Andersen, Louise B; Dechend, Ralf; Karumanchi, S Ananth
BACKGROUND: Spontaneous abortion is the most commonly observed adverse pregnancy outcome. The angiogenic factors soluble Fms-like kinase 1 and placental growth factor are critical for normal pregnancy and may be associated to spontaneous abortion. OBJECTIVE: We investigated the association between...... maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor, and subsequent spontaneous abortion. STUDY DESIGN: In the prospective observational Odense Child Cohort, 1676 pregnant women donated serum in early pregnancy, gestational week ..., interquartile range 71-103). Concentrations of soluble Fms-like kinase 1 and placental growth factor were determined with novel automated assays. Spontaneous abortion was defined as complete or incomplete spontaneous abortion, missed abortion, or blighted ovum
Hjøllund, Niels Henrik Ingvar; Jensen, T.K.; Bonde, J.P.
Existing studies of physical strain and spontaneous abortion are mainly retrospective or based only on pregnancies that have survived the first trimester. Furthermore, almost all studies have relied on averaged measures of physical strain, which tend to blur an effect if peak values during short...... pregnancy the women recorded physical strain prospectively in a structured diary. Physical strain around the time of implantation was associated with later spontaneous abortion. The adjusted risk ratio for women who reported physical strain higher than average at day 6 to 9 after the estimated date...
Norsker, Filippa Nyboe; Espenhain, Laura; rogvi, Sofie
To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion.......To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion....
高尔生; 邓新清; 何更生; 方可娟; 唐威; 楼超华
The spontaneous abortion is a common type of pregnant outcomes. The spontaneous abortion rate can be used to indicate the women's fecundity and the level of the reproductive health. It is also a sensitive indicator for determing the social, economic, and health status and prenatal care. To explore the preventive method for spontaneous abortion and improve women's health level, it is important to evaluate the status of spontaneous abortion and to determine the factors affecting
Full Text Available Background: Spontaneous abortion is the most common adverse pregnancy outcome. We aimed to investigate a possible link between nutrient deficiencies and the risk of spontaneous abortion. Materials and Methods: This case-control study included the case group (n=331 experiencing a spontaneous abortion before 14 weeks of pregnancy and the control group (n=331 who were healthy pregnant women over 14 weeks of pregnancy. The participants filled out Food Frequency Questionnaire (FFQ, in which they reported their frequency of consumption for a given serving of each food item during the past three months, on a daily, weekly or monthly basis. The reported frequency for each food item was converted to a daily intake. Then, consumption of nutrients was compared between the two groups. Results: There are significant differences between the two groups regarding consumed servings/day of vegetables, bread and cereal, meat, poultry, fish, eggs, beans, fats, oils and dairy products (P=0.012, P<0.001, P=0.004, P<0.001, P=0.019, respectively. There are significant differences between the two groups in all micronutrient including folic acid, iron, vitamin C, vitamin B6, vitamin B12 and zinc (P<0.001. Conclusion: Poor nutrientions may be correlated with increased risk of spontaneous abortion
Hjollund, N H; Jensen, Tina Kold; Bonde, Jens Peter
pregnancy the women recorded physical strain prospectively in a structured diary. Physical strain around the time of implantation was associated with later spontaneous abortion. The adjusted risk ratio for women who reported physical strain higher than average at day 6 to 9 after the estimated date...
Catalano, Ralph; Bruckner, Tim A.; Karasek, Deborah
spontaneous and non-clinically indicated induced abortions. This suggests, consistent with our theory, that mothers of conception cohorts that yielded more spontaneous abortions than expected opted more frequently than expected for non-clinically indicated induced abortion. LIMITATIONS, REASONS FOR CAUTION...
XUChong; CHENFu; LIULi; ZHAOFei-Sha
To clarify the possible correlation between antisperm antibodies (ASA) and spontaneous abortion, 68 women, aged 23-37, experienced 2-9 times of spontaneous abortion were tested for ASA by ELISA. 38 fertile women, aged 24-40, without history of abortion were employed as control.
