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Purpose of reviewEntertainment media contribute to how people understand and make sense of health issues, especially stigmatized ones such as abortion. This paper reviews the peer-reviewed literature published between 2019 and 2024 on how abortion is depicted in scripted television and film available for viewing in the United States.Recent findingsThe majority of recent studies focus on qualitative content analysis of a composite of television shows, documenting the myriad ways that these programs reflect and are distinct from the reality of abortion access in the United States. The quantitative studies find small but significant increases in abortion knowledge related to exposure to television abortion plotlines, but no increases in support for abortion postexposure. No studies track the impact of exposure to multiple abortion plotlines at multiple points in time. Only one study included a sample of entertainment content creators to understand their motivations for creating abortion plotlines.SummaryMedia depictions of abortion are often rife with misinformation, and may influence the U.S. public's general knowledge and beliefs about abortion. More research is needed to understand possible relationships between television and film abortion content and its impact on viewers.

BACKGROUND: This qualitative study aims to assess perspectives of clinicians and clinic staff on mail-order pharmacy dispensing for medication abortion. METHODS: Participants included clinicians and staff involved in implementing a mail-order dispensing model for medication abortion at eleven clinics in seven states as part of a prospective cohort study, which began in January 2020 (before the FDA removed the in-person dispensing requirement for mifepristone). From June 2021 to July 2022, we invited participants at the participating clinics, including six primary care and five abortion clinics, to complete a semi-structured video interview about their experiences. We then conducted qualitative thematic analysis of interview data, summarizing themes related to perceived benefits and concerns about the mail-order model, perceived patient interest, and potential barriers to larger-scale implementation. RESULTS: We conducted 24 interviews in total with clinicians (13 physicians and one nurse practitioner) and clinic staff (n = 10). Participants highlighted perceived benefits of the mail-order model, including its potential to expand abortion services into primary care, increase patient autonomy and privacy, and to normalize abortion services. They also highlighted key logistical, clinical, and feasibility concerns about the mail-order model, and specific challenges related to integrating abortion into primary care. CONCLUSION: Clinicians and clinic staff working in primary care and abortion clinics were optimistic that mail-order dispensing of medication abortion can improve the ability of some providers to provide abortion and enable more patients to access services. The feasibility of mail-order pharmacy dispensing of medication abortion following the Supreme Court Dobbs decision is to be determined. TRIAL REGISTRATION: Registry: Clinicaltrials.gov. TRIAL REGISTRATION NUMBER: NCT03913104. Date of registration: first submitted on April 3, 2019 and first posted on April 12, 2019.

Background: The Addressing Reproductive Coercion in Health Settings (ARCHES) intervention trains existing providers to address reproductive coercion (RC) and intimate partner violence (IPV) within routine family planning counseling. This study evaluated the effectiveness of a single ARCHES counseling session as adapted for use with abortion clients in Bangladesh. Methods: In this cluster-randomized controlled trial conducted between January 2019 and January 2021, health facilities with an abortion clinic with infrastructure for private counseling and onsite violence support services were eligible. Six facilities in Bangladesh met inclusion criteria, and matched pairs randomization with parallel assignment and a 1:1 allocation ratio was used to randomize three facilities to ARCHES and three facilities to control, which implemented standard counseling. Blinding was not possible as providers in intervention facilities participated in a three-day ARCHES training. Participants were abortion clients aged 18–49 years who could provide safe recontact information and be interviewed privately. The primary outcome was past three-month modern contraceptive use without interruption or interference. The trial was registered on clinicaltrials.gov (NCT03539315) on 29 May 2018. Findings: A total of 1492 intervention participants and 1237 control participants were enrolled. Available data were analyzed at each follow-up period: 1331 intervention and 1069 control participants at the three-month follow-up, and 1269 intervention and 1050 control participants at the twelve-month follow-up. ARCHES was associated with higher likelihood of modern contraceptive use at the three-month follow-up (adjusted RR = 1.08, 95% CI: 1.06–1.10) and the twelve-month follow-up (adjusted RR = 1.06, 95% CI: 1.02–1.10). ARCHES was also associated with decreased incident pregnancy, decreased IPV, and increased knowledge of IPV support services. Interpretation: The ARCHES intervention is effective in increasing post-abortion modern contraceptive use and decreasing incident pregnancy and IPV among abortion clients in Bangladesh. Implementation of ARCHES should be considered in facilities with sufficient privacy for counseling. Funding: Society of Family Planning (#SFPRF11-07) and Ipas.

A review of ROE V. DOBBS: THE PAST, PRESENT, AND FUTURE OF A CONSTITUTIONAL RIGHT TO ABORTION (Lee Bollinger & Geoffrey Stone eds. 2024) Dobbs v. Jackson Women's Health Organization [...]

ObjectivesEntertainment television is an influential source of health information, including about reproductive health. We investigated the association between exposure to television plotlines about medication abortion on audience awareness and beliefs about medication abortion.Study designWe administered a national cross-sectional online survey from December 2021 to January 2022 with a probability-based sample of people assigned female at birth. We asked respondents to select plotlines they had seen from a list of seven that portrayed medication abortion. Among the 3425 people who responded to plotline items, 3340 responded to our outcome measures. Using weighed multivariable analyses, we examined adjusted relationships between exposure to specific types of abortion plotlines and awareness of and beliefs about medication abortion medical safety.ResultsWe found that audience exposure to medication abortion plotlines in which the medication abortion was obtained from a clinic and portrayed as safe was associated with greater awareness of medication abortion compared to nonexposure (RR: 1.68; 95% CI: 1.17, 2.40). Exposure to plotlines that portrayed MA or self-managed MA as safe was associated with audience beliefs that medication abortion is safe.ConclusionsThis study demonstrates that the content of abortion plotlines and exposure to accurate information may be connected to audience awareness of and beliefs about abortion.ImplicationsIn a climate of misinformation about abortion, audience exposure to medically accurate television plotlines about medication abortion may be an effective way to increase awareness of medication abortion and influence beliefs about medication abortion safety.

This is a protocol for a systematic review and meta-analysis of research on mental health outcomes of abortion. Does abortion increase the risk of adverse mental health outcomes? That is the central question for this review. Our review aims to inform policy and practice by locating, critically appraising, and synthesizing empirical evidence on associations between abortion and subsequent mental health outcomes. Given the controversies surrounding this topic and the complex social, political, legal, and ideological contexts in which research and reviews on abortion are conducted, it is especially important to conduct this systematic review and meta-analysis with comprehensive, rigorous, unbiased, and transparent methods. We will include a variety of study designs to enhance understanding of studies methodological strengths and weaknesses and to identify potential explanations for conflicting results. We will follow open science principles, providing access to our methods, measures, and results, and making data available for re-analysis.

Introduction: The number and characteristics of pregnant patients presenting to the emergency department (ED) has not been well described. Our objective in this study was to determine the prevalence and characteristics of pregnant patients presenting to EDs in the US between 2010–2020. Methods: We completed a retrospective, cross-sectional study of patient encounters at hospital-based EDs in the US from 2010–2020. Using the ED subsample of the National Hospital Ambulatory Medical Care Survey (NHAMCS) we identified ED visits for female patients aged 15–44 years. We defined a subsample of these as visits for pregnant patients using discharge diagnosis codes specificto pregnancy. We compared this population of pregnant patient visits to those for non-pregnant patients and computed point estimates for nationally weighted values. Multivariable linear regression was used to determine factors independently associated with pregnant patient visits. Results: The 2010–2020 NHAMCS dataset included 255,963 ED visits. Of these visits 59,080 were for female patients 15–44 years old, and 6,068 of those visits were for pregnant patients. Pregnant patients accounted for 3% (95% confidence interval [CI] 2.7–3.2) of all ED visits and 8.6% (95% CI 8–9.3) of all visits among female patients 15–44 years. Weighting to a national sample, this equates to 2.77 million pregnant patients presenting for ED visits annually. Pregnant patients were more likely to be Black, Hispanic, or to use public insurance. Conclusion: Pregnant patients make up a significant number of ED visits annually and are more likely to be people of color or publicly insured. Interventions to address the effects of changing abortion legislation on emergency medicine practice may benefit from consideration that certain populations of pregnant people are more likely to present to the ED for care.

