols relating to pregnancy: teenage pregnancy and denial of pregnancy. Professionals are particularly concerned with teenagers with a history of early emotional deprivation and mistreatment, with the spectre of repetition. A partnership with a motherhood centre helps all concerned to work together to build resilience. PMID:27444534

  15. Distinction between early normal intrauterine pregnancies and pathological pregnancies by means of a logistic model.

    PubMed

    Thorburn, J; Bryman, I; Hahlin, M

    1992-01-01

    The probability of an unclear very early pregnancy being a normal intrauterine pregnancy was estimated using a logistic model. Five diagnostic measures of prognostic value were identified in the model: (i) daily change in human chorionic gonadotrophin (HCG), (ii) results of transvaginal ultrasound, (iii) vaginal bleeding, (iv) serum progesterone level and (v) risk score for ectopic pregnancy. With the use of this model, the probability of a normal intrauterine pregnancy has been estimated as 96.7%. PMID:1551947

  16. Pregnancy Loss and Distress among U.S. Women

    ERIC Educational Resources Information Center

    Shreffler, Karina M.; Greil, Arthur L.; McQuillan, Julia

    2011-01-01

    Although pregnancy loss--especially miscarriage--is a relatively common experience among reproductive-aged women, much of our understanding about the experience has come from small clinic-based or other nonrepresentative samples. We compared fertility-specific distress among a national sample of 1,284 women who have ever experienced a stillbirth…

  17. Endocrinologic events in early pregnancy failure.

    PubMed

    Aspillaga, M O; Whittaker, P G; Grey, C E; Lind, T

    1983-12-15

    Fourteen women experiencing early pregnancy failure have been studied during the time of conception and at frequent intervals until spontaneous abortion occurred. Serial measurements of serum estradiol, progesterone, 17 alpha-hydroxyprogesterone, prolactin, human placental lactogen (hPL), and human chorionic gonadotropin (hCG) were determined; regular sonar scanning allowed the time of fetal death to be determined to within 7 days in six patients and a diagnosis of blighted ovum to be made in the remainder. In all patients serum progesterone and estradiol concentrations were within the normal range up to 7 weeks but appeared to decrease from about 8 weeks' gestation whether or not a living fetus was present. The placenta continued to produce hCG and hPL but, despite the continuing presence of hCG, the levels of 17 alpha-hydroxyprogesterone declined to concentrations below those associated with normal pregnancy. These data suggest that the placenta may require a particular stimulus to take over production of progesterone and estradiol. PMID:6650626

  18. Early Childhood Adversity and Pregnancy Outcomes

    PubMed Central

    Smith, Megan V.; Gotman, Nathan; Yonkers, Kimberly A.

    2016-01-01

    Objectives To examine the association between adverse childhood experiences (ACEs) and pregnancy outcomes; to explore mediators of this association including psychiatric illness and health habits. Methods Exposure to ACEs was determined by the Early Trauma Inventory Self Report Short Form; psychiatric diagnoses were generated by the Composite International Diagnostic Interview administered in a cohort of 2303 pregnant women. Linear regression and structural equation modeling bootstrapping approaches tested for multiple mediators. Results Each additional ACE decreased birth weight by 16.33 g and decreased gestational age by 0.063. Smoking was the strongest mediator of the effect on gestational age. Conclusions ACEs have an enduring effect on maternal reproductive health, as manifested by mothers’ delivery of offspring that were of reduced birth weight and shorter gestational age. PMID:26762511

  19. Early Childhood Adversity and Pregnancy Outcomes.

    PubMed

    Smith, Megan V; Gotman, Nathan; Yonkers, Kimberly A

    2016-04-01

    Objectives To examine the association between adverse childhood experiences (ACEs) and pregnancy outcomes; to explore mediators of this association including psychiatric illness and health habits. Methods Exposure to ACEs was determined by the Early Trauma Inventory Self Report Short Form; psychiatric diagnoses were generated by the Composite International Diagnostic Interview administered in a cohort of 2303 pregnant women. Linear regression and structural equation modeling bootstrapping approaches tested for multiple mediators. Results Each additional ACE decreased birth weight by 16.33 g and decreased gestational age by 0.063. Smoking was the strongest mediator of the effect on gestational age. Conclusions ACEs have an enduring effect on maternal reproductive health, as manifested by mothers' delivery of offspring that were of reduced birth weight and shorter gestational age. PMID:26762511

  20. Spontaneous Pregnancy Loss in Denmark Following Economic Downturns.

    PubMed

    Bruckner, Tim A; Mortensen, Laust H; Catalano, Ralph A

    2016-04-15

    An estimated 11%-20% of clinically recognized pregnancies result in spontaneous abortion. The literature finds elevated risk of spontaneous abortion among women who report adverse financial life events. This work suggests that, at the population level, national economic decline-an ambient and plausibly unexpected stressor-will precede an increase in spontaneous abortion. We tested this hypothesis using high-quality information on pregnancy and spontaneous loss for all women in Denmark. We applied time-series methods to monthly counts of clinically detected spontaneous abortions (n = 157,449) and the unemployment rate in Denmark beginning in January 1995 and ending in December 2009. Our statistical methods controlled for temporal patterns in spontaneous abortion (e.g., seasonality, trend) and changes in the population of pregnancies at risk of loss. Unexpected increases in the unemployment rate preceded by 1 month a rise in the number of spontaneous abortions (β = 33.19 losses/month, 95% confidence interval: 8.71, 57.67). An attendant analysis that used consumption of durable household goods as an indicator of financial insecurity supported the inference from our main test. Changes over time in elective abortions and in the cohort composition of high-risk pregnancies did not account for results. It appears that in Denmark, ambient stressors as common as increasing unemployment may precede a population-level increase in spontaneous abortion. PMID:27009344

  1. A method for isolating and culturing placental cells from failed early equine pregnancies.

    PubMed

    Rose, B V; Cabrera-Sharp, V; Firth, M J; Barrelet, F E; Bate, S; Cameron, I J; Crabtree, J R; Crowhurst, J; McGladdery, A J; Neal, H; Pynn, J; Pynn, O D; Smith, C; Wise, Z; Verheyen, K L P; Wathes, D C; de Mestre, A M

    2016-02-01

    Early pregnancy loss occurs in 6-10% of equine pregnancies making it the main cause of reproductive wastage. Despite this, reasons for the losses are known in only 16% of cases. Lack of viable conceptus material has inhibited investigations of many potential genetic and pathological causes. We present a method for isolating and culturing placental cells from failed early equine pregnancies. Trophoblast cells from 18/30 (60%) failed equine pregnancies of gestational ages 14-65 days were successfully cultured in three different media, with the greatest growth achieved for cells cultured in AmnioChrome™ Plus. Genomic DNA of a suitable quality for molecular assays was also isolated from 29/30 of these cases. This method will enable future investigations determining pathologies causing EPL. PMID:26907389

  2. The effects of maternal exercise on early pregnancy outcome.

    PubMed

    Clapp, J F

    1989-12-01

    This study was designed to test the hypothesis that vigorous aerobic exercise during both the periconceptional period and early pregnancy increases the incidence of abnormal early pregnancy outcome. Exercise performance was prospectively monitored before and during pregnancy in 47 recreational runners, 40 aerobic dancers, and 28 physically active, fit controls. Pregnancy was diagnosed by an early test for beta-subunit human chorionic gonadotropin and viability was confirmed by ultrasonography at 40 days' conceptional age. Spontaneous abortion occurred in 19% of the pregnancies. The incidence was 17% in the runners, 18% in the aerobic dancers, and 25% in the controls. At term, one congenital abnormality was detected in each of the three groups. Late pregnancy events, potentially related to abnormalities of placentation, were limited to two cases of mild pregnancy-induced hypertension. We conclude that, in physically fit women, continuation of these types of aerobic activity at intensities between 50% and 85% of maximum during the periconceptional period and early pregnancy does not appreciably alter early pregnancy outcome. PMID:2603898

  3. Collecting data on pregnancy loss: a review of evidence from the World Fertility Survey.

    PubMed

    Casterline, J B

    1989-01-01

    Estimates of levels and differentials of pregnancy loss are presented for 40 developing countries participating in the World Fertility Survey (WFS) program. Judged against agreed-upon levels of spontaneous loss in human populations, WFS surveys measured from 50 to 80 percent of recognizable losses. The coverage of induced abortions appears to be much worse. Consistent with data from other sources and settings, the probability of loss is strongly correlated with maternal demographic characteristics: age, pregnancy order, pregnancy spacing, and pregnancy loss history. Despite incomplete coverage, the WFS data on pregnancy loss provide considerable, and largely unexploited, insight on the dynamics of the reproductive career. PMID:2655191

  4. Early Diagnosis of a Large Vesical Calculus Complicating Pregnancy

    PubMed Central

    Pricilla, Ruby Angeline; David, Kirubah Vasandhi; Venkatesan, Sankarapandian; Benjamin, Santosh Joseph

    2013-01-01

    Vesical calculus-complicating pregnancy is rare. This is a case report of a large vesical calculus-complicating pregnancy. The early diagnosis and appropriate surgical management of the large vesical calculus prevented complications like recurrent urinary tract infections and obstructed labor. It enabled the mother to have an uneventful vaginal delivery. PMID:24479053

  5. Thyroid hormone concentrations in relation to age, sex, pregnancy, and perinatal loss in bottlenose dolphins (Tursiops truncatus).

    PubMed

    West, Kristi L; Ramer, Jan; Brown, Janine L; Sweeney, Jay; Hanahoe, Erin M; Reidarson, Tom; Proudfoot, Jeffry; Bergfelt, Don R

    2014-02-01

    This study evaluated circulating concentrations of thyroid hormones in relation to age, sex, pregnancy status, and perinatal loss in bottlenose dolphins (Tursiops truncatus) under human care. A total of 373 blood samples were collected from 60 individual dolphins housed at nine aquariums/oceanariums. Serum concentrations of total and free thyroxine (T4) and triiodothyronine (T3) were analyzed with commercial RIA kits validated for use with dolphins. While the effect of age was indicated by higher (P<0.0001) concentrations of total and free T4 and T3 in juveniles than adults, the effect of sex on thyroid hormones was inconclusive. The effect of pregnancy was indicated by higher (P<0.035) total and free T4 and T3 during early pregnancy compared to non-pregnancy. For both successful and unsuccessful pregnancy outcomes, maternal concentrations of thyroid hormones were highest during early, intermediate during mid, and lowest during late pregnancy (P<0.07 to P<0.0001). Compared to live and thriving births, concentrations of total and free T4 and total T3 were lower (P<0.08 to P<0.001) in dolphins with perinatal loss. Lower concentrations ranged from 10% to 14% during early, 11% to 18% during mid, and 23% to 37% during late pregnancy. In conclusion, the effects of age, reproductive status and stage of pregnancy on thyroid hormone concentrations are necessary factors to take into account when assessing thyroid gland function. Since perinatal loss may be associated with hypothyroidism in dolphins, analysis of serum T4 and T3 should be considered for those dolphins that have a history of pregnancy loss. PMID:24321177

  6. Invited Commentary: Preventable Pregnancy Loss Is a Public Health Problem.

    PubMed

    Hogue, Carol J

    2016-04-15

    Pregnancy loss is common and can lead to long-standing parental depression and related problems. In this issue, a study of Danish registries by Bruckner et al. (Am J Epidemiol. 2016;183(8):701-708) correlates monthly trends in unemployment with monthly trends in reported spontaneous abortion, lagged by 1 month. The observed association might be caused by a general population phenomenon, as suggested by the authors, or might represent an increased miscarriage risk only within the subset of the population that is directly affected by lost income. Preventive interventions will vary depending on which interpretation is more likely. Research into the preventability of miscarriages and stillbirths is hampered in the United States by poor-quality vital registration of these events. Investment in improved surveillance systems is needed and would be worthwhile, as illustrated by the knowledge gained about the black/white gap in infant mortality when national birth and infant death records began to be linked. In addition, institution of the Pregnancy Risk Assessment Monitoring System in 1987 shed light on the association of stressful life events with poor birth outcomes. That system can be improved by sampling women who have experienced stillbirths. Better data would facilitate not only surveillance but also hypothesis-generating epidemiologic studies for identifying preventable pregnancy loss. PMID:27009345

  7. Early Pregnancy Diagnosis in Bovines: Current Status and Future Directions

    PubMed Central

    Gupta, Meenakshi; Singh, Surender; Mohanty, Ashok K.; Singh, Inderjeet

    2013-01-01

    An early and accurate diagnosis of reproductive dysfunctions or aberrations is crucial to better reproductive management in livestock. High reproductive efficiency is a prerequisite for high life-time production in dairy animals. Early pregnancy diagnosis is key to shorten the calving interval through early identification of open animals and their timely treatment and rebreeding so as to maintain a postpartum barren interval close to 60 days. A buffalo, the most important dairy animal in the Indian subcontinent, is known for problems related to high calving interval, late puberty, and high incidence of anestrus. Lack of reliable cow-side early pregnancy diagnosis methods further aggravates the situation. Several methods of pregnancy diagnosis are being practiced in bovine species, yet none qualifies as the ideal pregnancy diagnosis method due to the inherent limitations of sensitivity, accuracy, specificity, speed, and ease of performing the test. The advancement of molecular techniques like proteomics and their applications in animal research has given a new hope to look for pregnancy biomarker molecules in these animals. This review attempts to examine common pregnancy diagnosis methods available for dairy animals, while assessing the usefulness of the modern technologies in detecting novel pregnancy markers and designing future strategies for research in this area. PMID:24382949

  8. The expectant management of early pregnancies of uncertain site.

    PubMed

    Hahlin, M; Thorburn, J; Bryman, I

    1995-05-01

    The role of expectant management was evaluated in 80 women in whom clinical examination, including vaginal ultrasound, had failed to identify the location of an early pregnancy. In 45 cases, spontaneous resolution of the pregnancy products occurred. A normal intra-uterine pregnancy was diagnosed in 12 patients. A total of 23 patients underwent active therapeutic measures due to an ectopic pregnancy (n = 16) or a spontaneous abortion (n = 7). The effectiveness of different diagnostic measures to identify patients suitable for expectant management was analysed. In 33/34 patients (97%) with a relative daily human chorionic gonadotrophin (HCG) change of < -5%, and a serum progesterone concentration of < 20 nmol/l, spontaneous resolution of the pregnancy products occurred. Among 46 cases, with a relative daily HCG change of > -5% and/or serum progesterone > 20 nmol/l, active therapeutic measures were carried out in 22 cases (48%), a normal intra-uterine pregnancy was diagnosed in 12 cases (26%) and spontaneous resolution of the pregnancy products occurred in 12 cases (26%). In conclusion, the combination of a single progesterone assay and serial HCG determinations retrospectively identified early pregnancies of uncertain location in whom expectant management was a safe management option. PMID:7657770

  9. Pregnancy and early onset pauciarticular juvenile chronic arthritis

    PubMed Central

    Musiej-Nowakowska, E.; Ploski, R.

    1999-01-01

    OBJECTIVES—To study interaction of early onset pauciarticular juvenile chronic arthritis (EOP-JCA) and pregnancy in the Polish population, in particular to confirm the ameliorating effect of pregnancy on disease activity reported by others and to analyse the factors that govern the occurrence of postpartum flare, with emphasis on the potential role of breast feeding.
METHODS—The reproductive outcome and disease status in 39 adult women with history of EOP- JCA was examined by means of a questionnaire and an interview. In all patients the disease onset occurred before the 6th birthday, 19 had persistent pauciarticular JCA (PeEOP-JCA) and 20 had extended pauciarticular JCA (ExEOP-JCA).
RESULTS—23 women had at least one successful pregnancy, seven had unsuccessful pregnancies but all of them had also one or more successful pregnancies. Among those who have never been pregnant (n=16) there was a higher frequency of eye disease and ExEOP-JCA compared with the rest of the group. In almost all cases pregnancy was associated with remission of disease activity, however a postpartum flare appeared after 22 pregnancies (52%). The flares were more frequent in women who had an active disease before pregnancy, had a flare after a previous pregnancy and/or were breast feeding.
CONCLUSIONS—In EOP-JCA patients pregnancy generally has a good outcome and induces amelioration of disease activity. After delivery, however, a flare of disease often appears, especially in women who were breast feeding, had a postparum flare previously or had an active disease before pregnancy. The pattern of interaction between disease and pregnancy found in EOP-JCA makes EOP-JCA similar in this respect to RA, but different from systemic lupus erythematosus and ankylosing spondylitis.

 PMID:10419865

  10. Vitamin D Deficiency in Early Pregnancy

    PubMed Central

    Flood-Nichols, Shannon K.; Tinnemore, Deborah; Huang, Raywin R.; Napolitano, Peter G.; Ippolito, Danielle L.

    2015-01-01

    Objective Vitamin D deficiency is a common problem in reproductive-aged women in the United States. The effect of vitamin D deficiency in pregnancy is unknown, but has been associated with adverse pregnancy outcomes. The objective of this study was to analyze the relationship between vitamin D deficiency in the first trimester and subsequent clinical outcomes. Study Design This is a retrospective cohort study. Plasma was collected in the first trimester from 310 nulliparous women with singleton gestations without significant medical problems. Competitive enzymatic vitamin D assays were performed on banked plasma specimens and pregnancy outcomes were collected after delivery. Logistic regression was performed on patients stratified by plasma vitamin D concentration and the following combined clinical outcomes: preeclampsia, preterm delivery, intrauterine growth restriction, gestational diabetes, and spontaneous abortion. Results Vitamin D concentrations were obtained from 235 patients (mean age 24.3 years, range 18-40 years). Seventy percent of our study population was vitamin D insufficient with a serum concentration less than 30 ng/mL (mean serum concentration 27.6 ng/mL, range 13-71.6 ng/mL). Logistic regression was performed adjusting for age, race, body mass index, tobacco use, and time of year. Adverse pregnancy outcomes included preeclampsia, growth restriction, preterm delivery, gestational diabetes, and spontaneous abortion. There was no association between vitamin D deficiency and composite adverse pregnancy outcomes with an adjusted odds ratio of 1.01 (p value 0.738, 95% confidence intervals 0.961-1.057). Conclusion Vitamin D deficiency did not associate with adverse pregnancy outcomes in this study population. However, the high percentage of affected individuals highlights the prevalence of vitamin D deficiency in young, reproductive-aged women. PMID:25898021

  11. The role of religious beliefs in pregnancy loss

    PubMed Central

    Allahdadian, Maryam; Irajpour, Alireza

    2015-01-01

    Introduction: Birth can cause and post-traumatic stresses in many women even when the occasion of birth results in alive baby. Fetal death can challenge her understanding of justice and God's love toward his creatures. Religious beliefs have a considerable effect on decreasing individuals’ tendency toward bereavement; thus, it is expected to have a relationship with sorrow and mental distress ensuing fetal death. The present research has been conducted to review the existing literature on religion and fetal death and then study Iranian women and their families’ response to such a tragedy. Materials and Methods: This is a unsystematic (narrative) review. Research was conducted to study the role of mothers’ religious belief in their encounter with pregnancy loss in cases belonging to a 23-year period from 1990 to 2013. PubMed and Ovid databases and Iranian religious resources such as Tebyan were utilized for these studies. Of course, several articles were also derived by means of manual search. Results: Nine out of 31 papers had the searched keywords in common in the preliminary search. A review of the existing papers indicated that only 4 out of 22 papers dealt exactly with the role of religion on reaction of parents to fetal death. The four papers belonged to the years 2008, 2010, 2011, and 2012 indicating the new approach to religion in pregnancy loss cases. Conclusion: Religion has a significant effect on parents’ acceptance of such mishaps and it may have a considerable effect on their recovery from such tragic events. PMID:27462641

  12. Equine alpha-fetoprotein levels in Lipizzaner mares with normal pregnancies and with pregnancy loss.

    PubMed

    Vincze, Boglárka; Gáspárdy, András; Kulcsár, Margit; Baska, Ferenc; Bálint, Ádám; Hegedűs, György Tamás; Szenci, Ottó

    2015-12-01

    Alpha-fetoprotein has proved to be a good indicator of fetal well-being in human medicine for decades. Although this molecule is present in most of the mammalian species including horses, reference values in healthy and high-risk pregnant mares have not yet been published. The aim of the present study was to determine whether equine alpha-fetoprotein (eqAFP) is a good indicator of complicated pregnancies in Lipizzaner mares. A total of 111 serum samples from 30 mares have been analyzed for eqAFP levels throughout gestation (Days 60-325). After the pregnancy was confirmed, 23 mares had normal pregnancies with viable foals, six had late embryonic loss, and one of the mares aborted in the ninth gestational month. Equine alpha-fetoprotein concentrations significantly differed in the normal group (72.93 ± 49.25 pg/mL; mean ± standard deviation) and in the complicated pregnancy loss group (152 ± 36.48 pg/mL; mean ± standard deviation). The mares' age, gestational age, and the conception rate significantly affected the alpha-fetoprotein concentrations in the normal group. Furthermore, notable individual differences occurred in eqAFP concentrations between mares. Equine alpha-fetoprotein seems to be an important indicator of fetal well-being in horses, but there are still some unanswered questions (levels in foals of different age, ponies, and draft horses) regarding this serum protein. Large-scale studies are needed to assess the specificity, sensitivity, and reliability of this test as a possible future diagnostic tool for fetal well-being in horses. PMID:26359849

  13. Autophagy in Normal and Abnormal Early Human Pregnancies.

    PubMed

    Avagliano, Laura; Terraneo, Laura; Virgili, Eleonora; Martinelli, Carla; Doi, Patrizia; Samaja, Michele; Bulfamante, Gaetano Pietro; Marconi, Anna Maria

    2015-07-01

    Autophagy is an inducible catabolic process by which cells degrade and recycle materials to survive stress, starvation, and hypoxia. The aim of this study was to evaluate autophagy at the fetal-maternal interface, to assess autophagy involvement during the early phase of human gestation, and to explore autophagic modification in case of early abnormal pregnancy outcome. Specimens were collected from first-trimester normal gestations undergoing legal termination of pregnancy and first-trimester sporadic spontaneous miscarriages. Autophagy was studied in villous and decidual samples by transmission electron microscopy, immunohistochemistry, immunofluorescence, and Western blotting. Autophagy markers were found in cytotrophoblast, syncytiotrophoblast, extravillous trophoblast, and decidual stromal cells. Autophagy is physiologically involved in early normal gestation. Compared with normal pregnancy, spontaneous miscarriage presents an increase in autophagy expression in villous specimens due to an increment in concentration of autophagic vacuole in syncytiotrophoblast, suggesting a cytoprotective mechanism of the cells to respond to microenvironmental challenge. PMID:25544676

  14. Human Granulocytic Ehrlichiosis Complicating Early Pregnancy

    PubMed Central

    Muffly, Tyler; McCormick, T. Chad; Cook, Christopher; Wall, Jeffrey

    2008-01-01

    Background. The goal of this case is to review the zoonotic infection, human granulocytic ehrlichiosis, presenting with pyrexia. Case. A 22-year-old multigravid female presented to the emergency department with a painful skin rash, high fever, and severe myalgias. The patient underwent a diagnostic evaluation for zoonotic infections due to her geographical and seasonal risk factors. Treatment of human granulocytic ehrlichiosis was successful though the patient spontaneously aborted presumably due to the severity of the acute illness. Conclusion. Treatment of human granulocytic ehrlichiosis in pregnancy presents unique challenges. Management of pyrexia during pregnancy is limited to external cooling in the setting of thrombocytopenia and elevated aminotransferases. Extensive counseling regarding teratogenic potential of medications allows the patient to weigh the pros and cons of treatment. PMID:18509484

  15. Infertility, Pregnancy Loss and Adverse Birth Outcomes in Relation to Maternal Secondhand Tobacco Smoke Exposure

    PubMed Central

    Meeker, John D.; Benedict, Merle D.

