abortion

人工流产
  • 文章类型: Journal Article
    马匹疱疹病毒(EHVs)是一组影响马的极具影响力的病毒病原体,给全球马业带来巨大风险。其中,1型疱疹病毒(EHV-1)主要引起呼吸道感染。然而,它传播到远处器官的能力会导致严重的后果,如流产和神经系统疾病。这些病毒可以进入休眠期,用最少的活动,然后重新激活以随时触发活动性感染。最近,一种特别具有破坏性的EHV-1菌株的患病率显着上升,这种菌株被称为共同疱疹病毒性骨髓脑病(EHM)。鉴于EHV-1的动态性质,这篇综述提供了EHV-1的全面概述,并探讨了病毒生物学的进展如何影响病毒感染的病理生理学。这里提供的信息对于了解EHV-1感染的动态和制定切实可行的计划以阻止病毒在类群中的全球传播至关重要。
    Equid herpesviruses (EHVs) are a group of highly impactful viral pathogens that affect horses, presenting a substantial risk to the global equine industry. Among these, equid herpesvirus-1 (EHV-1) primarily causes respiratory infections. However, its ability to spread to distant organs can lead to severe consequences such as abortion and neurological diseases. These viruses can enter a dormant phase, with minimal activity, and later reactivate to trigger active infections at any time. Recently, there has been a notable rise in the prevalence of a particularly devastating strains of EHV-1 known as equid herpesviral myeloencephalopathy (EHM). In the light of dynamic nature of EHV-1, this review provides a thorough overview of EHV-1 and explores how advances in viral biology affect the pathophysiology of viral infection. The information presented here is crucial for understanding the dynamics of EHV-1 infections and creating practical plans to stop the virus\'s global spread among equid populations.
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  • 文章类型: Journal Article
    背景:然而,米索前列醇通常用于终止妊娠,但它也会引起副作用。单硝酸异山梨酯(ISMN)可以通过增加前列腺素E2的产生和血管舒张来帮助子宫颈成熟。考虑到这一领域的研究结果是矛盾的,本研究的目的是评估阴道ISMN联合米索前列醇与单用米索前列醇在早期和中期流产治疗中的疗效和安全性.
    方法:搜索过程是通过PubMed界面对MEDLINE进行的,Scopus,Web-of-Science,科学直接,Cochrane中央控制试验登记册(CENTRAL),谷歌学者,ClinicalTrials.gov,和世界卫生组织国际临床试验注册平台,直到2023年11月10日。我们对偏倚的评估基于随机试验的偏倚风险工具(RoB2)的版本2,我们的证据质量水平由GRADE确定。使用ReviewManager(RevMan)5.1版对所有数据进行Meta分析。
    结果:七项随机临床试验纳入系统评价,三项纳入荟萃分析,混合质量。荟萃分析结果显示,在妊娠中期流产中,将ISMN与阴道米索前列醇结合使用可显著缩短引产间期,具体到4.21h(95%CI:-7.45至-0.97,P=0.01)。在米索前列醇中添加阴道ISMN,与单独的阴道米索前列醇相比,完成堕胎的几率增加了3.76倍。(95%CI:1.08~13.15,P=0.04)。
    结论:这项研究的结果可以提供有价值的见解,旨在加强对专业环境中非手术药物流产方法的咨询和支持。此外,它提高了临床治疗的有效性,减少了流产管理方案中不必要的手术干预的发生。
    BACKGROUND: However, misoprostol is often used to terminate a pregnancy, but it can also cause side effects. Isosorbide mononitrate (ISMN) can help the cervix mature by increasing the production of prostaglandin E2 and vasodilation. Considering that the results of studies in this field are contradictory, it is the purpose of this study to evaluate the efficacy and safety of vaginal ISMN plus misoprostol compared to misoprostol alone in the management of first- and second-trimester abortions.
    METHODS: The search process was conducted for MEDLINE through the PubMed interface, Scopus, Web-of-Science, Science Direct, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform until November 10, 2023. Our assessment of bias was based on version 2 of the risk-of-bias tool (RoB2) for randomized trials and our level of evidence quality was determined by GRADE. Meta-analysis of all data was carried out using Review Manager (RevMan) version 5.1.
