Hasil untuk "Gynecology and obstetrics"

Gebretsadik Shibre, Wubegzier Mekonnen, Damen Haile Mariam

Abstract Background Maternal health care services and women’s empowerment have received attention in the Sustainable Development Goals. Limited evidence exists on the extent of distribution of antenatal care services across the ladder of women’s empowerment in Ethiopia. In this study, we sought to shed light on whether and how such disparities changed over time. Methods Data for the study came from the 2000 and 2016 Ethiopia Demographic and Health Surveys. The outcome variables were three measures of antenatal care services: quality antenatal care, early antenatal care, and four or more antenatal care services. Women’s empowerment was measured through a newly developed index, SWPER Global. Specifically, we used two domains of the measure: attitude to violence and social independence. Disparities in antenatal care services were measured using the Erreygers concentration index, Relative Index of Inequality, Average marginal effect, and second difference of the average marginal effects. We decomposed the concentration index to study the contributions of different factors to the empowerment disparities in the services in 2000 and 2016 as well as to the over-time change in the disparities. The Oaxaca-type decomposition technique was applied to investigate social determinants’ role on the change in the disparities between 2000 and 2016. A generalized linear regression model was used for the analyses. Results According to the concentration index, women’s empowerment disparities in the utilization of antenatal care services existed in both surveys, where the services were disproportionately concentrated among women with better levels of empowerment. By the measure of average marginal effect, there were disparities favoring empowered women based mainly on the point estimates, except that the attitude toward violence disparity in 2016 occurred to the advantage of poorly empowered women. However, the confidence intervals suggest mixed findings. The concentration indices showed that disparities mostly increased in 2016 and the change was underpinned by the changes in the inequalities of various factors and sensitivities of antenatal care services with respect to these variables, such as wealth, maternal education, media exposure, place of residence, and women’s empowerment itself. Overall, the results of the second difference showed no large change in the disparities between 2000 and 2016. However, relative disparities decreased substantially during the same time. Conclusions While concentration index-based absolute inequalities increased, relative inequalities decreased, suggesting the importance of using both absolute and relative measures in a study. The decomposition analyses suggest that working on the equitable distribution of social determinants could improve empowerment disparities in antenatal care services.

Jiaxin Zhang, Zehong Zhu, Junye Deng et al.

Villages areas hold significant importance in the study of human-land relationships. However, with the advancement of urbanization, the gradual disappearance of spatial characteristics and the homogenization of landscapes have emerged as prominent issues. Existing studies primarily adopt a single-disciplinary perspective to analyze villages spatial morphology and its influencing factors, relying heavily on qualitative analysis methods. These efforts are often constrained by the lack of digital infrastructure and insufficient data. To address the current research limitations, this paper proposes a Hierarchical Graph Neural Network (HGNN) model that integrates multi-source data to conduct an in-depth analysis of villages spatial morphology. The framework includes two types of nodes-input nodes and communication nodes-and two types of edges-static input edges and dynamic communication edges. By combining Graph Convolutional Networks (GCN) and Graph Attention Networks (GAT), the proposed model efficiently integrates multimodal features under a two-stage feature update mechanism. Additionally, based on existing principles for classifying villages spatial morphology, the paper introduces a relational pooling mechanism and implements a joint training strategy across 17 subtypes. Experimental results demonstrate that this method achieves significant performance improvements over existing approaches in multimodal fusion and classification tasks. Additionally, the proposed joint optimization of all sub-types lifts mean accuracy/F1 from 0.71/0.83 (independent models) to 0.82/0.90, driven by a 6% gain for parcel tasks. Our method provides scientific evidence for exploring villages spatial patterns and generative logic.

Renrong Shao, Wei Zhang, Kangyang Luo et al.

Source-free domain adaptation (SFDA) aims to address the challenge of adapting to a target domain without accessing the source domain directly. However, due to the inaccessibility of source domain data, deterministic invariable features cannot be obtained. Current mainstream methods primarily focus on evaluating invariant features in the target domain that closely resemble those in the source domain, subsequently aligning the target domain with the source domain. However, these methods are susceptible to hard samples and influenced by domain bias. In this paper, we propose a Consistent Assistant Domains Transformer for SFDA, abbreviated as CADTrans, which solves the issue by constructing invariable feature representations of domain consistency. Concretely, we develop an assistant domain module for CADTrans to obtain diversified representations from the intermediate aggregated global attentions, which addresses the limitation of existing methods in adequately representing diversity. Based on assistant and target domains, invariable feature representations are obtained by multiple consistent strategies, which can be used to distinguish easy and hard samples. Finally, to align the hard samples to the corresponding easy samples, we construct a conditional multi-kernel max mean discrepancy (CMK-MMD) strategy to distinguish between samples of the same category and those of different categories. Extensive experiments are conducted on various benchmarks such as Office-31, Office-Home, VISDA-C, and DomainNet-126, proving the significant performance improvements achieved by our proposed approaches. Code is available at https://github.com/RoryShao/CADTrans.git.

