Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The ob...Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.展开更多
Objective To determine the role of the circulating antisperm antibody （ASA） in the pathogenesis of missed abortion at the first-trimester pregnancy. Methods Sixty-two patients with a history of missed abortion at th...Objective To determine the role of the circulating antisperm antibody （ASA） in the pathogenesis of missed abortion at the first-trimester pregnancy. Methods Sixty-two patients with a history of missed abortion at the first-trimester pregnancy were enrolled into this study. Indirect immunobead test （IBT） was used to measure the circulating ASA levels. Fifty healthy women with the first-trimester pregnancy set as the control. Results No case had the positive level of ASA according to the World Health Organization criteria （50% or more of the motile sperm with immunobead binding）. Only 1 case in patient group and 1 case in the control had 10%-20% of the motile spermatozoa with ASA-IgG bead binding. In both patient and control groups, ASA-IgA was found to be completely negative binding. Conclusion The circulating ASA is not associated with the pathogenesis of missed abortions at the first-trimester pregnancy.展开更多
Objective: The aim of this study was to assess the achievement of pregnancy as well as the reproductive outcome after hysteroscopic septum resection in women with recurrent abortions or infertility. Design: retrospect...Objective: The aim of this study was to assess the achievement of pregnancy as well as the reproductive outcome after hysteroscopic septum resection in women with recurrent abortions or infertility. Design: retrospective, clinical trial. Setting: University hospitals. Patient(s): Fourty women with a diagnosis of uterine septum who had a history of pregnancy loss or infertility. They were randomized into two groups. Group I includes 18 infertile women and group II includes 22 recurrent miscarriage women. Intervention(s): Hysteroscopic metroplasty was performed on all patients in both groups. Result(s): 40 patients who were diagnosed with a partial septate uteri had hysteroscopic septum resection and were divided into two groups: Group I (18 patients) presented with infertility and Group II (22 patients) with recurrent abortions. The mean post-operative follow up period was 24 months. Group I, 12 patients (66.6%) and Group II, 17 patients (77.2%) achieved pregnancy, with respective abortion rates of 2 (11.1%) and 4 (18.1%). Conclusion(s): Using hysteroscopy to perform metroplasty on septate uteri makes the procedure safer, easier, and less complicated. This procedure is recommended for all cases diagnosed with an uterine septum.展开更多
Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion （EMA） up to 9 weeks of gestation. Methods An audit was performed on a retrospect...Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion （EMA） up to 9 weeks of gestation. Methods An audit was performed on a retrospective data analysis of 162 women who underwent an early medical abortion in Southampton U.K. Relevant data on completeness of abortion and other details were analyzed. Results Majority of the women （67%） aged 20-30 years old, 22% were between 30 and 40 years old and 1% were above 40 years old when they came for abortion. About 94.5% women had complete abortion following the use of single dose mifepristone combined with two doses of misoprostol, 4.9% had an incomplete abortion and 0.6% had failure of the procedure. These figures had significantly improved over the results of similar audit in 2005 with single dose of misoprostol to women below 7 weeks of pregnancy. The results in this audit were 82.1% complete abortion, 7.2% incomplete abortion and O. 7% failed procedure. Conclusion Mifepristone in combination with two doses of misoprostol appears to be more effective in all cases of early medical abortion when compared with single dose of misoprostol for termination below 49 d （7 weeks） and two doses of misoprostol between 49 d and 63 d （7-9 weeks） of pregnancy.展开更多
The magnitude of the overall prevalence and racial disparity in induced abortion suggests that it is a major influence on the demographic and socioeconomic composition of the population of the United States (US). Howe...The magnitude of the overall prevalence and racial disparity in induced abortion suggests that it is a major influence on the demographic and socioeconomic composition of the population of the United States (US). However, the years of potential lives averted by induced abortion have not been systematically studied. We applied race-specific intra-uterine death estimates to the induced abortions occurring to non-Hispanic (NH) white and non-Hispanic (NH) black women in the US state of North Carolina in 2008. The resultant estimate of births averted by induced abortion was used to project years of potential life lost. All-cause detailed mortality data were used to compare induced abortion with other contributing causes of years of potential life lost before age 75 (YPLL 75). For NH whites, induced abortions in 2008 contributed 59% of total YPLL 75, and 1.5 times the total YPLL 75 from all other causes combined. For NH blacks, induced abortions in 2008 contributed 76% of total YPLL 75 and 3.2 times the total YPLL 75 from all other causes combined. Induced abortion is the overwhelmingly predominant contributing cause of preventable potential lives lost in the North Carolina population, and NH blacks are disproportionately affected.展开更多
Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains l...Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complications were dominated by the anaemia (62.1%). Conclusion: The clandestine induced abortion is a frequent situation in the Chad and is cause of numerous complications.展开更多
Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a ma...Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.展开更多
Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads ...Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.展开更多
Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in C...Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I<sup>2</sup> and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.展开更多
Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out cla...Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out clandestine abortions, to describe the profile of the providers and the complications that result from it. Patients and Methods: This was a descriptive cross-sectional study of patients hospitalized at the University Hospital Center for Sino-Central African Friendship (CHUASC) from 2015 to 2019 on 236 cases. Results: We identified a total of 254 patients for 8039 live births in the same period, a frequency of 3.16%. The age of the patients was between 15 years old and 48 years old with an average of 25 years old. Singles accounted for 42.5%. Induced abortions were more performed among students (32.6%) and the unemployed 53.6%. Contraception was used in 11.5% of cases. The methods used were numerous: misoprostol (32%), the traditional method (18%), the mechanical method (50%). In this method, we note the dilation of the cervix by the cassava stem;Hegar’s candles;the probes, which are infusion tubes cut and introduced into the cervix, of which 2 cases had escaped at the level of the uterine muscles and emerged under the skin at the pubis part two years later. The practice of induced abortions in our series was done by medical students in 37.3% followed by unqualified staff in 49.7%. It took place either at home or in centers managed by Non-Governmental Organizations. The aseptic conditions were not perfect. Some patients (43.2%) were aware of the ensuing complications. All complications were present: hemorrhage (60.7%), pelviperitonitis (23.6%), uterine perforation (6.6%), peritonitis (2.8%) and death (2%) related to sepsis. Conclusion: Clandestine abortion remains a real health problem for young Central African women.展开更多
Objective:To compare the clinical efficacy of mifepristone-misoprostol medical management versus surgical curettage for first-trimester missed miscarriage,and to establish evidence-based sonographic cutoff values pred...Objective:To compare the clinical efficacy of mifepristone-misoprostol medical management versus surgical curettage for first-trimester missed miscarriage,and to establish evidence-based sonographic cutoff values predictive of incomplete abortion requiring surgical intervention.Methods:We retrospectively analyzed a cohort of 702 women diagnosed with first-trimester missed miscarriage between January 2020 and May 2023.Demographic characteristics and ultrasound parameters were systematically recorded.Receiver operating characteristic(ROC)curve analysis was performed to establish optimal sonographic cutoff values for predicting incomplete abortion requiring surgical intervention.Results:146 patients received medical treatment(mifepristone and misoprostol)and 556 underwent surgical curettage.At the 1-month follow-up,the medical group showed significantly greater endometrial thickness and longer postoperative bleeding duration than the surgical group(P<0.05).The menstrual volume reduction rate(23.56%)was significantly lower in the medical group than in the surgical group.The incomplete abortion rate was higher in the medical group(17.12%,25/146)than in the surgical group(2.88%,16/556).Among the medical group,14 patients(9.59%)required curettage due to incomplete abortion,while 11 cases resolved spontaneously after prolonged medication.ROC curve analysis identified two cut-off values indicating the need for surgical intervention:endometrial thickness>1.21 cm at 24 h post-medical abortion,and residual mass diameter>0.95 cm at 7 days post-medical abortion.Conclusions:Medical management of first-trimester missed miscarriage using mifepristone-misoprostol demonstrates comparable efficacy to surgical curettage.An endometrial thickness>1.21 cm at 24 h or residual tissue diameter>0.95 cm at 7 days post-medical abortion should prompt consideration of incomplete abortion.展开更多
Background: Some studies have indicated a potential link between a history of induced abortion (IA) and the subsequent risk of gestational diabetes mellitus (GDM), but the relationship is not fully understood, and the...Background: Some studies have indicated a potential link between a history of induced abortion (IA) and the subsequent risk of gestational diabetes mellitus (GDM), but the relationship is not fully understood, and the aim of this study was to further elucidate the association. Methods: The case-control study was conducted at 2 hospitals in central China from April 2018 to October 2020. GDM was diagnosed by an oral glucose tolerance test (OGTT). Information on history of IA was obtained through a face-to-face interview. Results: Among 396 GDM cases and 904 controls, the proportion of participants with history of IA in the case group was 30.6%, which was higher than that in the control group (23.1%), and the difference was statistically significant (p = 0.005). After adjusting for potential confounders, women with a history of IA had an increased subsequent risk of GDM compared with women without (OR, 1.24, 95% CI, 1.10 - 1.40, p = 0.002). The subsequent risk of GDM in pregnant women increased as the number of previous IAs increased (p for trend was equal to 0.004). Stratified analysis showed that women with a history of medical abortion (OR, 1.28, 95% CI, 1.01 - 1.62, p = 0.048) or surgical abortion (OR, 1.20, 95% CI, 1.04 - 1.38, p = 0.024) both had an increased subsequent risk of GDM compared with women without. Conclusion: History of IA, either medical or surgical, was related to an increased risk of GDM in subsequent pregnancy. The greater the number of previous IAs, the greater the subsequent risk of GDM.展开更多
