*Abortion, Criminal ; *Abortion, Habitual ; *Abortion, Missed ; *Abortion, Septic ; *Abortion, Threatened ; *Malaysia ; *Maternal Mortality ; *Statistics ; *Adolescent ; *Pregnancy

Synthetic progesterones have been used to treat menstrual disorders and to prevent habitual or threatened abortion. Recently, they are increasingly used as a part of assisted reproductive technique(ART) for the infertility related to the luteal insufficiency. Cutaneous reactions related to progesterone are rare and only isolated cases of autoimmune progesterone dermatitis have been described. We report, here in, a case of drug-induced progesterone dermatitis which was proved by positive skin test to intradermal progesterone.
Abortion, Threatened ; Dermatitis* ; Female ; Infertility ; Pregnancy ; Progesterone* ; Skin Tests

OBJECTIVE: The study was carried out to assess whether a sudden rise in the serum CA 125 level might predict spontaneous abortion in the first trimester. In the process, we assessed the clinical value of maternal CA 125 in patients with missed abortion and evaluate the prognostic significance of CA 125 in early normal pregnancies, threatened abortions. The purpose of this study was to prospectively compare serum CA 125 levels among women who abort in the first trimester, who experience threateneda bortion and who go through normal pregnancy. METHODS: Between March 2001 and September 2001, a total of 133 patients were observed in the Department of Obstetrics and Gynecology at CHA Hospital. Fifty-eight with missed abortions, forty-five with threatened abortions and thirty normal pregnancies (no history of endometriosis or ovarian mass) were evaluated during gestational age 6 to 12 weeks and maternal serum samples were collected. All patients were sonographically assessed and CA 125 values were compared. RESULTS: There was no statistically significant difference in the CA 125 levels between the spontaneous aborted patients and the patients without abortion: missed abortion, 72.9 +/- 102.0IU/ml (range 7.3-487.6); threatened abortion, 46.6 +/- 37.9IU/ml (range 13.9-206.1); normal pregnancy, 63.4 +/- 61.2IU/ml (range 13.8-62.8). CONCLUSION: Our study shows that serum CA 125 levels are not predictive of spontaneous abortion in the first trimester and failed to discriminate among missed abortions, threatened abortions, and normal pregnancies.
Abortion, Missed ; Abortion, Spontaneous ; Abortion, Threatened ; Endometriosis ; Female ; Gestational Age ; Gynecology ; Humans ; Obstetrics ; Pregnancy Trimester, First* ; Pregnancy* ; Prospective Studies

OBJECTIVE: To observe the effects of acupoint catgut embedding on miscarriage prevention and pregnancy outcome in patients with threatened abortion after in vitro fertilization-embryo transfer (IVF-ET). METHODS: Sixty cases of patients with threatened abortion after IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with intramuscular injection of progesterone (40 mg) once every day, while the patients in the observation group, on the basis of the treatment of control group, were treated with catgut embedding at Geshu (BL 17), Ganshu (BL 18), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21), Xuehai (SP 10), Diji (SP 8) and Fuliu (KI 7), once every two weeks, six times as a course of treatment. The treatment was given until 12 weeks into pregnancy. The level of serum human chorionic gonadotropin (HCG), estradiol (E) and progesterone (P) before and after treatment was recorded; the TCM syndrome score before and after treatment was compared; the successful pregnancy rate and spontaneous abortion rate after treatment were observed in the two groups. RESULTS: Compared before treatment, the scores of TCM syndrome in both groups were reduced after treatment (both <0.01), and score in the observation group was superior to that in the control group (<0.05). After treatment, the clinical efficacy in the observation group was superior to that in the control group (<0.05). After treatment, the hormone levels (β-HCG, E, P) in both groups were increased steadily; the hormone levels in 6-week pregnancy, 8-week pregnancy and 10-week pregnancy were significantly higher than those in 4-week pregnancy (all <0.05); except the levels of P and β-HCG in 10-week pregnancy, the hormone levels in the observation group were superior to those in the control group (all <0.05). After treatment, the early abortion rate was 16.7% (5/30) in the observation group, which was lower than 33.3% (10/30) in the control group (<0.01); the pregnancy rate was 96.0% (24/25) in the observation group, which was higher than 80.0% (16/20) in the control group (<0.01). CONCLUSION Acupoint catgut embedding is effective for preventing threatened abortion, which could significantly reduce the spontaneous abortion rate, improve the pregnancy success rate, regulate hormone levels in patients after IVF-ET.
Abortion, Threatened ; prevention & control ; Acupuncture Points ; Catgut ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Pregnancy