Mingming Cao, Weiyi Kong, Dachun Yang et al.

In this article, we establish the parabolic version of the celebrated Rubio de Francia extrapolation theorem. As applications, we obtain new characterizations of parabolic BMO-type spaces in terms of various commutators of parabolic fractional operators with time lag. The key tools to achieve these include to establish the appropriate form in the parabolic setting of the parabolic Rubio de Francia iteration algorithm, the Cauchy integral trick, and a modified Fourier series expansion argument adapted to the parabolic geometry. The novelty of these results lies in the fact that, for the first time, we not only introduce a new class of commutators associated with parabolic fractional integral operators with time lag, but also utilize them to provide a characterization of the parabolic BMO-type space in the high-dimensional case.

Yi-Sin Tan, Ching-Chang Tsai, Hsin-Hsin Cheng et al.

Background: The COVID-19 pandemic has substantially impacted healthcare systems and obstetric practices worldwide. Labor induction is a common procedure for preventing obstetric complications in high-risk populations. This study evaluated perinatal outcomes of labor induction using a modified management protocol in a tertiary care center during the COVID-19 pandemic. Methods: We conducted a retrospective study by reviewing electronic structured delivery records of women who underwent elective labor induction between June 2020 and October 2022. We analyzed maternal characteristics, maternal outcomes, and neonatal outcomes during the pre-pandemic (June 2020 to May 2021) and pandemic periods (May 2021 to October 2022). Results: The study included 976 cases: 325 pregnancies in the pre-pandemic group and 651 in the pandemic group. The pandemic group showed earlier gestational age at delivery (39 vs. 40 weeks, <i>p</i> < 0.01) and lower body mass index (27.1 vs. 27.5 kg/m², <i>p</i> = 0.03). During the pandemic period, we observed a significant increase in labor induction cases and a decrease in cesarean sections. Neonatal outcomes, including Apgar scores and intensive care admissions, showed no significant differences between groups. Subgroup analysis identified advanced maternal age (OR = 1.08; 95% CI = 1.03–1.14; <i>p</i> < 0.01) and primiparity (OR = 5.24; 95% CI = 2.75–9.99; <i>p</i> < 0.01) as independent risk factors for cesarean delivery. Conclusions: Even under modified protocols for labor induction during the COVID-19 pandemic, more pregnancies underwent labor induction while achieving a significant reduction in cesarean sections. Advanced maternal age and primiparity were identified as independent risk factors associated with cesarean delivery.

Xianxian Yuan, Yuru Ma, Jia Wang et al.

Abstract Background Maternal overweight/obesity and excessive gestational weight gain (GWG) are frequently reported to be risk factors for obesity and other metabolic disorders in offspring. Cord blood metabolites provide information on fetal nutritional and metabolic health and could provide an early window of detection of potential health issues among newborns. The aim of the study was to explore the impact of maternal prepregnancy overweight/obesity and excessive GWG on cord blood metabolic profiles. Methods A case control study including 33 pairs of mothers with prepregnancy overweight/obesity and their neonates, 30 pairs of mothers with excessive GWG and their neonates, and 32 control mother-neonate pairs. Untargeted metabolomic profiling of umbilical cord blood samples were performed using UHPLC‒MS/MS. Results Forty-six metabolites exhibited a significant increase and 60 metabolites exhibited a significant reduction in umbilical cord blood from overweight and obese mothers compared with mothers with normal body weight. Steroid hormone biosynthesis and neuroactive ligand‒receptor interactions were the two top-ranking pathways enriched with these metabolites (P = 0.01 and 0.03, respectively). Compared with mothers with normal GWG, in mothers with excessive GWG, the levels of 63 metabolites were increased and those of 46 metabolites were decreased in umbilical cord blood. Biosynthesis of unsaturated fatty acids was the most altered pathway enriched with these metabolites (P < 0.01). Conclusions Prepregnancy overweight and obesity affected the fetal steroid hormone biosynthesis pathway, while excessive GWG affected fetal fatty acid metabolism. This emphasizes the importance of preconception weight loss and maintaining an appropriate GWG, which are beneficial for the long-term metabolic health of offspring.