Ogura cytoplasmic male sterility(Ogura CMS)was first identified in wild radish(Raphanus sativus)and resulted in complete pollen abortion.However,the molecular mechanism of Ogura CMS in Chinese cabbage remains unclear....Ogura cytoplasmic male sterility(Ogura CMS)was first identified in wild radish(Raphanus sativus)and resulted in complete pollen abortion.However,the molecular mechanism of Ogura CMS in Chinese cabbage remains unclear.A cytological analysis confirmed nuclear degradation during the late uninucleate stage of pollen development,which diminished by the tricellular stage.Concurrently,tapetal cells exhibited abnormal enlargement and vacuolation starting from the tetrad stage.Serious developmental defects were observed in the pollen wall.During early pollen development,genes associated with cytochrome c and programmed cell death(PCD)were upregulated in the Ogura CMS line,while genes involved in pollen wall mitosis were downregulated.Conversely,at the late stage of pollen development,peroxisome and autophagy-related genes in the Ogura CMS line were upregulated.The mitochondrial orf138 gene mutation triggered the PCD process in tapetal cells,leading to their abnormal enlargement and the degradation of their contents,eventually resulting in vacuolation at the tricellular stage.These tapetal defects hindered the provision of adequate sporopollenin and nutrients to the microspores,consequently leading to abnormal pollen wall development and abnormal mitosis in the microspores.Ultimately,nuclear dispersion commenced during the late uninucleate stage,and autophagy occurred in the late stage of pollen development.Consequently,the plant could not produce functional pollen,resulting in male sterility in Chinese cabbage.Studies of Ogura CMS can promote the production and application of male sterile materials and enrich male sterile resources,which is of great significance for hybrid breeding.展开更多
Young women’s physical and mental health is seriously impacted by recurrent spontaneous abortion(RSA),a prevalent obstetric complication that is becoming more commonplace worldwide.Therefore,a thorough investigation ...Young women’s physical and mental health is seriously impacted by recurrent spontaneous abortion(RSA),a prevalent obstetric complication that is becoming more commonplace worldwide.Therefore,a thorough investigation into the pathophysiology of RSA and the development of novel therapeutic strategies are imperative.Recent developments suggest that mesenchymal stem cell(MSC)-based therapies may be viable for addressing RSA.Through a variety of mechanisms,the immunological circumstances at the maternal-fetal contact can be altered,including regulating immune cell homeostasis,enhancing immune tolerance,alleviating inflammatory responses,promoting angiogenic processes,and promoting tissue regeneration.MSCs exhibit a remarkable capacity for multidifferentiation that could enhance pregnancy outcomes.This article provides compelling studies supporting the efficacy of MSC-based therapies in improving pregnancy outcomes in women with RSA.展开更多
Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within...Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.展开更多
Background:Achromobacter xylosoxidans(A.xylosoxidans)subspecies strains are known to be opportunistic environmental inhabitants.Among the two species,A.xylosoxidans ssp.xylosoxidans is more commonly reported cause of ...Background:Achromobacter xylosoxidans(A.xylosoxidans)subspecies strains are known to be opportunistic environmental inhabitants.Among the two species,A.xylosoxidans ssp.xylosoxidans is more commonly reported cause of nosocomial infections colonizing the hospital environment and medical devices,while A.xylosoxidans ssp.denitrificans(AD)strains are widely distributed in the abiotic environment.The present retrospective observational study was aimed at understanding the occurrence of AD infections in the Bareilly region,and to look into the effective herbal and conventional antimicrobial resistance profile of the strains identified at the laboratory.Methods:The present retrospective study analysed Clinical Microbiology laboratory data of Indian veterinary research Institute.The data for the last 14 years(2011-2024)was retrieved,tabulated and analysed using MS Excel program to determine significance of occurrence,and variation in antimicrobial resistance of the strains isolated from different sources usingχ2 and odds ratio analysis.Results:The study revealed that AD was detectable as a potential pathogen not only from environmental samples but also from 51 clinical cases(either as pure culture or mixed infection),and also from healthy humans and animals.The pathogen was most commonly associated with deaths in animals and birds due to septicaemia and was isolated is single pathogen from blood samples.It was also detected as single pathogen from cases of abortions,metritis,and urinary tract infections.However,from cases of haemorrhagic