Telehealth abortion has become critical to addressing surges in demand in states where abortion remains legal but evidence on its effectiveness and safety is limited. California Home Abortion by Telehealth (CHAT) is a prospective study that follows pregnant people who obtained medication abortion via telehealth from three virtual clinics operating in 20 states and Washington, DC between April 2021 and January 2022. Individuals were screened using a standardized no-test protocol, primarily relying on their medical history to assess medical eligibility. We assessed effectiveness, defined as complete abortion after 200 mg mifepristone and 1,600 μg misoprostol (or lower) without additional intervention; safety was measured by the absence of serious adverse events. We estimated rates using multivariable logistic regression and multiple imputation to account for missing data. Among 6,034 abortions, 97.7% (95% confidence interval (CI) = 97.2-98.1%) were complete without subsequent known intervention or ongoing pregnancy after the initial treatment. Overall, 99.8% (99.6-99.9%) of abortions were not followed by serious adverse events. In total, 0.25% of patients experienced a serious abortion-related adverse event, 0.16% were treated for an ectopic pregnancy and 1.3% abortions were followed by emergency department visits. There were no differences in effectiveness or safety between synchronous and asynchronous models of care. Telehealth medication abortion is effective, safe and comparable to published rates of in-person medication abortion care.

Although contraception and abortion are considered medically necessary services, providers in Canada are permitted to deny services and referrals on the basis of their personal beliefs or conscience. Belief-based denial, sometimes referred to as 'conscientious objection,' remains a controversial issue leading to barriers to access and provision of care. We carried out a scoping review to explore what is currently known about the belief-based denial of contraception and abortion care in Canada. We used a predefined framework to search for relevant sources and found a total of 97 articles including 27 peer-reviewed articles, 47 media articles, and 23 articles from reproductive health organizations, published since 1990. The literature we found shows that policy has been a key area of discussion; sources also focus on conceptually defining belief-based denial and advocacy efforts for reproductive rights. There is a stark lack of peer-reviewed literature documenting and examining the impact of belief-based denial of contraception and abortion care on those denied care in Canada. KEYWORDS: Abortion, belief-based denial, Canada, conscientious objection, contraception, scoping review, Canadian federal policies define contraceptive and abortion care as medically necessary services, and women in Canada spend much of their reproductive lives using contraception (Black, 2019), with 85% reporting ever [...]

IntroductionOn June 24, 2022, the U.S. Supreme Court issued their decision on Dobbs vs Jackson Women's Health Organization (Dobbs). This decision had major implications on female reproductive choices, but also had potential implications on their male counterparts. We sought to determine the association of Dobbs with the number and characteristics of men seeking vasectomy.MethodsA retrospective review was performed to determine the number of vasectomy consults and procedures completed at a single Michigan health system in the 6 months following Dobbs (6/24/2022 - 12/24/2022) versus the same 6-month time frame between 2019 to 2021. Another retrospective review was conducted in the 3 months following Dobbs (6/24/2022 - 9/24/2022) versus the same days in 2021 to determine the number of vasectomy consults completed and to evaluate for differences in the characteristics of these men.ResultsIn the 6 months after Dobbs, there was a 150% and 160% increase in vasectomy consults and procedures completed, compared to a similar time frame in 2019 to 2021. In the 3 months after Dobbs, there was a 225% increase in new vasectomy consults compared to a similar time frame in 2021. There were no differences in the age, race, religion, median household income or insurance type of men seeking vasectomy consult pre-versus post-Dobbs. Partnerless men (OR 3.66) and those without children (OR 2.85) were more likely than married men and those with 3 or more children, respectively, to seek vasectomy consult post-Dobbs.ConclusionsDobbs was associated with a marked increase in vasectomy consultations and procedures at our institution in the state of Michigan. Future studies are needed to determine the long-term implications of Dobbs on vasectomy practices, and determine if vasectomy practices differ by states and their respective abortion laws.

PurposeMiscarriage, often resulting from a variety of genetic factors, is a common pregnancy outcome. Preconception genetic carrier screening (PGCS) identifies at-risk partners for newborn genetic disorders; however, PGCS panels currently lack miscarriage-related genes. In this study, we evaluated the potential impact of both known and candidate genes on prenatal lethality and the effectiveness of PGCS in diverse populations.MethodsWe analyzed 125,748 human exome sequences and mouse and human gene function databases. Our goals were to identify genes crucial for human fetal survival (lethal genes), to find variants not present in a homozygous state in healthy humans, and to estimate carrier rates of known and candidate lethal genes in various populations and ethnic groups.ResultsThis study identified 138 genes in which heterozygous lethal variants are present in the general population with a frequency of 0.5% or greater. Screening for these 138 genes could identify 4.6% (in the Finnish population) to 39.8% (in the East Asian population) of couples at risk of miscarriage. This explains the cause of pregnancy loss in approximately 1.1-10% of cases affected by biallelic lethal variants.ConclusionThis study has identified a set of genes and variants potentially associated with lethality across different ethnic backgrounds. The variation of these genes across ethnic groups underscores the need for a comprehensive, pan-ethnic PGCS panel that includes genes related to miscarriage.

Equine herpesvirus-1 (EHV-1) is a highly prevalent and frequently pathogenic infection of equids. The most serious clinical consequences of infection are abortion and equine herpesvirus myeloencephalopathy (EHM). The previous consensus statement was published in 2009 and considered pathogenesis, strain variation, epidemiology, diagnostic testing, vaccination, outbreak prevention and control, and treatment. A recent survey of American College of Veterinary Internal Medicine large animal diplomates identified the need for a revision to this original consensus statement. This updated consensus statement is underpinned by 4 systematic reviews that addressed key questions concerning vaccination, pharmaceutical treatment, pathogenesis, and diagnostic testing. Evidence for successful vaccination against, or effective treatment of EHV-1 infection was limited, and improvements in experimental design and reporting of results are needed in future studies of this important disease. This consensus statement also updates the topics considered previously in 2009.

INTRODUCTION: In 2017, Chile decriminalized abortion on three grounds: (i) if the pregnant persons life is at risk, (ii) fetal nonviability, and (iii) rape or incest. This multicase study explores the experiences of pregnant people legally entitled to but denied access to legal abortion in Chile. METHODS: Through a snowball sampling approach, we recruited adult Chilean residents who sought, were eligible for, and were denied a legal abortion after September 2017. We conducted semistructured interviews with participants to explore their experiences in seeking and being denied legal abortions. We recorded and transcribed the interviews, then coded and analyzed the transcriptions to identify common themes. RESULTS: We identified four women who met the eligibility criteria. The interviews revealed five common themes in their experiences: (i) disparate levels of social support in accessing abortion, (ii) abundant access barriers, (iii) forced pregnancy, (iv) abortion stigma, and (v) a failure of the law to provide access to abortion. DISCUSSION AND HEALTH EQUITY IMPLICATIONS: Although the 2017 law expanded legal access to abortion in Chile, significant barriers remain. Compounded with social stigma, and the socioeconomic disparities in abortion access, pregnant people continue to face insurmountable obstacles in obtaining legal abortions, even when their lives are at risk and the pregnancy is not viable. The state must prioritize equity of access to legal abortions. Future studies should continue to explore the challenges people face accessing legal abortion care to inform strategies to ensure people are able to obtain the quality care that they are legally entitled to.

