Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, trad...Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, traditional Chinese medicine has become a feasible alternative for certain diseases, including recurrent spontaneous abortion. However, because of the complex composition of the traditional Chinese medicine formula, its action mechanism remains unclear. Methods: We selected two isolated active ingredients (RAMP and baicalin) from the traditional Chinese medicine formula and used an abortion-prone CBA/J × DBA/2 model to simulate human RSA and compared the changes in fetal resorption rate, Treg cell percentage, and relevant cytokines before and after combination therapy. In addition, The mechanisms were preliminarily discussed using in vitro differentiation models. Results: In CBA/J × DBA/2 abortion-prone mice, the combination therapy resulted in a lower embryo resorption rate compared to that obtained with individual delivery of either RAMP or baicalin, thereby playing an embryo-protective role through the increase in Treg cells for the maintenance of maternal-fetal immune tolerance. In in vitro primary cell differentiation experiments, the concentration of Treg cells significantly increased from 11% to 17.9% after the combination therapy compared to that of the single administration group. Conclusion: the synergistic effects of RAMP and baicalin were responsible for Treg differentiation. The present study provides a solid basis for improving the applicability of traditional Chinese herbs in the treatment of recurrent spontaneous abortion.展开更多
Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abort...Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abortion remains one of the leading causes of maternal deaths in developing countries with induced abortion being the key cause. In 2014 from January to August, 9 abortion related deaths occurred in Botswana. There are several reasons female students in tertiary institutions resort to seeking induced abortion which include the socio-demographics like age and socio-economic factors like financial instability. Parental fears, unintended pregnancy and pressure from the partner also force females to terminate pregnancy. Induced abortion has claimed many women’s lives especially in developing countries with very restrictive abortion laws like Botswana as women do not access safe abortion care services. The study intends to establish the determinants of induced abortion among female students in selected tertiary learning institutions in Gaborone City, Botswana. It concentrated primarily on determining the prevalence of induced abortion. This was a descriptive cross-sectional study using both quantitative and qualitative data collection techniques. Systematic random sampling technique was used to come up with 278 participants. Prior to commencement of data collection, all ethical and logistical prerequisites were satisfied. Informed consent was solicited from all the study participants and the purpose of the study was fully explained. A self-administered questionnaire was used to collect data. Microsoft Excel spread sheet was used to code, clean, and enter the data, which was then exported for analysis to the statistical package for social sciences version 24. Frequency distribution tables, percentages graphs, and pie charts were used to illustrate the descriptive information. The study revealed that prevalence of induced abortion among female students in Gaborone City is 7.9%. They even suggested that induced abortion be liberalized. Age was the only socio-demographic factor associated with induced abortion with p = 0.047 using Chi Square test χ<sup>2</sup> = 7.609, df = 3. The study findings concluded that female students resort to induced abortion as a result of pressure from both parents and male partners especially when the pregnancy is unintended. The study recommends that the abortion law in Botswana be made liberal to ease access to safe abortion care services. It also recommends that contraceptive commodities should consistently be available in public health facilities.展开更多
Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads ...Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.展开更多
Background: Retention of fetal bones is a rare cause of abnormal uterine bleeding. Others may present as subfertility, chronic pelvic pain, abnormal vaginal discharge, menometrorrhagia, dysmenorrhea and spontaneous ex...Background: Retention of fetal bones is a rare cause of abnormal uterine bleeding. Others may present as subfertility, chronic pelvic pain, abnormal vaginal discharge, menometrorrhagia, dysmenorrhea and spontaneous expulsion of bony fragments. Incidence is 0.26% among patients undergoing hysteroscopy. Aim: To document a pattern of presentation of retained fetal bone and its management. Case Presentation: Our patient is an 18-year old who presented with vaginal bleeding of four weeks duration and managed for abnormal uterine bleeding due to retained fetal bone following second trimester abortion. Conclusion: The use of transvaginal ultrasound in making diagnosis of retained fetal bone is effective. Treatment by removal of bones through evacuation by dilatation and curettage or hysteroscopy brings about resolution of symptoms. Use of pelvic ultrasonography to confirm complete evacuation of the uterus after abortion especially second trimester abortion could aid in early diagnosis and management of incomplete abortion.展开更多
Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out cla...Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out clandestine abortions, to describe the profile of the providers and the complications that result from it. Patients and Methods: This was a descriptive cross-sectional study of patients hospitalized at the University Hospital Center for Sino-Central African Friendship (CHUASC) from 2015 to 2019 on 236 cases. Results: We identified a total of 254 patients for 8039 live births in the same period, a frequency of 3.16%. The age of the patients was between 15 years old and 48 years old with an average of 25 years old. Singles accounted for 42.5%. Induced abortions were more performed among students (32.6%) and the unemployed 53.6%. Contraception was used in 11.5% of cases. The methods used were numerous: misoprostol (32%), the traditional method (18%), the mechanical method (50%). In this method, we note the dilation of the cervix by the cassava stem;Hegar’s candles;the probes, which are infusion tubes cut and introduced into the cervix, of which 2 cases had escaped at the level of the uterine muscles and emerged under the skin at the pubis part two years later. The practice of induced abortions in our series was done by medical students in 37.3% followed by unqualified staff in 49.7%. It took place either at home or in centers managed by Non-Governmental Organizations. The aseptic conditions were not perfect. Some patients (43.2%) were aware of the ensuing complications. All complications were present: hemorrhage (60.7%), pelviperitonitis (23.6%), uterine perforation (6.6%), peritonitis (2.8%) and death (2%) related to sepsis. Conclusion: Clandestine abortion remains a real health problem for young Central African women.展开更多
Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic test...Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic testing technologies, there has been an increasing interest in using these tools to diagnose the etiology of RSA. This review discusses the different types of genetic testing methods, such as karyotyping, chromosomal microarray analysis, next-generation sequencing, and their applications in the diagnosis of the etiology RSA. The use of genetic testing in the diagnosis of RSA has the potential to improve the accuracy of diagnosis and the understanding of the underlying mechanisms of the disorder, which could lead to better management and treatment of affected individuals.展开更多
<strong>Background:</strong> Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive a...<strong>Background:</strong> Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. <strong>Methods: </strong>We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. <strong>Results: </strong>Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. <strong>Conclusions:</strong> Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.展开更多
Objective To introduce the background and development of post-abortion services such as contraceptive counseling at home and abroad,and its important role for women so as to provide a reference for the further popular...Objective To introduce the background and development of post-abortion services such as contraceptive counseling at home and abroad,and its important role for women so as to provide a reference for the further popularization of this service in China.Methods Chinese and English databases such as CNKI,WanFang Database,VIP,PubMed,and Web of Science were searched to find relevant studies on the implementation of post-abortion service,including post-abortion family planning and post-abortion contraceptive counseling in China.And then the literature on the implementation effect of post-abortion contraceptive counseling and related services was reviewed in China.Results and Conclusion The post-abortion contraceptive counseling service can effectively improve the reproductive health of the patients with induced abortion and the level of knowledge about contraception and birth control,so as to change the contraceptive behavior and adverse psychological state of the patients.Besides.it can guide patients to use more long-term and effective contraceptive measures,thereby reducing the occurrence of unintended pregnancy and repeated abortion.Standardized contraceptive counseling and related services can also improve patient satisfaction.According to the development and implementation effect of post-abortion service and post-abortion contraceptive counseling at home and abroad,it is necessary to further promote post-abortion contraceptive counseling service in the future.Much consideration should be given to carrying out a health technical assessment of the standardized post-abortion contraceptive counseling service as well as its implementation costs.Therefore,medical institutions will have a reference to carry out standardized post-abortion contraceptive counseling service.展开更多
<b>Background: </b>Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affect...<b>Background: </b>Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affects the operation and easily inducesabortion complications. Misoprostol can induce uterine contraction and soften the cervix. <b>Objective:</b> To investigate the clinical effect of misoprostol on abortion before and after painless induced abortion. <b>Methods:</b> 600 case pregnant women were divided into three groups: A, B and C, 200 case in each group. All patients were anesthetized. In group A, misoprostol 0.2 ug was placed in the posterior fornix of vagina 2 hours before the operation of induced abortion;in group B, misoprostol 0.2 ug was not only placed in the posterior fornix of vagina 2 hours before the operation of induced abortion but also taken orally 2 hours and 6 hours after the operation;in group C, misoprostol was not used before and after the operation. The operation time, intraoperative bleeding volume, postoperative bleeding, the percentage of cervical relaxation and the rate of incomplete abortion among the three groups were compared. <b>Results:</b> Compared with group A and group B, the operation time of group C was longer and the amount of bleeding was more (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The duration of bleeding in group B was less than that in group A (P < 0.05). The percentage of cervical relaxation in group A and B was higher than that in group C (P < 0.05). The rate of incomplete abortion in group B < group A < group C (P < 0.05), and there was no residual uterine cavity in group B. <b>Conclusion:</b> The use of misoprostol before and after painless induced abortion can not only shorten the time of operation, reduce intraoperative and postoperative vaginal bleeding, but also has not incurred incomplete abortion(primary outcome).展开更多
In 2011 a protocol for medical abortions (MA) up to 49 days of pregnancy was approved by the Ministry of Health of Catalonia’s autonomous government and it was progressively introduced through the public network of t...In 2011 a protocol for medical abortions (MA) up to 49 days of pregnancy was approved by the Ministry of Health of Catalonia’s autonomous government and it was progressively introduced through the public network of the Sexual and Reproductive Health Units (SRHU). In 2014, a new protocol extended to 63 days of pregnancy was set up. Data come from the official abortion registry held by the Ministry of Health, which collects statistical data from all abortions performed in Catalonia. Since 2011, the number and rate of abortions in Catalonia have decreased while the number of health centers providing abortions has increased, especially the SRHU. The proportion of MA abortions went from 0.4% (2010) to 36.9% (2014), while the percentage of early abortions (up to 7 weeks) surged by 14.7%. SRHU reported 73.4% of all MA and hospitals performed 18.7% of the total, while outpatient centers accounted for the remaining 7.9%. Compared to surgical abortions, women having had MA have higher levels of education and lower rates of unemployment. Furthermore, they have more living offspring and fewer previous terminations as well as more frequent attendance to a public family planning center.展开更多
