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Repeat abortion

Loren Fields, Alison Hathaway
Pregnancy of unknown location (PUL) is a descriptive term for when a woman with a positive pregnancy test has a transvaginal ultrasound that cannot determine the site of the pregnancy. While the majority of women with PUL are subsequently diagnosed with a spontaneous abortion or viable intrauterine pregnancy, 7% to 20% of these women have an ectopic pregnancy. The potential for morbidity and mortality related to an ectopic pregnancy means that considerable care is necessary in the evaluation and management of women with PUL...
October 25, 2016: Journal of Midwifery & Women's Health
A Ohannessian, C Jamin
OBJECTIVE: To establish guidelines of the French National College of Gynecologists and Obstetricians about post-abortion contraception. MATERIALS AND METHODS: A systematic review of the literature about post-abortion contraception was performed on Medline and Cochrane Database between 1978 and March 2016. The guidelines of the French and foreign scientific societies were also consulted. RESULTS AND DISCUSSION: After an abortion, if the woman wishes to use a contraception, it should be started as soon as possible because of the very early ovulation resumption...
October 20, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Amy Tyberg, Stefan Seewald, Reem Z Sharaiha, Guadalupe Martinez, Amit P Desai, Nikhil A Kumta, Arnon Lambroza, Amrita Sethi, Kevin M Reavis, Ketisha DeRoche, Monica Gaidhane, Michael Talbot, Payal Saxena, Felipe Zamarripa, Maximilien Barret, Nicholas Eleftheriadis, Valerio Balassone, Haruhiro Inoue, Michel Kahaleh
BACKGROUND: Per-oral endoscopic myotomy (POEM) has become an accepted treatment for patients with achalasia. Despite its excellent efficacy rate of greater than 80%, a small percentage of patients remain symptomatic postprocedure. Limited data exist as to the best management for recurrence of symptoms after POEM. We present the first international, multicenter experience on the efficacy and safety of a repeat POEM in the management of achalasia. METHODS: Patients who underwent a redo POEM from 15 centers in 9 countries were included in a dedicated registry...
October 15, 2016: Gastrointestinal Endoscopy
Monica V Dragoman, Daniel Grossman, Nathalie Kapp, Nguyen My Huong, Ndema Habib, Duong Lan Dung, Anand Tamang
BACKGROUND: Pain is often cited as one of the worst features of medical abortion. Further, inadequate pain management may motivate some women to seek unnecessary clinical care. There is a need to identify effective methods for pain control in this setting. METHODS/DESIGN: We propose a randomized, placebo-controlled trial. 576 participants (288 nulliparous; 288 parous) from study sites in Nepal, South Africa and Vietnam will be randomly allocated to one of three treatments: (1) ibuprofen 400 mg PO and metoclopramide 10 mg PO; (2) tramadol 50 mg PO and a placebo; or (3) two placebo pills, to be taken immediately before misoprostol and repeated once four hours later...
October 12, 2016: Reproductive Health
F F Coelho, F K Marques, M S Gonçalves, V C O Almeida, E C C Mateo, A C S Ferreira
Approximately 10-15% of all pregnancies end in spontaneous abortions. Many factors can lead to embryonic loss; however, it has been well established that over 50% of all miscarriages result from chromosomal abnormalities, primarily aneuploidies (>96%). Identifying the cause of miscarriage can significantly reduce the psychological stress in women, and enable better genetic counseling for a future pregnancy. Quantitative fluorescent polymerase chain reaction (QF-PCR) has been previously used in the study of chromosomal abnormalities...
September 23, 2016: Genetics and Molecular Research: GMR
Helena Kilander, Birgitta Salomonsson, Johan Thor, Jan Brynhildsen, Siw Alehagen
OBJECTIVES: A substantial proportion of women who undergo an abortion continue afterwards without switching to more effective contraceptive use. Many subsequently have repeat unintended pregnancies. This study, therefore, aimed to identify and describe health professionalś experiences of providing contraceptive counselling to women seeking an abortion. METHODS: We interviewed 21 health professionals (HPs), involved in contraceptive counselling of women seeking abortion at three differently sized hospitals in Sweden...
September 30, 2016: European Journal of Contraception & Reproductive Health Care
Stembile Mugore, Ntapi Tchiguiri K Kassouta, Boniface Sebikali, Laurel Lundstrom, Abdulmumin Saad
High-quality postabortion care (PAC) services that include family planning counseling and a full range of contraceptives at point of treatment for abortion complications have great potential to break the cycle of repeat unintended pregnancies and demand for abortions. We describe the first application of a systematic approach to quality improvement of PAC services in a West African country. This approach-IntraHealth International's Optimizing Performance and Quality (OPQ) approach-was applied at 5 health care facilities in Togo starting in November 2014...