Abstract: For over a century, abortion has been politically and socially contested, affecting people's lives through personal experience and/or public discourse. In the United States (US), abortion is sometimes exceptional—treated differently from other procedures, professions, and political issues—and sometimes an exemplar—an accessible example of a commonly occurring social, political, or personal phenomenon. It is, in other words, an excellent sociological case study. Yet the sociological literature on abortion is relatively thin. In this essay, we review research on abortion and opportunities for future sociological work in eight areas: gender; race; the body and embodiment; political economy; organizations, occupations, and work; medical sociology; law and society; and social movements. Sociologists have much to contribute to characterizing and understanding abortion, particularly following the 2022 US Supreme Court decision overturning the constitutional right to abortion. The discipline also has much to learn from studying abortion as a case. With its multifaceted social and political status and intersections with key areas of sociological interest, abortion offers a generative case for advancing sociological concepts, subfields, and constructs. While not exhaustive, our review aims to spark interest and inquiry, showcasing how a topic that spurs strong opinions can also catalyze sociological insights.

Evidence suggests that entertainment media may influence knowledge, attitudes, and behaviors related to health topics. After the overturning of Roe v. Wade, it is critical to examine how these media may be associated with people’s knowledge, attitudes, and behavioral intentions related to abortion. Using a non-experimental ex post facto design, we examined whether exposure to any of three abortion plotlines was correlated with (a) greater knowledge about abortion, (b) lower stigmatizing attitudes about abortion, and (c) higher likelihood of supporting someone seeking an abortion among a sample of television audience members (N = 1,016), administered via a survey on Qualtrics. We selected three scripted, fictional abortion plotlines on the U.S. television shows Station 19, Better Things, and A Million Little Things, based on medical accuracy and airdates near each other in March 2022. Exposure to a plotline was defined as accurately answering at least two recall questions about a given plotline. We found that compared to those who were not exposed to any of the plotlines, exposure to any of the three plot lines was associated with greater knowledge about abortion and higher willingness to support a friend seeking an abortion, but not with lower stigmatizing attitudes. Exposure to medically accurate depictions of abortion on television may be one way to improve knowledge about abortion and community support for people seeking abortion.

In June 2023, the Supreme Court declared that there was no longer a right to abortion under the federal constitution. This decision has allowed states to promulgate different restrictions on abortion, many of which implicate the practice of emergency medicine. An abortion is defined as a “medical intervention provided to individuals who need to end the medical condition of pregnancy” and includes care such as termination of an ectopic pregnancy and induction of labor for previable preterm premature rupture of membranes—interventions that emergency physicians either perform or rely on the assistance of consultants to perform. State bans on abortion must be evaluated against duties under the Emergency Medical Treatment and Labor Act, a federal law that preempts state law. In this paper we examine the conflict between state and federal law as it applies to emergency abortion care and describe how emergency physicians can continue caring for patients.

OBJECTIVE: To compare pregnancy outcomes using self-reported and objective levels of intracellular tenofovir diphosphate (TFV-DP) in pregnant women using preexposure prophylaxis (PrEP). DESIGN: We enrolled pregnant women >15 years without HIV at first antenatal care visit in an observational cohort study to compare pregnancy outcomes by PrEP use. METHODS: Exposure defined as: any PrEP use [tenofovir disoproxil and emtricitabine (TDF/FTC]) prescription + reported taking PrEP], or objectively-measured TFV-DP in dried blood spots in PrEP-using pregnant women. The primary outcome was a composite of pregnancy loss, preterm birth (

AbstractPurposeMaterials and Method(s)Results and ConclusionsThe aim of this retrospective cohort study was to investigate the effects of hysteroscopic uterine septum resection on the clinical pregnancy rate (CPR), live birth rate (LBR) and miscarriage rate.Hospital records of consecutive patients who underwent hysteroscopic uterine septum resection between February 2021 and December 2022 were reviewed. They were telephoned and interviewed about their reproductive performance after surgery, and pregnancy outcomes, if achieved.Sixty-nine eligible patients were enrolled. Forty-one (59.4%) of these patients were referred to our clinic for otherwise unexplained infertility of at least 1 year and 28 (40.6%) for pregnancy loss. During the follow-up period, 32 patients conceived. The overall CPR was 46.4%, the LBR per woman was 36.2%, the LBR per pregnancy was 78.1% and the miscarriage rate was 12.5%. The LBRs per pregnancy were 83.3% and 71.4% in the infertility and miscarriage subgroups, respectively. The miscarriage rates per pregnancy were 0% and 28.6% in the infertility and miscarriage subgroups, respectively. Three of 6 patients whose uterine septum was incomplete but prominent became pregnant (CPR: 50.0%), and all pregnancies resulted in live birth (LBR per pregnancy:100%, LBR per woman:50%). Two patients with complete uterine septum didn’t achieve pregnancy. Hysteroscopic uterine septum resection may improve the CPR, LBR and miscarriage rates in subfertile population with and without previous pregnancy loss. [ABSTRACT FROM AUTHOR]

This study investigates the environmental and food security implications of livestock abortions and calf mortality in Tanzanian dairy systems and Kenyan beef systems by utilizing data from previously published studies. The environmental impact of livestock abortion is assessed in Tanzanian dairy systems, examining indigenous and exotic breeds of cattle and goats in Northern Tanzania. Calf mortality's impact is evaluated in Kenyan beef systems, involving local cattle breeds in western Kenya. Greenhouse gas (GHG) emission intensity (EI) is estimated for both countries. The GHG emissions in Tanzania consider enteric fermentation, manure management, and feed production in different cattle and goat groups, as well as total milk production. In Kenya, enteric methane (CH4) EI related to calf mortality is assessed by estimating lifetime enteric CH4 emissions and total carcass production from dams and their offspring. The EI is compared between the observed scenario (16% calf mortality) and alternative scenarios (8, 4, and 0% calf mortality). A life cycle assessment using the Global Livestock Environmental Assessment Model- interactive (GLEAM- i) examines GHG sources and potential tradeoffs. Estimates are made for milk and carcass losses due to abortions and calf mortality, scaled to represent the entire country. Abortion increases milk EI by 4–18% in Tanzania, while Kenya's EI ranges from 25.9 to 27.6 kg CO2 eq per kg carcass weight. Animal protein loss due to abortions is equivalent to the potential annual animal protein requirements of approximately 649 thousand people in Tanzania, while a 16% calf mortality rate in Kenya is equivalent to per capita consumption of 4.5 million people. The findings highlight the significant impact of abortions and calf mortality on GHG emissions and animal protein availability, emphasizing the potential for reduced emissions and improved food security through mitigation efforts. The contribution of emissions from enteric fermentation and manure management is significant across both countries, underscoring the importance of a systems perspective in evaluating the environmental impact of livestock production. This study provides insights into the environmental and food security implications of livestock abortions and calf mortality in Tanzania and Kenya, emphasizing the need for targeted interventions in sustainable livestock production. [ABSTRACT FROM AUTHOR]

State governments have created a multitude of indirect restrictions on abortion in the decades since Roe v. Wade. Here we test whether indirect restrictions demobilize abortion supporters relative to direct restrictions. We draw on research from moral psychology showing that people judge indirect offenses as less morally wrong than direct offenses, holding constant the consequences of the offenses. In two experiments, pro‐choice participants answered how much they oppose a banning policy (a direct restriction), a defunding policy (an indirect restriction), or an excluding policy (the same as defunding but framed as more direct). In both experiments, pro‐choice participants were less opposed to defunding than banning or excluding, even when the number of women affected was held constant. These results support the hypothesis that indirect restrictions can demobilize political opponents. [ABSTRACT FROM AUTHOR]

The research paper examines subjective features of the crime related to illegal abortion provided for in Art. 134 of the Criminal Code of Ukraine. The authors focus on the problems of qualification of the subject of this offense, in particular, a person without special medical education who is not authorized by law to perform artificial abortion operations. The foreign experience of criminal-legal assessment of illegal abortion is partially highlighted. An analysis is provided regarding the relationship between illegal abortion and infliction of serious bodily harm, which can also lead to termination of pregnancy, but is subject to a different legal qualification. Some elements of the subjective side of the crime are also analyzed, in particular, the optional purpose and motive of the person who commits the offense, as well as manifestations of negligence in medical practice. Particular attention is paid to the issue of distinguishing between intentional actions and medical (medical) errors arising from professional negligence or lack of proper training. A scientific understanding of the medical error committed during the abortion, which led to a long-term health disorder, infertility or death of the victim (part 3 of article 134 of the Criminal Code of Ukraine) is offered. It is shown that this error can be caused by one or more objective or subjective factors that have been officially established and recorded in due process. The work gives examples of the practical application of criminal legislation, in particular, cases of illegal abortion due to selfish motives. It describes what goal the offender sets and what motivation is guided by the offender during an illegal abortion. The need to improve the provisions of criminal and medical legislation, which regulate the procedure for carrying out abortion operations, and also ensure the protection of women's reproductive rights, is emphasized. In particular, it is prospectively important to review the criminal liability of medical professionals who perform abortions in violation of medical pro tocols. In the mode of searching for ways to improve the text of Art. 134 of the Criminal Code of Ukraine proposed the author's version of the disposition of the first part of the ban. [ABSTRACT FROM AUTHOR]

