OBJECTIVE: Given Iran's recent shift towards pronatalist population policies, concerns have arisen regarding the potential increase in abortion rates. This review study examines the trends of (medical), intentional (illegal), and spontaneous abortions in Iran over the past two decades, as well as the factors that have contributed to these trends. METHODS: This paper reviewed research articles published between 2005 and 2022 on abortion in Iran. The study employed the PRISMA checklist for systematic reviews. Articles were searched from international (Google Scholar, PubMed, Science Direct, and Web of Science) and national databases (Magiran, Medlib, SID). Once the eligibility criteria were applied, 42 records were included from the initial 349 records. RESULTS: Abortion is influenced by a variety of socioeconomic and cultural factors and the availability of family planning services. Factors that contribute to unintended pregnancy include attitudes toward abortion, knowledge about reproductive health, access to reproductive health services, and fertility desires, among others. In addition to health and medical factors, consanguineous marriage plays an important role in spontaneous and therapeutic abortion. A higher number of illegal abortions were reported by women from more privileged socioeconomic classes. In comparison, a higher number of medical and spontaneous abortions were reported by women from less privileged socioeconomic classes. CONCLUSION: Iranian policymakers are concerned about the declining fertility rate and have turned to pronatalist policies. From a demographic standpoint, this seems to be a reasonable approach. However, the new population policies, particularly, the Family Protection and Young Population Law, along with creating limitations in access to reproductive health services and prenatal screening tests as well as stricter abortion law could potentially lead to an increase in various types of abortions and their associated consequences.

• MeSH
• indukovaný potrat * statistika a číselné údaje   zákonodárství a právo   trendy   MeSH
• lidé MeSH
• potrat nezákonný statistika a číselné údaje   MeSH
• samovolný potrat epidemiologie   MeSH
• socioekonomické faktory MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH
• Geografické názvy
• Írán MeSH

Lidský papilomavirus (HPV) je celosvětově nejběžnější sexuálně přenosnou virovou infekcí, která může vést ke vzniku benigních lézí nebo maligních nádorů. Prevalence HPV infekce je u těhotných žen dvakrát vyšší než u netěhotných. Navíc existuje riziko vertikálního přenosu HPV z matky na dítě během těhotenství nebo porodu. Různé studie uvádějí zvýšené riziko nepříznivých výsledků těhotenství u HPV pozitivních žen, včetně spontánního potratu, předčasného porodu, předčasné ruptury vaku blan, preeklampsie, růstové restrikce plodu a úmrtí plodu. Očkování proti HPV se v současnosti v těhotenství nedoporučuje. Na druhou stranu neexistují žádné důkazy spojující očkování proti HPV během těhotenství s nepříznivými výsledky těhotenství a ukončení těhotenství není v tomto případě opodstatněné.

Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, which may result in the development in benign lesions or malignant tumors. The prevalence of HPV infection is twice as high in pregnancy as in non-pregnant women. Additionally, there is a risk of vertical transmission of HPV from mother to fetus during pregnancy or childbirth. Various studies have reported an increased risk of adverse pregnancy outcomes in HPV-positive women, including miscarriage, preterm birth, premature rupture of membranes, preeclampsia, fetal growth restriction, and fetal death. HPV vaccination is not currently recommended during pregnancy. On the other hand, there is no evidence linking HPV vaccination during pregnancy with adverse pregnancy outcomes and termination of pregnancy is not justified in this case.

• MeSH
• genotyp MeSH
• infekce papilomavirem * epidemiologie   komplikace   přenos   MeSH
• komplikace těhotenství * epidemiologie   klasifikace   MeSH
• lidé MeSH
• lidské papilomaviry genetika   klasifikace   patogenita   MeSH
• předčasný porod epidemiologie   etiologie   MeSH
• riziko MeSH
• samovolný potrat epidemiologie   etiologie   MeSH
• těhotenství MeSH
• vakcinace škodlivé účinky   statistika a číselné údaje   MeSH
• vakcíny proti papilomavirům analýza   aplikace a dávkování   klasifikace   terapeutické užití   MeSH
• výsledek těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