Objective:To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats.Methods:After pregnancy,50 SPF female SD rats were se...Objective:To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats.Methods:After pregnancy,50 SPF female SD rats were selected and divided into control group,model group,progesterone group,Zishen Yutai pill group,and progesterone plus Zishen Yutai pill group(combination group),with 10 rats in each group.The rats of control group and abortion model group were lavaged with 2 mL/kg normal saline on pregnancy day 1 for continuous 10 days.Rats in Zishen Yutai pill group were given 1.575 g/kg/d of Zishen Yutai pill for intragastric administration for continuous 10 days.Rats in progesterone group were given intramuscular injection treatment of 0.1 mL/d progestin,continuous for 10 days.Rats in combination group were given injection therapy of aqueous solution of Zishen Yutai pill for continuous 10 days,and other treatments were the same as previous two groups.Abortion model were established then and live births,numbers of abortion and average rate of abortion were compared between the five groups.Peripheral blood was collected to detect the estradiol(E2) and progestational hormone(P),and obtain ratio of Th1/Th2 cytokines(IL-2,INF-γ,IL-4,IL-10).Results:Significant more live births of rats were found in the control group compared with other four groups(P<0.05).The numbers of live births of the rats in abortion model group were significantly less than that of progesterone group,Zishen Yutai pill group and joint group(P<0.05).The numbers of live births of rats in joint group were significant more than that of progesterone group and Zishen Yutai pill group.The serum E2 level of P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were significant higher than that of abortion model group(P<0.05).Serum levels of E2 and P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were not significant different(P>0.05) but these levels in the control group and Zishen Yutai pill group were significant lower than that of progesterone group and joint group(P<0.05).The maternal-fetal interface IL-4/IL-2,IL-10 / IL-2 of model group were balanced deviating to Th1,while the IL-4/IL-2,IL-10/IL-2 of progesterone group,Zishen Yutai pill group and joint group were balanced deviating to Th2,and joint group' deviation was better than progesterone group and Zishen Yutai pill group(P<0.05).Conclusions:Zishen Yutai pill combined with progesterone has a significant control effect for threatened abortion,which can obviously increase contents of maternal serums E2 and P,and regulate the Thl/Th2 balance with a remarkable effect.展开更多
Threatened abortion is a common problem in early pregnancy. This early vaginal bleeding happens in about 25% of pregnant women. The medications including progesterone, uterine muscle relaxant or human chorionic gonado...Threatened abortion is a common problem in early pregnancy. This early vaginal bleeding happens in about 25% of pregnant women. The medications including progesterone, uterine muscle relaxant or human chorionic gonadotropin have essential effects in developing pregnancy, but the clinical data are insufficient to prescribe them. In recent decades, medicinal herbs can help us to present new treatments. Grape (Vitis vinifera L.) can protect the fetus from the perspective of Persian medicine. So, we hypothesize about the salutary effects of grape in miscarriage prevention. We found five standard expected mechanisms of grape to prevent threatened abortion: immunomodulatory and anti-inflammatory, anti-oxidant, anti-contraction, hormonal and anti-stress activities. Grape reduces nitric oxide, prostaglandin E2, expression of nuclear factor κB and other pro-inflammatory cytokines like IL (Interleukin)-1β, IL-6, IL-8, and tumor necrosis factor-α. It also elevates anti-inflammatory mediators and expression of peroxisome proliferator-activated receptor-γ. Grape polyphenols have a crucial role in fetus protection with high antioxidant power and other functions such as prevention of stress-triggered abortion with proanthocyanidins, or hormonal effects and inhibition of uterine contractions with resveratrol. So according to these studies, grape probably has effects on the immune and endocrine factors involved in threatened miscarriage.展开更多
BACKGROUND Mifepristone-induced abortion(MIA)has been used worldwide to terminate pregnancies.However,the association between placenta accrete(PA)and MIA has seldom been reported.CASE SUMMARY A 26-year-old pregnant wo...BACKGROUND Mifepristone-induced abortion(MIA)has been used worldwide to terminate pregnancies.However,the association between placenta accrete(PA)and MIA has seldom been reported.CASE SUMMARY A 26-year-old pregnant woman presented with painless vaginal bleeding at 35 wk of gestation.She had a medical abortion(mifepristone followed by misoprostol)1 year ago at the sixth week of gestation.Her personal history for previous surgery was negative.Abdominal ultrasonography showed a normal foetus with complete placenta previa.The foetal membrane ruptured with massive vaginal bleeding and severe abdominal pain.An emergency Caesarean section was performed,and the newborn was delivered.The placenta failed to expel and manual extraction was carried out.A large defect was noted in the uterine fundus and repair of the uterine rupture was conducted immediately.The postoperative pathology report showed placenta accreta.CONCLUSION The evidence suggests a possible etiologic role of MIA in PA,as the incidence of PA after MIA is much higher than general population.Millions of pregnancies are complicated by PA each year,some of which result in fatality.To prevent subsequent placental complications after MIA,hormonal supplementation might be a promising therapeutic options.However,further studies are needed to identify the high-risk factors and to confirm the effectiveness of estrogen supplement therapy.展开更多
To investigate the relationship between inducible nitric oxide synthase (iNOS) and the early spontaneous abortion. , in situ hybridization and immunohistochemistry were used to detect the expression of iNOS in trophob...To investigate the relationship between inducible nitric oxide synthase (iNOS) and the early spontaneous abortion. , in situ hybridization and immunohistochemistry were used to detect the expression of iNOS in trophoblasts in the early pregnancy with and without spontaneous abortion (group Ⅰ and group Ⅱ). By light microscopy and computer color magic image analysis system (CMIAS), light density (D) and the positive cell number per statistic square (N/S) in situ hybridiza- tion were used to analyze the positive cell index, while total positive cells (N) and the positive unit (Pu) were used in immunohistochemistry. By in situ hybridization, D and N/S in trophoblasts were 0.35±0. 028, 0. 07±0. 011 respectively in group Ⅰ and 0. 18±0.016,0. 015±0. 003 in group Ⅱ . In terms of immunohistochemical staining, N and Pu were 0. 058±0.007, 11. 94±2. 01 in group Ⅰand 0.013±0.009, 1.08±0. 35 in group Ⅱ in trophoblasts. Significant differences existed between two groups. It is concluded that the higher nitric oxide produced by the higher expression of iNOS in tro- phoblasts might play an important role in the early spontaneous abortion.展开更多
Aim: To evaluate the benefits and hazards of routine progesterone supplementation in threatened abortion and whether it is a sound practice or not. Materials and Methods: This study was conducted at Obstetrics and Gyn...Aim: To evaluate the benefits and hazards of routine progesterone supplementation in threatened abortion and whether it is a sound practice or not. Materials and Methods: This study was conducted at Obstetrics and Gynecology Department, Tanta University in the period from January 2018 to December 2018. Eligible patients (n = 190) were randomly allocated into 2 groups: study group who will receive progesterone supplementation (prog. group) and control group who will receive no treatment (place. group). Results: No significant differences were found between both groups regarding all demographic data and pregnancy characteristics. Abortions were higher in place. group 17 (23.94%) than in prog. group 12 (16.44%) with no significant difference p value = 0.263. The incidence of preterm labour was also higher in the place. group 22 (30.99%) in comparison to the prog. group 17 (23.29%) with no significant difference p value = 0.300. Conclusion: Progesterone supplementation in threatened abortion was not beneficial although it reduced abortion and preterm labour rates.展开更多
