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Prevention of miscarriage

Manuel Luis Wolfson, Julieta Aisemberg, Fernando Correa, Ana María Franchi
BACKGROUND AND PURPOSE: Maternal infections with Gram-negative bacteria are associated with miscarriage and are one of the most common complications during pregnancy. Previous studies from our group have shown that lipopolysaccharide (LPS)-activated infiltrating peripheral blood mononuclear cells (PBMC) into decidual tissue play an important role on the establishment of a local inflammatory process that result in embryo cytotoxicity and early embryo resorption. Moreover, we have also shown that an increased endocannabinoid tone mediates LPS-induced deleterious effects during early pregnancy loss...
October 12, 2016: Journal of Cellular Physiology
Joanna Davies, Rezan Kadir
Management of factor XI (FXI) deficiency in pregnancy is complicated by lack of correlation between FXI level and bleeding risk. Clinicians should be vigilant about the potential for prolonged or excessive bleeding following miscarriage or termination of pregnancy, or postpartum hemorrhage (PPH). A multidisciplinary approach along with an individual care plan is recommended to prevent bleeding complications. Assessment of bleeding history, FXI level, and global tests of hemostasis can aid management decisions regarding hemostatic prophylaxis...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Maria Baudin, Ammar M Jumaa, Huda J E Jomma, Mubarak S Karsany, Göran Bucht, Jonas Näslund, Clas Ahlm, Magnus Evander, Nahla Mohamed
BACKGROUND: Rift Valley fever virus is an emerging mosquito-borne virus that causes infections in animals and human beings in Africa and the Arabian Peninsula. Outbreaks of Rift Valley fever lead to mass abortions in livestock, but such abortions have not been identified in human bezings. Our aim was to investigate the cause of miscarriages in febrile pregnant women in an area endemic for Rift Valley fever. METHODS: Pregnant women with fever of unknown origin who attended the governmental hospital of Port Sudan, Sudan, between June 30, 2011, and Nov 17, 2012, were sampled at admission and included in this cross-sectional study...
September 27, 2016: Lancet Global Health
Sophie Legrève
OBJECTIVE: Multifocal osteonecrosis is rare. A zone of epiphyseal bone-marrow necrosis of three or more joints characterizes it. The most common risk factors are glucocorticoids intake and alcoholism. However, there is a series of other causes that could be incriminated in osteonecrosis, among which antiphospholipid syndrome. This case report, illustrates a primary antiphospholipid syndrome with only one clinical manifestation: multifocal osteonecrosis. OBSERVATIONS: A 30-year-old woman, with a medical history of left total hip replacement (THR), presents with severe right coxalgia and pain in both knees and shoulders...
September 2016: Annals of Physical and Rehabilitation Medicine
Kara N Goldman, Jamie A Grifo
PURPOSE OF REVIEW: Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation...
September 24, 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
H Le Liepvre, A Dinh, B Idiard-Chamois, E Chartier-Kastler, V Phé, A Even, G Robain, P Denys
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. SETTING: NeuroUrology Department in a University Hospital, France. METHODS: All consecutive SCI pregnant women managed between 2001 and 2014 were included...
September 27, 2016: Spinal Cord
Adolf E Schindler
Over time, it became evident that with the use of micronized progesterone and dydrogesterone prevention or treatment of pregnancy disorders such as threatened miscarriage, recurrent (habitual) miscarriage, preterm labor or preeclampsia appears to be possible. The results so far obtained will be delineated and concepts of prevention or treatment are suggested with the aim to further explore these pregnancy disorders either by prevention or treatment concepts to obtain not only benefits to the mother and the fetus, but furthermore this results in benefits for lifetime for the individual, for the family and last but not least for society...
