Search Results (72)

Many piglet-producing farms are facing poor reproductive performance, yet their characteristics remain poorly understood. This study aimed to identify factors contributing to reproductive disorders based on information easily identifiable through an oral survey. Therefore, forty Austrian piglet producing farms (35–2000 sows) were surveyed using a questionnaire mainly addressing management, treatment and prophylaxis. Five key performance indicators (KPIs) were defined to assess farm productivity: farrowing rate, return-to-estrus rate, abortion rate, total piglets born per litter, and piglets weaned per litter. Farrowing rates were significantly higher in larger farms (r = 0.368; p = 0.019), PRRS-negative farms (r = 0.415; p = 0.008), and farms that did not clean the vulva before artificial insemination (r = 0.357; p = 0.024). Return-to-estrus rates were significantly higher in smaller farms (r = −0.431; p = 0.006), farms with more vaginal discharge after farrowing (r = 0.397; p = 0.011), those not using hormonal farrowing induction (r = 0.339; p = 0.033), and farms with older teaser boars (r = 0.385; p = 0.039). Larger farms had more piglets born per litter (r = 0.342; p = 0.031) and weaned more piglets (r = 0.391; p = 0.013). Weaned piglet numbers were also higher in farms with all-in/all-out implementation in farrowing pens (r = 0.353; p = 0.026), with restricted access of other animal species to the barn (r = 0.366; p = 0.028) and hormonal farrowing induction (r = 0.348; p = 0.028). Common well-established strategies for improving fertility performance like evaluation of body temperature after farrowing, antimicrobial, and hormonal treatments showed limited relevance. Further research is needed to confirm these findings and to identify additional factors influencing reproductive performance of sows. Full article

Background/Objectives: X-linked hypohidrotic ectodermal dysplasia (XLHED) is a rare monogenic disorder characterized by hypohidrosis, hypotrichosis, and hypodontia, caused primarily by pathogenic variants in the EDA gene. XLHED predominantly affects males due to its X-linked recessive inheritance, while female carriers may exhibit variable phenotypes due to random X-inactivation. Early diagnosis is critical for timely counseling and emerging therapeutic interventions. We report a rare prenatal diagnosis of XLHED in dizygotic dichorionic male twins during a dichorionic diamniotic pregnancy. At 24 weeks’ gestation, ultrasonographic anomalies—facial dysmorphisms, oligodontia, and hypoechogenic skin—raised suspicion for ectodermal dysplasia. Methods: Non-invasive prenatal test and targeted next-generation sequencing (NGS) of Cell-free DNA identified an hemizygous EDA deletion (c.612_629del; p.Ile205_Gly210del) with 52% variant allele frequency. Results: This in-frame deletion affects a highly conserved region in the TNF homology domain of ectodysplasin-A1, likely compromising protein function. The variant was confirmed in both fetuses via genetic analysis on amniotic fluid and in the heterozygous state in the mother, consistent with X-linked recessive inheritance. Family history revealed a maternal uncle with XLHED. Additional heterozygous variants were also identified in CPT2, GBA1, GJB2, and SMN1 genes. Following comprehensive genetic counseling, the mother opted for abortion. Conclusions: This case underscores the value of applying advanced genomic technologies—cfDNA-based NGS—for prenatal diagnosis of rare genetic disorders. The identification of apathogenic EDA variant expands the mutational spectrum of XLHED and supports early diagnosis for informed reproductive decisions and potential access to emerging prenatal therapies. Broader application of such technologies may improve outcomes in future pregnancies at risk for monogenic disorders. Full article