    2013-01-01

    A substantial proportion of the etiology involved in female infertility and adverse pregnancy outcomes remains idiopathic. Recent scientific research has suggested a role for environmental factors in these conditions. Secondhand tobacco smoke (STS) contains a number of known or suspected reproductive toxins, and human exposure to STS is prevalent worldwide. Robust evidence exists for the toxic effects of active smoking on fertility and pregnancy, but studies of passive exposure are much more limited in number. While the association between maternal STS exposure and declined birth weight has been fairly well-documented, only recently have epidemiologic studies begun to provide suggestive evidence for delayed conception, altered menstrual cycling, early pregnancy loss (e.g. spontaneous abortion), preterm delivery, and congenital malformations in relation to STS exposure. There is also new evidence that developmental exposures to tobacco smoke may be associated with reproductive effects in adulthood. To date, most studies have estimated maternal STS exposure through self-report even though exposure biomarkers are less prone to error and recall bias. In addition to utilizing biomarkers of STS exposure, future studies should aim to identify vital windows of STS exposure, important environmental co-exposures, individual susceptibility factors, and specific STS constituents associated with female infertility and adverse pregnancy outcomes. The role of paternal exposures/factors should also be investigated. PMID:23888128

  16. Preventing neonaticide by early detection and intervention in student pregnancy. .

    PubMed

    Platt, Lois M

    2014-11-01

    Pregnant students are the population group most likely to commit neonaticide, murder of an infant younger than 24 hours old. Denial by the student, lack of early pregnancy detection, and poor social support contribute to this disorder. As the health care professionals with whom the student has the most contact, school nurses are in an excellent position to prevent neonaticide through provision of health education, early detection of pregnancy, and intervention with students and their families to assist them in making healthy choices. PMID:25417331

  17. Lower pregnancy losses in lactating dairy cows fed a diet enriched in alpha-linolenic acid.

    PubMed

    Ambrose, D J; Kastelic, J P; Corbett, R; Pitney, P A; Petit, H V; Small, J A; Zalkovic, P

    2006-08-01

    The objectives were to determine if a diet enriched in alpha-linolenic acid (ALA) would influence ovarian function, early embryo survival, conception rates, and pregnancy losses in lactating dairy cows. Beginning 28 d before breeding, Holstein cows (55 +/- 22 d postpartum; mean +/- SD) were assigned to diets supplemented with either rolled flaxseed (FLAX; 56.7% ALA, n = 62) or rolled sunflower seed (SUNF; 0.1% ALA, n = 59) to provide approximately 750 g of oil/d. Diets continued for 32 d after timed artificial insemination (TAI, d 0) following a Presynch/Ovsynch protocol. Barley silage- and barley grain-based TMR were formulated to meet or exceed National Research Council requirements. Metabolizable protein and net energy for lactation concentrations were similar in the 2 diets. Based upon a mean dry matter intake of 22 kg/d, cows fed FLAX or SUNF consumed > 410 g or < 1 g of ALA, respectively. Pregnancy was confirmed by ultrasound 32 d after TAI. Nonpregnant cows were placed on a second Ovsynch regimen and reinseminated 42 d after first TAI, and received oilseeds for 32 d after second TAI. Relative to prediet levels, FLAX increased the ALA content of milk by 187%. Ovarian ultrasonography was performed in 8 cows per diet; the mean diameter of ovulatory follicles was larger in cows fed FLAX compared with SUNF (16.9 +/- 0.9 vs. 14.1 +/- 0.9 mm), but follicle number, corpus luteum size, and plasma progesterone concentrations remained unaffected. Presumptive conception (progesterone < 1 ng/mL on d 0 and > 1 ng/mL on d 21) rates to first TAI were greater in FLAX than in SUNF (72.6 vs. 47.5%). Pregnancy losses were lower in cows fed FLAX (9.8%) compared with those fed SUNF (27.3%). Including flaxseed in the ration of dairy cows increased the size of the ovulatory follicle and reduced pregnancy losses. PMID:16840624

  18. Early pregnancy cerebral venous thrombosis and status epilepticus treated with levetiracetam and lacosamide throughout pregnancy.

    PubMed

    Ylikotila, Pauli; Ketola, Raimo A; Timonen, Susanna; Malm, Heli; Ruuskanen, Jori O

    2015-11-01

    Cerebral venous thrombosis (CVT) is an uncommon cause of stroke, accounting to less than 1% of all strokes. We describe a pregnant woman with a massive CVT in early pregnancy, complicated by status epilepticus. The mother was treated with levetiracetam, lacosamide, and enoxaparin throughout pregnancy. A male infant was born on pregnancy week 36, weighing 2.2kg. Both levetiracetam and and lacosamide were present in cord blood in levels similar to those in maternal blood. The infant was partially breast-fed and experienced poor feeding and sleepiness, starting to resolve after two first weeks. Milk samples were drawn 5 days after the delivery and a blood sample from the infant 3 days later. Lacosamide level in milk was low, resulting in an estimated relative infant dose of 1.8% of the maternal weight-adjusted daily dose in a fully breast-fed infant. This is the first case describing lacosamide use during pregnancy and lactation. PMID:26187779

  19. The Impact of Previous Perinatal Loss on Subsequent Pregnancy and Parenting

    PubMed Central

    Lamb, Elizabeth H.

    2002-01-01

    The loss of any pregnancy through miscarriage, ectopic pregnancy, stillbirth, or neonatal death presents as a significant life crisis for any woman and has far-reaching implications into a couple's future aspirations. Planning another pregnancy after dealing with a perinatal loss is difficult and plagued by ambivalence, doubts, and insecurities. Despite this ambivalence, a majority of women do become pregnant within a year following a perinatal loss. Four recurring issues surrounding perinatal loss and subsequent pregnancy have been identified in this literature review: the effect of the grief process on the subsequent pregnancy; parental coping mechanisms during the subsequent pregnancy; replacement or vulnerable child syndrome; and parenting issues with the subsequent live-born child. Issues surrounding anxiety as a coping mechanism during a pregnancy following a perinatal loss are documented consistently in the literature; however, less is known about the impact that a loss has on parenting behaviors with subsequent children. Further research is imperative to examine these issues in more detail so that evidence-based practices can be established and updated. Health care providers are in a unique position to assist these couples in dealing with the issues that a perinatal loss may place on subsequent pregnancies. By providing a reassuring and supportive environment, women can achieve a positive pregnancy outcome with the correct tools to decrease anxiety and enhance attachment to the subsequent healthy child. PMID:17273295

  20. Human sexual size dimorphism in early pregnancy.

    PubMed

    Bukowski, Radek; Smith, Gordon C S; Malone, Fergal D; Ball, Robert H; Nyberg, David A; Comstock, Christine H; Hankins, Gary D V; Berkowitz, Richard L; Gross, Susan J; Dugoff, Lorraine; Craigo, Sabrina D; Timor-Tritsch, Ilan E; Carr, Stephen R; Wolfe, Honor M; D'Alton, Mary E

    2007-05-15

    Sexual size dimorphism is thought to contribute to the greater mortality and morbidity of men compared with women. However, the timing of onset of sexual size dimorphism remains uncertain. The authors determined whether human fetuses exhibit sexual size dimorphism in the first trimester of pregnancy. Using a prospective cohort study, conducted in 1999-2002 in the United States, they identified 27,655 women who conceived spontaneously and 1,008 whose conception was assisted by in vitro fertilization or intrauterine insemination and for whom a first-trimester measurement of fetal crown-rump length was available. First-trimester size was expressed as the difference between the observed and expected size of the fetus, expressed as equivalence to days of gestational age. The authors evaluated the association between fetal sex, first-trimester size, and birth weight. Eight to 12 weeks after conception, males were larger than females (mean difference: assisted conception = 0.4 days, 95% confidence interval (CI): 0.1, 0.7, p = 0.008; spontaneous conception = 0.3 days, 95% CI: 0.2, 0.4, p < 0.00001). The size discrepancy remained significant at birth (mean birth weight difference: assisted conception = 90 g, 95% CI: 22, 159, p = 0.009; spontaneous conception = 120 g, 95% CI: 107, 132, p < 0.00001). These data demonstrate that human fetuses exhibit sexual size dimorphism in the first trimester of pregnancy. PMID:17344203

  1. Validating Evidence and Using Standard Outcomes for Recurrent Pregnancy Loss Tests and Treatments.

    PubMed

    Scott, James R

    2016-09-01

    Unproven diagnostic tests and treatments for recurrent pregnancy loss patients can no longer be justified. The use of accepted study guidelines for conducting randomized trials, observational studies, systematic reviews and meta-analyses, diagnostic tests, animal research, and the development of standardized consensus derived outcomes would greatly improve the quality of recurrent pregnancy loss studies and their reporting. PMID:27380206

  2. ATRAZINE EFFECTS ON EARLY PREGNANCY AND IMPLANATION IN THE RAT

    EPA Science Inventory

    Atrazine Effects on Early Pregnancy and Implantation in the Rat.
    A.M. Cummings, B.E. Rhodes*, and R.L. Cooper*.
    Reproductive Toxicology Division, NHEERL, USEPA, Research Triangle Park, NC
    Atrazine (ATR), an herbicide, can induce mammary tumors in rats. ATR can also sup...

  3. [Involuntary admission of addict during early pregnancy].

    PubMed

    Hondius, Adger J K; Stikker, Tineke E; Wennink, J M B Hanneke; Honig, Adriaan

    2012-01-01

    A 30-year-old cocaine-dependent woman was 16 weeks pregnant. Because of possible endangerment of the fetus, an involuntary provisional admission was authorized. Of particular interest is the application of the Dutch Act on Formal Admissions to Psychiatric Hospitals for the primary diagnosis 'addiction' and the fact that the fetus was regarded as a legal 'other'. In severe cases of addiction combined with pregnancy an earlier intervention is needed and arrangement of accelerated legal custody of the newborn before birth should be considered. For the protection of the unborn, we advocate a stricter application of the United Nations Convention on the Rights of the Child. Information for addicted women with preconception counselling can help prevent a compulsory admission. PMID:22258443

  4. The Rapid Growth of Fibroids during Early Pregnancy

    PubMed Central

    Benaglia, Laura; Cardellicchio, Lucia; Filippi, Francesca; Paffoni, Alessio; Vercellini, Paolo; Somigliana, Edgardo; Fedele, Luigi

    2014-01-01

    Several studies aimed to disentangle whether pregnancy influences the growth of uterine fibroids but results were inconsistent. In this study, we speculated that fibroid enlargement during pregnancy may not be linear and we hypothesized that this phenomenon may mainly occur during initial pregnancy. To test this hypothesis, we set up a prospective cohort study of women with fibroids undergoing IVF. Cases were women achieving a viable pregnancy. Controls were the subsequent women with fibroids but failing to become pregnant. Twenty-five cases and 25 controls were recruited. The total number of fibroids in the two groups was 46 and 41, respectively. The mean ± SD diameter of the fibroids was 17±10 and 20±11 mm, respectively (p = 0.18). A statistically significant enlargement emerged exclusively in pregnant women. The median (Interquartile Range) modification of the diameter of the lesions in cases and controls was +34% (+6%/+65%) and +2% (−6%/+12%), respectively (p<0.001). The median (Interquartile Range) modification of the volume of the lesions was +140% (+23%/+357%) and 0% (−18%/+37%), respectively (p<0.001). In pregnant women, we failed to document any significant correlation between the magnitude of the growth and ovarian responsiveness to hyper-stimulation, suggesting that steroids hormones are not the unique factors involved. In conclusion, fibroids undergo a rapid and remarkable growth during initial pregnancy. Reasons behind this phenomenon remain to be clarified. The early rise in steroids hormones during early pregnancy may not be sufficient to explain the process. Other pregnancy-related hormones and proteins may play also key roles. PMID:24465797

  5. Early pregnancy B vitamin status, one carbon metabolism, pregnancy outcome and child development.

    PubMed

    Solé-Navais, Pol; Cavallé-Busquets, Pere; Fernandez-Ballart, Joan D; Murphy, Michelle M

    2016-07-01

    Periconception supplementation with folic acid is recommended until 12 gestational weeks to prevent neural tube defects. Doses of folic acid contained in supplements and timing and length of use during pregnancy vary. The effects of status in periconception and pregnancy folate, cobalamin, betaine and their interactions on one carbon metabolism (1C), as well as the global effect of 1C on foetal growth and pregnancy outcome, are reviewed. Results from prospective studies are reviewed. Cessation of folic acid supplement use after the first trimester is associated with a sharp drop in plasma folate status and enhanced conversion of betaine to dimethylglycine. Dimethylglycine production is also higher in mothers with low folate status than in those with normal-high folate status. The effects of high doses of folic acid on one carbon metabolism in mothers with low early pregnancy cobalamin status and on foetal growth are also reviewed. Several studies report that moderately elevated early pregnancy fasting plasma total homocysteine (tHcy) is inversely associated with birth weight and a predictor of intrauterine growth retardation. There is also evidence for increased risk of preterm birth when maternal folate status is low. PMID:26700149

  6. Effects of Shiga Toxin Type 2 on Maternal and Fetal Status in Rats in the Early Stage of Pregnancy

    PubMed Central

    Sacerdoti, Flavia; Amaral, María M.; Zotta, Elsa; Franchi, Ana M.; Ibarra, Cristina

    2014-01-01

    Shiga toxin type 2 (Stx2), a toxin secreted by Shiga toxin-producing Escherichia coli (STEC), could be one of the causes of maternal and fetal morbimortality not yet investigated. In this study, we examined the effects of Stx2 in rats in the early stage of pregnancy. Sprague-Dawley pregnant rats were intraperitoneally (i.p.) injected with sublethal doses of Stx2, 0.25 and 0.5 ng Stx2/g of body weight (bwt), at day 8 of gestation (early postimplantation period of gestation). Maternal weight loss and food and water intake were analyzed after Stx2 injection. Another group of rats were euthanized and uteri were collected at different times to evaluate fetal status. Immunolocalization of Stx2 in uterus and maternal kidneys was analyzed by immunohistochemistry. The presence of Stx2 receptor (globotriaosylceramide, Gb3) in the uteroplacental unit was observed by thin layer chromatography (TLC). Sublethal doses of Stx2 in rats caused maternal weight loss and pregnancy loss. Stx2 and Gb3 receptor were localized in decidual tissues. Stx2 was also immunolocalized in renal tissues. Our results demonstrate that Stx2 leads to pregnancy loss and maternal morbidity in rats in the early stage of pregnancy. This study highlights the possibility of human pregnancy loss and maternal morbidity mediated by Stx2. PMID:25157355

  7. Mosaic variegated aneuploidy in mouse BubR1 deficient embryos and pregnancy loss in human.

    PubMed

    Schmid, Michael; Steinlein, Claus; Tian, Qi; Hanlon Newell, Amy E; Gessler, Manfred; Olson, Susan B; Rosenwald, Andreas; Kneitz, Burkhard; Fedorov, Lev M

    2014-09-01

    Chromosome aberrations (aneuploidies mostly) are the cause of the majority of spontaneous abortions in humans. However, little is known about defects in the underlying molecular mechanisms resulting in chromosome aberrations and following failure of preimplantation embryo development, initiation of implantation and postimplantation pregnancy loss. We suggest that defects of the spindle assembly checkpoint (SAC) are responsible for aneuploidy and the following abortions. To develop our hypothesis, we modeled this process in the mouse after inactivation of protein BubR1, one of the key players of SAC. We found that soon after implantation, more than 50 % of cells of BubR1 (-/-) embryos were aneuploid and had an increased level of premature sister chromatid separation (PSCS). Aneuploid cells do not have a predominant gain or loss of some specific chromosomes, but they have mosaic variegated aneuploidy (MVA), which is characterised by random mixture of different chromosomes. MVA leads to growth retardation, stochastic massive apoptosis, disruption of bilateral symmetry, and embryo death between embryonic days 7.5 to 13.5. Analysis published human data revealed that human recurrent pregnancy loss (RPL) embryos and rare infant patients carrying BubR1 mutations that have been described so far have the PSCS and MVA as in BubR1 deficient/insufficient mice. Based on this data, we predict that deficiency/insufficiency of BubR1 and other components of the SAC in human are responsible for a significant fraction of both early and late RPLs. PMID:24981203

  8. Leukocyte driven-decidual angiogenesis in early pregnancy

    PubMed Central

    Lima, Patricia DA; Zhang, Jianhong; Dunk, Caroline; Lye, Stephen J; Anne Croy, B

    2014-01-01

    Successful pregnancy and long-term, post-natal maternal and offspring cardiac, vascular and metabolic health require key maternal cardiovascular adaptations over gestation. Within the pregnant decidualizing uterus, coordinated vascular, immunological and stromal cell changes occur. Considerable attention has been given to the roles of uterine natural killer (uNK) cells in initiating decidual spiral arterial remodeling, a process normally completed by mid-gestation in mice and in humans. However, leukocyte roles in much earlier, region specific, decidual vascular remodeling are now being defined. Interest in immune cell-promoted vascular remodeling is driven by vascular aberrations that are reported in human gestational complications such as infertility, recurrent spontaneous abortion, preeclampsia (PE) and fetal growth restriction. Appropriate maternal cardiovascular responses during pregnancy protect mothers and their children from later cardiovascular disease risk elevation. One of the earliest uterine responses to pregnancy in species with hemochorial placentation is stromal cell decidualization, which creates unique niches for angiogenesis and leukocyte recruitment. In early decidua basalis, the aspect of the implantation site that will cradle the developing placenta and provide the major blood vessels to support mature placental functions, leukocytes are greatly enriched and display specialized properties. UNK cells, the most abundant leukocyte subset in early decidua basalis, have angiogenic abilities and are essential for normal early decidual angiogenesis. The regulation of uNK cells and their roles in determining maternal and progeny cardiovascular health over pregnancy and postpartum are discussed. PMID:25066422

  9. Leukocyte driven-decidual angiogenesis in early pregnancy.

    PubMed

    Lima, Patricia D A; Zhang, Jianhong; Dunk, Caroline; Lye, Stephen J; Croy, B Anne

    2014-11-01

    Successful pregnancy and long-term, post-natal maternal and offspring cardiac, vascular and metabolic health require key maternal cardiovascular adaptations over gestation. Within the pregnant decidualizing uterus, coordinated vascular, immunological and stromal cell changes occur. Considerable attention has been given to the roles of uterine natural killer (uNK) cells in initiating decidual spiral arterial remodeling, a process normally completed by mid-gestation in mice and in humans. However, leukocyte roles in much earlier, region specific, decidual vascular remodeling are now being defined. Interest in immune cell-promoted vascular remodeling is driven by vascular aberrations that are reported in human gestational complications such as infertility, recurrent spontaneous abortion, preeclampsia (PE) and fetal growth restriction. Appropriate maternal cardiovascular responses during pregnancy protect mothers and their children from later cardiovascular disease risk elevation. One of the earliest uterine responses to pregnancy in species with hemochorial placentation is stromal cell decidualization, which creates unique niches for angiogenesis and leukocyte recruitment. In early decidua basalis, the aspect of the implantation site that will cradle the developing placenta and provide the major blood vessels to support mature placental functions, leukocytes are greatly enriched and display specialized properties. UNK cells, the most abundant leukocyte subset in early decidua basalis, have angiogenic abilities and are essential for normal early decidual angiogenesis. The regulation of uNK cells and their roles in determining maternal and progeny cardiovascular health over pregnancy and postpartum are discussed. PMID:25066422

  10. Histone retention, protein carbonylation, and lipid peroxidation in spermatozoa: Possible role in recurrent pregnancy loss.

    PubMed

    Mohanty, Gayatri; Swain, Nirlipta; Goswami, Chandan; Kar, Sujata; Samanta, Luna

    2016-06-01

    Contribution from a defective paternal genome has been attributed to be an important cause for spontaneous recurrent pregnancy loss (RPL). Increased oxidative stress results in decreased detoxification and is a cause for damage to chromatin, proteins, and membrane lipids. The present study aimed to explore if there is a significant relationship between retained histones due to defective packaging of DNA in spermatozoa and oxidative stress. RPL patients (n=16) with a history of ≥2 embryo losses before the 20th week of gestation and no female factor abnormality, and fertile healthy volunteers (n=20) as controls were included in the study. A significant difference in the levels of protein carbonylation and lipid peroxidation together with an increased retention of histones in the experimental groups was noticed. Histone carrying sites for oxidative modification such as arginine and lysine might be responsible for disturbing the paternal epigenomic control during early stages of embryonic differentiation leading to abortion. PMID:26980262

  11. Interventions for nausea and vomiting in early pregnancy

    PubMed Central

    Matthews, Anne; Dowswell, Therese; Haas, David M; Doyle, Mary; O’Mathúna, Dónal P

    2014-01-01

    Background Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy previously published in 2003. Objectives To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks’ gestation. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (28 May 2010). Selection criteria All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum which are covered by another review. We also excluded quasi-randomised trials and trials using a crossover design. Data collection and analysis Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials. Main results Twenty-seven trials, with 4041 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, vitamin B6 and several antiemetic drugs. We identified no studies of dietary or other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, and anti-emetic drugs to relieve mild or moderate nausea and vomiting. There was little information on maternal and fetal adverse outcomes and on psychological, social or economic outcomes. We

  12. Recurrent pregnancy loss in a subject with heterozygote factor V Leiden mutation; a case report

    PubMed Central

    Ebrahimzadeh-Vesal, Reza; Azam, Roza; Ghazarian, Arvin; Hajesmaeili, Mogge; Ranji, Najmeh; Ezzati, Mohammad Reza; Sadri, Mehrdad; Mohammadi, Mohammad Ali; Khavandi, Siamak

    2014-01-01

    Recurrent pregnancy loss is usually defined as the loss of two or more consecutive pregnancies before 20 weeks of gestation, which occurs in approximately 5% of reproductive-aged women. It has been suggested that women with thrombophilia have an increased risk of pregnancy loss and other adverse pregnancy outcomes. Thrombophilia is an important predisposition to blood clot formation and is considered as a significant risk factor for recurrent pregnancy loss. The inherited predisposition to thrombophilia is most often associated with factor V Leiden mutation, prothrombin G20210A mutation, and methylenetetrahydrofolate reductase C677T and A1298C gene variants. The net effect is an increased cleavage of prothrombin to thrombin and excessive blood coagulation. PMID:26989729

  13. A developmental approach to pregnancy prevention with early adolescent females.

    PubMed

    Proctor, S E

    1986-10-01

    Traditional pregnancy prevention strategies employed with adults and older teens do not recognize significant developmental differences between early adolescents and other age groups. Methods that compliment, reflect, and are consistent with developmental needs of the young teen provide cogent approaches to teen pregnancy prevention. Particular emphasis should be placed on interpersonal relationships and their importance in the young woman's life, especially the relationship between the young teen and her parents. Developing and improving all relationships instrumental in positively affecting teen decision-making represent potent approaches to pregnancy prevention. The axioms of Piaget, Erikson, and Mercer are examined in regard to cognitive, social, emotional, and psychosexual development in the 12-14 year old. Young teens' responses to sex education as well as their use of contraception are reviewed in relation to developmental theory. PMID:3534458

  14. [Early pregnancy risk: development and validation of a predictive instrument].

    PubMed

    Burrows, R; Rosales, M E; Díaz, M; Muzzo, S

    1994-06-01

    An early pregnancy risk scale, with scores ranging from 11 to 66 points from lower to higher risk, was constructed using variables associated with teenager's pregnancy. This scale was applied to 3000 female teenagers, coming from Metropolitan Santiago public schools. The sample was divided in three risk groups: group A (high risk) with scores equal or over 35 points, group B (low risk) with scores equal or below 20 points and group B (intermediate risk) with scores between 20.1 and 34.9 points. These girls were followed during 2 years. During this period, 84 girls became pregnant, 24 of 184 (13%) in group A, 60 of 2332 (2.6%) in group C and none of 307 in group B. There were 104 school desertions in group A and 37 in group B. To study associations and analyze risk, the sample was divided in two risk groups: high, with scores over 27 and low, with scores below 27. There was a high association between pregnancy risk score and the occurrence of pregnancy (RR 5.25 p < 0.0001) and school desertion (RR 3.32 p < 0.0001). Pregnancy was predicted with a 78% sensitivity and 55.6% specificity. School desertion was predicted with a 74% sensitivity and 56% specificity. The importance variable weighing using multiple regression models, to improve the predictor's sensitivity and specificity, is discussed. PMID:7732221

  15. Early Pregnancy Maternal Blood DNA Methylation in Repeat Pregnancies and Change in Gestational Diabetes Mellitus Status—A Pilot Study.