    RESULTS: Seven randomized clinical trials were included in the systematic review and three in the meta-analysis, with mixed quality. The results of the meta-analysis revealed that in the second-trimester abortion, the inclusion of ISMN in conjunction with vaginal misoprostol results in a noteworthy reduction in the induction abortion interval, specifically by 4.21 h (95% CI: -7.45 to -0.97, P = 0.01). The addition of vaginal ISMN to misoprostol, compared to vaginal misoprostol alone, increased the odds of a completed abortion by 3.76 times. (95% CI: 1.08 to 13.15, P = 0.04).
    CONCLUSIONS: The findings of this study can offer valuable insights aimed at enhancing counseling and support for non-surgical methods of medication abortion within professional settings. Moreover, it improves the effectiveness of clinical treatment and reduces the occurrence of unnecessary surgical interventions in the abortion management protocol.
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  • 文章类型: Journal Article
    背景:尼日利亚未婚青少年的意外怀孕和流产是多方面因素相互作用的结果。堕胎,全球公共卫生和社会问题,影响发达国家和发展中国家。这项范围审查研究了文献,并绘制了尼日利亚未婚女性青少年意外怀孕和堕胎的危险因素。
    方法:跨数据库进行范围界定文献检索,包括PubMed,科学直接,WebofScience,EBSCOhost,JSTOR,非洲医学指数,还有Scopus.纳入标准包括同行评审的文章和英文报告,关注未婚女性青少年。感兴趣的范围包括过去发生性行为的事件,意外怀孕,使用避孕药,和堕胎。排除分类为灰色文献的研究,以确保综合信息的可靠性和有效性。
    结果:共560篇,553通过数据库和7通过手工搜索确定,进行了全面的全文审查,结果纳入了22项符合最终审查标准的研究。范围审查揭示了过去发生性行为的事件,意外怀孕,使用避孕药,尼日利亚未婚青少年的堕胎。发生性行为的发生率从57.2%到82.7%不等,意外怀孕的患病率为23.4%至92.7%。避孕药具使用率明显较低,21.5%的人报告使用率低,导致堕胎的高发生率,从20.2%到51.0%不等。影响意外怀孕的因素包括对现代避孕药具缺乏认识以及获得性健康和生殖健康信息的获取有限。对于人工流产,对教育事业的影响等因素,确定了婚外生育和对学校开除的恐惧。
    结论:本范围审查,通过对现有文献的系统研究,有助于更有力地了解影响尼日利亚未婚青少年意外怀孕和堕胎的因素。这些发现为未来的研究方向提供了指导,并指导制定有针对性的干预措施,以改善这一弱势群体的生殖健康结果。
    BACKGROUND: Unintended pregnancies and abortions among unmarried adolescents in Nigeria are outcomes of the interplay of multifaceted factors. Abortion, a global public health and social issue, impacts both developed and developing countries. This scoping review explored the literature and mapped the risk factors for unintended pregnancies and abortions among unmarried female adolescents in Nigeria.
    METHODS: A scoping literature search was conducted across databases, including PubMed, Science Direct, Web of Science, EBSCOhost, JSTOR, African Index Medicus, and Scopus. Inclusion criteria encompassed peer-reviewed articles and reports in English, focusing on unmarried female adolescents. The range of interest included the past incidents of having sex, unintended pregnancies, contraceptive use, and abortions among this demographic. Studies categorized as grey literature were excluded to ensure the reliability and validity of the synthesized information.
    RESULTS: A total of 560 articles, 553 identified through databases and 7 through hand search, were subjected to a comprehensive full-text review, resulting in the inclusion of 22 studies that met the criteria for the final review. The scoping review shed light on the past incidents of having sex, unintended pregnancies, contraceptive use, and abortions among unmarried adolescents in Nigeria. The range of incidence for having sex varied from 57.2% to 82.7%, with the prevalence of unintended pregnancies ranging from 23.4% to 92.7%. Contraceptive use was notably low, with 21.5% reporting low usage, contributing to the high incidence of abortions, ranging from 20.2% to 51.0%. Factors influencing unintended pregnancies included a lack of awareness of modern contraceptives and limited access to sexual and reproductive health information. For induced abortions, factors such as the impact on educational career, childbearing outside wedlock and fear of expulsion from school were identified.
