Medication Rules of Traditional Chinese Medicine for Treating Threatened Abortion in the Early Stage of Pregnancy with Subchorionic Haematoma Based on Data Mining

Objective:Using data mining technology to explore the rules of traditional Chinese medicine(TCM)in the treatment of threatened abortion in the early stage of pregnancy with sub-chorionic haematoma(SCH).Methods:Literature of TCM in the treatment of threatened abortion in the early stage of pregnancy with SCH were retrieved from CNKI,VIP,WANFANG and Pubmed,EMBASE.The literature information database was established to be used for descriptive analysis,association rule analysis and cluster analysis of relevant data.Results:A total of 100 literatures were included,involving 114 Chinese herbs.The efficacy of Chinese herbs were mainly tonic drugs,hemostatic drugs,heat-clearing drugs,dissolving blood stasis and hemostatic drugs.The medicinal properties were mostly mild and warm,and the taste of the drug was mainly sweet,bitter and pungent.The liver meridian,spleen meridian and kidney meridian were frequently used.The commonly used drug pair combination was"Xu duan(Radix dipsaci,续断)-Tusizi(Semen Cuscutae,菟丝子)",and the core combination was"Tusizi-Xu duan-Ejiao(Donkeyhide gelatin,阿胶)-Baizhu(Atractylodes macrocephala,白术)-Dangshen(Codonopsis pilosula,党参)".Commonly used drugs for removing blood stasis and hemostasis were with Sanqi(Panax notoginseng,三七),Puhuang(cattail pollen,蒲黄),and Qiancao(Radix Rubiae,茜草).Conclusion:Data mining traditional Chinese medicine for the treatment of threatened abortion in the early stage of pregnancy with SCH clinically commonly used drug efficacy,taste,meridian,commonly used drug pairs,core combination and commonly used blood stasis hemostatic drugs,has important reference significance for the treatment of threatened abortion in the early stage of pregnancy combined with SCH.

Study on prevention effect of Zishen Yutai pill combined with progesterone for threatened abortion in rats

Objective:To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats.Methods:After pregnancy,50 SPF female SD rats were selected and divided into control group,model group,progesterone group,Zishen Yutai pill group,and progesterone plus Zishen Yutai pill group(combination group),with 10 rats in each group.The rats of control group and abortion model group were lavaged with 2 mL/kg normal saline on pregnancy day 1 for continuous 10 days.Rats in Zishen Yutai pill group were given 1.575 g/kg/d of Zishen Yutai pill for intragastric administration for continuous 10 days.Rats in progesterone group were given intramuscular injection treatment of 0.1 mL/d progestin,continuous for 10 days.Rats in combination group were given injection therapy of aqueous solution of Zishen Yutai pill for continuous 10 days,and other treatments were the same as previous two groups.Abortion model were established then and live births,numbers of abortion and average rate of abortion were compared between the five groups.Peripheral blood was collected to detect the estradiol(E2) and progestational hormone(P),and obtain ratio of Th1/Th2 cytokines(IL-2,INF-γ,IL-4,IL-10).Results:Significant more live births of rats were found in the control group compared with other four groups(P<0.05).The numbers of live births of the rats in abortion model group were significantly less than that of progesterone group,Zishen Yutai pill group and joint group(P<0.05).The numbers of live births of rats in joint group were significant more than that of progesterone group and Zishen Yutai pill group.The serum E2 level of P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were significant higher than that of abortion model group(P<0.05).Serum levels of E2 and P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were not significant different(P>0.05) but these levels in the control group and Zishen Yutai pill group were significant lower than that of progesterone group and joint group(P<0.05).The maternal-fetal interface IL-4/IL-2,IL-10 / IL-2 of model group were balanced deviating to Th1,while the IL-4/IL-2,IL-10/IL-2 of progesterone group,Zishen Yutai pill group and joint group were balanced deviating to Th2,and joint group' deviation was better than progesterone group and Zishen Yutai pill group(P<0.05).Conclusions:Zishen Yutai pill combined with progesterone has a significant control effect for threatened abortion,which can obviously increase contents of maternal serums E2 and P,and regulate the Thl/Th2 balance with a remarkable effect.

Routine Progesterone Supplementation in Threatened Abortion: Is It a Sound Practice?