    PubMed

    Enquobahrie, Daniel A; Moore, Amy; Muhie, Seid; Tadesse, Mahlet G; Lin, Shili; Williams, Michelle A

    2015-07-01

    Repeat pregnancies with different perinatal outcomes minimize underlying maternal genetic diversity and provide unique opportunities to investigate nongenetic risk factors and epigenetic mechanisms of pregnancy complications. We investigated gestational diabetes mellitus (GDM)-related differential DNA methylation in early pregnancy peripheral blood samples collected from women who had a change in GDM status in repeat pregnancies. Six study participants were randomly selected from among women who had 2 consecutive pregnancies, only 1 of which was complicated by GDM (case pregnancy) and the other was not (control pregnancy). Epigenome-wide DNA methylation was profiled using Illumina HumanMethylation 27 BeadChips. Differential Identification using Mixture Ensemble and false discovery rate (<10%) cutoffs were used to identify differentially methylated targets between the 2 pregnancies of each participant. Overall, 27 target sites, 17 hypomethylated (fold change [FC] range: 0.77-0.99) and 10 hypermethylated (FC range: 1.01-1.09), were differentially methylated between GDM and control pregnancies among 5 or more study participants. Novel genes were related to identified hypomethylated (such as NDUFC1, HAPLN3, HHLA3, and RHOG) or hypermethylated sites (such as SEP11, ZAR1, and DDR). Genes related to identified sites participated in cell morphology, cellular assembly, cellular organization, cellular compromise, and cell cycle. Our findings support early pregnancy peripheral blood DNA methylation differences in repeat pregnancies with change in GDM status. Similar, larger, and repeat pregnancy studies can enhance biomarker discovery and mechanistic studies of GDM. PMID:25676578

  16. Association between health beliefs and health behavior in early pregnancy.

    PubMed

    Bödecs, Tamás; Horváth, Boldizsár; Szilágyi, Eniko; Diffellné Németh, Marietta; Sándor, János

    2011-11-01

    Folate-supplementation significantly reduces the risk of neural tube defects. The aim of this research was to reveal associations between health beliefs and folate -supplementation as well as other elements of health behavior among Hungarian women early in their pregnancy. Three-hundred and seven women in early pregnancy completed the second part of Health and Illness Scale. Factor structure of health beliefs was established and associations of factors with pregnancy planning, folate-intake, vitamin-intake, smoking-habits and alcohol-consumption were tested. A six factor health model was formulated; the factor named 'mental capacities and abilities' was associated with greater chance on folate-intake, vitamin-intake and prepared pregnancy, as well as a reduced chance of smoking. The factors 'destiny', 'measures aiming at prevention', and 'relatives and acquaintances' related to lower chance on folate-intake. The health belief factor representing Internal Health Locus of Control was associated with more than one component of healthy behavior, while factors of external dimensions (Powerful Others Health Locus of Control and Chance Health Locus of Control) were predictive on unhealthy behavioral tendencies. New approaches aiming to shift one's health beliefs and health locus of control from external causes to internal dimensions are needed in order to reach greater openness towards health-improving interventions. PMID:20957513

  17. Pregnancy-associated breast cancer: significance of early detection.

    PubMed

    Ulery, Maryann; Carter, Linnette; McFarlin, Barbara L; Giurgescu, Carmen

    2009-01-01

    Pregnancy-associated breast cancer (PABC) is defined as cancer of the breast diagnosed during pregnancy and up to 1 year postpartum. Delays in diagnosis are frequently associated with increased morbidity and mortality. The aim of this article is to determine the significance of early detection of PABC and to alert health care providers to include PABC in the differential diagnosis when evaluating a breast mass in the perinatal period. This integrative literature review evaluated 15 research studies by using the hypothetical deductive model of clinical reasoning to determine factors related to diagnosis of PABC. As women delay childbearing, the incidence of PABC increases with age. In the reviewed studies, breast cancer was diagnosed with greater frequency in the postpartum period than during any trimester in pregnancy. Delay in diagnosis is complicated by axillary lymph node metastasis, high-grade tumors at diagnosis, and poor outcomes. Early detection is a significant predictor of improved outcomes. Diagnostic modalities such as ultrasound, mammography, and biopsy can be safely used for diagnostic purposes in the evaluation of potential cases of PABC during pregnancy. PMID:19720336

  18. Delivery outcome after the use of meclozine in early pregnancy.

    PubMed

    Källén, Bengt; Mottet, Isabelle

    2003-01-01

    In some countries, including Sweden, no risk is considered to exist with the use of meclozine for nausea and vomiting in pregnancy (NVP), but in other countries warnings against use during pregnancy are given. Rat tests indicate a teratogenic risk and published epidemiological studies are of restricted size. Delivery outcome was studied in 16,536 women who reported the use of meclozine in early pregnancy and was compared with all 540,660 women who gave birth. Information on drug usage was obtained prospectively in early pregnancy. Risk factors for using meclozine were young maternal age, to have had a previous child, not to smoke, to have a low body mass index. The use of some other drugs (antihypertensives, thyroxine, anticonvulsants) decreased the use of meclozine. Maternal diagnoses of preeclampsia or diabetes were less frequent when the woman had used meclozine. The twinning rate was increased and the sex distribution of the infants low (female excess). Preterm birth, low birth weight, short body length, and small head circumference occurred at a reduced rate after meclozine use, notably for boys. Also the rate of congenital malformations was reduced. If anything, delivery outcome is better than expected when the mother used meclozine. These beneficial effects are probably secondary to NVP. Meclozine can apparently be used without risk at this condition. PMID:12952140

  19. The Paradox of Time Post-Pregnancy Loss: Three Things Not to Say When Communicating Social Support.

    PubMed

    Meyer, Michaela D E

    2016-11-01

    In this essay, I interrogate the role time plays in the three most common social support messages I received post-pregnancy loss. In doing so, I illustrate how our most common "social support" responses to pregnancy loss, while uttered from caring, intentional places of support, can actually serve to marginalize and invalidate experiences of pregnancy loss. PMID:27050474

  20. Pregnancy outcomes following the administration of high doses of dexamethasone in early pregnancy

    PubMed Central

    Kayvan Jafari, Sabah; Nezafat Firizi, Maryam; Abbaspour, Ali Reza; Ghafoori Gharib, Fahime; Ghobadi, Yusef; Gholizadeh, Samira

    2016-01-01

    Objective In the present study, we aimed to evaluate the effects of high doses of dexamethasone (DEX) in early pregnancy on pregnancy outcomes. Methods Pregnant BALB/c mice were treated with high-dose DEX in the experimental group or saline in the control group on gestational days (GDs) 0.5 to 4.5. Pregnant mice were sacrificed on GDs 7.5, 13.5, or 18.5 and their peripheral blood, placentas, fetuses, and uterine tissue were collected. Decidual and placenta cell supernatants were examined to evaluate the effect of DEX on the proliferation of mononuclear cells, the quantity of uterine macrophages and uterine natural killer (uNK) cells, and levels of progesterone and 17β-estradiol, as determined by an 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. We also were measured fetal and placental growth parameters on GD 18.5. Results We found that high doses of DEX were associated with an increased abortion rate, enhancement of the immunosuppressive effect of the decidua, alterations in placental growth parameters, decreased progesterone and 17β-estradiol levels, and a reduced frequency of macrophages and uNK cells. Conclusion Our data suggest that the high-dose administration of DEX during early pregnancy negatively affected pregnancy outcomes. PMID:27104153

  1. Practical Work-up and Management of Recurrent Pregnancy Loss for the Front-Line Clinician.

    PubMed

    Branch, D Ware; Silver, Robert M

    2016-09-01

    Only a few so-called etiologies of recurrent pregnancy loss recurrent pregnancy loss in otherwise healthy women are adequately supported by well-designed investigations of association. The majority of proposed "treatments" have not been subjected to rigorous trials. The American Board of Internal Medicine Choosing Wisely initiative urges providers and patients to have constructive dialog aimed at choosing health care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary. We support the refreshing, objective frankness promoted by this campaign. A version of the Choosing Wisely "Do" and "Don't" format for recurrent pregnancy loss is presented. PMID:27403584

  2. Loss of renal India ink artifact-a useful radiological sign for obstructive hydronephrosis in pregnancy.

    PubMed

    Bolster, Ferdia; Lawler, Leo; Geoghegan, Tony

    2015-01-01

    Magnetic resonance imaging is a useful tool for investigating causes of abdominal pain in pregnancy. Differentiating between physiologic hydronephrosis of pregnancy and pathologic hydronephrosis can be challenging for clinicians and radiologists. This report describes loss of the India ink artifact around the obstructed kidney as a novel and potentially useful radiological sign, which may be of value in the evaluation of abdominal pain and hydronephrosis in pregnancy. PMID:25863876

  3. Maternal Hypothyroidism in Early Pregnancy and Infant Structural Congenital Malformations

    PubMed Central

    Norstedt Wikner, Birgitta

    2014-01-01

    Background. The question is debated on whether maternal hypothyroidism or use of thyroxin in early pregnancy affects the risk for infant congenital malformations. Objectives. To expand the previously published study on maternal thyroxin use in early pregnancy and the risk for congenital malformations. Methods. Data from the Swedish Medical Birth Register were used for the years 1996–2011 and infant malformations were identified from national health registers. Women with preexisting diabetes or reporting the use of thyreostatics, anticonvulsants, or antihypertensives were excluded from analysis. Risk estimates were made as odds ratios (ORs) or risk ratios (RRs) after adjustment for year of delivery, maternal age, parity, smoking, and body mass index. Results. Among 23 259 infants whose mothers in early pregnancy used thyroxin, 730 had a major malformation; among all 1 567 736 infants, 48012 had such malformations. The adjusted OR was 1.06 (95% CI 0.98–1.14). For anal atresia the RR was 1.85 (95% CI 1.00–1.85) and for choanal atresia 3.14 (95% CI 1.26–6.47). The risk of some other malformations was also increased but statistical significance was not reached. Conclusions. Treated maternal hypothyroidism may be a weak risk factor for infant congenital malformations but an association with a few rare conditions is possible. PMID:24744955

  4. Maternal influences on nausea and vomiting in early pregnancy.

    PubMed

    Chan, Ronna L; Olshan, Andrew F; Savitz, David A; Herring, Amy H; Daniels, Julie L; Peterson, Herbert B; Martin, Sandra L

    2011-01-01

    Symptoms of nausea and vomiting in early pregnancy (NVP) are common among pregnant women, but whether some women are more likely than others to experience these symptoms has not been well established. We examined potential risk factors for NVP symptom severity, timing of onset, and duration. We included 2,407 newly pregnant women who participated in a prospective cohort study on early pregnancy health between 2000 and 2004 in three U.S. cities. Data on NVP and other health information were collected through telephone interviews, early gestation ultrasound, and medical record abstractions. Generalized linear models were used to model possible risk factors for each NVP characteristic. Eighty-nine percent of women had NVP; for 99% of these, symptoms started in the first trimester. None of the characteristics examined were associated with having NVP. Among those with NVP, increasing risk of delayed symptoms onset was associated with advancing maternal age; increased risks were also seen among non-Hispanic Black [Risk ratio (RR) = 4.3, 95% confidence interval (CI): 1.6,11.6] and Hispanic women (RR = 2.3, 95% CI:0.4,11.5). NVP symptoms for multigravidae were more likely to last beyond the first trimester with each additional pregnancy. Most pregnant women experienced NVP. Nearly all of them, regardless of characteristics examined, had symptoms beginning in the first trimester. Maternal age, race/ethnicity, and gravidity were associated with delayed onset and symptoms that persisted into the second trimester. PMID:20012346

  5. Early pregnancy in the horse revisited - does exception prove the rule?

    PubMed

    Aurich, Christine; Budik, Sven

    2015-01-01

    Early equine pregnancy shares many features with that of more intensively assessed domestic animals species, but there are also characteristic differences. Some of those are poorly understood. Descent of the equine conceptus into the uterine lumen occurs at day 5 to 6 after ovulation but is only possible when the embryo secretes prostaglandin E2. Although maintenance of equine pregnancy probably involves secretion of a conceptus derived anti-luteolytic factor, this agent has not been identified. Rapid growth, conceptus mobility and presence of an acellular capsule at the time of maternal recognition of pregnancy, i.e. between days 12 and 14, are prerequisites to avoid pregnancy loss. Progesterone together with 5α-pregnanes is secreted by the corpus luteum and induces the production of endometrial histotroph which is responsible for conceptus nutrition until placention. A stable contact between the outer trophoblast layer of the allantochorion and the luminal epithelium of the endometrium is not established before days 40 to 42 of pregnancy. PMID:26635959

  6. Advanced pregnancy loss in the rudimentary horn of an undiagnosed unicornuate uterus.

    PubMed

    Perez-Medina, Tirso; García-Andrade, Carmen; Bajo-Arenas, José

    2009-06-01

    A case of advanced pregnancy loss in the rudimentary horn of a unicornuate uterus is presented herein. The unknown uterine malformation and advanced pregnancy resulted in the condition being incorrectly diagnosed on ultrasound. After a failed attempt at dilatation and curettage, a correct diagnosis was made and proper treatment was given during salvage laparotomy performed for arising complications (coagulopathy). PMID:19527403

  7. The effect of exposure to hypergravity on pregnant rat dams, pregnancy outcome and early neonatal development

    NASA Astrophysics Data System (ADS)

    Ladd, B.; Nguon, K.; Sajdel-Sulkowska, E. M.

    2006-01-01

    We previously reported that hypergravity exposure affects food intake and mass gain during pregnancy. In the present study, we explored the hypothesis that changes in maternal body mass in hypergravity-exposed pregnant rat dams affect pregnancy outcome and early offspring development. Furthermore, we hypothesized that the changes observed at 1.5G will be magnified at higher gravity and by exposure during critical developmental periods. To test this hypothesis, we compared maternal body mass gain, food consumption, birth outcome and early offspring development between Sprague Dawley rat dams exposed to graded (1.5 1.75G) chronic hypergravity (HG) or rotation (rotational control, RC) on a 24-ft centrifuge for 22.5 h starting on gestational day (G) 10 with dams housed under identical conditions but not exposed to hypergravity (SC). We also compared maternal body mass, food consumption, birth outcome and early offspring development between rat dams exposed to 1.65G during different stages of pregnancy and nursing. Exposure to hypergravity resulted in transient loss in body mass and prolonged decrease in food consumption in HG dams, but the changes observed at 1.5G were not magnified at 1.65G or 1.75G. On the other hand RC dams gained more mass and consumed more food than SC dams. Exposure to hypergravity also affected pregnancy outcome as evidenced by decreased litter size, lowered neonatal mass at birth, and higher neonatal mortality; pregnancy outcome was not affected in RC dams. Neonatal changes evidenced by impaired righting response observed at 1.5G was magnified at higher gravity and was dependent on the period of hypergravity exposure. On the other hand, righting response was improved in RC neonates. Hypergravity exposure during early postpartum affected the food consumption of nursing mothers and affected early survival of their offspring. The changes observed in dams and neonates appear to be due to hypergravity exposure since animals exposed to the rotation

  8. The Importance of an Evidence-based Workup for Recurrent Pregnancy Loss.

    PubMed

    Gibbins, Karen J; Porter, T Flint

    2016-09-01

    Choosing an evidence-based workup and treatment for recurrent pregnancy loss is imperative to provide best patient care and create a culture that permits rigorous research into potential (not yet evidence-based) tests and therapeutics. As health sciences technologies become more sophisticated, more precise, and less expensive, new tools may be developed that allow better evaluation and treatment of couples with recurrent pregnancy loss. The goal must remain optimizing value and adhering to evidence-based care. PMID:27455202

  9. Peritoneal pregnancy with massive hemoperitoneum in early gestation: two case reports

    PubMed Central

    Miyauchi, Azumi; Yamada, Mitsutoshi; Furuya, Masataka; Matsumura, Satoko; Murayama, Shinji; Yoshimura, Yasunori; Tanaka, Mamoru

    2015-01-01

    Key Clinical Message Peritoneal pregnancy may cause severe abdominal bleeding without genital bleeding as early as the fifth week of gestation. Awareness that pregnancy can exist in unusual locations is imperative. PMID:26185643

  10. Changes in vascular extracellular matrix composition during decidual spiral arteriole remodeling in early human pregnancy.

    PubMed

    Smith, Samantha D; Choudhury, Ruhul H; Matos, Patricia; Horn, James A; Lye, Stephen J; Dunk, Caroline E; Aplin, John D; Jones, Rebecca L; Harris, Lynda K

    2016-05-01

    Uterine spiral arteriole (SA) remodeling in early pregnancy involves a coordinated series of events including decidual immune cell recruitment, vascular cell disruption and loss, and colonization by placental-derived extravillous trophoblast (EVT). During this process, decidual SA are converted from narrow, muscular vessels into dilated channels lacking vasomotor control. We hypothesized that this extensive alteration in SA architecture must require significant reorganization and/or breakdown of the vascular extracellular matrix (ECM). First trimester decidua basalis (30 specimens) was immunostained to identify spiral arterioles undergoing trophoblast-independent and -dependent phases of remodeling. Serial sections were then immunostained for a panel of ECM markers, to examine changes in vascular ECM during the remodeling process. The initial stages of SA remodeling were characterized by loss of laminin, elastin, fibrillin, collagen types III, IV and VI from the basement membrane, vascular media and/or adventitia, and surrounding decidual stromal cells. Loss of ECM correlated with disruption and disorganization of vascular smooth muscle cells, and the majority of changes occurred prior to extensive colonization of the vessel wall by EVT. The final stages of SA remodeling, characterized by the arrival of EVT, were associated with the increased mural deposition of fibronectin and fibrinoid. This study provides the first detailed analysis of the spatial and temporal loss of ECM from the walls of remodeling decidual SA in early pregnancy. PMID:26602431

  11. Burden of malaria in early pregnancy: a neglected problem?

    PubMed

    Huynh, Bich-Tram; Cottrell, Gilles; Cot, Michel; Briand, Valérie

    2015-02-15

    According to the current World Health Organization guidelines, the drug prevention of malaria during pregnancy does not adequately cover the first trimester of gestation in high-transmission areas. Although the pathophysiological mechanisms of early infections are not completely understood yet, a review of the most recent studies on the topic suggests that their consequences are serious in terms of maternal anemia and low birth weight. Consequently, there is a need to focus on the awareness of women in a period hard to access, to develop safe drugs to be used in the first trimester, and to consider preconceptional interventions in teenage girls, such as a new malaria vaccine to be used in pregnancy. PMID:25362205

  12. Impact of spontaneous Neospora caninum infection on pregnancy loss and subsequent pregnancy in grazing lactating dairy cows.

    PubMed

    Pessoa, Gilson Antonio; Martini, Ana Paula; Trentin, Janislene Mach; Dalcin, Vanessa Calderaro; Leonardi, Carlos Eduardo Porciuncula; Vogel, Fernanda Silveira Flôres; de Sá Filho, Manoel Francisco; Rubin, Mara Iolanda Batistella; Silva, Carlos Antonio Mondino

    2016-02-01

    The impact of spontaneous Neospora caninum infection on pregnancy loss and subsequent pregnancy in grazing lactating dairy cows was evaluated. Data from 1273 females (878 multiparous and 395 first-calving cows) from six preselected dairy herds were analyzed. Cows were classified as seropositive (SP) (prevalence, 24%; range, 11%-33%) or seronegative (SN) by indirect immunofluorescence detection of antibodies against N caninum. Seropositive cows (prevalence, 40.0%) presented higher (P < 0.001) incidence of abortion compared with SN cows (prevalence, 4.1%). Neospora caninum DNA was detected by real-time polymerase chain reaction in 44.4% of intact aborted fetuses from SP cows, whereas none was found in those aborted from SN cows. The average daily milk production adjusted to 305 days was lower (P < 0.001) in SP (22.5 ± 0.3 L/day) than in SN cows (24.8 ± 0.2 L/day). Furthermore, SP cows presented greater occurrence of retained placenta (17.1% vs. 6.0%; P < 0.001) and acute postpartum metritis (9.8% vs. 2.4%; P < 0.001). Despite similar pregnancy rates after first postpartum artificial insemination (27.6% vs. 31.8%; P = 0.40), cumulative pregnancy rates during 300 days in milk (94.7% vs. 98.5%; P = 0.005) were greater in SN cows. A reduced (P = 0.0001) Cox proportional hazard of pregnancy rate at 300 days in milk and a longer interval from parturition or abortion to conception (median, 111 vs. 101 days) were observed in SP compared with SN cows. Spontaneous N caninum infection is a significant contributing factor of pregnancy loss and occurrence of uterine disease (i.e., retained placenta and metritis), negatively affecting subsequent pregnancy in grazing lactating dairy cows. PMID:26542136

  13. Global alteration in gene expression profiles of deciduas from women with idiopathic recurrent pregnancy loss

    PubMed Central

    Krieg, S.A.; Fan, X.; Hong, Y.; Sang, Q.-X.; Giaccia, A.; Westphal, L.M.; Lathi, R.B.; Krieg, A.J.; Nayak, N.R.

    2012-01-01

    Recurrent pregnancy loss (RPL) occurs in ∼5% of women. However, the etiology is still poorly understood. Defects in decidualization of the endometrium during early pregnancy contribute to several pregnancy complications, such as pre-eclampsia and intrauterine growth restriction (IUGR), and are believed to be important in the pathogenesis of idiopathic RPL. We performed microarray analysis to identify gene expression alterations in the deciduas of idiopathic RPL patients. Control patients had one antecedent term delivery, but were undergoing dilation and curettage for current aneuploid miscarriage. Gene expression differences were evaluated using both pathway and gene ontology (GO) analysis. Selected genes were validated using quantitative reverse transcription–polymerase chain reaction (qRT–PCR). A total of 155 genes were found to be significantly dysregulated in the deciduas of RPL patients (>2-fold change, P < 0.05), with 22 genes up-regulated and 133 genes down-regulated. GO analysis linked a large percentage of genes to discrete biological functions, including immune response (23%), cell signaling (18%) and cell invasion (17.1%), and pathway analysis revealed consistent changes in both the interleukin 1 (IL-1) and IL-8 pathways. All genes in the IL-8 pathway were up-regulated while genes in the IL-1 pathway were down-regulated. Although both pathways can promote inflammation, IL-1 pathway activity is important for normal implantation. Additionally, genes known to be critical for degradation of the extracellular matrix, including matrix metalloproteinase 26 and serine peptidase inhibitor Kazal-type 1, were also highly up-regulated. In this first microarray approach to decidual gene expression in RPL patients, our data suggest that dysregulation of genes associated with cell invasion and immunity may contribute significantly to idiopathic recurrent miscarriage. PMID:22505054

  14. Factors Related to Successful Misoprostol Treatment for Early Pregnancy Failure

    PubMed Central

    Creinin, Mitchell D.; Huang, Xiangke; Westhoff, Carolyn; Barnhart, Kurt; Gilles, Jerry M.; Zhang, Jun

    2006-01-01

    OBJECTIVE To identify potential predictors for treatment success in medical management with misoprostol for early pregnancy failure. METHODS We conducted a planned secondary analysis of data from a multicenter trial that compared medical and surgical management of early pregnancy failure. Medical management consisted of misoprostol 800 μg vaginally on study day 1, with a repeat dose if indicated on day 3. Women returned on days 3 and 15, and a telephone interview was conducted on day 30. Failure was defined as suction aspiration for any reason within 30 days. Demographic, historical, and outcome variables were included in univariable analyses of success. Multivariable analyses were conducted using clinical site, gestational age, and variables for which the univariable analysis resulted in a P < .1 to determine predictors of overall treatment success and first-dose success. RESULTS Of the 491 women who received misoprostol, 485 met the criteria for this secondary analysis. Lower abdominal pain or vaginal bleeding within the last 24 hours, Rh-negative blood type, and nulliparity were predictive of overall success. However, only vaginal bleeding within the last 24 hours and parity of 0 or 1 were predictive of first-dose success. Overall success exceeds 92% in women who have localized abdominal pain within the last 24 hours, Rh-negative blood type, or the combination of vaginal bleeding in the past 24 hours and nulliparity. CONCLUSION Misoprostol treatment for early pregnancy failure is highly successful in select women, primarily those with active bleeding and nulliparity. Clinicians and patients should be aware of these differences when considering misoprostol treatment. PMID:16582130

  15. Fetal outcomes following emergency department point-of-care ultrasound for vaginal bleeding in early pregnancy

    PubMed Central

    Varner, Catherine; Balaban, Dahlia; Borgundvaag, Bjug; McLeod, Shelley; Carver, Sally

    2016-01-01

    Objective To determine 20- and 40-week fetal outcomes following documentation of fetal cardiac activity (FCA) and intrauterine pregnancy (IUP) in women at less than 20 weeks’ gestation presenting to the emergency department (ED) with vaginal bleeding. Design Prospective observational cohort study. Setting Single-centre tertiary care ED. Participants Pregnant women at less than 20 weeks’ gestation presenting to the ED with vaginal bleeding. Intervention All study participants underwent ED point-of-care ultrasound (POCUS) to document IUP and FCA. Main outcome measures Prevalence of spontaneous abortion or pregnancy loss by 40 weeks’ gestational age following ED POCUS documentation of FCA or IUP in women at less than 20 weeks’ gestation. Results A total of 85 of 111 eligible patients were enrolled; FCA and IUP were detected in 43 (50.6%) and 54 (63.5%) participants, respectively. Participants with documented FCA on ED POCUS were less likely to experience pregnancy loss than participants without documented FCA were (5.0% vs 92.7%; Δ = 87.7%; 95% CI 71.0% to 93.7%), and participants with documented IUP were less likely to experience pregnancy loss than participants without documented IUP were (22.0% vs 93.5%; Δ = 71.5%; 95% CI 52.1% to 81.9%). Compared with radiologist-interpreted ultrasound, ED POCUS had sensitivity of 88.9% (95% CI 75.9% to 96.2%) and specificity of 100.0% (95% CI 89.6% to 100.0%) for documenting FCA, and sensitivity of 96.0% (95% CI 86.3% to 99.4%) and specificity of 93.1% (95% CI 77.2% to 99.0%) for documenting IUP. Conclusion In this cohort of women presenting to the ED with bleeding in the first 20 weeks of pregnancy, detection of IUP and especially FCA using POCUS performed by providers certified by the Canadian Emergency Ultrasound Society was associated with ongoing viable pregnancy at 20 and 40 weeks’ gestational age. These data might be useful for ED physicians counseling women with symptomatic early pregnancies about the chance

  16. Satisfaction with Hospital Care and Interventions after Pregnancy Loss.

    ERIC Educational Resources Information Center

    Lasker, Judith N.; Toedter, Lori J.

    1994-01-01

    Conducted longitudinal study of 194 women and men who experienced miscarriage, ectopic pregnancy, stillbirth, or newborn death to examine recommended interventions. Subjects were more satisfied if they had experienced intervention than if they had not, but having experienced more total interventions was not associated with lower grief or greater…

  17. Severity of Birth Defects After Propylthiouracil Exposure in Early Pregnancy

    PubMed Central

    Olsen, Jørn; Wu, Chun Sen; Laurberg, Peter

    2014-01-01

    Background: Propylthiouracil (PTU) used in the treatment of maternal hyperthyroidism in early pregnancy may be associated with a higher prevalence of birth defects in the face and neck region and in the urinary system but the severity of these complications remains to be elucidated. Methods: Review of hospital-registered cases of birth defects in the face and neck region and in the urinary system after PTU exposure in early pregnancy. We obtained information on maternal redeemed prescription of PTU and child diagnosis of birth defect from nationwide registers for all children born in Denmark between 1996 and 2008 (n=817,093). The children were followed until December 31, 2010 (median age, 8.3 years) and the Cox proportional hazards model was used to estimate adjusted hazard ratio (HR) with 95% confidence interval (CI) for having a birth defect after PTU exposure versus nonexposed children (n=811,730). Results: Fourteen cases of birth defects were identified in the face and neck region and in the urinary system after PTU exposure in early pregnancy; 11 children were exposed to PTU only (n=564), whereas 3 children were born to mothers who switched from methimazole (MMI)/carbimazole (CMZ) to PTU in early pregnancy (n=159). Among children exposed to PTU only, the adjusted HR for having a birth defect in the face and neck region was 4.92 (95% CI 2.04–11.86) and in the urinary system 2.73 (1.22–6.07). Looking into details of the 14 cases, 7 children were diagnosed with a birth defect in the face and neck region (preauricular and branchial sinus/fistula/cyst) and 7 children had a birth defect in the urinary system (single cyst of kidney and hydronephrosis). Surgical treatment was registered in 6 of the cases with a birth defect in the face and neck region and 3 of the cases with a birth defect in the urinary system. Two of the children with a birth defect in the urinary system also had other birth defects (genital organs). Conclusions: We report details on possible

  18. Sepsis in pregnancy and early goal-directed therapy

    PubMed Central

    Joseph, Julie; Sinha, Aneeta; Paech, Michael; Walters, Barry N J

    2009-01-01

    Sepsis is a major cause of serious morbidity and mortality in pregnant women and their babies. Conventional management has evolved over many years. Improved understanding of the underlying pathophysiology and randomized clinical trials have led to recommendations for the formalization and standardization of the management of severe sepsis in non-pregnant patients. Most of these recommendations are applicable to pregnancy. The Surviving Sepsis Campaign and Early Goal Directed Therapy have relevance to the care of pregnant women with serious infection and are reviewed here.

