Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The ob...Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.展开更多
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
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
Objective: To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua and concentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneou...Objective: To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua and concentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneous abortion, threatened abortion, and compare the levels with healthy pregnant women. Methods: Thirty-seven women with unexplained early spontaneous abortion, 27 women with threatened abortion, and 34 healthy pregnant women undergoing artificial abortion of pregnancy at 6 - 10 weeks of gestation were selected. Decidual samples were collected when women were undergoing artificial abortion, and blood samples were collected at the same time. The level of membrane tumor necrosis factor receptor 1 in decidua was detected by flow cytometer, and the concentration of soluble tumor necrosis factor receptor 1 in sera was measured with an enzyme-linked immunosorbent assay. Results: The percentages of membrane tumor necrosis factor receptor 1 positive decidual cells were 16.42 ± 7.10 Mean ± SD for women with unexplained early spontaneous abortion and 13. 14 ± 6.30 for healthy pregnant women ( P < 0.05). Serum concentration of soluble tumor necrosis factor receptor 1 was significantly higher in women with unexplained early spontaneous abortion than in healthy pregnant women and in women with threatened abortion, and no difference was found between healthy pregnant women and women with threatened abortion. Conclusion: Women with unexplained early spontaneous abortion present significantly higher expression of tumor necrosis factor receptor 1 than healthy pregnant women, suggesting that over-expression of tumor necrosis factor receptor 1 may contribute to the development of early spontaneous abortion.展开更多
The relationship between T cell immunoglobulin domain and mucin domain protein 3（Tim-3）/Galectin（Gal）-9 pathway and recurrent spontaneous abortion（RSA） was studied. Thirty-one pregnant women with RSA and 27 norm...The relationship between T cell immunoglobulin domain and mucin domain protein 3（Tim-3）/Galectin（Gal）-9 pathway and recurrent spontaneous abortion（RSA） was studied. Thirty-one pregnant women with RSA and 27 normal early gravidas were investigated to detect the levels of Tim-3 and Gal-9 in villi and deciduas by Western blotting. Meanwhile, the concentration of interleukin（IL）-4 and IL-12 in peripheral blood plasma was determined by ELISA in 25 healthy fertile non-pregnant controls, the normal early gravidas and pregnant women with RSA mentioned above, respectively. It was found that the relative expression levels of Tim-3 and Gal-9 in villi and deciduas were significantly increased in pregnant women with RSA as compared with those in the normal early gravidas. The concentration of IL-4 in peripheral blood plasma of pregnant women with RSA was lower than that of the normal early gravidas（P〈0.05） and healthy fertile non-pregnant controls（P〈0.05）, but that of IL-2 in pregnant women with RSA was significantly higher than that of the normal early gravidas（P〈0.05） and healthy fertile non-pregnant controls（P〈0.05）. It was suggested that the overexpression of Tim-3/Gal-9 pathway may be related to the pathogenesis of RSA.展开更多
Objectives To explore the relationship between CD80 expression on lymphocytes at the fetomaternal interface and the fertility characteristics in CBA/J×DBA/2 mice as a model of recurrent spontaneous abortion (RSA...Objectives To explore the relationship between CD80 expression on lymphocytes at the fetomaternal interface and the fertility characteristics in CBA/J×DBA/2 mice as a model of recurrent spontaneous abortion (RSA) and to investigate the effects of lymphocyte immunotherapy (LIT) on the level of CD80 expression. Materials & Methods The characteristics of fertility in CBA/J×DBA/2 mice were observed in a 120 day period and compared with four normal fertile groups. In another 15 pairs of CBA/J×DBA/2 breedings, resorption rate on day 13 of pregnancy were calculated and the proportion of CD80 + cells at the fetomaternal interface were determined by using two color flow cytometric analysis, mainly stained with CD80 FITC and CD45 PE. In order to determine the identity of CD80 + cells, the expression levels of CD3(T cell marker), DX5(NK cell marker), and MHC II(antigen presenting cell marker) were detected in this cell population. Furthermore, the resorption rate and the proportion of CD80 + cells among CBA/J×DBA/2 breedings with and without immunotherapy were also determined and compared with normal fertile controls. Results The characteristics of abortion in CBA/J×DBA/2 mice were recurrent abortion on about day 10 of gestation. The resorption rate in CBA/J×DBA/2 mice was significantly higher than that in BALB/c×DBA/2 mice (30.8%±16.6% vs. 7.7%±6.7%, P<0.01). Accordingly, the proportion of CD80 + cells evaluated at the fetomaternal interface in CBA/J×DBA/2 mice was also significantly higher (11.7% ±5.8% vs. 3.9%±1.8%, P<0.01). Resorption rate of CBA/J×DBA/2 mice underwent of LIT was significantly lower than that without LIT, and this decreased rate was correlated with decreased proportion of CD80 + cells. Conclusion In CBA/J×DBA/2 mice model, the characteristics of abortion seem to be peri implantation embryo resorption. A correlation between early embryonic waste and higher CD80 proportion at the fetomaternal interface suggests that CD80 + cells may be an important determinant in recurrent peri implantation abortion.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 troph...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