August 1, 2016: Hormone Molecular Biology and Clinical Investigation
Gian Carlo Di Renzo, Irene Giardina, Graziano Clerici, Eleonora Brillo, Sandro Gerli
Progesterone is an essential hormone in the process of reproduction. It is involved in the menstrual cycle, implantation and is essential for pregnancy maintenance. It has been proposed and extensively used in the treatment of different gynecological pathologies as well as in assisted reproductive technologies and in the maintenance of pregnancy. Called "the pregnancy hormone", natural progesterone is essential before pregnancy and has a crucial role in its maintenance based on different mechanisms such as: modulation of maternal immune response and suppression of inflammatory response (the presence of progesterone and its interaction with progesterone receptors at the decidua level appears to play a major role in the maternal defense strategy), reduction of uterine contractility (adequate progesterone concentrations in myometrium are able to counteract prostaglandin stimulatory activity as well as oxytocin), improvement of utero-placental circulation and luteal phase support (it has been demonstrated that progesterone may promote the invasion of extravillous trophoblasts to the decidua by inhibiting apoptosis of extravillous trophoblasts)...
July 1, 2016: Hormone Molecular Biology and Clinical Investigation
Shafquat Rozi, Zahid Ahmad Butt, Nida Zahid, Saba Wasim, Kashif Shafique
OBJECTIVES: The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan. DESIGN: A multicentre hospital-based case-control study. SETTING: Four leading maternity hospitals of Karachi. PARTICIPANTS: A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards...
2016: BMJ Open
Sanaa Itchimouh, Karima Khabtou, Sakher Mahdaoui, Houssine Boufettal, Naima Samouh
The incidence of uterine malformations affecting reproduction is difficult to assess. Their identification requires a specific assessment (hysterosalpingography, hysteroscopy, laparoscopy). Spontaneous fertility can be affected depending on the type of uterine abnormality. All these abnormalities can affect the evolution of pregnancy causing early and late miscarriage, ectopic pregnancy, threat of premature labour, premature labour, vascular pathologies during pregnancy and inadequate intra-uterine growth. Bicornuate uterus is the most common uterine malformation and represents about half of all uterine anomalies The occurrence of this type of pregnancy is associated with an increased risk of maternal mortality, but early diagnosis and proper monitoring can lead pregnancies to term on malformed uterus...
2016: Pan African Medical Journal
Huan Zhou, Yongping Liu, Lu Liu, Min Zhang, Xingzhi Chen, Yulong Qi
OBJECTIVE: To assess the relationship of the pre-pregnancy modifiable risks with miscarriage. STUDY DESIGN: We randomly selected 51 communities or villages from January 2013 to December 2014 in Anhui, China. We calculated incidence rate ratios (RR) and 95% confidence intervals (CIs) for each risk factor for miscarriage. RESULTS: The incidence rate of miscarriage was 7.45%, and pre-embryonic loss account for 12.66%, embryonic loss account for 38%, and fetal losses account for 49...
August 12, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Kate Duhig, Lucy C Chappell, Andrew H Shennan
Oxidative stress is implicated in the pathophysiology of many reproductive complications including infertility, miscarriage, pre-eclampsia, fetal growth restriction and preterm labour. The presence of excess reactive oxygen species can lead to cellular damage of deoxyribonucleic acids, lipids and proteins. Antioxidants protect cells from peroxidation reactions, limiting cellular damage and helping to maintain cellular membrane integrity. There is overwhelming evidence for oxidative stress causing harm in reproduction...
September 2016: Obstetric Medicine
M Lemmers, M A C Verschoor, K Oude Rengerink, C Naaktgeboren, B C Opmeer, P M Bossuyt, J A F Huirne, C A H Janssen, C Radder, E R Klinkert, J Langenveld, R Catshoek, L Van der Voet, F Siemens, P Geomini, M H Van Hooff, J M Van der Ploeg, S F P J Coppus, W M Ankum, B W J Mol
STUDY QUESTION: Is curettage more effective than expectant management in case of an incomplete evacuation after misoprostol treatment for first trimester miscarriage? SUMMARY ANSWER: Curettage leads to a higher chance of complete evacuation but expectant management is successful in at least 76% of women with an incomplete evacuation of the uterus after misoprostol treatment for first trimester miscarriage. WHAT IS KNOWN ALREADY: In 5-50% of the women treated with misoprostol, there is a suspicion of incomplete evacuation of the uterus on sonography...