OBJECTIVES: The exposure of embryos or foetuses to ionising radiation can cause serious detriments to health. Thus, an enhanced incidence of spontaneous abortions and congenital anomalies might be expected in the vicinity of a uranium processing plant. We analysed the situation in the vicinity of MAPE Mydlovary, a facility about 20 km from České Budějovice, South Bohemia, Czech Republic, which was in operation from 1963 to 1992. METHODS: No relevant data are available for the period of operation of the uranium processing plant. Statistical data have only been collected since 1994. As sanitation work in the area was initiated at around that time and has yet to be completed, we considered a study of possible prenatal effects in the vicinity of MAPE Mydlovary to still be of interest. Data were provided by the Institute of Health Information and Statistics of the Czech Republic for the years 1994-2013. RESULTS: We tested whether there are demonstrable, statistically significant differences between the microregions of the four closest villages (Mydlovary, Olešník, Zahájí, and Zliv), the District of České Budějovice, the South-Bohemian Region, and the Czech Republic. CONCLUSIONS: No increase was found in the incidence of spontaneous abortions and congenital anomalies in the vicinity of this former uranium processing plant compared to the surrounding District of České Budějovice, the South Bohemian Region, or the Czech Republic as a whole.

• MeSH
• charakteristiky bydlení statistika a číselné údaje   MeSH
• elektrárny statistika a číselné údaje   MeSH
• incidence MeSH
• lidé MeSH
• samovolný potrat epidemiologie   MeSH
• těhotenství MeSH
• uran * MeSH
• vrozené vady epidemiologie   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.

• MeSH
• Betacoronavirus * genetika   izolace a purifikace   MeSH
• COVID-19 MeSH
• gestační stáří MeSH
• infekční komplikace v těhotenství epidemiologie   virologie   MeSH
• klinické laboratorní techniky MeSH
• kohortové studie MeSH
• koronavirové infekce komplikace   diagnóza   epidemiologie   MeSH
• lidé MeSH
• novorozenec nedonošený MeSH
• novorozenec MeSH
• odumření plodu * MeSH
• pandemie MeSH
• perinatální smrt * MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• rizikové faktory MeSH
• samovolný potrat epidemiologie   MeSH
• SARS-CoV-2 MeSH
• těhotenství MeSH
• testování na COVID-19 MeSH
• vakcíny proti COVID-19 MeSH
• vertikální přenos infekce statistika a číselné údaje   MeSH
• virová pneumonie komplikace   diagnóza   epidemiologie   MeSH
• výsledek těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Gestational surrogacy, is a treatment option for women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. The aim of our study was to review, evaluate and share our experience and outcomes over the last 13 years of the largest surrogacy program in the Czech republic. METHODS: A total of 75 intended mothers and 82 surrogate mothers participated in this study. A retrospective cohort study was performed. Anonymized data were collected on 130 cycles of gestational surrogate (2004-2017) directly from the Clinic database. RESULTS: We performed 130 in vitro fertilization cycles with gestational surrogacy which involved 73 fresh embryo transfers and 57 frozen embryo transfers. We achieved 57 (43.9%) pregnancies and 42 (32.3%) live births. The rate of multiple pregnancies was only 2.3 %. The most common indication for using was an absent or damaged uterus (65%), followed by medical conditions precluding pregnancy (23%) and repeated in vitro fertilization cycles or pregnancy failure (12%). CONCLUSION: In the 14 years of our experience, we have shown that treatment of young women with specific indications for gestational surrogacy is beneficial, successful and relatively free of complications. However, it is imperative to follow the medical indications for this treatment and specialist recommendations.

