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Patient-physician race concordant dyads have been shown to improve patient outcomes; the race and ethnicity of family physicians providing women's health procedures has not been described. Using self-reported data, this analysis highlights the racial disparities in scope of practice; underrepresented in medicine (URiM) females are less likely to perform women's health procedures which may lead to disparities in care received by minority women., Competing Interests: Conflict of interest: None., (© Copyright by the American Board of Family Medicine.)

ABSTRACT While it is well established that medical student learning about abortion is inadequate and lacks systemisation, there is little research on why this might be the case. This exploratory study draws on a survey sent to 438 medical educators at Australia's 21 accredited medical schools through March-May 2021. Forty-eight educators responded to the survey. In this article, I examine their responses alongside policy and research on medical education to consider how curricula are determined. I conceptualise abortion exceptionalism - the singling out of abortion from other areas of medicine on the grounds that it is special, different, or more complex or risky than is empirically justified - as a mode of 'stigma-in-action', arguing that medical curricula are powerful sites for its reproduction and undoing.

The article considers problem of infertility in married couples, which has ultimate social-demographic importance and affects interests of the state, society and the family itself. The purpose of the study is to analyze situation with infertility of married couples in Russia and to propose means to resolve mentioned problem. The risk factors in reproductology are to be taken into account both at all stages of growth, development and vital activity of human organism and at selection of married couples. It is noted that maximal prevention of secondary infertility is a task of particular importance that requires implementation of extensive measures of explanatory character and lifestyle improvement. This key direction in health protection strategy is applied to married couples, young people and population as a whole. The study is one of evidences of systematic expansion of therapeutic and preventive possibilities for rehabilitation of disorders of childbearing function. The attitude to problems of reproduction depends on social-demographic situation. The shortage of population growth on national scale requires active measures stimulating childbearing. In Russia, social measures, legislation and demographic policy are targeted to maintaining population growth. The methodical study and timely elimination of inherited defects and acquired abnormal states of genitals and taking into account importance of maintenance of reproductive function, amelioration of conditions of life and labor significantly increase efficiency of rehabilitation measures.

The growing acknowledgment of the phenomenon of individuals terminating their pregnancies by obtaining the medications necessary for an abortion-which this article refers to as "self-sourced medication abortion" (SSMA)-has shed light on the current contradictions in the world of abortion provision. This article offers a brief historical overview of the relationship between abortion provision and mainstream medicine, pointing to the factors that have led to the marginalization of abortion care. It then discusses interviews with 40 physicians who provide abortions about their perspectives on SSMA, and it explores how this group responds to the contradictions presented by SSMA. In doing so, it interrogates the changing meaning of "physician authority" among this subset of physicians. The authors suggest that these interviewees represent an emergent sensibility among this generation of abortion physicians, a sensibility strongly tied to a commitment to social justice., (Copyright © 2023 by Duke University Press.)

Background: Multiple studies have been recorded regarding the perception of abortion among students in the health area., Objective: To know if medical-scientific training is sufficient to generate a change in the perception of first-year students of the National Autonomous University of Mexico Faculty of Medicine., Material and Methods: A cross-sectional survey was applied in two times, with the level of relationship between the items of each dimension being analyzed using Cramer's V test. The results were compared to analyze if there was a change in the perception of abortion after the human embryology course., Results: With an initial population of 2,150 students, 393 pre-course and 394 post-course surveys were conducted. The results indicated that despite the existence of changes in the perception of Faculty of Medicine students with regard to abortion, they are not significant., Conclusions: The medical-scientific training provided by the human embryology course is not enough to provide foundations to the perception of students on issues such as abortion or conscientious objection., (Copyright: © 2023 Permanyer.)

Abstract Pregnancy termination is still a sensitive and continuing public health issue due to several political, economic, religious, and social concerns. This study assesses the applications of machine learning models in the prediction of pregnancy termination using data from eleven national datasets in East Africa. Nine machine learning models, namely: Random Forests (RF), Decision Tree, Logistic Regression, Support Vector Machine, eXtreme Gradient Boosting (XGB), AdaBoost, CatBoost, K-nearest neighbor, and feedforward neural network models were used to predict pregnancy termination, with six evaluation criteria utilized to compare their performance. The pooled prevalence of pregnancy termination in East Africa was found to be 4.56%. All machine learning models had an accuracy of at least 71.8% on average. The RF model provided accuracy, specificity, precision, and AUC of 92.9%, 0.87, 0.91, and 0.93, respectively. The most important variables for predicting pregnancy termination were marital status, age, parity, country of residence, age at first sexual activity, exposure to mass media, and educational attainment. These findings underscore the need for a tailored approach that considers socioeconomic and regional disparities in designing policy initiatives aimed at reducing the rate of pregnancy terminations among younger women in the region.

Abstract Background Different results were found in earlier research on pregnant women with hepatitis B virus infection and past abortions. The current meta-analysis’s objective was to investigate the connection between previous abortion and hepatitis B virus infection in pregnant women. Methods In January 2023, the following databases were searched: PubMed, Google Scholar, Web of Science, and Cochrane Library. A total of 9 articles that were published in English from 2012 to 2022 were included. Egger’s test and the funnel plot’s asymmetry were employed to look for publication bias. JBI critical appraisal checklist for analytical cross-sectional studies and case–control studies were used. Using the random effect model; the combined odds ratio and 95% confidence interval were obtained. Results There were 212 pregnant women with hepatitis B virus infection among the 3582 participants in nine (9) investigations. Comparing pregnant women who had prior abortions to pregnant women who had not had prior abortions, the combined effect size (OR) for hepatitis B virus infection was 3.43 (95% CI 1.66–7.10, p = 0.0009, I2 = 77%). Significant heterogeneity was present (Q = 34.33, I2 = 77%, p 0.00001). There was no evidence of publication bias (Egger’s test: p = 0.495; Begg’s test: p = 0.532). In all, 3582 (17.39%) pregnant women had previously had abortions, and 5.91% of pregnant women had Hepatitis B virus infection. Conclusions Prior abortions elevated a pregnant woman's risk of contracting the hepatitis B virus. However, as a result of this study, we recommend to healthcare professionals to prevent unsafe abortions in order to enhance maternal health by lowering hepatitis B virus infection. Unsafe abortion can be prevented through: good sexuality education; prevention of unintended pregnancy through use of effective contraception, including emergency contraception; and provision of safe, legal abortion. In addition, deaths and disability from unsafe abortion can be reduced through the timely provision of emergency treatment of complications. .