Objective To investigate the effect of apoptosis and inducible nitric oxide (iNOS) on the early spontaneous abortion Methods TUNEL method was used to detect the apoptosis in trophoblast cells in early pregnancy wi...Objective To investigate the effect of apoptosis and inducible nitric oxide (iNOS) on the early spontaneous abortion Methods TUNEL method was used to detect the apoptosis in trophoblast cells in early pregnancy with and without spontaneous abortion (the experiment group and the control group), while iNOS was detected by both in situ hybridization and immunohistochemistry. By computer color magic image analysis system(CMIAS), positive cell indexes were represented by D (density) and N/S(number/square) in both apoptosis and in situ hybridization, in immunohistochemistry were N/S and PU(positive unit). Results Positive cell indexes of apoptosis D and N/S were significntly higher in the experiment group (0.48±0.004, 0.045±0.002) than that in the control group(0.35+0.06, 0.031±0.003. P<0.001). D and N/S of inducible nitric oxide synthase in situ hybridization were 0.33±0.028, 0.074±0.001 respectively in the experiment group and 0.13±0.015, 0.019±0.004 respectively in the control group. N/S and PU were significantly higher in the experiment group(0.058±0.007, 11.94±2.01) than that in the control group (0.007±0.001, 1.18±0.35, P<0.01). There existed a positive correlation between iNOS and apoptosis too. Conclution Apoptosis and iNOS in trophoblasts might play an important role in early spontaneous abortion and there was a positive correlation between apoptosis and iNOS.展开更多
Objective To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage. Methods Fifty-seven patients with a history of unexplained abortion were enrolled as t...Objective To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage. Methods Fifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombinⅢ(AT-Ⅲ), as well as activated protein C resistance (APC-R). The control group con-sisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for measuring serum activity of protein C, protein S, AT-Ⅲ, and APC-R. Patients with positive APC-R were tested for factorⅤ(FⅤ) Lei-den gene mutation by PCR-RFLP method. Results Of the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-Ⅲdeficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-Ⅲdeficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FⅤLeiden gene mutation was identified in all the patients with positive APC-R results. Late spontan-eous abortion cases had higher incidence of anticoagulation protein defect than the early cases. Conclusion Anticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurr-ing in late stage of pregnancy.展开更多
Objective: To explore the mRNA expression of the related genes of p53, MDM2, vascular endothelial growth factor (VEGF) and hypoxia inducible transcription factors-1 a (HIF-la) in villous samples of spontaneous abortio...Objective: To explore the mRNA expression of the related genes of p53, MDM2, vascular endothelial growth factor (VEGF) and hypoxia inducible transcription factors-1 a (HIF-la) in villous samples of spontaneous abortion mouse models and normal pregnancy models, and to discuss the effect of p53, MDM2 on the growth of villous trophoblast cells. Methods: The abortion-prone CBAXDBA/2 matings were established as the model of spontaneous abortion and the non-abortion-prone CBAXBALB/c matings as the model of normal pregnancy. Applied q Real-time PCR method to detect the mRNA expression levels of p53, MDM2, VEGF and HIF-la in villous samples of spontaneous abortion mouse models and normal pregnancy models. Results: The relationship of the mRNA expression level of p53, MDM2, VEGF and HIF-la in vinous samples of spontaneous abortion mouse models: in the villous samples of spontaneous abortion mouse models, the expression of p53 was positively correlated with the expression of MDM2, HIF-la (r = 0.35;r = 0.63), and the relationship was significant (P = 0.01;P < 0.001);but negatively correlated to the expression of VEGF (r = ?0.30), and the relationship was significant (P = 0.03). The expression of MDM2 was positively correlated with the expression of HIF-la (r = 0.28), and the relationship was significant (P = 0.04);and negatively correlated with the expression of VEGF (r = ?0.08), but the relationship was not significant (P = 0.57). The expression of HIF-la was negatively correlated with the expression of VEGF (r = ?0.37), and the relationship was significant (P = 0.007). The relationship of the mRNA expression level of p53,MDM2, VEGF and HIF-1 a in vinous samples of normal pregnancy models: in the vinous samples of normal pregnancy models, the expression of p53 was positively correlated with the expression of MDM2, VEGF and HIF-la (r = 0. 31;r = 0. 48;r = 0. 67), and the relationship was significant (P = 0.03;P = 0.003;P < 0.001). The expression of MDM2 was positively correlated with the expression of VEGF (r = 0. 23), but the relationship was not significant (P = 0.11);and negatively correlated with the expression of HIF-la (r = ?0.03), but the relationship was not significant (P = 0.84). The expression of HIF-la was positively correlated with the expression of VEGF (r = 0. 35), and the relationship was significant (P = 0.01). Conclusion: angiogenesis reduces in villous samples of spontaneous abortion mouse model, P53 and MDM2 involve in angiogenesis in villous samples, unlikely p53, and MDM2 have effects on normal early pregnancy villous angiogenesis and when the cell DNA damages or hypoxia exacerbates, it can induce high expression of p53, MDM2, inhibit angiogenesis in villous samples in early pregnancy. P53, MDM2 generegulate villous trophoblast cell growth by adjusting expression of HIF-1a and VEGF gene, finally influences pregnancy.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