Early pregnancy factor(EPF) is believed to be a pregnancy-associated immunosuppressivepolypeptide which might inhibit the function of maternal lymphocyte during pregnancy. Thephysiological role of EPF in human pregnancy has remained controversal. The purposes of thisstudy are to investigate whether EPF determinations have prognostic value in women withthreatened abortion, and to evaluate usefulness in diagnosing early pregnancy and in predictingthe outcome of embryo transferred in vitro fertilization-embryo transfer(IVF-ET) program.EPF activity was measured by a recently developed, micro rosette inhibition test in sera from76 normal pregnant women, 25 normal healthy women with tubal ligation, 58 women withtherapeutic surgical abortion(n=18) or threatened abortion(n=40) and 29 IVF-ET patients. Rosetteinhibition titer>or=3 was defined as an index for the presence of EPF activity. EPF activity wasundetectable in sera of normal healthy women with tubal ligation and in sera taken before ET.In normal pregnancy EPF was detected in 88~92% of sera during the first and second trimesterand almost disappeared in the third trimester. Surgical therapeutic abortion in the firsttrimester lead to disappearance of EPF activity in 92.3% of cases second day after procedure.The sensitivity of the EPF assay in predicting the outcome in pregnant women with threatenedabortion was 88.0% and the specificity was found to be 86.7%. In patients who became pregnantafter IVF-ET procedure EPF activity was detected in 85.7% of sera on the 5th day andin all sera on the 12th day. In 80.0%(9/13) sera of patients who failed to become pregnant afterET, EPT activity was detected on the 5th day but 17(94.4%) of 18 sera was proved to benegative for EPF activity on the 12th day. These data suggest that EPF assay by micro rosetteinhibition test may be useful in monitoring the embryo after ET, in dignosing early pregnancyand in predicting the outcome in women with threatened abortion.
Abortion, Therapeutic ; Abortion, Threatened* ; Embryonic Structures ; Female ; Humans ; Lymphocytes ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity ; Sterilization, Tubal

OBJECTIVE: The purpose of our study was to investigate the relationship between prognosis of threatened abortion and embryonic heart rate at diagnosis. METHODS: The study group included 86 patients in which a singleton fetus with cardiac activity was initially documented. The study population was divided into successful pregnancy group (73 cases, pregnancy was maintained above 20 weeks of gestation) and spontaneous abortion group (13 cases). We compared the embryonic heart rate, age of mother, gestational age at diagnosis between two groups. RESULTS: A significant difference of embryonic heart rate was noted between the successful group and the spontaneous abortion group (153.1+/-22.9 vs 134.6+/-18.8 beats/min, p=0.0076). There was no statistical difference in the gestational age at diagnosis (8.0+/-1.9 vs 7.5+/-1.9 weeks), the age of mother, and primi para proportion. CONCLUSION: The prognosis of threatened abortion was related to the embryonic heart rate. Embryos with slow heart rates had a greater risk of spontaneous abortion. All cases with slow embryonic heart rate (<110 beats/min) had occurred spontaneous abortion. Therefore, these case were needed more information and aggressive treatment.
Abortion, Spontaneous ; Abortion, Threatened* ; Diagnosis ; Embryonic Structures ; Female ; Fetus ; Gestational Age ; Heart Rate* ; Heart* ; Human ; Humans ; Mothers ; Pregnancy ; Prognosis* ; Surrogate Mothers