Abstract Background Toxoplasmosis not only leads to abortion in humans but also in herbivores, which causes significant financial and quality-adjusted life-year losses. The present study aimed to determine the prevalence of toxoplasmosis in aborted fetuses via serological and molecular assays. Moreover, the genotypes of the obtained isolates were detected. Methods Serological and molecular methods were used to study aborted fetuses from Bojnourd City, North Khorasan Province, Iran, which included 52 ovines and 16 bovines. Nested PCR of the B1 gene was used to detect parasite DNA in brain tissues. The PCR-RFLP method for the GRA6 gene was used to determine the genotype of T. gondii. Results Out of 68 aborted fetuses, 16.1% showed the presence of anti-T. gondii IgG. Among these, 11.7% were identified in bovine fetuses and 4.4% in ovine fetuses. Additionally, two (2.94%) samples of ovine tested positive for anti-T. gondii IgM. Our PCR analysis detected parasite DNA in two cases (2.94%) among 11 IgG-positive samples. All obtained isolates belong to type I of T. gondii. Conclusion Infection with Type I of T. gondii during the neonatal period may partly be responsible for abortion and economic losses in livestock farming in our studied region. To understand the molecular epidemiology and genotypes of T. gondii associated with abortion, further evaluation of aborted samples from different geographical locations is necessary.

Abstract Numerous traditional practices are both beneficial and harmful. Traditional harmful practices, such as female genital mutilation and traditional cervical cauterization, are carried out for a number of reasons but can have negative health and social effects. In addition to deeply held beliefs, a lack of knowledge and awareness of the consequences of these practices contributes to the persistence of these issues. The objective of this study is to examine whether traditional cervical cauterizations were associated with preterm births in Somalia. This prospective cohort study was conducted at our hospital over a one-year period. Seven hundred and two patients were included in this study; these patients were divided into two groups, cauterized and non-cauterized groups, and the two groups were compared on pregnancy outcomes. We examined whether traditional cervical cauterizations were associated with adverse pregnancy outcomes, including preterm births. According to the findings of this study, traditional cervical cauterization was prevalent among patients visiting MSTREH (n = 328, 46.7%). Infections of the uterine cervix and infertility were the two main indications for cauterization, 44.8%, and 34.8%, respectively.Being older, uneducated, and poverty were significantly associated with traditional cauterization (P

Context: Aims: This study aims to compare the effectiveness, induction to abortion interval, blood loss, and side effect profile between administration of intraamniotic prostaglandin F2 alpha (PGF2α) with a combination of mifepristone and misoprostol for medical termination of pregnancy in mid-trimester. Prospective observational study. Subjects and Methods: The study was conducted by dividing the women with indicated mid-trimester abortions into two groups of 20 women each. Group-I received Tablet Mifepristone 200 mg orally on day 1 and then after 48 h, Tablet Misoprostol 400 μg given per vaginally every 4 h till abortion was completed or a maximum of 5 doses whichever was earlier. Group-II received a single injection of PGF2α (250 μg) intra-amniotically under ultrasonography guidance. Group comparisons were made using t-test/Mann–Whitney U-test for normally/nonnormally distributed continuous data, respectively, and Chi-square test for categorical variables. SPSS version 23 was used for analysis. P < 0.05 was taken as the cut-off for statistical significance. Results: The success rate was 100% in both the groups. There was a significant difference in the mean induction to abortion interval between Group-I, the mean being 12.92 ± 2.68 h compared to Group-II being 33.08 ± 6.35 h (P < 0.001). Group-I had a mean blood loss of 221 ± 55.15 mL, significantly more than Group-II 160 ± 25.13 mL (P < 0.001). Twenty-five percent of the Group-I woman had retained products of conception with none in Group-II (P = 0.029). The pain score was better in Group II (pain score 4.4 vs. 5.7, P < 0.001). Fewer women developed chills in Group II compared to Group I (0% vs. 50%, P < 0.001). Conclusions: PGF2α is equally effective as a combination of Mifepristone and Misoprostol in mid-trimester abortion. Although it has a longer induction to abortion interval, it appears to be better with respect to the completeness of evacuation, lesser blood loss, and better patient tolerance.

Introduction: Unintended pregnancies constitute one of the major public health problems of important concern in Nigeria, where sex refusal in marriage might be impossible. This descriptive, household-based study, investigated the prevalence and predictors of unintended pregnancy in the past two years among married women aged 35-49 years in Ibadan, South West, Nigeria. Methods: A three-stage sampling technique was used to recruit 425 respondents across three local government areas. Data were collected and analyzed using a structured interviewer-administered questionnaire. The dependent variable, “Unintended pregnancy,” was defined as an unplanned, unwanted, or mistimed pregnancy. Data were summarized using descriptive statistics. Bivariate chi-square tests were used to determine the factors associated with unintended pregnancy, while binary logistic regression was used to determine the predictors of unintended pregnancy (α0.05). Results: The mean age of the women was 41.1 ± 4.2 years, 149 (35.1%) had high autonomy, while 233 (54.8%) had medium autonomy. Further, 177 (41.6%) were poor, while 106 (25.0%) were rich. In all, 108 (25.4%) women have had an unintended pregnancy. Women with low autonomy (AOR=3.41, 95%C.I.=1.70-6.82, p=0.001) and medium autonomy (AOR=2.41, C.I.=1.29-4.49, p=0.006) had higher odds of unintended pregnancy. The likelihood of unintended pregnancy was higher among women living in poor households (AOR=2.04, 95%C.I.=1.13-3.68, p=0.017). Conclusions: The level of unintended pregnancy was high among older women of reproductive age in Ibadan. Social interventions that focus on empowerment of such women should be undertaken by governmental agencies, non-governmental agencies, and community-based organizations to increase women’s autonomy and reduce unintended pregnancy among them.

Background: Ovine enzootic abortion (OEA) caused by Chlamyidia abortus is one of the most important abortive disease in small ruminants. Diagnosis of Ovine enzootic abortion depends on the isolation and detection of the agent or its nucleic acid. The aim of the present study was to detect Chlamydia abortus using both isolation method and real-time PCR in Brucella free flocks in Iran. Methods: Twenty-eight vaginal and conjunctival swab samples which were Chlamydia abortus seropositive, were selected from ewes and does with recent abortion. Then the samples were tested by real-time PCR and positive molecular samples were inoculated into McCoy cells. Results: Using real-time PCR, 18 samples (64.3%) were positive and 7 (25%) of them were isolated in cell culture. Conclusion: The present results indicate that Chlamydia can play a relatively significant role in the abortion in does and ewes in Iran. Although the isolation of Chlamydia abortus have 100% specificity, because of low sensitivity, time consuming, cost and high probability of contamination, it is not suitable for routine laboratory diagnosis. Therefore, applying real-time PCR which have high sensitivity and specificity is recommended.

