abortion

Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL). The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments.

A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data.

The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values < 0.05).

Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.

Amniocentesis and chorionic villus sampling (CVS) are the most widely used prenatal diagnostic methods. Despite their benefits, they can be associated with adverse pregnancy effects, but the exact prevalence of these complications especially in twin pregnancies is not exactly known. Therefore, the present study was conducted to determine post-amniocentesis or CVS complications in twin pregnancies.

This retrospective observational study was conducted on 187 pregnant women who underwent amniocentesis or CVS in the perinatology department of Yas Hospital affiliated with Tehran University of Medical Sciences from January 2011 to March 2020. All participants were evaluated with amniocentesis or CVS by an expert perinatologist. The study outcomes were considered as the occurrence of vaginal bleeding, rupture of the membranes, chorioamnionitis, and abortion.

The mean age of women was 33.5 ± 6.5 years. About 90 % of pregnant women underwent amniocentesis and the others underwent CVS. In 132 (70.6%) pregnant women, the most common indication for diagnostic prenatal tests was having high-risk first/second-trimester screening followed
by abnormal ultrasound anomaly scan in 31 (16.6%) cases. It was also found that in 80 (42.8%) patients, the placenta site was in the anterior part and 65 (34.8%) in the posterior part. The diagnostic test results were normal in 170 (90.4%) cases, while trisomy 21 was detected in 13 (7%) cases and trisomy 13 in 4 (2.1%) cases. The rate of abortion following CVS or amniocentesis in twin pregnancies was 3.7%, which was not associated with the study variables.

The results of the present study showed that the rate of miscarriage following amniocentesis and CVS in twin pregnancies is 3.7%. Therefore, reassuring the parents about the benefits of amniocentesis or CVS rather than their rare complications is necessary.

Abortion has been accompanied by challenges in various legal systems and religious doctrines, with different countries adopting varying criminal policies regarding it. Regardless of the legal systems’ perspectives on the permissibility of abortion, the issue of criminal and civil liability of medical staff in cases of abortion remains significant. While various provisions have been set forth in the Islamic penal code (IPC) and the law on protection of family and youth in Iran, the concept of negligence has received less attention in this field. The aim of this research was to examine the responsibility of medical staff in cases of neglect that result in abortion.

The present study was conducted using an analytical-descriptive method and relied on library sources. Additionally, information was gathered through documentary research involving the study of laws and reputable jurisprudential sources.

Based on the research findings, different rulings exist regarding negligence, with possible implications of intentional crime attributed to medical staff in certain cases.

According to the investigations conducted, the legal system in Iran, among others, considers medical staff liable for punishment even in instances of mere negligence. Furthermore, upon meeting certain conditions, such as the presence of a duty and a causal relationship, medical staff will be held responsible for negligence resulting in abortion.

Ovine enzootic abortion (OEA) caused by Chlamyidia abortus is one of the most important abortive disease in small ruminants. Diagnosis of Ovine enzootic abortion depends on the isolation and detection of the agent or its nucleic acid. The aim of the present study was to detect Chlamydia abortus using both isolation method and real-time PCR in Brucella free flocks in Iran.

Twenty-eight vaginal and conjunctival swab samples which were Chlamydia abortus seropositive, were selected from ewes and does with recent abortion. Then the samples were tested by real-time PCR and positive molecular samples were inoculated into McCoy cells.

Using real-time PCR, 18 samples (64.3%) were positive and 7 (25%) of them were isolated in cell culture.

 The present results indicate that Chlamydia can play a relatively significant role in the abortion in does and ewes in Iran. Although the isolation of Chlamydia abortus have 100% specificity, because of low sensitivity, time consuming, cost and high probability of contamination, it is not suitable for routine laboratory diagnosis. Therefore, applying real-time PCR which have high sensitivity and specificity is recommended.

This study aimed to assess the correlation between serum levels of anti-Mullerian hormone (AMH), basal follicle-stimulating hormone (FSH), basal luteinizing hormone (LH), and basal estradiol with pregnancy outcomes.

Conducted at Shariati Hospital in Tehran from 2020 to 2021, this prospective cohort study included women under 38 years old with idiopathic recurrent miscarriage (IRM). Individuals with AMH levels below 1 ng/mL were classified as the poor responder group. All participants with IRM received a daily combination of 20 mg prednisolone and 200 mg progesterone vaginal suppositories from the beginning of pregnancy until 12 weeks, along with aspirin and folic acid. Pregnancy was monitored until 36 weeks, and outcomes were evaluated over two years using univariate and multiple logistic regression, with P-values < 0.05 considered significant.