OBJECTIVE: Yun Kang oral liquid is a listed proprietary Chinese Medicine. To further evaluate its efficacy, this experiment established a kidney deficiency and luteum inhibition threatened abortion rat model to observe the effects of Yun Kang oral liquid. METHODS: Sixty pregnant rats were randomly divided into normal control group (NC), model group (MG), dydrogesterone group (DT, 3.02 mg/kg), and Yun Kang oral liquid low-dose group (YK-L, 4 ml/kg), medium dose group (YK-M, 6 ml/kg), high dose group (YK-H, 9 ml/kg), 10 in each group. On the first day of pregnancy, each administration group was treated with the test drug at the prescribed dose every morning, and the NC group and the MG group were given an equal volume of purified water for 10 days; the rats were intragastrically administrated every afternoon, except for the NC group. In addition, the other groups were intragastrically administered with hydroxyurea at a dose of 450 mg/kg for 9 days, and mifepristone was administered at a dose of 4.0 mg/kg on the 10th day. On the 9th day of pregnancy, behavioral signs such as back temperature, grasping force, pain threshold, and autonomic activity were measured in each group. On the 11th day of pregnancy, blood was collected from the abdominal aorta in each group to determine serum levels of estradiol (E) , progesterone (P) and thromboxane B (TXB) . Ovary and fetal uterus were removed, the number and diameter of embryos were observed, and the ovary and uterus indexes were calculated. RESULTS: Compared with the NC group, the back temperature, grip, pain threshold, number of spontaneous activities, number of embryos, embryo diameter, uterus index and serum E, P, TXB levels in the MG group were decreased significantly (P＜0.05, 0.01). Compared with the MG group, the back temperature, grasping force, number of embryos, embryo diameter and serum E and P levels were increased significantly in each dose group (P＜0.05, 0.01); the pain threshold, autonomic activity, and uterus index of YK-M and YK-H group were increased significantly (P＜0.05); serum level of TXB in YK-H group were increased significantly (P＜0.05). CONCLUSION Yun Kang oral liquid has a clear kidney-filling effect on rats with threatened abortion caused by kidney deficiency-luteal suppression. The mechanism may be related to raising serum E, P, TXB levels, improving kidney deficiency and improving embryo quality.
Abortion, Spontaneous ; prevention & control ; Abortion, Threatened ; prevention & control ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Estradiol ; Female ; Humans ; Kidney ; physiopathology ; Luteal Phase ; Pregnancy ; Progesterone ; Rats ; Uterus

OBJECTIVETo investigate the serum levels of estradiol (E2) and progesterone (P) in patients with the auras of threatened abortion (ATA), i.e., fetal irritability and vaginal bleeding, and the relation with prognosis.

METHODSChinese medicine syndrome of 598 pregnant women with ATA consulted in authors' hospital were differentiated into 5 types, 151 patients of Shen-deficiency type; 151 of Pi-Shen deficiency type; 36 of qi-blood insufficiency type, 235 of blood-heat type, and 25 of traumatic injured type. Their serum levels of E2 and P at the 5th to 13th gestation week were monitored by competitive chemiluminescnet enzyme immunoassay. And the outcome of pregnancy, continued or defeated, was observed.

RESULTS(1) From the 7th gestation week on, serum E2 level in women with continued pregnancy (CP) increased continuously, showed a higher value than that at the previous week (P < 0.05), and was higher than that in women with defeated pregnancy (DP) of same gestation age (P < 0.05). (2) Serum P level was not different in CP women at various gestation age (P > 0.05), but from the 7th week on, it was higher in CP women than in DP women of same gestation age (P < 0.05). (3) The comparison of serum E2 in CP versus DP of women with Shen-deficiency type or Pi-Shen deficiency type was identical to that in CP versus DP of all women enrolled.