Keke Huang, Yu Guang Wang, Ming Li et al.

Spectral Graph Neural Networks (GNNs), alternatively known as graph filters, have gained increasing prevalence for heterophily graphs. Optimal graph filters rely on Laplacian eigendecomposition for Fourier transform. In an attempt to avert prohibitive computations, numerous polynomial filters have been proposed. However, polynomials in the majority of these filters are predefined and remain fixed across different graphs, failing to accommodate the varying degrees of heterophily. Addressing this gap, we demystify the intrinsic correlation between the spectral property of desired polynomial bases and the heterophily degrees via thorough theoretical analyses. Subsequently, we develop a novel adaptive heterophily basis wherein the basis vectors mutually form angles reflecting the heterophily degree of the graph. We integrate this heterophily basis with the homophily basis to construct a universal polynomial basis UniBasis, which devises a polynomial filter based graph neural network - UniFilter. It optimizes the convolution and propagation in GNN, thus effectively limiting over-smoothing and alleviating over-squashing. Our extensive experiments, conducted on a diverse range of real-world and synthetic datasets with varying degrees of heterophily, support the superiority of UniFilter. These results not only demonstrate the universality of UniBasis but also highlight its proficiency in graph explanation.

Sotaro Katayama, Noriaki Takasugi, Mitsuhisa Kaneko et al.

This paper presents a stochastic/robust nonlinear model predictive control (NMPC) to enhance the robustness of model-based legged locomotion against contact uncertainties. We integrate the contact uncertainties into the covariance propagation of stochastic/robust NMPC framework by leveraging the guard saltation matrix and an extended Kalman filter-like covariance update. We achieve fast stochastic/robust NMPC computation by utilizing the zero-order algorithm with additional improvements in computational efficiency concerning the feedback gains. We conducted numerical experiments and demonstrate that the proposed method can accurately forecast future state covariance and generate trajectories that satisfies constraints even in the presence of the contact uncertainties. Hardware experiments on the perceptive locomotion of a wheeled-legged robot were also carried out, validating the feasibility of the proposed method in a real-world system with limited on-board computation.

Heba Abu Saleem, Yara Edweidar, Mutaz Abu Salim et al.

Bicornuate uterus (BU) is a rare congenital anomaly that may present with various obstetric complications, and very rarely may be a risk factor for uterine rupture, even of an unscarred uterus.A 21-year-old primigravida woman, at 19 weeks and 5 days of gestation, presented with severe abdominal pain and features of hypovolemic shock. Urgent laparotomy showed a large hemoperitoneum, a ruptured left horn of a BU and a dead fetus in the abdominal cavity. Excision of the ruptured left horn was performed and the uterine defect was sutured. Postoperative recovery was uneventful. Bicornuate uterus is a rare uterine anomaly and is associated with various obstetric complications at different gestational ages. Ruptured uterus should be considered in the differential diagnoses of acute abdominal pain and a picture of hypovolemia in women with mid-trimester pregnancies.

Ying Yang, Hongyang Liu, Youming Chen et al.

Abstract Non-small cell lung cancer (NSCLC) is one of the most threatening malignancies to human health and life. In most cases, patients with NSCLC are already at an advanced stage when they are diagnosed. In recent years, lung cancer has made great progress in precision therapy, but the efficacy of immunotherapy is unstable, and its response rate varies from patient to patient. Several biomarkers have been proposed to predict the outcomes of immunotherapy, such as programmed cell death-ligand 1 (PD-L1) expression and tumor mutational burden (TMB). Nevertheless, the detection assays are invasive and demanding on tumor tissue. To effectively predict the outcomes of immunotherapy, novel biomarkers are needed to improve the performance of conventional biomarkers. Liquid biopsy is to capture and detect circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) and exosomes in body fluids, such as blood, saliva, urine, pleural fluid and cerebrospinal fluid as samples from patients, so as to make analysis and diagnosis of cancer and other diseases. The application of liquid biopsy provides a new possible solution, as it has several advantages such as non-invasive, real-time dynamic monitoring, and overcoming tumor heterogeneity. Liquid biopsy has shown predictive value in immunotherapy, significantly improving the precision treatment of lung cancer patients. Herein, we review the application of liquid biopsy in predicting the outcomes of immunotherapy in NSCLC patients, and discuss the challenges and future directions in this field.