Background: There are few reliable Iranian-induced abortion data. The aim of this paper was to investigate the prevalence and socioeconomic characteristics of women and men who report having had or been a partner in an abortion. Materials and Methods: A cross-sectional survey of women and men aged 15–49 years referred to the health center that randomly selected from 110 health center that was used. Results: Data from 1520 women and men surveys were analyzed. One in 10 women and one in 12 men had experienced or been a partner in an abortion. In adjusted analyses, women and men in the 34–49 age group [adjusted odds ratio (AOR) 0.62, 95% (CI) 0.41, 0.96], the importance of religion in fertility (AOR = 0.42; 95% CI 0.26, 0.67), dissatisfied general health (AOR = 0.52; 95% CI 0.32, 0.87), and history of unwanted pregnancy for twice (AOR = 2.32; 95% CI 1.43, 3.77) and history of unwanted pregnancy for three-time or more (AOR = 2.69; 95% CI 1.59, 5.49) were associated with significantly increased odds of abortion. Haven’t heard of medication abortion, that is, abortion with tablets (AOR = 0.43; 95% CI 0.29, 0.67) was associated with significantly reduced odds of abortion. Conclusions: The findings contribute to scarce information about abortion in Iranian. Due to the high prevalence of abortion and the country’s population growth policy, Iranian women need a full range of sexual and reproductive health services, including contraceptive counseling and accessible abortion care.

This research addresses the intricate dimensions of reproductive healthcare by examining the complex interplay of medical, legal, and ethical considerations surrounding abortion. The Choice on Termination of Pregnancy Act (CTOP) of 1996 in South Africa aims to establish the circumstances and conditions under which a woman’s pregnancy may be terminated and addresses related matters. The Act specified that, for terminations during 0–12 weeks, safe medical procedures, primarily medication abortion, are predominant. In contrast, terminations during 13–20 weeks present additional complexities, requiring a combination of medical and surgical interventions.

Abstract This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate placement of intrauterine devices (IUDs) versus delayed placement after artificial abortion. PubMed, Embase, Cochrane, Web of Science, CNKI, and Wanfang databases were comprehensively searched up to January 12, 2024 for studies that compared immediate versus delayed insertion of IUDs after abortion. The evaluation metrics included the number of IUD insertion after surgical or medical abortions, the frequency of expulsion and removal at 6 months or 1 year, the number of continued usage, pain intensity scores, the number of infections, the duration of bleeding, and instances of uterine perforation during or after IUD insertion. Ten randomized controlled articles were eligible, comprising 11 research projects, of which 3 projects involved the placement of an IUD after surgical abortion, and 8 projects involved the placement of an IUD after medical abortion. This included 2025 patients (977 in the immediate insertion group and 1,048 in the delayed insertion group). We summarized all the extracted evidence. The meta-analysis results indicated that for post-surgical abortions, the immediate insertion group exhibited a higher IUD placement rate than the delayed insertion group. After medical abortions, the immediate insertion group showed higher rates of IUD placement, utilization, and expulsion at 6 months or 1 year. The two groups showed no statistically significant differences in the removal rate, post-insertion infection rate, pain scores during insertion, and days of bleeding during the follow-up period. Compared to delayed placement, immediate insertion of IUDs can not only increase the usage rate at 6 months or 1 year but also enhance the placement rate.

Introduction: Single Umbilical Artery (SUA) is a congenital anomaly that can occur either as an isolated finding or in association with other systemic anomalies. Several studies have reported that SUA is linked to dysplastic kidneys, ventricular septal defects, oesophageal atresia, spina bifida, diaphragmatic hernia and cystic hygromas. Therefore, investigating cases of SUA in autopsies is crucial. Aim: To estimate the frequency of SUA in foetal autopsies and determine the association between SUA and other systemic anomalies. Materials and Methods: The present ambispective observational study was conducted in the Department of Pathology, Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India, over a 13 year period from January 2009 to December 2021. A total of 63 cases of SUA detected during foetal autopsies were included. Factors such as age, parity and multiple births were collected where available. The hospital-based frequency of SUA was calculated as a percentage. The association between SUA and systemic anomalies was assessed using the Chi-square test. Results: A total of 1338 perinatal autopsies were performed during the study period, with SUA present in 63 (4.70%) cases. The most common associated anomaly was genitourinary defects identified in 16 (25.39%) cases. However, a statistically significant association was observed with musculoskeletal (11.11%), nervous (11.11%), and gastrointestinal system anomalies (19.04%) with a p-value of

Abstract Background Medical curricula include advocacy competencies, but how much physicians engage in advocacy and what enables this engagement is not well characterized. The authors assessed facilitators and barriers to advocacy identified by physician alumni of a reproductive health advocacy training program. Methods The authors present secondary results from a mixed methods program evaluation from 2018 to 2020, using alumni data from a cross-sectional survey (n = 231) and in-depth interviews (IDIs, n = 36). The survey measured engagement in policy, media, professional organization, and medical education advocacy and the value placed on the community fostered by the program (eight questions, Cronbach’s alpha = 0.81). The authors estimated the association of community value score with advocacy engagement using multivariable Poisson regression to estimate prevalence ratios and analyzed IDI data inductively. Results Over one third of alumni were highly engaged in legislative policy (n = 90, 39%), professional organizations (n = 98, 42%), or medical education (n = 89, 39%), with fewer highly active in media-based advocacy (n = 54, 23%) in the year prior to the survey. Survey and IDI data demonstrated that passion, sense of urgency, confidence in skills, and the program’s emphasis on different forms of advocacy facilitated engagement in advocacy, while insufficient time, safety concerns, and sense of effort redundancies were barriers. The program community was also an important facilitator, especially for “out loud” efforts and for those working in environments perceived as hostile to abortion care (e.g., alumni in hostile environments with high community value scores were 1.8 times [95% CI 1.3, 2.6] as likely to report medium/high levels of media advocacy compared to those with low scores after adjusting for age, gender, and clinical specialty). Conclusion Physician advocacy training curricula should include both skills- and community-building and identify a full range of forms of advocacy. Community-building is especially important for physician advocacy for reproductive health services such as abortion care.

Abstract Background and Aims One of the causes of preterm labor and recurrent abortion is progesterone deficiency in the luteal phase. The aim of the study was a comparison of the effect of oral dydrogesterone and vaginal progesterone for luteal‐phase support (LPS) in assisted reproductive technology cycles (ART). Methods This randomized clinical control trial study was conducted on 207 infertile women. Samples were randomly divided into two groups. The first group received a natural micronized vaginal progesterone (MVP) of 400 mg once daily and the second group received dydrogesterone (Duphestone) 20 mg twice daily. Then chemical pregnancy, abortion, and live births were compared in two groups. Results The results of the study showed that the vaginal form of the drug could increase the chance of pregnancy (positive β‐human chorionic gonadotropin) versus the oral form. According to the results of multiple logistic regression analysis after adjusting for other variables, the live birth rate in the vaginal group was more than five times that of the oral group (odds ratio = 5.07; 95% confidence interval = 1.24–20.65; p = 0.023). Conclusion The vaginal form of the progesterone could increase the chance of pregnancy and the outcome of fertility (live birth). Thus, vaginal progesterone is effective for LPS in women undergoing fresh embryo transfer.