  19. Pregnancy Loss in Dairy Cattle: Relationship of Ultrasound, Blood Pregnancy-Specific Protein B, Progesterone and Production Variables.

    PubMed

    Gábor, G; Kastelic, J P; Abonyi-Tóth, Z; Gábor, P; Endrődi, T; Balogh, O G

    2016-08-01

    Objectives were to determine associations between percentage pregnancy loss (PPL) in dairy cattle and: (i) pregnancy diagnosis by ultrasonography; (ii) pregnancy diagnosis by serum pregnancy-specific protein B (PSPB) concentrations, with or without serum progesterone concentrations; and (iii) production and environmental factors. This study included 149 822 pregnancy diagnoses conducted over 13 years in Holstein-Friesian cows in Hungarian dairy herds. The following were determined: PPL in cows diagnosed pregnant by transrectal ultrasonography 29-42 days after artificial insemination (AI; n = 11 457); PPL in cows diagnosed pregnant by serum PSPB 29-35 days after AI (n = 138 365); and PPL and its association with serum progesterone concentrations, PSPB and production/environmental variables. The definition of PPL was percentage of cows initially diagnosed pregnant based on ultrasonography or PSPB, but not pregnant when examined by transrectal palpation 60 -70 days after AI. The PPL was lower (p < 0.001) in cows following ultrasonographic vs PSPB diagnosis of pregnancy at 29-35 days (8.1 vs 19.3%, respectively), but was higher in cows following ultrasonographic pregnancy diagnosis on 29-35 vs 36-42 days (8.1 vs 7.1%, respectively, P < 0.05). Furthermore, 72.9% of pregnancies with ultrasound-detected morphological abnormalities resulted in pregnancy loss. As a subset of PSPB data, a fully quantitative PSPB assay was used for 20 430 samples; PPL in cows with a high PSPB concentration (>1.1 ng/ml) was lowest (15.0%), whereas cows with low concentrations of both PSPB and progesterone (0.6-1.1 and <2 ng/ml, respectively) had the highest PPL (76.3%; p < 0.0001). Furthermore, PPL was higher in cows with advanced parity and with high milk production, when ambient temperatures were high, although body condition score (BCS) had no effect on PPL. Finally, there were no significant associations between serum PSPB and environmental temperatures or number of

  20. Early pregnancy screening for neural tube defects in Israel.

    PubMed

    Legum, C; Shomrat, R; Yedwab, G; Jaffa, A J; Rudick, A

    1986-01-01

    A pilot project to detect neural tube defects (NTD) of the fetus by maternal serum alpha-fetoprotein (MSAFP) screening of women in early pregnancy was initiated in Tel Aviv in 1982 at the instigation of the Israel Ministry of Health. The program was designed to be an extension of routine pregnancy care, which in this city is provided in municipal family clinics that are attended by about 50% of pregnant women before the 20th week of pregnancy. Of these women, 89% complied with the program. Women with a MSAFP level above a cutoff point of 2.4 multiples of the median (MOM) were invited for an ultrasound examination of the fetus, without having to repeat the MSAFP test, thereby reducing maternal anxiety. This deviation from the usual test system protocol did not impair sensitivity (87%), or specificity of the test on its own (95.6%), or in combination with ultrasound examination of the fetus and alpha-fetoprotein and acetylcholinesterase testing of the amniotic fluid (99.9%). The program detected 13 fetuses with an NTD; there were two false-negative results and one false-positive. The predictive value of a positive test was 93%. Its effectiveness as a preventive measure was impaired by the fact that 50% of pregnant women did not attend the family clinic before the 20th gestational week. An educational program for professionals and for the public is contemplated in order to reduce this proportion. Only 50% of normal twin pregnancies had an elevated MSAFP. A check on compliance with other screening systems during the interview for MSAFP screening led to the detection and elective abortion of two fetuses with Tay-Sachs disease. MSAFP screening in Israel is cost-effective rather than cost-beneficial. PMID:2427475

  1. Vitamin D status in early pregnancy and risk of preeclampsia

    PubMed Central

    Achkar, Madonna; Dodds, Linda; Giguère, Yves; Forest, Jean-Claude; Armson, B. Anthony; Woolcott, Christy; Agellon, Sherry; Spencer, Anne; Weiler, Hope A.

    2016-01-01

    OBJECTIVE We sought to examine the association between maternal serum 25-hydroxyvitamin D (25[OH]D) concentration in early pregnancy and the subsequent diagnosis of preeclampsia (PE). STUDY DESIGN This was a nested case-control study from 2 prospective Canadian cohorts conducted in Quebec City, Quebec, and Halifax, Nova Scotia, from 2002 through 2010. Participants were pregnant women (n=169 cases with PE and 1975 controls). Maternal serum was drawn <20 weeks of gestation, and 25(OH)D measurement was performed. Cases were ascertained from medical records. Logistic regression analysis was used to estimate adjusted odds ratios with 95% confidence intervals. RESULTS Women who developed PE had a significantly lower 25(OH)D concentration at a mean gestational age of 14 weeks compared with women in the control group (mean ± SD 25[OH]D 47.2 ± 17.7 vs 52.3 ± 17.2 nmol/L, P < .0001). Women with 25(OH)D <30 nmol/L compared to those with at least 50 nmol/L had a greater risk of developing PE (adjusted odds ratio, 2.23; 95% confidence interval, 1.29–3.83) after adjustment for prepregnancy body mass index, maternal age, smoking, parity, season and year of blood collection, gestational week at blood collection, and cohort site. Exploratory analysis with cubic splines demonstrated a dose-response relationship between maternal 25(OH)D and risk of PE, up to levels around 50 nmol/L, where the association appeared to plateau. CONCLUSION Maternal vitamin D deficiency early in pregnancy defined as 25(OH)D<30 nmol/L may be an independent risk factor for PE. The relevance of vitamin D supplementation for women of child-bearing age should be explored as a strategy for reducing PE and for promoting a healthier pregnancy. PMID:25446694

  2. Internet-based treatment after pregnancy loss: concept and case study.

    PubMed

    Kersting, Anette; Kroker, Kristin; Schlicht, Sarah; Wagner, Birgit

    2011-06-01

    The loss of a child during pregnancy results in significant psychological stress for many women, and may lead to long-lasting grief and psychological illnesses. However, only a small percentage of those affected seek or receive traditional forms of psychological treatment, and therefore novel treatment approaches and methods are required. This article introduces an Internet-based psychotherapy programme for patients after pregnancy loss. The five-week intervention comprises two components: structured writing disclosure and cognitive-behavioural therapy. Communication between the therapist and patient is text-based and asynchronous. The writing protocol consists of three treatment phases: self-confrontation, cognitive reappraisal and social sharing. A case report is presented to illustrate the course of the treatment and clinical considerations associated with delivering Internet-based interventions to patients after pregnancy loss. PMID:21329485

  3. Association between polymorphisms of prokineticin receptor (PKR1 rs4627609 and PKR2 rs6053283) and recurrent pregnancy loss*

    PubMed Central

    Cao, Yun-lei; Zhang, Zhao-feng; Wang, Jian; Miao, Mao-hua; Xu, Jian-hua; Shen, Yue-ping; Chen, Ai-min; Du, Jing; Yuan, Wei

    2016-01-01

    Recurrent pregnancy loss (RPL) is a condition with complex etiologies, to which both genetic and environmental factors may contribute. During the last decade, studies indicated that the expression patterns of the prokineticin receptor (PKR1 and PKR2) are closely related to early pregnancy. However, there are few studies on the role of PKR1 and PKR2 in RPL. In this study, we purpose to investigate the association between polymorphisms of the prokineticin receptor (PKR1 rs4627609 and PKR2 rs6053283) and RPL on a group of 93 RPL cases and 169 healthy controls. Genotyping of the single nucleotide polymorphisms (SNPs) was performed using a Sequenom MassARRAY iPLEX system. The results revealed a significant association between PKR2 rs6053283 polymorphism and RPL (P=0.003), whereas no association was observed between PKR1 rs4627609 polymorphism and RPL (P=0.929) in the Chinese Han population. PMID:26984842

  4. Association between polymorphisms of prokineticin receptor (PKR1 rs4627609 and PKR2 rs6053283) and recurrent pregnancy loss.

    PubMed

    Cao, Yun-Lei; Zhang, Zhao-Feng; Wang, Jian; Miao, Mao-Hua; Xu, Jian-Hua; Shen, Yue-Ping; Chen, Ai-Min; Du, Jing; Yuan, Wei

    2016-03-01

    Recurrent pregnancy loss (RPL) is a condition with complex etiologies, to which both genetic and environmental factors may contribute. During the last decade, studies indicated that the expression patterns of the prokineticin receptor (PKR1 and PKR2) are closely related to early pregnancy. However, there are few studies on the role of PKR1 and PKR2 in RPL. In this study, we purpose to investigate the association between polymorphisms of the prokineticin receptor (PKR1 rs4627609 and PKR2 rs6053283) and RPL on a group of 93 RPL cases and 169 healthy controls. Genotyping of the single nucleotide polymorphisms (SNPs) was performed using a Sequenom MassARRAY iPLEX system. The results revealed a significant association between PKR2 rs6053283 polymorphism and RPL (P=0.003), whereas no association was observed between PKR1 rs4627609 polymorphism and RPL (P=0.929) in the Chinese Han population. PMID:26984842

  5. Annexin A5 Promoter Haplotype M2 Is Not a Risk Factor for Recurrent Pregnancy Loss in Northern Europe

    PubMed Central

    Rull, Kristiina; Christiansen, Ole B.; Nielsen, Henriette S.; Laan, Maris

    2015-01-01

    Introduction Annexin A5 is an essential component of placental integrity that may potentially mediate susceptibility to phenotypes of compromised pregnancy. A promoter haplotype termed M2 of the coding gene ANXA5 has been implicated in various pregnancy complications such as preeclampsia and recurrent pregnancy loss (RPL), however with inconclusive results. Study subjects and methods A retrospective case-control study combining resequencing and restriction fragment length polymorphism (RFLP) analysis was undertaken in 313 women with unexplained RPL and 214 fertile women from Estonia and Denmark to estimate the RPL disease risk of the M2 haplotype in Northern Europe. Comparative prevalence of the studied ANXA5 genetic variants in human populations was estimated based on the 1000 Genomes Project (n = 675, whole-genome sequencing data) and the KORA S3 500K dataset of South German samples (n = 1644, genome-wide genotyping data). Results Minor allele frequency of common polymorphisms in ANXA5 promoter was up to two-fold lower among Estonian RPL subjects than fertile controls. The M2 haplotype was not associated with RPL and a trend for decreased prevalence was observed among RPL patients compared to controls both in Estonia (8.1% vs 15.2%, respectively) and Denmark (9.7% vs 12.6%). The high M2 prevalence in fertile controls was consistent with estimations for European and East Asian populations (9.6%-16.0%). Conclusions This study cautions to consider the M2 haplotype as a deterministic factor in early pregnancy success because: i) no RPL disease risk was associated with the haplotype in two clinically well-characterized RPL case-control study samples, ii) high prevalence of the haplotype among fertile controls and world-wide populations is inconsistent with the previously proposed severe impact on early pregnancy success, iii) weak impact of M2 haplotype on the production of ANXA5 protein has been established by others. PMID:26135579

  6. Immunologic Abnormalities, Treatments, and Recurrent Pregnancy Loss: What Is Real and What Is Not?

    PubMed

    Wang, Nathalie F; Kolte, Astrid M; Larsen, Elisabeth C; Nielsen, Henriette S; Christiansen, Ole B

    2016-09-01

    Recurrent pregnancy loss, depending on the definition, affects 1% to 3% of women aiming to have a child. Little is known about the direct causes of recurrent pregnancy loss, and the condition is considered to have a multifactorial and complex pathogenesis. The aim of this review was to summarize the evaluation and the management of the condition with specific emphasis on immunologic biomarkers identified as risk factors as well as current immunologic treatment options. The review also highlights and discusses areas in need of further research. PMID:27380207

  7. Relaxin supports implantation and early pregnancy in the marmoset monkey.

    PubMed

    Einspanier, Almuth; Lieder, Kai; Husen, Bettina; Ebert, Katja; Lier, Susanne; Einspanier, Ralf; Unemori, Elaine; Kemper, Martina

    2009-04-01

    To test the hypothesis that relaxin is an important factor supporting implantation, two approaches have been carried out using a human-relevant animal model, the marmoset monkey. First, uterine mRNA transcription and protein expression during the implantation phase in the conceptive and nonconceptive cycles were examined. Second, functional parameters were analyzed to assess the in vivo effects of exogenous applied relaxin throughout implantation. Relaxin and its receptor, RXFP1, were highly upregulated shortly before and during the physical process of implantation, indicating that relaxin is an important factor for remodeling and immunotolerance. The action of relaxin on the uterus was accompanied by an increase of estrogen-associated factors and macrophage infiltration, suggesting redundant systems necessary for successful implantation. The data from relaxin-treated animals supported those obtained from naive tissues in terms of increases in angiogenesis as well as earlier and faster growth of the uterus and placenta in the relaxin-treated marmoset monkey group, resulting in parturition 7-10 days earlier than the control group, but not pathological. In general, relaxin is very effective in preparing the endometrium for implantation. These findings should encourage further clinical research regarding introducing relaxin for pathological pregnancies, such as early pregnancy failure or insufficient placenta. PMID:19416176

  8. Serum biomarkers may help predict successful misoprostol management of early pregnancy failure.

    PubMed

    Schreiber, Courtney A; Ratcliffe, Sarah J; Quinley, Kelly E; Miller, Carrie; Sammel, Mary D

    2015-06-01

    In order to simplify management of early pregnancy loss, our goal was to elucidate predictors of successful medical management of miscarriage with a single dose of misoprostol. In this secondary analysis of data from a multicenter randomized controlled trial, candidate biomarkers were compared between 49 women with missed abortion who succeeded in passing their pregnancy with a single dose of misoprostol and 46 women who did not pass their pregnancy with a misoprostol single dose. We computed the precision of trophoblastic protein and hormone concentrations to discriminate between women who succeed or fail single dose misoprostol management. We also included demographic factors in our analyses. We found overlap in the concentrations of the individual markers between women who succeeded and failed single-dose misoprostol. However, hCG levels ≥ 4000 mIU/mL and ADAM-12 levels ≥ 2500 pg/mL were independently associated with complete uterine expulsion after one dose of misoprostol in our population. A multivariable logistic model for success included non-Hispanic ethnicity and parity <2 in addition to hCG ≥ 4000 mIU/mL and ADAM-12 ≥ 2500 pg/mL and had an area under the receiver operating characteristic (ROC) of 0.81 (95% confidence interval: 72-90%). Categorizing women with a predicted probability of ≥ 0.65 resulted in a sensitivity of 75.0%, specificity 77.1% and positive predictive value of 81.8%. While preliminary, our data suggest that serum biomarkers, especially when combined with demographic characteristics, may be helpful in guiding patient decision-making regarding the management of early pregnancy failure (EPF). Further study is warranted. PMID:26051455

  9. VALIDATION OF PROTOCOLS FOR ASSESSING EARLY PREGNANCY FAILURE IN THE RAT: CLOMIPHENE CITRATE

    EPA Science Inventory

    Following the assembly of a battery of protocols for the assessment of maternally-mediated toxicity during early pregnancy, the validation of this battery for its utility in detecting and defining mechanisms of early pregnancy failure is ongoing. his report describes the use of c...

  10. Provider knowledge, attitudes and treatment preferences for early pregnancy failure

    PubMed Central

    Dalton, Vanessa K.; Harris, Lisa H.; Gold, Katherine J.; Kane-Low, Lisa; Schulkin, Jay; Guire, Ken; Fendrick, A. Mark

    2010-01-01

    Objective To describe health care provider knowledge, attitudes and treatment preferences for early pregnancy failure (EPF). Study Design We surveyed 976 obstetrician/gynecologists, midwives and family medicine practitioners on their knowledge and attitudes toward treatment options for EPF, and barriers to adopting misoprostol and office uterine evacuations. We used descriptive statistics to compare practices by provider specialty and logistic regression to identify associations between provider factors and treatment practices. Results Seventy percent of providers have not used misoprostol and 91% have not used an office uterine evacuation to treat EPF in the past 6 months. Beliefs about safety and patient preferences, and prior induced abortion training were significantly associated with use of both of these treatments. Conclusions Increasing education and training on the use of misoprostol and office uterine evacuation, and clarifying patient treatment preferences may increase the willingness of providers to adopt new practices for EPF treatment. PMID:20227674

  11. PREGNANCY LOSS ASSOCIATED WITH EXPOSURE TO PERFLUOROOCTANOIC ACID IN THE MOUSE

    EPA Science Inventory

    Pregnancy loss in the mouse due to perfluorooctanoic acids (PFOA) was investigated in this present study. Daily administration of PFOA (20 or 40 mg/kg) by oral gavage to pregnant CD-1 mice from GD 1-17 led to 75% and 100% incidence respectively, of total resorption at term with c...

  12. Lack of Association between Recurrent Pregnancy Loss and Inherited Thrombophilia in a Group of Colombian Patients

    PubMed Central

    Cardona, Henry; Castañeda, Serguei A.; Cardona Maya, Wálter; Alvarez, Leonor; Gómez, Joaquín; Gómez, Jorge; Torres, José; Tobón, Luis; Bedoya, Gabriel; Cadavid, Ángela P.

    2012-01-01

    Studies have shown an association between recurrent pregnancy loss and inherited thrombophilia in Caucasian populations, but there is insufficient knowledge concerning triethnic populations such as the Colombian. The aim of this study was to evaluate whether inherited thrombophilia is associated with recurrent pregnancy loss. Methods. We conducted a case-control study of 93 patients with recurrent pregnancy loss (cases) and 206 healthy multiparous women (controls) in a Colombian subpopulation. Three single nucleotide polymorphisms (SNPs) markers of the inherited thrombophilias factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T were genotyped by PCR-RFLP. Activated protein C resistance and plasma levels of antithrombin, protein C, and protein S were also measured. Results. The frequency of thrombophilia-associated SNPs, activated protein C resistance, and anticoagulant protein deficiencies, was low overall, except for the methylenetetrahydrofolate reductase C677T SNP. The differences between patients and controls had no statistical significance. Conclusion. Our study confirms the low prevalence of inherited thrombophilias in non-Caucasian populations and it is unlikely that the tested thrombophilias play a role in the pathogenesis of recurrent pregnancy loss in this Colombian population. PMID:22577540

  13. PREGNANCY LOSS AND DELAYED PARTURITION CAUSED BY ATRAZINE AND ITS METABOLITES IN F344 RATS

    EPA Science Inventory

    Previously we reported that atrazine (ATR), a widely used herbicide, caused pregnancy loss (i.e., full-litter resorption) and, in surviving litters, delayed parturition in the rat. In this study we compared the dose-response relationships for ATR and four metabolites. Hydroxyatr...

  14. PREGNANCY LOSS IN THE F344 RAT CAUSED BY BROMODICHLOROMETHANE: EFFECTS ON SERUM LUTEINIZING HORMONE LEVELS

    EPA Science Inventory

    PREGNANCY LOSS IN THE F344 RAT CAUSED BY BROMODICHLOROMETHANE: EFFECTS ON SERUM LUTEINIZING HORMONE LEVELS
    Bielmeier1, S.R., D.S. Best2, and M.G. Narotsky2; 1University of North Carolina at Chapel Hill, Curriculum in Toxicology, 2Reproductive Toxicology Division, U.S. Enviro...

  15. DOSE ADDITIVITY OF ATRAZINE AND BROMODICHLOROMETHANE IN CAUSING PREGNANCY LOSS IN F344 RATS

    EPA Science Inventory

    DOSE ADDITIVITY OF ATRAZINE AND BROMODICHLOROMETHANE IN CAUSING
    PREGNANCY LOSS IN F344 RATS.

    AUTHORS (ALL): Narotsky, Michael G1; Best, Deborah S1; Bielmeier, Susan R2; Cooper, Ralph L1
    SPONSOR NAME: James E Andrews

    INSTITUTIONS (ALL):
    1. Reproductive Toxi...

  16. Management of First Trimester Pregnancy Loss Can Be Safely Moved Into the Office

    PubMed Central

    Allison, Jana L; Sherwood, Rebecca S; Schust, Danny J

    2011-01-01

    Management of first trimester pregnancy loss has conventionally involved two options: expectant management or dilation and curettage in the operating room. New options in the outpatient setting are providing women with alternatives that can be less expensive and performed in more private settings. This review discusses the available approaches to expectant, medical, and surgical management of first trimester loss and the comparative efficacy of each method. PMID:21629493

  17. Detection of fetal structural abnormalities with US during early pregnancy.

    PubMed

    Fong, Katherine W; Toi, Ants; Salem, Shia; Hornberger, Lisa K; Chitayat, David; Keating, Sarah J; McAuliffe, Fionnuala; Johnson, Jo-Ann

    2004-01-01

    Ultrasonography (US) is performed during early pregnancy for dating, determination of the number of fetuses, assessment of early complications, and increasingly for evaluation of the fetus, including measurement of the thickness of the nuchal translucency (NT). Measurement of NT thickness between 11 and 14 weeks gestation, combined with maternal age and maternal serum biochemistry, can be an effective method of screening for trisomy 21 and other chromosomal abnormalities. Furthermore, an increased NT thickness in the presence of a normal karyotype is associated with an increased frequency of structural defects and genetic syndromes. Therefore, this finding is an indication for a more detailed anatomic survey of the fetus. Besides nuchal abnormalities, a wide range of other congenital anomalies can be diagnosed with US at 11-14 weeks gestation, including defects of the central nervous system, heart, anterior abdominal wall, urinary tract, and skeleton. The anatomic survey can be performed with a standardized protocol by using transabdominal US and, when necessary, transvaginal US. A thorough knowledge of the US features of normal fetal development is necessary to avoid potential diagnostic pitfalls. PMID:14730044

  18. Need for testing glucose tolerance in the early weeks of pregnancy

    PubMed Central

    Veeraswamy, Seshiah; Divakar, Hema; Gupte, Sanjay; Datta, Manjula; Kapur, Anil; Vijayam, Balaji

    2016-01-01

    Aims: This observational study aims to determine the frequency of occurrence of glucose intolerance in the early weeks of pregnancy. Materials and Methods: New World Health Organization 2013 guidelines recommends “A Single Step Procedure” (SSP) as an option for diagnosing gestational diabetes mellitus (GDM). Pregnant women attending 131 prenatal clinics across India for the first time underwent SSP consisting of administration of 75 goral glucose irrespective of the last meal timing and to diagnose GDM with 2 h plasma glucose (PG) value ≥7.8 mmol/L (7.8 mmol/L). Results: In a cohort of n = 11,785, the number of pregnant women who underwent the test in first, second, and third trimesters were 4300, 4632, and 2853, respectively. Documented blood glucose values were available for 9282 pregnant women and in them, diagnosis of GDM was made in 740 (8%). Among them, 233 (31.5%), 320 (43.2%), and 187 (25.3%) were in the first, second and third trimesters, respectively. Positive family history of diabetes (43%) and history of fetal loss in previous pregnancy (27%) was more common in women diagnosed with GDM in the first trimester compared to GDM diagnosed in the second or third trimester. Conclusion: Manifestation of GDM in the early weeks of gestation is quite common. PMID:26904467

  19. Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study.