AbstractWe explored how contraception is addressed in pre-abortion counseling, with a focus on the conversational strategies used by healthcare providers. We recorded 28 pre-abortion counseling sessions at three South African public hospitals and analyzed them using conversation analysis. In discussions about past contraceptive use, patients were often positioned as irresponsible and required to account for assumed inadequate contraceptive practices. This framing laid the groundwork for the coercive provision of post-abortion contraception, particularly long-acting reversible contraceptives (LARCs). Short-term users and younger patients were singled out, receiving repeated warnings about daily adherence or parental enforcement. Providers’ efforts to prevent the perceived “mistake” of abortion led to the use of coercive conversational tactics. [ABSTRACT FROM AUTHOR]

Background: Infectious diseases, particularly the Goatpox virus (GTPV) from the Poxviridae family, significantly impact livestock health and agricultural economies, especially in developing regions. Recent GTPV outbreaks in previously eradicated areas underscore the need for effective control measures, with vaccination being the most reliable strategy. This study investigates the effects of administering standard and double doses of live attenuated goatpox vaccine in pregnant Murcia-Granada goats, a non-native breed in Iran, to determine optimal vaccination protocols. Results: In 2018, 400 healthy and pregnant Murcia Granada goats imported from Spain were divided into groups of 200 and vaccinated with either a standard dose (0.5 ml) or a double dose (single 0.9 ml injection) of live attenuated goatpox vaccine. Post-vaccination, the goats were monitored daily for clinical signs of infection, with samples collected for PCR analysis to detect the presence of GTPV strains. In group A, which received the standard vaccine dose, no abortions or vaccine-related side effects were observed, and body temperatures remained normal. In group B, administered a double dose, 37% of the goats experienced abortions, displaying signs of GTPV infection, such as skin lesions (pox lesions) and increased body temperatures. Molecular analysis confirmed the vaccine strain of GTPV as the infection source, ruling out external contamination. Statistical analysis showed no significant differences in abortion rates concerning gestational age or t he age of the pregnant goats. Conclusion: The study highlights the importance of adhering to standard vaccine dosages in pregnant Murcia Granada goats to prevent adverse outcomes like abortions. This study emphasizes the necessity to review and revise vaccination protocols tailored to specific breeds and varying maintenance conditions, including pregnancy and outbreak scenarios. These findings stress the necessity for cautious and tailored vaccination strategies to ensure the safety and efficacy of vaccines in different goat breeds. [ABSTRACT FROM AUTHOR]

Corporations are increasingly wading into social and political matters that are unrelated to their business operations. This Paper empirically investigates corporate participation in social debates through the corporate response to Dobbs, the Supreme Court's decision overturning the constitutional right to abortion. First, the Paper identifies and examines the public companies that reacted to the reversal of Roe v. Wade ("Reacting Companies"). Only a few corporations reacted. On the one side, they tend to be large, with sizeable workforces, concentrated in consumer-facing and tech industries, and headquartered in states with no restrictions on abortion rights. On the other side, they tend to have more female representation on the boards and more liberal-leaning CEOs. The findings suggest that companies decided to speak mainly driven by strategic positioning reasons, but leadership's gender and ideology might have facilitated their choice to take a stand on reproductive rights. This view is further supported by the examination of the corporate contributions to the Republican Attorney General Association ("RAGA"), which has been vocal about its fight against abortion rights. More than 20% of the Reacting Companies made anti-abortion donations, even after the reversal of Roe v. Wade, disclosing the potential inconsistency of corporations' political speech. Second, the Paper focuses on how corporations speak. An empirical survey of the corporate statements in reaction to Dobbs reveals heterogeneous responses. The majority of the statements only announced the coverage of employees' abortion travel expenses ("Employee Statements"). A third of the statements expressed instead a clear political stance in support of abortion rights and against the Supreme Court's ruling ("Political Statements"). Companies that issued Employee Statements were more likely to have Republican-leaning CEOs and to make anti-abortion donations, indicating they may have spoken due to their constituencies' pressure. Political Statements, conversely, tended to be issued by smaller companies and were significantly more likely to be authored by the CEO itself, making it unclear if the CEO was speaking on behalf of the company or expressing a personal belief. [ABSTRACT FROM AUTHOR]

ABSTRACT: The article presents the LGBTQIA + inclusivity analysis of the Medical Termination of Pregnancy (Amendment) Act 2021, which aims to provide safe abortion services across India. The analysis reports the use of cisgender-heteronormative language, instead of gender-neutral terms and pronouns in the legislation. Sexual assault/rape as an eligibility criterion for permitting abortion under this act does not apply to non-binary, trans- and queer individuals due to non-inclusivity in Rape Laws (Indian Penal Code 375 and 376). The analysis highlights the necessity for critical amendments to expand its scope to ensure LGBTQIA+ inclusive abortion services. [ABSTRACT FROM AUTHOR]

The increased politicization of sexual and reproductive health has created barriers to medically necessary care. In absence of formal health care, social ties become critical sources of information and resources, yet the disclosure of stigmatized health needs carries significant risk. How do people navigate the risks and benefits of disclosure when seeking care for stigmatized needs? Drawing on original survey data (N = 153) and in-depth interviews (N = 55) with women who attempted a self-managed abortion, I first describe the distinct roles of weak and strong ties in women's health-seeking experiences. I then demonstrate how both partial disclosure and nondisclosure are critical tools for obtaining information, resources, and emotional support during periods of health-seeking. Findings advance understanding of disclosure as a continuum that can be strategically wielded by people with stigmatized needs to confront and evade stigma and surveillance from their networks, the state, and the formal health care system. [ABSTRACT FROM AUTHOR]

Abortion is a safe and common medical procedure. Roughly one in four women in the United States will have an abortion before the end of her reproductive years. Because of how common this experience is and how rapidly abortion policy is shifting, understanding the relationship between abortion and women's socioeconomic futures is well worth exploring. Extant research has demonstrated that the transition to parenthood is a critical inflection point in women's socioeconomic trajectories, often leading to poorer outcomes. In this article, we connect previous sociological work elucidating mechanisms of socioeconomic stratification and gender by considering the relationship between abortion use and access and future socioeconomic outcomes such as education, income, and financial stability—as measured by several measures, including evictions, debt, ability to pay bills, and a separate index of economic instability. We use national longitudinal survey data to assess socioeconomic outcomes associated with abortion using two statistical approaches. We find that women who lived in a location with fewer abortion restrictions in adolescence, and women who had an abortion, compared to a live birth, in adolescence, are more likely to have graduated from college, have higher incomes, and have greater financial stability at two time-points over an almost 25-year period. Our results provide evidence that policy environments allowing access to abortion, and teenagers having the option to use abortion to avoid early parenthood, are important axes along which women's economic lives are shaped. Our research implies that the widespread abortion bans and restrictions in the United States are likely to lead to lower educational attainment and adult economic stability among women living under such restrictions, as compared to women in locations with better access to abortion. [ABSTRACT FROM AUTHOR]