Introduction: The World Health Organization has suggested preconception care to improve pregnancy outcomes. Hence, the study aimed to compare the effect of preconception care on pregnancy outcomes, particularly prematurity and low birth weight. Methods: We carried out interventions in one tribal and one non-tribal block. For comparison, one adjacent tribal block and one non-tribal block were included in Nashik district, India. The total study period was from April 2018 to July 2021. All reproductive age group women desiring pregnancy within one year in selected four blocks participated in the study. The services included clinical examination, laboratory investigations, treatment, six-monthly deworming, anemia management, folic acid supplementation, family planning services, and behavioral change communication using different media. The existing healthcare workers provided services to the women until they became pregnant or until the end of the follow-up period (27 months). We monitored pregnancy outcomes, including abortion, stillbirth, and live birth; among live births, low birth weight, preterm birth, congenital physical anomaly, and neonatal death. Results: The study enrolled 7,875 women, and 3,601 had outcomes. The proportion of preterm births in the intervention and comparison block was 11.18 % and 14.99 %, respectively (p = 0.001), and the proportion of low-birth-weight babies was 9.23 % and 11.25 %, respectively (p = 0.01). The adjusted prevalence ratio showed that the risk of preterm births in the absence of intervention was 1.3 (CI: 1.1–1.6). Preterm birth was a mediator between preconception care and low birth weight. Conclusion: Reduction in proportion of low birth weight and preterm babies can be achieved through preconception care using minimal additional resources.

Uterine perforation is a major but rare complication of surgical abortion, with some of the dreaded complications being bowel herniation, strangulation, gangrene, and sepsis. With the legalisation of medical termination of pregnancy, such life-threatening complications have become a rarity in recent times. Usually, the patient presents with lower abdominal pain, and a history of surgical abortion may not being forthcoming at most of the time. A high index of suspicion should be kept while imaging the patient in an emergency setting, since early diagnosis is key to survival, especially if an unsafe abortion has been performed. Hereby, the authors present a case of a 30-year-old female patient presenting with non specific complaints of abdominal pain. Upon vaginal examination, a structure protruding out of the internal os (admitting the tip of a finger) was noted, and a boggy mass was felt in the pouch of Douglas. Ultrasonography and Contrast-enhanced Computed Tomography scan (CECT) performed in an emergency setting revealed uterine rupture with a rent, intra-abdominal foetal extrusion, and bowel loop herniation through the vagina. A delayed CT scan provided additional information about right ureteral injury, which was helpful in proper urological preoperative planning. In conclusion, ultrasonography and CECT imaging are useful in cases with lower abdominal pain having recent history of abortion to rule out uterine perforation and other obvious and occult associated complications for proper patient management.

Abstract Contraception and abortion topics are variably, but often poorly, addressed in medical school curricula. Restrictions on contraceptive and abortion care at faith-based hospitals may hinder comprehensive family planning training for medical students during Ob/Gyn clerkships. Here we investigated whether medical students at faith-based and non-faith-based clerkships experienced different observations during their Ob/Gyn clerkship and/or differences in self-perceived competency in patient counseling, objective knowledge, and perceived adequacy of training in contraception and abortion topics post-clerkship. A survey was distributed to third- and fourth-year medical students at New York Institute of Technology, College of Osteopathic Medicine. Across all clerkship sites (n = 102 students), observations of, and competency in, contraceptive care was higher than in abortion care. Students at non-faith-based clerkship sites (n = 54) reported the highest levels of observation of contraceptive and abortion care (19.6–90.7%), while those at Catholic sites (n = 26) typically reported the lowest (7.7–34.6%). Students at non-faith-based sites reported significantly higher competency in contraceptive care and some aspects of abortion care, than those at Catholic, and some other faith-based sites (n = 48). Clerkship training at faith-based sites, specifically Catholic sites, resulted in poorer Ob/Gyn training, particularly in contraceptive care. Training outcomes in abortion care were poor at all Ob/Gyn clerkship sites.

Mycoplasma spp. has been involved in canine infertility, but research on this topic is limited and shows conflicting results, as it has also been isolated from vaginal swabs of healthy dogs. This study aimed to retrospectively research Mycoplasma DNA by a conventional dual Polymerase Chain Reaction from 114 cases of canine abortion, stillbirth, and neonatal mortality that occurred in Central Italy. In addition, four fetal membranes from dystocic dams were analyzed. In total, 7 out of 114 cases (6.14%) and one of the fetal membranes tested positive for Mycoplasma DNA. From five of them (62.5%), other microorganisms were identified, particularly Canid herpesvirus-1 (2/8, 25%) and Escherichia coli, Staphylococcus aureus, and/or Staphylococcus pseudintermedius (3/8, 37.5%), notoriously responsible for infertility in bitches or neonatal mortality. In two different litters, only one puppy of each one tested positive for Mycoplasma DNA. Additionally, Mycoplasma DNA was detected in fetal membranes collected during a cesarean section of a bitch whelping Mycoplasma-negative puppies, supporting that Mycoplasma spp. is part of the normal genital microflora of the female. The detection of Mycoplasma DNA in association with other major pathogens and its detection in the female genital tract without transmission to puppies support the hypothesis that Mycoplasma belongs to the autochthonous genital microflora or, at most, may play a secondary role in canine abortion and neonatal mortality.

Background: Spontaneous abortions occur in 12.5% of pregnancies and have a significant impact on the well-being of women. Dissatisfaction with health services is well-documented, but no studies have been conducted in district health services of the Western Cape. The aim was to explore the lived experiences of women presenting with spontaneous abortions to the emergency department at Helderberg Hospital. Methods: A descriptive phenomenological qualitative study used criterion-based purposive sampling to identify suitable participants. Data were collected through semi-structured individual interviews. Atlas-ti (version 22) software assisted with data analysis using the framework method. Results: A total of nine participants were interviewed. There were four main themes: a supportive environment, staff attitudes and behaviour, the impact of time, and sharing of information. The comfort, cleanliness and privacy of the environment were important. COVID-19 had also impacted on this. Showing interest, demonstrating empathy and being nonjudgemental were important, as well as the waiting time for definitive treatment and the time needed to assimilate and accept the diagnosis. In addition, the ability to give relevant information, explain the diagnosis and help patients share in decision-making were key issues. Conclusion: This study highlighted the need for a more person-centred approach and managers should focus on changes to organisational culture through training and clinical governance activities. Attention should be paid to the physical environment, availability of patient information materials and sequential coordination of care with primary care services. Contribution: This study identifies issues that can improve person-centredness and women’s satisfaction with care for spontaneous abortion.