OBJECTIVE: To study the association between cigarette, alcohol, and caffeine consumption and the occurrence of spontaneous abortion. METHODS: The study population consisted of 330 women with spontaneous abortion and 1168 pregnant women receiving antenatal care. A case-control design was utilized;...... units alcohol per week and 375 mg or more caffeine per day during pregnancy may increase the risk of spontaneous abortion.......OBJECTIVE: To study the association between cigarette, alcohol, and caffeine consumption and the occurrence of spontaneous abortion. METHODS: The study population consisted of 330 women with spontaneous abortion and 1168 pregnant women receiving antenatal care. A case-control design was utilized......; cases were defined as women with a spontaneous abortion in gestational week 6-16 and controls as women with a live fetus in gestational week 6-16. The variables studied comprise age, parity, occupational situation, cigarette, alcohol, and caffeine consumption. The association between cigarette, alcohol...
Nielsen, Ann; Hannibal, Charlotte Gerd; Lindekilde, Bodil Eriksen
BACKGROUND: Few studies have examined smoking prior to pregnancy and the occurrence of spontaneous abortion, as most studies have addressed the risk of spontaneous abortion in relation to smoking during pregnancy. However, results are not entirely consistent. The aim of the present study...... was to assess the risk of spontaneous abortion considering smoking prior to pregnancy. METHODS: We performed a nested case-control study using prospective data from a population-based cohort comprising 11,088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n=343......) or who gave birth (n=1,578) during follow-up were selected. Associations between self-reported smoking at enrollment and subsequent spontaneous abortion were analyzed by means of multiple logistic regression. RESULTS: The risk of spontaneous abortion in relation to pre-pregnancy smoking showed a clear...
Helgstrand, Stine; Andersen, Anne-Marie Nybo
BACKGROUND: To evaluate the risk of spontaneous abortion in relation to maternal pre-pregnant underweight. METHODS: The study was designed as a cohort study within the framework of the Danish National Birth Cohort (DNBC). The participants were a total of 23 821 women recruited consecutively...... spontaneous abortion. Relative risk of spontaneous abortion was calculated as Hazard Ratios using Cox regression with delayed entry. RESULTS: The outcome measure was spontaneous abortion. The hazard ratio for spontaneous abortion in women with a pre-pregnant body mass index (BMI) below 18.5 was 1.24 (95......% confidence limits 0.95-1.63) compared to women with pre-pregnant BMI 18.5-24.9. Women with a BMI of 25 or more had a smaller increase in risk of spontaneous abortion. Adjustment for maternal age, parity, previous miscarriages, and lifestyle factors did not affect the estimates substantially, neither did...
Nielsen, Stine Yde; Mølbak, Kåre; Hjøllund, Niels Henrik
Q-fever is a zoonotic infection. Pregnant women constitute a specific risk group as the infection may cause spontaneous abortion, intrauterine death, growth retardation, oligohydramnios and premature birth. A 39 year-old veterinarian had a spontaneous abortion in pregnancy week seven. During the ...
