Twin pregnancy in mares is one of the leading causes of abortions. Abortion invariably impacts both fetuses. This report describes an unusual case of a twin surviving to term following the abortion of its co-twin at 9 months in a 7-year-old Egyptian Arabian mare. At the time of abortion at 9 months of gestation, the size of the aborted fetus was equivalent to one of approximately 5 months of age while the age of the live co-twin was 9 months. Both fetuses were males. A skin sample was collected from the aborted fetus and hair samples were collected from the dam, sire and live foal for parentage analysis. The parentage analysis confirmed that both fetuses were by the same dam and sire stallion. The authors suggest several scenarios to explain this condition. This report describes a unique case of a twin surviving to term following the abortion of its co-twin at 9 months in a mare.

An aborted female foal was submitted for necropsy. During the gross examination, the ovaries were pale, grayish, and enlarged (6 × 5 cm), with a well-developed vascular structure surrounding the external surface; the cut surface of the ovaries showed a brownish parenchyma with white follicular areas mainly localized in the peripheral region. The ovaries were fixed for histological investigations. The histological evaluation of the ovaries showed polygonal-shaped cells with abundant cytoplasm and round or oval nuclei, arranged in cords of single cells. The tissue architecture was characterized by the presence of lobular-like tissues with a central vein. The tissue mimicking hepatocytes was delimited by a mature fibrous tissue and was surrounded by the normal ovarian tissue characterized by germinal epithelium and primordial follicular structures. Based on the histological findings, a diagnosis of bilateral ovarian hamartoma was carried out initially. For a better characterization of the ovarian tissue, the expression of tissue-specific (liver and ovary) markers was investigated using immunohistochemistry. Following the immunohistochemical analysis, the hamartoma diagnosis was excluded. The ovaries exhibited unique characteristics different from those of adult horse ovaries as well as unique morphological features different from other mammalian species. This case report enhances our understanding of ovaries at a later stage of pregnancy and unveils unique characteristics of horse ovaries development, avoiding misdiagnosis with pathological findings, hamartomas, or neoplasia.

The intricate relationship between antiphospholipid antibody (APLA) syndrome and pregnancy outcomes challenges the prevailing notion of inevitable reproductive complications associated with APLA. The introduction provides a comprehensive overview of APLA, its autoimmune thrombophilic nature, and its common association with adverse pregnancy outcomes, emphasizing the need for a nuanced understanding. Here we discuss five case reports to showcase diverse scenarios, each highlighting successful pregnancies in APLA-positive patients, thereby contributing valuable insights into the management of this complex condition. The cases span various clinical presentations, patient demographics, and therapeutic approaches, emphasizing the heterogeneity of APLA-positive pregnancies and the importance of personalized care. The discussion delves into the broader context of APLA\'s impact on pregnancy, emphasizing recurrent miscarriage and venous thromboembolism (VTE) as severe complications. It underscores the significance of pre-conceptional counseling, a multidisciplinary approach, and regular antenatal monitoring in managing APLA-positive pregnancies. The identification of commonalities among the cases provides a basis for recognizing mitigating factors that contribute to positive outcomes, offering valuable guidance for healthcare providers. The series acknowledges the existence of catastrophic antiphospholipid syndrome (CAPS) and underscores the importance of early recognition and intervention in high-risk cases. Despite the challenges posed by APLA, the cases in the series offer a ray of hope by showcasing instances of successful pregnancies, attributing positive outcomes to optimized therapeutic interventions and vigilant antenatal care. In conclusion, the case series serves as a valuable resource for healthcare professionals, researchers, and policymakers, providing a nuanced perspective on APLA-positive pregnancies. By synthesizing diverse experiences and outcomes, the series contributes to the ongoing dialogue surrounding optimal management strategies, ultimately aiming to improve the quality of care for individuals facing the unique challenges posed by APLA during their reproductive journey.