Background: Preterm labor and abortion, often influenced by cervical-vaginal infections (CVIs), remain pressing reproductive health challenges. This study explores the interplay between socio-demographic factors, emerging pathogens like Mycoplasma genitalium, and their combined implications for these adverse pregnancy outcomes. Methods and Results: The study utilized a retrospective approach based on sonographic databases, laboratory data, and clinical records of patients monitored at the Bylykbashi clinic and subsequently at the University Hospital of Obstetrics and Gynecology ‘Mbreteresha Geraldine’, Tirana. Data were analyzed from 2016 to 2020, involving a cohort of 1,738 pregnancies. The final group consisted of 1,482 pregnancies. These pregnancies were tracked from the time of pregnancy diagnosis until its conclusion. Vaginal secretion examinations were rigorously conducted using direct microscopy, cultures, and the A.F. GENITAL SYSTEM kit to diagnose Ureaplasma-Mycoplasma (UM) presence, with a focus on its association with abortions and preterm births. Our study of 1,482 participants showed that 47.2% resided in urban areas, while 52.8% were from rural settings. Most participants fall within the 26-30 (29.6%) and 31-35 (28.1%) age groups. Regarding parity, 28.8% were primigravida, and 63% have had 12 years or less of formal education. The data showed that a significant portion (82.1%) of participants had their first sexual intercourse after the age of 18. The occurrence of urinary tract infections during pregnancy was reported by 32% of the women. UM-positive cases constituted 51.5% of the respondents. Group B Streptococcus and Candida albicans were detected in 28.5% and 47.0% of the respondents, respectively. Multivariate analyses identified younger age, early sexual debut, and primigravida status as notable risk factors for preterm births and abortions. Conclusion: The correlation between sociodemographic factors and CVIs takes on significant importance in predicting maternal health outcomes, especially concerning preterm births and abortions. The heightened risk among younger individuals, those with early sexual debut, and those undergoing early onset of menarche underscores the profound influence of age and life experiences on cervical-vaginal health. Our findings related to CVIs emphasize the critical need for early detection, increased awareness, and prompt treatment.

Background: Thyroid disorders are the most common cause of endocrine dysfunction among women of childbearing age. It is well-established that hypothyroid dysfunction can have significant adverse effects on pregnancy and fetal development. This study aimed to determine the prevalence of thyroid disorders among antenatal women and assess the maternal and fetal outcomes in pregnant women with hypothyroid disorders. Methods: This prospective study was conducted in the antenatal clinic of the Department of Obstetrics and Gynaecology in association with the Biochemistry Department. After obtaining written informed consent, antenatal women aged 18-40 years were included in this study, regardless of their gestational period. Venous blood samples were collected from the antecubital vein, and thyrotropin, free triiodothyronine (free T3), and free thyroxine (free T4) levels were measured. Hypothyroid antenatal women were monitored throughout their pregnancies to evaluate maternal and fetal outcomes. Results: Among the participants in this study, 149 antenatal women had thyroid disorders, with a prevalence rate of 12.6%. Subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism were observed in 6.9%, 3.2%, 1.8%, and 0.7% of cases, respectively. Maternal complications included oligohydramnios (5.8%), preeclampsia (13.3%), and preterm delivery (5%), while fetal complications included low birth weight (20.8%), hyperbilirubinemia (9.1%), and neonatal intensive care unit (NICU) admissions (13.3%). Conclusion: A high prevalence (12.6%) of thyroid disorders, particularly hypothyroidism (10.1%), among pregnant women, emphasizing the importance of routine thyroid testing for all antenatal individuals.

Background: Uterine natural killer (uNK) cells have a significant impact on pregnancy and related complications. Given the importance of receptors in the activity of uNK cells, the present study aimed to determine the number of uNK cells and NKp46 (one of the most important NK cell-activating receptors) expression in the endometrium of women with recurrent miscarriage (RM) or a history of in vitro fertilization (IVF) failure. Materials and Methods: This case-control study was performed on 48 participants, including 16 healthy controls, 27 cases with RM, and 5 cases with repeated implantation failure (RIF) during the mid-luteal phase according to a standardized diagnostic protocol. All participants were assessed using transvaginal ultrasound to determine embryo survival rate and confirm gestational age. Endometrial specimens were collected and subjected to immunohistochemistry (IHC) staining using an anti-human NKp46 antibody expressed by uNK cells. Results: A significantly higher number of cells positive for NKp46 was obtained among two groups of cases versus healthy subjects (patients: 1.46±0.78, controls: 0.82±62, P=0.006), and the number of CD56+cells was significantly higher in patients than in controls (patients: 18.14±7.14, controls: 11.71±6.17, P=0.003). Additionally, there was not a significant difference in the frequency ratio of NKp46+NK cell subset to CD56+uNK cells between the patients (P=0.59) and control healthy group. Conclusion: The increase in the number of uterine NK cells and their cytotoxic activity during implantation and early pregnancy, possibly resulting from an excessive expression of inflammatory cytokines, confirms a significant association between uNK cell activity and a higher risk of RM and RIF. Therefore, immunomodulatory treatments may benefit these patients.

Background: This study aimed to investigate the relationship between plasma fluoride and hemoglobin levels, glutathione peroxidase (GPx) activity, and abortion among rural and urban pregnant women from Settat province (Morocco). Methods: Blood samples were collected from rural pregnant women who had not undergone abortion (N = 224), rural pregnant women who had an abortion (N = 38), urban pregnant women who had not undergone abortion (N = 163), and urban pregnant women who had an abortion (N = 14). Results: The highest (p < 0.01) plasma fluoride levels and the lowest (p < 0.01) GPx activity were observed in rural pregnant women. In all participants, plasma fluoride levels were significantly higher (p < 0.001), and the GPx activity was significantly (p < 0.001) lower in pregnant women who had an abortion compared with those who did not undergo such process. No significant difference was observed between the hemoglobin levels of all participants. Furthermore, abortion was positively correlated with plasma fluoride levels (p < 0.001) and negatively correlated with GPx activity (p < 0.001) in rural participants. Conclusions: Rural pregnant women had higher plasma fluoride levels and lower GPx activity, which correlated with the increased abortion risk and oxidative stress.

