• 【对患有自然流产的妇女进行同种异体预防接种后,抑制了细胞介导的免疫以及单核细胞和自然杀伤细胞的活性。】 复制标题 收藏 收藏
    DOI:10.1023/a:1027372409361 复制DOI
    作者列表:Gafter U,Sredni B,Segal J,Kalechman Y
    BACKGROUND & AIMS: Spontaneous recurrent abortion (SRA) has been treated by means of immunization with paternal or third-party white blood cells, yet the immunological basis for SRA and for the role of immunization protocols in pregnancy outcome remains controversial. To elucidate this question, nine women with SRA were immunized with paternal mononuclear cells and studied before and 2 weeks after immunization. Seven women who became pregnant gave birth to live newborns. Secretion of the T helper 1 cytokines IL-2 and interferon-gamma by patients, mononuclear cells decreased, while production of IL-10 increased. The levels of natural killer and lymphokine-activated killer cell-mediated cytotoxicity were markedly decreased. Monocyte functions such as secretion of IL-1 alpha, tumor necrosis factor alpha, IL-6, and cytotoxic activity decreased concurrently with elevations in IL-10 and transforming growth factor beta secretion. Production of IL-12, a pivotal regulatory cytokine, decreased. Furthermore, B7/1 expression on patients' mononuclear cells was downregulated. This resulted in a decrease in monocyte costimulatory activity of purified T cells with soluble anti-CD3, paralleled by a decline in allogeneic proliferative responses. These results suggest that the improved pregnancy success rate in women with SRA following immunization may be partly related to suppression of cell-mediated immunity and monocyte and natural killer cell activity.

    背景与目标: 自发性复发性流产 (SRA) 已通过父亲或第三方白细胞预防接种进行治疗,但SRA的免疫学基础以及预防接种方案在妊娠结局中的作用仍存在争议。为了阐明这个问题,对9名患有SRA的妇女进行了父本单核细胞免疫,并在免疫前和免疫后2周进行了研究。七名怀孕的妇女生下了活新生儿。T辅助细胞因子IL-2和干扰素-γ 的分泌由患者,单核细胞减少,而IL-10的产生增加。自然杀伤和淋巴因子激活的杀伤细胞介导的细胞毒性水平显着降低。单核细胞功能 (例如IL-1 α,肿瘤坏死因子 α,IL-6和细胞毒性活性的分泌) 随着IL-10和转化生长因子 β 分泌的升高而降低。IL-12 (一种关键的调节细胞因子) 的产生减少。此外,B7/1在患者单核细胞上的表达下调。这导致具有可溶性anti-CD3的纯化T细胞的单核细胞共刺激活性降低,同时同种异体增殖反应下降。这些结果表明预防接种后SRA妇女的妊娠成功率提高可能部分与抑制细胞介导的免疫,单核细胞和自然杀伤细胞活性有关。
  • 2 Is there a 'new ethics of abortion'? 复制标题 收藏 收藏

    【是否有 “新的堕胎伦理”?】 复制标题 收藏 收藏
    DOI:10.1136/jme.27.suppl_2.ii5 复制DOI
    作者列表:Gillon R
    BACKGROUND & AIMS: :This paper argues that the central issue in the abortion debate has not changed since 1967 when the English parliament enacted the Abortion Act. That central issue concerns the moral status of the human fetus. The debate here is not, it is argued, primarily a moral debate, but rather a metaphysical debate and/or a theological debate--though one with massive moral implications. It concerns the nature and attributes that an entity requires to have "full moral standing" or "moral inviolability" including a "right to life". It concerns the question when, in its development from newly fertilised ovum to unequivocally mature, autonomous morally inviolable person does a human being acquire that nature and those attributes, and thus a "right to life". The paper briefly reviews standard answers to these questions, outlining some problems associated with each. Finally there is a brief discussion of one way in which the abortion debate has changed since 1967--notably in the increasingly vociferous claim, especially from disability rights sectors, that abortion on grounds of fetal abnormality implies contempt for and rejection of disabled people--a claim that is rebutted.