This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of in...This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.展开更多
Rice panicle apical abortion(PAA)is a detrimental agronomic trait resulting in spikelet number reduction and yield loss.To understand its underlying molecular mechanism,we identified one recessive PAA mutant tutou2 fr...Rice panicle apical abortion(PAA)is a detrimental agronomic trait resulting in spikelet number reduction and yield loss.To understand its underlying molecular mechanism,we identified one recessive PAA mutant tutou2 from the offspring of tissue cultures.The mutation locus was finely mapped to a 75-kb interval on the long arm of chromosome 10.Sequence analysis revealed a single nucleotide substitution of A to T at the 941 position of LOC_Os10g31910 in tutou2,resulting in an amino acid change from isoleucine to phenylalanine.Complementation analysis showed that the degenerated panicle phenotype in tutou2 was rescued in the transgenic lines.A phenotype similar to tutou2 can also be obtained by LOC_Os10g31910 knockout in wild-type rice.These results suggested that LOC_Os10 g31910 is the causative locus TUTOU2 responsible for the tutou2 PAA phenotype and probably also the locus of DEL1,previously documented as a leaf senescence gene.The significant phenotypic differences between del1 and tutou2 suggest that the locus DEL1/TUTOU2 plays roles in both leaf and panicle development which were not considered fully in previous studies.展开更多
BACKGROUND Improper methods of contraception greatly increase the risk of abortion,cervical or endometrial lesions,and the number of recurrent artificial abortions.These complications result in the deterioration of a ...BACKGROUND Improper methods of contraception greatly increase the risk of abortion,cervical or endometrial lesions,and the number of recurrent artificial abortions.These complications result in the deterioration of a patient’s outcome.Further,the proportion of artificial abortions is highest among unmarried females.Placement of an intrauterine device,such as the Mirena,after an artificial abortion may decrease the likelihood of an endometrial injury caused by recurrent abortions while significantly improving its contraceptive effects.AIM To discuss the effect of Mirena placement on reproductive hormone levels at different time points after an artificial abortion.METHODS Women(n=119)undergoing an artificial abortion operation were divided into the study(n=56)and control(n=63)groups.In the study group,the Mirena was inserted immediately after the artificial abortion,whereas in the control group,it was inserted 4–7 d after the onset of the first menstrual cycle after abortion.All participants were followed-up for 6 mo to observe the continuation and expulsion rates and adverse reactions and to measure the levels of serum estradiol(E2),follicle stimulating hormone(FSH),and luteinizing hormone(LH).RESULTS The continuation rates were 94.64%and 93.65%in the study group and the control group,respectively.The expulsion rates were 1.79%and 3.17%in the study group and the control group,respectively.There was no statistically significant difference between the two groups(P>0.05).There were also no statistically significant differences in the proportion of patients with bacterial vaginitis,trichomonas vaginitis,or cervicitis between the groups(P>0.05).Six months after Mirena placement,E2 Levels were 45.50±7.13 pg/mL and 42.91±8.10 pg/mL,FSH 13.60±3.24 mIU/mL and 14.54±3.11 mIU/mL,and LH 15.11±2.08 mIU/mL and 14.60±3.55 mIU/mL in the study and control groups,respectively.There were no significant differences in hormone levels between the two groups(P>0.05).There were also no statistically significant differences in the proportions of abnormal menstruation,prolonged menstruation,or pain during intercourse between the study and control groups after Mirena placement(P>0.05).There were no statistically significant differences in uterine volume,sexual desire,sexual activity,or the sexual satisfaction score between the study and control groups before and after Mirena placement(P>0.05).CONCLUSION Placement of a Mirena intrauterine device immediately after an artificial abortion does not increase the risk of adverse reactions and can help prevent endometrial injury caused by recurrent abortions.展开更多
Recurrent spontaneous abortion is a common disease in gynecology,and it seriously affects women's reproductive health and brings heavy burden and pain to society and families.The cause of recurrent spontaneous abo...Recurrent spontaneous abortion is a common disease in gynecology,and it seriously affects women's reproductive health and brings heavy burden and pain to society and families.The cause of recurrent spontaneous abortion is complicated,in addition to the well-defined genetic,anatomical,infection and endocrine factors,and there are still some unknown causes,which is called as unexplained recurrent spontaneous abortion,accounting for 40%of recurrent abortion.At present,there are a lot of researches on the treatment methods of the patients with the unexplained recurrent spontaneous abortion,which also shows that the treatment of traditional Chinese and Western medicine all have certain clinical application effect.Western medicine clinical methods mainly includes immunotherapy,immunosuppressive therapy,anticoagulation therapy,progesterone therapy,etc.Based on the experience of the professor and combined with many years of clinical practice,the author believes that the pathogenesis of this disease in traditional Chinese medicine is mainly due to impaired impulse and deficiency of Spleen,lack of qi and blood,can not nourishing the fetus;deficiency of Kidney Qi,blood flow was delayed,and blood stasis and could not raise the fetus.Clinical treatment is based on invigorating the kidney,tonifying spleen and nourishing blood,promoting blood circulation to remove blood stasis and dredging collaterals.Oral Chinese medicine combined with external acupuncture and moxibustion has achieved excellent effects in improving pregnancy rate.This article reviews the domestic and foreign methods of treating unexplained recurrent miscarriage in order to provide clinical reference.In the future,the combination of Chinese and Western medicine should become the main therapy to increase pregnancy rate.展开更多
基金the National Natural Science Foundation of China(81973221)National Natural Science Foundation for Young Scientists of China(81603647)+2 种基金the Women and Children Health Talent Project of Jiangsu Province(FRC201785)the Chinese Clinical Medicine Innovation Center of Obstetrics,Gynecology,and Reproduction in Jiangsu Province(ZX202102)the Women and Children Health Science Foundation of Jiangsu Province(F202206).
文摘Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, traditional Chinese medicine has become a feasible alternative for certain diseases, including recurrent spontaneous abortion. However, because of the complex composition of the traditional Chinese medicine formula, its action mechanism remains unclear. Methods: We selected two isolated active ingredients (RAMP and baicalin) from the traditional Chinese medicine formula and used an abortion-prone CBA/J × DBA/2 model to simulate human RSA and compared the changes in fetal resorption rate, Treg cell percentage, and relevant cytokines before and after combination therapy. In addition, The mechanisms were preliminarily discussed using in vitro differentiation models. Results: In CBA/J × DBA/2 abortion-prone mice, the combination therapy resulted in a lower embryo resorption rate compared to that obtained with individual delivery of either RAMP or baicalin, thereby playing an embryo-protective role through the increase in Treg cells for the maintenance of maternal-fetal immune tolerance. In in vitro primary cell differentiation experiments, the concentration of Treg cells significantly increased from 11% to 17.9% after the combination therapy compared to that of the single administration group. Conclusion: the synergistic effects of RAMP and baicalin were responsible for Treg differentiation. The present study provides a solid basis for improving the applicability of traditional Chinese herbs in the treatment of recurrent spontaneous abortion.
文摘Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abortion remains one of the leading causes of maternal deaths in developing countries with induced abortion being the key cause. In 2014 from January to August, 9 abortion related deaths occurred in Botswana. There are several reasons female students in tertiary institutions resort to seeking induced abortion which include the socio-demographics like age and socio-economic factors like financial instability. Parental fears, unintended pregnancy and pressure from the partner also force females to terminate pregnancy. Induced abortion has claimed many women’s lives especially in developing countries with very restrictive abortion laws like Botswana as women do not access safe abortion care services. The study intends to establish the determinants of induced abortion among female students in selected tertiary learning institutions in Gaborone City, Botswana. It concentrated primarily on determining the prevalence of induced abortion. This was a descriptive cross-sectional study using both quantitative and qualitative data collection techniques. Systematic random sampling technique was used to come up with 278 participants. Prior to commencement of data collection, all ethical and logistical prerequisites were satisfied. Informed consent was solicited from all the study participants and the purpose of the study was fully explained. A self-administered questionnaire was used to collect data. Microsoft Excel spread sheet was used to code, clean, and enter the data, which was then exported for analysis to the statistical package for social sciences version 24. Frequency distribution tables, percentages graphs, and pie charts were used to illustrate the descriptive information. The study revealed that prevalence of induced abortion among female students in Gaborone City is 7.9%. They even suggested that induced abortion be liberalized. Age was the only socio-demographic factor associated with induced abortion with p = 0.047 using Chi Square test χ<sup>2</sup> = 7.609, df = 3. The study findings concluded that female students resort to induced abortion as a result of pressure from both parents and male partners especially when the pregnancy is unintended. The study recommends that the abortion law in Botswana be made liberal to ease access to safe abortion care services. It also recommends that contraceptive commodities should consistently be available in public health facilities.
文摘Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.
文摘Background: Retention of fetal bones is a rare cause of abnormal uterine bleeding. Others may present as subfertility, chronic pelvic pain, abnormal vaginal discharge, menometrorrhagia, dysmenorrhea and spontaneous expulsion of bony fragments. Incidence is 0.26% among patients undergoing hysteroscopy. Aim: To document a pattern of presentation of retained fetal bone and its management. Case Presentation: Our patient is an 18-year old who presented with vaginal bleeding of four weeks duration and managed for abnormal uterine bleeding due to retained fetal bone following second trimester abortion. Conclusion: The use of transvaginal ultrasound in making diagnosis of retained fetal bone is effective. Treatment by removal of bones through evacuation by dilatation and curettage or hysteroscopy brings about resolution of symptoms. Use of pelvic ultrasonography to confirm complete evacuation of the uterus after abortion especially second trimester abortion could aid in early diagnosis and management of incomplete abortion.
文摘Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out clandestine abortions, to describe the profile of the providers and the complications that result from it. Patients and Methods: This was a descriptive cross-sectional study of patients hospitalized at the University Hospital Center for Sino-Central African Friendship (CHUASC) from 2015 to 2019 on 236 cases. Results: We identified a total of 254 patients for 8039 live births in the same period, a frequency of 3.16%. The age of the patients was between 15 years old and 48 years old with an average of 25 years old. Singles accounted for 42.5%. Induced abortions were more performed among students (32.6%) and the unemployed 53.6%. Contraception was used in 11.5% of cases. The methods used were numerous: misoprostol (32%), the traditional method (18%), the mechanical method (50%). In this method, we note the dilation of the cervix by the cassava stem;Hegar’s candles;the probes, which are infusion tubes cut and introduced into the cervix, of which 2 cases had escaped at the level of the uterine muscles and emerged under the skin at the pubis part two years later. The practice of induced abortions in our series was done by medical students in 37.3% followed by unqualified staff in 49.7%. It took place either at home or in centers managed by Non-Governmental Organizations. The aseptic conditions were not perfect. Some patients (43.2%) were aware of the ensuing complications. All complications were present: hemorrhage (60.7%), pelviperitonitis (23.6%), uterine perforation (6.6%), peritonitis (2.8%) and death (2%) related to sepsis. Conclusion: Clandestine abortion remains a real health problem for young Central African women.
文摘Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic testing technologies, there has been an increasing interest in using these tools to diagnose the etiology of RSA. This review discusses the different types of genetic testing methods, such as karyotyping, chromosomal microarray analysis, next-generation sequencing, and their applications in the diagnosis of the etiology RSA. The use of genetic testing in the diagnosis of RSA has the potential to improve the accuracy of diagnosis and the understanding of the underlying mechanisms of the disorder, which could lead to better management and treatment of affected individuals.
文摘<strong>Background:</strong> Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. <strong>Methods: </strong>We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. <strong>Results: </strong>Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. <strong>Conclusions:</strong> Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.
文摘Objective To introduce the background and development of post-abortion services such as contraceptive counseling at home and abroad,and its important role for women so as to provide a reference for the further popularization of this service in China.Methods Chinese and English databases such as CNKI,WanFang Database,VIP,PubMed,and Web of Science were searched to find relevant studies on the implementation of post-abortion service,including post-abortion family planning and post-abortion contraceptive counseling in China.And then the literature on the implementation effect of post-abortion contraceptive counseling and related services was reviewed in China.Results and Conclusion The post-abortion contraceptive counseling service can effectively improve the reproductive health of the patients with induced abortion and the level of knowledge about contraception and birth control,so as to change the contraceptive behavior and adverse psychological state of the patients.Besides.it can guide patients to use more long-term and effective contraceptive measures,thereby reducing the occurrence of unintended pregnancy and repeated abortion.Standardized contraceptive counseling and related services can also improve patient satisfaction.According to the development and implementation effect of post-abortion service and post-abortion contraceptive counseling at home and abroad,it is necessary to further promote post-abortion contraceptive counseling service in the future.Much consideration should be given to carrying out a health technical assessment of the standardized post-abortion contraceptive counseling service as well as its implementation costs.Therefore,medical institutions will have a reference to carry out standardized post-abortion contraceptive counseling service.
文摘<b>Background: </b>Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affects the operation and easily inducesabortion complications. Misoprostol can induce uterine contraction and soften the cervix. <b>Objective:</b> To investigate the clinical effect of misoprostol on abortion before and after painless induced abortion. <b>Methods:</b> 600 case pregnant women were divided into three groups: A, B and C, 200 case in each group. All patients were anesthetized. In group A, misoprostol 0.2 ug was placed in the posterior fornix of vagina 2 hours before the operation of induced abortion;in group B, misoprostol 0.2 ug was not only placed in the posterior fornix of vagina 2 hours before the operation of induced abortion but also taken orally 2 hours and 6 hours after the operation;in group C, misoprostol was not used before and after the operation. The operation time, intraoperative bleeding volume, postoperative bleeding, the percentage of cervical relaxation and the rate of incomplete abortion among the three groups were compared. <b>Results:</b> Compared with group A and group B, the operation time of group C was longer and the amount of bleeding was more (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The duration of bleeding in group B was less than that in group A (P < 0.05). The percentage of cervical relaxation in group A and B was higher than that in group C (P < 0.05). The rate of incomplete abortion in group B < group A < group C (P < 0.05), and there was no residual uterine cavity in group B. <b>Conclusion:</b> The use of misoprostol before and after painless induced abortion can not only shorten the time of operation, reduce intraoperative and postoperative vaginal bleeding, but also has not incurred incomplete abortion(primary outcome).
文摘In 2011 a protocol for medical abortions (MA) up to 49 days of pregnancy was approved by the Ministry of Health of Catalonia’s autonomous government and it was progressively introduced through the public network of the Sexual and Reproductive Health Units (SRHU). In 2014, a new protocol extended to 63 days of pregnancy was set up. Data come from the official abortion registry held by the Ministry of Health, which collects statistical data from all abortions performed in Catalonia. Since 2011, the number and rate of abortions in Catalonia have decreased while the number of health centers providing abortions has increased, especially the SRHU. The proportion of MA abortions went from 0.4% (2010) to 36.9% (2014), while the percentage of early abortions (up to 7 weeks) surged by 14.7%. SRHU reported 73.4% of all MA and hospitals performed 18.7% of the total, while outpatient centers accounted for the remaining 7.9%. Compared to surgical abortions, women having had MA have higher levels of education and lower rates of unemployment. Furthermore, they have more living offspring and fewer previous terminations as well as more frequent attendance to a public family planning center.