enteritis,diarrhoea,mastitis,wound infections,pyoderma and abscesses,and middle ear infections AD was isolated in association of one or more potentially pathogenic bacteria.Of the 80 isolates in the study,68 had multiple drug resistance,and 21 produced metallo-β-lactamases responsible for resistance against most of theβ-lactam antibiotics,including cephalosporins and carbapenems.The most effective antibiotic was gentamicin,inhibiting 90.67%of the isolates,followed by tigecycline(85.00%),ciprofloxacin(80.77%),piperacillin tazobactam(80.65%);other antibiotics were effective against less than 80%of the isolates.Among the herbal antimicrobials,cinnamaldehyde,cinnamon oil,carvacrol,and ajowan oil inhibited 98.41%,85.07%,85.00%,and 83.75%of the isolates,respectively.Conclusion:The study concluded that in the Bareilly region in India,multiple-drug-resistance AD may be an emerging pathogen prevalent in environment and apparently healthy animals.More studies are warranted to understand the AD strains at molecular level to understand their zoonotic potential and circulation in the environment.展开更多
Francophone countries in sub-Saharan Africa had been more resistant to induced abortion.Their cultural heritage from France had been influential in strengthening their pronatalist position regarding contraception and ...Francophone countries in sub-Saharan Africa had been more resistant to induced abortion.Their cultural heritage from France had been influential in strengthening their pronatalist position regarding contraception and abortion.Most of them inherited the judicial system and cultural value from France,which have been transmitted to Francophone countries.However,cultural and behavioral changes in reproductive health have begun in Francophone sub-Saharan Africa since the mid-1990s after the paradigm shift on population policy with the International Conference on Population and Development(ICPD)in 1994.Some women have started to use contraception for birth limitation.Induced abortion to prevent unintended pregnancy has been increasingly liberalized in some settings.In this study,the changing contexts for induced abortion in Francophone countries will be reviewed.Recent step undertaken by Benin to legalize abortion in most circumstances shows that Francophone countries may be overcoming their cultural barriers and adapting universal human rights based reproductive behaviors.展开更多
Objective Heat wave exposure significantly impacts human health.Nevertheless,studies on the long-term effects of heat wave exposure during adolescence on adverse pregnancy outcomes(APOs)are rare.This study aimed to in...Objective Heat wave exposure significantly impacts human health.Nevertheless,studies on the long-term effects of heat wave exposure during adolescence on adverse pregnancy outcomes(APOs)are rare.This study aimed to investigate the relationship between the long-term effects of heat wave exposure during adolescence and APOs.Methods We analyzed data from 3,376 female and 3,013 male participants across 31 provinces in China.All adolescents(10–19 years old),early adolescents(10–14),and late adolescents(15–19)were chosen as exposure windows.Heat waves were defined as periods lasting 2‒4 consecutive days with the daily temperature exceeding the 75th,90th,and 92.5th percentiles.We employed multivariate logistic regression models to assess the associations between exposure to heat waves during adolescence and APOs.Results The results revealed significant associations between male exposure to heat wave events during late adolescence and spontaneous abortion(P<0.05),which was more pronounced in South China.In contrast,no statistically significant associations were detected between males’exposure to heat wave events during adolescence and their partners’preterm birth(P>0.05 for all comparisons).The exposure of females to heat waves during adolescence was not significantly associated with subsequent spontaneous abortion or preterm birth(P>0.05 for all comparisons).Conclusions This study demonstrates that spontaneous abortion in females is associated with heat wave exposure in their male partner during adolescence.展开更多
Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively ...Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively the fertility in the future by tubo-peritoneal lesions. The current study aimed to highlight the infertility factors associated with USA. Material and Methods: From January 1st 2000 to December 31st 2021, a total of 3876 patients that sought care for infertility in the University Clinic of Kinshasa and the Edith Medical Center were enrolled. The socio-demographic, clinical and paraclinical variables were recorded and analyzed in relation to USA history. Results: The patients’ average age was 33.4 ± 5.7 years. Half of them were housewives;about sixty percent of the patients were nulliparous (59.31%). Seventy percent had a secondary infertility with 43.33% having a history of unsafe abortion. The main diagnosis was genital infections and uterus myoma. The chronic endometritis, bilateral tubal occlusion and Uterine synechiae were more associated with USA group. The spermogram anomalies and other partners’ lesions seemed of infectious origin. Conclusion: The USA remains a more frequent phenomenon in our setting. The chronic endometritis, bilateral tubal occlusion, uterine synechiae and indirectly uterus myoma were the infertility factors related to USA. The genital infection of any origin seems to be the main denominator underlying the female and the male infertility in our setting.展开更多
文摘Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.
文摘Objective To determine the role of the circulating antisperm antibody （ASA） in the pathogenesis of missed abortion at the first-trimester pregnancy. Methods Sixty-two patients with a history of missed abortion at the first-trimester pregnancy were enrolled into this study. Indirect immunobead test （IBT） was used to measure the circulating ASA levels. Fifty healthy women with the first-trimester pregnancy set as the control. Results No case had the positive level of ASA according to the World Health Organization criteria （50% or more of the motile sperm with immunobead binding）. Only 1 case in patient group and 1 case in the control had 10%-20% of the motile spermatozoa with ASA-IgG bead binding. In both patient and control groups, ASA-IgA was found to be completely negative binding. Conclusion The circulating ASA is not associated with the pathogenesis of missed abortions at the first-trimester pregnancy.
文摘Objective: The aim of this study was to assess the achievement of pregnancy as well as the reproductive outcome after hysteroscopic septum resection in women with recurrent abortions or infertility. Design: retrospective, clinical trial. Setting: University hospitals. Patient(s): Fourty women with a diagnosis of uterine septum who had a history of pregnancy loss or infertility. They were randomized into two groups. Group I includes 18 infertile women and group II includes 22 recurrent miscarriage women. Intervention(s): Hysteroscopic metroplasty was performed on all patients in both groups. Result(s): 40 patients who were diagnosed with a partial septate uteri had hysteroscopic septum resection and were divided into two groups: Group I (18 patients) presented with infertility and Group II (22 patients) with recurrent abortions. The mean post-operative follow up period was 24 months. Group I, 12 patients (66.6%) and Group II, 17 patients (77.2%) achieved pregnancy, with respective abortion rates of 2 (11.1%) and 4 (18.1%). Conclusion(s): Using hysteroscopy to perform metroplasty on septate uteri makes the procedure safer, easier, and less complicated. This procedure is recommended for all cases diagnosed with an uterine septum.
文摘Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion （EMA） up to 9 weeks of gestation. Methods An audit was performed on a retrospective data analysis of 162 women who underwent an early medical abortion in Southampton U.K. Relevant data on completeness of abortion and other details were analyzed. Results Majority of the women （67%） aged 20-30 years old, 22% were between 30 and 40 years old and 1% were above 40 years old when they came for abortion. About 94.5% women had complete abortion following the use of single dose mifepristone combined with two doses of misoprostol, 4.9% had an incomplete abortion and 0.6% had failure of the procedure. These figures had significantly improved over the results of similar audit in 2005 with single dose of misoprostol to women below 7 weeks of pregnancy. The results in this audit were 82.1% complete abortion, 7.2% incomplete abortion and O. 7% failed procedure. Conclusion Mifepristone in combination with two doses of misoprostol appears to be more effective in all cases of early medical abortion when compared with single dose of misoprostol for termination below 49 d （7 weeks） and two doses of misoprostol between 49 d and 63 d （7-9 weeks） of pregnancy.
文摘The magnitude of the overall prevalence and racial disparity in induced abortion suggests that it is a major influence on the demographic and socioeconomic composition of the population of the United States (US). However, the years of potential lives averted by induced abortion have not been systematically studied. We applied race-specific intra-uterine death estimates to the induced abortions occurring to non-Hispanic (NH) white and non-Hispanic (NH) black women in the US state of North Carolina in 2008. The resultant estimate of births averted by induced abortion was used to project years of potential life lost. All-cause detailed mortality data were used to compare induced abortion with other contributing causes of years of potential life lost before age 75 (YPLL 75). For NH whites, induced abortions in 2008 contributed 59% of total YPLL 75, and 1.5 times the total YPLL 75 from all other causes combined. For NH blacks, induced abortions in 2008 contributed 76% of total YPLL 75 and 3.2 times the total YPLL 75 from all other causes combined. Induced abortion is the overwhelmingly predominant contributing cause of preventable potential lives lost in the North Carolina population, and NH blacks are disproportionately affected.