Two outbreaks of pine needle abortions in cattle are here reported for the first time in Argentina. The cases occurred in Chubut and Neuquén provinces in the Patagonia region, causing 29.6% and 9% of abortions in each herd respectively. In both outbreaks, the dams were in the last third of gestation, and, due to a period of cold, snow and lack of available forage, they gained access to Pinus ponderosa and Pinus contorta forests. No pathological lesions, serological, molecular, or microbiological evidence of infectious causes were observed in any of the six fetuses analyzed. Microhistological analysis of feces confirmed higher presence of fragments of Pinus spp. needles in the diet of affected dams than in that of non-affected ones (12.2 vs 3.0%). Moreover, toxicological analysis showed higher tetrahydroagathic acid in the sera of affected dams than in that of non-affected ones (10.05 vs 2.81 ppm). In addition, this acid was detected in different fetal fluids (3.6-8.1 ppm) of the six fetuses analyzed. Interestingly, isocupressic acid was detected only in needles of P. ponderosa, and its content was lower than that found in other areas of the world (0.31 and 0.5% in Chubut and Neuquén respectively). These results confirm that the consumption of P. ponderosa by dams could have been the cause of these abortion outbreaks, a fact that should be considered as differential diagnosis in abortions of cattle, especially in silvopastoral systems of Argentina.

This article evaluated the effect of the Shanghai protocol on a hypergonadotropic hypogonadism patient undergoing in vitro fertilization (IVF) treatment. Hypergonadotropic hypogonadism was characterized by low sex hormone levels and elevated gonadotropins, leading to infertility. Poor ovarian response and failed pregnancy outcomes were the results of previous IVF treatments using conventional stimulation methods. The 37-year-old female patient was advised to follow the Shanghai protocol, which involved gonadotropin stimulation following pituitary suppression with a long-acting gonadotropin-releasing hormone agonist (GnRH-a). The Shanghai protocol significantly improved the ovarian response. Two oocytes were retrieved, and one 4AA grade (number 4 represents an expanded blastocyst, the embryo is large, and the zona is thin; first A represents the inner cell mass of numerous and tightly packed cells; second A represents trophectoderm, with many cells organized in epithelium) embryo was formed. According to her previous result, the patient with hypergonadotropic hypogonadism who had one unsuccessful IVF cycle after visiting our infertility center was advised of the Shanghai protocol. Establishing these results and enhancing the Shanghai protocol\'s implementation to this specific patient treatment, clinical pregnancy was achieved.

Introduction: Unintended pregnancies are a worldwide health issue, faced each year by one in 16 people, and experienced in various ways. In this study we focus on unintended pregnancies that are, at some point, experienced as unwanted because they present the pregnant person with a decision to continue or terminate the pregnancy. The aim of this study is to learn more about the decision-making process, as there is a lack of insights into how people with an unintended pregnancy reach a decision. This is caused by 1) assumptions of rationality in reproductive autonomy and decision-making, 2) the focus on pregnancy outcomes, e.g. decision-certainty and reasons and, 3) the focus on abortion in existing research, excluding 40% of people with an unintended pregnancy who continue the pregnancy. Method: We conducted a narrative literature review to examine what is known about the decision-making process and aim to provide a deeper understanding of how persons with unintended pregnancy come to a decision.Results: Our analysis demonstrates that the decision-making process regarding unintended pregnancy consists of navigating entangled layers, rather than weighing separable elements or factors. The layers that are navigated are both internal and external to the person, in which a \'sense of knowing\' is essential in the decision-making process. Conclusion: The layers involved and complexity of the decision-making regarding unintended pregnancy show that a rational decision-making frame is inadequate and a more holistic frame is needed to capture this dynamic and personal experience.