Background: The standard protocol for early first-trimester termination of pregnancy (TOP) involves administration of mifepristone followed by misoprostol after a 48-h interval. While concurrent administration may improve convenience and access, evidence regarding its effectiveness remains limited. This study aims to compare the efficacy, safety, and acceptability of concurrent oral administration of mifepristone and misoprostol with the 48-h interval regimen for early TOP. Methods: In this randomized controlled trial (ClinicalTrials.gov: NCT03440866), 250 patients with intrauterine pregnancies up to 49 days’ gestation were randomized to receive either concurrent treatment (600 mg mifepristone and 400 mcg misoprostol) or the same medications administered 48 h apart. The primary outcome was complete abortion without additional intervention. Secondary outcomes included adverse events, pain, and patient satisfaction. Follow-up occurred approximately two weeks post-treatment. Data were available for 220 participants. Results: The concurrent group had a significantly lower success rate compared to the control group (68.8% vs. 84.3%, p = 0.007). Continuing pregnancy was more frequent with concurrent administration (13.4% vs. 2.8%, p = 0.004). No significant differences were observed in hemoglobin change, adverse events, or pain scores. Patient satisfaction was higher in the control group (81.1% vs. 63.6%, p = 0.04), though preferences for future abortion methods did not differ between groups. Conclusions: Concurrent administration of mifepristone and misoprostol is less effective and less satisfactory than the standard 48-h regimen, although safety and pain profiles are comparable. It should not replace the interval protocol, and patients choosing concurrent treatment should be counseled about its lower efficacy and higher likelihood of requiring additional intervention. Full article

Telemedicine has emerged as a promising tool in obstetric and reproductive healthcare, offering new possibilities for patient-centered care delivery. This literature review explores its impact across key areas, including abortion, assisted reproduction, childbirth, contraception, gestational diabetes, mental health, opioid and smoking cessation, and perinatal care during the COVID-19 pandemic. A structured narrative approach was applied, with studies identified through PubMed and Scopus databases for screening, with selection based on predefined inclusion and exclusion criteria, and synthesized narratively with attention to clinical outcomes, access, satisfaction, and barriers to implementation. Perspectives on the acceptance of telemedicine among healthcare providers, technological advancements enhancing reproductive outcomes, and telemedicine’s pivotal role in maintaining continuity of care during crises, such as the COVID-19 pandemic, are examined. The review also addresses challenges and barriers, including technological proficiency and patient acceptance, while emphasizing telemedicine’s potential to improve accessibility, patient satisfaction, and healthcare outcomes across diverse reproductive health services. Full article

Background: Repeat induced abortion (defined as ≥two lifetime procedures) is becoming more common worldwide, yet its independent influence on women’s psychological health remains contested, particularly in settings where access to modern contraception is restricted. Objectives: This review sought to quantify the burden of depression, anxiety, stress, and generic quality of life (QoL) among women with repeat abortions and to determine how barriers to contraceptive access alter those outcomes. Methods: Following the preregistered PRISMA-2020 protocol, PubMed, Embase and Scopus were searched from inception to 31 June 2025. Results: Eight eligible studies comprising approximately 262,000 participants (individual sample sizes up to 79,609) revealed wide variation in psychological morbidity. Prevalence of clinically significant symptoms ranged from 5.5% to 24.8% for depression, 8.3% to 31.2% for anxiety, and 18.8% to 27% for perceived stress; frequent mental distress affected 12.3% of women in neutral policy environments but rose to 21.9% under highly restrictive abortion legislation. Having three or more abortions, compared with none or one, increased the odds of depressive symptoms by roughly one-third (pooled OR ≈ 1.37, 95% CI 1.13–1.67). Contextual factors exerted comparable or stronger effects: abortions sought for socioeconomic reasons elevated depression odds by 34%, unwanted disclosure of the abortion episode increased depressive scores by 0.62 standard deviations, and low partner support raised them by 0.67 SD. At the structural level, every standard deviation improvement in a state’s reproductive rights index reduced frequent mental distress odds by 5%, whereas enactment of a near-total legal ban produced an absolute increase of 6.8 percentage points. QoL outcomes were less frequently reported; where measured, denied or heavily delayed abortions were associated with a 0.41-unit decrement on a seven-point life satisfaction scale. Conclusions: Psychological morbidity after abortion clusters where legal hostility, financial hardship, or interpersonal coercion constrain contraceptive autonomy while, in comparison, the mere number of procedures is a weaker predictor. Interventions that integrate stigma-free mental health support with confidential, affordable, and rights-based contraception are essential to protect well-being in women who experience repeat abortions. Full article