    背景与目标: : 本文认为,当英国议会颁布《堕胎法》时,堕胎辩论的中心问题并没有1967年改变。这个中心问题涉及人类胎儿的道德状况。有人认为,这里的辩论主要不是道德辩论,而是形而上学的辩论和/或神学辩论-尽管具有巨大的道德含义。它涉及实体要求具有 “完全道德地位” 或 “道德不可侵犯” (包括 “生命权”) 的性质和属性。它涉及的问题是,在从新受精的卵子发展到明确成熟的,道德上不可侵犯的自主的人是否获得了自然和那些属性,从而获得了 “生命权”。本文简要回顾了这些问题的标准答案,概述了与每个问题相关的一些问题。最后,简要讨论了自1967年以来堕胎辩论发生变化的一种方式-特别是在日益激烈的主张中,尤其是来自残疾人权利部门的主张,即基于胎儿异常的堕胎意味着对残疾人的蔑视和拒绝-被驳回。
  • 【[内分泌因素在ivf-et后自然流产发病机制中的作用]。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Paszkowski T,Wrona W,Szkodziak P
    BACKGROUND & AIMS: :There is large body of evidence to show that the risk of early pregnancy loss is higher after IVF-ET than after natural conception. Several hypotheses have been proposed to explain this phenomenon. One of the possible etiopathogetic factors is the patient's age which is significantly higher in women undergoing IVF than in the general population of naturally conceiving women. Immunologic factors have also been suggested. It seems that procedures like ICSI do not increase the risk of spontaneous abortion (SAB) after IVF-ET. Moreover, the proportion of products of conception with chromosomal aberration in cases of SAB following ICSI procedure is not elevated. Many authors point to the problem of iatrogenic luteal defect after IVF-ET. The use of luteal support after IVF-ET is widely recommended. Interestingly, firm evidence is lacking regarding the efficacy of progestagen or hCG supplementation on the risk of SAB after IVF-ET. However the issue of the effectiveness of progesterone support in decreasing the risk of SAB after ART procedures is far from being conclusively resolved--it deserves well planned, randomized studied to be performed.
    背景与目标: : 大量证据表明,ivf-et后早期妊娠流产的风险高于自然受孕后。已经提出了几种假设来解释这种现象。可能的病因因素之一是患者的年龄,在接受IVF的妇女中,其年龄明显高于自然受孕妇女的一般人群。还提出了免疫因素。似乎像ICSI这样的程序不会增加ivf-et后自然流产 (SAB) 的风险。此外,在ICSI程序后的SAB病例中,具有染色体畸变的受孕产物的比例并未升高。许多作者指出了ivf-et后医源性黄体缺陷的问题。广泛推荐在ivf-et后使用黄体支持。有趣的是,缺乏关于孕激素或hCG补充对ivf-et后SAB风险的疗效的确凿证据。然而,在ART手术后,孕酮支持在降低SAB风险方面的有效性问题远未得到最终解决-值得进行精心计划的随机研究。
  • 【妇产科医生堕胎培训的经验: 来自定性研究的医生见解。】 复制标题 收藏 收藏
    DOI:10.1016/j.contraception.2010.01.003 复制DOI
    作者列表:Freedman L,Landy U,Steinauer J
    BACKGROUND & AIMS: BACKGROUND:Abortion is one of the most contested, yet common surgical procedures in the United States and a required component of obstetrics and gynecology resident education. Approaches to abortion training are variable. STUDY DESIGN:We conducted in-depth interviews with 30 physicians who had graduated 5-10 years prior from four US residency programs with routine abortion training. Interviews focused on their experiences with abortion during training and in practice. RESULTS:Graduates' positive and negative experiences demonstrated that many valued teaching about the social issues surrounding abortion as well as training in surgical skills. Respondents found training rewarding when attending physicians openly discussed their personal commitment to abortion practice, respected differences of opinions about abortion and demonstrated high regard for abortion training. Some residents who opted out of surgical training for abortion valued partially participating in the rotation. CONCLUSIONS:Many physicians-in-training consider didactics related to the social context of care and respect for moral boundaries important components of abortion training.