Bluetongue (BT) is an economically significant viral disease caused by bluetongue virus (BTV). BTV is spread by arthropods, which affects domestic and wild animals. In fetal ruminants, BTV exhibits neurotropism, leading to abortion and congenital defects in brain especially in cattle and sheep when infected in utero. Transplacental transmission (TPT) of wild Indian BTV-1 in late pregnancy has never been proven experimentally. This study is the first to demonstrate TPT of wild Indian BTV-1 during late pregnancy using an immunocompetent mouse model of IFNAR1 blockade. The present study examines sequential pathology, developmental anomalies, demonstration of BTV-1 antigen localization in the reproductive organs, haematological and biochemical alterations, and humoral immunity during the late stage of gestation. During late stage of gestation, the rate of TPT was notably higher at 80.00%. Clinical signs became increasingly noticeable in dams from 5 dpi onward, including symptoms such as abortion, anorexia, ocular discharge, and huddling tendency. Reduced growth rate, rough hair coat, and head tilting due to nervous signs were observed in 10-day-old fetuses. BTV-1 infection during the late stage of gestation caused abortion, maceration, necro-haemorrhagic lesions in reproductive organs, hemorrhages in foetal organs, and non-significantly decreased bone size (Alizarin red staining) in fetuses. Perivascular hemorrhages due to endothelial damage in lungs, interstitial pneumonia and meningitis were observed in 10-day-old fetuses. BTV-infected pregnant mice showed leukopenia with lymphopenia and seroconversion by 6 dpi (21 days of gestation). Further, significant alterations in serum biochemical values were observed when compared them to those of the uninfected control group. BTV-1 antigen was demonstrated in foetuses, placenta, uterus, and ovaries using immunohistochemistry and RT-PCR. This mouse model presents a suitable platform for studying the mechanisms underlying transplacental transmission. [ABSTRACT FROM AUTHOR]

Protestors recently repurposed the abortion rights' mantra, "my body, my choice," to oppose COVID-19 mandates. But do those who oppose public health mandates fully support the right to choose? We answer this question by using exploratory analyses to identify the unique response patterns underlying support for abortion and COVID-19 mandates in random samples from the United States (Study 1; N = 2,331) and New Zealand (Study 2; N = 33,310). Latent profile analyses revealed a small subgroup in both countries (12.6% and 3.4% of the respective samples) who opposed mandates. Yet contrary to the "my body, my choice" rhetoric seen at anti-mandate protests, they also opposed abortion. Across both studies, those in the Anti-Mandate profile tended to be more religious, conservative, and distrustful of institutions. In Study 2, they were also low on cognitive consistency and high on conspiracy belief. Finally, the Anti-Mandate profile was opposed to free speech critical of both the United States and religion (Study 1), high on sexual prejudice (both studies), unsupportive of progressive protests (but supportive of reactionary protests; Study 2), and likely to vote for conservative parties (both studies). These results reveal the mobilization potential of the anti-mandate movement, uncover important contradictions within its members, and illustrate the nuanced ways in which opposition to gender policies (i.e., reproductive rights) coalesce with reactionary protests. [ABSTRACT FROM AUTHOR]

Introduction: Although perinatal death rates in the Nordic countries are among the lowest in the world, the risk of perinatal death is unevenly distributed across the Nordic countries, despite similarity in health care systems and pregnancy care. Birth registration practices across countries may explain some of the differences. We investigated differences in national registration of perinatal mortality within the Nordic countries and its impact on perinatal mortality according to gestational age. Material and Methods: Each country provided information by answering a questionnaire about registration of perinatal deaths. Furthermore, we collected aggregated count data based on Medical Birth Registries (MBR) from all Nordic countries in 2000 to 2021. Perinatal mortality was defined as stillbirth or neonatal death occurring within first 7 days of life. Data were grouped into six groups by gestational age (GA): extremely preterm (>28 + 0 weeks, subdivided into 22 + 0–23 + 6 and 24 + 0–27 + 6), very preterm (GA 28 + 0–31 + 6), moderate preterm (GA 32 + 0–33 + 6), late preterm (GA 34 + 0–36 + 6), term (GA 37 + 0–40 + 6) and late term or post‐term birth (GA ≥ 41 + 0). Perinatal mortality rate and risk ratio with 95% confidence intervals were calculated per country for each gestational age group. For Denmark, separate analyses included and excluded induced abortions. Results: The study included 6 343 805 live births, 22 727 stillbirths and 8932 liveborn infants who died within the first week of life after GA 22 + 0. Further 25 057 births were included with GA < 22 + 0, unknown GA and as a result of induced abortion. Overall, perinatal mortality rates decreased during year 2000–2021 in all Nordic countries. After exclusion of induced abortions, the perinatal mortality rate was similar in the five Nordic countries. The perinatal mortality rate for extremely preterm born infants was highest in Denmark, whereas the highest rate among infants born late term/post‐term was in Sweden. Conclusions: The perinatal mortality rate in the Nordic countries is still decreasing, especially in the group of extremely preterm born infants. This study supports the need for further standardization of birth registration practices to ensure the validity of international comparisons. [ABSTRACT FROM AUTHOR]

Although numerous states have enacted policies banning or limiting abortion since the Dobbs decision in 2022, public opinion in most states remains solidly in favor of abortion access. However, whether public opinion is reflected in the public policy of individual states depends on how political institutions mediate between opinion and policy. Activists on both sides of the abortion issue, therefore, have attempted to locate policymaking regarding abortion access in state institutional systems most congenial to their desired outcomes. In states with direct democracy, even where legislatures and governorships are dominated by conservative Republicans, activists have been successful in harnessing public opinion to protect abortion rights by winning public referenda. In response, Republicans have attempted to curtail the power of these referenda, shifting power back to legislatures more likely to be held by actors opposed to abortion rights. This venue shopping for policymaking advantage ultimately raises vital, difficult, and often uncomfortable questions about how political institutions and citizens negotiate the boundaries of democratic legitimacy in policymaking. Key Points: Since US federal courts overturned Roe vs. Wade and allowed states to ban abortion, public opinion in both Democratic‐ and Republican‐controlled states has been in favor of abortion rights.However, this favorable public opinion is generally only reflected in the state abortion policy in competitive or Republican‐controlled US states when political institutions include direct democracy provisions.Despite supporters of abortion rights succeeding in protecting abortion access through voter initiatives, opponents are attempting to curtail or change those processes to keep abortion policymaking as the province of bodies more likely to be against abortion. [ABSTRACT FROM AUTHOR]

Background: Induced abortion, as a legal medical practice in China, has an enormous negative impact on women's sexual and reproductive health. After the implementation of the three-child policy, guiding women to choose appropriate contraceptive measures to protect their fertility is the focus of China's family planning. But little is known about the impact of the family planning policy on women's contraceptive behaviour. Methods: We collected 7022 cases who underwent abortion between July 2020 and June 2022 in Wuhan. Based on the time of implementation of the policy, the study population was divided into two groups, namely, the pre-policy group (before July 2021, Group 1) and the post-policy group (after July 2021, Group 2). Logistic regression was used to analyse the effect of the policy on women's choice of different contraceptive methods for abortion. Results: There were a total of 3487 cases in Group 1, accounting for 49.65%, and 3535 cases in Group 2, accounting for 50.34%. The proportion of women choosing efficient contraceptive methods after the Three-Child Policy decreased compared with before. A correlation was observed between the implementation of the Three-Child Policy and whether to choose efficient contraceptive methods after abortion (p < 0.001). Conclusion: The study has found that after the Three-Child Policy, women opting for induced abortion tend to prefer less effective contraceptive methods, particularly condoms. There is a marked shift towards more effective contraception methods both before and after the implementation of the Three-Child Policy. SHORT CONDENSATION: The implementation of the three-child policy in China has changed the preferences of women who choose contraception methods after induced abortion. Family planning work should raise awareness and help women choose appropriate contraceptive methods to reduce induced abortion and protect women fertility. [ABSTRACT FROM AUTHOR]