    CONCLUSIONS: This scoping review, through a systematic examination of existing literature, contributes to a more robust understanding of the factors influencing unintended pregnancies and abortions among unmarried adolescents in Nigeria. The findings inform future research directions and guide the development of targeted interventions to improve reproductive health outcomes for this vulnerable population.
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  • 文章类型: Journal Article
    紧急产科护理(EmOC)信号功能是能够避免因孕产妇死亡的五个主要直接原因而死亡的关键临床干预措施的候选清单;自1997年以来,它们已被用作EmOC监测框架的一部分,以跟踪低收入和中等收入环境中EmOC服务的可用性。它们的广泛使用和拟议的适应包括其他类型的护理,比如照顾新生儿,证明了他们作为生殖健康测量架构一部分的遗产。然而,自从最初引入EmOC信号功能以来,孕产妇和新生儿健康(MNH)的格局发生了很大变化。作为修改EmOC监测框架项目的一部分,我们进行了元叙事启发的审查,以反映信号功能是如何发展和概念化在过去的二十年,以及不同的叙述,随着不断发展的MNH景观出现,在信号函数测量的概念化中发挥了作用。我们确定了三个总体叙事传统:1)临床2)卫生系统和3)人权,主导了围绕信号功能使用的话语和批评。通过迭代综合过程,包括19篇最终文章,我们探索了三种叙事传统之间的和解模式和矛盾领域。我们总结了围绕信号功能使用的五个元主题:i)确定边界;ii)超越临床能力;iii)捕获树林和树木;iv)分组信号功能和v)测量挑战。我们打算让这次审查有助于更好地理解围绕信号功能的论述,并为这种监测方法在急诊产科和新生儿护理中的未来作用提供见解。
    Emergency obstetric care (EmOC) signal functions are a shortlist of key clinical interventions capable of averting deaths from the five main direct causes of maternal mortality; they have been used since 1997 as a part of an EmOC monitoring framework to track the availability of EmOC services in low- and middle-income settings. Their widespread use and proposed adaptation to include other types of care, such as care for newborns, is testimony to their legacy as part of the measurement architecture within reproductive health. Yet, much has changed in the landscape of maternal and newborn health (MNH) since the initial introduction of EmOC signal functions. As part of a project to revise the EmOC monitoring framework, we carried out a meta-narrative inspired review to reflect on how signal functions have been developed and conceptualised over the past two decades, and how different narratives, which have emerged alongside the evolving MNH landscape, have played a role in the conceptualisation of the signal function measurement. We identified three overarching narrative traditions: 1) clinical 2) health systems and 3) human rights, that dominated the discourse and critique around the use of signal functions. Through an iterative synthesis process including 19 final articles selected for the review, we explored patterns of conciliation and areas of contradiction between the three narrative traditions. We summarised five meta-themes around the use of signal functions: i) framing the boundaries; ii) moving beyond clinical capability; iii) capturing the woods versus the trees; iv) grouping signal functions and v) measurement challenges. We intend for this review to contribute to a better understanding of the discourses around signal functions, and to provide insight for the future roles of this monitoring approach for emergency obstetric and newborn care.