Medication abortion with mifepristone and misoprostol is a safe and effective method for ending a pregnancy. Pharmacy dispensing of mifepristone was approved by the U.S. Food and Drug Administration in 2023, but educational opportunities for pharmacists were nonexistent. We designed a 1 h continuing education course on medication abortion for pharmacists, which was offered in a live-webinar or recorded-video format over 3 years. It included key medication abortion topics, including medications, patient counseling, relevant policies, and implementing pharmacy dispensing. Using a prepost design, we administered online surveys to participants prior to and after completing the course to assess changes in overall medication abortion knowledge score (six items, Cronbach’s alpha = 0.76) and support for pharmacist dispensing of medication abortion (one Likert-scaled item). During the study period, 279 students and pharmacists took the course, of which 148 completed both the pre- and post-course questionnaires. Adjusted regression analyses demonstrated significant increases in knowledge scores and support for pharmacist dispensing of medication abortion post-course; most thought dispensing mifepristone would be very (21.6%) or somewhat easy (38.5%) to implement, and 75% indicated a willingness to dispense mifepristone if allowed. These findings suggest that video-based education on medication abortion is an effective tool for enhancing pharmacists’ knowledge and support for medication abortion, which could increase access to reproductive health care. Full article

Background: In Italy, voluntary termination of pregnancy (VTP) is a legally protected healthcare service. However, in Apulia, a southern region, access remains uneven due to ongoing healthcare rationalization, which has reduced service availability, particularly in decentralized areas. Conscientious objection among providers may also contribute, although the number of VTPs per provider has decreased over time. This study examines whether women access VTP services outside their healthcare catchment area (CA) and how socioeconomic deprivation and individual factors may influence mobility. Methods: We applied a ranking method, based on spatial and temporal distance between hospitals and municipalities to define the catchment area (CA) around hospitals of the Apulia region that offers VTP service. A Poisson multivariable clustered model was applied to evaluate the association among demographic and socioeconomic factors and the choice of the VTP service. Results: The analysis revealed that 54.7% of VTPs were performed outside the women’s catchment area. This mobility was significantly more frequent among women from medium and low socioeconomically deprived areas compared to very low deprived areas (RR = 1.20; 95%CI: [1.02–1.42]) and (RR = 1.28; 95%CI: [1.03–1.57]). Higher education level (RR = 1.09; 95% CI: [1.04–1.14]) and employment (RR = 1.09; 95%CI: [1.03–1.14]) were also associated with higher rates of undergoing a VTP outside of CA, with variations observed across local health authorities. Conclusions: These findings have shown the influence of socioeconomic conditions and educational level on women’s access to VTP services, suggesting that structural inequalities continue to shape healthcare choices and mobility. Full article

Background: Adolescents in Ethiopia, particularly in rural areas, face significant barriers to accessing comprehensive sexual and reproductive health (SRH) services, resulting in poor health outcomes. The youth-friendly health services (YFHS) initiative addresses these challenges by training Health Extension Workers (HEWs) to deliver tailored, age-appropriate care at the primary care level. This study evaluates the cost-effectiveness of YFHS implementation in rural health posts in the Jimma Zone, Ethiopia. Methods: Using an ingredient-based costing approach, costs were analyzed across six health posts, three implementing YFHS and three offering routine services. Health outcomes were modeled using disability-adjusted life years (DALYs) averted, and incremental cost-effectiveness ratios (ICERs) were calculated. Results: Results showed that YFHS reached 9854 adolescents annually at a cost of USD 29,680, compared to 2012.5 adolescents and USD 7519 in control sites. The study showed the ICER of USD 25.50 per DALY averted. The intervention improved health outcomes, including a 27% increase in antenatal care uptake, a 34% rise in contraceptive use, and a 0.065% reduction in abortion-related mortality, averting 52.11 DALYs versus 26.42 in controls. Conclusions: The ICER was USD 25.50 per DALY averted, well below Ethiopia’s GDP per capita, making it highly cost-effective by WHO standards. Scaling YFHS through HEWs offers a transformative, cost-effective strategy to advance adolescent SRH equity and achieve universal health coverage in Ethiopia. Full article

