Chromosomal aberrations are common causes of abnormal development of fetuses leading to the birth of malformed indvidual or to the intrauterine death. Half of miscarriages in the first trimester and a third in the second trimester are caused by fetal chromosomal abnormalities, mainly aneuploidies. If fetus is abnormally developed, invasive prenatal cytogenetic diagnosis should be recommended. Positive cytogenetic finding can be reason for induced abortion till the end of 24th week of gestation. We investigated 81 miscarriages, 46 fetuses from induced abortions and 80 fetuses with abnormal development from ongoing pregnancies. G-banding analysis was used as the main method for investigating miscarriages. Genomic DNA isolated from abnormally developed fetuses was screened by array CGH technique. We found 43,75 % chromosomal abnormal miscarried fetuses, majority of them with numerical aberrations (91,4 %). In group of induced abortions, 25,71 % fetuses carried chromosomal abnormality. The lowest rate 11,67 % of chromosoal aberrations was detected in group of prenatally diagnosed fetuses from ongoing pregnancies. Array CGH detected submicroscopic aberrations in 13,41 % fetuses with ultrasound findings. All together 25,74 % microscopic and causal submicroscopic chromosomal abnormalities were found to be...

Die Schwangerschaft ist ein komplexer Vorgang, bei dem es zu einer Interaktion zwischen dem mütterlichen Immunsystem und dem Fetus kommt. Der allogene Fetus kann als natürlich auftretendes Allotransplantat angesehen werden. Man nimmt daher an, dass die Toleranzmechanismen, die im Rahmen einer erfolgreichen Schwangerschaft auftreten, den Mechanismen zur Akzeptanz eines Transplantates ähnlich sind. HO-1 wurde als ein gewebe-schützendes und anti-apoptotisches Molekül beschrieben, welches eine wichtige Rolle bei der Akzeptanz von Transplantaten spielt. Verschiedene Studien konnten zeigen, dass HO-1 in der Plazenta verschiedener Spezies exprimiert wird und dass die Expression von HO-1 bei Schwangerschaftskomplikationen, wie dem spontanen Abort, vermindert ist. Dies lässt vermuten, dass HO im Laufe der Schwangerschaft eine Rolle spielt. In diesem Kontext sollte die vorliegende Arbeit das Verständnis über die Funktion von HO-1 bei den beiden Schwangerschaftskomplikationen spontaner Abort und Präeklampsie (Schwangerschaftshypertonie) erweitern. Mit Hilfe des Mausmodells für einen spontanen Abort, bei dem weibliche CBA/J Mäuse mit männlichen DAB/2J Mäusen verpaart werden, wurde der Einfluss der HO-1 Expression auf die Abortrate untersucht und mit BALB/c-verpaarten CBA/J Weibchen, welche eine normale Schwangerschaft aufweisen, verglichen. In Mäusen mit spontanem Abort zeigte sich eine Reduktion der HO-1 und HO-2 Expression. Die Induktion von HO-1 mittels Co-PP war in der Lage, die Abortrate zu senken, wohingegen eine Reduktion der HO-1 mittels Zn-PP die Abortrate erhöhte. Es zeigte sich, dass es neben der Induktion von HO-1 auch zu einer erhöhten Expression des anti-apoptotischen Moleküls Bag-1 kam. Im Mausmodell für Präeklampsie wurde ebenfalls die Expression von HO-1 und möglicher Interaktionspartner untersucht. Des Weiteren wurde der Einfluss einer erhöhten bzw. verminderten HO-1 Expression auf die Präeklampsie-ähnlichen Symptome in diesem Mausmodell analysiert. Im Laufe der Arbeit zeigte sich jedoch, dass HO-1 Veränderungen keinen Einfluss auf die Präeklampsie-ähnlichen Symptome hat. Die Daten dieser Arbeit lassen vermuten, dass eine erhöhte Expression von HO-1 zum Zeitpunkt der Implantation den Fetus vor einem spontanen Abort schützt und dass die protektive Funktion von HO-1 durch eine Interaktion mit anti-apoptotischen Molekülen wird. Bei der Präeklampsie hingegen scheint HO-1 keine bzw. nur eine untergeordnete Rolle zu spielen. / Pregnancy maintenance is a very complex phenomenon, involving interactions between the maternal immune system and the semiallogenic foetus, which does not lead to immune rejection but to tolerance. Thus it is thought that the tolerance mechanisms involved in a successful pregnancy are closely related to those allowing graft acceptances. Heme Oxygenases (HO) were described to be tissue-protective and to have anti-apoptotic properties. Up-regulation of HO, particularly of HO-1, allows tissue tolerance after transplantation. The presence of HO-1 had been reported in the placenta of different species during normally progressing pregnancies; in pregnancy complications like spontaneous abortion the levels of HO-1 were reduced. This led to the proposal that HO-1 may play a protective role. The aim of this work was to analyze the influence of HO-1 changes in the outcome of pregnancy, using two different murine models for pregnancy complications, namely of spontaneous abortion and pre-eclampsia. The influence of HO-1 expression on the abortion rate was analysed in DBA/2J-mated CBA/J females, which spontaneously show high abortion rates compared to BALB/c-mated CBA/J females, having fully normal pregnancy. The induction of HO-1 by Co-PP led to diminished abortion rates, while the blocking of HO-1 and HO-2 by Zn-PP boosted abortion. In mice with reduced abortion rates after HO-1 induction, up-regulated levels of the anti-apoptotic molecule Bag-1 could be observed. In mice showing signs for preeclampsia after transfer of Th1 activated cells, the expression of HO-1, Th1/Th2 and eNOS was analysed. Furthermore HO-1 was of up- or down-regulated by using Co-PP or Zn-PP respectively. HO-1 changes did not influence the outcome of the disease, as we could not observe a diminution in the blood pressure levels. In summary, the results of this study indicate that high levels of HO-1 during implantation are able to prevent foetal rejection and that the beneficial effects of the HO-1 induction are related to the up-regulation of tissue protective molecules as Bag-1. No relationship could be observed between HO-1 levels and preeclampsia outcome.