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  • 文章类型: Journal Article
    自然流产和人工流产是妊娠的常见结局。有不一致的证据表明早期妊娠丢失与女性随后的糖尿病和高血压疾病之间存在关联。这项系统评价和荟萃分析评估了早期妊娠丢失妇女随后发生妊娠和非妊娠相关糖尿病和高血压疾病风险的证据。
    在七个电子数据库中进行了系统搜索(CINAHLPlus,Ovid/EMBASE,Ovid/MEDLINE,ProQuest,PubMed,Scopus,和WebofScience)从成立到2023年12月22日。如果他们报告了自然流产(SAB)的暴露,人工流产(IA)或复发性妊娠丢失(RPL),结果为妊娠糖尿病,先兆子痫,妊娠期高血压,和非妊娠相关的糖尿病和高血压疾病。使用非随机暴露研究的偏倚风险工具(ROBINS-E)评估偏倚风险。随机效应荟萃分析用于汇集早期妊娠失败后发生糖尿病和高血压疾病的几率。本研究在PROSPERO(CRD42022327689)注册。
    在20,176条记录中,确定了60篇独特的文章进行全文审查,52篇符合纳入标准,代表来自22个国家的4,132,895名妇女的总人口。35项研究适用于荟萃分析,导致先前SAB后妊娠糖尿病的合并比值比(OR)为1.44(95%置信区间(CI)1.23-1.68),先前SAB后先兆子痫的合并OR为1.06(95%CI0.90-1.26).RPL增加了患先兆子痫的几率(OR1.3795%CI1.05-1.79)。IA与糖尿病和高血压疾病之间没有关联。
    先前的SAB与妊娠糖尿病的几率增加有关,但不是先兆子痫.然而,经历RPL的女性随后发生先兆子痫的风险增加.未来的研究需要建立早期妊娠丢失与非妊娠相关的糖尿病和高血压疾病之间关联的证据。
    国家卫生与医学研究委员会。
    UNASSIGNED: Spontaneous and induced abortions are common outcomes of pregnancy. There is inconsistent evidence of an association between early pregnancy loss and subsequent diabetic and hypertensive disorders in women. This systematic review and meta-analysis evaluated evidence on the risk of the subsequent development of pregnancy and non-pregnancy related diabetic and hypertensive disorders in women who experienced an early pregnancy loss.
    UNASSIGNED: Systematic searches were conducted in seven electronic databases (CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, ProQuest, PubMed, Scopus, and Web of Science) from inception to 22nd December 2023. Studies were included if they reported an exposure of spontaneous abortion (SAB), induced abortion (IA) or recurrent pregnancy loss (RPL) with an outcome of gestational diabetes mellitus, pre-eclampsia, gestational hypertension, and non-pregnancy related diabetic and hypertensive disorders. Risk of bias was assessed using Risk of Bias Instrument for Non-Randomized Studies of Exposures (ROBINS-E). Random effects meta-analysis was used to pool odds of developing diabetic and hypertensive disorders following an early pregnancy loss. This study is registered with PROSPERO (CRD42022327689).
    UNASSIGNED: Of 20,176 records, 60 unique articles were identified for full-text review and 52 met the inclusion criteria, representing a total population of 4,132,895 women from 22 countries. Thirty-five studies were suitable for meta-analysis, resulting in a pooled odds ratio (OR) of 1.44 (95% confidence interval (CI) 1.23-1.68) for gestational diabetes mellitus following a prior SAB and a pooled OR of 1.06 (95% CI 0.90-1.26) for pre-eclampsia following a prior SAB. RPL increased the odds of developing pre-eclampsia (OR 1.37 95% CI 1.05-1.79). There was no association between IA and diabetic and hypertensive disorders.
    UNASSIGNED: A prior SAB was associated with increased odds of gestational diabetes mellitus, but not pre-eclampsia. However, women who experienced RPL had an increased risk of subsequent pre-eclampsia. Future research is required to establish evidence for an association between early pregnancy loss with non-pregnancy related diabetic and hypertensive disorders.
    UNASSIGNED: National Health and Medical Research Council.
