• Title/Summary/Keyword: Spontaneous abortion

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Women s Experience of Abortion : Phenomenological Perspectives (여성의 유산경험에 대한 현상학적 연구)

  • 이경혜;고명숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.2
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    • pp.157-174
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    • 1994
  • Women’s experience of abortion are not only widespread but also significant event in their lives. But this experience has not been a concern for professional care by health care providers, especially nurses. As professional nurses should have holistic approaches to clients, need to understand the lived experience of abortion from women’s perspectives. These Nurses must identify unique means for improving the quality of life of women. This study identified the meaning and structure of the lived experience of abortion. The participants were residents of Seoul and Kwang ju who were recruited through personal recommendation. Colaizzi’s method was used for the phenomenological analysis. The research question was aimed at revealing the covert meaning of abortion. The 14 women who had a spontaneous abortion and /or an artificial abortion and who argeed to participate in the study were informed of the purpose of the study, the possible risks and benefits of participation, the data generation method and they were assured of privacy and confidentiality. The investigator conducted in-depth unstructured interviews which were audiotaped with the permission of the participants. The investigator read the data repeatdly to identify and categorize themes and basic structural elements. Eight themes of abortion as experienced by these participants were : 1) complicated feelings about the anticipated abortion 2) feelings of fear and anxiety about the operation and complications 3) grieving related loss and injury 4) feelings of lonliness in perceiving no supportive person, 5) attributing the cause of the abortion to siginificant others or to self, 6) guilt feelings and resentment, 7) vacillating between regretting and not regretting, 8) struggling to a responsible person. Five basic structures identified were : 1) Complicated feelings 2) Feelings of loss and need for caring 3) Attributings to cause to significant others 4) Paradoxical emotion 5) Struggling to be a responsible being The significes of this study for nursing are : 1) It enables nurses and other health care providers understand more clearly the lived experience of abortion 2) It provides information which can be used in for women who experience abortion.

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A Case of Antiphospholipid Syndrome Associated with Protein C Deficiency (C단백질 부족증과 관련된 항인지질 증후군 1례)

  • Nam, Y.S.;Han, S.Y.;Choi, D.H.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.123-126
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    • 1999
  • A successful outcome of pregnancy requires an efficient uteroplacental vascular system. Since this system may be compromised by disorders of haemostasis associated with a prothrombotic state, maternal thrombophilia might be a risk factor for fetal loss. Hereditary deficiencies of the naturally occuring anticoagulants are well recognized conditions predisposing to recurrent venous thromboembolism. Since thrombotic phenomena have been implied as a cause of abortion and stillbirth, these deficiencies might increase the risk of fetal demise. We have experienced a case of antiphospholipid syndrome associated with protein C deficiency in patient with recurrent spontaneous abortion. So we report this case with a brief review of literatures.

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Spontaneous resolution of serous retinal detachment caused by choroidal mass after a first trimester abortion

  • Lee, You Hyun;Kim, Yu Cheol
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.242-245
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    • 2020
  • Pregnancy-related ocular diseases develop mostly in the third trimester of pregnancy. Here, we describe a case of a pregnant woman with a choroidal mass that caused a serous retinal detachment during the first trimester of pregnancy. The patient's condition resolved spontaneously after an abortion.

A Case of Antiphospholipid Syndrome Associated with Autoimmune Thrombocytopenic Purpura (자가면역 혈소판감소성 자반병과 관련된 항인지질 증후군 1례)

  • Nam, Y.S.;Lee, W.S.;Park, C.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.265-269
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    • 1999
  • Thrombocytopenic patients without detectable bound antiplatelet antibody should be diagnosed with idiopathic thrombocytopenic purpura (ITP) if no other cause of their decreased platelet count could be found. More recently the term "autoimmune thrombocytopenic purpura (ATP) has supplanted ITP since the disease is related to the production of autoantibodies against one's own platelets. This entity should not be confused with isoimmune thrombocytopenic purpura (also called alloimmune thrombocytopenic purpura). In this cases maternal antiplatelet antibodies directed against the PLA 1 antigen on the fetal platelets causes severe fetal and neonatal thrombocytopenia in a situation analogous to Rheusus disease. Antibodies to the negatively charged phospholipids, lupus anticoagulant, and anticardiolipin have been linked to adverse pregnancy events. Pregnant women possessing these antibodies have an increased risk of spontaneous abortion, stillbirths, intrauterine fetal growth retardation, preterm birth, and arterial and venous thrombosis. Antiphospholipid antibodies decrease or may even disappear between pregnancies only to recur with increased activity in a subsequent pregnancy and lead to loss. We have experienced a case of antiphospholipid syndrome associated with autoimmune thrombocytopenic purpura in patient with recurrent spontaneous abortion. So we report this case with a brief review of literatures.