文摘Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complications were dominated by the anaemia (62.1%). Conclusion: The clandestine induced abortion is a frequent situation in the Chad and is cause of numerous complications.
文摘Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.
文摘Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.
文摘Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I<sup>2</sup> and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.
文摘Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out clandestine abortions, to describe the profile of the providers and the complications that result from it. Patients and Methods: This was a descriptive cross-sectional study of patients hospitalized at the University Hospital Center for Sino-Central African Friendship (CHUASC) from 2015 to 2019 on 236 cases. Results: We identified a total of 254 patients for 8039 live births in the same period, a frequency of 3.16%. The age of the patients was between 15 years old and 48 years old with an average of 25 years old. Singles accounted for 42.5%. Induced abortions were more performed among students (32.6%) and the unemployed 53.6%. Contraception was used in 11.5% of cases. The methods used were numerous: misoprostol (32%), the traditional method (18%), the mechanical method (50%). In this method, we note the dilation of the cervix by the cassava stem;Hegar’s candles;the probes, which are infusion tubes cut and introduced into the cervix, of which 2 cases had escaped at the level of the uterine muscles and emerged under the skin at the pubis part two years later. The practice of induced abortions in our series was done by medical students in 37.3% followed by unqualified staff in 49.7%. It took place either at home or in centers managed by Non-Governmental Organizations. The aseptic conditions were not perfect. Some patients (43.2%) were aware of the ensuing complications. All complications were present: hemorrhage (60.7%), pelviperitonitis (23.6%), uterine perforation (6.6%), peritonitis (2.8%) and death (2%) related to sepsis. Conclusion: Clandestine abortion remains a real health problem for young Central African women.
基金supported by National Natural Science Foundation of China(Project approval number 82201825).
文摘Objective:To compare the clinical efficacy of mifepristone-misoprostol medical management versus surgical curettage for first-trimester missed miscarriage,and to establish evidence-based sonographic cutoff values predictive of incomplete abortion requiring surgical intervention.Methods:We retrospectively analyzed a cohort of 702 women diagnosed with first-trimester missed miscarriage between January 2020 and May 2023.Demographic characteristics and ultrasound parameters were systematically recorded.Receiver operating characteristic(ROC)curve analysis was performed to establish optimal sonographic cutoff values for predicting incomplete abortion requiring surgical intervention.Results:146 patients received medical treatment(mifepristone and misoprostol)and 556 underwent surgical curettage.At the 1-month follow-up,the medical group showed significantly greater endometrial thickness and longer postoperative bleeding duration than the surgical group(P<0.05).The menstrual volume reduction rate(23.56%)was significantly lower in the medical group than in the surgical group.The incomplete abortion rate was higher in the medical group(17.12%,25/146)than in the surgical group(2.88%,16/556).Among the medical group,14 patients(9.59%)required curettage due to incomplete abortion,while 11 cases resolved spontaneously after prolonged medication.ROC curve analysis identified two cut-off values indicating the need for surgical intervention:endometrial thickness>1.21 cm at 24 h post-medical abortion,and residual mass diameter>0.95 cm at 7 days post-medical abortion.Conclusions:Medical management of first-trimester missed miscarriage using mifepristone-misoprostol demonstrates comparable efficacy to surgical curettage.An endometrial thickness>1.21 cm at 24 h or residual tissue diameter>0.95 cm at 7 days post-medical abortion should prompt consideration of incomplete abortion.
文摘Background: Some studies have indicated a potential link between a history of induced abortion (IA) and the subsequent risk of gestational diabetes mellitus (GDM), but the relationship is not fully understood, and the aim of this study was to further elucidate the association. Methods: The case-control study was conducted at 2 hospitals in central China from April 2018 to October 2020. GDM was diagnosed by an oral glucose tolerance test (OGTT). Information on history of IA was obtained through a face-to-face interview. Results: Among 396 GDM cases and 904 controls, the proportion of participants with history of IA in the case group was 30.6%, which was higher than that in the control group (23.1%), and the difference was statistically significant (p = 0.005). After adjusting for potential confounders, women with a history of IA had an increased subsequent risk of GDM compared with women without (OR, 1.24, 95% CI, 1.10 - 1.40, p = 0.002). The subsequent risk of GDM in pregnant women increased as the number of previous IAs increased (p for trend was equal to 0.004). Stratified analysis showed that women with a history of medical abortion (OR, 1.28, 95% CI, 1.01 - 1.62, p = 0.048) or surgical abortion (OR, 1.20, 95% CI, 1.04 - 1.38, p = 0.024) both had an increased subsequent risk of GDM compared with women without. Conclusion: History of IA, either medical or surgical, was related to an increased risk of GDM in subsequent pregnancy. The greater the number of previous IAs, the greater the subsequent risk of GDM.