Shengzhe Wang, Zhixin Meng, and Peiqiang Yan et al.

We present a cold atomic beam source based on a two-dimensional (2D)+ magneto-optical trap (MOT), capable of generating a continuous cold beam of 87Rb atoms with a flux up to 4.3*10^9 atoms/s, a mean velocity of 10.96(2.20) m/s, and a transverse temperature of 16.90(1.56) uK. Investigating the influence of high cooling laser intensity, we observe a significant population loss of atoms to hyperfine-level dark states. To account for this, we employ a multiple hyperfine level model to calculate the cooling efficiency associated with the population in dark states, subsequently modifying the scattering force. Simulations of beam flux at different cooling and repumping laser intensities using the modified scattering force are in agreement with experimental results. Optimizing repumping and cooling intensities enhances the flux by 50%. The influence of phase modulation on both the pushing and cooling lasers is experimentally studied, revealing that the mean velocity of cold atoms can be tuned from 9.5 m/s to 14.6 m/s with a phase-modulated pushing laser. The versatility of this continuous beam source, featuring high flux, controlled velocity, and narrow transverse temperature, renders it valuable for applications in atom interferometers and clocks, ultimately enhancing bandwidth, sensitivity, and signal contrast in these devices.

Xiaochen Zan, Wenfang Li, Geng Wang et al.

Highlights 1. Circ-CSNK1G1 is upregulated in TNBC. 2. Circ-CSNK1G1 knockdown inhibits the proliferation, migration, invasion and glycolysis energy metabolism of TNBC cells. 3. Circ-CSNK1G1 knockdown inhibits tumor formation in vivo. 4. Circ-CSNK1G1 promotes TNBC development by regulating the miR-28-5p/LDHA pathway.

Indri Paradillah, Evi Martha, Farandi Agesti Ramadhan et al.

Background: Infant mortality is one of the sensitive indicators to know the degree of health of a country and even to measure the level of progress of a nation. The Low Birth Weight Babies (LBW) are the highest cause of infant mortality in Depok until it reaches 81 cases in 2019. One of the efforts made by public health office to reduce the infant mortality rate is to use Kangaroo Mother Care. This research aims to analyze the implementation of Kangaroo Mother Care Program in public health center in Depok, Indonesia.  Methods: The method of study is qualitative with purposive sampling approach. Result: The results showed that the informants were not aware of the existence of Mayor Regulation Number 89 year 2020 regarding Kangaroo Method Care. Health workers do not yet have sufficient knowledge about the implementation of the Kangaroo Method of Care. The implementation of the Kangaroo Method of Care is still not supported by complete facilities. Human Resources is also still inadequate. Conclusion: The conclusion of this research is the Kangaroo Method Care program has not run optimally. There needs to be an effort to improve the implementation of the Kangaroo Method Care program at the public health center.

Zeinab Jalambadani, Zakieh Sadat Hosseini

Aim. The purpose of this study was to predictors of mental health in pregnant women based on theory of planned behavior referred to Iran health centers during the COVID-19 in 2021. Materials and methods. This study was cross-sectional study thatwas conducted on 250 pregnant women. Pregnant women completed General Health Questionnaire (GHQ) and theory of planned behavior questionnaire. The data were analyzed with SPSS software version 20 (SPSS Inc., Chicago, IL, USA) through running Pearson Correlation statistical tests, descriptive statistics methods including frequency, percentage, mean, standard deviation scores. The Kruskal-Wallis test was used for normally distributed variable. The significance level of the tests was considered to be 0.05. Results. There was a significant correlation between mental health disorders and some personal and socioeconomic factors. The findings showed that all structures attitude (r=0.69, p0.001), subjective norms (r=0.58, p0.001) and perceived behavioral control (r=0.56, p0.001) and intention (r=0.51, p0.001) had significant correlations with mental health. Among the variables entered into the regression model, attitude, subjective norms and perceived behavioral control were able to predict 65 percent of variance of mental health among the participants (F=60.75, R=0.66, R2=0.65). Conclusion. It is necessary to plan for appropriate care in order to prevent the occurrence of mental disorders among this vulnerable group.

Yieh-Loong Tsai, Tsung-Hsuan Lai, Hsuan-Che Liu et al.