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IL-23 Inhibits Trophoblast Proliferation, Migration, and EMT via Activating p38 MAPK Signaling Pathway to Promote Recurrent Spontaneous Abortion

  • He, Shan;Ning, Yan;Ma, Fei;Liu, Dayan;Jiang, Shaoyan;Deng, Shaojie
    • Journal of Microbiology and Biotechnology
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    • v.32 no.6
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    • pp.792-799
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    • 2022
  • As a vital problem in reproductive health, recurrent spontaneous abortion (RSA) affects about 1% of women. We performed this study with an aim to explore the molecular mechanism of interleukin-23 (IL-23) and find optimal or effective methods to improve RSA. First, ELISA was applied to evaluate the expressions of IL-23 and its receptor in HTR-8/SVneo cells after IL-23 treatment. CCK-8, TUNEL, wound healing and transwell assays were employed to assess the proliferation, apoptosis, migration and invasion of HTR-8/SVneo cells, respectively. Additionally, the expressions of apoptosis-, migration-, epithelial-mesenchymal transition- (EMT-) and p38 MAPK signaling pathway-related proteins were measured by western blotting. To further investigate the relationship between IL-23 and p38 MAPK signaling pathway, HTR-8/SVneo cells were treated for 1 h with p38 MAPK inhibitor SB239063, followed by a series of cellular experiments on proliferation, apoptosis, migration and invasion, as aforementioned. The results showed that IL-23 and its receptors were greatly elevated in IL-23-treated HTR-8/SVneo cells. Additionally, IL-23 demonstrated suppressive effects on the proliferation, apoptosis, migration, invasion and EMT of IL-23-treated HTR-8/SVneo cells. More importantly, the molecular mechanism of IL-23 was revealed in this study; that is to say, IL-23 inhibited the proliferation, apoptosis, migration, invasion and EMT of IL-23-treated HTR-8/SVneo cells via activating p38 MAPK signaling pathway. In conclusion, IL-23 inhibits trophoblast proliferation, migration, and EMT via activating p38 MAPK signaling pathway, suggesting that IL-23 might be a novel target for the improvement of RSA.

Pregnancy in Patients with Prosthetic Heart Valve (심장판막을 대치 받은 환자에서의 임신)

  • 이석열;장병철;박한기;박용원;강면식;홍승록;조범구;홍필훈
    • Journal of Chest Surgery
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    • v.32 no.11
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    • pp.1023-1030
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    • 1999
  • This is a retrospective study of 42 pregnancies from 33 women with prosthetic heart valves who were on anticoagulation regimen prior to or during their pregnancy. Material and Method: Of the 17 women with bioprosthesis, 15 had 21 pregnancies following cessation of the anticoagulation therapy which resulted in the delivery of 20 healthy babies and 1 abortion. Remaining 2 had 3 pregnancies maintained with heparin, resulting in 2 healthy babies and 1 spontaneous abortion. Result: Among 16 women with mechanical heart valves, there were 7 pregnancies during which warfarin was used and this was associated with 4 fetal wastages(2 therapeutic abortion, 1 spontaneous abortion and 1 stillbirth with cerebral hemorrhage). However, in pregnancies where heparin was used, there was no fetal wastage. A patient who did not take anticoagulant for the first trimester and took warfarin for the remaining period and a patient who did not take anticoagulant during pregnancy delivered normal babies. There was an other fetal wastage in a patient on anti-platelet therapy for the first trimester and warfarin therapy for the remaining periods. There was 1 minor petechial complication in a heparin administered group. Conclusion: The study indicates that woman with bioprosthetic heart valves can go through pregnancy without undue risks or complications. On the other hand, the use of warfarin during pregnancy in women with mechanical heart valves, was shown to be associated with unacceptable high risk for the fetus. However, in the same group of women, judicious use of heparin during pregnancy was accompanied by a much reduced risk. The safety and adequate therapeutic range of heparin usage under such circumstances are subject to further studies.

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Induced Abortion and Breast Cancer: Results from a Population-Based Case Control Study in China

  • Wu, Jun-Qing;Li, Yu-Yan;Ren, Jing-Chao;Zhao, Rui;Zhou, Ying;Gao, Er-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3635-3640
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    • 2014
  • Aim: To determine whether induced abortion (IA) increases breast cancer (BC) risk. Materials and Methods: A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency-matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. Results: After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. Conclusions: The results suggest that a history of induced abortions may not increase the risk of breast cancer.