基金supported by the China Agricultural Research System(CARS-23-G15)the Innovation Team of Henan Academy of Agricultural Sciences,China(2024TD06)+2 种基金the Autonomous Innovation Project of Henan Academy of Agricultural Sciences,China(2024ZC034)the Joint Research on Agricultural Variety Improvement of Henan Province,China(2022010504)the Key Research&Development Project of Henan Province,China(221111110100)。
文摘Ogura cytoplasmic male sterility(Ogura CMS)was first identified in wild radish(Raphanus sativus)and resulted in complete pollen abortion.However,the molecular mechanism of Ogura CMS in Chinese cabbage remains unclear.A cytological analysis confirmed nuclear degradation during the late uninucleate stage of pollen development,which diminished by the tricellular stage.Concurrently,tapetal cells exhibited abnormal enlargement and vacuolation starting from the tetrad stage.Serious developmental defects were observed in the pollen wall.During early pollen development,genes associated with cytochrome c and programmed cell death(PCD)were upregulated in the Ogura CMS line,while genes involved in pollen wall mitosis were downregulated.Conversely,at the late stage of pollen development,peroxisome and autophagy-related genes in the Ogura CMS line were upregulated.The mitochondrial orf138 gene mutation triggered the PCD process in tapetal cells,leading to their abnormal enlargement and the degradation of their contents,eventually resulting in vacuolation at the tricellular stage.These tapetal defects hindered the provision of adequate sporopollenin and nutrients to the microspores,consequently leading to abnormal pollen wall development and abnormal mitosis in the microspores.Ultimately,nuclear dispersion commenced during the late uninucleate stage,and autophagy occurred in the late stage of pollen development.Consequently,the plant could not produce functional pollen,resulting in male sterility in Chinese cabbage.Studies of Ogura CMS can promote the production and application of male sterile materials and enrich male sterile resources,which is of great significance for hybrid breeding.
基金Supported by the Natural Science Foundation of Liaoning Province,No.2024-MSLH-525.
文摘Young women’s physical and mental health is seriously impacted by recurrent spontaneous abortion(RSA),a prevalent obstetric complication that is becoming more commonplace worldwide.Therefore,a thorough investigation into the pathophysiology of RSA and the development of novel therapeutic strategies are imperative.Recent developments suggest that mesenchymal stem cell(MSC)-based therapies may be viable for addressing RSA.Through a variety of mechanisms,the immunological circumstances at the maternal-fetal contact can be altered,including regulating immune cell homeostasis,enhancing immune tolerance,alleviating inflammatory responses,promoting angiogenic processes,and promoting tissue regeneration.MSCs exhibit a remarkable capacity for multidifferentiation that could enhance pregnancy outcomes.This article provides compelling studies supporting the efficacy of MSC-based therapies in improving pregnancy outcomes in women with RSA.
文摘Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.
基金supported by grants from CAAST-ACLH(NAHEP/CAAST/2018-19)of the ICAR-World Bank-funded National Agricultural Higher Education Project(NAHEP).
文摘Background:Achromobacter xylosoxidans(A.xylosoxidans)subspecies strains are known to be opportunistic environmental inhabitants.Among the two species,A.xylosoxidans ssp.xylosoxidans is more commonly reported cause of nosocomial infections colonizing the hospital environment and medical devices,while A.xylosoxidans ssp.denitrificans(AD)strains are widely distributed in the abiotic environment.The present retrospective observational study was aimed at understanding the occurrence of AD infections in the Bareilly region,and to look into the effective herbal and conventional antimicrobial resistance profile of the strains identified at the laboratory.Methods:The present retrospective study analysed Clinical Microbiology laboratory data of Indian veterinary research Institute.The data for the last 14 years(2011-2024)was retrieved,tabulated and analysed using MS Excel program to determine significance of occurrence,and variation in antimicrobial resistance of the strains isolated from different sources usingχ2 and odds ratio analysis.Results:The study revealed that AD was detectable as a potential pathogen not only from environmental samples but also from 51 clinical cases(either as pure culture or mixed infection),and also from healthy humans and animals.The pathogen was most commonly associated with deaths in animals and birds due to septicaemia and was isolated is single pathogen from blood samples.It was also detected as single pathogen from cases of abortions,metritis,and urinary tract infections.However,from cases of haemorrhagic enteritis,diarrhoea,mastitis,wound infections,pyoderma and abscesses,and middle ear infections AD was isolated in association of one or more potentially pathogenic bacteria.Of the 80 isolates in the study,68 had multiple drug resistance,and 21 produced metallo-β-lactamases responsible for resistance against most of theβ-lactam antibiotics,including cephalosporins and carbapenems.The most effective antibiotic was gentamicin,inhibiting 90.67%of the isolates,followed by tigecycline(85.00%),ciprofloxacin(80.77%),piperacillin tazobactam(80.65%);other antibiotics were effective against less than 80%of the isolates.Among the herbal antimicrobials,cinnamaldehyde,cinnamon oil,carvacrol,and ajowan oil inhibited 98.41%,85.07%,85.00%,and 83.75%of the isolates,respectively.Conclusion:The study concluded that in the Bareilly region in India,multiple-drug-resistance AD may be an emerging pathogen prevalent in environment and apparently healthy animals.More studies are warranted to understand the AD strains at molecular level to understand their zoonotic potential and circulation in the environment.