September 28, 2016: Global Health, Science and Practice
Sara Sadeghi, Almudena García-Molina, Ferran Celma, Anthony Valverde, Sogol Fereidounfar, Carles Soler
DNA fragmentation has been shown to be one of the causes of male infertility, particularly related to repeated abortions, and different methods have been developed to analyze it. In the present study, two commercial kits based on the SCD technique (Halosperm ® and SDFA) were evaluated by the use of the DNA fragmentation module of the ISAS ® v1 CASA system. Seven semen samples from volunteers were analyzed. To compare the results between techniques, the Kruskal-Wallis test was used. Data were used for calculation of Principal Components (two PCs were obtained), and subsequent subpopulations were identified using the Halo, Halo/Core Ratio, and PC data...
September 27, 2016: Asian Journal of Andrology
Gamal Wareth, Falk Melzer, Denny Böttcher, Mohamed El-Diasty, Mohamed El-Beskawy, Nesma Rasheed, Gernot Schmoock, Uwe Roesler, Lisa D Sprague, Heinrich Neubauer
Bovine brucellosis is endemic in Egypt in spite of application of surveillance and control measures. An increase of abortions was reported in a Holstein dairy cattle herd with 600 animals in Damietta governorate in Egypt after immunisation with Brucella (B.) abortus RB51 vaccine. Twenty one (10.6%) of 197 vaccinated cows aborted after 3 months. All aborted cows had been tested seronegative for brucellosis in the past 3 years. B. abortus was isolated from four foetuses. Conventional biochemical and bacteriological identification and polymerase chain reaction (PCR) confirmed two B...
September 21, 2016: Acta Tropica
Helena Hognert, Helena Kopp Kallner, Sharon Cameron, Christina Nyrelli, Izabella Jawad, Rebecca Heller, Annette Aronsson, Ingela Lindh, Lina Benson, Kristina Gemzell-Danielsson
STUDY QUESTION: Does a progestin releasing subdermal contraceptive implant affect the efficacy of medical abortion if inserted at the same visit as the progesterone receptor modulator, mifepristone, at medical abortion? SUMMARY ANSWER: A etonogestrel releasing subdermal implant inserted on the day of mifepristone did not impair the efficacy of the medical abortion compared with routine insertion at 2-4 weeks after the abortion. WHAT IS ALREADY KNOWN: The etonogestrel releasing subdermal implant is one of the most effective long acting reversible contraceptive methods...
September 22, 2016: Human Reproduction
Katherine D Pocius, Deborah Bartz, Rie Maurer, Asha Stenquist, Jennifer Fortin, Alisa B Goldberg
OBJECTIVES: To prospectively describe the decline in serum human chorionic gonadotropin (hCG) in the first 5 days after complete medical abortion and evaluate the influence of initial hCG and gestational duration. STUDY DESIGN: We conducted a prospective, physiologic study of women ≤63 days gestation who underwent medical abortion with 200 mg mifepristone and 800 mcg buccal misoprostol. We stratified enrollment into two gestational cohorts, <49 days and 49-63 days, to ensure gestational variability...
September 13, 2016: Contraception
Dina M R Dakhly, Yomna A Bayoumi, Mohamed Sharkawy, Sherine H Gad Allah, Mohamed A Hassan, Hisham M Gouda, Ahmed T Hashem, Dina L Hatem, Mona F Ahmed, Waleed El-Khayat
OBJECTIVE: To investigate the efficacy of intralipid supplementation in women with recurrent spontaneous abortion (RSA) and elevated natural killer cell activity undergoing in vitro fertilization/intracytoplasmic sperm injection. METHODS: Between February 10, 2013, and April 30, 2015, a double-blind randomized controlled study was conducted at a center in Egypt. Women with unexplained secondary infertility, RSA, and elevated levels of natural killer cells (>12%) were enrolled and randomly assigned to receive intralipid (2mL diluted at 20% in 250mL saline) or saline (250mL) infusion on the day of oocyte retrieval using random numbers and sealed envelopes...
August 30, 2016: International Journal of Gynaecology and Obstetrics
Elizabeth G Raymond, Mark A Weaver, Karmen S Louie, Yi-Ling Tan, Manuel Bousiéguez, Ana Gabriela Aranguré-Peraza, Elba M Lugo-Hernández, Patricio Sanhueza, Alisa B Goldberg, Kelly R Culwell, Clair Kaplan, Lisa Memmel, Sarita Sonalkar, Roxanne Jamshidi, Beverly Winikoff
OBJECTIVE: To evaluate the effects of timing of depot medroxyprogesterone acetate injection on medical abortion outcome and risk of repeat pregnancy within the subsequent 6 months. METHODS: In a multinational randomized trial, we assigned women undergoing medical abortion who wanted depot medroxyprogesterone acetate to administration either with mifepristone (Quickstart group) or after the abortion (Afterstart group). We ascertained abortion outcome, pregnancies, and contraception use over 7 months...