In order to study the molecular immune-pathological mechanism of spontaneous abortion (SA), immunohistochemistry techniques were used to detect the FasL expression of first trimester trophoblast in the SA patients and...In order to study the molecular immune-pathological mechanism of spontaneous abortion (SA), immunohistochemistry techniques were used to detect the FasL expression of first trimester trophoblast in the SA patients and normal controls. High precise color-image measure system for immuno-histochemistry (HPIS) was used to determine the quantity of FasL expression. The results showed that the scale and intensity of FasL expression on the trophoblasts in SA group were significantly lower than in the control group. It is indicated that abnormal expression of FasL on trophoblasts, which damages the immunological tolerance between mother and fetus, may be one of the important mechanisms of development of SA. To induce the expression of FasL or to regulate the immunological tolerance will be a new way to treat SA.展开更多
Objective To investigate the effects of allograft inflammatory factor-1 （AIF-1） and （RANTES） in sera and deciduas on unexplained early spontaneous abortion. Methods AIF-1 and RANTES were examined in sera and decid...Objective To investigate the effects of allograft inflammatory factor-1 （AIF-1） and （RANTES） in sera and deciduas on unexplained early spontaneous abortion. Methods AIF-1 and RANTES were examined in sera and deciduas/endometria of 43 unexplained early spontaneous abortion women （group A）, 40 healthy women with early pregnancy（group B） and 20 healthy women with no pregnancy （group C）. Immunohistochemistry and enzyme linked immunosorbent assay （ELISA） were used in this study. Results AIF-1 protein was expressed both in deciduas of group A and in endometria of group C. In group A, H scores in the recurrent abortion deciduas specimens were significantly greater than those in the first abortion;in endometrium, expression of AIF-1 was greater in the secretory than in proliferative phase of group C. In group B, concentrations of RANTES in sera were higher in 7th-8th week of pregnancy than in 6th-7th and 〉8th week of pregnancy; expression of AIF-1 protein showed a negative correlation with RASNTES concentration; a significant increase of the RANTES levels in sera and tissue was observed in group B. Conclusion These results demonstrate, for the first time, that AIF-1 are expressed in deciduas of unexplained spontaneous abortion suggesting that AIF-1 involve in alloimmune abortion; RANTES might act as a novel blocking antibody;AIF-1 and RANTES might act as reliable markers for diagnosis of early alloimmune abortion.展开更多
Objective To investigate the factors resulting in spontaneous abortion after transferring frozen-thawing blastocysts.Methods A total of 108 cases transferring vitrified blastocysts were divided into two groups. aborti...Objective To investigate the factors resulting in spontaneous abortion after transferring frozen-thawing blastocysts.Methods A total of 108 cases transferring vitrified blastocysts were divided into two groups. abortion group （n=20） and ongoing group （n=88）. Cytogenetic analysis of apoblemas was performed in 12 cases of the abortion.Results The overall spontaneous abortion rate was 18.50%（20/108） and the early spontaneous rate was 16.67%（18/108）. A significant difference in maternal age was observed （abortion group： 33.3±4.0years, ongoing group： 31.0 ±3.6years, P=0.02）. No difference in other parameters was found. Cytogenetic analysis of apoblemas was obtained for 12 cases, and 2 specimens were contaminated. Seven often patients had abnormal karyotypes.Conclusion The underlying cause of spontaneous abortion after transferring frozenthawing blastoeysts appears to be abnormal karyotypes. Advancing maternal age seems to increase the risk of spontaneous abortion.展开更多
Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,Pu...Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,PubMed,Embase,and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021;meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation.Results:Seven trials were included,with 496 patients;the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate[RR=1.22,95%CI(1.10,1.35),Z=3.80(P=0.0001)],embryo survival rate at pregnancy of 12 weeks[RR=1.25,95%CI(1.10,1.41),Z=3.53(P=0.0004)],D-dimer levels[SMD=-1.59,95%CI(-2.20,-0.97),Z=5.07(P<0.00001)],and fibrinogen levels[MD=-1.00,95%CI(-1.29,-0.70),Z=6.61(P<0.00001)],but the statistical heterogeneity was significant;in terms of incidence of adverse reactions,there was no statistical difference between Bushen Huoxue prescription and western medicine.Conclusion:Compared with western medicine alone,Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency,embryonic survival rate at 12 weeks of pregnancy,and reducing D-dimer values as well as fibrinogen levels,without any significant difference in the incidence of adverse effects;however,the number of included studies is small and there are drawbacks,such as small sample size and low quality;therefore,high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.展开更多
Objective To investigate the effect of active immunotherapy on unexplained recurrent spontaneous abortion （URSA ） during the process of gestation and delivery period. Methods We collected the data of the women with ...Objective To investigate the effect of active immunotherapy on unexplained recurrent spontaneous abortion （URSA ） during the process of gestation and delivery period. Methods We collected the data of the women with URSA and their offsprings. The women were treated by immunization with paternal lymphocytes and then had a successful pregnancy. The fore mentioned group of women were compared with those who had a normal pregnancy and then delivered in the same period. Results The incidences of premature rupture of membranes, adherent placenta, and residual cauls in the group of URSA patients were statistically higher than those in the normal group. Correspondingly, gestational age at delivery and birth weight of the newborns of the group of URSA patients were lower, but there were no significant differences between the two groups. Conclusion These results indicate that paternal lymphocyte immunotherapy is effective on the maintenance of pregnancy in women with URSA, and has no deleterious effects on the fetus or newborns. However, in case of the higher incidence of premature rupture of membranes, adherent placenta, and residual cauls, more attention should be paid to the treated patients to avoid intrauterine growth retardation and postpartum hemorrhage.展开更多