Catalano, Ralph; Bruckner, Tim A; Karasek, Deborah; Adler, Nancy E; Mortensen, Laust H
Does the incidence of spontaneous abortion correlate positively over conception cohorts with the incidence of non-clinically indicated induced abortion as predicted by shared risk aversion? We find that the number of spontaneous and non-clinically indicated induced abortions correlates in conception cohorts, suggesting that risk aversion affects both the conscious and non-conscious mechanisms that control parturition. Much literature speculates that natural selection conserved risk aversion because the trait enhanced Darwinian fitness. Risk aversion, moreover, supposedly influences all decisions including those that individuals can and cannot report making. We argue that these circumstances, if real, would manifest in conscious and non-conscious decisions to invest in prospective offspring, and therefore affect incidence of induced and spontaneous abortion over time. Using data from Denmark, we test the hypothesis that monthly conception cohorts yielding unexpectedly many non-clinically indicated induced abortions also yield unexpectedly many spontaneous abortions. The 180 month test period (January 1995 through December 2009), yielded 1 351 800 gestations including 156 780 spontaneous as well as 233 280 induced abortions 9100 of which were clinically indicated. We use Box-Jenkins transfer functions to adjust the incidence of spontaneous and non-clinically indicated induced abortions for autocorrelation (including seasonality), cohort size, and fetal as well as gestational anomalies over the 180-month test period. We use cross-correlation to test our hypothesized association. We find a positive association between spontaneous and non-clinically indicated induced abortions. This suggests, consistent with our theory, that mothers of conception cohorts that yielded more spontaneous abortions than expected opted more frequently than expected for non-clinically indicated induced abortion. Limitations of our work include that even the world's best registration system
江静; 傅曼芬; 王德芬
Objective To examine the relationship between spontaneous abortion and chromosomal abnormalities. Methods Couples who had one or more consecutive spontaneous abortions and had normal genitals were enrolled for cytogenetic karyotype analysis. Results In the 61 couples, the detected incidence was 11.5%, with five Robertsonian translocations, one reciprocal translocation, and one pericentric inversion of chromosome 7. Conclusion Chromosomal abnormalities may play an important role in fetal wastage.
Yong-hong LI; Hai-lin WANG; Ya-juan ZHANG
Objective To investigate the effects of allograft inflammatory factor-1(AIF-1)and (RANTES) in sera and deciduas on unexplained early spontaneous abortion.Methods AIF-1 and RANTES were examined in sera and deciduas/endometria of 43 unexplained early spontaneous abortion women (group A),40 healthy women with early pregnancy(group B)and 20 healthy women with no pregnancy (group C). Immunohistochemistry and enzyme linked immunosorbent assay (ELISA) were used in this study. Results AIF-1 protein was expressed both in deciduas of group A and in endometria of group C.In group A, H scores in the recurrent abortion deciduas specimens were significantly greater than those in the first abortion;in endometrium,expression of AIF-1 was greater in the secretory than in proliferative phase of group C.In group B,concentrations of RANTES in sera were higher in 7th-8th week of pregnancy than in 6th-7th and ＞8th week of pregnancy;expression of AIF-1 protein showed a negative correlation with RASNTES concentration;a significant increase of the RANTES levels in sera and tissue was observed in group B. Conclusion These results demonstrate, for the first time,that AIF-1 are expressed in deciduas of unexplained spontaneous abortion suggesting that AIF-1 involve in alloimmune abortion; RANTES might act as a novel blocking antibody;AIF-1 and RANTES might act as reliable markers for diagnosis of early alloimmune abortion.
Nielsen, Stine Yde; Mølbak, Kåre; Hjøllund, Niels Henrik
the first weeks of her pregnancy, she handled birth by-products from cows with Q-fever. The Q-fever titres revealed that she was most likely infected in very early pregnancy. According to the literature, infection in the first trimester constitutes a specific risk of spontaneous abortion....
Howards, Penelope P; Hertz-Picciotto, Irva; Bech, Bodil H
BACKGROUND: Medications may be consumed periconceptionally before a woman knows she is pregnant. In this study, the authors evaluate the association of a prescription diet drug (Letigen) containing ephedrine (20 mg) and caffeine (200 mg) with spontaneous abortion (SAB) in the Danish National Birth...
Gharesi-Fard, Behrouz; Zolghadri, Jaleh; Foroughinia, Leila; Tavazoo, Fahimeh; Samsami Dehaghani, Alamtaj
Recurrent spontaneous abortion (RSA) is defined as three or more sequential abortions before the twentieth week of gestation. There are evidences to support an allo-immunologic mechanism for RSA. One of the methods for treatment of RSA is leukocyte therapy; however there is still controversy about effectiveness of this method. To evaluate the effectiveness of leukocyte therapy for treatment of RSA. Ninety two non-pregnant women with at least three sequential abortions (60 primary & 32 secondary aborters) recognized as RSA were referred to our Laboratory for immunotherapy. All the cases were immunized by isolated lymphocytes from their husbands. Fifty to 100 million washed and resuspended mononuclear cells were injected by I.V., S.C., and I.D. route. The result of each injection was checked by WBC cross matching between couples after four weeks of injections. Immunization was repeated in fifth week to a maximum of 3 times if needed. Eighty one age-matched non-pregnant RSA women (52 primary and 29 secondary aborters) with at least three sequential abortions were also included in this study as controls. The control group was not immunized. 67 out of 92 (72.8%) immunized cases and 44 out of 81 controls (54.3%) showed a successful outcome of pregnancy (pRSA patients. Despite the current controversy and limitation of leukocyte therapy in RSA, the results of our investigation provide evidence supporting the use of allo-immunization in improving the outcome of pregnancy in primary RSA patients.