    PubMed

    Alwan, Nisreen A; Cade, Janet E; McArdle, Harry J; Greenwood, Darren C; Hayes, Helen E; Simpson, Nigel A B

    2015-06-28

    Fe deficiency anaemia during early pregnancy has been linked with low birth weight and preterm birth. However, this evidence comes mostly from studies measuring Hb levels rather than specific measures of Fe deficiency. The present study aimed to examine the association between maternal Fe status during the first trimester of pregnancy, as assessed by serum ferritin, transferrin receptor and their ratio, with size at birth and preterm birth. In the Baby VIP (Baby's Vascular health and Iron in Pregnancy) study, we recruited 362 infants and their mothers after delivery in Leeds, UK. Biomarkers were measured in maternal serum samples previously obtained in the first trimester of pregnancy. The cohort included sixty-four (18 %) small for gestational age (SGA) babies. Thirty-three babies were born preterm (9 %; between 34 and 37 weeks). First trimester maternal Fe depletion was associated with a higher risk of SGA (adjusted OR 2·2, 95 % CI 1·1, 4·1). This relationship was attenuated when including early pregnancy Hb in the model, suggesting it as a mediator (adjusted OR 1·6, 95 % CI 0·8, 3·2). For every 10 g/l increase in maternal Hb level in the first half of pregnancy the risk of SGA was reduced by 30 % (adjusted 95 % CI 0, 40 %); levels below 110 g/l were associated with a 3-fold increase in the risk of SGA (95 % CI 1·0, 9·0). There was no evidence of association between maternal Fe depletion and preterm birth (adjusted OR 1·5, 95 % 0·6, 3·8). The present study shows that depleted Fe stores in early pregnancy are associated with higher risk of SGA. PMID:25946517

  20. Severe visual loss associated with idiopathic intracranial hypertension (IIH) in pregnancy

    PubMed Central

    Zamecki, Katherine J; Frohman, Larry P; Turbin, Roger E

    2007-01-01

    Idiopathic intracranial hypertension (IIH) in pregnancy is often responsive to conservative management and usually carries a favorable prognosis. Pregnant patients may be managed with dietary control, corticosteroid therapy, diuretics, and occasionally serial lumbar puncture. We report an unusual case of permanent visual loss due to IIH in pregnancy, requiring aggressive CSF diversion and bilateral optic nerve sheath fenestration after failure to improve with a brief course of medical management and a lumbar puncture. Despite resolution of the papilledema, the subject’s acuity improved only to 20/40 in the right eye and remained no light perception in the left eye. PMID:19668497

  1. First Trimester Pregnancy Loss and the Expression of Alternatively Spliced NKp30 Isoforms in Maternal Blood and Placental Tissue

    PubMed Central

    Shemesh, Avishai; Tirosh, Dan; Sheiner, Eyal; Benshalom-Tirosh, Neta; Brusilovsky, Michael; Segev, Rotem; Rosental, Benyamin; Porgador, Angel

    2015-01-01

    Capsule: We observed that first trimester pregnancy loss is associated with an altered expression profile of the three isoforms of the NK receptor NKp30 expressed by NKs in PBMC and placental tissue. In this study, we aimed to investigate whether first trimester pregnancy loss is associated with differences in expression of NKp30 splice variants (isoforms) in maternal peripheral blood or placental tissue. We conducted a prospective case–control study; a total of 33 women undergoing dilation and curettage due to first trimester pregnancy loss were further subdivided into groups with sporadic or recurrent pregnancy loss. The control group comprises women undergoing elective termination of pregnancy. The qPCR approach was employed to assess the relative expression of NKp30 isoforms as well as the total expression of NKp30 and NKp46 receptors between the selected groups. Results show that in both PBMC and placental tissue, NKp46 and NKp30 expressions were mildly elevated in the pregnancy loss groups compared with the elective group. In particular, NKp46 elevation was significant. Moreover, expression analysis of NKp30 isoforms manifested a different profile between PBMC and the placenta. NKp30-a and NKp30-b isoforms in the placental tissue, but not in PBMC, showed a significant increase in the pregnancy loss groups compared with the elective group. Placental expression of NKp30 activating isoforms-a and -b in the pregnancy loss groups was negatively correlated with PLGF expression. By contrast, placental expression of these isoforms in the elective group was positively correlated with TNFα, IL-10, and VEGF-A expression. The altered expression of NKp30 activating isoforms in placental tissue from patients with pregnancy loss compared to the elective group and the different correlations with cytokine expression point to the involvement of NKp30-mediated function in pregnancy loss. PMID:26082773

  2. Relationship between Prepregnancy and Early Pregnancy Uterine Blood Flow and Resistance Index

    PubMed Central

    Hale, Sarah A.; Schonberg, Adrienne; Badger, Gary J.; Bernstein, Ira M.

    2010-01-01

    We evaluated the relationship between prepregnancy and early pregnancy uterine blood flow (UBF) and resistance index (RI). Nineteen nulliparous subjects were studied during cycle day 8 ± 4, and early pregnancy (13.4 ± 1.6 wks). Color Doppler ultrasound of both uterine arteries and maternal heart was performed to calculate uterine RI, volumetric UBF and cardiac output (CO), respectively. We observed a strong negative association of uterine RI with prepregnancy UBF (r = −0.82, p < 0.001) that weakened, but remained significant in early pregnancy (r = − 0.48, p = 0.04). Prepregnancy uterine index (UBF/CO) was significantly associated with early pregnancy uterine index; r = 0.48, p = 0.04). There was also a trend associating prepregnancy and early pregnancy volumetric UBF (r = 0.44, p = 0.068). Prepregnancy UBF may be a determinant of early pregnancy UBF and UBF may have independent value as a predictor of adverse pregnancy outcome. PMID:19657141

  3. Preterit Loss in Early Modern Nuremberg

    ERIC Educational Resources Information Center

    Bagwell, Angela Catania

    2013-01-01

    This study investigates "Prateritumschwund," one of the most salient developments in the Upper German dialect area during the Early Modern period. Drawing on a wide range of text types originating in Nuremberg and its surrounding areas from the 13th to the 17th centuries, this study tests various hypotheses put forward as alleged causes…

  4. Lymph Region in the Female Internal Reproductive Organs during the Early Postpartum Period after Normal Pregnancy.

    PubMed

    Dergacheva, T I; Borodin, Yu I; Gorchakov, V N; Konenkov, V I

    2015-11-01

    The structural and functional changes in the lymph region of the female internal reproductive organs in rats were studied during the early postpartum period after normal pregnancy. The results indicated that the main role of the lymph region in pregnancy consisted in supporting sufficient lymph production and drainage in the hypertrophic uterus. PMID:26601833

  5. Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?

    ERIC Educational Resources Information Center

    Ellis, Bruce J.; Bates, John E.; Dodge, Kenneth A.; Fergusson, David M.; Horwood, L. John; Pettit, Gregory S.; Woodward, Lianne

    2003-01-01

    Longitudinal studies in two countries investigated impact of father absence on girls' early sexual activity (ESA) and teenage pregnancy. Findings indicated that greater exposure to father absence strongly related to elevated ESA and adolescent pregnancy risk. Elevated risk was not explained (U.S. sample) or only partly explained (New Zealand…

  6. EVALUATION OF THE EFFECTS OF METHANOL DURING EARLY PREGNANCY IN THE RAT

    EPA Science Inventory

    Recent attention to methanol (MeOH) as a potential alternative fuel prompted an evaluation of the chemical's effects during very early pregnancy. ats were dosed by gavage during Days 1-8 of pregnancy at 0, 1.6, 2.4 or 3.2 g MeOH/kg/day. roups of animals were killed on Days 9, 11 ...

  7. Parental Family Stress during Pregnancy and Cognitive Functioning in Early Childhood: The Generation R Study

    ERIC Educational Resources Information Center

    Henrichs, Jens; Schenk, Jacqueline J.; Kok, Rianne; Ftitache, Bouchra; Schmidt, Henk G.; Hofman, Albert; Jaddoe, Vincent W. V.; Verhulst, Frank C.; Tiemeier, Henning

    2011-01-01

    We investigated whether parental family stress during pregnancy is associated with cognitive functioning in early childhood in a population-based cohort (n = 3139). Family stress was assessed using the Family Assessment Device at the 20th week of pregnancy and was reported by mothers and fathers. Mothers completed the MacArthur Communicative…

  8. Prevalence of Uterine Myomas Among Women with 2 or More Recurrent Pregnancy Losses: A Systematic Review.

    PubMed

    Russo, Miguel; Suen, Michael; Bedaiwy, Mohamed; Chen, Innie

    2016-01-01

    Recurrent pregnancy loss (RPL), defined as 2 or more failed clinical pregnancies, affects approximately 5% of reproductive women. Several etiologies for RPL have been studied including uterine myomas. However, the effect of uterine myomas on pregnancy outcomes in this patient population remains unclear. The purpose of this systematic review was to critically appraise the evidence associating uterine myomas with RPL and quantify the prevalence of uterine myomas in this patient population. The inclusion criteria included women of reproductive age with at least 2 or more recurrent, failed clinical pregnancies found to have a submucosal and/or intramural myoma distorting the uterine cavity on a hysterosalpingogram, a saline infusion sonogram, and/or hysteroscopy. Studies with biochemical pregnancies; molar, ectopic, and pregnancies of unknown location; pregnancies conceived with assisted-reproductive technologies; therapeutic abortions; subserosal myomas and intramural myomas not distorting the uterine cavity; studies using only 2-dimensional pelvic ultrasound; or studies in which no additional workup for RPL was initiated or in which multiple etiologies were included were omitted from this review. Risk of bias and quality assessment were conducted using the Quality Assessment Tool for Observational Cohort and Cross-sectional studies published by the National Institutes of Health. The electronic search yielded 934 citations. After title, abstract, and full-text screening, 3 studies had met the pre-established inclusion/exclusion criteria and were included in the review. The prevalence of submucosal and cavity-distorting myomas in women with 2 or more pregnancy losses was found to be 4.08% (29/711). The prevalence of uterine myomas was highest in women with 3 or more RPLs (5.91% [28/473]). No studies with a proper control group were identified. In summary, the association between uterine myomas and RPL remains unclear. High-quality studies are required to assert the

  9. How education changes clinical documentation in early pregnancy.

    PubMed

    Ali, Fida; Higgins, Mary F

    2016-05-01

    The aim of this audit was to record medical history taking in the records of women attending with early pregnancy issues in order to assess the effect of training in this area. The medical education intervention comprised of a 30-min interactive tutorial. Retrospective chart review at three time points: pre education (July 2013, n = 45), immediately post-education (August 2013, n = 45) and longer term post-intervention (October 2013, n = 20). Pre-education, medical history was missing in 77.8% of charts compared to 13.4% immediately post-intervention and 10% long-term post-intervention (p < 0.05). Similar findings were noted with regard to documentation of age, surgical history, medications, allergies and last menstrual period (LMP). While there was a high rate of ultrasound investigations, the documentation of these (by placing an image in the chart) improved after the intervention. Education in requirements for medical history taking can improve documentation. PMID:26789554

  10. Early pregnancy factor is an immunosuppressive contaminant of commercial preparations of human chorionic gonadotrophin.

    PubMed Central

    Rolfe, B E; Morton, H; Clarke, F M

    1983-01-01

    Early pregnancy factor (EPF) is a pregnancy associated substance detected in human serum and urine throughout the first and second trimesters of pregnancy. It has also been detected in several commercial preparations of human chorionic gonadotrophin (hCG). The various molecular weight forms of EPF which occur in human pregnancy serum, urine and commercial hCG preparations have been partially characterized and found to be similar to each other but distinct from hCG. Further evidence is presented which suggests that it is EPF rather than hCG which is responsible for the immunosuppressive activity of some crude hCG preparations. PMID:6831771

  11. Differential diagnosis of early human pregnancies: impact of different diagnostic measures.

    PubMed

    Thorburn, J; Bryman, I; Hahlin, M; Lindblom, B

    1992-01-01

    A total of 261 women in early pregnancy, either with mild symptoms of ectopic pregnancy (EP) or being at an increased risk for this condition, were included in a longitudinal study. The effectiveness of different diagnostic measures in obtaining correct final diagnoses was analyzed. In addition to clinical findings and symptoms, the use of serum human chorionic gonadotropin, serum progesterone, endovaginal sonography and a risk score for EP were all proven to be valuable in distinguishing normal intrauterine pregnancies from pathological pregnancies. PMID:1505809

  12. Evaluation of the effects of methanol during early pregnancy in the rat

    SciTech Connect

    Cummings, A.M.

    1993-01-01

    Recent attention to methanol (MeOH) as a potential alternative fuel prompted an evaluation of the chemical's effects during very early pregnancy. Rats were dosed by gavage during Days 1-8 of pregnancy at 0, 1.6, 2.4 or 3.2 g MeOH/kg/day. Groups of animals were killed on Days 9, 11 or 20 of pregnancy, and maternal, embryonic, or fetal parameters were assessed, depending on the stage of pregnancy. The decidual cell response (DCR) technique was also applied to rats treated with MeOH during pseudopregnancy. (Copyright (c) 1993 Elsevier Scientific Publishers Ireland Ltd.).

  13. Brain May Compensate for Dopamine Neuron Loss Early in Parkinson's

    MedlinePlus

    ... More Science News Brain May Compensate for Dopamine Neuron Loss Early in Parkinson’s - May 09 2014 Scientists ... at least 25 percent of the brain’s dopamine neurons already have been lost. So why do symptoms ...

  14. Early solar mass loss, element diffusion, and solar oscillation frequencies

    SciTech Connect

    Guzik, J.A.; Cox, A.N.

    1994-07-01

    Swenson and Faulkner, and Boothroyd et al. investigated the possibility that early main-sequence mass loss via a stronger early solar wind could be responsible for the observed solar lithium and beryllium depiction. This depletion requires a total mass loss of {approximately}0.1 M{circle_dot}, nearly independent of the mass loss timescale. We have calculated the evolution and oscillation frequencies of solar models including helium and element diffusion, and such early solar mass loss. We show that extreme mass loss of 1 M{circle_dot} is easily ruled out by the low-degree p-modes that probe the solar center and sense the steeper molecular weight gradient produced by the early phase of more rapid hydrogen burning. The effects on central structure are much smaller for models with an initial mass of 1.1 M{circle_dot} and exponentially-decreasing mass loss irate with e-folding timescale 0.45 Gyr. While such mass loss slightly worsens the agreement between observed and calculated low-degree modes, the observational uncertainties of several tenths of a microhertz weaken this conclusion. Surprisingly, the intermediate-degree modes with much smaller observational uncertainties that probe the convection zone bottom prove to be the key to discriminating between models: The early mass loss phase decreases the total amount of helium and heavier elements diffused from the convection zone, and the extent of the diffusion produced composition gradient just below the convection zone, deteriorating the agreement with observed frequencies for these modes. Thus it appears that oscillations can also rule out this smaller amount of gradual early main-sequence mass loss in the young Sun. The mass loss phase must be confined to substantially under a billion years, probably 0.5 Gyr or less, to simultaneously solve the solar Li/Be problem and avoid discrepancies with solar oscillation frequencies.

  15. Aplastic anemia induced disc edema and visual loss in pregnancy: a case report

    PubMed Central

    Gupta, Shailesh K; Brar, Vikram S; Keshavamurthy, Ravi; Chalam, Kakarla V

    2008-01-01

    Introduction A case of aplastic anemia diagnosed during pregnancy, which developed bilateral disc edema and acute pre-retinal hemorrhage leading to vision loss. Case Presentation A 20 year old primagravid female developed acute vision loss in her right eye, during hospitalization for treatment of aplastic anemia diagnosed during her pregnancy. Her best-corrected visual acuity (BCVA) was hand motions and fundus evaluation revealed a large pre-macular hemorrhage in the right eye (OD) and bilateral disc edema. Neuro-imaging studies did not reveal any signs of intracranial mass lesion or edema. Conclusion There was resolution of the disc edema with improvement in the pre-macular hemorrhage resulting in 20/50 vision in the right eye, following supportive transfusions. Ophthalmic manifestations developing in a pregnant patient with aplastic anemia can be successfully managed with supportive care including red blood cell and platelet transfusions. PMID:19017378

  16. Mild and Unilateral Hearing Loss: Implications for Early Intervention

    ERIC Educational Resources Information Center

    Holstrum, W. June; Biernath, Krista; McKay, Sarah; Ross, Danielle S.

    2009-01-01

    Newborn hearing screening has become a standard practice in most birthing hospitals in the United States. Historically, the primary target for the identification of hearing loss has been infants with permanent bilateral loss of moderate degree or greater (i.e., greater than 40 dB). However, research indicates that without early identification and…

  17. Interleukin-17 and leptin genes polymorphisms and their levels in relation to recurrent pregnancy loss in Egyptian females.

    PubMed

    Zidan, Haidy E; Rezk, Noha A; Alnemr, Amr Abd Almohsen; Moniem, Mohamed I Abdel

    2015-11-01

    Recurrent pregnancy loss (RPL) is a common problem during early gestation. The aim of our study was to investigate the association of IL-17 F( rs763780), IL-17 A (rs2275913), and leptin (2548 G/A) gene polymorphisms with RPL in obese and lean Egyptian females, and to find out whether these gene polymorphisms affect the women’s serum levels. One hundred and twenty patients with RPL and 120 fertile volunteers with no history of pregnancy loss were genotyped for leptin (2548 G/A), IL-17 A (rs2275913), and IL-17 F (rs763780) polymorphisms by RFLP. The serum level of IL-17 was measured by ELISA, while serum leptin level was measured by HPLC. We found that IL-17 F (rs763780) polymorphism was associated with a decreased risk of RPL in Egyptian females, and we also found that IL-17 A (rs2275913) and LEP (2548 G/A) SNP were associated with an increased risk of RPL. We also demonstrated that both the IL-17 and leptin levels were elevated in the women with RPL and in an obese subgroup within RPL in comparison to a lean one. PMID:26467330

  18. Pregnancy-associated glycoprotein (PAG) concentration in plasma and milk samples for early pregnancy diagnosis in Lacaune dairy sheep.

    PubMed

    El Amiri, B; Sousa, N M; Alvarez Oxiley, A; Hadarbach, D; Beckers, J F

    2015-04-01

    In the present study, four RIA systems (RIA-1 to -4) based on two antisera raised against ovine pregnancy-associated glycoproteins (ovPAGs), combined with an ovine or a bovine PAG tracer were used to measure PAG concentrations in plasma and milk samples of dairy ewes. Blood and milk samples were collected on different days of gestation: 0, 18, 20, 22, 25, 28, 32, 42, and 49. From day 20 onward, the PAG in plasma could be detected in all pregnant ewes using the four RIA systems. By using milk, except for RIA-1, the other systems showed a sensitivity of 100% from day 28 of gestation onward. In plasma, PAG concentrations were higher in multiple than in single pregnancies, while no clear relationship was observed in milk. In conclusion, milk is a good alternative to plasma for early pregnancy diagnosis in sheep from day 28 to day 42. PMID:25613086

  19. The Effects of Interpregnancy Intervals and Previous Pregnancy Outcome on Fetal Loss in Rwanda (1996–2010)

    PubMed Central

    Habimana-Kabano, Ignace; Broekhuis, Annelet; Hooimeijer, Pieter

    2015-01-01

    In 2005, a WHO consultation meeting on pregnancy intervals recommended a minimum interval of 6 months after a pregnancy disruption and an interval of two years after a live birth before attempting another pregnancy. Since then, studies have found contradictory evidence on the effect of shorter intervals after a pregnancy disruption. A binary regression analysis on 21532 last pregnancy outcomes from the 2000, 2005, and 2010 Rwanda Demographic and Health Surveys was done to assess the combined effects of the preceding pregnancy outcome and the interpregnancy intervals (IPIs) on fetal mortality in Rwanda. Risks of pregnancy loss are higher for primigravida and for mothers who lost the previous pregnancy and conceived again within 24 months. After a live birth, interpregnancy intervals less than two years do not increase the risk of a pregnancy loss. This study also confirms higher risks of fetal death when IPIs are beyond 5 years. An IPI of longer than 12 months after a fetal death is recommended in Rwanda. Particular attention needs to be directed to postpregnancy abortion care and family planning programs geared to spacing pregnancies should also include spacing after a fetal death. PMID:26613103

  20. Effects of catecholaminergic nerve lesion on endometrial development during early pregnancy in Mice.

    PubMed

    Dong, Yulan; Liu, Guanhui; Wang, Zixu; Li, Jing; Cao, Jing; Chen, Yaoxing

    2016-04-01

    Maternal stress is common during pregnancy and the postnatal period. This stress typically activates the sympathetic nervous system which releases catecholamines. This study explored the influence of sympathectomy by using neurotoxin 6-hydroxydopamine (6-OHDA) on embryo implantation, and investigated the influence mechanism of sympathectomy on reconstruction of endometrial structure during early pregnancy. In the 6-OHDA-treated mice, uterine glands in the endometrium developed poorly, and the gland epithelia were arranged irregularly during early pregnancy. Furthermore, vacuoles, karyopykosis and plasmarrhexis appeared in some gland epithelia. The percentage of uterine glands and the density of proliferating cell nuclear antigen (PCNA) positivity were dramatically decreased, and Fas ligand (FasL) expression was decreased in cells from pregnancy days 5-9 (E5-9) in the treated group. Antioxidant enzyme activity levels in uteri were lower but the malondialdehyde (MDA) levels were higher in the 6-OHDA mice than those in the control mice at E5-9. Similarly, the number of inducible nitric oxide synthase (iNOS) positive cells was significantly increased during early pregnancy following treatment with 6-OHDA. Our results have indicated that peripheral catecholaminergic nerve lesions induced by 6-OHDA cause adverse pregnancy outcomes through disruption of endometrial gland development, which increases oxidative stress and iNOS expression in the endometrium. Thus, catecholaminergic nerves might favourably influence blastocyst implantation, foetal survival and development during early pregnancy by oxidative state regulation and endometrial gland reconstruction. PMID:26554516

  1. Antihistamine Use in Early Pregnancy and Risk of Birth Defects

    PubMed Central

    Li, Qian; Mitchell, Allen A.; Werler, Martha M.; Yau, Wai-Ping; Hernández-Díaz, Sonia

    2014-01-01

    Background Several studies have reported an association between use of specific antihistamines in early pregnancy and certain specific birth defects. Objective To test 16 previously-hypothesized associations between specific antihistamines and specific birth defects, and identify possible new associations. Methods We used 1998-2010 data from the Slone Epidemiology Center Birth Defects Study, a multicenter case-control surveillance program of birth defects in North America. Mothers were interviewed within six months of delivery about demographic, reproductive, medical, and behavioral factors, and details on use of prescription and non-prescription medications. We compared 1st trimester exposure to specific antihistamines between 13,213 infants with specific malformations and 6,982 non-malformed controls, using conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment for potential confounders, including indication for use. Results Overall, 13.7% of controls were exposed to antihistamines during the 1st trimester. The most commonly-used medications were diphenhydramine (4.2%), loratadine (3.1%), doxylamine (1.9%), and chlorpheniramine (1.7%). Where estimates were stable, none supported the previously-hypothesized associations. Among over 100 exploratory comparisons of other specific antihistamine/defect pairs, 14 had ORs ≥1.5 of which 6 had 95% CI bounds excluding 1.0 before but not after adjustment for multiple comparisons. Conclusion Our findings do not provide meaningful support for previously-posited associations between antihistamines and major congenital anomalies; at the same time, we identified associations that had not been previously suggested. We suspect that previous associations may be chance findings in the context of multiple comparisons, a situation which may also apply to our new findings. PMID:24565715

  2. Developmental Origins of Pregnancy Loss in the Adult Female Common Marmoset Monkey (Callithrix jacchus)

    PubMed Central

    Rutherford, Julienne N.; deMartelly, Victoria A.; Layne Colon, Donna G.; Ross, Corinna N.; Tardif, Suzette D.

    2014-01-01

    Background The impact of the intrauterine environment on the developmental programming of adult female reproductive success is still poorly understood and potentially underestimated. Litter size variation in a nonhuman primate, the common marmoset monkey (Callithrix jacchus), allows us to model the effects of varying intrauterine environments (e.g. nutrient restriction, exposure to male womb-mates) on the risk of losing fetuses in adulthood. Our previous work has characterized the fetuses of triplet pregnancies as experiencing intrauterine nutritional restriction. Methodology/Principal Findings We used over a decade of demographic data from the Southwest National Primate Research Center common marmoset colony. We evaluated differences between twin and triplet females in the number of pregnancies they produce and the proportion of those pregnancies that ended in fetal loss. We found that triplet females produced the same number of total offspring as twin females, but lost offspring during pregnancy at a significantly higher rate than did twins (38% vs. 13%, p = 0.02). Regardless of their own birth weight or the sex ratio of the litter the experienced as fetuses, triplet females lost more fetuses than did twins. Females with a male littermate experienced a significant increase in the proportion of stillbirths. Conclusions/Significance These striking findings anchor pregnancy loss in the mother’s own fetal environment and development, underscoring a "Womb to Womb" view of the lifecourse and the intergenerational consequences of development. This has important translational implications for understanding the large proportion of human stillbirths that are unexplained. Our findings provide strong evidence that a full understanding of mammalian life history and reproductive biology requires a developmental foundation. PMID:24871614

  3. Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review

    PubMed Central

    Daugirdaitė, Viltė; van den Akker, Olga; Purewal, Satvinder

    2015-01-01

    Objective. The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF). Methods. Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines. Results. Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss. Conclusions. This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss. PMID:25734016

  4. The association of idiopathic recurrent pregnancy loss with polymorphisms in hemostasis-related genes.

    PubMed

    Cao, Yunlei; Zhang, Zhaofeng; Xu, Jianhua; Yuan, Wei; Wang, Jian; Huang, Xianliang; Shen, Yueping; Du, Jing

    2013-11-10

    Recurrent pregnancy loss (RPL) is a complex, multifactorial condition. Inherited thrombophilia is the leading cause of thromboembolism and is associated with an increased risk of RPL. The aims of the current study were to investigate the effects of polymorphisms in hemostasis-related genes antithrombin (SERPINC1), thrombomodulin (THBD), tissue factor pathway inhibitor (TFPI), factor V, factor II and annexin A5 (ANXA5), involved in reproductive failure in 94 RPL cases with two or more consecutive pregnancy losses prior to 20weeks of pregnancy and 169 healthy controls who had at least one term delivery and no history of pregnancy loss. The genotypes of SERPINC1 G786A, THBD C1418T, TFPI T-33C, factor V G1628A, factor II A19911G and ANXA5 G76A were assayed by the Sequenom MassARRAY system. Genotype and allele frequencies for SERPINC1 (rs2227589), TFPI (rs8176592), factor V (rs6020), factor II (rs3136516) and ANXA5 (rs113588187) in cases and controls were similar. The distribution of THBD C1418T allele showed significant differences between RPL cases and healthy controls (odds ratio (OR): 1.58, 95%, confidence interval (CI): 1.05-2.39, P=0.027). In univariate logistic regression analyses, carriers of THBD 1418T allele (CT+TT) had an increased risk of RPL (OR: 1.83, 95%, CI: 1.10-3.06, P=0.020). This indicated that THBD 1418T allele was associated with increasing the risk of RPL. PMID:23954867

  5. The Effects of Viral Load Burden on Pregnancy Loss among HIV-Infected Women in the United States

    PubMed Central

    Cates, Jordan E.; Westreich, Daniel; Edmonds, Andrew; Wright, Rodney L.; Minkoff, Howard; Colie, Christine; Greenblatt, Ruth M.; Cejtin, Helen E.; Karim, Roksana; Haddad, Lisa B.; Kempf, Mirjam-Colette; Golub, Elizabeth T.; Adimora, Adaora A.