The study comprised 128 individuals with a mean age of 36.4 ± 3.9 years. Of these, 80 became pregnant, while 48 did not. Among the pregnant individuals, 34 had terminations before 26 weeks (13 ongoing and 21 clinical), while 46 had pregnancies lasting 26 weeks or longer. Maternal age (RR = 1.23, 95% CI: 1.10 - 1.90, P = 0.001), history of abortion (RR = 1.262, 95% CI: 1.052 - 1.327, P = 0.008), and low serum AMH level (RR = 0.752, 95% CI: 0.227 - 0.934, P = 0.035) were significantly associated with the probability of subsequent pregnancies. Maternal age (RR = 1.108, 95% CI: 1.05 - 1.350, P = 0.025) and history of abortion (RR = 1.097, 95% CI: 1.02 - 1.161, P = 0.042) were the only factors associated with the risk of non-pregnancy.

The study findings suggest that AMH levels in women with IRM significantly influence pregnancy outcomes, including abortion and live births at 26 weeks or more. The univariate analysis revealed significant correlations between age, serum AMH levels, previous history of abortion, and the risk of abortion. Additionally, AMH levels were found to relate to follicle storage rather than egg quality, indicating that AMH does not predict live birth after IVF. Overall, this prospective study underscores the importance of maternal age, AMH level, and previous abortion history in predicting pregnancy outcomes.

Abortion is a shocking and traumatic event that can lead to psychological disorders, such as anxiety, in women. Perceived social support of these women can be an appropriate method for helping them deal with challenging life events after abortion.

This study aims to determine the relationship between perceived social support and anxiety in pregnant women with a history of abortion. 

In this analytical cross-sectional study, 193 pregnant women with a history of abortion participated. They were selected using a convenience sampling method from among those referred to the prenatal clinic of a hospital in Rasht, north of Iran. The data were collected by a sociodemographic/obstetric form, Spielberger’s state and trait anxiety inventory-form Y, and the multidimensional scale of perceived social support. The collected data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman’s correlation test, and multiple linear regression analysis.

The mean age of women was 32.1±5.6 years and their mean gestational age was 24.6±10.9 weeks. The mean total scores of perceived social support, state anxiety, and trait anxiety were 64.2±14.9, 40.8±11.9, and 38.5±12.2, respectively. A significant negative correlation was observed between perceived social support and state anxiety (r=-0.267, P=0.001) and trait anxiety (r=-0.319, P=0.001). State anxiety was significantly different based on the interval between the current pregnancy and the previous abortion, educational level, family income level, type of pregnancy, and number of prenatal care visits (P=0.001). State anxiety was significantly different based on family income level, type of pregnancy, and the interval between the current pregnancy and the previous abortion (P=0.001). Based on multiple regression analyses, higher perceived social support could significantly predict the decrease in state anxiety (B=-0.18, 95% CI; -0.30%, -0.07%, P=0.002) and trait anxiety (B=-0.24, 95% CI; -0.36%, -0.11%, P=0.001). 

Perceived social support can affect the state and trait anxiety of pregnant women with a history of abortion. Therefore, healthcare providers should consider the high level of anxiety in these women and provide counseling to their husbands or families to strengthen their social support for them.

In Italy the percentage of repeated abortions is about 24%. Long-acting reversible contraceptive (LARC) methods are currently considered the most effective mode worldwide and are associated with the highest rate of 12-months continuation, with a potential reported reduction of recurrent abortions. The aim of this study was evaluating LARC continuation and the patients’ satisfaction at two and twelve months in use.

A longitudinal observational study collected women who underwent surgical abortion and placed a LARC method at the time of abortion in our hospital.

Totally 828 women underwent surgical abortion during the study period from which 434 choose a LARC method. After two months the rate of continuation of 52mg LNG IUD was 100% in women presenting for follow-up. Continuation rate at one year was approximately 70% for all LARC methods. More than 70% of women declared themselves satisfied or very satisfied with all LARC methods.

Despite a high rate of patient loss at follow-up, LARC methods showed a high rate of continuation at two and twelve months, with a high degree of patients' satisfaction.

Abortion, a common pregnancy complication, is influenced by multifaceted reproductive, economic, social, and cultural factors. This study investigates abortion determinants among pregnant women in Khorramabad, Iran, from September 2020 to March 2021.

This case-control study involved 416 pregnant women (208 cases, 208 controls) selected from Khorramabad health centers through census and random sampling during the COVID-19 pandemic. Data on demographics and pregnancy history were collected using a checklist and analyzed with STATA16.

Among the 416 pregnant women, the mean age was 31.00 ± 5.53 years in the control group and 32.27 ± 6.85 years in the case group. Furthermore, 74 (35.58%) mothers in the case group had a diploma, 192 (92.31%) were housewives, and 106 (50.96%) had A+ blood group. The majority of mothers (46.63% in case, 39.42% in control) had an overweight range of pre-pregnancy BMI (25-29.9) (kg/m2). The mean height was 162.97 ± 5.30 in the control group and 160.86 ± 5.39 in the case group. Multiple regression logistic analysis confirmed significant associations between abortion and mother's age (OR=4.67, 95%CI=1.11-19.62), previous cesarean delivery (OR=4.33, 95%CI=1.94-9.66), not taking folic acid pills during pregnancy (OR=14.92, 95%CI=6.25-35.61), low income (OR=7.00, 95%CI=2.02-24.35), not smoking (OR=0.28, 95%CI=0.08-0.94), and absence of pre-diabetes (OR=0.13, 95%CI=0.03-0.47) (p < 0.05). No significant relationships were found between abortion and other studied risk factors.