• MeSH
• chronická nemoc MeSH
• dospělí MeSH
• ductus Mülleri abnormality   MeSH
• fertilizace in vitro * MeSH
• hysterektomie MeSH
• lidé MeSH
• náhradní matky * MeSH
• narození živého dítěte epidemiologie   MeSH
• poruchy sexuálního vývoje s karyotypem 46, XX MeSH
• přenos embrya MeSH
• přenos jednoho embrya MeSH
• retrospektivní studie MeSH
• samovolný potrat epidemiologie   MeSH
• těhotenství mnohočetné statistika a číselné údaje   MeSH
• těhotenství MeSH
• transplantace orgánů MeSH
• úhrn těhotenství na počet žen v reprodukčním věku * MeSH
• vrozené vady MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Chromozomové aberace jsou častou příčinou časných reprodukčních ztrát. Možnou přítomnost chromozomové aberace je možné ověřit cytogenetickým vyšetřením tkáně potraceného plodu. V rámci naší studie na Ústavu biologie a lékařské genetiky 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice v Praze jsme analyzovali vzorek tkáně u 233 případů časných spontánních či zamlklých potratů. Ve 212 případech byla kultivace úspěšná a celkem v 52 případech (24,5 %) byla zachycena chromozomová aberace – nejčastěji trizomie chromozomu 21, monozomie chromozomu X, triploidie a trizomie chromozomů 16 a 22. Celková četnost chromozomových aberací byla v našem souboru spíše nižší oproti obdobným studiím. I s ohledem na další ukazatele předpokládáme, že by příčinou mohla být kontaminace některých vzorků mateřskými buňkami, což ale nelze u rutinního cytogenetického vyšetření předem vyloučit. Dále jsme v rámci studie potvrdili vyšší četnost chromozomových aberací v případech s vyšším věkem matky a dále pak častější zastoupení chromozomových aberací v případech potratu ve vyšších týdnech těhotenství. Tyto nálezy byly statisticky významné.

Chromosomal aberrations are common cause of early miscarriage. Possible presence of chromosomal aberration may be assessed by cytogenetic examination of the aborted fetus tissue. In our study from the Institute of Biology and Medical Genetics of the First Faculty of Medicine of Charles University and General University Hospital in Prague we analysed tissue sample from 233 early spontaneous or missed abortions. In 212 cases the cultivation process was successful. Among those – we identified 52 cases with chromosomal aberration (24,5 %). Most common aberrations were – trisomy 21, monosomy X, triploidy and trisomies of chromosomes 16 and 22. Our overall incidence of aberrations was lower – compared to similar studies. According to other indicators we suppose that this may be caused by the higher incidence of maternal cells contamination – but this phenomenon cannot be completely excluded while using classical karyotyping. We also confirmed higher incidence of chromosomal aberrations in the miscarriage cases in elder mothers and furthermore we found higher incidence of aberrations in cases from higher gestation weeks. Both trends were statistically significant.

• Klíčová slova
• reprodukční ztráty,
• MeSH
• chromozomální aberace * embryologie   klasifikace   statistika a číselné údaje   MeSH
• cytogenetické vyšetření statistika a číselné údaje   MeSH
• genetická zdatnost MeSH
• karyotypizace statistika a číselné údaje   MeSH
• lidé MeSH
• potracený plod abnormality   cytologie   MeSH
• retrospektivní studie MeSH
• rozmnožování genetika   MeSH
• samovolný potrat epidemiologie   etiologie   MeSH
• těhotenství MeSH
• věkové faktory MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• autoantigeny * imunologie   MeSH
• autoprotilátky * krev   MeSH
• dospělí MeSH
• hodnocení výsledků zdravotní péče * MeSH
• jodidperoxidasa * imunologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předčasný porod * epidemiologie   krev   prevence a kontrola   MeSH
• proteiny vázající železo * imunologie   MeSH
• první trimestr těhotenství MeSH
• samovolný potrat * epidemiologie   krev   prevence a kontrola   MeSH
• těhotenství MeSH
• thyreotropin * krev   MeSH
• thyroxin * aplikace a dávkování   farmakologie   krev   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• souhrny MeSH
• Geografické názvy
• Itálie MeSH