<i>Background and Objectives</i>: Septins (SEPTs) are highly conserved GTP-binding proteins and the fourth component of the cytoskeleton. Polymerization of SEPTs contributes to several critical cellular processes such as cytokinesis, cytoskeletal remodeling, and vesicle transportation. In our previous study, we found that SEPT14 mutations resulted in teratozoospermia with >87% sperm morphological defects. SEPT14 interactors were also identified through proteomic assays, and one of the peptides was mapped to RAB3B and RAB3C. Most studies on the RAB3 family have focused on RAB3A, which regulates the exocytosis of neurotransmitters and acrosome reactions. However, the general expression and patterns of the RAB3 family members during human spermatogenesis, and the association between RAB3 and teratozoospermia owing to a SEPT14 mutation, are largely unknown. <i>Materials and Methods</i>: Human sperm and murine male germ cells were collected in this study and immunofluorescence analysis was applied on the collected sperm. <i>Results</i>: In this study, we observed that the RAB3C transcripts were more abundant than those of RAB3A, 3B, and 3D in human testicular tissues. During human spermatogenesis, the RAB3C protein is mainly enriched in elongated spermatids, and RAB3B is undetectable. In mature human spermatozoa, RAB3C is concentrated in the postacrosomal region, neck, and midpiece. The RAB3C signals were delocalized within human spermatozoa harboring the <i>SEPT14</i> mutation, and the decreased signals were accompanied by a defective head and tail, compared with the healthy controls. To determine whether RAB3C is involved in the morphological formation of the head and tail of the sperm, we separated murine testicular tissue and isolated elongated spermatids for further study. We found that RAB3C is particularly expressed in the manchette structure, which assists sperm head shaping at the spermatid head, and is also localized at the sperm tail. <i>Conclusions</i>: Based on these results, we suggest that the localization of RAB3C proteins in murine and human sperm is associated with <i>SEPT14</i> mutation-induced morphological defects in sperm.

Mahbod Ebrahimi, Firoozeh Akbari Asbagh, Fatemeh Davari Tanha et al.

Abstract Background: The common causes of infertility in women with endometriosis are folliculogenesis alternation, steroidogenesis and fertilization impairment, oocyte and embryo quality reduction, and implantation defect. Objective: To compare in vitro fertilization (IVF) cycle success rates of women with endometriosis who were treated with letrozole + gonadotropin (LA) vs. placebo + gonadotropin (PA). Materials and Methods: This double-blind, randomized clinical trial study was conducted with 94 infertile women with endometriosis (47 in the LA group and 47 in the PA group) who were candidates for IVF, from April-June 2021. For all participants, the long agonist protocol was applied. In both groups, gonadotropin-releasing hormone agonist was prescribed in the mid-luteal stage and from the third day of the cycle, and gonadotropin was started and its doses were regulated based on the patient's age, serum anti-Mullerian hormone and follicle-stimulating hormone. From the third day of the menstrual cycle, 5 mg of letrozole daily for 5 days was prescribed for the LA group, while the placebo was prescribed for the PA group on the identical days and duration. After embryo transfer, biochemical and clinical pregnancy were measured in the 2 groups. Results: The gonadotropin dosage (p < 0.01) and estradiol level (p = 0.02) on the human chorionic gonadotropin administration day were significantly lower in the LA group compared with in the PA group. Fetus transfer was done for 32 women. No significant differences were detected between the study groups regarding biochemical or clinical pregnancy (p = 0.72 for both). Conclusion: Letrozole as a co-treatment drug in the IVF cycle of women with endometriosis can significantly reduce the gonadotropin dosage and estradiol level with the same pregnancy rates.

Shabana Siddique, Imen Farhat, Cariton Kubwabo et al.