Abortion has existed throughout history, often outside of formal health care systems. This type of care, now called self‐managed abortion, has historically been achieved in part through botanicals and traditional medicines. Their use continues into the modern day, especially in Asia, Hawai'i, and other Pacific Islands, where indigenous medicine traditions practice alongside allopathic medicine. Many of these botanicals, such as papaya leaves, hibiscus flowers, and young kī, and traditional medicines, such as tianhuafen, yuanhua, and Shenghua Decoction, have undergone scientific and clinical investigation of their potential abortifacient and antifertility action. The incidence of self‐managed abortion with such abortifacients in countries with severe abortion restrictions are only estimates, leading to the possibility that legal rulings and societal pressures may cause underreporting. The Asian American, Native Hawaiian, and Pacific Islander communities in the United States also suffer from a lack of abortion access in addition to unique health disparities and barriers to reproductive health care. As difficulties in abortion access increases due to the Supreme Court decision in Dobbs v. Jackson Women's Health Organization, some may seek or even prefer self‐managed abortion through traditional methods that have been passed down in their communities. Midwives and other health care providers may then be contacted during this process. This narrative review provides an overview of the literature on the use of botanicals, herbs, and traditional medicines used for self‐managed abortion, specifically in Asia, Hawai‧i, and other Pacific Islands. Their implications for practice for providers in the United States and further opportunities for research are also presented. [ABSTRACT FROM AUTHOR]

Abstract Gene expression and posttranscriptional regulation can be strongly influenced by epigenetic modifications. N6-methyladenosine, the most extensive RNA modification, has been revealed to participate in many human diseases. Recently, the role of RNA epigenetic modifications in the pathophysiological mechanism of female reproductive diseases has been intensively studied. RNA m6A modification is involved in oogenesis, embryonic growth, and foetal development, as well as preeclampsia, miscarriage, endometriosis and adenomyosis, polycystic ovary syndrome, premature ovarian failure, and common gynaecological tumours such as cervical cancer, endometrial cancer, and ovarian cancer. In this review, we provide a summary of the research results of m6A on the female reproductive biology and pathophysiology in recent years and aim to discuss future research directions and clinical applications of m6A-related targets. Hopefully, this review will add to our understanding of the cellular mechanisms, diagnostic biomarkers, and underlying therapeutic strategies of female reproductive system diseases. Video Abstract

Abstract Background Wernicke–Korsakoff syndrome is a neuropsychiatric disorder caused by thiamine deficiency composed of two related disorders accounting for an acute presentation and chronic progression. Hyperemesis gravidarum presents a significant risk factor for Wernicke–Korsakoff syndrome as symptoms may rapidly progress in the setting of pregnancy. We present the first-reported case of hyperemesis-gravidarum-associated Wernicke encephalopathy in a patient in the first half of pregnancy in which a missed diagnosis led to septic shock, fetal demise, and eventual profound Korsakoff syndrome. Case presentation We present the case of a 33-year-old primigravid African American woman at 15 weeks gestational age who initially presented at a community emergency department with nausea and vomiting that ultimately progressed to severe hyperemesis-gravidarum-associated Wernicke–Korsakoff syndrome, fetal demise, and septic shock. The patient received a total of 6 weeks of high-dose parenteral thiamine. Magnetic resonance imaging of the head and formal neuropsychological assessment following treatment plateau confirmed the diagnosis of Wernicke–Korsakoff syndrome. Conclusions The multisystem complications seen in severe thiamine deficiency can delay timely administration of high-dose thiamine, particularly in pregnancy, in which the classic triad of Wernicke–Korsakoff syndrome may not raise clinical suspicion due to rapid progression of neurological sequelae in this population. We advise a low threshold for parenteral thiamine repletion in pregnant women with persistent vomiting as hyperemesis gravidarum-induced severe thiamine deficiency can result in Wernicke–Korsakoff syndrome, sepsis, and fetal demise.

Introduction: Retained products of conception are a frequent outpatient dilemma faced by gynecologists.Blind dilatation and curettage can lead to endometritis, perforations and hemorrhage.We aimed to study the correlation of transvaginal sonography (TVS) and hysteroscopy in the detection of retained products of conception (RPOC) immediately after dilatation and suction evacuation (S and E) in first-trimester abortion. Materials and Methods: This was a prospective observational study conducted at the gynecology department in a university-affiliated hospital. All women with a diagnosis of intrauterine RPOC by TVS showing a heterogeneous intrauterine sac of more than 15 mm thickness, without endometritis, treated with S and E for RPOC, who also underwent subsequent hysteroscopy and TVS ,were enrolled in the study. Results: Since no literature is available comparing these two modalities directly, 50 cases as a pilot study were studied. TVS findings of RPOC with endometrial thickness >15 mm and hyperechoic area or area of mixed echogenicity along with hysteroscopy findings of RPOC were tabulated and correlated. The strength of agreement between TVS and hysteroscopy was determined. In our study, 28% of the participants who had S and E done for first-trimester abortion had RPOC on TVS. The sensitivity and specificity of RPOC on TVS were 69.2% and 86.5%, respectively, with a positive predictive value of 64.3%. Twenty-six percent of the participants had RPOC on hysteroscopy who later underwent re-evacuation procedure using operative hysteroscopy. Conclusion: Hysteroscopy is the gold standard for removal of RPOC. A combination of TVS and hysteroscopy for detection of RPOC would lower rates of complications and postoperative intrauterine adhesions.

Background: Abortion is one of the leading causes of morbidity and mortality amongst Nigerian women in a country with restrictive abortion laws. Despite being illegal, abortions are still performed, and about 50% of abortions are performed by untrained persons in unhygienic conditions. This study assessed the determinants of attitude of undergraduates to legalisation of safe abortion in Nigeria. Methods: It is a descriptive cross-sectional study. We used a three-stage sampling technique to select 423 undergraduates using a pre-tested questionnaire. The predictors of attitude towards abortion and its legalisation were identified during multivariate analysis. Results: Good knowledge of abortion and its sequelae was found in about two-thirds (62.2%) of the participants, while over half (56.3%) had a negative perspective to abortion legalisation in Nigeria. Older participants were more likely to have positive perspectives to legalisation of abortion compared to their younger counterparts (odds ratio [OR] = 4.72, confidence interval [CI]: 2.61–8.55). Furthermore, respondents from upper social class and those with good knowledge were more likely to have positive perspectives to legalisation of abortion compared to their counterparts (OR = 5.63, CI: 3.12–10.16 and OR = 4.50, CI: 2.89–7.01). Conclusion: The study showed that respondents' knowledge of abortion was relatively low amongst the study population, and more than half of the respondents did not want abortion to be legalised. Increasing awareness on the importance of abortion and its complications in Nigeria will curb the menace of death due to abortion now and in the future.