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  • 文章类型: Journal Article
    本范围审查通过研究和分析全球堕胎禁令或限制的报道影响,解决了美国堕胎限制的潜在孕产妇健康结果。目的是检查由于施加的限制而无法流产具有严重医学异常的胎儿的孕妇的医学意义。EMBASE,Medline,在2022年Roev.Wade案被推翻之前,在任何国家搜索了以英文发表的关于堕胎限制的医学影响的研究和CINAHL数据库。对于使用布尔运算符的搜索条件,关键词包括术语“胎儿异常,\"\"堕胎禁令,“和”含义。“纳入标准纳入了1980年至2021年发表的研究,旨在评估干预措施的对照实验研究被排除在外。这导致了最初发现的469条记录。已删除重复的记录,并进行了两次单独的层级审查。11名审稿人独立筛选了332条记录的摘要和标题,以确定资格。资格包括被诊断为胎儿异常的孕妇,妇女被剥夺了安全堕胎的机会,以及这对产妇和胎儿的医疗影响。在第二次筛选中,三名审稿人独立阅读了36篇文章,以进一步评估资格,最终审查了14篇文章。这项研究的结果表明,世界各国的堕胎禁令导致寻求非法堕胎服务的妇女出现健康并发症,产妇心理健康下降,包括压力和抑郁,各种医疗并发症,如难产,以及出生时出现严重缺陷的高风险胎儿增加。这项审查的结果预示着在美国受更严格的堕胎法约束的妇女将经历类似的负面后果
    This scoping review addresses the potential maternal health outcomes of abortion restrictions in the U.S. by studying and analyzing the reported effects of abortion bans or limitations globally. The goal was to examine the medical implications for pregnant women who are unable to abort fetuses that have severe medical anomalies due to imposed restrictions. EMBASE, Medline, and CINAHL databases were searched for studies published in English concerning the medical implications of abortion restrictions in any country prior to the overturn of Roe v. Wade in 2022. For the search criteria using Boolean operators, keywords included the terms \"fetal anomaly,\" \"abortion ban,\" and \"implications.\" Inclusion criteria incorporated studies published between 1980 and 2021, and controlled experimental research studies aimed to evaluate interventions were excluded. This resulted in 469 records initially found. Duplicate records were removed, and two separate tier reviews were conducted. Eleven reviewers independently screened abstracts and titles of 332 records to ascertain eligibility. Eligibility included pregnant women diagnosed with fetal anomalies, women denied access to safe abortions, and the maternal and fetal medical impacts of this. Three reviewers in the second screening independently read 36 full articles to further assess eligibility, resulting in 14 articles in the final review. Findings from this study showed that abortion bans in countries around the world have led to health complications in women seeking illegal abortion services, a decline in maternal mental health, including stress and depression, various medical complications such as obstructed labor, and an increase in high-risk fetuses born with severe deficits. The findings of this review portend similar negative consequences to be experienced by women who are subject to stricter abortion laws in the U.S.
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  • 文章类型: Journal Article
    布鲁氏菌病是最常见和广泛分布的细菌性人畜共患病之一,由属于布鲁氏菌属的革兰氏阴性细菌引起。这些生物能够在胎盘内感染和复制,导致流产,布鲁氏菌病的主要临床体征之一。虽然小鼠模型被广泛用于研究布鲁氏菌的毒力,最近,为了评估新疫苗的保护,在实验条件上没有明确的共识(例如,小鼠品系,剂量,接种途径,感染/妊娠时间)和生殖布鲁氏菌病妊娠小鼠模型的自然宿主可重复性。缺乏共识要求进行审查,以整合有关布鲁氏菌野生型和疫苗株感染对小鼠妊娠的影响的主要发现。我们发现了足够的证据证明妊娠小鼠模型可以研究布鲁氏菌引起的胎盘炎和流产,并提出了合适的实验条件(剂量,感染时间)和妊娠结局读数为流产芽孢杆菌和B.melitensis研究。最后,我们讨论了妊娠小鼠作为布鲁氏菌活疫苗流产效果预测模型的实用性和局限性。
    Brucellosis is one of the most common and widespread bacterial zoonoses and is caused by Gram-negative bacteria belonging to the genus Brucella. These organisms are able to infect and replicate within the placenta, resulting in abortion, one of the main clinical signs of brucellosis. Although the mouse model is widely used to study Brucella virulence and, more recently, to evaluate the protection of new vaccines, there is no clear consensus on the experimental conditions (e.g., mouse strains, doses, routes of inoculation, infection/pregnancy time) and the natural host reproducibility of the pregnant mouse model for reproductive brucellosis. This lack of consensus calls for a review that integrates the major findings regarding the effect of Brucella wild-type and vaccine strains infections on mouse pregnancy. We found sufficient evidence on the utility of the pregnant mouse model to study Brucella-induced placentitis and abortion and propose suitable experimental conditions (dose, time of infection) and pregnancy outcome readouts for B. abortus and B. melitensis studies. Finally, we discuss the utility and limitations of the pregnant mouse as a predictive model for the abortifacient effect of live Brucella vaccines.