Objective: To investigate the correlation between recurrent spontaneous abortion patients and brain derived neurotrophic factor BDNF gene polymorphism and the mechanism of BDNF and recurrent spontaneous abortion under...Objective: To investigate the correlation between recurrent spontaneous abortion patients and brain derived neurotrophic factor BDNF gene polymorphism and the mechanism of BDNF and recurrent spontaneous abortion under stress state in order to provide theoretical basis for nursing psychological intervention of patients with recurrent abortion. Methods: Medical coping Questionnaire (MCMO) and post-traumatic stress Diagnostic Scale (POST-traumatic stress Scale) were adopted Dissorder (PTSD) (PCL-c) scale was used to diagnose the psychological stress of recurrent spontaneous abortion in our hospital, and the BDNF gene polymorphism and the correlation factors of METHYLation in BDNF promoter region were studied in 30 cases (control group) and normal control group. Results: The MCMQ score of the case group and the control group was significantly lower than that of the conventional group (P Conclusion: There are significant differences in PTSD between the case group and the control group, which are related to methylation in the PROMOTER region of BDNF and SNP g-712A of BDNF gene. AG patients in the case group are more susceptible to anxiety and depression, and GG PTSD is more severe in the case group. BDNF promoter methylation and G-712A were independent risk factors for PTSD in the case group.展开更多
Objective To investigate the aberrant expressions of TNF-α and TGF-β1 in peripheral blood mononuclear cells （PBMCs） and placental tissues in patients with early spontaneous abortion Methods Using the technique of ...Objective To investigate the aberrant expressions of TNF-α and TGF-β1 in peripheral blood mononuclear cells （PBMCs） and placental tissues in patients with early spontaneous abortion Methods Using the technique of semi-quantitative reverse transcript-polymerase chain reaction （RT-PCR）, TNF-α mRNA and TGF-β1 mRNA in PBMCs were measured in spontaneous abortion group （30 cases）, normal pregnancy group （25 cases） and nonpregnant group （25 cases）. The expressive intension of TNF-α protein and TGF-β1 protein in placental tissues was also identified by immunohistochemistry. Results Both levels of TNF-α mRNA and TGF-β1 mRNA expressed in PBMCs were significantly different between the three groups respectively （P〈0.05）. Levels of TNF-α in syncytiotrophoblastic and cytotrophoblastic cells of the two aborted groups were substantially higher than those of the nonregnant group （P〈0.01）, but the levels of TGF-β1 in syncytiotrophoblastic cells of the two aborted groups were markedly lower than those of the non-pregnant group （P〈0.01）. Conclusion There is potential relation between TGF-β at the fetomaternal interface and spontaneous abortion. TGF-β1 may contribute to the maintenance of pregnancy, and low-level expression of TGF-β1 may be associated with pregnancy failure.展开更多
Background: Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive spontaneous abortion prior to 20 weeks from the last menstrual period. It affects approximately 1% to 2% of wo...Background: Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive spontaneous abortion prior to 20 weeks from the last menstrual period. It affects approximately 1% to 2% of women, and about 40% - 80% of RSA are still remained unexplained. In recent years, a lot of studies suggest that RSA is caused by the immune factors. T helper 1(Th1)-type immunity is associated with unsuccessful pregnancy especially in women with RSA, while Th2-type immunity is associated with pregnancy success. Interleukin (IL)-2 may influence Th1/Th2 immune responsiveness and has been implicated association with RSA. Aim: The aim of this study was to investigate the association of the interleukin 2 (IL-2) promoter polymorphisms at the site ‐330 A/C (rs2069762) with RSA. Methods: The study group comprised 189 women with RSA, and the control group consisted of 187 healthy pregnant women. Gene polymorphisms were detected by the technique of polymerase chain reaction restriction fragment length polymorphism. Results: The frequency of genotype ‐330C/C was significant higher (χ2 = 7.266, p = 0.007, OR = 0.362, 95% CI = 0.169 - 0.777) in the control group than in the patient group. And the frequency of the -330Aallele was significant higher (χ2 = 11.862, p = 0.001, OR = 1.741, 95% CI = 1.268 - 2.389) in the patient group than in the control group. Conclusions: This study indicated that the IL-2-330Aallele may be considered as a risk factor for RSA. C→A mutation is may associated with RSA in Ningxia Han people.展开更多
Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify ...Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify differentially expressed piRNAs in deciduas of RSA patients.Decidua tissues were collected by curettage from recruited RSA patients and normal early pregnant(NEP)women with their informed consent.Small RNA sequencing was used to evaluate the differences in piRNA expression profiles between RSA and NEP.The present results demonstrated that the counts of total piRNA reads in RSA samples were increased compared with those in NEP samples(0.21%vs.0.11%).Differential expression analysis identified 29 upregulated piRNAs and 18 downregulated piRNAs in RSA samples.RT-qPCR further confirmed that the expression levels of uniq-109625,uniq-89328,uniq-50651 and uniq-4569 were decreased in 8 RSA tissues,compared with 13 NEP tissues.Otherwise,pi-22628 and uniq-173406 were increased in 8 RSA tissues.Based on GO term and KEGG pathway analysis,we speculate that these piRNAs regulate RSA by targeting extracellular matrix component pathway,cell adhesion pathway and focal adhesion pathway.PiRNAs may be involved in RSA pathogenesis by target genes function on adhesion and extracellular matrix component.展开更多
文摘Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.