September 2, 2016: Human Reproduction
Yu Kanzaki, Eiji Kondoh, Kaoru Kawasaki, Haruta Mogami, Yoshitsugu Chigusa, Ikuo Konishi
AIM: There are an increasing number of reports of pregnancy following liver transplantation, but many questions remain regarding preconception counseling and management of the pregnancy. The aim of this study was to report pregnancy outcomes in women who had undergone liver transplants and to gain insight into these issues. METHODS: We conducted a retrospective review of liver transplant recipients who had received prenatal care at Kyoto University Hospital between January 2001 and December 2015...
August 24, 2016: Journal of Obstetrics and Gynaecology Research
Nejat Demircan, Ülkü Özmen, Fürüzan Köktürk, Hamdi Küçük, Şevket Ata, Müge Harma, İnan İlker Arıkan
Objectives. The frequency, predisposing factors and impact of urinary incontinence (UI) on quality of life (QoL) during pregnancy were investigated. Materials and Method. A preliminary cross-sectional survey was studied among pregnant women between January and July of 2014. A total of 132 pregnant women were recruited using a questionnaire form for sociodemographic features, the Turkish version of the International Consultation on Incontinence-Short Form (ICIQ-SF), for the characteristics of UI and Wagner's Quality of Life scale to assess impact on QoL...
2016: PeerJ
Kazuyoshi Kanki, Masaaki Ii, Yoshito Terai, Masahide Ohmichi, Michio Asahi
Bone marrow-derived endothelial progenitor cells (EPCs) have been shown to contribute to not only angiogenesis in ischemic tissue but also neovascularization in uterine endometrium formation. Reduced neovascularization and elevation of serum soluble Flt-1, a functional blockage of VEGF, in the development of placenta is thought to be one of the major causes of repeated miscarriages in gestation. We then examined whether transfusion of VEGF expressing extrinsic EPCs prevented frequent miscarriage via its promotional effect on neovascularization with a VEGF-eNOS signaling pathway in a mouse miscarriage model...
August 5, 2016: Cell Transplantation
Kate MacWilliams, Jean Hughes, Megan Aston, Simon Field, Faith Wight Moffatt
INTRODUCTION: Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a miscarriage is risk factor modification, the treatment focuses on confirming the miscarriage has occurred and medical management of symptoms. Although women experiencing a miscarriage are frequently directed to seek medical care in emergency departments, the patients are often triaged as nonemergent patients unless they are unstable, which exposes women to potentially prolonged wait times...
August 6, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Roger A Levy, Guilherme R de Jesús, Nilson R de Jesús, Evandro M Klumb
The crucial issue for a better pregnancy outcome in women with autoimmune rheumatic diseases is appropriate planning, with counseling of the ideal timing and treatment adaptation. Drugs used to treat rheumatic diseases may interfere with fertility or increase the risk of miscarriages and congenital abnormalities. MTX use post-conception is clearly linked to abortions as well as major birth defects, so it should be stopped 3months before conception. Leflunomide causes abnormalities in animals even in low doses...
October 2016: Autoimmunity Reviews
Xiaonan Qi, Huatao Li, Xia Cong, Xin Wang, Zhongling Jiang, Rongfeng Cao, Wenru Tian
Scutellaria baicalensis has been effectively used in Chinese traditional medicine to prevent miscarriages. However, little information is available on its mechanism of action. This study is designed specifically to reveal how baicalin, the main effective ingredient of S. baicalensis, improves developmental competence of embryos in vitro, using the mouse as a model. Mouse pronuclear embryos were cultured in KSOM medium supplemented with (0, 2, 4 and 8 μg/ml) baicalin. The results demonstrated that in vitro culture conditions significantly decreased the blastocyst developmental rate and blastocyst quality, possibly due to increased cellular stress and apoptosis...
July 29, 2016: Journal of Reproduction and Development
Hengxi Chen, Jing Fu, Wei Huang
BACKGROUND: Hyperprolactinemia is the presence of abnormally high circulating levels of prolactin. Idopathic hyperprolactinemia is the term used when no cause of prolactin hypersecretion can be identified and it is causally related to the development of miscarriage in pregnant women, especially women who have a history of recurrent miscarriage. A possible mechanism is that high levels of prolactin affect the function of the ovaries, resulting in a luteal phase defect and miscarriage. A dopamine agonist is a compound with high efficacy in lowering prolactin levels and restoring gonadal function...
2016: Cochrane Database of Systematic Reviews
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