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  • 文章类型: Journal Article
    这是一项关于堕胎心理健康结果研究的系统评价和荟萃分析方案。堕胎是否会增加不良心理健康结局的风险?这是本综述的核心问题。我们的审查旨在通过定位来为政策和实践提供信息,批判性评估,并综合了堕胎与随后的心理健康结果之间关联的经验证据。鉴于围绕这个话题的争议和复杂的社会,政治,legal,以及进行堕胎研究和审查的意识形态背景,进行全面的系统回顾和荟萃分析尤为重要,严谨,没有偏见,透明的方法。我们将包括各种研究设计,以增强对研究方法优势和劣势的理解,并确定冲突结果的潜在解释。我们将遵循开放科学原则,提供访问我们的方法,措施,和结果,并使数据可用于重新分析。
    This is a protocol for a systematic review and meta-analysis of research on mental health outcomes of abortion. Does abortion increase the risk of adverse mental health outcomes? That is the central question for this review. Our review aims to inform policy and practice by locating, critically appraising, and synthesizing empirical evidence on associations between abortion and subsequent mental health outcomes. Given the controversies surrounding this topic and the complex social, political, legal, and ideological contexts in which research and reviews on abortion are conducted, it is especially important to conduct this systematic review and meta-analysis with comprehensive, rigorous, unbiased, and transparent methods. We will include a variety of study designs to enhance understanding of studies\' methodological strengths and weaknesses and to identify potential explanations for conflicting results. We will follow open science principles, providing access to our methods, measures, and results, and making data available for re-analysis.
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  • 文章类型: Journal Article
    锌是参与不同生理功能的必需微量元素。在怀孕期间,它在健康的胚胎发育中起着至关重要的作用。堕胎是与早期妊娠并发症相关的最严重的问题。这项研究旨在比较有流产和没有流产的母亲的锌水平。
    本研究是对1980年至2022年在PubMed上发表的研究的系统回顾和荟萃分析,科学直接,专业任务,威利,WebofScience,和Scopus数据库。搜索使用main和Mesh关键字进行,专门针对与堕胎有关的术语,怀孕失败,和锌。使用卡方检验等统计检验评估荟萃分析中包含的研究中的异质性,I2和森林地块。使用Begg\和Egger测试评估出版偏倚。使用Stata15进行所有分析,并且在p<0.05时考虑统计学显著性。
    一般来说,本分析包括9项研究.根据荟萃分析的结果,有流产和未流产的母亲之间锌水平的平均差异等于193.18(95%CI;107.11至279.25,P≤0.001)。换句话说,未流产母亲组的锌水平比流产母亲组高193个单位。根据Begg检验(P值=0.858)和Egger检验(P值=0.270),对有流产和无流产母亲的Zn水平比较的调查均未发现任何发表偏倚的迹象。
    研究结果表明,与未流产的母亲相比,流产母亲的锌含量较低之间存在显着关联。这表明,较高的锌水平可能对孕妇流产的发生具有预防作用。数据还突出了痕量金属的积极作用,特别是锌,在影响妊娠结局方面,并表明维持足够的锌水平可能会降低流产发生的可能性,以及其他促成因素。重要的是要注意,进一步的研究,包括前瞻性队列研究和实验研究,需要提供更多实质性证据并加强这些发现。
    UNASSIGNED: Zinc is an essential trace element involved in different physiological functions. During pregnancy, it plays a crucial role in healthy embryogenesis. Abortion is the most severe problem associated with early pregnancy complications. This study aims to compare the levels of Zn in mothers with and without abortion.
    UNASSIGNED: This study is a systematic review and meta-analysis of studies published between 1980 and 2022 in PubMed, Science Direct, Pro Quest, Wiley, Web of Science, and Scopus databases. The search was conducted using both main and Mesh keywords, specifically targeting terms related to abortion, pregnancy loss, and zinc. Heterogeneity in the studies included in the meta-analysis was evaluated using statistical tests such as the chi-square test, I2, and forest plots. Publication bias was assessed using Begg\'s and Egger\'s tests. All analyses were conducted using Stata 15, and statistical significance was considered at p < 0.05.