Purpose: Annually, approximately 31,000 people experience a termination of pregnancy (TOP) in the Netherlands. In 2021, about one-third of them chose medical termination of pregnancy (MTOP). We explored experiences with MTOP and to what extent expectations, pain, and counselling in the clinic are associated with satisfaction with MTOP. Materials and methods: A retrospective cross-sectional study was conducted using an online questionnaire. We included 138 respondents, ≥16 years, who chose MTOP (September 2020–March 2022). Results: The majority of respondents experienced MTOP more positively than expected or as expected (67%). For 24%, the experience was more negative than expected. In the event of another TOP, half of these respondents would hesitate to choose or would not choose MTOP, mainly due to physical side effects. The majority of respondents (73%) would choose MTOP again. Their main motivation was self-determination during treatment. Respondents cited four key elements: pain, intensity of experience during and after treatment, blood loss, and duration. Correspondence between MTOP expectations and experiences was associated with satisfaction with MTOP, while pain and satisfaction with counselling were not. Conclusions: The majority of respondents were satisfied with MTOP and would choose the treatment again. Non-correspondence between expectations and experiences negatively affected satisfaction with MTOP. This highlights the importance of managing expectations by providing accessible information about the variety in expectations and experiences to patients with a focus on key elements of the experience. SHORT CONDENSATION: The majority experienced the abortion pill more positively than expected or as expected. Four experience elements are key: pain, intensity during and after treatment, blood loss, duration. Information about these elements is crucial since non-correspondence of expectation and experience negatively affects satisfaction. [ABSTRACT FROM AUTHOR]

Objective: To document the information on medication abortion on university Student Health Center (SHC) websites. Study Sample: Four-year bachelors granting public universities' Student Health Center websites. Methods: We conduct thematic content analysis for medication abortion-related information on 547 SHC websites in the United States as of August 2022 using computer-assisted software. We validate the software with human annotation. Results: Medication abortion is mentioned on 23 (4%) university SHC websites, and in 13 (57%) of these websites, it is only mentioned to exclude it from definitions of emergency contraception. Only two websites, 6% of the California public schools included in the sample, advertise medication abortion services through their SHC websites. One hundred fifteen (21%) university websites provide links to Planned Parenthood that gives information on how to navigate abortion access across all 50 states. Conclusion: There is inadequate information on SHC websites regarding medication abortion services and how to access them. [ABSTRACT FROM AUTHOR]

• Novel thermogel significantly enhances pain management in hysteroscopic procedures. • Patient-centered approach integrates tailored pain relief strategies effectively. • High satisfaction and safety profile support widespread clinical use of the thermogel. • Detailed analysis underscores the impact of anatomical factors on procedure outcomes. • Study emphasizes the need for personalized treatment plans in gynecological care. This study aimed to explore the use of an anesthetic lidocaine thermogel in outpatient operative hysteroscopies. Specifically, it assessed the safety, tolerability, and ease of use of the gel, as well as its potential for pain reduction during the procedure. This was a multicenter observational study conducted in 9 gynecological units between March 2023 and January 2024. The study included adult women scheduled for outpatient operative hysteroscopies, excluding those with hypersensitivity to the product or recent participation in other clinical studies. The target sample size was 60 to account for potential dropouts. Data collection was electronic, and SPSS was used for analysis. The study assessed visibility conditions, procedure duration, pain scores at different stages of the procedure, and adverse event frequency. Statistical analyses utilized descriptive statistics, Student's t-tests, Wilcoxon and Friedman tests, and Chi-Square or Fisher tests as appropriate. Binary logistic regression was applied to identify factors influencing gel volume. All 60 participants met the inclusion criteria. The mean age was 45.5 (SD 8.8) years, with a mean BMI of 27.0 (SD 5.6) kg/m2. Medical histories were reported in 46.7% of participants, and 50% had undergone previous gynecological surgeries. Prior to the procedure, 51.8% of participants took analgesics. The average procedure duration was 13.9 (SD 15.1) minutes. Pain scores were collected at different stages of the procedure, with median VAS scores ranging from 0 to 5 out of 10. In 50% of cases, the quality of vision during the procedure was rated 9 or higher on a 10-point scale. The full recommended dose of thermogel was administered in 91.7% of cases. The mean gel volume used was 7.0 (SD 1.9) milliliters. Regression analysis showed that younger age and a history of abortions or childbirth were significantly associated with higher gel volume use. The anesthetic thermogel demonstrated effectiveness in managing pain during outpatient operative hysteroscopies, with median pain scores ranging from 0 to 5 out of 10 across different stages of the procedure. The gel showed a favorable safety profile, with only 15% of participants reporting adverse effects, all of which were minor and resolved satisfactorily. The high rate of complete gel application (91.7% of cases) and positive physician feedback suggest good tolerability and ease of use. Further research is recommended to evaluate the gel's efficacy in other gynecological procedures and to optimize application protocols based on patient-specific factors such as age and reproductive history. [ABSTRACT FROM AUTHOR]

• We showed a high prevalence of domestic and sexual violence in the context of abortion. • There was no association between a history of sexual violence and the absence of a gynecological consultation in the past two years years. • The combination of ethical, moral, and psychological constraints associated with violence screening and abortion care was a challenge to patient recruitment. • This study encourages further research on the association between domestic or sexual violence and the uptake of gynecological care in the context of abortion care, particularly to characterize the multiple or frequent use of gynecological care following violence. The aim of this study was to determine the prevalence of domestic and sexual violence and to characterize the association between exposure to domestic and sexual violence and low uptake of gynecological care, in the context of induced abortion. Study design. We conducted a case-control study among women seeking abortion care, in mother and child centers and sexual health centers in the Paris, France area (April 2022-March 2023). A total of 103 women were included in the study during induced abortion care. Physical, psychological or sexual domestic violence was reported by 48.5 % and sexual violence, whoever the perpetrator, was reported by 23.3 %. In the bivariate analysis, a history of physical, psychological or sexual domestic violence was not associated with the absence of a gynecological consultation in the past two years, compared with no history of intimate partner violence (p = 0.09). After adjustment for regular pelvic pain, dysmenorrhea, vulvodynia and dyspareunia, there was no association between a history of sexual violence and the absence of a gynecological consultation in the past two years (OR 1.05; CI95% 0.27–4.13, p = 0.93). Violence was a common finding among women seeking abortion care. We did not find any association between a history of sexual violence and the absence of a gynecological consultation in the past two years. We suggest investigating multiple or frequent use of gynecological care following violence. The combination of ethical, moral, and psychological constraints associated with violence screening and abortion care is a challenge to patient recruitment in future studies. [ABSTRACT FROM AUTHOR]

• PROM before 26 weeks in twin pregnancies is associated with a 20.9% rate of spontaneous miscarriage or fetal demise and a 71.6% live birth rate of at least one twin in pregnancies not undergoing TOP, with a mean latency between PROM and delivery of 5.4 weeks. • The rate of sTOP due to PROM was about 25%, with this subset of pregnancies associated with a significantly lower rate of fetal demise and a significantly longer latency between PROM and delivery. • This meta -analysis might help maternal-fetal specialists in their daily clinical practice to offer the best state-of-the-art knowledge to the patients. To investigate the rate of obstetric and perinatal outcomes of premature rupture of membranes (PROM) occurring before 26 weeks in twin pregnancies. Medline, Embase, Cinahl and Web of Science databases were searched electronically up to January 2024. The selection criteria included both prospective and retrospective studies of twin pregnancies with PROM before 26 weeks of gestation. Case reports, case series with fewer than 5 cases, review articles, letters to the editor and editorials were excluded. Studies including both singletons and twin pregnancies were also excluded. We used meta -analyses of proportions to combine data and assess the pooled proportions. We used a random-effect model to perform the pooled data analyses. The study was registered with the PROSPERO database (CRD 42022368057). Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. Eight studies including 227 twin pregnancies were included in the analysis. The pooled proportion of termination of pregnancy (TOP) was 4.6 % (95 % CI 1.5–13.4), while the rate of selective TOP (sTOP) was 24.5 % (95 % CI 7.1–57.7). After the exclusion of cases of TOP, the overall rate of spontaneous miscarriage or fetal demise was 20.9 % (95 % CI 11.1–35.8), whereas the live birth rate of at least one twin was 71.6 % (95 % CI 61.2–80.1) of the ongoing pregnancies. The mean gestational age at delivery was 26.5 (95 % CI 25.1–28.0) weeks and the mean latency between PROM and delivery was 5.4 weeks (95 % CI 4.8–5.9) in all cases including those with fetal deaths. Neonatal outcomes showed that the overall neonatal mortality was 26.4 % (95 % CI 16.7–39.2). When focusing only on pregnancies undergoing sTOP, the observed livebirth rate was 87.7 %. The gestational age at rupture of membranes in these cases was 16.8 (95 % CI 14.9–18.6) weeks and the latency between PROM and delivery was significantly longer (19.9 (95 % CI 18.0–21.7) weeks) than that observed in unterminated pregnancies, with a mean gestational age at delivery nearly in the range of term (36.9 weeks). PROM in twins before 26 weeks is associated with overall high rates of adverse obstetric and neonatal outcomes, and it represents a clinical challenge for both counseling and management. Larger prospective studies unified objective protocols in terms of antenatal surveillance and management are needed. [ABSTRACT FROM AUTHOR]