    背景与目标:
  • 【法国瓜德罗普岛和留尼汪岛的人工流产避孕使用: 人工流产后护理管理的差异。】 复制标题 收藏 收藏
    DOI:10.3109/13625181003782852 复制DOI
    作者列表:Moreau C,Trussell J,Desfreres J,Bajos N
    BACKGROUND & AIMS: OBJECTIVES:The abortion rate varies greatly within the French overseas territories including the Caribbean island of Guadeloupe and La Réunion in the Indian Ocean. We compare women's contraceptive paths surrounding an abortion in both territories. METHODS:The data for this study are part of a nationally representative survey of women undergoing abortion in France in 2007. The analysis included 1,211 women from Guadeloupe and 1531 from La Réunion. RESULTS:Results show differences in women's use of contraception before the abortion by study location. Women in Guadeloupe were more likely not to have used contraception in the month they conceived (40% vs. 32%, p < 0.0001). Among those using no contraception or less effective contraception before the abortion, 74% in Guadeloupe and 86% in La Réunion received a prescription for a very effective method such as a hormonal method or intrauterine device after the procedure. In both settings, women with no health insurance or a government health plan were 70% less likely to have received a prescription for a very effective method. CONCLUSIONS:While this study shows a significant increase in the prescription of very effective methods, it also indicates the ineffectiveness of the health care system in closing the gap in the pre-abortion contraceptive disparities observed between Guadeloupe and La Réunion.
    背景与目标:
  • 【早期药物流产的管理-提供者之间的国际调查。】 复制标题 收藏 收藏
    DOI:10.1016/j.ejogrb.2020.01.022 复制DOI
    作者列表:Fiala C,Bombas T,Parachini M,Agostini A,Lertxundi R,Lubusky M,Saya L,Danielsson KG
    BACKGROUND & AIMS: OBJECTIVE:To record the definition and management of Very Early Medical Abortion (VEMA) in different countries. STUDY DESIGN:An Internet survey was circulated internationally among providers of medical abortion via a website. The questionnaire focused on reasons for performing or delaying medical abortion at a very early gestational age and the perceived advantages and disadvantages of VEMA. RESULTS:Out of 220 completed questionnaires, 50 % came from European abortion providers (n = 110). Most respondents (72 %) defined VEMA as abortion performed in the presence of a positive hCG pregnancy test but with an empty uterine cavity or a gestational sac-like structure, and no signs or symptoms of ectopic pregnancy. A total of 74 % of respondents thought it was not necessary to wait for a diagnosis of intrauterine pregnancy before starting medical abortion. Equally, 74 % were aware of the possibility of an ectopic pregnancy. CONCLUSION:According to European providers of medical abortion, waiting for the diagnosis of an intrauterine pregnancy is not necessary and does not improve treatment of ectopic pregnancy. Providers should know that medical abortion can be performed effectively and safely as soon as the woman has decided. There is no lower gestational age limit.
    背景与目标:
  • 【在可辩护的范围内: 对Simkulet反对基于自然流产的反堕胎观点的论点的回应。】 复制标题 收藏 收藏
    DOI:10.1136/medethics-2017-104688 复制DOI
    作者列表:Friberg-Fernros H
    BACKGROUND & AIMS: :In a recent article, William Simkulet has argued against the anti-abortion view by invoking the fact that many human fetuses die from spontaneous abortion. He argues that this fact poses a dilemma for proponents of the anti-abortion view: either they must abandon their anti-abortion view or they must engage in preventing spontaneous abortion significantly more than at present-either to the extent that they try to prevent induced abortion or at least significantly more than they do today. In this reply, I acknowledge that, if the latter would follow, the anti-abortionist view would imply implausibly strong obligations. My aim with this reply is to demonstrate that anti-abortionists can hold on to their view without having implausibly strong obligations to prevent spontaneous abortion. My conclusion is that Simkulet clearly overstates his position by not sufficiently considering the differences between the act of killing versus death by natural causes and between positive and negative rights.