Exposure to organophosphate esters (OPEs) is extensive, yet few studies have investigated their association with hormone levels or semen quality. Here, we studied the association between urinary concentrations of OPEs and their metabolites with hormone levels and semen parameters in men (n = 117) predominantly in the 20–29 years age range who were recruited from the greater Montreal area between 2009 and 2012. Urine, serum, and semen samples were analyzed for OPEs, hormones, and semen quality, respectively. Bis(2-ethylhexyl) phosphate (BEHP), bis(2,4-di-tert-butylphenyl) hydrogen phosphate (B2,4DtBPP), tris(2-chloroisopropyl) phosphate (TCIPP), diphenyl phosphate (DPHP), bis (2-butoxyethyl) phosphate (BBOEP) and di-cresyl phosphate (DCPs) were detected in urine at a frequency ≥ 95%. The highest geometric mean concentration was observed for DPHP (18.54 ng/mL) and the second highest was B2,4DtBPP (6.23 ng/mL). Associations between a doubling in analyte concentrations in urine and hormone levels and semen quality parameters were estimated using multivariable linear regression. B2,4DtBPP levels were positively associated with total T3 (β = 0.09; 95% CI: 0.01, 0.17). DPHP was inversely associated with estradiol (β = -2.56; 95% CI: −5.00, −0.17), and TCIPP was inversely associated with testosterone (β = -0.78; 95% CI: −1.40, −0.17). Concentrations of BCIPP were inversely associated with sperm concentrations (β = -7.76; 95% CI: −14.40, −0.61), progressive motility (β = − 4.98; 95% CI: −8.71, −1.09), and the sperm motility index (β = -9.72; 95% CI: −17.71, −0.96). In contrast, urinary DPHP concentrations were positively associated with the sperm motility (β = 4.37; 95% CI: 0.76, 8.12) and fertility indices (β = 6.64; 95% CI: 1.96, 11.53). Thus, OPE detection rates were high and exposure to several OPEs was associated with altered hormone levels and semen parameters. The possibility that OPEs affect male reproduction warrants further investigation.

Qi Wang, Zhe Ding, Gary Wong et al.

Acoustic mixing of droplets is a promising way to implement biosensors that combine high speed and minimal reagent consumption. To date, this type of droplet mixing is driven by a volume force resulting from the absorption of high-frequency acoustic waves in the bulk of the fluid. Here, we show that the speed of these sensors is limited by the slow advection of analyte to the sensor surface due to the formation of a hydrodynamic boundary layer. We eliminate this hydrodynamic boundary layer by using much lower ultrasonic frequencies to excite the droplet, which drives a Rayleigh streaming that behaves essentially like a slip velocity. Three-dimensional simulations show that this provides a threefold speedup compared to Eckart streaming. Experimentally, we shorten a SARS-CoV-2 antibody immunoassay from 20 min to 40 s.

K. Schulz, I. Chalmers, D. Grimes et al.

Kebede K, Gashawbeza B, Gebremedhin S et al.

Lemi Belay Tolu,1 Kidus Kebede,1 Biruck Gashawbeza,1 Samson Gebremedhin2 1Saint Paul New Millennium Medical College, Addis Ababa, Ethiopia; 2School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Lemi Belay Tolu Email lemi.belay@gmail.comBackground: Second-trimester abortions disproportionately contribute to the increased medical cost, maternal morbidity, and mortality compared to the first trimester. Therefore, the aim of the current study was to determine the magnitude and determinants of late presentation for safe abortion care at a tertiary hospital in Ethiopia.Methods: We conducted a cross-sectional study among pregnant women who requested safe abortion care from January 2019 to April 2020. Participants were selected using systematic sampling and data were collected using the interviewer-administered questionnaire. P-value adjusted odds ratios (AOR) with their 95% confidence interval (CI) were used to determine the association between variables.Results: The prevalence of second-trimester abortion was 53.4%. Young age, &le; 19 years (AOR= 6.37, 95% CI=1.84&ndash; 22.06), decision ambivalence (AOR=5.64, 95% CI=1.71&ndash; 18.61), delay to suspect pregnancy (AOR= 8.56, 95% CI=2.11&ndash; 34.57), delay to diagnose pregnancy (AOR=3.83, 95% CI=1.51&ndash; 9.75), lack of awareness on pregnancy signs and symptoms (AOR=4.22, 95% CI=1.59&ndash; 11.23), delay to get the service (AOR =4.43, 95% CI=1.43&ndash; 13.67), and lack of information where to get the abortion service (AOR=3.90, 95% CI=1.53&ndash; 9.96) were significantly associated with presentation in second trimester.Conclusion: More than half of women who request safe abortion at Saint Paul&rsquo;s Hospital Millennium Medical College do so in the second trimester. Young age, delay in diagnosis of pregnancy, delayed decision, and lack of information where to get service were contributing factors. Therefore, comprehensive adolescent sexuality education, increasing access to contraception, and safe abortion service including self-care interventions are very imperative to avert late gestation abortion and its consequences.Keywords: late gestation abortion, safe abortion, Saint Paul Millennium Medical College