基金supported by Natural Sciences Fund of Zhejiang Province(grant number:LY14H040011)Subject of Zhejiang Provincial Administration of traditional Chinese Medicine(grant number:2013ZB058)
文摘Objective:To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats.Methods:After pregnancy,50 SPF female SD rats were selected and divided into control group,model group,progesterone group,Zishen Yutai pill group,and progesterone plus Zishen Yutai pill group(combination group),with 10 rats in each group.The rats of control group and abortion model group were lavaged with 2 mL/kg normal saline on pregnancy day 1 for continuous 10 days.Rats in Zishen Yutai pill group were given 1.575 g/kg/d of Zishen Yutai pill for intragastric administration for continuous 10 days.Rats in progesterone group were given intramuscular injection treatment of 0.1 mL/d progestin,continuous for 10 days.Rats in combination group were given injection therapy of aqueous solution of Zishen Yutai pill for continuous 10 days,and other treatments were the same as previous two groups.Abortion model were established then and live births,numbers of abortion and average rate of abortion were compared between the five groups.Peripheral blood was collected to detect the estradiol(E2) and progestational hormone(P),and obtain ratio of Th1/Th2 cytokines(IL-2,INF-γ,IL-4,IL-10).Results:Significant more live births of rats were found in the control group compared with other four groups(P<0.05).The numbers of live births of the rats in abortion model group were significantly less than that of progesterone group,Zishen Yutai pill group and joint group(P<0.05).The numbers of live births of rats in joint group were significant more than that of progesterone group and Zishen Yutai pill group.The serum E2 level of P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were significant higher than that of abortion model group(P<0.05).Serum levels of E2 and P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were not significant different(P>0.05) but these levels in the control group and Zishen Yutai pill group were significant lower than that of progesterone group and joint group(P<0.05).The maternal-fetal interface IL-4/IL-2,IL-10 / IL-2 of model group were balanced deviating to Th1,while the IL-4/IL-2,IL-10/IL-2 of progesterone group,Zishen Yutai pill group and joint group were balanced deviating to Th2,and joint group' deviation was better than progesterone group and Zishen Yutai pill group(P<0.05).Conclusions:Zishen Yutai pill combined with progesterone has a significant control effect for threatened abortion,which can obviously increase contents of maternal serums E2 and P,and regulate the Thl/Th2 balance with a remarkable effect.
文摘Threatened abortion is a common problem in early pregnancy. This early vaginal bleeding happens in about 25% of pregnant women. The medications including progesterone, uterine muscle relaxant or human chorionic gonadotropin have essential effects in developing pregnancy, but the clinical data are insufficient to prescribe them. In recent decades, medicinal herbs can help us to present new treatments. Grape (Vitis vinifera L.) can protect the fetus from the perspective of Persian medicine. So, we hypothesize about the salutary effects of grape in miscarriage prevention. We found five standard expected mechanisms of grape to prevent threatened abortion: immunomodulatory and anti-inflammatory, anti-oxidant, anti-contraction, hormonal and anti-stress activities. Grape reduces nitric oxide, prostaglandin E2, expression of nuclear factor κB and other pro-inflammatory cytokines like IL (Interleukin)-1β, IL-6, IL-8, and tumor necrosis factor-α. It also elevates anti-inflammatory mediators and expression of peroxisome proliferator-activated receptor-γ. Grape polyphenols have a crucial role in fetus protection with high antioxidant power and other functions such as prevention of stress-triggered abortion with proanthocyanidins, or hormonal effects and inhibition of uterine contractions with resveratrol. So according to these studies, grape probably has effects on the immune and endocrine factors involved in threatened miscarriage.
文摘BACKGROUND Mifepristone-induced abortion(MIA)has been used worldwide to terminate pregnancies.However,the association between placenta accrete(PA)and MIA has seldom been reported.CASE SUMMARY A 26-year-old pregnant woman presented with painless vaginal bleeding at 35 wk of gestation.She had a medical abortion(mifepristone followed by misoprostol)1 year ago at the sixth week of gestation.Her personal history for previous surgery was negative.Abdominal ultrasonography showed a normal foetus with complete placenta previa.The foetal membrane ruptured with massive vaginal bleeding and severe abdominal pain.An emergency Caesarean section was performed,and the newborn was delivered.The placenta failed to expel and manual extraction was carried out.A large defect was noted in the uterine fundus and repair of the uterine rupture was conducted immediately.The postoperative pathology report showed placenta accreta.CONCLUSION The evidence suggests a possible etiologic role of MIA in PA,as the incidence of PA after MIA is much higher than general population.Millions of pregnancies are complicated by PA each year,some of which result in fatality.To prevent subsequent placental complications after MIA,hormonal supplementation might be a promising therapeutic options.However,further studies are needed to identify the high-risk factors and to confirm the effectiveness of estrogen supplement therapy.
文摘To investigate the relationship between inducible nitric oxide synthase (iNOS) and the early spontaneous abortion. , in situ hybridization and immunohistochemistry were used to detect the expression of iNOS in trophoblasts in the early pregnancy with and without spontaneous abortion (group Ⅰ and group Ⅱ). By light microscopy and computer color magic image analysis system (CMIAS), light density (D) and the positive cell number per statistic square (N/S) in situ hybridiza- tion were used to analyze the positive cell index, while total positive cells (N) and the positive unit (Pu) were used in immunohistochemistry. By in situ hybridization, D and N/S in trophoblasts were 0.35±0. 028, 0. 07±0. 011 respectively in group Ⅰ and 0. 18±0.016,0. 015±0. 003 in group Ⅱ . In terms of immunohistochemical staining, N and Pu were 0. 058±0.007, 11. 94±2. 01 in group Ⅰand 0.013±0.009, 1.08±0. 35 in group Ⅱ in trophoblasts. Significant differences existed between two groups. It is concluded that the higher nitric oxide produced by the higher expression of iNOS in tro- phoblasts might play an important role in the early spontaneous abortion.