October 2016: Obstetrics and Gynecology
Deborah Constant, Jane Harries, Thokozile Malaba, Landon Myer, Malika Patel, Gregory Petro, Daniel Grossman
OBJECTIVE: To document clinical outcomes and women's experiences following the introduction of mifepristone into South African public sector second-trimester medical abortion services, and compare with historic cohorts receiving misoprostol-only. METHODS: Repeated cross-sectional observational studies documented service delivery and experiences of women undergoing second-trimester medical abortion in public sector hospitals in the Western Cape, South Africa. Women recruited to the study in 2008 (n = 84) and 2010 (n = 58) received misoprostol only...
2016: PloS One
Muhammad A B Shabbir, Haihong Hao, Muhammad Z Shabbir, Qin Wu, Adeel Sattar, Zonghui Yuan
Bacteriophages are the most common entities on earth and represent a constant challenge to bacterial populations. To fend off bacteriophage infection, bacteria evolved immune systems to avert phage adsorption and block invader DNA entry. They developed restriction-modification systems and mechanisms to abort infection and interfere with virion assembly, as well as newly recognized clustered regularly interspaced short palindromic repeats (CRISPR). In response to bacterial immune systems, bacteriophages synchronously evolved resistance mechanisms, such as the anti-CRISPR systems to counterattack bacterial CRISPR-cas systems, in a continuing evolutionary arms race between virus and host...
2016: Frontiers in Microbiology
Ushma D Upadhyay, Nicole E Johns, Sarah L Combellick, Julia E Kohn, Lisa M Keder, Sarah C M Roberts
BACKGROUND: In February 2011, an Ohio law took effect mandating use of the United States Food and Drug Administration (FDA)-approved protocol for mifepristone, which is used with misoprostol for medication abortion. Other state legislatures have passed or enacted similar laws requiring use of the FDA-approved protocol for medication abortion. The objective of this study is to examine the association of this legal change with medication abortion outcomes and utilization. METHODS AND FINDINGS: We used a retrospective cohort design, comparing outcomes of medication abortion patients in the prelaw period to those in the postlaw period...
August 2016: PLoS Medicine
Ekaterine Pestvenidze, Nino Berdzuli, Nino Lomia, Tinatin Gagua, Lia Umikashvili, Babill Stray-Pedersen
OBJECTIVE: To examine the multi-faceted characteristics of women with repeat induced abortions and assess post-abortion family planning service provision in Georgia. STUDY DESIGN: We performed secondary analysis of the data from the Georgian Reproductive Health Survey 2010. A logistic regression model was used to assess the socio-demographic and behavioral factors, contraceptive practices in relation to repeat induced abortions for 2203 women of reproductive age with at least one induced abortion...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Melaku Samuel, Tamara Fetters, Demeke Desta
Where unmet need for the safest, most effective, and long-acting reversible contraceptives (LARCs) is very high, the health system and partners need to implement problem-solving, locally feasible, and comprehensive family planning delivery strategies. Because young and unmarried women are most at risk for unintended pregnancy and repeat abortion due to poor access to contraceptive services, postabortion family planning (PAFP) is a key component in such strategies. In Southern Nations, Nationalities, and People's Region, Ethiopia, Ipas implemented health system strengthening efforts from fiscal year (FY) 2010 (July 2009 to June 2010) to FY 2014 (July 2013 to June 2014) to improve the quality of PAFP services and expand method choice in 101 public facilities...
August 11, 2016: Global Health, Science and Practice
Soheila Arefi, Ahmad Hoseini, Fattaneh Farifteh, Hojjat Zeraati
BACKGROUND: Natural endometrium in Frozen-thawed Embryo Transfer (FET) may have some benefits upon implantation in patients with Repeated Implantation Failure (RIF). It might be due to possible differences between natural and stimulated endometrial growth factors and cytokins secretions. OBJECTIVE: The objective of this study was to compare the pregnancy rate of FET on modified natural cycle versus hormone replacement therapy (HRT) cycle endometrium in patients with RIF...
July 2016: International Journal of Reproductive Biomedicine (Yazd, Iran)
Nancy Krieger, Sofia Gruskin, Nakul Singh, Mathew V Kiang, Jarvis T Chen, Pamela D Waterman, Jason Beckfield, Brent A Coull
INTRODUCTION: Little current research examines associations between infant mortality and US states' funding for family planning services and for abortion, despite growing efforts to restrict reproductive rights and services and documented associations between unintended pregnancy and infant mortality. MATERIAL AND METHODS: We obtained publicly available data on state-only public funding for family planning and abortion services (years available: 1980, 1987, 1994, 2001, 2006, and 2010) and corresponding annual data on US county infant death rates...
December 2016: SSM—Population Health
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