Aim: To evaluate the benefits and hazards of routine progesterone supplementation in threatened abortion and whether it is a sound practice or not. Materials and Methods: This study was conducted at Obstetrics and Gynecology Department, Tanta University in the period from January 2018 to December 2018. Eligible patients (n = 190) were randomly allocated into 2 groups: study group who will receive progesterone supplementation (prog. group) and control group who will receive no treatment (place. group). Results: No significant differences were found between both groups regarding all demographic data and pregnancy characteristics. Abortions were higher in place. group 17 (23.94%) than in prog. group 12 (16.44%) with no significant difference p value = 0.263. The incidence of preterm labour was also higher in the place. group 22 (30.99%) in comparison to the prog. group 17 (23.29%) with no significant difference p value = 0.300. Conclusion: Progesterone supplementation in threatened abortion was not beneficial although it reduced abortion and preterm labour rates.

Clinical application of Bushen Jianpi Gutai Decoction in threatened abortion

Objective:To discuss the clinical application of the"seven,five and three"odd-numbered law theory and analyze the effect on serum sex hormone level.Methods:A total of 100 patients with early threatened abortion admitted from January 2021 to October 2021 were randomly divided into study group and control group,with 50 patients in each group.Patients in the control group were treated with dydrogesterone tablets,while patients in the study group were treated with Bushen JianpiGutai Decoction combined with dydrogesterone tablets.Clinical efficacy and progesterone level before and after treatment were observed and compared between the two groups,as well as clinical symptom relief time of the two groups,including hemostasis time,abdominal pain relief time and lumbar acid relief time,and sex hormone level of the two groups were observed and compared.Results:The clinical efficacy was significantly better than control patients(P<0.05),no significant difference in progesterone level comparison before treatment(P>0.05),significantly better than control patients(P<0.05),hemostasis,abdominal pain remission and waist acid remission were significantly shorter than control patients(P<0.05),and both significantly better sex hormone levels after treatment(P<0.05).Conclusion:Traditional Chinese medicine has certain advantages in the treatment of threatened abortion,odd-numbered law theoryguidesthe regulation of Yin and Yang in the female menstrual cycle and reproductive function is mainly the regular change of Yin and Yang.Under the guidance of"seven,five,three"odd-numbered law theoryof Traditional Chinese medicine master Xia Guicheng,master the key date and the best time of its transformation,regulate Yin and Yang in the female body,to prevent the occurrence and development of menstrual diseases and adverse childbirth.Bushen Jianpi Gutai decoction can effectively treat threatened abortion,significantly improve the clinical symptoms,improve the level of serum sex hormone,worthy of clinical promotion.

A clinical protocol: A double-blinded, randomized controlled trial on the effect of traditional Chinese medicine formula Shoutai Pill in the treatment of threatened abortion

for about 20%of all clinically confirmed pregnancy.It is the main cause of early abortion.Vaginal bleeding is the main clinical manifestation,which seriously affects the mental health and quality of life of pregnant women.Currently,there is effective treatment for this condition.A recent meta-analysis showed that Shoutai Pill(ST Pill),a traditional Chinese medicine(TCM)formula,can effectively decrease the rate of threatened abortion.However,high heterogeneity was found among the studies included in the meta-analysis,this conclusion on the efficacy of TCM is not definitive.Although several have been conducted,some of them do not describe randomization and blinding methods.To address these problems,this article proposes an improved clinical treatment scheme based on ST Pill,which is to be tested through a well-designed randomized controlled trial,for the treatment of threatened abortion.Methods:This is a double-blinded,randomized,placebo-controlled trial to be conducted in a public Three-A hospital in China's Mainland.A total of 200 people will be enrolled.Using computer-generated random numbers,the participants will be randomly divided into two groups at a ratio of 1:1(treatment group(treated with ST Pill group)and placebo group).Both groups will receive medication to the end of the 20th gestational week or 1 week after vaginal bleeding stops,depending on which is longer.Participants in the treatment group will be treated with ST Pill(20 pills/time,once a day),and those in the placebo group will receive a placebo drug which is similar in appearance and smell with ST Pill.The main observation index is the live birth rate.Discussion:Although the efficacy of ST Pill in threatened abortion is well-known,no study has tested its efficacy through a double-blinded,randomized trials.Therefore,there is an urgent need for a standardized randomized double-blinded controlled trial to evaluate the clinical efficacy of ST Pill.ST Pill is likely to be a convenient and effective TCM pill for the prevention of threatened abortion.

Plasma β-Endorphin Levels in Women with Early Threatened Abortion before and after the Treatment of Integrated Chinese and Western Medicine

To observe plasm a β-endorphin (β-EP) and gonadotrophin releasing horm one (GnRH), hum an chorionic gonadotrophin (hCG), progesterone (P4) levelsin w om en w ith early threatened abortion and w ith a history of recurrent spontaneous abortions (RSA). Tw enty patientsw ith threatened abortion at7～8 w eeksof gestation w ere re- cruited, allof them had a history of 3 or m ore recurrentunexplained abortions. They w ere treated w ith psychologicalconsultation accompanied by traditionalChinese herbs. Blood samples w ere taken to m easure β-EP, GnRH, hCG and P4 levels by radioim - m unoassay (RIA). The treatm ents w ere continued till10～12 w eeks, blood w astaken during this period to compare changes in these peptides / horm ones. Tw enty norm al pregnantw om en at7～8 and 10～12 w eeksand 20 patientsw ith incompleteabortion at 10～12 w eeksw ererecruited for comparativestudies. Results: (1) In norm alpregnant w om en, plasm a β-EP, GnRH, hCGand P4 levelsat10～12 w eeksw ere significantly higher than thatat7～8 w eeks (P< 0.01). (2) In patients w ith threatened abortion and a history of RSA, plasm a β-EP levels at7～8 w eeks w ere significantly higher than those of norm al pregnantw om en (P< 0.01); on the contrary, plasm a GnRH, hCGand P4 levelsin these patientsw ere significantly low er than thosein norm alcases (P< 0.01). After treatm ent, 16 of the 20 patients succeeded in m aintaining their pregnancies, the levels of the four plasm a contents at10～12 w eeks w ere sim ilar to thosein norm alpregnantw om en (P> 0.05). (3) Plasm a β-EPlevelsin patientsw ith incomplete abortionsat10～12 w eeksw ere dram atically higher and GnRH, hCGand P4 levelsw ere low er than in norm alpregnantw om en (P< 0.01). β-EP m ightplay a role in the pathophysiology of spontaneousabortion.

Network pharmacology of threatened abortion treated by ShouTaiWan

Objective: To explore the mechanism of ShouTaiWan's intervention in the treatment of Threatened Abortion based on Network Pharmacology. Methods: The effective active ingredients and targets in ShouTaiWan were obtained by searching in TCMSP database, BATMAN-TCM database and Uniprot database. The target of threatened abortion was obtained by searching for 'threatened abortion' in GeneCards. And the co-target gene of ShouTaiWan and threaten abortion can be obtained through the use of gene mapping in Venn diagram. Then an interaction network "disease-drug-target" can be constructed through a software called Cytoscape. Upload the Co-targeted gene to the STRING database to construct the protein interaction network map (PPI) , which would be screened for the key genes by using R language. Finally, used the R language to analyze gene ontology (GO) enrichment and kyoto encyclopedia of genes and genome (KEGG) pathway enrichment. Result: It is predicted that 21 effective active ingredients for the treatment of threatened abortion and 89 common effective targets are expected. Quercetin, kaempferol, beta-sitosterol, and isorhamnetin were the most effective components. As for the targets, prostaglandin endoperoxidase receptor (PTGS2), progesterone receptor (PGR), prostaglandin endoperoxidase receptor 1 (PTGS1), and Peroxisome proliferator activates receptor gamma (PPARG) were the most effective ones. The core targets in PPI network are Interleukin-6 (IL-6), protein kinase (AKT1), vascular endothelial growth factor A (VEGFA), etc. GO enrichment analysis shows that the activity of cytokines, regulatory functions, nuclear protein receptors and transcription of genes would be affected. KEGG pathway enrichment analysis illustrates that advanced glycation end products-receptor for AGE (AGE-RAGE) pathways are of the highest significance, followed by the fluid shear stress and atherosclerosis pathways. Conclusion: ShouTaiWan can achieve anti-inflammatory, increase vascular permeability,improve endometrial receptivity and other aspects of regulation to treat threatened abortion and embryo implantation through regulating cytokine.

Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

The potential role of grape (Vitis vinifera L.) in prevention of threatened abortion via immunomodulatory and anti-inflammatory abilities: a hypothesis

Threatened abortion is a common problem in early pregnancy. This early vaginal bleeding happens in about 25% of pregnant women. The medications including progesterone, uterine muscle relaxant or human chorionic gonadotropin have essential effects in developing pregnancy, but the clinical data are insufficient to prescribe them. In recent decades, medicinal herbs can help us to present new treatments. Grape (Vitis vinifera L.) can protect the fetus from the perspective of Persian medicine. So, we hypothesize about the salutary effects of grape in miscarriage prevention. We found five standard expected mechanisms of grape to prevent threatened abortion: immunomodulatory and anti-inflammatory, anti-oxidant, anti-contraction, hormonal and anti-stress activities. Grape reduces nitric oxide, prostaglandin E2, expression of nuclear factor κB and other pro-inflammatory cytokines like IL (Interleukin)-1β, IL-6, IL-8, and tumor necrosis factor-α. It also elevates anti-inflammatory mediators and expression of peroxisome proliferator-activated receptor-γ. Grape polyphenols have a crucial role in fetus protection with high antioxidant power and other functions such as prevention of stress-triggered abortion with proanthocyanidins, or hormonal effects and inhibition of uterine contractions with resveratrol. So according to these studies, grape probably has effects on the immune and endocrine factors involved in threatened miscarriage.

Randomized Double-Blind Controlled Clinical Study of Ciprofol and Propofol in Patients with Painless Artificial Abortion

Background and Objectives: Propofol is a commonly used intravenous anesthetic for painless artificial abortion, but the injection pain and related adverse reactions such as those related to respiration and circulation it induces have also been criticized. We aimed to conduct a comparative study on the efficacy, safety and comfort of ciprofol and propofol applied in painless artificial abortion. Materials and Methods: A total of 140 early pregnant patients undergoing painless induced abortion were selected and randomly divided into the ciprofol combined with fentanyl group (Group C) and the propofol combined with fentanyl group (Group P), with 70 cases in each group. The anesthetic effect, depth of anesthesia sedation (NI), onset time, recovery time, recovery time of orientation, retention time in the anesthesia recovery room and total amount of intravenous anesthetic drug were recorded in both groups. The respiratory rate (RR), oxygen saturation (SpO2), mean arterial pressure (MAP), and heart rate (HR) at different time points were recorded. The occurrence of perioperative adverse events, injection pain, postoperative nausea and vomiting, and dizziness were compared. The pain score at 30 minutes after operation and the satisfaction of patients and surgeons with anesthesia were evaluated. Results: The success rate of anesthesia in both groups was 100%. There were no statistically significant differences in the NI value at each time point, intraoperative body movement, recovery time, recovery time of orientation, retention time in the anesthesia recovery room, and total dosage of sedative drugs (ml) between the two groups;the onset time in Group C was longer than that in Group P, with a statistically significant difference (P Conclusion: The efficacy of ciprofol in painless induced abortion is equivalent to that of propofol, and the incidence of adverse reactions is lower than that of propofol, with higher safety and comfort.

Prevalence of Induced Abortion among Female Students in Selected Tertiary Learning Institutions in Gaborone City, Botswana

Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abortion remains one of the leading causes of maternal deaths in developing countries with induced abortion being the key cause. In 2014 from January to August, 9 abortion related deaths occurred in Botswana. There are several reasons female students in tertiary institutions resort to seeking induced abortion which include the socio-demographics like age and socio-economic factors like financial instability. Parental fears, unintended pregnancy and pressure from the partner also force females to terminate pregnancy. Induced abortion has claimed many women’s lives especially in developing countries with very restrictive abortion laws like Botswana as women do not access safe abortion care services. The study intends to establish the determinants of induced abortion among female students in selected tertiary learning institutions in Gaborone City, Botswana. It concentrated primarily on determining the prevalence of induced abortion. This was a descriptive cross-sectional study using both quantitative and qualitative data collection techniques. Systematic random sampling technique was used to come up with 278 participants. Prior to commencement of data collection, all ethical and logistical prerequisites were satisfied. Informed consent was solicited from all the study participants and the purpose of the study was fully explained. A self-administered questionnaire was used to collect data. Microsoft Excel spread sheet was used to code, clean, and enter the data, which was then exported for analysis to the statistical package for social sciences version 24. Frequency distribution tables, percentages graphs, and pie charts were used to illustrate the descriptive information. The study revealed that prevalence of induced abortion among female students in Gaborone City is 7.9%. They even suggested that induced abortion be liberalized. Age was the only socio-demographic factor associated with induced abortion with p = 0.047 using Chi Square test χ2 = 7.609, df = 3. The study findings concluded that female students resort to induced abortion as a result of pressure from both parents and male partners especially when the pregnancy is unintended. The study recommends that the abortion law in Botswana be made liberal to ease access to safe abortion care services. It also recommends that contraceptive commodities should consistently be available in public health facilities.

Spontaneous Abortions in the Second Trimester of Pregnancy: Research and Analysis of Factors Associated at Laquintinie Hospital in Douala

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.

Effect of emotion management and nursing on patients with painless induced abortion after operation

BACKGROUND With an estimated 121 million abortions following unwanted pregnancies occurring worldwide each year,many countries are now committed to protecting women’s reproductive rights.AIM To analyze the impact of emotional management and care on anxiety and contraceptive knowledge mastery in painless induced abortion(IA)patients.METHODS This study was retrospective analysis of 84 patients with IA at our hospital.According to different nursing methods,the patients were divided into a control group and an observation group,with 42 cases in each group.Degree of pain,rate of postoperative uterine relaxation,surgical bleeding volume,and postoperative bleeding volume at 1 h between the two groups of patients;nursing satisfaction;and mastery of contraceptive knowledge were analyzed.RESULTS After nursing,Self-Assessment Scale,Depression Self-Assessment Scale,and Hamilton Anxiety Scale scores were 39.18±2.18,30.27±2.64,6.69±2.15,respectively,vs 45.63±2.66,38.61±2.17,13.45±2.12,respectively,with the observation group being lower than the control group(P<0.05).Comparing visual analog scales,the observation group was lower than the control group(4.55±0.22 vs 3.23±0.41;P<0.05).The relaxation rate of the cervix after nursing,surgical bleeding volume,and 1-h postoperative bleeding volumes were 25(59.5),31.72±2.23,and 22.41±1.23,respectively,vs 36(85.7),42.39±3.53,28.51±3.34,respec tively,for the observation group compared to the control group.The observation group had a better nursing situation(P<0.05),and higher nursing satisfaction and contraceptive knowledge mastery scores compared to the control group(P<0.05).CONCLUSION The application of emotional management in postoperative care of IA has an ideal effect.

Patterns of Infertility and Abortion in Saudi Arabia: A Cross-Sectional Study

Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influence perceptions and management of these issues, necessitating research to understand the patterns and associated factors. Study Aim: This cross-sectional study aimed to investigate the patterns of infertility and abortion among 458 women in Saudi Arabia, focusing on demographic profiles, reproductive histories, medical conditions, and lifestyle factors. Methodology: Participants were recruited from healthcare facilities, and data on age, BMI, reproductive history, medical conditions, assisted reproduction methods, and lifestyle behaviors were collected. Statistical analyses, including chi-square tests, were conducted to examine associations between variables. Results: The majority of participants were aged 30 - 39 years (47.4%), with 76.9% experiencing secondary infertility. Among those with offspring (76.9%), 31% reported using assisted reproduction methods, primarily ovarian stimulators (54.2%). Abortion history was reported by 39.5% of participants. Significant associations were found between age and infertility type (X2 = 5.8, p = 0.054), having offspring and infertility type (X2 = 458.0, p = 0.001), menstrual irregularity and infertility type (X2 = 11.4, p = 0.001), and abortion history and delayed fertility (X2 = 10.4, p = 0.001). Conclusion: Our study reveals significant associations between demographic, medical, and lifestyle factors with infertility patterns and abortion history among Saudi women. These findings emphasize the need for tailored interventions addressing medical conditions, age-related factors, and access to reproductive healthcare services.

Populational change of CD4^(+)CD25^(+)Treg cells is responsible for the synergistic effect of the combination of RAMP2 with baicalin in treating recurrent spontaneous abortion mouse models

Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, traditional Chinese medicine has become a feasible alternative for certain diseases, including recurrent spontaneous abortion. However, because of the complex composition of the traditional Chinese medicine formula, its action mechanism remains unclear. Methods: We selected two isolated active ingredients (RAMP and baicalin) from the traditional Chinese medicine formula and used an abortion-prone CBA/J × DBA/2 model to simulate human RSA and compared the changes in fetal resorption rate, Treg cell percentage, and relevant cytokines before and after combination therapy. In addition, The mechanisms were preliminarily discussed using in vitro differentiation models. Results: In CBA/J × DBA/2 abortion-prone mice, the combination therapy resulted in a lower embryo resorption rate compared to that obtained with individual delivery of either RAMP or baicalin, thereby playing an embryo-protective role through the increase in Treg cells for the maintenance of maternal-fetal immune tolerance. In in vitro primary cell differentiation experiments, the concentration of Treg cells significantly increased from 11% to 17.9% after the combination therapy compared to that of the single administration group. Conclusion: the synergistic effects of RAMP and baicalin were responsible for Treg differentiation. The present study provides a solid basis for improving the applicability of traditional Chinese herbs in the treatment of recurrent spontaneous abortion.

Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review

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 I2 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.

Distribution and conservation of near threatened plants in China

Plants classified as Near Threatened(NT) are at high risk of becoming threatened because of anthropogenic interference and climate change.Especially in conservation efforts,such species have however long been overlooked.Here,we obtained 98,419 precise occurrence points for 2442 NT plants in China,and used species richness,species complementarity,and weighted endemism that consider all,endemic and narrow-ranged species in order to identify the diversity hotspots of NT plants.Then we evaluated the conservation effectiveness of current nature reserves for them.Our results indicate that the diversity hotspots of NT plants were mainly confined to southwestern and southern China,and only 35.87% of hotspots and 71.5% of species were protected by nature reserves.Numerous hotspots in southwestern China(e.g.,Sichuan,Yunnan,Guangxi,and Hainan) were identified as conservation gaps.Given that NT plants include large proportions of endemic and narrow-ranged species,they represent an important value in conservation priority.So,more conservation efforts in the future should be tilted towards NT plants.Additionally,when comparing with the recently updated NT list,there are already 87 species raised to threatened categories,while 328 species were lowered to least concern,56 species were now categorized as data deficient,and 119 species considered as uncertain due to changes of scientific names.It is essential to carry out a continuous assessment of species’ threatened categories to realize targeting conservation.

Abnormal Uterine Bleeding due to Retention of Fetal Bones after Abortion: A Case Report

Background: Retention of fetal bones is a rare cause of abnormal uterine bleeding. Others may present as subfertility, chronic pelvic pain, abnormal vaginal discharge, menometrorrhagia, dysmenorrhea and spontaneous expulsion of bony fragments. Incidence is 0.26% among patients undergoing hysteroscopy. Aim: To document a pattern of presentation of retained fetal bone and its management. Case Presentation: Our patient is an 18-year old who presented with vaginal bleeding of four weeks duration and managed for abnormal uterine bleeding due to retained fetal bone following second trimester abortion. Conclusion: The use of transvaginal ultrasound in making diagnosis of retained fetal bone is effective. Treatment by removal of bones through evacuation by dilatation and curettage or hysteroscopy brings about resolution of symptoms. Use of pelvic ultrasonography to confirm complete evacuation of the uterus after abortion especially second trimester abortion could aid in early diagnosis and management of incomplete abortion.

Clandestine Abortions and Its Complications at the University Hospital Center of the Sino-Central African Friendship

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.

Advances of Genetic Testing Technology in Etiology Diagnosis of Recurrent Spontaneous Abortion

Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic testing technologies, there has been an increasing interest in using these tools to diagnose the etiology of RSA. This review discusses the different types of genetic testing methods, such as karyotyping, chromosomal microarray analysis, next-generation sequencing, and their applications in the diagnosis of the etiology RSA. The use of genetic testing in the diagnosis of RSA has the potential to improve the accuracy of diagnosis and the understanding of the underlying mechanisms of the disorder, which could lead to better management and treatment of affected individuals.