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Medical abortion

Mkaya Mwamburi, Andrew T Tenaglia, Eric J Leibler, Peter S Staats
Migraine affects 15% of the population in the United States and is associated with comorbidities, with an estimated economic burden of $78 billion annually. GammaCore is used adjunctively with current standard of care and abortive medications and has shown to be superior in acute treatment of episodic migraine compared to sham. However, the economic impact has not been characterized for this indication. We conducted a cost-effectiveness analyses for 2 hypothetical scenarios: a primary model for treatment options gammaCore plus standard of care compared to standard of care alone for acute treatment of migraine; and a secondary model for treatment sequence strategies where acute treatment with gammaCore or standard of care each prior to erenumab prevention compared to initiating erenumab prevention with no prerequisite...
December 2018: American Journal of Managed Care
Judith Fullerton, Michelle M Butler, Cheryl Aman, Tobi Reid, Melanie Dowler
Introduction: The International Confederation of Midwives (ICM) represents 132 midwifery associations in 113 countries. The ICM disseminates the Essential Competencies for Basic Midwifery Practice (EC) that describes the global scope of midwifery practice. The basic (core) and expanded (additional or optional) role of midwives in providing abortion-related care services was first described in 2010. A literature review about three items that are particularly critical to access to abortion services was conducted...
2018: International Journal of Women's Health
Parisa Goodarzi, Khadijeh Falahzadeh, Hamidreza Aghayan, Moloud Payab, Bagher Larijani, Sepideh Alavi-Moghadam, Akram Tayanloo-Beik, Hossein Adibi, Kambiz Gilany, Babak Arjmand
Regenerative medicine as a background of stem cell research and therapy has a long history. A wide variety of diseases including Parkinson's disease, heart diseases, multiple sclerosis, spinal cord injury, diabetes mellitus and etc. are candidate to be treated using different types of stem cells. There are several sources of stem cells such as bone marrow, umbilical cord, peripheral blood, germ cells and the embryo/fetus tissues. Fetal stem cells (FSCs) and embryonic stem cells (ESCs) have been described as the most potent stem cell source...
December 7, 2018: Cell and Tissue Banking
Zubair Ahammad, Jason Milton, Kailash Narayan, Victor Awuor
Background: Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy within the spectrum of rheumatologic diseases. The systemic inflammation that characterizes AS leads to bone resorption and reformation. Pathologic remodeling may include kyphosis, osteoporosis, and multi-segment auto-fusion. Cervical fractures account for 53-78% of spinal trauma seen with AS. Surgical planning is often challenging owing to spinal deformity, medical comorbidities, the cervicothoracic foci of injury, and gross instability of these fracture...
2018: Surgical Neurology International
Elizabeth G Raymond, Margo S Harrison, Mark A Weaver
OBJECTIVE: To summarize available data on the effectiveness and safety of single-agent misoprostol for medical abortion in the first trimester. DATA SOURCES: We searched MEDLINE, CABI, Cochrane, EMBASE, LILACS, the Web of Science, and for English-language studies that evaluated misoprostol alone for abortion of a viable pregnancy in the first trimester. METHODS OF STUDY SELECTION: Our search yielded 1,562 citations, of which 38 included data from 53 trial groups that met our inclusion and exclusion criteria...
December 4, 2018: Obstetrics and Gynecology
Elizabeth G Clement, Sarah Horvath, Arden McAllister, Nathanael C Koelper, Mary D Sammel, Courtney A Schreiber
OBJECTIVE: To document the terminology patients hear during the treatment course for a nonviable pregnancy and to ask patients their perceived clarity and preference of terminology to identify a patient-centered lexicon. METHODS: We performed a preplanned substudy survey of English-speaking participants in New York, Pennsylvania, and California at the time of enrollment in a randomized multisite trial of medical management of first-trimester early pregnancy loss...
December 4, 2018: Obstetrics and Gynecology
Terence T Lao, Annie S Y Hui, Lai-Wa Law, Daljit S Sahota
OBJECTIVES: To explore the relationship between prior abortion history with incidence of pregnancy hypertensive disorders (PHD), including gestational hypertension (GH) and pre-eclampsia (PE), to determine whether the secular increases in GH and PE in developed countries could be related in part to the decreased incidence of abortion. STUDY DESIGN: A single center retrospective cohort study on primiparous Chinese gravidae managed in 1997-2015 in our hospital. MAIN OUTCOME MEASURES: The occurrence of PHD, GH and PE with respect to the presence or otherwise of prior abortions, with the analysis stratified for risk factors that include advanced age, high body mass index (BMI), history of medical disorders, birth before 34 weeks, and maternal hepatitis B virus (HBV) infection and rubella non-immunity which have been shown to influence the occurrence of PHD in our population...