Consanguinity is the marriage of two related persons. This type of marriage is one of the main pillars when it comes to recessive hereditary diseases, birth defects, infertility, miscarriages, abortion, and infant deaths. Intermarriage continues to be a common practice in various communities in North Africa, the Middle East, and West and South Asia, as well as among migrants from Europe and North America, even though in more and more countries it has become illegal. Even if security and stability are some of the motivations for consanguineous marriage, studies show that women often suffer physical and verbal abuse from their husbands. However, because of the blood bond, tolerance for these habits is much higher. In addition, it seems that the divorce rate is much lower because separation would affect the entire state of the family. The choice of partner is significantly influenced by variables such as limited access to education and financial resources. Illiterate people coming from poor rural areas are much more likely to choose consanguineous marriage to maintain wealth in the family. The lack of medical knowledge about the negative effects of consanguinity leads to an increased rate of abortions, infant deaths, and births of children with congenital birth defects. Today, because of the process of urbanization and increased levels of knowledge, the younger generation is becoming increasingly less receptive to this particular form of marriage. In addition, as education has become more accessible to women, they have become more independent and eager to fulfill their own goals and not the wishes of the family. In conclusion, contrary to the many apparent advantages of consanguineous marriage, partners should put genetic risks first, as medical problems bring with them increased costs in the medical system and also within the family, leading to even lower economic status and consequently perpetuation of this type of marriage. Full article

Objective: This study examines YouTube comments following the overturn of Roe v. Wade, investigating how perceptions of health implications differ based on commenters’ gender and abortion stance. Methods: Using Netlytic, 25,730 comments were extracted from YouTube videos discussing the overturn of Roe v. Wade, half of which featured physicians discussing public health implications. Manual coding of 21% of the comments identified discussions on abortion stance and medical implications, while Gender API approximated the commenters’ gender. A term co-occurrence network was generated with VOSviewer to visualize key terms and their interrelations. Custom overlays explored patterns related to gender, abortion views, and medical implications, and comparisons within these overlays intersected with the medical implications overlay to illustrate contextual differences across demographics. Results: Four clusters emerged in the network: Constitutional Law, addressing the U.S. Constitution’s interpretation and legal impacts; Reproductive Rights and Responsibility, discussing alternatives to abortion and access; Human Development, exploring the intersection of abortion laws and individual beliefs; and Religious Beliefs, linking abortion laws to faith. Prochoice users focused on medical and socioeconomic impacts on women, whereas prolife users emphasized the prevention of unwanted pregnancies and moral considerations. Gender analysis revealed males centered on constitutional issues, while females highlighted medical and personal effects. Conclusion: The findings underscore that monitoring YouTube discourse offers valuable insights into public responses to shifts in health policy. Full article

This paper examines the historical relationship between Shi’i jurisprudence and the Islamic Republic of Iran’s reproductive biopolitics. Using archival methods, the paper looks into the similarities and differences between religious interpretations and Iranian law. It then analyzes the implications of the recent ‘Family Protection and Youthful Population’ law, enacted in 2021 in response to fears of a looming ‘population crisis,’ and how it further restricts women’s access to abortion (care). The paper argues that reproductive policies are influenced not only by religious authorities and pronatalist patriarchal rationales but also by specific anxieties about a population crisis and decline considered a threat to the country’s national security. Reproductive policies exist within a moral framework at the intersection of demographic anxieties, biopolitics, and religious discourses that push women toward unpaid maternal labor and traditional gender roles. Full article

Introduction: Pharmacies are important points of access and information for women seeking medication abortion. In the context of the Democratic Republic of Congo [DRC], where the legal conditions for abortion have expanded in recent years and now allow pharmacies to dispense medication abortion with a prescription, little is known about medication abortion counseling and care offered by pharmacy staff. The aim of this study was to explore the quality of information provided by pharmacy staff to customers seeking medication abortion in Kinshasa. Methodology: A cross-sectional study using the mystery client (MC) approach was conducted in 480 pharmacies between April and May 2023. Trained female (n = 9) and male (n = 3) investigators played the role of mystery clients seeking abortion medication for themselves (or their partner or relative), and they asked questions to assess the performance of pharmacy staff and the quality of the provided information. The MCs recorded the results of their visits immediately after they left the pharmacy. Data were analyzed using Stata 17.0 and QGIS. The research protocol received ethical approval from the Kinshasa School of Public Health, and the need for informed consent was waived as pharmacy providers were being observed acting in their professional capacity. Results: Misoprostol was available at 40% of pharmacies visited, while mifepristone–misoprostol was available at less than 2%. Correct dosage information for misoprostol was provided by only 23% of the providers, with the lowest proportion observed in interactions involving male partners (2.4%). During discussions, only 10.6% of the providers explained what to expect during the abortion process. The quality of information differed according to the client profile, the district, and whether the client had a prescription. Conclusions: While medication abortion can provide a safe option for women seeking to manage their own abortion, the lack of adequate information on the correct dosage and administration can hinder the effectiveness of this regimen. To fully realize the potential of this medication for reducing unsafe abortion, it is essential that pharmacy staff are trained and supported to provide high-quality information and services, and that inequities in access to medications are addressed. Full article