    背景与目标: : 在最近的一篇文章中,威廉·辛库莱特 (William Simkulet) 反对反堕胎的观点,他援引了许多人类胎儿死于自然流产的事实。他认为,这一事实给反堕胎观点的支持者带来了两难选择: 要么他们必须放弃反堕胎的观点,要么他们必须比目前更多地参与预防自然流产 -- 要么达到他们试图预防人工流产的程度,要么至少比今天多得多。在这份答复中,我承认,如果后者遵循,反堕胎主义的观点将意味着难以置信的强有力的义务。我的答复目的是证明反堕胎主义者可以坚持自己的观点,而不必承担防止自然流产的强大义务。我的结论是,Simkulet没有充分考虑自然原因造成的杀戮行为与死亡行为之间以及积极和消极权利之间的差异,显然夸大了他的立场。
  • 【堕胎后三到五周,亚特兰大女权主义妇女健康中心的客户使用避孕药具。】 复制标题 收藏 收藏
    DOI:10.1007/s10995-010-0631-6 复制DOI
    作者列表:Moslin TA,Rochat RW
    BACKGROUND & AIMS: :Little is known about women's contraceptive use and sexual activity in the immediate post-abortion period although effective contraceptive use is paramount during this time because fertility returns almost immediately. This study sought to learn more about women's contraceptive use and sexual behaviors to inform abortion providers and help them serve their clients better, potentially leading to a decline in the rates of unintended pregnancy and repeat abortion. Abortion clients of an Atlanta, GA clinic were surveyed over the telephone 3-5 weeks post-abortion. Background information was collected from clinic medical charts. Simple and stratified frequencies and logistic regression were used to describe women's sexual activity and contraceptive use in the immediate post-abortion period and to determine if variables known at the time of the abortion could predict contraceptive use 3-5 weeks post-abortion. 54.2% (n = 39) of women had engaged in sexual intercourse in the immediate post-abortion period. Of these, 30.8% (n = 12) were not using a contraceptive method or were not using it effectively. Women who said they did not want or need information about birth control on their medical history form were less likely to be using contraception 3-5 weeks post abortion. Emphasizing the rapid return of fertility and risk of conception in pre-abortion counseling sessions could prevent future unintended pregnancies among abortion clients. Further research could explore the interaction between a willingness to talk about contraceptive methods at the time of abortion and method use post-abortion.
    背景与目标: : 对妇女在流产后立即使用避孕药具和性行为知之甚少,尽管在此期间有效使用避孕药具至关重要,因为生育力几乎立即恢复。这项研究试图更多地了解妇女的避孕药具使用和性行为,以告知堕胎提供者并帮助她们更好地为客户服务,从而可能导致意外怀孕和重复流产的发生率下降。堕胎后3-5周,通过电话对佐治亚州亚特兰大诊所的堕胎客户进行了调查。背景信息是从诊所医疗图表中收集的。使用简单和分层的频率以及逻辑回归来描述妇女在流产后立即进行的性活动和避孕药具的使用,并确定流产时已知的变量是否可以预测流产后3-5周的避孕药具的使用。54.2% (n = 39) 的妇女在流产后立即进行性交。其中,30.8% (n = 12) 没有使用避孕方法或没有有效使用避孕方法。表示自己不希望或不需要病史表格上有关节育信息的妇女在流产后3-5周使用避孕措施的可能性较小。在流产前咨询会议中强调生育能力的迅速恢复和受孕的风险,可以防止流产客户将来意外怀孕。进一步的研究可以探索在流产时谈论避孕方法的意愿与流产后使用方法之间的相互作用。
  • 【不安全堕胎导致的住院: 13个发展中国家的估计。】 复制标题 收藏 收藏
    DOI:10.1016/S0140-6736(06)69778-X 复制DOI
    作者列表:Singh S
    BACKGROUND & AIMS: BACKGROUND:Complications from unsafe abortion are believed to account for the largest proportion of hospital admissions for gynaecological services in developing countries. The WHO estimates that one in eight pregnancy-related deaths result from unsafe abortions. The social stigma and legal restrictions associated with abortion in many countries means that data on the magnitude of this problem are scarce; this article estimates the rate and numbers of hospital admissions resulting from unsafe abortions in developing countries to help quantify the problem. METHODS:National estimates of abortion-related hospital admissions in women aged 15-44 years were compiled for 13 developing countries: Africa (Egypt, Nigeria, and Uganda), Asia (Bangladesh, Pakistan, and the Philippines), and Latin America and the Caribbean (Brazil, Chile, Colombia, Dominican Republic, Guatemala, Mexico, and Peru). These data were combined with supplementary data from five countries in sub-Saharan Africa (Burkina Faso, Ghana, Kenya, Nigeria, and South Africa) to give estimates for the three world regions. FINDINGS:The annual hospitalisation rate varies from a low of about 3 per 1000 women in Bangladesh to a high of about 15 per 1000 in Egypt and Uganda. Nigeria, Pakistan, and the Philippines have rates of 4-7 per 1000, and two countries in Latin America with recent data have rates of almost 9 per 1000. In the developing world as a whole, an estimated five million women are admitted to hospital for treatment of complications from induced abortions each year. This equates to an average rate of 5.7 per 1000 women per year in all developing regions, excluding China. By comparison, in developed countries complications from abortion procedures or hospitalisation are rare. INTERPRETATION:These results help quantify the magnitude of the adverse health effects of unsafe abortion in developing countries and highlight the need for improved access to post-abortion care. The provision of abortion services is changing to include the drug misoprostol and this could reduce the severity of abortion complications and the number of women who are hospitalised. Researchers will need to monitor these changes to provide countries with up-to-date information on illness and death from unsafe abortion. Improved contraceptive services are necessary to prevent unintended pregnancy. However, increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, and remains a high priority for developing countries.