October 2018: Pregnancy Hypertension
Elie Sader, Melissa Rayhill
Headache is a neurologic disorder that displays gender dichotomy. It is well established that there is a strong link between migraine headache and sex hormones, specifically estrogen, which influences the severity of migraines during the menstrual cycle, pregnancy, and menopause. Furthermore, the epidemiology of headaches during pregnancy and the postpartum period is very distinct from that in males or nonpregnant females, in part due to the hemodynamic and hematologic changes that occur during pregnancy. These changes put women at higher risk for cerebral venous thrombosis, hemorrhagic stroke, and hypertensive disorders of pregnancy like preeclampsia, eclampsia, posterior reversible encephalopathy syndrome, and reversible cerebral vasoconstriction syndrome...
December 2018: Seminars in Neurology
Mohamad Irani, Nikica Zaninovic, Zev Rosenwaks, Kangpu Xu
BACKGROUND: Age-related decline in reproductive potential is mainly due to the increased incidence of aneuploidy. Furthermore, two recent studies have shown that euploid embryos of older women may have a lower implantation potential compared to those of younger women, suggesting that aging might compromise embryos beyond their ploidy status. However, the inherent limitations of these studies preclude solid conclusions. OBJECTIVE: To determine whether maternal age at retrieval affects the implantation potential of euploid blastocysts...
December 3, 2018: American Journal of Obstetrics and Gynecology
Silvia Elizalde, Natacha Mateo
The work analyzes the characteristics, arguments and conditions of possibility present in the gender activisms carried out in recent years by young women in Argentina, with special attention paid to the generational mark they imprint onto the collective demands and struggles for legal, safe and free abortion. The article reconstructs some of the social and personal circumstances at the base of the motivation or the decision of a group of young women to carry out an abortion with misoprostol, with the purpose of exploring concretely the support networks and the information circulating among these young women in relation to the practice of medical abortion, at a time in which access to this right has not yet been legally instituted in the country...
July 2018: Salud Colectiva
Claudia Calquín Donoso, Jennifer Cerda Guinez, Cristopher Yáñez-Urbina
This article presents the results of a study aimed at identifying and analyzing the discursive construction of the fetus as a subject of rights on the part of medical-religious institutions in the discussion of the decriminalization of abortion due to three causes in Chile during the 2013-2016 period. To this end, a triangulation was carried out based on an analysis of thematic content and an analysis of certain discursive strategies from the critical discourse analysis perspective using a textual corpus composed of 16 documents...
July 2018: Salud Colectiva
Zeynep Öztürk, Ercüment Ölmez, Tuğba Gürpınar, Kamil Vural
Öztürk Z, Ölmez E, Gürpınar T, Vural K. Birth outcomes after inadvertent use of category X drugs contraindicated in pregnancy: Where is the real risk? Turk J Pediatr 2018; 60: 298-305. Drugs contraindicated in pregnancy are medicines that should be avoided by pregnant women, since they carry a concern for teratogenicity or there is no indication for their use during pregnancy. It does not mean that exposures to these drugs always cause harm. The aim of the present study was to investigate the risk of adverse outcomes following maternal exposure to the drugs contraindicated in pregnancy...
2018: Turkish Journal of Pediatrics
Armin S Razavi, Stephen T Chasen
Objective  To determine the rate of unsuspected noncardiac abnormalities in newborns suspected to have isolated cardiac abnormalities in the second trimester. Study Design  A review of the ultrasound database from the Weill Cornell Medical Center identified fetuses with a suspected cardiac abnormality from January 2006 to November 2016. Cases with prenatally suspected noncardiac structural abnormalities, abnormal fetal or neonatal karyotype or microarray, and those who delivered at an outside institution or underwent abortion were excluded...
October 2018: American Journal of Perinatology Reports
Ari P Sanders, Barry Sanders
OBJECTIVE: To introduce and demonstrate an approach to the hysteroscopic removal of retained intrauterine devices (IUDs) in pregnancy. Pregnancy risks associated with retained IUDs are also discussed, specifically spontaneous abortion and preterm labor. DESIGN: A step-by-step explanation of the procedure with surgical video footage. SETTING: Academic medical center. PATIENT(S): We present four patients undergoing hysteroscopic removal of IUDs in pregnancy...