    2015-01-01

    Background. To evaluate the effects of HIV viral load, measured cross-sectionally and cumulatively, on the risk of miscarriage or stillbirth (pregnancy loss) among HIV-infected women enrolled in the Women's Interagency HIV Study between 1994 and 2013. Methods. We assessed three exposures: most recent viral load measure before the pregnancy ended, log10 copy-years viremia from initiation of antiretroviral therapy (ART) to conception, and log10 copy-years viremia in the two years before conception. Results. The risk of pregnancy loss for those with log10 viral load >4.00 before pregnancy ended was 1.59 (95% confidence interval (CI): 0.99, 2.56) times as high as the risk for women whose log10 viral load was ≤1.60. There was not a meaningful impact of log10 copy-years viremia since ART or log10 copy-years viremia in the two years before conception on pregnancy loss (adjusted risk ratios (aRRs): 0.80 (95% CI: 0.69, 0.92) and 1.00 (95% CI: 0.90, 1.11), resp.). Conclusions. Cumulative viral load burden does not appear to be an informative measure for pregnancy loss risk, but the extent of HIV replication during pregnancy, as represented by plasma HIV RNA viral load, predicted loss versus live birth in this ethnically diverse cohort of HIV-infected US women. PMID:26582966

  6. Risk Factors and Birth Outcomes of Anaemia in Early Pregnancy in a Nulliparous Cohort

    PubMed Central

    Masukume, Gwinyai; Khashan, Ali S.; Kenny, Louise C.; Baker, Philip N.; Nelson, Gill

    2015-01-01

    Background Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality. Objective The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of ‘low risk’ women participating in a large international multicentre prospective study (n = 5 609), to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation. Methods The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization’s definition of anaemia in pregnancy (haemoglobin < 11g/dL). Binary logistic regression with adjustment for potential confounders (country, maternal age, having a marital partner, ethnic origin, years of schooling, and having paid work) was the main method of analysis. Results The hallmark findings were the low prevalence of anaemia (2.2%), that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78), and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score < 7 at one and five minutes). Adverse pregnancy outcomes were however more common in those with anaemia than in those without. Conclusion In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia’s conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy. PMID:25875012

  7. Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review

    PubMed Central

    Gentile, Salvatore

    2010-01-01

    Objective: Both first- (FGAs) and second-generation antipsychotics (SGAs) are routinely used in treating severe and persistent psychiatric disorders. However, until now no articles have analyzed systematically the safety of both classes of psychotropics during pregnancy. Data sources and search strategy: Medical literature information published in any language since 1950 was identified using MEDLINE/PubMed, TOXNET, EMBASE, and The Cochrane Library. Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from companies developing drugs. Search terms were pregnancy, psychotropic drugs, (a)typical-first-second-generation antipsychotics, and neuroleptics. A separate search was also conducted to complete the safety profile of each reviewed medication. Searches were last updated on July 2008. Data selection: All articles reporting primary data on the outcome of pregnancies exposed to antipsychotics were acquired, without methodological limitations. Conclusions: Reviewed information was too limited to draw definite conclusions on structural teratogenicity of FGAs and SGAs. Both classes of drugs seem to be associated with an increased risk of neonatal complications. However, most SGAs appear to increase risk of gestational metabolic complications and babies large for gestational age and with mean birth weight significantly heavier as compared with those exposed to FGAs. These risks have been reported rarely with FGAs. Hence, the choice of the less harmful option in pregnancy should be limited to FGAs in drug-naive patients. When pregnancy occurs during antipsychotic treatment, the choice to continue the previous therapy should be preferred. PMID:18787227

  8. Prevention of Defective Placentation and Pregnancy Loss by Blocking Innate Immune Pathways in a Syngeneic Model of Placental Insufficiency.

    PubMed

    Gelber, Shari E; Brent, Elyssa; Redecha, Patricia; Perino, Giorgio; Tomlinson, Stephen; Davisson, Robin L; Salmon, Jane E

    2015-08-01

    Defective placentation and subsequent placental insufficiency lead to maternal and fetal adverse pregnancy outcome, but their pathologic mechanisms are unclear, and treatment remains elusive. The mildly hypertensive BPH/5 mouse recapitulates many features of human adverse pregnancy outcome, with pregnancies characterized by fetal loss, growth restriction, abnormal placental development, and defects in maternal decidual arteries. Using this model, we show that recruitment of neutrophils triggered by complement activation at the maternal/fetal interface leads to elevation in local TNF-α levels, reduction of the essential angiogenic factor vascular endothelial growth factor, and, ultimately, abnormal placentation and fetal death. Blockade of complement with inhibitors specifically targeted to sites of complement activation, depletion of neutrophils, or blockade of TNF-α improves spiral artery remodeling and rescues pregnancies. These data underscore the importance of innate immune system activation in the pathogenesis of placental insufficiency and identify novel methods for treatment of pregnancy loss mediated by abnormal placentation. PMID:26071558

  9. Are female orphans at risk for early marriage, early sexual debut, and teen pregnancy? Evidence from sub-Saharan Africa.

    PubMed

    Palermo, Tia; Peterman, Amber

    2009-06-01

    Female orphans are widely cited as being at risk for early marriage, early childbearing, and risky sexual behavior; however, to date no studies have examined these linkages using population-level data across multiple countries. This study draws from recent Demographic and Health Surveys from ten sub-Saharan African countries to examine the relationship between orphanhood status and measures of early marriage, early sexual debut, and teen pregnancy among adolescent girls aged 15 to 17. Results indicate that, overall, little association is found between orphanhood and early marriage or teen pregnancy, whereas evidence from seven countries supports associations between orphanhood and early sexual debut. Findings are sensitive to the use of multivariate models, type of orphan, and country setting. Orphanhood status alone may not be a sufficient targeting mechanism for addressing these outcomes in many countries; a broader, multidimensional targeting scheme including orphan type, schooling, and poverty measures would be more robust in identifying and aiding young women at risk. PMID:19662802

  10. Early pregnancy metabolite profiling discovers a potential biomarker for the subsequent development of gestational diabetes mellitus.

    PubMed

    de Seymour, Jamie V; Conlon, Cathryn A; Sulek, Karolina; Villas Bôas, Silas G; McCowan, Lesley M E; Kenny, Louise C; Baker, Philip N

    2014-10-01

    Current early pregnancy screening tools to identify women at risk of developing gestational diabetes mellitus lack both specificity and sensitivity. As a result, the foetus and mother are often subjected to insult during disease progression, prior to diagnosis and treatment in later pregnancy. Metabolomics is an analytical approach, which allows for appraisal of small molecular mass compounds in a biofluid. The aim of this pilot study was to investigate the relationship between the early gestation serum metabolite profile and the subsequent development of gestational diabetes mellitus in the search for early pregnancy biomarkers and potential metabolic mechanisms. Our nested case-control study analysed maternal serum at 20 weeks' gestation, obtained from the New Zealand cohort of the Screening for Pregnancy Endpoints study. Metabolomic profiling was performed using gas chromatography coupled to mass spectrometry, and metabolites were identified using R software and an in-house mass spectral library. Statistical analysis was performed using SPSS version 21.0. Forty-eight metabolites were identified in the serum samples. Itaconic acid (P = 0.0003), with a false discovery rate of 0.012, was found to be significantly more abundant in women who subsequently developed gestational diabetes mellitus, when compared to controls with uncomplicated pregnancies. The current pilot study found that itaconic acid may have potential as a novel biomarker in early pregnancy to predict the subsequent development of gestational diabetes mellitus. However, the findings from this pilot study require validation with a larger, diverse population before translation into the clinical setting. PMID:25064235

  11. Hormonal monitoring of early pregnancy by a direct radioimmunoassay of steroid glucuronides in first morning urine

    SciTech Connect

    Mendizabal, A.F.; Quiroga, S.; Farinati, Z.; Lahoz, M.; Nagle, C.

    1984-11-01

    The usefulness of the direct 4-hour radioimmunoassay of estriol-16-glucuronide (E/sub 3/G) and pregnanediol-3-glucuronide (P/sub 2/G) in first morning urine (FMU) for establishing a prognosis of the early pregnancy outcome was evaluated in 106 patients that became pregnant. Microaliquots of FMU were serially assayed from day 3 of the conception cycle until day 80 of pregnancy. The E/sub 3/G and P/sub 2/G profiles of 19 pregnancies which terminated in spontaneous abortion with either a diagnosis of the blighted ovum syndrome (n = 11) or presumption of a corpus luteum/trophoblast failure (n = 8) have been compared with those of clinically normal pregnancies (n = 87). Normal pregnancies displayed typical patterns of E/sub 3/G and P/sub 2/G development, while variations were observed in abortive events that reflected changes of the fetoplacental unit.

  12. Nephrotic syndrome due to focal segmental glomerulosclerosis occurring in early pregnancy

    PubMed Central

    Smyth, A; Wall, C A

    2011-01-01

    Physiological proteinuria is common during pregnancy, but pathological proteinuria may also occur. Nephrotic range proteinuria most commonly occurs due to preeclampsia, but primary renal disease may also occur. We present a case of a woman who presented with nephrotic range proteinuria and nephrotic syndrome at an early stage of her second pregnancy. Due to proteinuria, haematuria, progressive symptoms and high need for medical treatment, renal biopsy was performed and she was noted to have focal segmental glomerulosclerosis (FSGS). She commenced immunosuppression but remained nephrotic during pregnancy. She delivered a healthy baby boy at 35 weeks gestation. Postpartum she remained nephrotic, and developed further complications requiring renal replacement therapy. Despite a successful pregnancy, this case of FSGS highlights that despite aggressive treatment FSGS in pregnancy is often associated with adverse renal outcome. We discuss investigations, including renal biopsy and empiric treatment options in this report.

  13. Decreased expression of the vitamin D receptor in women with recurrent pregnancy loss.

    PubMed

    Yan, Xiaoting; Wang, Liqin; Yan, Chunfang; Zhang, Xinwen; Hui, Lingyun; Sheng, Qiu; Xue, Mingzhan; Yu, Xuewen

    2016-09-15

    The multiple functions of vitamin D3 have stimulated interest in the role that this vitamin may play during pregnancy. The present study investigated the expression of the vitamin D receptor (VDR) in women during the first trimester of pregnancy in order to determine whether VDR is associated with recurrent pregnancy loss (RPL). Forty women at 7-10 weeks gestation with RPL and 40 women of similar gestational age with a healthy pregnancy were recruited. VDR mRNA and protein in chorionic villi and decidua were evaluated by immunohistochemistry, confocal laser scanning microscopy (CLSM), western blot, and quantitative real-time polymerase chain reaction. The serum levels of VDR were measured by an enzyme-linked immunosorbent assay. Women with RPL had a significantly weaker expression of VDR mRNA in villi and decidual tissues compared with the control women (both p < 0.0001). Western blot analysis showed an approximately 46% decrease in VDR expression in villi and a 52% decrease in decidua in the RPL vs. the controls. Serum VDR levels were also significantly lower in the RPL group than in the control group (p = 0.003). Compared with the controls, immunohistochemical and CLSM analysis revealed significantly lower VDR expression in villous cytotrophoblasts and stromal cells, as well as in decidual glandular epithelial and stromal cells (all p < 0.05). In conclusion, these observations show that women with RPL have lower levels of VDR expression in chorionic villi, decidua and serum compared with normal pregnant women, suggesting that decreased VDR expression in the first trimester pregnancy may be associated with RPL. PMID:27477959

  14. Successful delivery after vaginal occlusion in addition to cerclage in a trachelectomy patient with recurrent second trimester pregnancy loss: a case report

    PubMed Central

    Sneider, Kirstine; Poulsen, Mette Østergaard; Ottosen, Christian; Langhoff-Roos, Jens

    2014-01-01

    Key Clinical message Pregnancy outcome after trachelectomy has high risk of complications such as second trimester pregnancy loss and preterm birth. We report beneficial effect of a simple procedure of vaginal occlusion in addition to cerclage in a patient with trachelectomy and two prior second trimester pregnancy losses. PMID:25356275

  15. Sex ratio following preconception low-dose aspirin in women with prior pregnancy loss

    PubMed Central

    Radin, Rose G.; Mumford, Sunni L.; Silver, Robert M.; Lesher, Laurie L.; Galai, Noya; Faraggi, David; Wactawski-Wende, Jean; Townsend, Janet M.; Lynch, Anne M.; Simhan, Hyagriv N.; Sjaarda, Lindsey A.; Perkins, Neil J.; Zarek, Shvetha M.; Schliep, Karen C.; Schisterman, Enrique F.

    2015-01-01

    BACKGROUND. Several lines of evidence suggest that male embryos may have greater vulnerability than female embryos to disordered inflammation; therefore, antiinflammatory drugs, such as low-dose aspirin (LDA), may alter the sex ratio. Here, we assessed the effect of LDA on male live birth and male offspring, incorporating pregnancy losses (n = 56) via genetic assessment, as part of a parallel-design, block-randomized, placebo-controlled trial of preconception LDA. METHODS. Participants (615 treated with LDA, 613 treated with placebo) ranged in age from 18 to 40 years of age, with 1 to 2 prior pregnancy losses. We estimated the intention-to-treat (ITT) risk ratio (RR) and 95% CI and assessed interaction with baseline high-sensitivity C-reactive protein (hsCRP) serum concentration — a marker of systemic inflammation. RESULTS. Among the 1,078 women who completed follow-up (535 treated with LDA, 543 treated with placebo), the male live birth ITT RR equaled 1.31 (95% CI: 1.07–1.59). With increasing tertile of hsCRP, the proportion of males at birth decreased in the placebo group, and the effect of LDA on male live birth increased (first tertile: 48% male in LDA vs. 52% in placebo, ITT RR = 0.97, 95% CI: 0.70–1.35; second tertile: 57% male in LDA vs. 43% in placebo, ITT RR = 1.36, 95% CI: 0.98–1.90; third tertile: 53% male in LDA vs. 35% in placebo, ITT RR = 1.70, 95% CI: 1.13–2.57; P interaction = 0.03). Analysis of pregnancy with male offspring yielded similar results. CONCLUSION. Initiation of LDA prior to conception restored numbers of male live births and pregnancy with male offspring among women with 1 to 2 prior pregnancy losses. Moreover, our data suggest that LDA modulates inflammation that would otherwise reduce the conception or survival of male embryos. TRIAL REGISTRATION. ClinicalTrials.gov NCT00467363. FUNDING. Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of

  16. Pregnancy Problems, Postpartum Depression, and Early Mother-Infant Interactions.

    ERIC Educational Resources Information Center

    Field, Tiffany; And Others

    1985-01-01

    Mothers observed at 3 to 5 months postpartum interacting with their infants were given attitude questionnaires. Mothers who had reported preganancy problems were more depressed and anxious and expressed more punitive childrearing attitudes than mothers not reporting pregnancy problems. (Author/NH)

  17. Pregnancy and infant loss support: a new, feminist, American, patient movement?

    PubMed

    Layne, Linda L

    2006-02-01

    Using as examples three of the earliest pregnancy and infant loss organizations and multiple recent initiatives, I argue this is a unique patient movement, in part due to the particularities of pregnant patienthood. Although during the first 20 years of this distinctively US movement, pregnancy and infant loss support was hospital-based, there was remarkably little attention to the "medical" dimensions of these losses, e.g. etiology, diagnosis, prevention, and treatment. The thrust was instead on changing ideas and feelings. It is only since the turn of the century that bereaved parents have started to forge collaborations with physicians to work toward prevention. During the first phase (mid-1970s to mid-1990s), it was a women's movement, though it did not present itself as such, and although it was indebted to the feminist movement and included some feminist initiatives, the movement was dominated by a traditionally feminine ethos and included pro-life elements. During the second phase, as physicians and researchers have become more involved, leadership has become somewhat less female-centric while at the same time, more initiatives are explicitly feminist. PMID:16194590

  18. Self-reported Vitamin Supplementation in Early Pregnancy and Risk of Miscarriage

    PubMed Central

    Olshan, Andrew F.; Herring, Amy H.; Savitz, David A.; Siega-Riz, Anna Maria; Hartmann, Katherine E.

    2009-01-01

    Miscarriage is a common and poorly understood adverse pregnancy outcome. In this study, the authors sought to evaluate the relation between self-reported use of prenatal vitamins in early pregnancy and the risk of miscarriage. Between 2000 and 2008, 4,752 US women were prospectively enrolled in Right From the Start. Information about vitamin use was obtained from a first-trimester interview. Discrete-time hazard models were used, candidate confounders were assessed, and the following variables were included in the model: study site, maternal age, gravidity, marital status, education, race/ethnicity, smoking, and use of progesterone in early pregnancy. Approximately 95% of participants reported use of vitamins during early pregnancy. A total of 524 women had a miscarriage. In the final adjusted model, any use of vitamins during pregnancy was associated with decreased odds of miscarriage (odds ratio = 0.43, 95% confidence interval: 0.30, 0.60) in comparison with no exposure. These results should be viewed in the context of a potentially preventive biologic mechanism mitigated by possible confounding by healthy behaviors and practices that are also associated with vitamin supplement use during pregnancy. PMID:19372214

  19. Women's voices after pregnancy loss: couples' patterns of communication and support.

    PubMed

    Black, R B

    1991-01-01

    This paper reports results of a study of prenatal diagnosis patients who lost pregnancies. The women felt they shared much in common with their male partners and generally felt understood and supported by the men. However, many of the women also saw their responses to the loss as different from those of their male partners. A variety of coping patterns were adopted by the women in the face of these differences. Implications are considered for preventive efforts to minimize distress; treatment approaches to help couples who experience greater difficulties; and future research directions. PMID:1808722

  20. Pregnancy is not a risk factor for idiopathic sudden sensorineural hearing loss: A nationwide population-based study.

    PubMed

    Yen, Ting-Ting; Lin, Ching-Heng; Shiao, Jiun-Yih; Liang, Kai-Li

    2016-05-01

    Conclusion Sudden sensorineural hearing loss (SSNHL) in pregnancy is rare. It usually occurs in the third trimester. SSNHL in pregnancy does not increase risks during delivery or subsequent stroke. Objectives This study aimed to investigate the incidence and to determine the factors associated with SSNHL in pregnancy. Method Data were retrieved from Taiwan's National Health Insurance Database (NHIRD), covering the years 2000-2009. Patients admitted for SSNHL during pregnancy were enrolled. An age-matched controlled cohort was randomly selected from pregnant women without SSNHL in the NHIRD. The clinical characteristics of both cohorts were collected for further analyses. Results Thirty-three patients with SSNHL in pregnancy were enrolled. The estimated incidence of SSNHL in pregnancy in Taiwan was 2.71 per 100,000 pregnancies. The incidence of SSNHL in pregnancy was lower than that of the general female population. The incidence of SSNHL in the third trimester was higher compared to the other two. The incidence of SSNHL occurring in the 30-39 years old age group was higher than other groups. Women with better socioeconomic status had a higher incidence of SSNHL. There were no identified systemic diseases before SSNHL. Two patients had pre-eclampsia and one patient had premature delivery. Nevertheless, SSNHL in pregnancy did not increase the risk for stroke. PMID:27052963

  1. Ectopic Pregnancy

    MedlinePlus

    ... and how far into the pregnancy she is: Methotrexate Methotrexate is a medicine that stops an ectopic pregnancy ... of ectopic pregnancies can be successfully treated with methotrexate if detected early enough. The rest will require ...

  2. Sensory Temporal Processing in Adults with Early Hearing Loss

    ERIC Educational Resources Information Center

    Heming, Joanne E.; Brown, Lenora N.

    2005-01-01

    This study examined tactile and visual temporal processing in adults with early loss of hearing. The tactile task consisted of punctate stimulations that were delivered to one or both hands by a mechanical tactile stimulator. Pairs of light emitting diodes were presented on a display for visual stimulation. Responses consisted of YES or NO…

  3. Including Children with Hearing Loss in Early Childhood Programs

    ERIC Educational Resources Information Center

    Katz, Laurie; Schery, Teris K.

    2006-01-01

    These are typical scenarios of children with hearing loss who are being included increasingly in early childhood settings. Recent federal legislation encourages states to develop programs to screen the hearing of all infants before they leave the hospital, and currently 39 states have adopted newborn infant hearing screening mandates (ASHA 2005).…

  4. Human chronic gonadotropin concentrations in very early pregnancy and subsequent preeclampsia.

    PubMed

    Rabie, Nader Z; Magann, Everett F

    2014-09-01

    Evaluation of: Asvold BO, Vatten LJ, Tanbo TG, Eskild A. Concentrations of human chorionic gonadotrophin in very early pregnancy and subsequent pre-eclampsia: a cohort study. Hum. Reprod. 29(6), 1153-1160 (2014). A total of 2405 consecutive singleton pregnancies were followed to determine if early HCG levels were associated with the development of preeclampsia. All pregnancies were conceived by in vitro fertilization, which allowed very accurate gestational age dating. HCG levels were obtained on day 12, and grouped into 4 categories (<50, 50-99, 100-149, ≥ 150). HCG levels less than 50 were associated with an odds ratio of 2.3 (95% CI: 1.2-4.7) for preeclampsia and and odds ratio of 4.2 (95% CI: 1.4-12.2) for severe preeclampsia. Early HCG levels may serve as a marker for the detection of preeclampsia. PMID:25335537

  5. Cumulative Chemical Exposures During Pregnancy and Early Development.

    PubMed

    Mitro, Susanna D; Johnson, Tyiesha; Zota, Ami R

    2015-12-01

    Industrial and consumer product chemicals are widely used, leading to ubiquitous human exposure to the most common classes. Because these chemicals may affect developmental milestones, exposures in pregnant women and developing fetuses are of particular interest. In this review, we discuss the prevalence of chemical exposures in pregnant women, the chemical class-specific relationships between maternal and fetal exposures, and the major sources of exposures for six chemical classes of concern: phthalates, phenols, perfluorinated compounds (PFCs), flame retardants, polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCs). Additionally, we describe the current efforts to characterize cumulative exposures to synthetic chemicals during pregnancy. We conclude by highlighting gaps in the literature and discussing possible applications of the findings to reduce the prevalence of cumulative exposures during pregnancy. PMID:26341623

  6. Congenital Bands with Intestinal Malrotation after Propylthiouracil Exposure in Early Pregnancy

    PubMed Central

    Leung, Alexander A.; Yamamoto, Jennifer; Luca, Paola; Beaudry, Paul; McKeen, Julie

    2015-01-01

    Exposure to propylthiouracil in early pregnancy may be associated with an increased risk of birth defects. But the spectrum of associated congenital anomalies is not yet well defined. While preliminary reports suggest that most cases of propylthiouracil-associated birth defects are restricted to the preauricular and urinary systems, careful consideration should be given to other possible manifestations of teratogenicity. We propose that congenital bands may potentially represent a rare yet serious complication of propylthiouracil exposure in early pregnancy, possibly arising from an early mesenteric developmental anomaly. We report a case of a 17-day-old girl that presented with acute small bowel obstruction associated with intestinal malrotation arising from several anomalous congenital bands. Her mother was treated for Graves' disease during pregnancy with first trimester exposure to propylthiouracil but remained clinically and biochemically euthyroid at conception and throughout the duration of pregnancy. This case suggests that the use of propylthiouracil in early pregnancy may be associated with congenital bands and intestinal malrotation. More reports are needed to further support this association. PMID:26664769

  7. Congenital Bands with Intestinal Malrotation after Propylthiouracil Exposure in Early Pregnancy.

    PubMed

    Leung, Alexander A; Yamamoto, Jennifer; Luca, Paola; Beaudry, Paul; McKeen, Julie

    2015-01-01

    Exposure to propylthiouracil in early pregnancy may be associated with an increased risk of birth defects. But the spectrum of associated congenital anomalies is not yet well defined. While preliminary reports suggest that most cases of propylthiouracil-associated birth defects are restricted to the preauricular and urinary systems, careful consideration should be given to other possible manifestations of teratogenicity. We propose that congenital bands may potentially represent a rare yet serious complication of propylthiouracil exposure in early pregnancy, possibly arising from an early mesenteric developmental anomaly. We report a case of a 17-day-old girl that presented with acute small bowel obstruction associated with intestinal malrotation arising from several anomalous congenital bands. Her mother was treated for Graves' disease during pregnancy with first trimester exposure to propylthiouracil but remained clinically and biochemically euthyroid at conception and throughout the duration of pregnancy. This case suggests that the use of propylthiouracil in early pregnancy may be associated with congenital bands and intestinal malrotation. More reports are needed to further support this association. PMID:26664769

  8. Early predictors of nonmarital first pregnancy and abortion.

    PubMed

    Udry, J R; Kovenock, J; Morris, N M

    1996-01-01

    Most research on abortion has focused on women's characteristics at the time of the procedure, but individuals' behavior may also be shaped by their experiences from younger ages. This study uses longitudinal data on 351 California white women aged 27-30 in 1990-1991 to identify characteristics in childhood and adolescence that predict who will have a nonmarital first pregnancy and, of those who do, which women will seek an abortion. Bivariate analyses reveal that psychosocial characteristics indicating a strong sense of autonomy, such as feeling it is important not to be tied down and engaging in socially undesirable behavior, are significantly associated with the likelihood of having a nonmarital first pregnancy (odds ratios of 1.7 and 1.5, respectively), but family characteristics are not. However, among women who have a first pregnancy out of wedlock, the odds of having an abortion are mostly influenced by family rather than psychological characteristics, particularly having been a good student and having a well-educated mother (2.0 and 1.7). PMID:8827147

  9. Partner relationship satisfaction and maternal emotional distress in early pregnancy

    PubMed Central

    2011-01-01

    Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558) completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25). Other predictors were dissatisfaction at work (β = 0.11), somatic disease (β = 0.11), work related stress (β = 0.10) and maternal alcohol problems in the preceding year (β = 0.09). Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P < 0.05). Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors. PMID:21401914

  10. The Impact of Maternal Smoking during Pregnancy on Early Child Neurodevelopment

    PubMed Central

    Prater, Kaitlin; McCarthy, Ann Marie; Castilla, Eduardo E.; Murray, Jeffrey C.