Objective: Fetal cardiac anomalies are the most commonly diagnosed structural anomalies. In these cases, Maternal-Fetal Medicine (MFM) specialists are tasked with counseling patients on a spectrum of diagnoses as well as their prognostic implications. A recent study of pediatric cardiologists demonstrated that personal beliefs regarding termination impact the counseling provided to patients. Our objective was to study whether the personal beliefs of MFMs impact counseling of patients with severe fetal cardiac anomalies and to compare these providers to their cardiology counterparts. Methods: We conducted an anonymous cross-sectional survey of MFMs in New England that assessed personal beliefs and counseling practices when diagnosing hypoplastic left heart syndrome (HLHS). We subsequently compared these providers to the previously surveyed cardiologists. Results: A total of 34 respondents representing a broad spectrum of age and experience across several states in New England were analyzed. When presented with the statement "some life is always better than no life at all," 79% (n = 27) of respondents disagreed and all respondents (n = 34) offered termination, palliative care, and treatment options when counseling patients with HLHS. Additionally, while 74% (n = 25) of providers would personally support a decision to terminate a pregnancy with HLHS, 94% (n = 32) would professionally support the decision to pursue termination. MFMs and cardiologists differed in their responses to "some life is better than no life" and the belief that termination should be offered, though differences did not reach statistical significance. However, with respect to the providers' personal and professional support of the decision to terminate the pregnancy, the groups of respondents varied significantly in their level of support, both professionally and personally with fewer cardiologists supporting this decision. Conclusion: When diagnosing a severe and potentially fatal congenital cardiac anomaly, counseling by MFMs was largely unaffected by personal beliefs regarding termination of pregnancy. While this is consistent with previously published data on counseling practices among pediatric cardiology specialists, some important differences between the specialties were seen. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to improve the accuracy of prenatal diagnosis by analyzing fetal echocardiographic features of criss-cross heart (CCH), to provide an effective basis for the development of management strategies and improve the prognosis of patients. Methods: A retrospective analysis was performed on CCH cases diagnosed prenatally at our center between July 2016 and June 2022. Clinical data and prenatal fetal echocardiographic images were reviewed. Literature on prenatal diagnosis of CCH was searched from January 2000 to December 2023 in the PubMed database. Results: Fourteen (0.03%) CCH cases were diagnosed from a database of fetal echocardiograms of 41354 cases at our center. The prenatal genetic testing results were normal in 10 cases and 4 cases didn't check. All cases underwent termination of pregnancy. All cases showed crossed ventricular inflow tracts and combined with other cardiac structural abnormalities. A total of eight articles containing 25 cases were found in the literature review and all cases were associated with other cardiac structural abnormalities. Conclusion: Prenatal echocardiography is the primary tool for fetal diagnosis of CCH. Continuous scanning helps avoid missing data and misdiagnosis. [ABSTRACT FROM AUTHOR]

Objective: This retrospective follow-up study analyzes the effect of intrauterine postpartum hemorrhage (PPH) therapy on menstrual, reproductive, and mental health outcomes. Methods: All women who delivered at a university hospital between 2016 and 2021 with PPH and who needed intrauterine therapy were included. A questionnaire on well-being, menses, fertility, and reproductive outcomes was mailed to the patients. Those who did not reply were surveyed by telephone. Results: A total of 214 women treated with chitosan-covered gauze (group A) and 46 women treated with a balloon tamponade (group B) were recruited, and their short-term courses were analyzed. For long-term follow-up, 71 women of group A (33%) and 21 women of group B (46%) could be reached. A total of 89% of group A and 95% of group B had regular menstrual bleeding in the most recent 12 months; 27% (group A) and 29% (group B) were trying to conceive again, and all of them did so successfully. There were 12 deliveries, 3 ongoing pregnancies, 3 miscarriages, and 2 terminations of pregnancies (TOP) in group A and 4 deliveries, 1 miscarriage, and 2 TOPs in group B. More than half of our study participants was sorted into grade II or III of the Impact of Events Scale, indicating they experienced clinical impacts in the form of psychological sequelae. One-quarter of patients had symptoms of post-traumatic stress disorder. Conclusion: Chitosan gauze as well as balloon tamponade appear to have few adverse effects on subsequent menstrual and reproductive function. Women after PPH are at increased risk of long-term adverse psychological outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Mirror syndrome (MS) is a condition characterized by the presence of maternal, fetal, and placental edema and is reversible through delivery or pregnancy termination. As fetal hydrops itself may be amenable to treatment, we sought to determine outcomes for MS primarily managed by fetal therapy through a narrative review of the literature and cases managed at our fetal center. Study design: PubMed, Embase, Web of Science, Scopus, and Google Scholar databases were searched through January 2024 using key words: mirror syndrome, Ballantyne's syndrome, fetal hydrops, maternal hydrops, pseudotoxemia, triple edema, maternal recovery, fetal therapy, and resolution. Manuscripts describing primary management by fetal therapy that included maternal and fetal outcomes were identified. Clinical details of MS patients managed with fetal therapy at our center were also included for descriptive analysis. Results: 16 of 517 manuscripts (3.1%) described fetal therapy as the primary intended treatment in 17 patients. 3 patients managed at our center were included in the analysis. Among 20 patients undergoing primary fetal therapy for management of mirror syndrome, median gestational age of presentation was 24 weeks and 5 days gestation; predominant clinical findings were maternal edema (15/20), proteinuria (10/20), pulmonary edema (8/20), and hypertension (8/20); the primary laboratory abnormalities were anemia (8/20) and elevated creatinine or transaminases (5/20). Condition-specific fetal therapies led to resolution of hydrops in 17 (85%) cases and MS in 19 (95%) cases. The median time to hydrops resolution was 7.5 days and to resolution of mirror syndrome was 10 days. Fetal therapy prolonged pregnancy by a median of 10 weeks with a median gestational age of 35 weeks and 5 days at delivery. All women delivered for indications other than mirror syndrome and 19/20 fetuses survived. Conclusion: In appropriately selected cases, MS often resolves after fetal therapy of hydrops allowing for safe pregnancy prolongation with good maternal and infant outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To explore the prenatal clinical utility of chromosome microarray analysis (CMA) for polyhydramnios and evaluate the short and long-term prognosis of fetuses with polyhydramnios. Methods: A total of 600 singleton pregnancies with persistent polyhydramnios from 2014 to 2020 were retrospectively enrolled in this study. All cases received amniocentesis and were subjected to CMA results. All cases were categorized into two groups: isolated polyhydramnios and non-isolated polyhydramnios [with soft marker(s) or with sonographic structural anomalies]. All fetuses were followed up from 6 months to five years after amniocentesis to acquire short and long-term prognosis. Results: The detection rates of either aneuploidy or pathogenic copy number variants in fetuses with non-isolated polyhydramnios were significantly higher than those with isolated polyhydramnios (5.0 vs. 1.5%, p = 0.0243; 3.6 vs. 0.8%, p = 0.0288). The detection rate of total chromosomal abnormalities in the structural abnormality group was significantly higher than that in the isolated group (10.0 vs. 2.3%, p = 0.0003). In the CMA-negative cases, the incidence of termination of pregnancy, neonatal and childhood death, and non-neurodevelopmental disorders in fetuses combined with structural anomalies was significantly higher than that in fetuses with isolated polyhydramnios (p < 0.05). We did not observe any difference in the prognosis between the isolated group and the combined group of ultrasound soft markers. In addition, the risk of postnatal neurodevelopmental disorders was also consistent among the three groups (1.6 vs. 1.3 vs. 1.8%). Conclusion: For low-risk pregnancies, invasive prenatal diagnosis of isolated polyhydramnios might be unnecessary. CMA should be considered for fetuses with structural anomalies. In CMA-negative cases, the prognosis of fetuses with isolated polyhydramnios was good, and polyhydramnios itself did not increase the risk of postnatal neurological development disorders. The worse prognosis mainly depends on the combination of polyhydramnios with structural abnormalities. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to explore the functions and mechanisms of the LncRNA-KCNQ1OT1/miR-29a-3p/SOCS3 molecular pathway in the context of unexplained recurrent spontaneous abortion (URSA). Methods: We conducted qRT-PCR to assess the levels of LncRNA-KCNQ1OT1, miR-29a-3p, and SOCS3 in both abortion tissues from women who experienced URSA and healthy early pregnant women. A dual-luciferase assay was employed to investigate whether miR-29a-3p targets SOCS3. Furthermore, RNA IP and RNA Pull-Down assays were employed to confirm the interaction between KCNQ1OT1 and SOCS3 with miR-29a-3p. RNA FISH was used to determine the cellular localization of KCNQ1OT1. Additionally, trophoblast cells (HTR8/SVneo) were cultured and the CCK-8 assay was utilized to assess cell proliferation, while flow cytometry was employed to analyze cell apoptosis. Results: Compared to abortion tissues obtained from healthy early pregnant individuals, those from women who experienced URSA displayed a notable downregulation of KCNQ1OT1 and SOCS3, accompanied by an upregulation of miR-29a-3p. Suppression of KCNQ1OT1 resulted in the inhibition of cell proliferation and the facilitation of apoptosis in HTR8/SVneo cells. Our findings suggest that KCNQ1OT1 may exert a regulatory influence on SOCS3 through a competitive binding mechanism with miR-29a-3p. Notably, KCNQ1OT1 exhibited expression in both the cytoplasm and nucleus, with a predominant localization in the cytoplasm. Furthermore, we observed a negative regulatory relationship between miR-29a-3p and SOCS3, as the miR-29a-3p mimic group demonstrated significantly reduced cell proliferation and an increased rate of apoptosis when compared to the negative control (NC mimic) group. Additionally, the SOCS3 Vector group exhibited a substantial improvement in proliferation capability and a marked reduction in the apoptosis rate in comparison to the NC Vector group. The miR-29a-3p mimic + SOCS3 Vector group demonstrated a remarkable enhancement in proliferation and a reduction in apoptosis when compared to the miR-29a-3p mimic group. Conclusion: The competitive binding of miR-29a-3p to LncRNA-KCNQ1OT1 appears to result in the elevation of SOCS3 expression, consequently fostering the proliferation of trophoblast cells while concomitantly suppressing apoptosis. [ABSTRACT FROM AUTHOR]