文摘Francophone countries in sub-Saharan Africa had been more resistant to induced abortion.Their cultural heritage from France had been influential in strengthening their pronatalist position regarding contraception and abortion.Most of them inherited the judicial system and cultural value from France,which have been transmitted to Francophone countries.However,cultural and behavioral changes in reproductive health have begun in Francophone sub-Saharan Africa since the mid-1990s after the paradigm shift on population policy with the International Conference on Population and Development(ICPD)in 1994.Some women have started to use contraception for birth limitation.Induced abortion to prevent unintended pregnancy has been increasingly liberalized in some settings.In this study,the changing contexts for induced abortion in Francophone countries will be reviewed.Recent step undertaken by Benin to legalize abortion in most circumstances shows that Francophone countries may be overcoming their cultural barriers and adapting universal human rights based reproductive behaviors.
基金funded by the Key Project of the University Outstanding Youth Backbone Talented Person Foreign Visits Study Does Research of Anhui Province(No.gxgwfx2020025).
文摘Objective Heat wave exposure significantly impacts human health.Nevertheless,studies on the long-term effects of heat wave exposure during adolescence on adverse pregnancy outcomes(APOs)are rare.This study aimed to investigate the relationship between the long-term effects of heat wave exposure during adolescence and APOs.Methods We analyzed data from 3,376 female and 3,013 male participants across 31 provinces in China.All adolescents(10–19 years old),early adolescents(10–14),and late adolescents(15–19)were chosen as exposure windows.Heat waves were defined as periods lasting 2‒4 consecutive days with the daily temperature exceeding the 75th,90th,and 92.5th percentiles.We employed multivariate logistic regression models to assess the associations between exposure to heat waves during adolescence and APOs.Results The results revealed significant associations between male exposure to heat wave events during late adolescence and spontaneous abortion(P<0.05),which was more pronounced in South China.In contrast,no statistically significant associations were detected between males’exposure to heat wave events during adolescence and their partners’preterm birth(P>0.05 for all comparisons).The exposure of females to heat waves during adolescence was not significantly associated with subsequent spontaneous abortion or preterm birth(P>0.05 for all comparisons).Conclusions This study demonstrates that spontaneous abortion in females is associated with heat wave exposure in their male partner during adolescence.
文摘Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively the fertility in the future by tubo-peritoneal lesions. The current study aimed to highlight the infertility factors associated with USA. Material and Methods: From January 1st 2000 to December 31st 2021, a total of 3876 patients that sought care for infertility in the University Clinic of Kinshasa and the Edith Medical Center were enrolled. The socio-demographic, clinical and paraclinical variables were recorded and analyzed in relation to USA history. Results: The patients’ average age was 33.4 ± 5.7 years. Half of them were housewives;about sixty percent of the patients were nulliparous (59.31%). Seventy percent had a secondary infertility with 43.33% having a history of unsafe abortion. The main diagnosis was genital infections and uterus myoma. The chronic endometritis, bilateral tubal occlusion and Uterine synechiae were more associated with USA group. The spermogram anomalies and other partners’ lesions seemed of infectious origin. Conclusion: The USA remains a more frequent phenomenon in our setting. The chronic endometritis, bilateral tubal occlusion, uterine synechiae and indirectly uterus myoma were the infertility factors related to USA. The genital infection of any origin seems to be the main denominator underlying the female and the male infertility in our setting.