    2011-01-01

    Early child neurodevelopment has major impacts on future human capital and health. However, not much is known about the impacts of prenatal risk factors on child neurodevelopment. This study evaluates the effects of maternal smoking during pregnancy on child neurodevelopment between 3 and 24 months of age and interactions with socioeconomic status (SES). Data from a unique sample of children from South America are employed. Smoking has large adverse effects on neurodevelopment, with larger effects in the low SES sample. The study results highlight the importance of early interventions beginning before and during pregnancy for enhancing child development and future human capital attainment. PMID:22272363

  11. Maternal fish consumption during pregnancy and risk of early childhood asthma.

    PubMed

    Salam, Muhammad T; Li, Yu-Fen; Langholz, Bryan; Gilliland, Frank D

    2005-01-01

    Maternal fish consumption during pregnancy may affect children's asthma risk by modulating early-life immune development. Type of fish intake may be important because of differences in fatty acid content. To test this hypothesis, we conducted a nested case-control study, selecting subjects from the Children's Health Study, a population-based study of school-aged children in southern California. Cases had physician-diagnosed asthma and controls were asthma-free by age 5 years. Mothers or guardians provided information on fish consumption during pregnancy in telephone interviews. We computed odds ratio (OR) and 95% confidence interval (CI) by using conditional logistic regression models that accounted for the sampling. In children born to mothers with a history of asthma, the OR of asthma was 0.20 (95% CI = 0.06-0.65) when mothers ate oily fish at least monthly during pregnancy compared with no consumption (p(trend) = 0.006). Maternal oily fish consumption during pregnancy did not benefit children of non-asthmatic mothers. In contrast, fish stick (a source of trans-fats) consumption during pregnancy increased asthma risk in children (OR = 2.04; 95% CI = 1.18-3.51). Our results suggest that maternal oily fish intake during pregnancy may protect offspring from asthma; however, eating fish sticks during pregnancy may increase asthma risk in children. PMID:16293548

  12. Pregnancy

    MedlinePlus

    ... each trimester are described below. 1 First Trimester (Week 1 to Week 12) The events that lead to pregnancy begin ... and oxygen to the fetus. 2 Second Trimester (Week 13 to Week 28) At 16 weeks, and ...

  13. Complement Split Products in Amniotic Fluid in Pregnancies Subsequently Developing Early-Onset Preeclampsia

    PubMed Central

    Banadakoppa, Manu; Vidaeff, Alex C.; Yallampalli, Uma; Ramin, Susan M.; Belfort, Michael A.; Yallampalli, Chandra

    2015-01-01

    Objective. To determine the second-trimester amniotic fluid concentrations of complement split products in pregnancies subsequently affected by early-onset preeclampsia. Study Design. Cohort of 731 women with singleton pregnancies undergoing second-trimester genetic amniocentesis followed up to delivery and analyzed as a nested case-control study. Cases of preeclampsia developing before 34 weeks' gestation (n = 15) were compared with 47 uncomplicated term controls. Amniotic fluid collected at amniocentesis was tested for complement split products Bb, C4a, C3a, and C5a. Results. Women who developed early-onset preeclampsia as compared with the term pregnant controls had significantly higher (P = 0.04) median amniotic fluid C3a levels (318.7 ng/mL versus 254.5 ng/mL). Median amniotic fluid Bb levels were also significantly higher (P = 0.03) in preeclamptic women than in normal pregnant women (1127 ng/mL versus 749 ng/mL). Median levels of C4a and C5a were not significantly different between the groups. Conclusion. Our data suggest that complement activation in early pregnancy is associated with early-onset preeclampsia. We believe this to be the first prospective study to link complement activation in amniotic fluid in early pregnancy and later development of preeclampsia. Our findings provide evidence that immune dysregulation may precede the clinical manifestations of preeclampsia and that the alternative complement pathway is principally involved. PMID:26556948

  14. Ileosigmoid knotting in early pregnancy: A case report

    PubMed Central

    Maunganidze, Aspect Jacob Vengani; Mungazi, Simbarashe Gift; Siamuchembu, Maphios; Mlotshwa, Makhosini

    2016-01-01

    Ileosigmoid knotting refers to the wrapping of the ileum around the base of the sigmoid colon, or vice versa thus forming a knot. It is a rare cause of intestinal obstruction, more so in pregnancy. We herein report a case of a primigravid woman who presented with an acute abdomen at 13weeks of gestation. The patient underwent emergency surgery. Laparotomy showed ileosigmoid knotting with gangrenous loops of both small bowel and sigmoid colon. The gangrenous bowel was resected. Primary anastomosis of small bowel and a Hartman’s procedure was performed. PMID:27082994

  15. [Early diagnosis of tubal pregnancy with vaginal sonography].

    PubMed

    Schurz, B; Wenzl, R; Eppel, W; Söregi, G; Reinold, E

    1989-07-01

    In 19 patients, the transvaginal (TVU) and in 24 patients, the transabdominal (TAU) ultrasound approaches were compared in their ability to identify by visualization the adnexal mass of ectopic pregnancy. The direct visualization of ectopic pregnancy (EUP) was 25% in TAU and 94.7% in TVU approach (p 0.03). All women had a proven EUP in laparoscopy. TAU approach showed a significant inferiority (p 0.02) and TVU a significant superiority (p 0.08) in comparison to palpation. 83% out of 43 women had spotting. Unspecific signs for EUP, like retrouterine fluid, was seen in 20.9%. Striated endometrium was seen in 6.9%, in 37.2% the thickness of endometrium was less than 10 mm, in 55.8% more than 10 mm. A pseudogestationsac was detected in 6.9%, corpus luteum formation in 27.2%. With vaginosonography, organs can be seen at close range, and the specific signs of EUP, an extrauterine ring-formation surrounded by a dam-like structure of the tube, was identified in 94.7%. PMID:2476361

  16. Seeking Safety and Empathy: Adolescent Health Seeking Behavior during Pregnancy and Early Motherhood in Central Uganda

    ERIC Educational Resources Information Center

    Atuyambe, Lynn; Mirembe, Florence; Annika, Johansson; Kirumira, Edward K.; Faxelid, Elisabeth

    2009-01-01

    Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study…

  17. Early Pregnancy among Adolescent Females with Serious Emotional Disturbances: Risk Factors and Outcomes.

    ERIC Educational Resources Information Center

    Yampolskaya, Svetlana; Brown, Eric C.; Greenbaum, Paul E.

    2002-01-01

    A study involving 109 female adolescents with serious emotional disturbances (ages 9-18) found the following risk factors for early pregnancy: being African American, low family income, dropping out of school, conduct disorder, and substance use disorder. However, according to multivariate analysis, only dropping out of school was a significant…

  18. Opportunity, Community, and Early Adolescent Pregnancy: A Replication of Research with Older Teenaged Girls.

    ERIC Educational Resources Information Center

    Bickel, Robert; McDonough, Meghan; Williams, Tony

    1999-01-01

    Attempts to broaden the analytic categories for understanding early-adolescent pregnancy, suggesting an antidote to the methodological individualism that emphasizes individual and family characteristics by using broader contextual factors. Seemingly imprudent behaviors can be rendered interpretably rational when placed in social context. Without…

  19. Docosahexaenoic Acid Supplementation Early in Pregnancy May Prevent Deep Placentation Disorders

    PubMed Central

    Carvajal, Jorge A.

    2014-01-01

    Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction). Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called “deep placentation disorders”; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids) rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA) supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction. PMID:25019084

  20. Maternal hair selenium levels as a possible long-term nutritional indicator of recurrent pregnancy loss

    PubMed Central

    2013-01-01

    Background Approximately 1% of all couples trying to conceive will suffer from recurrent pregnancy loss (RPL). Nutritional deficiencies have been postulated as a possible cause of RPL and in particular, selenium deficiency has been associated with reproductive failure in animal studies and more recently, in some human studies. This study was undertaken to assess the maternal hair selenium levels in women with RPL without an identified cause and to compare these results with those of women with successful reproductive histories. Methods Twenty four patients with RPL and twenty four control subjects with at least one successful pregnancy and no pregnancy failures, who were matched for age and ethnicity, were recruited. A questionnaire was completed, which included demographic and social information and a dietary history. Hair samples were collected and analyzed for selenium content by inductively coupled plasma mass spectrometry. Results The control subjects had a higher mean income and had completed more years of education compared with the RPL patients. There was no significant difference in the intake of selenium rich foods between the 2 groups. The patients, however, consumed significantly more fruit, cheese, potatoes and chocolate than the controls. The median (range) selenium content was 0.80 ppm (0.19-4.15) and 0.68 ppm (0.43-3.76) in patients and controls respectively (Mann Whitney U test 209.5 p = 0.74). Conclusions While there were significant differences in the 2 groups with regard to resources, education and diet our results show that hair selenium concentrations and dietary selenium intake, were similar in the two groups. Both groups had low levels of this important element. PMID:24148900

  1. Deficiency of monoclonal non-specific suppressor factor beta (MNSFB) promotes pregnancy loss in mice.

    PubMed

    Gu, Yan; He, Yaping; Zhang, Xuan; Shi, Yan; Yang, Qian; Yu, Lin; Sun, Zhaogui; Zhang, Huiqing; Wang, Jianmei; Gao, Xiang; Wang, Jian

    2015-06-01

    Maternal immune tolerance to the semi-allogenic fetus is required for successful pregnancy in mammals. Monoclonal nonspecific suppressor factor beta (MNSFB) is an immunosuppressive factor present in uterine epithelial and stromal cells, as well as in macrophages and T cells. Although the functional neutralization of MNSFB using specific antibodies against it lead to failed embryo implantation in mice, the exact role of MNSFB at the fetal-maternal interface remains unclear. The present study generated conditional heterozygous Mnsfb-deficient (Mnsfb(+/) (-) ) mice using the LoxP/Cre system. Western-blot analyses showed that uterine MNSFB protein in Mnsfb(+/-) mice was remarkably down-regulated compared to that in the wild-type (Mnsfb(+/+) ) mice. The litter size of female Mnsfb(+/-) mice was significantly reduced, which corresponded to developmental failure of embryos beyond Day 11 of pregnancy. The expression level of MNSFB protein was also lower in the failing compared to the normal embryos. An aberrant interaction between the embryos of Day-4 pregnant wild-type mice and endometrial stromal cells of female Mnsfb(+/-) mice was observed in vitro. The uterine Day-5 abundance of P53, BAX, and BCL-G in pregnant Mnsfb(+/-) mice was significantly decreased compared to that of wild-type mice, whereas the expression of P27 and tumor necrosis factor alpha (TNFA) was elevated. By comparison, the levels of MNSFB and BAX proteins in human decidual tissues obtained from recurrent spontaneous miscarriage patients were significantly reduced compared to those obtained from legal medial abortion, highlighting the involvement of MNSFB in the pathogenesis of recurrent spontaneous miscarriage. Together, these results demonstrated that a deficiency in MNSFb is associated with pregnancy loss, probably through reduced P53 and/or increased TNFA production at the fetal-maternal interface. PMID:26031240

  2. [A too-early pregnancy could lead to sterility].

    PubMed

    Cisse, C T

    1990-08-01

    In traditional sub-Saharan Africa where a pronatalist culture prevails, the exclusive first vocation of a couple is procreation. Thus, a couple without children finds life very difficult. Regardless of whether infertility is primary, secondary, or recurring, it is seen as an illness, first by the couple, then by peers and society, which generally accuses the woman of being responsible for it. The infertile woman cannot achieve her status as a woman. The man refuses his responsibility and, in most cases, he seeks different partners. In a retrospective study of infertility visits among 429 couples during 1983-1989 at a gynecology clinic at Aristide Le Dantec Hospital of Dakar, Senegal, two women among all infertile women who were or blamed as the cause of infertility were adolescents (17 and 16 years old), both of whom were married. They comprised about 0.5% of infertile women, which is much higher than the infertility rate for women aged 20-30. One woman had primary infertility (anovulation for four years). The other woman had secondary infertility for two years. She delivered a stillborn at 8 months and miscarried at four months. Examinations could not determine the cause of her infertility. Adolescent pregnancy can directly cause infertility by a perforated uterus during induced abortion, pelvic infection, endometrial lesions, ruptured uterus caused by a difficult labor and/or delivery, and puerperal infection. These problems are more common and more serious in adolescents than in adult women. For the most part, infertility is a result of an unexpected genital infection during adolescence. Family planning policies can play a role in solving these problems by delaying the first pregnancy until the young woman is morphologically and psychologically mature enough to care for herself and her future child. They can also promote prevention of infections and correct treatment of sexually transmitted diseases. PMID:12346451

  3. DISTINGUISHING BETWEEN FERTILIZATION FAILURE AND EARLY PREGNANCY LOSS WHEN IDENTIFYING MALE-MEDIATED ADVERSE PREGNANCY OUTCOMES

    EPA Science Inventory

    Successful reproduction depends upon the precise orchestration of many physiological processes. With respect to male reproductive performance, normal copulatory behavior and ejaculatory function are required to insure that semen is deposited in the female tract. Then, a suffici...

  4. Clinical relevance of multiple antibody specificity testing in anti-phospholipid syndrome and recurrent pregnancy loss

    PubMed Central

    Tebo, A E; Jaskowski, T D; Hill, H R; Branch, D W

    2008-01-01

    We wanted to evaluate whether testing for anti-phosholipid antibodies other than anti-cardiolipin (aCL) and anti-beta-2 glycoprotein I (aβ2GPI) immunoglobulin (Ig)G and IgM identifies patients with recurrent pregnancy loss (RPL) who may be positive for anti-phospholipid syndrome (APS). In a cross-sectional study comprising 62 patients with APS, 66 women with RPL, 50 healthy blood donors and 24 women with a history of successful pregnancies, we tested IgM and IgG antibodies to phosphatidic acid, phosphatidyl choline, phosphatidyl ethanolamine, phosphatidyl glycerol, phosphatidyl inositol and phosphatidyl serine with and without beta-2 glycoprotein I (β2GPI) from a single manufacturer as well as aCL and aβ2GPI antibodies. Diagnostic accuracies of individual and combined anti-phospholipid (aPL) assays were assessed by computing sensitivities, specificities, positive predictive values and negative predictive values together with their 95% confidence intervals. There was a general trend for increased sensitivities in the presence of β2GPI co-factor with significant effect for certain specificities. The overall combined sensitivity of the non-recommended aPL assays was not significantly higher than that of the aCL and aB2GPI tests. Multiple aPL specificities in RPL group is not significantly different from controls and therefore of no clinical significance. PMID:18826497

  5. Clinical relevance of multiple antibody specificity testing in anti-phospholipid syndrome and recurrent pregnancy loss.

    PubMed

    Tebo, A E; Jaskowski, T D; Hill, H R; Branch, D W

    2008-12-01

    We wanted to evaluate whether testing for anti-phosholipid antibodies other than anti-cardiolipin (aCL) and anti-beta-2 glycoprotein I (abeta2GPI) immunoglobulin (Ig)G and IgM identifies patients with recurrent pregnancy loss (RPL) who may be positive for anti-phospholipid syndrome (APS). In a cross-sectional study comprising 62 patients with APS, 66 women with RPL, 50 healthy blood donors and 24 women with a history of successful pregnancies, we tested IgM and IgG antibodies to phosphatidic acid, phosphatidyl choline, phosphatidyl ethanolamine, phosphatidyl glycerol, phosphatidyl inositol and phosphatidyl serine with and without beta-2 glycoprotein I (beta2GPI) from a single manufacturer as well as aCL and abeta2GPI antibodies. Diagnostic accuracies of individual and combined anti-phospholipid (aPL) assays were assessed by computing sensitivities, specificities, positive predictive values and negative predictive values together with their 95% confidence intervals. There was a general trend for increased sensitivities in the presence of beta2GPI co-factor with significant effect for certain specificities. The overall combined sensitivity of the non-recommended aPL assays was not significantly higher than that of the aCL and aB2GPI tests. Multiple aPL specificities in RPL group is not significantly different from controls and therefore of no clinical significance. PMID:18826497

  6. Early pregnancy sex steroids and maternal breast cancer: a nested case-control study.

    PubMed

    Fortner, Renée T; Schock, Helena; Kaaks, Rudolf; Lehtinen, Matti; Pukkala, Eero; Lakso, Hans-Åke; Tanner, Minna; Kallio, Raija; Joensuu, Heikki; Grankvist, Kjell; Zeleniuch-Jacquotte, Anne; Toniolo, Paolo; Lundin, Eva; Surcel, Helja-Marja

    2014-12-01

    Pregnancy, parity, and circulating steroid hormone levels are associated with risk of breast cancer, but little is known about hormone concentrations during pregnancy and subsequent breast cancer risk. We evaluated early pregnancy (<140 days gestation) serum estradiol, estrone, progesterone, and testosterone and breast cancer risk in a nested case-control study in the Finnish Maternity Cohort. The cohort includes 98% of pregnancies registered in Finland since 1983. Individuals with samples collected in the first pregnancy leading to a live birth were eligible. Breast cancer cases (n = 1,199) were identified through linkage with the Finnish Cancer Registry; 2,281 matched controls were selected using incidence density sampling. ORs were calculated using conditional logistic regression. Hormone concentrations were not associated with breast cancer overall. Estradiol was positively associated with risk of breast cancer diagnosed age <40 [4th vs. 1st quartile OR 1.60 (1.07-2.39); Ptrend = 0.01], and inversely associated with breast cancer diagnosed at age ≥40 [4th vs. 1st quartile OR 0.71 (0.51-1.00); Ptrend = 0.02]. Elevated concentrations of the steroid hormones were associated with increased risk of estrogen receptor (ER)- and progesterone receptor (PR)-negative tumors in women age <40 at diagnosis. We observed no association between steroid hormones and ER(+)/PR(+) disease. These data suggest a positive association between high concentrations of early pregnancy steroid hormones and risk of ER(-)/PR(-) breast cancer in women diagnosed age <40, and an inverse association for overall breast cancer diagnosed age ≥40. Further research on pregnancy hormones and risk of steroid receptor-negative cancers is needed to further characterize this association. PMID:25281720

  7. Role of early serum beta human chorionic gonadotropin measurement in predicting multiple pregnancy and pregnancy wastage in an in vitro ET fertilization cycle

    PubMed Central

    Singh, Neeta; Begum, Anjuman Ara; Malhotra, Neena; Bahadur, Anupama; Vanamail, P.

    2013-01-01

    OBJECTIVE: This study was performed to assess the prognostic value of serum beta human chorionic gonadotropin (βhCG), measured on day 14 post embryo transfer (ET) for predicting multiple gestation and pregnancy wastage in women undergoing in vitro fertilization ET (IVF-ET). MATERIALS AND METHODS: This retrospective study was performed between May 2009 and November 2012. Out of the 181 women who conceived, 168 were included and the remaining 13 were excluded as their pregnancy was biochemical. Serum βhCG was measured using a chemiluminescent enzyme immunometric assay. The predictive values of serum βhCG for establishing multiple pregnancy and pregnancy wastages were calculated by receiver operating characteristic (ROC) curve analysis. Median values of serum βhCG and outcome of all pregnancies were compared. RESULTS: Out of the 168 patients who conceived after IVF treatment, 114 (68%) were viable pregnancies (delivered/ongoing). Among the viable pregnancies, 97 (85%) had a successful pregnancy outcome and the remaining 17 patients are ongoing pregnancies. Median values of βhCG (625 IU/L) among viable pregnancies was significantly (P < 0.05) higher than that of nonviable pregnancies (174 IU/L). The median values of βhCG for singleton (502 IU/L), twins (1093 IU/L), and triplets (2160 IU/L) was statistically significant (P < 0.05). Using ROC curve it was predicted that for a value of βhCG at 375 IU/L, the sensitivity of viable pregnancy was 65% and specificity of viable pregnancy was also 65%, with positive and negative predictive values of 65 and 68%, respectively. Similarly for multiple pregnancy and pregnancy wastage the predictive values of βhCG were 808 and 375 IU/L, respectively; while the sensitivity and specificity is more than 65% each. CONCLUSION: βhCG cutoff values determined on day 14 post ET by ROC curve analysis are useful in discriminating between multiple pregnancy and pregnancy losses. The cutoff value might aid in the prognosis, clinical

  8. Intravitreal vascular endothelial growth factor (VEGF) inhibitor injection in unrecognised early pregnancy.

    PubMed

    Kianersi, Farzan; Ghanbari, Heshmatollah; Naderi Beni, Zahra; Naderi Beni, Afsaneh

    2016-10-01

    The use of intravitreal vascular endothelial growth factor (VEGF) inhibitor medications has widened considerably to include indications affecting females of reproductive age. Our patient was inadvertently exposed to bevacizumab within the first trimester when placental growth and fetal organogenesis take place and patient suffered pregnancy loss. There is insufficient information to suggest that such use is safe, nor is there definitive evidence to suggest that it causes harm. We advise that ophthalmologists discuss pregnancy with women of childbearing age undergoing intraocular anti-VEGF injections and in pregnant woman counselling is needed to explain the potential risks and benefits. PMID:27251054

  9. High rates of pregnancy loss by subordinates leads to high reproductive skew in wild golden lion tamarins (Leontopithecus rosalia)

    PubMed Central

    Henry, MaLinda D.; Hankerson, Sarah J.; Siani, Jennifer M.; French, Jeffrey A.; Dietz, James M.

    2013-01-01

    Across taxa, cooperative breeding has been associated with high reproductive skew. Cooperatively breeding golden lion tamarins (Leontopithecus rosalia) were long thought to have a monogynous mating system in which reproduction was limited to a single dominant female. Subordinates with few reproductive opportunities delayed dispersal and remained in the natal group to provide alloparental care to siblings, thus allowing dominant reproductive females to meet the energetic needs associated with high rates of reproduction and successful infant rearing. The goal of this study was to re-assess monogyny in wild golden lion tamarin groups based upon pregnancy diagnoses that used non-invasive enzyme immunoassay for progesterone and cortisol, combined with weekly data on individual weight gain, bi-annual physical examinations noting pregnancy and lactation status and daily behavioral observations. We established quantitative and qualitative criteria to detect and determine the timing of pregnancies that did not result in the birth of infants. Pregnancy polygyny occurred in 83% of golden lion tamarin groups studied. The loss of 64% of subordinate pregnancies compared to only 15% by dominant females limited reproductive success mainly to dominant females, thus maintaining high reproductive skew in female golden lion tamarins. Pregnancy loss by subordinate adults did not appear to result from dominant interference in subordinate hormonal mechanisms, but more likely resulted from subordinate abandonment of newborn infants to mitigate dominant aggression. PMID:23454002

  10. Inheritance of the 8.1 ancestral haplotype in recurrent pregnancy loss

    PubMed Central

    Kolte, Astrid M.; Nielsen, Henriette S.; Steffensen, Rudi; Crespi, Bernard; Christiansen, Ole B.

    2015-01-01

    Background and objectives: The 8.1 ancestral haplotype (AH) (HLA-A1, C7, B8, C4AQ0, C4B1, DR3, DQ2) is a remarkably long and conserved haplotype in the human major histocompatibility complex. It has been associated with both beneficial and detrimental effects, consistent with antagonistic pleiotropy. It has also been proposed that the survival of long, conserved haplotypes may be due to gestational drive, i.e. selective miscarriage of fetuses who have not inherited the haplotype from a heterozygous mother. Recurrent pregnancy loss (RPL) is defined as three or more consecutive pregnancy losses. The objective was to test the gestational drive theory for the 8.1AH in women with RPL and their live born children. Methodology: We investigated the inheritance of the 8.1AH from 82 heterozygous RPL women to 110 live born children. All participants were genotyped for HLA-A, -B and -DRB1 in DNA from EDTA-treated blood or buccal swaps. Inheritance was compared with a Mendelian inheritance of 50% using a two-sided exact binomial test. Results: We found that 55% of the live born children had inherited the 8.1AH, which was not significantly higher than the expected 50% (P = 0.29). Interestingly, we found a non-significant trend toward a higher inheritance of the 8.1AH in girls, 63%, P = 0.11 as opposed to boys, 50%, P = 1.00. Conclusions and implications: We did not find that the 8.1AH was significantly more often inherited by live born children of 8.1AH heterozygous RPL women. However our data suggest that there may be a sex-specific effect which would be interesting to explore further, both in RPL and in a background population. PMID:26675299

  11. Prepregnancy and Early Adulthood Body Mass Index and Adult Weight Change in Relation to Fetal Loss

    PubMed Central

    Gaskins, Audrey J.; Rich-Edwards, Janet W.; Colaci, Daniela S.; Afeiche, Myriam C.; Toth, Thomas L.; Gillman, Matthew W.; Missmer, Stacey A.; Chavarro, Jorge E.