Background: Missed Abortion is non-viable intrauterine pregnancy with either an empty gestational sac or a gestational sac contains an embryo without fetal heart activity. Objectives: The aim of this study was to compare effect of misoprostol with clomiphene citrate, misoprostol with letrozole and misoprostol alone in terminating first trimester missed abortion. Patients and methods: This randomized clinical trial was included patients with missed abortion attending to our outpatient clinic at South Valley University Hospital, Department of Obstetrics and Gynecology. Fifteen patients were excluded during the follow-up period; hence, 37 patients per group were included in the final analysis. They divided into three groups: Interventional group (A): received 5mg letrozole ; Group (B): received 100 mg clomiphene citrate and Group (C): Control group received calcium carbonate . Then all patients received two doses of 800 microgram misoprostol orally. Results: As regard outcome among the three studied groups. The results showed that 21.6% cases in group (A) showed failure in management with six cases needed surgical evacuation and two cases completed treatment on misoprostol, 32.4% cases in group(B) showed failure in management with ten cases needed surgical evacuation and two cases completed treatment on misoprostol and 37.8% cases in group(C) showed failure in management with ten cases needed surgical evacuation and four cases completed treatment on misoprostol. Conclusion: Letrozole pre-treatment with misoprostol increases efficacy of misoprostol in induction of complete abortion of non-viable first trimester pregnancy with no evident side effects.

Abstract In July 2022, the United States Supreme Court issued a decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, the Supreme Court decision that legalized access to abortion in the United States. The overturning of Roe v. Wade means women’s ability to choose to have an abortion or continue a pregnancy is no longer protected by the constitution of the Unites States (Rohan, Editorial: Overturning Roe v. Wade: What are the implications for perinatal nurses?, 2021). Consequently, each state can now independently decide the legality of abortion. The purpose of this commentary is to discuss potential consequences of the overturning of Roe v. Wade for women’s health, particularly midlife women’s health, in the United States. The consequences discussed include unintended pregnancy, access to the full array of reproductive health services including abortion, impact on the reproductive health of poor women and women of color, and the impact on midlife women in their caregiving roles.

The only genus of the Francisellaceae family known to contain species pathogenic to mammals is Francisella, for which reported cases in the Southern Hemisphere have been limited to Australia. We describe severe necrotizing and inflammatory lesions and intralesional immunohistochemical identification of Francisella sp. lipopolysaccharide among aborted ovine fetuses in Uruguay.

The Roe v. Wade case, which legally supported abortion in the U.S., was overturned in 2022, and the international conversation about reproductive justice gained momentum as a result. Reproductive justice is a concept that advocates reproductive freedom (the freedom to have/not have children and the freedom to raise children in a healthy environment) for all couples and individuals. This paper introduces the family care relationship in reproductive justice and presents a concept of reproductive justice. By incorporating family care relationships in the concept of reproduction, the complexity and uniqueness of the reproductive choice process are preserved. Family care relationships are well suited for focusing on family-centered societies and the processes leading to abortion care, and autonomous decision-making in reproductive choice can be strengthened. It is important to explore appropriate support methods from the dynamism of the caring network, advocate for positive freedom, and settle the decision-making power in a moderated position, even with some abandonment of individualism.

Background: In Ethiopia only 53% of induced abortions were performed in a health facility. Even though efforts have been made to improve comprehensive abortion care (CAC), still several health facilities fail to provide the services. Even in facilities where such care is provided, significant numbers of clients report their dissatisfaction with the service. Hence, this study sought to assess availability and readiness to meet the need for CAC, client satisfaction with the service and associated factors in public health facilities of East Shawa Zone, from March 1 to July 31, 2020. Method: Cross-sectional study was conducted taking a random sample of 30 health facilities and 900 women who received CAC and providers who delivered the services. Data were collected using interviewer-administered questionnaire and observational checklist. The analysis was performed using Stata-13. Descriptive summaries were used to characterize study participants, to determine service availability and readiness of facilities. The levels of satisfaction were estimated using proportion with a 95% confidence interval (CI). Multilevel ordinal logistic regression analysis was performed to identify factors associated with service satisfaction. The magnitude of association was estimated by adjusted odds ratios (AOR) with a 95% CI, and a p-value < 0.05 was used to declare statistical significance. Results: The study found that all health facilities fulfilled at least three-fourth (75%) of the requirements that ensure CAC services availability. However, the percentage of facilities that fulfilled at least three-fourth of equipment was 60%; medicines, 56.7%; and basic amenities, 46.7%. Overall, 19.3% of women (95% CI 16.9%, 22.0%) reported very high level of satisfaction with CAC services. The levels of Satisfaction with the services were associated with being treated with second trimester abortion (AOR) = 2.07; 95% CI 1.03, 4.15) and having good procedure outcome (AOR = 2.09; 95% CI 1.09, 4.15), being treated by younger service provider, less than 35 year old (AOR = 8.58; 95% CI 3.66, 20.12), by a nurse (AOR = 2.96; 95% CI 1.49, 5.87), provider with three to five years of experience (AOR = 0.46; 95% CI 0.23, 0.92) and with the availability of essential medicines (AOR = 4.34; 95% CI 1.06, 18.20). Conclusions: The availability of essential medicines was below the standards set by World Health Organization. The levels of satisfaction with CAC is comparably lower than other studies findings and affected by the availability of essential medicines, procedure outcome, and gestational age of terminated pregnancy, the health care provider's age, profession and years of experience. Plain English summary: In Ethiopia only 53% of induced abortions were performed in a health facility. Even though efforts have been made to improve Comprehensive Abortion Care (CAC), still several health facilities fail to provide the services. Even in facilities where such care is provided, large proportions of clients report their dissatisfaction with the service. Hence, the study sought to assess service availability and readiness to meet the need for CAC, client satisfaction with the service and associated factors in public health facilities of East Shawa Zone, from March 1 to July 31, 202. The study relied on snapshot of information, investigated at a particular point-in-time within the study period. It was conducted on randomly selected sample of 30 health facilities, 900 women who received CAC and providers who delivered the services. Data were collected using face-to-face interview and checklist-based observations, and analyzed using computer software. Proportions were used to summarize the data regarding the characteristics of study participants, availability and readiness of facilities. Factors affecting women's satisfaction with CAC services were identified by comparing the proportions of service satisfaction among different groups of women, providers and facilities. The current study findings revealed that all health facilities fulfilled at least three fourth of material requirements that ensures the availability of CAC services. However, the percentage of facilities that fulfilled at least three fourth of equipment was 60%; medicines, 56.7%; and basic amenities, 46.7%. Among participated women, 19.3% of participants were reported very high level of satisfaction with CAC services. The higher chance of being satisfied with the service was observed among women who were treated for abortion within the second trimester of pregnancy, women treated by younger service provider, a nurse or provider with fever years of experience. Similarly the chance of being satisfied was higher among women who were treated in facilities where availability of essential medicines was not a problem and had good treatment outcome. Based on the study findings; it was concluded that, the availability of basic amenities and medicines was below the minimum standards set by World Health Organization. The level of satisfaction with CAC is comparably low and affected by the availability of medicines, the procedure outcome, the gestational age of terminated pregnancy, the health care provider's age, profession and years of experience. [ABSTRACT FROM AUTHOR]

Key Clinical Message In women of childbearing age, severe proteinuria in systemic lupus erythematosus raises concern for renal involvement and pregnancy complications. While persisting renal loss of protein is known to culminate in extensive interventions, intermittent proteinuria in inactive disease requires an adjusted approach. Contextual awareness of this urinary finding is thus essential.