    UNASSIGNED: In general, nine studies were included in this analysis. Based on the results of the meta-analysis, the mean difference in the Zn level between mothers with and without abortion is equal to 193.18 (95 % CI; 107.11 to 279.25, P ≤ 0.001). In other words, the level of Zn in the group of mothers without abortion is 193 units higher than the group of mothers with abortion. The investigation into the comparison of Zn levels in mothers with and without abortion did not reveal any indication of publication bias according to both Begg\'s test (P-value = 0.858) and Egger\'s test (P-value = 0.270).
    UNASSIGNED: the study findings indicate a significant association between lower levels of Zn in mothers with abortion compared to mothers without abortion. This suggests that a higher level of Zn may have a preventive effect on the occurrence of abortion in pregnant women. The data also highlights the positive role of trace metals, particularly Zn, in influencing pregnancy outcomes and suggests that maintaining adequate levels of Zn may reduce the likelihood of abortion occurrence, along with other contributing factors. It is important to note that further research, including prospective cohort and experimental studies, is needed to provide more substantial evidence and strengthen these findings.
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  • 文章类型: Journal Article
    本文旨在报告插入率的全面和最新的分析和证据,驱逐率,去除率,人工流产后立即放置宫内节育器(IUD)与延迟放置的使用率。PubMed,Embase,科克伦,WebofScience,CNKI,截至2024年1月12日,对万方数据库进行了全面搜索,以比较流产后立即插入宫内节育器与延迟插入宫内节育器的研究。评估指标包括手术或药物流产后插入宫内节育器的数量,6个月或1年驱逐和驱逐的频率,继续使用的次数,疼痛强度评分,感染的数量,出血的持续时间,以及宫内节育器插入期间或之后子宫穿孔的实例。十篇随机对照文章符合条件,包括11个研究项目,其中3个项目涉及手术流产后放置宫内节育器,8个项目涉及药物流产后放置宫内节育器。这包括2025名患者(立即插入组977名,延迟插入组1,048名)。我们总结了所有提取的证据。荟萃分析结果表明,对于术后流产,立即插入组的IUD放置率高于延迟插入组。医疗流产后,立即插入组显示出更高的宫内节育器放置率,利用率,并在6个月或1年时被驱逐。两组拔除率差异无统计学意义,插入后感染率,插入过程中的疼痛评分,以及随访期间出血天数。与延迟放置相比,立即插入宫内节育器不仅可以提高6个月或1年的使用率,还可以提高放置率。
    This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate placement of intrauterine devices (IUDs) versus delayed placement after artificial abortion. PubMed, Embase, Cochrane, Web of Science, CNKI, and Wanfang databases were comprehensively searched up to January 12, 2024 for studies that compared immediate versus delayed insertion of IUDs after abortion. The evaluation metrics included the number of IUD insertion after surgical or medical abortions, the frequency of expulsion and removal at 6 months or 1 year, the number of continued usage, pain intensity scores, the number of infections, the duration of bleeding, and instances of uterine perforation during or after IUD insertion. Ten randomized controlled articles were eligible, comprising 11 research projects, of which 3 projects involved the placement of an IUD after surgical abortion, and 8 projects involved the placement of an IUD after medical abortion. This included 2025 patients (977 in the immediate insertion group and 1,048 in the delayed insertion group). We summarized all the extracted evidence. The meta-analysis results indicated that for post-surgical abortions, the immediate insertion group exhibited a higher IUD placement rate than the delayed insertion group. After medical abortions, the immediate insertion group showed higher rates of IUD placement, utilization, and expulsion at 6 months or 1 year. The two groups showed no statistically significant differences in the removal rate, post-insertion infection rate, pain scores during insertion, and days of bleeding during the follow-up period. Compared to delayed placement, immediate insertion of IUDs can not only increase the usage rate at 6 months or 1 year but also enhance the placement rate.
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