A Case Study of Gunggi-tang that induces Natural Expulsion in Missed Abortion (계류유산 환자의 자연배출을 돕는 궁귀탕가감(芎歸湯加減) 치험 1례)

  • Kim, Eun-Seop;Jang, Eun-Ha;Choi, Ho-Su
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.3
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    • pp.136-145
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    • 2017
  • Objectives: The aim of this study was to report a case of 43 year-old patient, diagnosed with missed abortion who previously failed to do spontaneous gestational sac expulsion in spite of 2 week-expectant-method, eventually succeeded with Traditional Korean Herb Medicine (TKHM) treatment only. Methods: In transabdominal sonography, gestational sac was not present at week 8. Due to the possibility of effect of medication on future pregnancy and post-surgery complications, D&C (Dilation & Curettage) as well as any other treatment was not done. Instead, she presented to our clinic. A combination of 2 main TKHMs was prescribed with 120-150 cc/dose (2 times per day for a week) : Gunggi-tang for helping expulsion of the dead fetus and placenta, and Wooseul-tang for treating retained placenta. Results: On day 6 of TKHM treatment, initiation of placenta expulsion was done. From day 8, hemorrhage started, lasting for 6 days. On day 10, placenta was expelled. On day 13, gestational sac and placenta were completely expelled. No infection, delayed bleeding, or pain was observed. After bleeding stopped, menorrhea started from week 7. Conclusions: This report implies a potential of TKHM as an optional and safe medication for the natural expulsion of conceptus in missed abortion.

When Dose Losses of Maternal Lymphocytes Response to Trophoblast Antigen or Alloantigen Occur in Women with a History of Recurrent Spontaneous Abortion? (반복유산을 경험한 환자에서 임신중 태반항원과 동종항원에 노출된 모체 림프구면역반응은 언제부터 소실되나?)

  • Choi, Bum-Chae;Hill, Joseph A.
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.115-122
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    • 1998
  • The maintenance of a viable pregnancy has long been viewed as an immunological paradox. The deveolping embryo and trophoblast are immunologically foreign to the maternal immune system due to their maternally inherited genes products and tissue-specific differentiation antigens (Hill & Anderson, 1988). Therefore, speculation has arisen that spontaneous abortion may be caused by impaired maternal immune tolerance to the semiallogenic conceptus (Hill, 1990). Loss of recall antigen has been reported in immunosuppressed transplant recipients and is associated with graft survival (Muluk et al., 1991; Schulik et al., 1994). Progesterone $(10^{-5}M)$ has immunosuppressive capabilities (Szekeres-Bartho et al., 1985). Previous study showed that fertile women, but not women with unexplained recurrent abortion (URA), lose their immune response to recall antigens when pregnant (Bermas & Hill, 1997). Therefore, we hypothesized that immunosuppressive doses of progesterone may affect proliferative response of lymphocytes to trophoblast antigen and alloantigen. Proliferative responses using $^3H$-thymidine ($^3H$-TdR) incorporation of peripheral blood mononuclear cells (PBMCs) to the irradiated allogeneic periperal blood mononuclear cells as alloantigen, trophoblast extract and Flu as recall antigen, and PHA as mitogen were serially checked in 9 women who had experienced unexplained recurrent miscarriage. Progesterone vaginal suppositories (100mg b.i.d; Utrogestan, Organon) beginning 3 days after ovulation were given to 9 women with unexplained RSA who had prior evidence of Th1 immunity to trophoblast. We checked proliferation responses to conception cycle before and after progesterone supplementation once a week through the first 7 weeks of pregnancy. All patients of alloantigen and PHA had a positive proliferation response that occmed in the baseline phase. But 4 out of 9 patients (44.4%) of trophoblast antigen and Flu antigen had a positive proliferative response. The suppression of proliferation response to each antigen were started after proliferative phase and during pregnancy cycles. Our data demonstrated that since in vivo progesterone treated PBMCs suppressed more T-lymphocyte activation and $^3H$-TdR incorporation compare to PBMCs, which are not influenced by progesterone. This data suggested that it might be influenced by immunosuppressive effect of progesterone. In conclusion, progesterone may play an important immunological role in regulating local immune response in the fetal-placental unit. Furthermore, in the 9 women given progesterone during a conception cycle, Only two (22%) repeat pregnancy losses occured in these 9 women despite loss of antigen responsiveness (one chemical pregnancy loss and one loss at 8 weeks of growth which was karyotyped as a Trisomy 4). These finding suggested that pregnancy loss due to fetal aneuploidy is not associated with immunological phenomena.

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