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Objective: To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua and concentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneous abortion, threatened abortion, and compare the levels with healthy pregnant women. Methods: Thirty-seven women with unexplained early spontaneous abortion, 27 women with threatened abortion, and 34 healthy pregnant women undergoing artificial abortion of pregnancy at 6 - 10 weeks of gestation were selected. Decidual samples were collected when women were undergoing artificial abortion, and blood samples were collected at the same time. The level of membrane tumor necrosis factor receptor 1 in decidua was detected by flow cytometer, and the concentration of soluble tumor necrosis factor receptor 1 in sera was measured with an enzyme-linked immunosorbent assay. Results: The percentages of membrane tumor necrosis factor receptor 1 positive decidual cells were 16.42 ± 7.10 Mean ± SD for women with unexplained early spontaneous abortion and 13. 14 ± 6.30 for healthy pregnant women ( P < 0.05). Serum concentration of soluble tumor necrosis factor receptor 1 was significantly higher in women with unexplained early spontaneous abortion than in healthy pregnant women and in women with threatened abortion, and no difference was found between healthy pregnant women and women with threatened abortion. Conclusion: Women with unexplained early spontaneous abortion present significantly higher expression of tumor necrosis factor receptor 1 than healthy pregnant women, suggesting that over-expression of tumor necrosis factor receptor 1 may contribute to the development of early spontaneous abortion.
基金supported by grants from the National Science Foundation of China(Nos.30973205 and 81172464)the National "Twelfth-Five Year" Research and Development Program of China(No.2014BAI05B05)
文摘The relationship between T cell immunoglobulin domain and mucin domain protein 3（Tim-3）/Galectin（Gal）-9 pathway and recurrent spontaneous abortion（RSA） was studied. Thirty-one pregnant women with RSA and 27 normal early gravidas were investigated to detect the levels of Tim-3 and Gal-9 in villi and deciduas by Western blotting. Meanwhile, the concentration of interleukin（IL）-4 and IL-12 in peripheral blood plasma was determined by ELISA in 25 healthy fertile non-pregnant controls, the normal early gravidas and pregnant women with RSA mentioned above, respectively. It was found that the relative expression levels of Tim-3 and Gal-9 in villi and deciduas were significantly increased in pregnant women with RSA as compared with those in the normal early gravidas. The concentration of IL-4 in peripheral blood plasma of pregnant women with RSA was lower than that of the normal early gravidas（P〈0.05） and healthy fertile non-pregnant controls（P〈0.05）, but that of IL-2 in pregnant women with RSA was significantly higher than that of the normal early gravidas（P〈0.05） and healthy fertile non-pregnant controls（P〈0.05）. It was suggested that the overexpression of Tim-3/Gal-9 pathway may be related to the pathogenesis of RSA.
基金National Key Fundamental Research Plan(" 973") Project( G1 9990 50 43 0 3 ) ,China
文摘Objectives To explore the relationship between CD80 expression on lymphocytes at the fetomaternal interface and the fertility characteristics in CBA/J×DBA/2 mice as a model of recurrent spontaneous abortion (RSA) and to investigate the effects of lymphocyte immunotherapy (LIT) on the level of CD80 expression. Materials & Methods The characteristics of fertility in CBA/J×DBA/2 mice were observed in a 120 day period and compared with four normal fertile groups. In another 15 pairs of CBA/J×DBA/2 breedings, resorption rate on day 13 of pregnancy were calculated and the proportion of CD80 + cells at the fetomaternal interface were determined by using two color flow cytometric analysis, mainly stained with CD80 FITC and CD45 PE. In order to determine the identity of CD80 + cells, the expression levels of CD3(T cell marker), DX5(NK cell marker), and MHC II(antigen presenting cell marker) were detected in this cell population. Furthermore, the resorption rate and the proportion of CD80 + cells among CBA/J×DBA/2 breedings with and without immunotherapy were also determined and compared with normal fertile controls. Results The characteristics of abortion in CBA/J×DBA/2 mice were recurrent abortion on about day 10 of gestation. The resorption rate in CBA/J×DBA/2 mice was significantly higher than that in BALB/c×DBA/2 mice (30.8%±16.6% vs. 7.7%±6.7%, P<0.01). Accordingly, the proportion of CD80 + cells evaluated at the fetomaternal interface in CBA/J×DBA/2 mice was also significantly higher (11.7% ±5.8% vs. 3.9%±1.8%, P<0.01). Resorption rate of CBA/J×DBA/2 mice underwent of LIT was significantly lower than that without LIT, and this decreased rate was correlated with decreased proportion of CD80 + cells. Conclusion In CBA/J×DBA/2 mice model, the characteristics of abortion seem to be peri implantation embryo resorption. A correlation between early embryonic waste and higher CD80 proportion at the fetomaternal interface suggests that CD80 + cells may be an important determinant in recurrent peri implantation abortion.
