Characteristic of the karyotype of products of conception depending on reproductive history of women

Aim. The prognosis of the reproductive function of women with pregnancy loss is complex and partly based on the results of karyotyping of material of reproductive loss. We studied the features of the karyotype of material of EPL depending on the reproductive history of women with an emphasis on viable and non–viable karyotype abnormalities(KA). Methods. Banding cytogenetic and interphase mFISH with the centromeric probe panel for chromosomes 13, 14, 15, 16, 17, 18, 21, 22, X and Y were used. Results. Were examined 1734 cases of material EPL. Abnormal karyotype was set in 39.3% of cases. The frequency of KA is not significantly different in the material of EPL obtained from women with different reproductive history, namely: first pregnancy loss– 38.9% RPL – 38.2% and SPL – 41.0% (P> 0.05). In the group with RPL significantly more frequent non–viable KA and less viable KA, compared with a group of SPL namely 70.15% and 29.85% compared to 58.85% and 41.15% respectively(P<0.025). Conclusions. The contribution of different KA in genesis of the EPL depends on the reproductive history of women, namely women with RPL significantly increases the proportion of non–viable KA and reduced contribution viable KA compared with a group of SPL. Keywords: early reproductive loss, maternal reproductive history, karyotype abnormalities.

Telomere length in individuals with early pregnancy losses

Aim. Over the past decade, telomere biology has become an important topic in the field of human reproduction.We focused on the relationship between relative telomere length (RTL) and tendency to early pregnancy loss (EPL) in humans. Methods. RTL was measured in DNA isolated from the blood samples using a real-time polymerase chain reaction approach. RTL was examined in control group (C) (N=209) – women (CW) (N=107) and men (CM) (N=102) who had healthy pregnancies with no history of infertility or miscarriage, and in group with EPL (N=445) – women (EPLW) (N=223) and men (EPLM) (N=212) who had single or more EPL. RTL data were analyzed by gender and reproductive history. Results. Women (CW+EPLW) have significantly higher RTL that men (CM+EPLM) (1.74±0.06 in women and 1.40±0.05 in men, P=0.000053). Average RTL were significantly lower in CM compared to CW (CW: 2.27±0.12 versus CM: 1.15±0.08, P=0.0000001), and were similar in EPLW and EPLM (1.50±0.06 in EPLW and 1.53±0.06 in EPLM, P=0.47). The EPLW group had significantly lower RTL than control (EPLW: 1.50±0.06 versus CW: 2.27±0.12, P=0.0000001). Average RTL were significantly lower in CM compared to EPLM (1.15±0.08 in CM and 1.53±0.06 in EPLM, P=0.00006). Conclusions. Women with no history of EPL have longer telomere than men. Woman with EPL have shorter telomere that women without miscarriage. In EPL group women and men have similar telomere length.Keywords: telomeres, RT-PCR, gender, early reproductive loss.

The Resurrection and Unborn Beings: The Seeds of a Materialist Emergence Proposal

This article looks at how two apparently unrelated issues—the afterlife and reproductive loss—turn out to be interrelated in complex theological and ethical ways. Eschatology is important to address, because how one thinks about resurrected bodies in the afterlife has implications for how one treats bodies that procreate in this life. Rethinking the notion of personhood lies at the heart of clarifying the nature of the resurrection. This article presents a theological anthropology that draws from the recent philosophical theory known as emergence. This theory allows us to conceptualize the resurrection of the “spiritual body” as a divinely initiated organic process that begins from a “bare seed” at death (1 Cor 15:44, 37). I hope to demonstrate that an emergence model of the resurrection both speaks to those grieving reproductive loss and also avoids eclipsing women’s exercise of moral discernment in reproductive matters.

The Precarious Space for Mourning: Sick Leave as an Ambiguous Topic in Bereaved Parents’ Accounts of the Return to Everyday Life After Reproductive Loss

This article addresses conflicting concerns related to space for mourning in Norway. It draws on material from qualitative interviews with bereaved parents who have lost a child in stillbirth. Space for mourning, and the need for sick leave, arose as a crucial concern and complex issue in these interviews. Although initiatives have been developed to introduce grief as a valid category in diagnostic repertoires, it is not a legitimate basis for sick leave in the acute phase. Common alternatives have been referrals to psychic instability or depression. Both variations represent a medicalization of the normal with implications that need to be addressed, and which this article discusses from the bereaved parents’ point of view. Extended parental leave, and the introduction of grief allowance, are possible alternatives for the provision of space in normal but demanding times of grief. Despite not yet part of the repertoire for gatekeepers in the Norwegian welfare state, they are part of the public discourse. Besides a crucial acknowledgment of the grief of the parents, these options also represent possibilities for preventing a pathologization of what is a normal rite of passage.

Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third (39.6%) of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double (136.9% vs. 63.6%) for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance.

The course of pregnancy, childbirth and the postpartum period in patients after ovarian apoplexy

The objective: to study the features of the course of pregnancy, childbirth and the postpartum period in women with a history of surgical treatment of ovarian apoplexy.Materials and methods. The study involved 62 women in labor (main group, n=62), who were operated on for ovarian apoplexy before pregnancy, and 60 patients in the control group (n=60), who did not have this pathology in the anamnesis. The average age of women was 26,1±2,3 years, the time interval from an episode of ovarian apoplexy to pregnancy was 5,44±2,7 years. Re-apoplexy was observed in 2 cases (3,22%).Results. The study found that the main complication in the first trimester of pregnancy was reproductive loss, mainly in the form of a stillborn pregnancy. In the early stages of gestation, the threat of abortion was 3 times more often observed in the main group than in the control group. In the second trimester draws attention to several facts of complications that are characteristic of patients in the main group: the widespread prevalence of acute or chronic infectious pathology in the acute stage (51,6% vs. 11,7% in the control group), the development of preeclampsia 2 times more often among pregnant women with ovarian apoplexy (38,7% vs. 20,0%), as well as mild anemia (40,3% vs. 21,6%).The results of the study indicate a high frequency of premature ejaculation of amniotic fluid in pregnant women with ovarian apoplexy (29,0% vs. 13,3%), rapid labor (16,1% vs. 1,7%), umbilical cord entanglement (33,9% vs. 15,0%), hypotonic bleeding in the early postpartum period (14,5% vs. 1,67%). The frequency of cesarean section did not differ significantly in both groups (p>0,05). The assessment of newborns on the Apgar scale had no statistically significant differences.Conclusion. Pregnant women who have a history of surgical treatment of ovarian apoplexy are at risk for developing early miscarriage, complicated gestation, childbirth and the postpartum period. Analysis of the reproductive function of women in the study groups reflected the problems of gestation mainly in the early stages in the form of reproductive loss or symptoms of miscarriage, in the late stages of pregnancy complications were mainly due to extragenital pathology. The data obtained during the study in practice should contribute to the development of rehabilitation measures and pre-pregnancy training, which are aimed at restoring reproductive health and prevention of complications of pregnancy and childbirth in women at risk.