    背景与目标:
  • 【妊娠中期人工流产时的炎症或感染。】 复制标题 收藏 收藏
    DOI:10.1016/j.contraception.2012.09.016 复制DOI
    作者列表:Roncari D,Politch JA,Sonalkar S,Finneseth M,Borgatta L
    BACKGROUND & AIMS: BACKGROUND:Induced abortion via dilation and evacuation (D&E) typically involves cervical preparation. Some clinicians also induce fetal death in the second trimester. We designed this study to determine if the combination of intra-amniotic digoxin and osmotic dilators induced intrauterine inflammatory changes. STUDY DESIGN:Twenty-two women requesting abortion at 19-23 weeks gestation had amniotic fluid sent for measurement of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), white blood cell (WBC) count and anaerobic and aerobic cultures on day 1, before dilators and digoxin amnioinjection. Sampling was repeated on Day 2, prior to D&E. RESULTS:All subjects had significantly elevated IL-6, IL-8 and TNF-α in the amniotic fluid on Day 2. The median difference for IL-6 was 19,893.4 pg/mL (p<.0001), 7040.7 pg/mL (p<.0001) for IL-8 and 181.0 pg/mL (p<.0001) for TNF-α. There was no significant difference in WBC count. There were no clinically significant positive cultures and no clinical infections. CONCLUSION:The administration of intra-amniotic digoxin and the placement of osmotic dilators prior to D&E create an intrauterine inflammatory response.
    背景与目标:
  • 【第三帝国期间的医生,怀孕,分娩和堕胎。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Chelouche T
    BACKGROUND & AIMS: :This paper does not attempt to deal with the legitimate ethical or moral debate on abortion. Utilizing abortion as a subject I will show how science and medicine in general, and abortion in particular, were used as weapons of mass destruction by Nazi physicians in their zeal to comply with the political climate of the time. Nazi policy on abortion and childbirth was just one of the methods devised and designed to ensure the extermination of those whom the Nazis deemed had "lives not worth living." Physicians implemented these policies, not with the fate of their patients in mind, but rather in the name of the "state." When discussing pregnancy, abortion and childbirth during the Holocaust it is imperative to include an essay of how these issues affected the Jewish prisoner doctors in the ghettos and camps. Nazi policy dictated their actions too. From an extensive search of their testimonies, I conclude that for these doctors ethical discourse comprised a fundamental component of their functioning. I do not propose to judge them in any way and one should not, in my opinion, argue whether their behavior was or was not morally acceptable under such duress; nevertheless, unlike their Nazi counterparts, a key theme in their testimonies was to "keep their medical values."