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Objective To investigate the effect of apoptosis and inducible nitric oxide (iNOS) on the early spontaneous abortion Methods TUNEL method was used to detect the apoptosis in trophoblast cells in early pregnancy with and without spontaneous abortion (the experiment group and the control group), while iNOS was detected by both in situ hybridization and immunohistochemistry. By computer color magic image analysis system(CMIAS), positive cell indexes were represented by D (density) and N/S(number/square) in both apoptosis and in situ hybridization, in immunohistochemistry were N/S and PU(positive unit). Results Positive cell indexes of apoptosis D and N/S were significntly higher in the experiment group (0.48±0.004, 0.045±0.002) than that in the control group(0.35+0.06, 0.031±0.003. P<0.001). D and N/S of inducible nitric oxide synthase in situ hybridization were 0.33±0.028, 0.074±0.001 respectively in the experiment group and 0.13±0.015, 0.019±0.004 respectively in the control group. N/S and PU were significantly higher in the experiment group(0.058±0.007, 11.94±2.01) than that in the control group (0.007±0.001, 1.18±0.35, P<0.01). There existed a positive correlation between iNOS and apoptosis too. Conclution Apoptosis and iNOS in trophoblasts might play an important role in early spontaneous abortion and there was a positive correlation between apoptosis and iNOS.
文摘Objective To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage. Methods Fifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombinⅢ(AT-Ⅲ), as well as activated protein C resistance (APC-R). The control group con-sisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for measuring serum activity of protein C, protein S, AT-Ⅲ, and APC-R. Patients with positive APC-R were tested for factorⅤ(FⅤ) Lei-den gene mutation by PCR-RFLP method. Results Of the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-Ⅲdeficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-Ⅲdeficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FⅤLeiden gene mutation was identified in all the patients with positive APC-R results. Late spontan-eous abortion cases had higher incidence of anticoagulation protein defect than the early cases. Conclusion Anticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurr-ing in late stage of pregnancy.
文摘Objective: To explore the mRNA expression of the related genes of p53, MDM2, vascular endothelial growth factor (VEGF) and hypoxia inducible transcription factors-1 a (HIF-la) in villous samples of spontaneous abortion mouse models and normal pregnancy models, and to discuss the effect of p53, MDM2 on the growth of villous trophoblast cells. Methods: The abortion-prone CBAXDBA/2 matings were established as the model of spontaneous abortion and the non-abortion-prone CBAXBALB/c matings as the model of normal pregnancy. Applied q Real-time PCR method to detect the mRNA expression levels of p53, MDM2, VEGF and HIF-la in villous samples of spontaneous abortion mouse models and normal pregnancy models. Results: The relationship of the mRNA expression level of p53, MDM2, VEGF and HIF-la in vinous samples of spontaneous abortion mouse models: in the villous samples of spontaneous abortion mouse models, the expression of p53 was positively correlated with the expression of MDM2, HIF-la (r = 0.35;r = 0.63), and the relationship was significant (P = 0.01;P < 0.001);but negatively correlated to the expression of VEGF (r = ?0.30), and the relationship was significant (P = 0.03). The expression of MDM2 was positively correlated with the expression of HIF-la (r = 0.28), and the relationship was significant (P = 0.04);and negatively correlated with the expression of VEGF (r = ?0.08), but the relationship was not significant (P = 0.57). The expression of HIF-la was negatively correlated with the expression of VEGF (r = ?0.37), and the relationship was significant (P = 0.007). The relationship of the mRNA expression level of p53,MDM2, VEGF and HIF-1 a in vinous samples of normal pregnancy models: in the vinous samples of normal pregnancy models, the expression of p53 was positively correlated with the expression of MDM2, VEGF and HIF-la (r = 0. 31;r = 0. 48;r = 0. 67), and the relationship was significant (P = 0.03;P = 0.003;P < 0.001). The expression of MDM2 was positively correlated with the expression of VEGF (r = 0. 23), but the relationship was not significant (P = 0.11);and negatively correlated with the expression of HIF-la (r = ?0.03), but the relationship was not significant (P = 0.84). The expression of HIF-la was positively correlated with the expression of VEGF (r = 0. 35), and the relationship was significant (P = 0.01). Conclusion: angiogenesis reduces in villous samples of spontaneous abortion mouse model, P53 and MDM2 involve in angiogenesis in villous samples, unlikely p53, and MDM2 have effects on normal early pregnancy villous angiogenesis and when the cell DNA damages or hypoxia exacerbates, it can induce high expression of p53, MDM2, inhibit angiogenesis in villous samples in early pregnancy. P53, MDM2 generegulate villous trophoblast cell growth by adjusting expression of HIF-1a and VEGF gene, finally influences pregnancy.
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.