BACKGROUND: Various countries have ratified the law declaring that safe abortion is a fundamental women’s right. Rwanda has expanded legal grounds for abortion in Law n° 68/2018 of 30/08/2018, determining offenses and penalties in general. This study aimed to gain an in- depth understanding of how physicians, midwives and nurses perceive safe abortion service provision and their experience of providing the service in Rwanda. METHODS: A qualitative, descriptive phenomenological method with transcendental theory devised by Husserl Edmund was used to guide this study. A non-random purposive sampling recruited twenty-three informants, and a semi-structured interview guide was used to collect data. The data analysis used NVivo pro 12 software to categorize and code ideas, while the eight steps of transcendental descriptive phenomenology were used to generate the final themes. RESULTS: Four themes with ten sub-themes were generated: (1) personal feelings and beliefs (humiliation and stigma, guilty and wonder); (2) resilient mechanisms (Clients’ protection, institutional support, appreciation of the law); (3) training and (4) informants’ recommendations (integrated service, community awareness, psychological support, follow-up). CONCLUSION: Healthcare providers’ willingness to provide safe abortion services depend on the individual’s beliefs about abortion. Professionalism and resilient mechanisms are key to sustaining the safe abortion service provision in addition to the law determining offenses and penalties in general in Rwanda.

Aim:The aim of this study is to examine the role of platelet value, mean platelet volume (MPV) value, platelet distribution width (PDW) value, MPV/platelet ratio and PDW/platelet ratio in predicting abortus imminens and abortion that may occur during pregnancy.Materials and Methods:Our study was conducted between the years of 2018 and 2020 and 300 pregnant women between the 6th and 12th gestational weeks, who were admitted to obstetrics outpatient clinics and gave complete blood count test, were included in the study. The patients’ ages, number of abortion, gestational weeks, platelet values, MPV values, PDW values, MPV/platelet ratios and PDW/platelet ratios were recorded from the patient files. Patients were divided into 3 groups; abortion, abortus imminens and control groups. All data were analyzed comparatively.Results:There was no significant difference (p>0.05) among the abortion group, the abortus imminens group and the control group in terms of platelet values, PDW values, MPV values, PDW/platelet ratios and MPV/platelet ratios. When evaluated in terms of laboratory parameters, the mean platelet value was found as 256.7±65.6, the PDW value as 12.2±1.8, the MPV value as 10.2±0.8, the MPV/platelet ratio as 0.042±0.011, and the PDW/platelet ratio as 0.051±0.016.Conclusion:MPV, PDW and MPV/platelet and PDW/platelet ratios obtained from the complete blood count tests of healthy pregnant women in the first trimester are not effective in predicting the risk of further abortion and abortus imminens.

Abortion continues to be a hotly debated topic in the United States, despite the majority of the populace endorsing it as a legal right. The June 2022 ruling from the Supreme Court turned the legal question about abortion back to the states, which will drastically reduce abortion services in the country and confine abortion access mainly to the coasts. The intersection between abortion and a pregnancy achieved using assisted reproductive technology is one that lacks understanding. While presumed to be rare, as data is not collected in the US about abortions, this intersection exists but is understudied. This paper illuminates the little that we know to date about this intersection as well as where our knowledge is profoundly lacking. Creating a better sense of understanding will enable clinics to counsel patients appropriately when the intersection arises.

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Unwanted pregnancies and abortions are experiences shared by many women. In light of the fact that some general framework conditions are currently changing in Germany, and that the Corona pandemic represents a particular challenge for the care of women with unwanted pregnancies, current data from the statistics on terminations of pregnancy of the Federal Statistical Office are outlined. Compared to Europe, Germany has a low proportion of induced abortions. In 2021, 94,596 abortions were reported. The number of abortions as well as the abortion rate and the abortion ratio have decreased since 2001. 95.8% of abortions took place according to the so-called counselling provision. In more than half of the abortions (52.1%) vacuum aspiration was used, in 11.4% curettage, 32.3% were medical abortions using mifepristone. There are large regional differences in the method used.

Objectives: Herbal medicine is a worldwide health topic. Vitex agnus–castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy.Methods : : Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups: control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software.Results : : We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates.Conclusion : : VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.

Infection by Brucella species in pregnant animals and humans is associated with an increased risk of abortion, preterm birth, and transmission of the infection to the offspring. The pathogen has a marked tropism for the placenta and the pregnant uterus and has the ability to invade and replicate within cells of the maternal–fetal unit, including trophoblasts and decidual cells. Placentitis is a common finding in infected pregnant animals. Several proinflammatory factors have been found to be increased in both the placenta of Brucella-infected animals and in trophoblasts or decidual cells infected in vitro. As normal pregnancies require an anti-inflammatory placental environment during most of the gestational period, Brucella-induced placentitis is thought to be associated with the obstetric complications of brucellosis. A few studies suggest that the blockade of proinflammatory factors may prevent abortion in these cases.

Pregnancy is associated with a 5–26 times increased risk of invasive Haemophilus influenzae infection and subsequent adverse pregnancy outcomes. Incidence rate and outcome are published in some regions, but the characterisation of bacterial isolates is limited. We performed comparative genomic analyses of isolates from 12 pregnancy-associated cases, cultured from maternal bacteraemia in pregnancy (nine), postpartum bacteraemia (one), neonatal bacteraemia (one), and placental tissue (one). In two bacteraemia cases, identical isolates were also cultured from cervical swabs. Eight cases occurred early in pregnancy (gestational week 7–26), and seven of them resulted in miscarriage or neonatal death. All bacterial genomes were devoid of capsule loci, and they were evenly distributed in the major phylogenetic group I of the species. The conspicuous tropism of H. influenzae for pregnancy and placental tissue is associated with the species rather than specific clonal subtypes.