    背景与目标: : 本文不试图处理有关堕胎的合法道德或道德辩论。以堕胎为主题,我将展示纳粹医生如何将科学和医学,特别是堕胎作为大规模杀伤性武器,以顺应当时的政治气候。纳粹关于堕胎和分娩的政策只是旨在确保消灭纳粹认为 “不值得生活的人” 的方法之一。医生实施这些政策,不是考虑到病人的命运,而是以 “国家” 的名义。在讨论大屠杀期间的怀孕,堕胎和分娩时,必须包括一篇有关这些问题如何影响贫民窟和营地中的犹太囚犯医生的文章。纳粹政策也决定了他们的行动。通过对他们的证词的广泛搜索,我得出结论,对于这些医生,道德话语构成了他们功能的基本组成部分。我不建议以任何方式对他们进行评判,我认为,在这种胁迫下,不应争论他们的行为在道德上是否可以接受; 然而,与纳粹同行不同,他们证词的一个关键主题是 “保持他们的医疗价值”。
  • 【早期药物流产的痛苦经历: 尼泊尔、南非和越南的定性结果。】 复制标题 收藏 收藏
    DOI:10.1186/s12905-019-0816-0 复制DOI
    作者列表:Grossman D,Raifman S,Bessenaar T,Duong LD,Tamang A,Dragoman MV
    BACKGROUND & AIMS: BACKGROUND:Medical abortion (MA) has become an increasingly popular choice for women even where surgical abortion services are available. Pain is often cited by women as one of the worst aspects of the MA experience, yet we know little about women's experience with pain management during the process, particularly in low resource settings. The aim of this study is to better understand women's experiences of pain with MA and strategies for improving quality of care. METHODS:This qualitative study was conducted as part of a three-arm randomized, controlled trial in Nepal, Vietnam, and South Africa to investigate the effect of prophylactic pain management on pain during MA through 63 days' gestation. We purposively sampled seven parous and seven nulliparous women with a range of reported maximum pain levels from each country, totaling 42 participants. Thematic content analysis focused on MA pain experiences and management of pain compared to menstruation, labor, and previous abortions. RESULTS:MA is relatively less painful compared to giving birth and relatively more painful than menstruation, based on four factors: pain intensity, duration, associated symptoms and side effects, and response to pain medications. We identified four types of pain trajectories: minimal overall pain, brief intense pain, intermittent pain, and constant pain. Compared to previous abortion experiences, MA pain was less extreme (but sometimes longer in duration), more private, and less frightening. There were no distinct trends in pain trajectories by treatment group, parity, or country. Methods of coping with pain in MA and menstruation are similar in each respective country context, and use of analgesics was relatively uncommon. The majority of respondents reported that counseling about pain management before the abortion and support during the abortion process helped ease their pain and emotional stress. CONCLUSIONS:Pain management during MA is increasingly essential to ensuring quality abortion care in light of the growing proportion of abortions completed with medication around the world. Incorporating a discussion about pain expectations and pain management strategies into pre-MA counseling and providing access to information and support during the MA process could improve the quality of care and experiences of MA patients. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry ACTRN12613000017729 , registered January 8, 2013.
    背景与目标:
  • 【牙买加自然流产妇女抗心磷脂抗体阳性的患病率及其与既往临床病史的相关性。】 复制标题 收藏 收藏
    DOI:10.1080/01443610410001685646 复制DOI
    作者列表:Wharfe G,Fletcher H,Smikle M,Frederick J,Reid M
    BACKGROUND & AIMS: :One hundred and thirty-eight (138) pregnant women who had spontaneous abortions were screened for immunoglobulin G (IgG) antibodies to cardiolipin (aCL) by enzyme immunoassay (EIA). A total of 85 (61.6%) tested negative, while 53 (38.4%) had positive aCL test results. A review of the patients' hospital notes was conducted and comparisons were made between patients with moderate/high positive (21/138, 15.2%), those with low positive (32/138, 23.1%) and those with negative aCL results (85/138, 61.6%). The variables examined were a history of previous abortions, the number of previous fetal deaths and a past history of medical problems such as thrombosis or high blood pressure. No significant differences were found between the patients with moderate/high positive aCL; low positive aCL; and those with negative aCL test results for any of the clinical variables examined. In conclusion, the prevalence of positive IgG aCL tests was high in this cohort of patients with spontaneous abortion. However, intervention is not necessary in many of these patients who have only a positive aCL test, but none of the clinical conditions of the antiphospholipid syndrome.