December 2018: Fertility and Sterility
Yonghong Zhang, Lina Ma, Xiaohui Hu, Jinlu Ji, Gil Mor, Aihua Liao
STUDY QUESTION: What is the role of the programmed cell death-1 (PD-1)/PD-1 ligand-1 (PD-L1) axis in macrophage polarization during early pregnancy? SUMMARY ANSWER: PD-1 signaling is a major regulator of macrophage differentiation and function, and it is critical for the success of a pregnancy. WHAT IS KNOWN ALREADY: The predominance of decidual macrophages (DMs) with an M2 phenotype is an important contributor to maternal-fetal tolerance during early pregnancy...
November 30, 2018: Human Reproduction
Yongxiu Hao, Yiming Pang, Huina Yan, Yali Zhang, Jufen Liu, Lei Jin, Lailai Yan, Da Chen, Ligang Hu, Qian Liu, Yanan Qin, Bin Wang, Zhiwen Li, Rongwei Ye, Le Zhang, Aiguo Ren
BACKGROUND: The effect of maternal copper (Cu) level on the risk of spontaneous preterm birth (SPB) remains debate. Therefore, we conducted a prospective nested case-control study in Shanxi Province to investigate the relationship between maternal serum Cu concentration and SPB risk, as well as the potential mediation effect of lipid metabolism. METHOD: From an overall cohort of 4229 women, 147 women affected by SPB at 20-36 gestational weeks (cases) and 381 women who delivered at ≥37 gestational weeks (controls) were included in our nested case-control study...
November 22, 2018: Environment International
Sara Adelman, Chris Smith, Caroline Free
OBJECTIVE: To evaluate which characteristics collected at the point of abortion are associated with contraceptive use over the extended post-abortion period for women in Cambodia. METHODS: The study includes a cohort of 500 women who attended a Marie Stopes International Cambodia clinic for an induced abortion. The primary outcomes are use of effective contraception≥80% of the time over the four and 12-month period post-abortion. We conducted a bivariate analysis to assess the association between each characteristic and the outcome, followed by multivariable modelling to identify the strongest predictors of the outcomes...
November 21, 2018: Contraception
Howard Minkoff, Ronald S Gibbs
Changes in the make-up of the Supreme Court make an overturn of the Roe v Wade decision a realistic possibility. In order to mitigate any adverse health consequences that could result from a change in the law, all stakeholders in women's health have to start to plan for that contingency. These stakeholders include physicians, nurse midwives, nurses, their professional organizations, health advocacy groups, health policy experts, and legislators. Among the tasks for physicians and their professional organization, we include education about the management of women injured by unsafe abortions, post residency training for physicians with reduced access to residency training in abortion, and planning for the management of medically complicated pregnancies that are often currently terminated (e...
November 21, 2018: American Journal of Obstetrics and Gynecology
Juana Marin, Nicola Giffin, Elizabeth Consiglio, Candace McClure, Eric Liebler, Brendan Davies
BACKGROUND: Evidence supports the use of non-invasive vagus nerve stimulation (nVNS; gammaCore®) as a promising therapeutic option for patients with cluster headache (CH). We conducted this audit of real-world data from patients with CH, the majority of whom were treatment refractory, to explore early UK clinical experience with nVNS used acutely, preventively, or both. METHODS: We retrospectively analysed data from 30 patients with CH (29 chronic, 1 episodic) who submitted individual funding requests for nVNS to the National Health Service...
November 23, 2018: Journal of Headache and Pain
Ilaria Morra, Cinzia Ferrara, Gabriella Sglavo, Anna Sansone, Gabriele Saccone, Lisa Perriera, Costantino Di Carlo
OBJECTIVES: To compare uterine rupture rates in women having a medical abortion receiving gemeprost alone to those receiving mifepristone plus gemeprost. STUDY DESIGN: We reviewed the records of women undergoing medical abortion at 13 0/7-23 6/7weeks from January 2007 to December 2014 at a single center in Italy. Prior to January 2011, we used gemeprost 1mg vaginally every 3h up to a maximum of 5 doses. After January 2011, we added mifepristone 200 mg orally 24h prior to the same gemeprost protocol...
November 20, 2018: Contraception
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