Introduction: Neural tube defects (NTDs) represent a spectrum of heterogeneous birth anomalies characterized by the incomplete closure of the neural tube. In Jordan, NTDs are estimated to occur in approximately one out of every 1000 live births. Timely identification of NTDs during the 18–22 weeks of gestation period offers parents various management options, including intrauterine NTD repair and termination of pregnancy (TOP). This study aims to assess and compare parental knowledge and perceptions of these management modalities between parents of affected children and those with healthy offspring. Materials and methods: This retrospective case-control study was conducted at Jordan University Hospital (JUH) using telephone-administered questionnaires. Categorical variables were summarized using counts and percentages, while continuous variables were analyzed using mean and standard deviation. The association between exposure variables and outcomes was explored using binary logistic regression. Data analysis was performed using SPSS for Windows version 26 (SPSS Inc., Chicago, IL). Results: The study sample comprised 143 participants, with 49.7% being parents of children with NTDs. The majority of NTD cases were associated with unplanned pregnancies, lack of folic acid supplementation, and postnatal diagnosis. Concerning parental knowledge of TOP in Jordan, 86% believed it to be legally permissible in certain situations. However, there was no statistically significant difference between cases and controls regarding attitudes toward TOP. While the majority of parents with NTD-affected children (88.7%) expressed a willingness to consider intrauterine surgery, this percentage decreased significantly (to 77.6%) after receiving detailed information about the procedure's risks and benefits (p =.013). Conclusions: This study represents the first case-control investigational study in Jordan focusing on parental perspectives regarding TOP versus intrauterine repair of myelomeningocele following a diagnosis of an NTD-affected fetus. Based on our findings, we urge the implementation of a national and international surveillance program for NTDs, assessing the disease burden, facilitating resource allocation toward prevention strategies, and promoting early diagnosis initiatives either by using newly suggested diagnostic biomarkers or early Antenatal ultrasonography. [ABSTRACT FROM AUTHOR]

Objective: While there is increasing information regarding the occupational risks to pregnant physicians, there is inconsistent and limited subspecialty data. Physicians may be at increased risk for pregnancy complications due to occupational exposure, long work hours, nightshifts, and physical/mental demands. Additionally, little is known regarding the education physicians receive pertaining to pregnancy risks respective to their specialties as well as departmental/institutional support for pregnancy loss or complication. Therefore, a survey was developed and distributed across multiple academic sites to ascertain if there is an inherent occupation-associated risk of pregnancy complication(s) and/or pregnancy loss for anesthesiologists (ANES) when compared to obstetrician/gynecologists (OB/GYN). Methods: A specialty-specific survey was distributed electronically to attending ANES and OB/GYN, via departmental listservs at six participating academic medical centers. Responses were collected from March to October 2022 and included demographic information, practice characteristics, education about pregnancy risks and details of pregnancy complications and loss. The primary comparison between specialty groups was the occurrence of at least one pregnancy complication and/or loss. Logistic regression was used to evaluate specialty outcome associations. Additionally, complication rates and types between specialties were compared using univariate and multivariable models. Results: The survey was distributed to 556 anesthesiology and 662 obstetrics–gynecology faculty members with 224 ANES and 168 OB/GYN respondents, yielding an overall 32.2% response rate. Of the survey respondents, 103 ANES and 116 OB/GYN reported at least one pregnancy. Demographics were similar between the two cohorts. ANES had higher gravidity and parity relative to OB/GYN and tended to be earlier in their career at first pregnancy (p =.008, <.001, and.043, respectively). The rate of any pregnancy complication, including loss, was similar between specialties (65.1% (67/103) vs. 65.5% (76/116), p =.942). Of the respondents reporting at least one pregnancy, 56.7% of ANES and 53.9% of OB/GYN experienced a complication while at work. Obstetrician–gynecologists had higher use of reproductive assistance (28% (47/116) vs. 11% (20/103), p <.001). There were no notable differences between cohorts for complications, prematurity, and neonatal intensive care admission. Forty-one percent (161/392) of total respondents recalled learning about occupational risks to pregnancy, and ANES were more likely than OB/GYN to have recalled learning about these risks (121/224 (54%) and 40/168 (23.8%), respectively, p <.001). Conclusions: ANES and OB/GYN had similar risks for pregnancy complications and loss. Anesthesiologists were more likely to recall receiving education regarding occupational risk to pregnancy, though fewer than half of all survey respondents recalled learning about these risks. Our survey results are similar to the previously identified higher rate of pregnancy complications and loss in female physicians while uncovering areas of potential knowledge gaps for which institutions and practices could strive to improve upon. More research is needed to examine the relationship between occupation and pregnancy risk pertaining to female physicians with the goal being to identify modifiable risk factors. [ABSTRACT FROM AUTHOR]