    背景与目标: : 通过酶免疫法 (EIA) 筛选了一百三十八名 (138) 自然流产的孕妇的免疫球蛋白G (IgG) 抗心磷脂 (aCL) 抗体。共有85 (61.6%) 测试为阴性,而53 (38.4%) 的aCL测试结果为阳性。对患者的住院记录进行了回顾,并比较了中/高阳性 (21/138,15.2%),低阳性 (32/138,23.1%) 和aCL结果阴性 (85/138,61.6%) 的患者。检查的变量是以前的流产史,以前的胎儿死亡人数以及过去的疾病史,例如血栓形成或高血压。中/高aCL阳性的患者之间没有发现显着差异; 低阳性aCL; 和那些检查的任何临床变量的aCL测试结果阴性的患者。总之,在该自然流产患者队列中,IgG aCL测试阳性的患病率很高。但是,对于许多仅具有阳性aCL测试但没有抗磷脂综合征临床状况的患者,没有必要进行干预。
  • 【[在法律禁止的背景下考虑并服从年轻人堕胎: 少女怀孕的隐藏方面]。】 复制标题 收藏 收藏
    DOI:10.1590/s0102-311x2006000700006 复制DOI
    作者列表:Peres SO,Heilborn ML
    BACKGROUND & AIMS: :This article aims to unveil the notion of abortion as an element in young people's thoughts on teenage pregnancy. The study analyzes data from semi-structured interviews with 123 young men and women 18-24 years of age in Porto Alegre, Rio de Janeiro, and Salvador, Brazil, belonging to different social strata. Based on information concerning their affective, sexual, and reproductive circumstances, an abortion typology was established with a gradient ranging from considering the act to the attempt to materialize it, actually submitting to abortion, and even ruling out the possibility of interrupting the pregnancy. According to the data, 73% of interviewees had considered the possibility of an abortion, demonstrating an important presence of this notion as a recourse vis-à-vis an unpredicted pregnancy, even in the Brazilian context where abortion is illegal. Among the 86 young people who had experienced a pregnancy, 27 reported having resorted to abortion (20 males and seven females). The results indicate gender differences and contribute to an understanding of teenage pregnancy by examining induced abortion, a hidden dimension in the public and scientific debate on this issue.
    背景与目标: : 本文旨在揭示堕胎的概念,这是年轻人对少女怀孕思想中的一个要素。该研究分析了来自巴西阿雷格里港,里约热内卢和萨尔瓦多的123名18-24岁的年轻男女的半结构化访谈数据,这些男女属于不同的社会阶层。根据有关其情感,性和生殖环境的信息,建立了堕胎类型学,其梯度范围从考虑该行为到试图实现该行为,实际上屈服于堕胎,甚至排除了中断怀孕的可能性。根据数据,有73% 的受访者考虑了堕胎的可能性,这表明即使在巴西堕胎是非法的情况下,这一概念也是对不可预测的怀孕的重要手段。在86名经历过怀孕的年轻人中,有27人报告堕胎 (男性20人,女性7人)。结果表明性别差异,并通过检查人工流产,公众和有关此问题的科学辩论中的一个隐藏维度,有助于理解少女怀孕。
  • 【抗苗勒激素作为自然妊娠前三个月流产的标志。】 复制标题 收藏 收藏
    DOI:10.1002/ijgo.13104 复制DOI
    作者列表:Kostrzewa M,Żyła M,Garnysz K,Kaczmarek B,Szyłło K,Grzesiak M
    BACKGROUND & AIMS: OBJECTIVE:To assess anti-Müllerian hormone (AMH) levels as a marker of early abortion in the first trimester among women younger than 35 years. METHODS:Prospective study of women aged 18-34 years with a spontaneous pregnancy at less than 12.6 gestational weeks in Łódź, Poland, between January 2017 and November 2018. Cases of anembryonic abortion and assisted conception were excluded. Blood samples were collected and assayed for serum AMH levels. Data were compared between women with an embryo with no cardiac activity by ultrasound (n=30) and those with a normal embryo (n=33) by using Statistica12 software. RESULTS:The 10th and 90th percentiles of serum AMH concentration among control women were used to identify a reference AMH range (1.1-4.5 ng/mL). Risk of pregnancy loss in the first trimester was found to be higher for both low AMH (<1.1 ng/mL; relative risk [RR], 3.66; 95% confidence interval [CI], 2.1-6.4; P<0.001) and high AMH (>4.5 ng/mL; RR, 3.0; 95% CI, 1.61-5.59; P<0.001). CONCLUSIONS:Both very low and very high AMH concentrations were found to significantly increase the risk of abortion in the first trimester of pregnancy. Serum AMH might be a valuable marker to predict the risk of early abortion.
    背景与目标:

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