OBJECTIVE: To analyze oocyte competence in gonadotropin-releasing hormone agonist (GnRHa) stimulation cycles with regard to maturity, fertilization and blastocyst rate, as well as clinical outcome (pregnancy and live-birth rate), in relation to follicular volume, measured by three-dimensional transvaginal sonography (3D-TVS), and follicular fluid composition. METHODS: This was a prospective single-center study conducted between June 2012 and June 2014, including 118 ovum pick-ups with subsequent embryo transfer. Ovarian stimulation was performed using the GnRHa long protocol. Of 1493 follicles aspirated individually, follicular volume was evaluated successfully in 1236 using automated 3D-TVS during oocyte retrieval. Oocyte maturity and blastocyst development were tracked according to follicular volume. Intrafollicular concentrations of estradiol, testosterone, progesterone, luteinizing hormone, follicle-stimulating hormone and granulocyte-colony stimulating factor were quantified by immunoassay. Clinical outcome, in terms of implantation rate, (clinical) pregnancy rate, miscarriage and live-birth rate (LBR), was evaluated. RESULTS: Follicles were categorized, according to their volume, into three arbitrary groups, which included 196 small (8-12 mm/0.3-0.9 mL), 772 medium (13-23 mm/1-6 mL) and 268 large (≥ 24 mm/> 6 mL) follicles. Although oocyte recovery rate was significantly lower in small follicles compared with medium and large ones (63.8% vs 76.6% and 81.3%, respectively; P < 0.001), similar fertilization rates (85.1% vs 75.3% and 81.4%, respectively) and blastocyst rates (40.5% vs 40.6% and 37.2%, respectively) per mature metaphase II oocyte were observed. A trend towards higher LBR after transfer of blastocysts derived from small (< 1 mL) follicles compared with medium (1-6 mL) or large (> 6 mL) follicles (54.5% vs 42.0%, and 41.7%, respectively) was observed. No predictive value of follicular fluid biomarkers was identified. CONCLUSIONS: Our data indicate that the optimal follicular volume for a high yield of good quality blastocysts with good potential to lead to a live birth is 13-23 mm/1-6 mL. However, oocytes derived from small follicles (8-12 mm/0.3-0.9 mL) still have the capacity for normal development and subsequent delivery of healthy children, suggesting that aspiration of these follicles should be encouraged as this would increase the total number of blastocysts retrieved per stimulation. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

• MeSH
• blastocysta fyziologie   MeSH
• dospělí MeSH
• folikuly stimulující hormon terapeutické užití   MeSH
• hormon uvolňující gonadotropiny antagonisté a inhibitory   MeSH
• indukce ovulace * MeSH
• lidé MeSH
• mladý dospělý MeSH
• narození živého dítěte MeSH
• novorozenec MeSH
• odběr oocytu metody   MeSH
• oocyty fyziologie   MeSH
• ovariální folikul fyziologie   MeSH
• porodnost MeSH
• přenos embrya * metody   MeSH
• prospektivní studie MeSH
• samovolný potrat epidemiologie   MeSH
• těhotenství MeSH
• úhrn těhotenství na počet žen v reprodukčním věku MeSH
• výsledek těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND AND AIMS: Opioid maintenance treatment (OMT) is recommended to opioid-dependent females during pregnancy. However, it is not clear which medication should be preferred. We aimed to compare neonatal outcomes after prenatal exposure to methadone (M) and buprenorphine (B) in two European countries. DESIGN: Nation-wide register-based cohort study using personalized IDs assigned to all citizens for data linkage. SETTING: The Czech Republic (2000-14) and Norway (2004-13). [Correction added after online publication on 26 April 2018: The Czech Republic (2000-04) corrected to (2000-14).] PARTICIPANTS: Opioid-dependent pregnant Czech (n = 333) and Norwegian (n = 235) women in OMT who received either B or M during pregnancy and their newborns. MEASUREMENTS: We linked data from health registries to identify the neonatal outcomes: gestational age, preterm birth, birth weight, length and head circumference, small for gestational age, miscarriages and stillbirth, neonatal abstinence syndrome (NAS) and Apgar score. We performed multivariate linear regression and binary logistic regression to explore the associations between M and B exposure and outcomes. Regression coefficient (β) and odds ratio (OR) were computed. FINDINGS: Most neonatal outcomes were more favourable after exposure to B compared with M, but none of the differences was statistically significant. For instance, in the multivariate analysis, birth weight was β = 111.6 g [95% confidence interval (CI) = -10.5 to 233.6 and β = 83.1 g, 95% CI = -100.8 to 267.0] higher after B exposure in the Czech Republic and Norway, respectively. Adjusted OR of NAS for B compared with M was 0.94 (95% CI = 0.46-1.92) in the Norwegian cohort. CONCLUSIONS: Two national cohorts of women receiving opioid maintenance treatment during pregnancy showed small but not statistically significant differences in neonatal outcomes in favour of buprenorphine compared with methadone.