Latin American upper-middle-income countries (LAUMICs) face significant challenges in ensuring equitable access to sexual and reproductive health (SRH) for adolescents due to socioeconomic inequalities, migration, and historical violence. This systematic review examines the barriers and facilitators to sexual and reproductive health access for adolescent girls (≤19 years old) in vulnerable situations across Latin America. Using six databases, 391 articles were reviewed; 10 met the inclusion criteria, and 10 more were included through backward search, resulting in 20 analyzed studies. Structural barriers such as economic, regulatory, and institutional constraints were found to restrict SRH access, exacerbated by social stigma and negative narratives, especially in cases involving sexual violence and clandestine abortions. Facilitators included intersectoral collaboration, preventive education, and community networks, which improved access to and the quality of services for vulnerable populations. The findings emphasize the need for sustainable strategies that address structural inequalities and stigma while strengthening health systems, and intersectoral cooperation. Comprehensive, culturally tailored education and clear regulatory frameworks are essential to achieving equitable and sustainable SRH services. These insights offer practical guidance for public policy and program design in LAUMICs, particularly for addressing the needs of marginalized adolescent populations. Full article

Background/Objectives: Comprehensive sexual education and access to contraceptives play a vital role in alleviating the economic, health, and social challenges associated with unplanned pregnancies in adolescents. According to the World Health Organization (WHO), adolescence refers to the transitional stage from childhood to adulthood, encompassing individuals aged 10 to 19. This period is critical for reproductive decision making, making it essential to closely observe patterns of sexual activity and contraceptive use among young people. Despite advancements, many adolescents still encounter significant barriers to accessing and effectively utilizing contraceptive methods. Methods: A bibliographic search was performed across three major biomedical databases: PubMed, Embase, and CINAHL. The research question was developed utilizing the PIO (Population, Intervention, Outcome) framework to guide the investigation. Results: Long-acting reversible contraceptives (LARCs), including the etonogestrel (ENG) implant, have been recognized for their ability to significantly reduce maternal and neonatal mortality and morbidity as well as decrease the incidence of unsafe abortions. Conclusions: Access to adequate counseling and effective contraceptive services can profoundly impact young people’s lives, preventing unplanned pregnancies and promoting optimal sexual and reproductive health. Full article

Introduction: Bovine neosporosis represents a significant threat to reproduction and production in livestock systems worldwide. This disease is caused by the protozoan Neospora caninum, resulting in abortions of cows and neurological signs in newborn calves. This leads to significant economic losses, decreasing meat and milk production, especially in tropical regions. The infection has an endogenous and exogenous cycle of transmission involving dogs that shed the oocysts, with the highest transmission successes in humid areas. Similarly, there is a lack of knowledge about the epidemiological risk factors and management practices involved in the transmission success in tropical humid regions. Methods: In this sense, a cross-sectional epidemiological survey was conducted on 150 farms from 24 municipalities of the Huila area. A total of 360 cattle were sampled, and information about the production system was collected using a structured poll with 128 questions. Results: In these cattle, 53% (191/360) were positive for antibodies against Neospora caninum using ELISA. The logistic regression analysis using the information collected from the poll identified the presence of flooring type, water access, production systems, and feed management as risk factors. Among the protective factors were identified the geographical area, molasses supplementation, and biosecurity practices such as animal separation and access control. Discussion: This study identified for the first time the epidemiological risk factors associated mainly with the exogenous cycle of neosporosis. The present study contributes to the design of intervention strategies oriented to minimize the impact of parasitism in Colombian herds. Full article