CONCLUSIONSSerum levels of E2 and P in women with ATA at 5th to 13th gestation weeks were obtained. The 7th week of pregnancy is the critical period of pregnancy development, a comparative high E2 levels and its sustained and steady elevation indicates the good-ending of pregnancy with fetal irritability and vaginal bleeding. The Chinese medicine syndrome presented in women with ATA is dominantly the Shen-deficiency type. The variation of serum E2 is one of the important material foundation in pregnancy with fetal irritability and vaginal bleeding of Shen-deficiency type.

Abortion, Threatened ; blood ; Diagnosis, Differential ; Estradiol ; blood ; Female ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pregnancy ; Pregnancy Trimester, First ; Progesterone ; blood ; Uterine Hemorrhage

OBJECTIVETo study the clinical effects of Prescription Zhuyun-III (ZYIII) on early pregnant women diagnosed as threatened abortion, and its mechanism in immunity and endocrine by determining serum Th1- and Th2-type cytokines, progesterone, and beta-human chorionic gonadotropin (beta-HCG).

METHODSThe treatment group comprised 30 early pregnant women diagnosed as threatened abortion of deficiency syndrome of Pi, Shen, or both. The control group consisted of 20 normal early pregnant women of similar gestational age. Patients in the treatment group were administered with ZYIII for 4 weeks. Peripheral blood samples were collected pre- and post-treatment from both the treatment and the control groups. Serum Th1-type cytokine [interleukin-2 (IL-2)] and Th2-type cytokine [interleukin-10 (IL-10)] were determined by flow cytometry, and serum progesterone and beta-HCG were determined by ELISA.

RESULTS(1) The treatment was effective in 26 and ineffective in 4 patients of the treatment group. Therefore, the cure percentage was 86.67%. (2) In the treatment group before the treatment, IL-2 was significantly higher, IL-10 tended to be less, and the Th1/Th2 balance shifted toward Th1 compared with those in the control group. (3) After the treatment, IL-2 was decreased, IL-10 was increased, and IL-2/IL-10 was decreased. Both progesterone and beta-HCG were increased. Changes of progesterone were positively correlated with changes of IL-10, whereas changes of beta-HCG were negatively correlated with changes of IL-2.

CONCLUSIONSOur study suggests that ZYIII has an evident function of protecting the fetus, and one of its mechanisms is inhibiting the secretion of Th1 cytokines, promoting the secretion of Th2 cytokines, and recovering the pathological shift of the Th1/Th2 balance. The other possible mechanism is increasing serum progesterone and beta-HCG concentrations. Moreover, there are some correlations between the above two effects.

Abortion, Threatened ; Chorionic Gonadotropin ; blood ; Cytokines ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Medicine, Chinese Traditional ; Pregnancy ; Progesterone ; blood ; Th1 Cells ; immunology ; Th2 Cells ; immunology

OBJECTIVETo observe the fetus protection effects of Zhixue Baotai Decoction (ZBD) on women of early threatened abortion with dark area surrounding pregnancy sac.

METHODSThe 105 patients with early threatened abortion, in whom vaginal bleeding was shown already, were randomly assigned to the treatment group and the control group, who were treated respectively with ZBD and progesterone to protect fetus. The efficacy of treatment was evaluated by dynamic monitoring of serum hormone and B-ultrasonic examination.

RESULTSAmong the 54 cases in the treatment group the fetus was protected successfully, showing a fetus protecting rate of 81.5%; while among the 51 cases in the control group, the protection was effective in 22 cases (43.1%), the success rate in the former was better (P<0.01). The dark area was absorbed in 16 out of 19 cases (84.2%) in the treatment group, while in the control group absorption occurred only in 6 out of 17 (35.3%).

CONCLUSIONThe effect of ZBD is superior to that of progesterone in treating women of early threatened abortion with dark area surrounding pregnancy sac.

Abortion, Threatened ; diagnostic imaging ; drug therapy ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Extraembryonic Membranes ; diagnostic imaging ; Female ; Humans ; Phytotherapy ; Pregnancy ; Pregnancy Trimester, First ; Treatment Outcome ; Ultrasonography ; Young Adult