文摘Aim: To evaluate the benefits and hazards of routine progesterone supplementation in threatened abortion and whether it is a sound practice or not. Materials and Methods: This study was conducted at Obstetrics and Gynecology Department, Tanta University in the period from January 2018 to December 2018. Eligible patients (n = 190) were randomly allocated into 2 groups: study group who will receive progesterone supplementation (prog. group) and control group who will receive no treatment (place. group). Results: No significant differences were found between both groups regarding all demographic data and pregnancy characteristics. Abortions were higher in place. group 17 (23.94%) than in prog. group 12 (16.44%) with no significant difference p value = 0.263. The incidence of preterm labour was also higher in the place. group 22 (30.99%) in comparison to the prog. group 17 (23.29%) with no significant difference p value = 0.300. Conclusion: Progesterone supplementation in threatened abortion was not beneficial although it reduced abortion and preterm labour rates.
文摘This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.
基金supported by grants from the National Transgenic Science and Technology Program,China(2016ZX08009003-003)the National Key Research and Development Program of China(2016YFD0101100)+1 种基金the Youth Innovation Team Program of Chongqing Academy of Agricultural Sciences,China(NKY-2018QC03)the National Natural Science Foundation of China(31960401)。
文摘Rice panicle apical abortion(PAA)is a detrimental agronomic trait resulting in spikelet number reduction and yield loss.To understand its underlying molecular mechanism,we identified one recessive PAA mutant tutou2 from the offspring of tissue cultures.The mutation locus was finely mapped to a 75-kb interval on the long arm of chromosome 10.Sequence analysis revealed a single nucleotide substitution of A to T at the 941 position of LOC_Os10g31910 in tutou2,resulting in an amino acid change from isoleucine to phenylalanine.Complementation analysis showed that the degenerated panicle phenotype in tutou2 was rescued in the transgenic lines.A phenotype similar to tutou2 can also be obtained by LOC_Os10g31910 knockout in wild-type rice.These results suggested that LOC_Os10 g31910 is the causative locus TUTOU2 responsible for the tutou2 PAA phenotype and probably also the locus of DEL1,previously documented as a leaf senescence gene.The significant phenotypic differences between del1 and tutou2 suggest that the locus DEL1/TUTOU2 plays roles in both leaf and panicle development which were not considered fully in previous studies.
文摘BACKGROUND Improper methods of contraception greatly increase the risk of abortion,cervical or endometrial lesions,and the number of recurrent artificial abortions.These complications result in the deterioration of a patient’s outcome.Further,the proportion of artificial abortions is highest among unmarried females.Placement of an intrauterine device,such as the Mirena,after an artificial abortion may decrease the likelihood of an endometrial injury caused by recurrent abortions while significantly improving its contraceptive effects.AIM To discuss the effect of Mirena placement on reproductive hormone levels at different time points after an artificial abortion.METHODS Women(n=119)undergoing an artificial abortion operation were divided into the study(n=56)and control(n=63)groups.In the study group,the Mirena was inserted immediately after the artificial abortion,whereas in the control group,it was inserted 4–7 d after the onset of the first menstrual cycle after abortion.All participants were followed-up for 6 mo to observe the continuation and expulsion rates and adverse reactions and to measure the levels of serum estradiol(E2),follicle stimulating hormone(FSH),and luteinizing hormone(LH).RESULTS The continuation rates were 94.64%and 93.65%in the study group and the control group,respectively.The expulsion rates were 1.79%and 3.17%in the study group and the control group,respectively.There was no statistically significant difference between the two groups(P>0.05).There were also no statistically significant differences in the proportion of patients with bacterial vaginitis,trichomonas vaginitis,or cervicitis between the groups(P>0.05).Six months after Mirena placement,E2 Levels were 45.50±7.13 pg/mL and 42.91±8.10 pg/mL,FSH 13.60±3.24 mIU/mL and 14.54±3.11 mIU/mL,and LH 15.11±2.08 mIU/mL and 14.60±3.55 mIU/mL in the study and control groups,respectively.There were no significant differences in hormone levels between the two groups(P>0.05).There were also no statistically significant differences in the proportions of abnormal menstruation,prolonged menstruation,or pain during intercourse between the study and control groups after Mirena placement(P>0.05).There were no statistically significant differences in uterine volume,sexual desire,sexual activity,or the sexual satisfaction score between the study and control groups before and after Mirena placement(P>0.05).CONCLUSION Placement of a Mirena intrauterine device immediately after an artificial abortion does not increase the risk of adverse reactions and can help prevent endometrial injury caused by recurrent abortions.
基金National Natural Science Foundation of China(No.81973894)。
文摘Recurrent spontaneous abortion is a common disease in gynecology,and it seriously affects women's reproductive health and brings heavy burden and pain to society and families.The cause of recurrent spontaneous abortion is complicated,in addition to the well-defined genetic,anatomical,infection and endocrine factors,and there are still some unknown causes,which is called as unexplained recurrent spontaneous abortion,accounting for 40%of recurrent abortion.At present,there are a lot of researches on the treatment methods of the patients with the unexplained recurrent spontaneous abortion,which also shows that the treatment of traditional Chinese and Western medicine all have certain clinical application effect.Western medicine clinical methods mainly includes immunotherapy,immunosuppressive therapy,anticoagulation therapy,progesterone therapy,etc.Based on the experience of the professor and combined with many years of clinical practice,the author believes that the pathogenesis of this disease in traditional Chinese medicine is mainly due to impaired impulse and deficiency of Spleen,lack of qi and blood,can not nourishing the fetus;deficiency of Kidney Qi,blood flow was delayed,and blood stasis and could not raise the fetus.Clinical treatment is based on invigorating the kidney,tonifying spleen and nourishing blood,promoting blood circulation to remove blood stasis and dredging collaterals.Oral Chinese medicine combined with external acupuncture and moxibustion has achieved excellent effects in improving pregnancy rate.This article reviews the domestic and foreign methods of treating unexplained recurrent miscarriage in order to provide clinical reference.In the future,the combination of Chinese and Western medicine should become the main therapy to increase pregnancy rate.