文摘In order to study the molecular immune-pathological mechanism of spontaneous abortion (SA), immunohistochemistry techniques were used to detect the FasL expression of first trimester trophoblast in the SA patients and normal controls. High precise color-image measure system for immuno-histochemistry (HPIS) was used to determine the quantity of FasL expression. The results showed that the scale and intensity of FasL expression on the trophoblasts in SA group were significantly lower than in the control group. It is indicated that abnormal expression of FasL on trophoblasts, which damages the immunological tolerance between mother and fetus, may be one of the important mechanisms of development of SA. To induce the expression of FasL or to regulate the immunological tolerance will be a new way to treat SA.
文摘Objective To investigate the effects of allograft inflammatory factor-1 （AIF-1） and （RANTES） in sera and deciduas on unexplained early spontaneous abortion. Methods AIF-1 and RANTES were examined in sera and deciduas/endometria of 43 unexplained early spontaneous abortion women （group A）, 40 healthy women with early pregnancy（group B） and 20 healthy women with no pregnancy （group C）. Immunohistochemistry and enzyme linked immunosorbent assay （ELISA） were used in this study. Results AIF-1 protein was expressed both in deciduas of group A and in endometria of group C. In group A, H scores in the recurrent abortion deciduas specimens were significantly greater than those in the first abortion;in endometrium, expression of AIF-1 was greater in the secretory than in proliferative phase of group C. In group B, concentrations of RANTES in sera were higher in 7th-8th week of pregnancy than in 6th-7th and 〉8th week of pregnancy; expression of AIF-1 protein showed a negative correlation with RASNTES concentration; a significant increase of the RANTES levels in sera and tissue was observed in group B. Conclusion These results demonstrate, for the first time, that AIF-1 are expressed in deciduas of unexplained spontaneous abortion suggesting that AIF-1 involve in alloimmune abortion; RANTES might act as a novel blocking antibody;AIF-1 and RANTES might act as reliable markers for diagnosis of early alloimmune abortion.
文摘Objective To investigate the factors resulting in spontaneous abortion after transferring frozen-thawing blastocysts.Methods A total of 108 cases transferring vitrified blastocysts were divided into two groups. abortion group （n=20） and ongoing group （n=88）. Cytogenetic analysis of apoblemas was performed in 12 cases of the abortion.Results The overall spontaneous abortion rate was 18.50%（20/108） and the early spontaneous rate was 16.67%（18/108）. A significant difference in maternal age was observed （abortion group： 33.3±4.0years, ongoing group： 31.0 ±3.6years, P=0.02）. No difference in other parameters was found. Cytogenetic analysis of apoblemas was obtained for 12 cases, and 2 specimens were contaminated. Seven often patients had abnormal karyotypes.Conclusion The underlying cause of spontaneous abortion after transferring frozenthawing blastoeysts appears to be abnormal karyotypes. Advancing maternal age seems to increase the risk of spontaneous abortion.
基金National Natural Science Foundation of China Project(Project Number:81603656)Shaanxi University of Traditional Chinese Medicine 2017 Annual Scientific Research Program Project(Project Number:2017PY10)Infertility Innovation Team(Project Number:132041929).
文摘Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,PubMed,Embase,and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021;meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation.Results:Seven trials were included,with 496 patients;the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate[RR=1.22,95%CI(1.10,1.35),Z=3.80(P=0.0001)],embryo survival rate at pregnancy of 12 weeks[RR=1.25,95%CI(1.10,1.41),Z=3.53(P=0.0004)],D-dimer levels[SMD=-1.59,95%CI(-2.20,-0.97),Z=5.07(P<0.00001)],and fibrinogen levels[MD=-1.00,95%CI(-1.29,-0.70),Z=6.61(P<0.00001)],but the statistical heterogeneity was significant;in terms of incidence of adverse reactions,there was no statistical difference between Bushen Huoxue prescription and western medicine.Conclusion:Compared with western medicine alone,Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency,embryonic survival rate at 12 weeks of pregnancy,and reducing D-dimer values as well as fibrinogen levels,without any significant difference in the incidence of adverse effects;however,the number of included studies is small and there are drawbacks,such as small sample size and low quality;therefore,high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.
文摘Objective To investigate the effect of active immunotherapy on unexplained recurrent spontaneous abortion （URSA ） during the process of gestation and delivery period. Methods We collected the data of the women with URSA and their offsprings. The women were treated by immunization with paternal lymphocytes and then had a successful pregnancy. The fore mentioned group of women were compared with those who had a normal pregnancy and then delivered in the same period. Results The incidences of premature rupture of membranes, adherent placenta, and residual cauls in the group of URSA patients were statistically higher than those in the normal group. Correspondingly, gestational age at delivery and birth weight of the newborns of the group of URSA patients were lower, but there were no significant differences between the two groups. Conclusion These results indicate that paternal lymphocyte immunotherapy is effective on the maintenance of pregnancy in women with URSA, and has no deleterious effects on the fetus or newborns. However, in case of the higher incidence of premature rupture of membranes, adherent placenta, and residual cauls, more attention should be paid to the treated patients to avoid intrauterine growth retardation and postpartum hemorrhage.
文摘Objective: To investigate the correlation between recurrent spontaneous abortion patients and brain derived neurotrophic factor BDNF gene polymorphism and the mechanism of BDNF and recurrent spontaneous abortion under stress state in order to provide theoretical basis for nursing psychological intervention of patients with recurrent abortion. Methods: Medical coping Questionnaire (MCMO) and post-traumatic stress Diagnostic Scale (POST-traumatic stress Scale) were adopted Dissorder (PTSD) (PCL-c) scale was used to diagnose the psychological stress of recurrent spontaneous abortion in our hospital, and the BDNF gene polymorphism and the correlation factors of METHYLation in BDNF promoter region were studied in 30 cases (control group) and normal control group. Results: The MCMQ score of the case group and the control group was significantly lower than that of the conventional group (P Conclusion: There are significant differences in PTSD between the case group and the control group, which are related to methylation in the PROMOTER region of BDNF and SNP g-712A of BDNF gene. AG patients in the case group are more susceptible to anxiety and depression, and GG PTSD is more severe in the case group. BDNF promoter methylation and G-712A were independent risk factors for PTSD in the case group.
基金This study is supported by the Fund of Fujian Provincial Health Department for the Transcenturial Scholarship Leaders (99J122).
文摘Objective To investigate the aberrant expressions of TNF-α and TGF-β1 in peripheral blood mononuclear cells （PBMCs） and placental tissues in patients with early spontaneous abortion Methods Using the technique of semi-quantitative reverse transcript-polymerase chain reaction （RT-PCR）, TNF-α mRNA and TGF-β1 mRNA in PBMCs were measured in spontaneous abortion group （30 cases）, normal pregnancy group （25 cases） and nonpregnant group （25 cases）. The expressive intension of TNF-α protein and TGF-β1 protein in placental tissues was also identified by immunohistochemistry. Results Both levels of TNF-α mRNA and TGF-β1 mRNA expressed in PBMCs were significantly different between the three groups respectively （P〈0.05）. Levels of TNF-α in syncytiotrophoblastic and cytotrophoblastic cells of the two aborted groups were substantially higher than those of the nonregnant group （P〈0.01）, but the levels of TGF-β1 in syncytiotrophoblastic cells of the two aborted groups were markedly lower than those of the non-pregnant group （P〈0.01）. Conclusion There is potential relation between TGF-β at the fetomaternal interface and spontaneous abortion. TGF-β1 may contribute to the maintenance of pregnancy, and low-level expression of TGF-β1 may be associated with pregnancy failure.
文摘Background: Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive spontaneous abortion prior to 20 weeks from the last menstrual period. It affects approximately 1% to 2% of women, and about 40% - 80% of RSA are still remained unexplained. In recent years, a lot of studies suggest that RSA is caused by the immune factors. T helper 1(Th1)-type immunity is associated with unsuccessful pregnancy especially in women with RSA, while Th2-type immunity is associated with pregnancy success. Interleukin (IL)-2 may influence Th1/Th2 immune responsiveness and has been implicated association with RSA. Aim: The aim of this study was to investigate the association of the interleukin 2 (IL-2) promoter polymorphisms at the site ‐330 A/C (rs2069762) with RSA. Methods: The study group comprised 189 women with RSA, and the control group consisted of 187 healthy pregnant women. Gene polymorphisms were detected by the technique of polymerase chain reaction restriction fragment length polymorphism. Results: The frequency of genotype ‐330C/C was significant higher (χ2 = 7.266, p = 0.007, OR = 0.362, 95% CI = 0.169 - 0.777) in the control group than in the patient group. And the frequency of the -330Aallele was significant higher (χ2 = 11.862, p = 0.001, OR = 1.741, 95% CI = 1.268 - 2.389) in the patient group than in the control group. Conclusions: This study indicated that the IL-2-330Aallele may be considered as a risk factor for RSA. C→A mutation is may associated with RSA in Ningxia Han people.
基金Supported by the National Natural Science Foundation of China Grants(No.81801523)the Natural Science Foundation of Guangdong Province(Nos.2017A030313789,2018A030313528,2019A1515011984)+3 种基金the Science and Technology Planning Foundation of Guangzhou City(201904010017,202102080102)Guangdong Province Medical Research Funding(No.A2021269)the Family Planning Research Institute Innovation Team of Guangdong Province grants(C-03)the Family Planning Research Institute of Guangdong Province Grants(S2018010).
文摘Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify differentially expressed piRNAs in deciduas of RSA patients.Decidua tissues were collected by curettage from recruited RSA patients and normal early pregnant(NEP)women with their informed consent.Small RNA sequencing was used to evaluate the differences in piRNA expression profiles between RSA and NEP.The present results demonstrated that the counts of total piRNA reads in RSA samples were increased compared with those in NEP samples(0.21%vs.0.11%).Differential expression analysis identified 29 upregulated piRNAs and 18 downregulated piRNAs in RSA samples.RT-qPCR further confirmed that the expression levels of uniq-109625,uniq-89328,uniq-50651 and uniq-4569 were decreased in 8 RSA tissues,compared with 13 NEP tissues.Otherwise,pi-22628 and uniq-173406 were increased in 8 RSA tissues.Based on GO term and KEGG pathway analysis,we speculate that these piRNAs regulate RSA by targeting extracellular matrix component pathway,cell adhesion pathway and focal adhesion pathway.PiRNAs may be involved in RSA pathogenesis by target genes function on adhesion and extracellular matrix component.