    2014-01-01

    Objective To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18, and weight change since age 18 with risk of fetal loss. Methods Our prospective cohort study included 25,719 pregnancies reported by 17,027 women in the Nurses’ Health Study II between 1990 and 2009. In 1989, height, current weight, and weight at age 18 were self-reported. Current weight was updated every 2 years thereafter. Pregnancies were self-reported, with case pregnancies lost spontaneously and comparison pregnancies ending in ectopic pregnancy, induced abortion, or live birth. Results Incident fetal loss was reported in 4,494 (17.5%) pregnancies. Compared to those of normal BMI, the multivariate relative risk (RR) (95% confidence interval [CI]) of fetal loss was 1.07 (1.00, 1.15) for overweight women, 1.10 (0.98, 1.23) for class I obese women, and 1.27 (1.11, 1.45) for class II & III obese women (P, trend=<0.001). BMI at age 18 was not associated with fetal loss (P, trend=0.59). Compared to women who maintained a stable weight (+/− 4 kg) between age 18 and before pregnancy, women who lost weight had a 20% (95% CI 9, 29%) lower risk of fetal loss. This association was stronger among women who were overweight at age 18. Conclusion Being overweight or obese prior to pregnancy was associated with higher risk of fetal loss. In women overweight or obese at age 18, losing 4 kg or more was associated with a lower risk of fetal loss. PMID:25198273

  12. Depression and emotional stress is highly prevalent among women with recurrent pregnancy loss

    PubMed Central

    Kolte, A.M.; Olsen, L.R.; Mikkelsen, E.M.; Christiansen, O.B.; Nielsen, H.S.

    2015-01-01

    STUDY QUESTION Is the prevalence of psychological stress and moderate/severe depression higher for women with recurrent pregnancy loss (RPL) than pregnancy planners trying to conceive naturally? SUMMARY ANSWER Both psychological stress and major depression are significantly more common among women with RPL than in those trying to conceive naturally. WHAT IS KNOWN ALREADY RPL has a significant emotional impact on couples, especially the woman. Previous studies have shown inconclusive results. STUDY DESIGN, SIZE, DURATION In this cross-sectional study, we compared the prevalence of stress and depression among 301 women with RPL and 1813 women attempting to conceive naturally. We defined RPL as three or more pregnancy losses before 12 weeks' gestation. RPL patients were enrolled from 2010 to 2013 and the comparison group from 2011 to 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS RPL patients completed an online questionnaire before their first consultation at the Danish RPL Unit. In addition, we included data from a comparison group of 1813 women who participated in the Soon Parents Study (www.SnartForældre.dk). The Major Depression Index (MDI) was used to assess symptoms of depression, and Cohen's Perceived Stress Scale (PSS) was used to measure stress. Relevant demographic data were also retrieved. MAIN RESULTS AND THE ROLE OF CHANCE Of the RPL patients, 26 (8.6%) had a score on the MDI corresponding to moderate/severe depression, as did 40 (2.2%) of the women in Soon Parents Study (adjusted odds ratio (OR) 5.53 (95% confidence interval (CI): 2.09; 14.61)). A high stress level, defined as ≥19 on the PSS scale, was reported by 124 (41.2%) of the patients and 420 (23.2%) in the comparison group (adjusted OR 1.59 (95% CI 1.03; 2.44)). LIMITATIONS, REASONS FOR CAUTION We used online questionnaires, and have no interview data. We were unaware if any of the women in the comparison group suffer from RPL. WIDER IMPLICATIONS OF THE FINDINGS This study should entail a

  13. Comparison of normal and abnormal cardiotocography with pregnancy outcomes and early neonatal outcomes.

    PubMed

    Sultana, Jobaida; Chowdhury, T A; Begum, Kohinoor; Khan, Manir Hossain

    2009-01-01

    Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum foetal surveillance in the majority hospitals of developed countries. The purpose of this study was to compare the pregnancy outcome and early neonatal outcome among the normal and abnormal CTG groups. In this prospective study, fifty consecutive normal and fifty consecutive abnormal CTG were collected within one hour before delivery from patients who have singleton pregnancy with gestational age >or=32 weeks and having obstetric or medical indication for CTG. In this study, the measure of pregnancy outcomes were mode of delivery, indications of caesarean section, percentage requiring caesarean section for foetal distress, oligohydramnios, meconium stained liquor, small placenta and cord around the neck. Early neonatal outcomes included apgar score, birth weight, admission into neonatal intensive care unit (NICU), duration of stay in NICU and perinatal mortality. There were significant differences between the two groups regarding pregnancy outcomes and early neonatal outcomes. So, CTG is an important test to assess the foetal condition in both antepartum and intrapartum period. The sensitivity of CTG was 87%, specificity was 66%, positive predictive value was 54% and negative predictive value was 92% in the prediction of abnormal outcomes. So, normal CTG is more predictive of normal outcomes than abnormal CTG regarding abnormal outcomes. PMID:19377417

  14. Metabolite Profile of Cervicovaginal Fluids from Early Pregnancy Is Not Predictive of Spontaneous Preterm Birth

    PubMed Central

    Thomas, Melinda M.; Sulek, Karolina; McKenzie, Elizabeth J.; Jones, Beatrix; Han, Ting-Li; Villas-Boas, Silas G.; Kenny, Louise C.; McCowan, Lesley M. E.; Baker, Philip N.

    2015-01-01

    In our study, we used a mass spectrometry-based metabolomic approach to search for biomarkers that may act as early indicators of spontaneous preterm birth (sPTB). Samples were selected as a nested case-control study from the Screening for Pregnancy Endpoints (SCOPE) biobank in Auckland, New Zealand. Cervicovaginal swabs were collected at 20 weeks from women who were originally assessed as being at low risk of sPTB. Samples were analysed using gas chromatography-mass spectrometry (GC-MS). Despite the low amount of biomass (16–23 mg), 112 compounds were detected. Statistical analysis showed no significant correlations with sPTB. Comparison of reported infection and plasma inflammatory markers from early pregnancy showed two inflammatory markers were correlated with reported infection, but no correlation with any compounds in the metabolite profile was observed. We hypothesise that the lack of biomarkers of sPTB in the cervicovaginal fluid metabolome is simply because it lacks such markers in early pregnancy. We propose alternative biofluids be investigated for markers of sPTB. Our results lead us to call for greater scrutiny of previously published metabolomic data relating to biomarkers of sPTB in cervicovaginal fluids, as the use of small, high risk, or late pregnancy cohorts may identify metabolite biomarkers that are irrelevant for predicting risk in normal populations. PMID:26610472

  15. Immunomorphological changes in the rhesus monkey endometrium and decidua during the menstrual cycle and early pregnancy

    PubMed Central

    Bondarenko, Gennadiy I.; Durning, Maureen; Golos, Thaddeus G.

    2012-01-01

    Problem Throughout the reproductive cycle and into early pregnancy, the normal endometrium undergoes changes in a range of leukocytes, epithelia, stromal fibroblasts, and vascular structures caused by intersecting effects of hormone balance and embryo implantation. The direct investigation in humans of reproductive tract responses during normal and physiologically altered cycles is not practical or feasible. Method and Study The aim of this study was to define immunological and morphological changes through immunohistological and morphometric evaluation of the endometrium throughout the menstrual cycle and the decidua during early gestation in the rhesus monkey, a tractable experimental animal model. Results A zone-dependent method for the immunohistological description of the rhesus uterine mucosa was established, and showed that leukocyte infiltration, stromal cell decidualization, glandular and vascular responses were zone- and cell type-dependent, and changed throughout the cycle and early pregnancy. Morphological heterogeneity of uterine NK cells in the cycling endometrium and gestational decidua were consistent with the recent characterization of phenotypic subsets. Conclusions These data establish a morphological platform upon which to further study the regulation of endometrial responses to the hormonal mileau of pregnancy, the control of local leukocyte populations, and the responses to threatened pregnancy, infection, and inflammation. PMID:22784010

  16. HYPERGLYCOSYLATED HUMAN CHORIONIC GONADOTROPIN AS AN EARLY PREDICTOR OF PREGNANCY OUTCOMES AFTER IN VITRO FERTILIZATION

    PubMed Central

    Chuan, Sandy; Homer, Michael; Pandian, Raj; Conway, Deirdre; Garzo, Gabriel; Yeo, Lisa; Su, H. Irene

    2014-01-01

    Objective To determine if hyperglycosylated hCG (hhCG), produced by invasive trophoblasts, measured as early as 9 days after egg retrieval can predict ongoing pregnancies (OP) after in vitro fertilization and fresh embryo transfer (IVF-ET). Design Cohort Setting Academic ART center Patients Consecutive patients undergoing IVF-ET Interventions Serum hhCG and hCG levels measured 9 (D9) and 16 (D16) days after egg retrieval Outcome Ongoing pregnancy (OP) beyond 9 weeks of gestation Results OP (62 of 112 participants) was associated with higher D9 levels of hhCG and hCG However, hhCG was detectable in all D9 OP samples, while hCG was detectable in only 22%. D9 hhCG levels >110 pg/mL was 96% specific for OP, yielding a positive predictive value of 95%. Compared to D9 hCG levels, hhCG was more sensitive and had a larger area under the curve (0.87 vs. 0.67). Diagnostic test characteristics were similar between D16 hhCG and hCG levels. Conclusions In patients undergoing assisted reproduction, a test to detect pregnancy early and predict outcomes is highly desirable. HhCG is detectable in serum 9 days after egg retrieval IVF-ET cycles. At this early assessment, hhCG is superior to traditional hCG and highly predictive of ongoing pregnancies. PMID:24355054

  17. Endovaginal and translabial ultrasound in pregnancy.

    PubMed

    Levi, C S; Lyons, E A; Lindsay, D J; Holt, S C; Dashefsky, S M

    1992-04-01

    Endovaginal sonography provides earlier and enhanced visualization of the gestational sac and its contents than does transvesical sonography. This paper discusses the role of endovaginal sonography in common first trimester diagnostic problems, including pregnancy dating, first trimester pregnancy loss, ectopic pregnancy, and early diagnosis of fetal anomalies, and reviews the use of endovaginal color flow Doppler in the diagnosis of ectopic pregnancy. A brief discussion of the role of endovaginal and translabial sonography in the second and third trimesters is included. PMID:1554591

  18. Diagnostic value of the plasmatic ADM level for early ectopic pregnancy

    PubMed Central

    Yan, Qi; Lu, Qi; Tao, Yu; Wang, Yu-Dong; Zhao, Wen-Xia

    2015-01-01

    Objective: To analyze the plasmatic ADM level in early pregnancy and to investigate the diagnostic value of ADM in early ectopic pregnancy (EP). Methods: 70 patients with EP who had menopause for 5~8 weeks were included as study group, while 155 women with normal intrauterine pregnancy were also included as control group. The correlation between ADM level and menopause weeks was statistically analyzed and ROC curve was used to identify the diagnostic value of ADM. Results: (1) In 155 cases of normal intrauterine pregnancy, the plasmatic ADM level was increased with menopause weeks in linear relationship, and the correlation coefficient (R) was 0.991 (P<0.05). In 70 patients with EP, no significant increase was found with menopause weeks and no linear relationship can be found between ADM level and menopause weeks in EP group. The correlation coefficient (R) was 0.744 (P>0.05). (2) The multiple of median of plasmatic ADM level in EP group of menopause for 8 weeks was obviously lower than the intrauterine control group (P<0.01). (3) ROC curve was used to analyze the cut-off value of ADM level in the diagnosis of EP, and the area under the ROC curve was 0.523 (P>0.05) regardless of menopause weeks, however, the area under the ROC curve was 0.702 (P<0.05) at 8 weeks after menopause with sensitivity of 53.50% and specificity of 85.00%. Conclusions: Different from normal intrauterine pregnancy, plasmatic ADM level in early EP was relatively lower and no significant increase was found with menopause weeks; further studies are still needed for plasmatic ADM level as an indicator in the early diagnosis of EP. PMID:26823809

  19. SMAD Signaling Is Required for Structural Integrity of the Female Reproductive Tract and Uterine Function During Early Pregnancy in Mice.

    PubMed

    Rodriguez, Amanda; Tripurani, Swamy K; Burton, Jason C; Clementi, Caterina; Larina, Irina; Pangas, Stephanie A

    2016-08-01

    Pregnancy is a complex physiological process tightly controlled by the interplay among hormones, morphogens, transcription factors, and signaling pathways. Although recent studies using genetically engineered mouse models have revealed that ligands and receptors of transforming growth factor beta (TGFbeta) and bone morphogenetic protein (BMP) signaling pathways are essential for multiple reproductive events during pregnancy, the functional role of SMAD transcription factors, which serve as the canonical signaling platform for the TGFbeta/BMP pathways, in the oviduct and uterus is undefined. Here, we used a mouse model containing triple conditional deletion of the BMP receptor signaling Smads (Smad1 and Smad5) and Smad4, the central mediator of both TGFbeta and BMP signaling, to investigate the role of the SMADs in reproductive tract structure and function in cells from the Amhr2 lineage. Unlike the respective single- or double-knockouts, female Smad1(flox/flox) Smad5(flox/flox) Smad4(flox/flox) Amhr2(cre/+)conditional knockout (i.e., Smad1/5/4-Amhr2-cre KO) mice are sterile. We discovered that Smad1/5/4-Amhr2-cre KO females have malformed oviducts that subsequently develop oviductal diverticuli. These oviducts showed dysregulation of multiple genes essential for oviduct and smooth muscle development. In addition, uteri from Smad1/5/4-Amhr2-cre KO females exhibit multiple defects in stroma, epithelium, and smooth muscle layers and fail to assemble a closed uterine lumen upon embryo implantation, with defective uterine decidualization that led to pregnancy loss at early to mid-gestation. Taken together, our study uncovers a new role for the SMAD transcription factors in maintaining the structural and functional integrity of oviduct and uterus, required for establishment and maintenance of pregnancy. PMID:27335065

  20. Thrombophilia and Pregnancy Complications

    PubMed Central

    Simcox, Louise E.; Ormesher, Laura; Tower, Clare; Greer, Ian A.

    2015-01-01

    There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage) and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction). Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question. PMID:26633369

  1. Comparison of a commercial bovine pregnancy-associated glycoprotein ELISA test and a pregnancy-associated glycoprotein radiomimmunoassay test for early pregnancy diagnosis in dairy cattle.

    PubMed

    Karen, Aly; Sousa, Noelita Melo De; Beckers, Jean-François; Bajcsy, Árpád Csaba; Tibold, János; Mádl, István; Szenci, Ottó

    2015-08-01

    The present study aimed to compare the accuracy of a commercial PAG-ELISA test (Bovine Preg Test 29) and bovine pregnancy-associated glycoprotein radioimmunoassay (PAG-RIA) for diagnosing pregnancy at Day 28 after insemination in dairy cows. Transrectal ultrasonography (TRUS) was performed in 100 Holstein-Friesian cows at Day 28 after artificial insemination (AI; Day 0) to diagnose pregnancy. After TRUS examination, blood sample was collected from the coccygeal vessels of each cow to measure the concentrations of bPAGs by PAG-RIA test and Bovine Preg Test 29. Milk samples were collected at Days 0, 21 and 28 for measurement of progesterone (P4) by ELISA test. The cows were re-examined by TRUS at Day 42 to confirm the pregnancy diagnoses. The actual gold standard was based on TRUS outcomes at Day 28 that agreed with the outcomes of PAG-RIA test or PAG-ELISA test. If the outcomes of TRUS at Day 28 and PAG-RIA test and PAG-ELISA test did not agree, the gold standard was based on the outcome of TRUS at Day 42. Out of 100 inseminated cows, 41 were confirmed pregnant at Day 28 after AI. Based on the actual gold standard, the sensitivity of TRUS, PAG-ELISA and PAG-RIA tests for diagnosing pregnant cows at Day 28 were 92.7%, 90.2% and 100%, while the specificity of the three tests for diagnosing non-pregnant cows were 91.5%, 98.3% and 94.4%, respectively. The overall accuracy of the three tests were 92%, 95% and 97%, respectively. The degree of agreement (Kappa±S.E.) between PAG-RIA and PAG-ELISA test was 0.90 ±0.04. The degrees of agreement between PAG-RIA and PAG-ELISA and TRUS at Day 28 were 0.80±0.05 and 0.76±0.06, respectively. In conclusion, the commercial PAG-ELISA test is a highly accurate method for diagnosing early pregnancy in dairy cows on Day 28 after AI and may be used as an alternative method to the TRUS and the PAG-RIA test. PMID:26059776

  2. Virginity Loss and Pregnancy in U.S. and Dutch Teen Girl Magazines: A Content-Analytic Comparison

    ERIC Educational Resources Information Center

    Joshi, Suchi P.; Peter, Jochen; Valkenburg, Patti M.

    2014-01-01

    Using Hofstede's cultural dimension of masculinity/femininity, this quantitative content analysis investigated the coverage of virginity loss (i.e., occurrence, tone, and association with negative consequences) and pregnancy (i.e., occurrence, tone, and negative consequence of sex) in 2,496 feature stories from all issues of three U.S. and…

  3. SERUM HORMONE CHARACTERIZATION AND EXOGENEOUS HORMONE RESCUE OF BROMODICHLOROMETHANE-INDUCED PREGNANCY LOSS IN THE F344 RAT

    EPA Science Inventory

    SERUM HORMONE CHARACTERIZATION AND EXOGENEOUS HORMONE RESCUE OF BROMODICHLOROMETHANE-INDUCED
    PREGNANCY LOSS IN THE F344 RAT
    Susan R. Bielmeier*, Deborah S. Best^, and Michael G. Narotsky^

    ABSTRACT
    Previously, we demonstrated that bromodichloromethane (BDCM), a d...

  4. RESCUE OF BROMODICHLOROMETHANE-INDUCED PREGNANCY LOSS IN THE F344 RAT BY EXOGENOUS PROGESTERONE AND HCG

    EPA Science Inventory

    Rescue of bromodichloromethane-induced pregnancy loss in the F344 rat by exogenous progesterone and hCG.

    Susan R. Bielmeier1, Deborah S. Best2 and Michael G. Narotsky2

    1 Curriculum in Toxicology, Univ. of North Carolina, Chapel Hill, NC, USA
    2 Reproductive Toxico...

  5. Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis.

    PubMed

    Wu, Pensée; van den Berg, Caroline; Alfirevic, Zarko; O'Brien, Shaughn; Röthlisberger, Maria; Baker, Philip Newton; Kenny, Louise C; Kublickiene, Karolina; Duvekot, Johannes J

    2015-01-01

    Pre-eclampsia (PE) complicates 2%-8% of all pregnancies and is an important cause of perinatal morbidity and mortality worldwide. In order to reduce these complications and to develop possible treatment modalities, it is important to identify women at risk of developing PE. The use of biomarkers in early pregnancy would allow appropriate stratification into high and low risk pregnancies for the purpose of defining surveillance in pregnancy and to administer interventions. We used formal methods for a systematic review and meta-analyses to assess the accuracy of all biomarkers that have been evaluated so far during the first and early second trimester of pregnancy to predict PE. We found low predictive values using individual biomarkers which included a disintegrin and metalloprotease 12 (ADAM-12), inhibin-A, pregnancy associated plasma protein A (PAPP-A), placental growth factor (PlGF) and placental protein 13 (PP-13). The pooled sensitivity of all single biomarkers was 0.40 (95% CI 0.39-0.41) at a false positive rate of 10%. The area under the Summary of Receiver Operating Characteristics Curve (SROC) was 0.786 (SE 0.02). When a combination model was used, the predictive value improved to an area under the SROC of 0.893 (SE 0.03). In conclusion, although there are multiple potential biomarkers for PE their efficacy has been inconsistent and comparisons are difficult because of heterogeneity between different studies. Therefore, there is an urgent need for high quality, large-scale multicentre research in biomarkers for PE so that the best predictive marker(s) can be identified in order to improve the management of women destined to develop PE. PMID:26404264

  6. Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis

    PubMed Central

    Wu, Pensée; van den Berg, Caroline; Alfirevic, Zarko; O’Brien, Shaughn; Röthlisberger, Maria; Baker, Philip Newton; Kenny, Louise C.; Kublickiene, Karolina; Duvekot, Johannes J.

    2015-01-01

    Pre-eclampsia (PE) complicates 2%–8% of all pregnancies and is an important cause of perinatal morbidity and mortality worldwide. In order to reduce these complications and to develop possible treatment modalities, it is important to identify women at risk of developing PE. The use of biomarkers in early pregnancy would allow appropriate stratification into high and low risk pregnancies for the purpose of defining surveillance in pregnancy and to administer interventions. We used formal methods for a systematic review and meta-analyses to assess the accuracy of all biomarkers that have been evaluated so far during the first and early second trimester of pregnancy to predict PE. We found low predictive values using individual biomarkers which included a disintegrin and metalloprotease 12 (ADAM-12), inhibin-A, pregnancy associated plasma protein A (PAPP-A), placental growth factor (PlGF) and placental protein 13 (PP-13). The pooled sensitivity of all single biomarkers was 0.40 (95% CI 0.39–0.41) at a false positive rate of 10%. The area under the Summary of Receiver Operating Characteristics Curve (SROC) was 0.786 (SE 0.02). When a combination model was used, the predictive value improved to an area under the SROC of 0.893 (SE 0.03). In conclusion, although there are multiple potential biomarkers for PE their efficacy has been inconsistent and comparisons are difficult because of heterogeneity between different studies. Therefore, there is an urgent need for high quality, large-scale multicentre research in biomarkers for PE so that the best predictive marker(s) can be identified in order to improve the management of women destined to develop PE. PMID:26404264

  7. Devaki syndrome: a culture-bound psychological reaction in Indian Hindu women in response to repeated pregnancy loss?

    PubMed

    Nath, Kamal; Bhattacharya, Arnab; Sinha, Prakriti; Praharaj, Samir Kumar

    2015-02-01

    Depression and anxiety are observed in pregnant women with previous foetal loss due to spontaneous abortions. Culture has important influence on the expression of psychopathology. We report two Hindu women during second trimester of pregnancy with symptoms of depression and anxiety along with identification with a mythological figure - Devaki, with extreme preoccupations with child Krishna and expecting a male child, which precipitated after a series of unfortunate foetal losses. PMID:25583112

  8. Efficacy of progesterone supplementation during early pregnancy in cows: A meta-analysis.

    PubMed

    Yan, Leyan; Robinson, Robert; Shi, Zhendan; Mann, George

    2016-05-01

    Progesterone is a critical hormone during early pregnancy in the cow. As a result, a number of studies have investigated the effects of progesterone supplementation on pregnancy rates. In this study, a meta-analysis using a univariate binary random effects model was carried out on 84 specific treatments reported in 53 publications involving control (n = 9905) and progesterone-treated (n = 9135) cows. Although the results of individual studies showed wide variations (-40% to +50% point changes), progesterone treatment resulted in an overall increase in pregnancy rate odds ratio (OR = 1.12; P < 0.01). Improvements in pregnancy rate were only observed in cows treated at natural estrus (OR = 1.41, P < 0.01) and not following synchronization of estrus or ovulation. Although treatment between Days 3 to 7 postinsemination was beneficial (OR = 1.15; P < 0.01), treatment earlier or later than this was not. Progesterone supplementation was beneficial in cows of lower fertility (<45% control pregnancy rate) but not in cows with higher fertility. These results indicated that the benefit of progesterone supplementation on fertility of cows required exogenous progesterone supplementation to start between Day 3 to 7 and the appropriate reproductive status (i.e., lower fertility, natural estrus) of the treated cows. PMID:26822872

  9. Method for early detection of cooling-loss events

    SciTech Connect

    Bermudez, Sergio A.; Hamann, Hendrik; Marianno, Fernando J.

    2015-06-30

    A method of detecting cooling-loss event early is provided. The method includes defining a relative humidity limit and change threshold for a given space, measuring relative humidity in the given space, determining, with a processing unit, whether the measured relative humidity is within the defined relative humidity limit, generating a warning in an event the measured relative humidity is outside the defined relative humidity limit and determining whether a change in the measured relative humidity is less than the defined change threshold for the given space and generating an alarm in an event the change is greater than the defined change threshold.

  10. Method for early detection of cooling-loss events

    SciTech Connect

    Bermudez, Sergio A.; Hamann, Hendrik F.; Marianno, Fernando J.

    2015-12-22

    A method of detecting cooling-loss event early is provided. The method includes defining a relative humidity limit and change threshold for a given space, measuring relative humidity in the given space, determining, with a processing unit, whether the measured relative humidity is within the defined relative humidity limit, generating a warning in an event the measured relative humidity is outside the defined relative humidity limit and determining whether a change in the measured relative humidity is less than the defined change threshold for the given space and generating an alarm in an event the change is greater than the defined change threshold.