Made available in DSpace on 2016-04-04T18:27:26Z (GMT). No. of bitstreams: 1 Miriam Tachibana.pdf: 1018235 bytes, checksum: d260b46d844da4acfd0bb3d85ab02f84 (MD5) Previous issue date: 2006-12-04 / This study aimed at investigating psychoanalytically the mutative potential of a different feature which was called therapeutic meetings , destinated to women who had recently suffered spontaneous abortion. This practice consisted in three or four individual encounters, which were realized a few days after those women had lost their babies, in which the verbal communication was completed by using the Drawing-and-Story Procedure of Trinca, according to the paradigm present in the Squiggle Game of Winnicott, a combination that allowed a mutual interaction. After realizing each one of the therapeutic encounters, psychoanalytical narratives were written, and were presented to the group of researchers, so that it was possible to apprehend the clinical occur by identifying the psychological fields, what would permit the viewing of the movements of integration. It was possible to observe, through constratransferencial feelings, that the two participants of this study could integrate, through the therapeutic encounters realized, aspects that were related to their functions as daughters and women, associated to their difficulties in walking towards the motherhood. It was possible to apprehend the clinical efficacy of this different feature, what indicates its implementation in hospital institutions of the areas of ginecology and obstetrics. / O presente estudo objetivou investigar psicanaliticamente o potencial mutativo de um enquadre diferenciado, denominado encontros terap?uticos, destinado ao atendimento da mulher que sofreu aborto espont?neo recente. Tal pr?tica consistiu na realiza??o de encontros individuais, em s?ries constitu?das por tr?s a quatro sess?es, poucos dias ap?s a ocorr?ncia da perda, durante as quais a comunica??o verbal podia ser complementada pela utiliza??o do Procedimento de Desenhos Est?rias de Trinca, paradigmaticamente inspirada no Jogo do Rabisco, configurando uma intera??o marcada pela mutualidade. Ap?s a realiza??o de cada encontro terap?utico, foram redigidas narrativas psicanal?ticas, que foram compartilhadas no espa?o de interlocu??o do grupo de pesquisa, visando apreender o acontecer cl?nico, pela via da identifica??o dos campos psicol?gico- vivenciais, no contexto dos quais se tornam vis?veis eventuais movimentos de supera??o de dissocia??es. P?de-se observar, a partir dos sentimentos contratransferenciais, que as duas pacientes puderam, a partir do encontro inter-humano que lhes foi proporcionado, integrar aspectos relacionados aos modos de serem filhas e mulheres, associados ?s suas dificuldades em caminhar rumo ? maternidade. Foi poss?vel, dessa maneira, vislumbrar a efic?cia cl?nica deste enquadre diferenciado, o que indica sua implementa??o em institui??es ambulatoriais e hospitalares da ?rea da gineologia e obstetr?cia.

The thesis deals with the issue of spontaneous abortion as well as induced termination of pregnancy and its potential negative impacts on woman's mental and physical health. The theoretical part summarizes the findings about particular kinds of pregnancy loss and defines the possibilities of psychological adaptation to this loss. The author paid the close attention to Post-abortion syndrome (PAS), which is regarded as a special form of Post- Traumatic Stress Disorder. The thesis is further focused on the emotional, social, psychological and physical effects following abortion, the most threatened group of women with a higher probability of having PAS and finally the way of medical treatment. In the empirical part, the main symptoms of PAS were detected by means of the Helpline database analysis. Detection of these syndromes enabled to compile the questionnaire related to pregnancy loss. The main task was to discover the perceived changes in a woman's life after the pregnancy loss. In the final part of the work, the questionnaire regarding pregnancy loss had been tested and finally the main benefits together with limits had been critically evaluated.

Made available in DSpace on 2015-07-22T20:50:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-25 / Por ser uma prática criminosa, o aborto provocado acaba sendo realizado clandestinamente tornando-se um grave problema de Saúde Pública. O objetivo deste estudo foi o de estimar a prevalência de mulheres em idade fértil com histórico de aborto. O estudo é transversal, resultante de uma amostra aleatória de mulheres 15 a 49 anos-, residentes no subdistrito da Vila Mariana, 2006. Os dados foram coletados mediante aplicação de questionários. Foi considerada como variável dependente classificação da mulher quanto ao aborto: sem aborto, aborto espontâneo e aborto provocado; e independentes: idade, defasagem do número ideal de filhos, atividade remunerada, escolaridade, estado civil, uso de contraceptivos e opinião sobre o aborto provocado. Para análises foram utilizados testes de qui-quadrado e modelos de regressão logística multinomial policotômica. Dentre o total de mulheres entrevistadas (n=1121), 84,4% (n=946) são de mulheres sem histórico de aborto; 11,2% (n=126) são de mulheres com histórico de aborto espontâneo e, 4,4% (n=49) são de mulheres com histórico de aborto provocado. A razão de chances de ter realizado aborto provocado sobre a sem aborto é 6,33 vezes maior (p0,001) entre mulheres que aceitam esta prática; 4,58 vezes maior (p=0,002) entre as mulheres que possuem menos de 4 anos de estudo e ainda, as chances da mulher declarar um aborto provocado comparado às sem aborto é 7% maior a cada ano em que a mulher envelhece. Dentre as 1121 mulheres, 49,5% (n=555) declararam ter tido alguma gravidez. Para que engravidaram a prevalência de mulheres com aborto espontâneo foi de 22,7% (n=126) de aborto provocado 8,85 (n=49). A razão de chances de ter realizado aborto provocado sobre a sem aborto é 28,34 vezes maior (p0,001) entre as que não possuem nenhum filho nascido vivo; 6,42 vezes maior (p0,001) entre as que aceitam esta prática; 4,96 vezes maior (p=0,002) entre as que possuem menos de 4 anos de estudo; e as chances de declarar um aborto provocado comparado as sem aborto é 8% maior a cada ano a mais de vida. Por outra parte, este estudo revela ainda que entre o total de mulheres a razão de chances de ter tido aborto espontâneo sobre a sem aborto é 0,34 (p0,001) entre as mulheres que não possuem nenhum filho nascido vivo; e, as chances da mulher declarar um aborto espontâneo comparado às sem aborto é 4% maior a cada ano de idade da mulher. O comportamento reprodutivo das mulheres deste estudo é equiparável ao das residentes em países desenvolvidos. Ao ter acesso a métodos contraceptivos considerados eficazes o aborto provocado legalizado, não seria utilizado de forma irresponsável. / Induced abortions are illegal in Brazil, leading many women to seek out clandestine clinics and practitioners, resulting in a serious public health problem. The purpose of this study was to estimate the number of women in the general population of fertile age with a history of abortion. This is a retrospective transversal study, based on a random sample of women – 15 to 49 years old –, residing at the Vila Mariana neighborhood of São Paulo in 2006. Data was collected through questionnaires. As the dependent variable we used different abortion categories, reflecting different types of experiences with abortion, which included: no abortion, spontaneous abortion and induced abortion. As independent variables we used: age, the difference between number of children and ideal number of children, employment and marital status, level of education, use of contraceptives, and personal opinion about induced abortion. Analyses were carried out using chi-square tests and polytomous multinomial logistic regressions. Furthermore, 84,4% (n=946) had no history of abortion; 11,2% (n=126) indicated having had a spontaneous abortion; and 4.4% (n=49) indicated having had an induced abortion. We found that it is 6,33 times more likely (p0,001) to have had an induced abortion versus no abortion among women who are pro-choice; 4,58 times more likely (p=0,002) among women who have less than 4 years of formal education; and the chances of a woman admitting an induced abortion compared to no abortion are 7% higher for each additional year of age. We surveyed a total of 1121 women, among which 49.5% (n=555) indicated that they had been pregnant at least once. Among the latter, 22,7% (n=126) indicated having at least one spontaneous abortion and 8,85% (n=49) indicated having at least one induced abortion. Our results show that among women with no live birth pregnancies it is 28,34 times more likely that they have undergone induced abortion versus no abortion (p0,005); among those that are pro-choice it is 6,42 times more likely (p0,001); among those who have less than 4 years of formal education it is 4,96 times more likely (p=0,002); and the chances of admitting to an induced abortion versus no abortion increases by 8% higher for each additional year of age. Finally, this study reveals that women with no live births are 0,34 more likely (p0,001) to have had an spontaneous abortion versus no abortion; and the chances of a woman admitting spontaneous abortion compared to no abortion is 4% higher for each additional year of age. In conclusion, the reproductive behavior of women in this study is comparable to the behavior of women who live in developed countries. With broad access to effective contraceptive methods, legalized induced abortion would not be carried out irresponsibly. / TEDE

Bereavement of a miscarriage is complex because of factors that are unique to this loss. There is no visible child to mourn for, no memories or shared life experiences. The death is sudden and there usually a lack of recognition of the significance of such a loss by society. In addition, women who miscarry are often in need of the absent social and emotional support that is provided with other types of bereavement. The suppression of appropriate mourning due to society’s inhibitions may cause further stress and long-term emotional consequences. Prenatal loss is unique in the sense that the parents do not know the object of loss as it would be with the death of a loved one who has been part of their lives and social structure. The anticipated child is both a fantasy child and an internal entity within a woman’s body. The loss of a baby is also the loss of part of a women’s self. The researcher is of the opinion that a miscarriage is a traumatic experience which, if not thoroughly dealt with, can cause great damage to a sufferer’s life. According to her, projective techniques in the form of play therapy can encourage women to talk about their miscarriage in order to deal with suppressed emotions. The purpose of this research was to determine to what extent projective techniques could be used in respect of a mother’s emotional experience of a miscarriage. For this study the qualitative research approach was used. The participants were selected by making use of purposive sampling as a form of non-probability sampling. During the empiric research two respondents attended eight in-depth interviewes with a therapeutic component. The first interview comprised a semi-structured interview schedule. Six interviews followed where projective play therapeutic techniques were used. The empirical data was obtained from the interview schedule and the researcher was the primer instrument of gathering information. The value of meaning that the participants attached to the subject was of great importance. The empirical data showed that the two participants were better enabled to deal with their miscarriages after the interviews. Thus, regarding the experience of the two paricipants, it was possible to answer the research question positively. It seems as if projective techniques can indeed be used in respect of a mother’s emotional experience of a miscarriage. / Dissertation (MA (Play Therapy))--University of Pretoria, 2005. / Social Work / unrestricted

Bakgrund: En graviditet ses hos många kvinnor som något positivt och för med sig mycket glädje, men en graviditet innebär också en risk för missfall. Omkring 20–30 procent av alla gravida kvinnor kan komma att drabbas. Ett missfall kan göra kvinnor extra sårbara och utsatta. Det är betydelsefullt att undersöka kvinnors upplevelser vid missfall för att få ökad förståelse och kunskap om hur missfall kan upplevas.  Syfte: Syftet var att beskriva kvinnors upplevelser vid missfall.  Metod: En litteraturöversikt har använts som metod för arbetet. Tio vetenskapliga originalartiklar med kvalitativ metod har analyserats utifrån Fribergs analysmodell. Litteraturöversikten utgick från kvinnor som haft missfall innan graviditetsvecka 22. Resultat: Resultatet innehåller tre huvudteman: Kvinnors emotionella smärta, Stöd från familj och vänner, Omvårdnad vid missfall samt två underteman: Missfall - ett stigma, och Känslig omvårdnad. Slutsats: Slutsatsen i denna litteraturöversikt var att kvinnor upplever en emotionell smärta med känslor av sorg, tomhet och hjälplöshet, och ett stöd från familj, vänner och andra kvinnor som genomgått missfall är viktigt för att de ska kunna bearbeta sitt missfall. Kvinnor beskrev att omvårdnaden var avgörande i hur de upplevde sitt missfall, och en känslig omvårdnad där vårdpersonalen visar empati och förståelse för kvinnan är väsentligt för hennes välmående vid ett missfall. / Background: A pregnancy is seen by many women as something positive and brings a lot of joy, but a pregnancy also entails a risk of miscarriage. Around 20-30 percent of all pregnant women may be affected. A miscarriage can make women extra vulnerable and exposed. It is important to investigate women's experiences of miscarriage in order to gain increased understanding and knowledge of how miscarriage can be experienced.  Aim: The aim was to describe women’s experiences of miscarriage. Method: A literature review has been used as a method for this work. Ten original scientific articles using a qualitative method have been analyzed based on Friberg’s model of analysis. The literature study was based on women who had miscarried before 22 weeks of pregnancy.  Results: The result contains three main themes: Women's emotional pain, Support from family and friends, Nursing care in case of miscarriage, and two sub-themes: Miscarriage - a stigma, and Sensitive care.  Summary: The conclusion of this literature review was that women experience an emotional pain with feelings of sadness, emptiness and helplessness, and support from family, friends and other women who have experienced a miscarriage is important for them to be able to process their miscarriage. Women described that the care was decisive in how they experienced their miscarriage, and sensitive care where the care staff shows empathy and understanding for the woman is essential for her well-being in the event of a miscarriage.