• MeSH
• Apgar skóre MeSH
• buprenorfin terapeutické užití   MeSH
• dospělí MeSH
• gestační stáří MeSH
• hypotrofický novorozenec MeSH
• komplikace těhotenství farmakoterapie   MeSH
• lidé MeSH
• lineární modely MeSH
• logistické modely MeSH
• methadon terapeutické užití   MeSH
• mladý dospělý MeSH
• narození mrtvého plodu epidemiologie   MeSH
• novorozenec MeSH
• novorozenecký abstinenční syndrom epidemiologie   MeSH
• opiátová substituční terapie metody   MeSH
• opioidní analgetika terapeutické užití   MeSH
• poruchy spojené s užíváním opiátů farmakoterapie   MeSH
• předčasný porod epidemiologie   MeSH
• registrace MeSH
• samovolný potrat epidemiologie   MeSH
• těhotenství MeSH
• výsledek těhotenství epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Norsko MeSH

AIMS: Metformin is used to treat type 2 diabetes, polycystic ovary syndrome associated infertility, and gestational diabetes. This study aims to evaluate the safety of metformin in early pregnancy. METHOD: We evaluated the risk of major birth defects and pregnancy losses in a cohort of pregnant women exposed to metformin during the first trimester for different indications relative to a matched unexposed reference group. RESULTS: The risk of major birth defects was 5.1% (20/392) in pregnancies exposed to metformin during the first trimester and 2.1% (9/431) in the reference group [adjusted odds ratio (OR) 1.70; 95% CI 0.70-4.38]. Among metformin users, this risk was 7.8% (17/219) in patients with pre-gestational diabetes and 1.7% (3/173) in those without this diagnosis. Compared to the unexposed reference, the OR for metformin user with diabetes was 3.95 (95% CI 1.77-9.41) and for metformin with other indications it was 0.83 (95% CI 0.18-2.81). The risk of pregnancy losses (spontaneous abortions and stillbirths) was 20.8% in women on metformin during the first trimester and 10.8% in the reference group [adjusted hazard ratio (HR) 1.57; 95% CI 0.90-2.74]. The risks for women on metformin with and without pre-gestational diabetes were 24.0% and 16.8% respectively, with adjusted HR of 2.51 (95% CI 1.44-4.36) and 1.38 (95% CI 0.74-2.59) when compared to the reference. CONCLUSION: Pregnant women with pre-gestational diabetes on metformin are at a higher risk for adverse pregnancy outcomes than the general population. This appears to be due to the underlying diabetes since women on metformin for other indications do not present meaningfully increased risks.

• MeSH
• dospělí MeSH
• hypoglykemika aplikace a dávkování   škodlivé účinky   MeSH
• kohortové studie MeSH
• komplikace těhotenství farmakoterapie   MeSH
• lidé MeSH
• metformin aplikace a dávkování   škodlivé účinky   MeSH
• narození mrtvého plodu epidemiologie   MeSH
• prospektivní studie MeSH
• první trimestr těhotenství MeSH
• samovolný potrat epidemiologie   MeSH
• těhotenství při diabetu farmakoterapie   MeSH
• těhotenství MeSH
• výsledek těhotenství * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH