(1/49) A randomized double-blind placebo-controlled study to assess the effect of oral contraceptive pills on the outcome of medical abortion with mifepristone and misoprostol.

This was a randomized double-blind placebo-controlled trial to determine the effect of oral contraceptive (OC) pills taken immediately after medical abortion on the duration of bleeding and complete abortion rate. Two hundred women in the first 49 days of pregnancy were given 200 mg mifepristone orally followed by 400 microg misoprostol vaginally 48 h later. One day later, they were randomized to receive either OC pills (30 microg of ethinyl oestradiol and 0.15 mg of levonorgestrel per tablet) or placebo for 21 days. The complete abortion rates were 98% in the OC group and 99% in the placebo group. The median duration of bleeding was similar: 17 (range: 5-57) days in the OC group and 16 (range: 6-55) days in the placebo group. In the OC group there was a small but significant fall in the haemoglobin concentration by 14 days (5.3 g/dl) after administration of mifepristone. The incidence of side-effects was similar in the two groups. We conclude that the use of OC pills does not decrease the duration of bleeding after medical abortion nor does it affect the abortion rate.  (+info)

(2/49) Increased blood vessel density in decidua parietalis is associated with spontaneous human first trimester abortion.

Spontaneous pregnancy loss affects 15-18% of couples, and a number of potential causes are being discussed. The purpose of the present study was to assess if angiogenic disorders in the decidua of early human pregnancy could be related to spontaneous abortions. First trimester human decidua from elective terminations of normally progressing pregnancies and from missed abortions were investigated immunohistochemically. We quantified vessel density in decidua from normal pregnancies and from abortions by von Willebrand factor (vWF), platelet endothelial cell adhesion molecule (PECAM-1) and CD34 staining. Decidual blood vessel expression of alphavbeta3 integrin was also investigated. Significant increase (P < 0.02) in vessel density was observed in decidua parietalis of abortions, compared to decidua basalis. This increase was detected on slides stained for vWF and CD34, but not for PECAM-1. We observed a 15% increase analysing with vWF and a 77% increase with CD34 staining. alphavbeta3 integrin expression was not significantly different, neither in decidua parietalis from abortion, nor parietalis from normal pregnancies. Our data suggest that the increased vascularization in decidua parietalis from abortions could reflect complex disorders, such as specific cytokine expressions and hypoxia phenomena during the development of the decidua.  (+info)

(3/49) Role of decidual natural killer (NK) cells in patients with missed abortion: differences between cases with normal and abnormal chromosome.

In order to study the mechanism of abortion, the proportions of NK cells in the peripheral blood and decidual lymphocytes were evaluated in both chromosomally normal and abnormal missed abortions. In normal pregnancy, CD56+16-3- NK cells are a major element of decidual lymphocytes. The percentages of CD56+16-3-NK cells of peripheral lymphocytes in normal pregnancies were not statistically significantly different from those of chromosomally normal and abnormal abortions. In the decidua, the percentages of CD56+16-3- NK cells of decidual lymphocytes showed no statistically significant differences between normal pregnancies and chromosomally abnormal abortions. However, the percentages of CD56+16-3-NK cells of chromosomally normal abortions were lower than those of chromosomally abnormal (P = 0.0025). Moreover, the percentages of CD56+16- NK cells in abortions with normal chromosomes were lower than those in normal pregnancies or abortions with abnormal chromosomes (P = 0.0037, P = 0.0025). However, when the proportion of CD56+ NK cells expressing CD16 was evaluated, there were no statistically significant differences in the percentages of CD56+16+ NK cells in normal pregnancies and missed abortions with normal chromosomes and abnormal chromosomes. We conclude that the expression of decidual CD56+16-3- NK cells in missed abortions with normal chromosomes is different from abortions with abnormal chromosomes and that this phenomenon may depend on an abnormal immune response of the maternal side.  (+info)

(4/49) Fecal estrone sulfate profile of a sow showing abnormal pregnancy with fetal mummification.

Fecal and plasma E1S of a sow with mummified fetuses, was compared with normal delivery cases. Fecal and plasma fluctuation patterns in E1S were similar. In the sow with fetal mummification both fecal and plasma E1S concentration rapidly decreased after day 80-90 compared to normal farrowing sows. This coincided with the estimated time of fetal death.  (+info)

(5/49) Triploid pregnancy after ICSI of frozen testicular spermatozoa into cryopreserved human oocytes: case report.

Although freezing oocytes is ethically more acceptable than cryopreservation of embryos, variable oocyte survival, fertilization rate and possible risk of increased ploidy after cryopreservation have precluded the widespread clinical application of oocyte cryopreservation in assisted reproduction techniques. We report a triploid pregnancy from intracytoplasmic sperm injection of recombinant FSH-stimulated frozen/thawed testicular spermatozoa into cryopreserved oocytes in a hormone replacement cycle. To our knowledge, this is the first report of a pregnancy where both gametes have been frozen. It illustrates the need for further research when applying new techniques in assisted reproduction.  (+info)

(6/49) A prospective randomized control trial comparing medical and surgical treatment for early pregnancy failure.

A prospective randomized control trial was designed to assess the effectiveness of single dose, 800 microg misoprostol administered p.v. compared with surgical evacuation for the treatment of early pregnancy failure. A total of 80 women with a diagnosis of early pregnancy failure were randomized to study (vaginal misoprostol) and control (surgical curettage) groups. Success of treatment, side-effects as assessed during, immediately after and 10 days after treatment, and patient satisfaction were compared. Intravaginal misoprostol was successful in 82.5% (33 out of 40) of the patients. None of the control group patients required a repeat evacuation. The number of patients who experienced significant abdominal pain following treatment did not differ between the groups. The duration of pain was shorter in the control group; however, they required more analgesics during this short period. The number of patients with significant vaginal bleeding, the duration or severity of bleeding did not show any significant difference between the groups. All 33 patients in the study group who had successful treatment expressed satisfaction, whereas only 58% of the control group did so. In conclusion this randomized control study demonstrated the efficacy and safety of the administration of 800 microg of misoprostol p.v. for the management of early pregnancy failure.  (+info)

(7/49) Abdominal pregnancy presenting as a missed abortion at 16 weeks' gestation.

We report on an abdominal pregnancy that presented as a missed abortion at 16 weeks' gestation and review the literature on the management of abdominal pregnancy. The clinical presentation of abdominal pregnancy varies, and the diagnosis depends on a high index of suspicion. Ultrasonography is useful for early diagnosis of the condition. The management depends on the gestation at presentation; for advanced abdominal pregnancy, surgical intervention is recommended. The treatment of the placenta is a matter of controversy. In general, expectant management is suggested. When the placenta is left behind, the use of prophylactic methrotrexate is not advocated. An awareness of abdominal pregnancy is very important for reducing associated morbidity and mortality.  (+info)

(8/49) The role of ultrasound in the expectant management of early pregnancy loss.

OBJECTIVE: To define the sonographic criteria which best determine the likelihood of successful expectant management of early pregnancy failure (EPF). METHODS: Women with an ultrasound diagnosis of EPF at 7-14 weeks' gestation were offered the option of expectant management or surgical evacuation. RESULTS: Five hundred and forty-five women had a diagnosis of EPF; 298 with incomplete miscarriage and 247 with missed miscarriage or an embryonic pregnancy. A total of 305 women opted for expectant management, with an overall success rate of 86%. The success rate for incomplete miscarriage (96%) was significantly better than that for missed miscarriage (62%). CONCLUSION: This study demonstrates that EPF can be safely managed expectantly. Ultrasound has an invaluable role in predicting the likelihood of successful expectant management enabling patients to make an informed choice about their medical care.  (+info)

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