 Older mothers with lower income levels are more likely to experience abortion. Additionally, factors such as pre-existing pre-diabetes, previous cesarean deliveries, smoking, lack of folic acid supplementation, and maternal infections are identified as risk factors for abortion. Providing education, healthcare, and continuous support from healthcare workers can promote safe pregnancies, reduce the risk of abortion, and enhance maternal and child health outcomes.

One of the critical cases of recurrent pregnancy loss is immunological factors, whereas obtaining effective prevention or treatment is necessary for cognition of reasons.

In this study, we tried to evaluate some immunological factors related to recurrent pregnancy loss.

This case-control study was conducted on 66 women at the age of 18-35 yr who were referred to the Clinic of Gynecology and Obstetrics, Ali Ibn Abi Taleb hospital, Zahedan, Iran, from August-December 2019. Interleukin 33 (IL-33) serum levels were measured using enzyme-linked immunosorbent assay. Immunoglobulin G, Immunoglobulin A, Immunoglobulin M (IgM), and C-reactive protein levels were measured by serology and hematology methods.

The mean age of total participants was 30.8 ± 3.80 yr. The mean serum IL-33 in the case group was 318.5±  254.1 pg/ml and was lower than the control group (354.2±  259.9 pg/ml), which was not statistically significant (p = 0.52). The level of C-reactive protein in the case and control was not significantly different (p = 0.27), and Immunoglobulin A and Immunoglobulin G in the case and control were also not significantly different) p = 0.46, and p = 0.16, respectively), but there were significant differences (p=  0.003) between the level of the IgM in the case and control groups.

No statistically significant difference was observed in the IL-33 serum level, for at least 4-6 months after the last abortion in the case group and the final live birth in the control group. In contrast, serum levels of IgM were statistically significant. Finally, the need for more studies is felt according to the different results of the previous studies in this field.

One of the most common pregnancy complications is an abortion that has several complications in the mental domain for women and their families. This study aimed to compare the effectiveness of group reality therapy and cognitive behavioral therapy on coping strategies of women after abortion. The method of this study was semi-experimental research with pre-test and post-test design with a control group. In this study, 45 women with abortion practices were randomly assigned to the first three test groups (15 people), the second test (15 people), intervention (15 people). The data collection instrument was the coping strategies questionnaire (1984). Educational interventions were implemented with pre-established targets for women and the questionnaires were again executed and data analysis was carried out 50 days later. Data were analyzed by mixed variance analysis, and Bonferroni test using SPSS.22. Findings showed that there was a significant difference between reality therapy and cognitive behavioral therapy on coping strategies in all components (p<0.05) except for confrontative coping and distancing. It can be concluded that cognitive-behavioral therapy was more effective than reality therapy on improving coping strategies.

Bacterial infections are among the most serious infections worldwide. They can cause miscarriage, premature birth, stillbirth, and ectopic pregnancy in pregnant women. The aim of this study was to investigate the relationship between bacterial infections and pregnancy outcomes through a systematic review and meta‑analysis.

PubMed, Scopus, Web of Science, and Embase databases were searched from January 2000 to December 2018 using appropriate keywords to identify related articles. The final related studies were selected and evaluated using the Newcastle‑Ottawa Scale (NOS).

Results of this meta‑analysis based on combining case‑control studies showed that the presence of bacterial infections could lead increase in the odds of all pregnancy outcomes like premature infant birth (odd ratio [OR]: 1.50; 95% Confidence Interval [CI], 1.39–1.61), preterm delivery (OR: 1.54; 95% CI, 1.39–1.70), abortion (OR: 1.16; 95% CI, 1.04–1.29), stillbirth (OR, 1.29; 95% CI, 1.12–1.49), and ectopic pregnancy (OR: 1.12; 95% CI, 1.05–‑1.19). The results showed that the Risk Ratio (RR) of preterm delivery in pregnant women with vaginal infections was 1.57 (95% CI, 1.46–1.67), whereas the RR of abortion was 2.02 (95% CI, 1.72–2.38).

Based on the results of this meta‑analysis, the presence of bacterial infections in pregnant women can lead increase in the risk of pregnancy outcomes especially, preterm delivery, abortion, stillbirth, and ectopic pregnancy. Therefore, it is necessary for obstetricians and gynecologists to pay attention to the diagnosis of these infections in women before pregnancy and during pregnancy in order to prevent the consequences of these infections.