Intrauterine retention of fetal bone fragments is a rare complication that can be seen after pregnancy termination, especially in advanced gestational weeks. Here, we present a case of intrauterine fetal bone retention detected during routine gynecological examination in an asymptomatic woman whose pregnancy was terminated 12 years ago. Under local anesthesia and ultrasound guidance, the fetal bone was removed with a grasper. This case report highlights the importance of post-curettage ultrasound examination to ensure that no fetal tissue is left behind after termination of pregnancy.

Background There is no sound evidence for the association of blood groups with the risk of endometriosis, and no studies from Saudi Arabia have examined this association. Therefore, the primary aim was to determine whether there is an association between the distribution of ABO and Rh blood groups and the incidence of endometriosis in a cohort from Saudi Arabia and also to evaluate the potential risk factors related to endometriosis among the population.  Methods This case-control study included women diagnosed with endometriosis (n = 44) who presented to King Abdulaziz University Hospital Obstetrics and Gynecology Clinic, Jeddah, Saudi Arabia, between 2010 and 2021. Women from the blood donors database of King Abdulaziz University Hospital were included as a control group (n = 184). The total sample size was 228. Demographic data, diagnosis method, ABO blood type, and Rh blood type were obtained from hospital records. In addition, data were collected from self-reported questionnaires, which included family history, dysmenorrhea, age of menarche, age of childbearing, number of children, history of abortion, parity, number of children, use of oral contraceptives for alleviating dysmenorrhea, iron deficiency, duration of menstrual flow, and volume of bleeding during menses. Odds ratio, Pearson chi-squared test (χ2), and independent t-test were used to analyze the associations between variables. Results Most of the participants had blood type O (n = 117, 51.3%), which was followed by blood type A (n = 59, 26.0%), and the majority were Rh+ (n = 215, 94.3%). There was no significant difference in the risk of endometriosis according to ABO (P = 0.237) and Rh (P = 0.283) blood types. However, endometriosis was found to have a significant relationship with dysmenorrhea, heavy bleeding during menses, history of abortion, long duration of menstrual flow, lower number of children, late pregnancy, and use of oral contraceptive pills to relieve dysmenorrhea (p ≤ 0.05). Conclusions The present results indicate that ABO and Rh blood types are not associated with the risk of endometriosis. However, there was a strong, significant association between endometriosis and other factors.

Monoamniotic twins develop when a blastocyst spontaneously splits its progenitor cells, and each group of progenitor cells independently grows to become an individual. It is the rarest type of twin pregnancy and usually has significant developmental or congenital abnormalities, a higher rate of abortion, perinatal morbidity, and mortality. There is no information regarding monoamniotic twins in livestock species. Here, we reported a spontaneous abortion of monoamniotic twins in a dromedary camel at 278 days of gestation. Gonadorelin acetate (100 μg) was injected intramuscularly to induce ovulation in the recipient. A 7 days-old embryo produced by somatic cell nuclear transfer was transferred transcervically to the recipient. Early pregnancy was confirmed by an elevated level of serum progesterone followed by ultrasonography at 22 and 44 days after embryo transfer. A single sac was observed on 22 days while twins were evident 44 days after embryo transfer. Pregnancy was periodically monitored by the tail-up phenomenon. A ruptured fetal sac was observed on the ground having two fetuses. On autopsy, full-grown fetuses were found. Their bodies were separated. There was no congenital anomaly or any malformation in the fetuses. According to the reported chronology in human twins, we hypothesized that the blastocyst splitted before 13 days as it was monoamniotic and not conjoined. If the embryo splits within 4 to 8 days, it develops two amniotic sacs, and splitting after 13 days develops conjoined fetuses. To the authors\' knowledge, this is the first reported case of monoamniotic twin abortion in dromedary camels. This report will increase awareness among practicing veterinarians and camel breeders about twin abortions.

Punitive policy responses to substance use and to abortion care constitute direct attacks on personal liberty and bodily autonomy. In this article, we leverage the concept of \"syndemics\" to anticipate how the already synergistic stigmas against people who use drugs and people who seek abortion services will be further compounded the Dobbs decision.