[Truncated abstract] Veterinarians have considerable potential for exposure to several known reproductive hazards such as radiation, anaesthetic gases, pesticides, long working hours and occupational stress. Reproductive effects are a concern to female veterinarians, especially now that about 65% of graduates from Australian veterinary science schools are female. In the last two decades, there have been reports on the possible associations between occupational exposures and adverse reproductive outcomes in female veterinarians, but most of them have been equivocal and the whole area remains controversial. More evidence is needed before firm conclusions can be drawn. The Health Risks of Australian Veterinarians project (HRAV) was conducted as a questionnaire-based survey of all graduates from Australian veterinary schools during the 40-year period 1960-2000. Of 5,748 eligible veterinarians who were sent the questionnaires (73% of the whole cohort), 2,800 replied including 1,197 females (42.8%). Among women veterinarians eligible to participate, 59% participated . . . Identification of these associations may provide the opportunity for preventing harmful exposures and thus reduce the risk of any adverse reproductive outcomes not only for veterinarians, but also for other groups exposed to these risks such as veterinary nurses, animal laboratory technicians, anaesthetists, dentists, dental assistants, and other similar professional groups. The author of this thesis, having completely addressed the research objectives of her doctoral candidacy, has set out and acted on a future research agenda designed to explore the association between perceived occupational stress and pregnancy outcomes and infertility in Australian female veterinarians.

This diploma thesis is aimed at problems of abortion and simultaneously of a different view of theological and biological sciences that deal with these problems. Concurrently, it is necessary to offer an essential outline of basic embryological and medical processes which enable understanding the given problem in view of importance of this situation. On the one hand the thesis presents legal essentials related to the topic in a historical legal context, on the other hand it does not exclude contemporary trends. It regards the given problems through a point of view of various Christian churches as well as world religious streams. It refers to negative health consequences of miscarriage and induced abortion but in the same time it presents basic information about contraception and differentiation of contraceptive and interceptive means. The thesis also presents opinions of individual churches that express their view of contraception or interception. The author of this thesis thinks critically over these thoughts and invites readers to create their own reflection of given problems. He tries to outline a wide range of these problems in the new, wider and often ignored point of view, that is of father's view. A father is often totally ignored during an abortion though he is actually a half-donor of...

This diploma thesis is aimed at an induced abortion issue and it considers it a bioethical issue. The author refers to a difference between views of theological and biological sciences that deal with the given issue. Simultaneously it provides a reader with an essential outline of basic embryological and medical processes which enable understanding of the given issue. On the one hand, the thesis presents a reader legal essentials related to the given topic in a historical legal context, on the other hand it does not ignore a contemporary development. It regards the given issue from a point of view of various Christian churches, although it does not work in a field of theology. It refers to negative health consequences of a miscarriage and induced abortion and simultaneously it presents basic information about contraception and about contraceptive and abortive means. The thesis also presents a reader with opinions and moral norms of selected Christian churches that express their opinions on abortion, contraception and interception. The author reflects upon the given moral norms. One of the aims of the thesis is to find a suitable way of presenting the moral norms in the field of induced abortion and interception so that the reason and consciousness of the individual were respected. The diploma...