Coleman, Mary Clayton
In his classic paper, 'Why abortion is immoral', Don Marquis argues that what makes killing an adult seriously immoral is that it deprives the victim of the valuable future he/she would have otherwise had. Moreover, Marquis contends, because abortion deprives a fetus of the very same thing, aborting a fetus is just as seriously wrong as killing an adult. Marquis' argument has received a great deal of critical attention in the two decades since its publication. Nonetheless, there is a potential challenge to it that seems to have gone unnoticed. A significant percentage of fetuses are lost to spontaneous abortion. Once we bring this fact to our attention, it becomes less clear whether Marquis can use his account of the wrongness of killing to show that abortion is the moral equivalent of murder. In this paper, I explore the relevance of the rate of spontaneous abortion to Marquis' classic anti-abortion argument. I introduce a case I call Unexpected Death in which someone is about to commit murder, but, just as the would-be murderer is about to strike, his would-be victim dies unexpectedly. I then ask: what does Marquis' account of killing imply about the moral status of what the would-be murderer was about to do? I consider four responses Marquis could give to this question, and I examine what implications these responses have for Marquis' strategy of using his account of the wrongness of killing an adult to show that abortion is in the same moral category.
Dong YANG; Zheng-yi SUN; Cheng-yan DENG; Qi YU; Fang-fang HE
Objective To investigate the factors resulting in spontaneous abortion after transferring frozen-thawing blastocysts. Methods A total of 108 cases transferring vitrified blastocysts were divided into two groups: abortion group (n =20) and ongoing group (n=88). Cytogenetic analysis of apoblemas was performed in 12 cases of the abortion.Results The overall spontaneous abortion rate was 18.50%(20/108) and the early spontaneous rate was 16.67%(18/108). ,4 significant difference in maternal age was observed (abortion group: 33.3±4.0 years, ongoing group: 31.0±3.6 years, P=0.02). No difference in other parameters was found. Cytogenetic analysis of apoblemas was obtained for 12 cases, and 2 specimens were contaminated. Seven of ten patients had abnormal karyotypes. Conclusion The underlying cause of spontaneous abortion after transferring frozen thawing blastocysts appears to be abnormal karyotypes.Advancing maternal age seems to increase the risk of spontaneous abortion.
Olsen, Jørn; Basso, Olga; Christensen, Kaare
and environmental factors by studying reproductive histories in population based cohorts. We based the study upon two cohorts. The 'abortion cohort' consisted of 55 259 women who had a hospitalised spontaneous abortion in Denmark between 1980 and 1992 and who had a subsequent non-terminated pregnancy. The 'birth...... the municipality of residence to a low risk area (based upon the geographical distribution of spontaneous abortions) reduced the risk of spontaneous abortion in both cohorts. A paternal effect on the recurrence risk of spontaneous abortion cannot be ruled out but environmental factors also play a role.......No less than 10% of clinically recognised pregnancies end as spontaneous abortions and the recurrence risk is high. Due to lack of data and appropriate study design only little is known about preventable causes of miscarriage. The aim of this study was to estimate the effect of paternal...
Aziza A. Saad
Full Text Available Reproductive health is exquisitely sensitive to characteristics of an individual’s environment including physical, biological, behavioral, cultural and socioeconomic factors. This study was launched to elucidate the effect of the exposure to chemical pollutants as aromatic amines viz. (benzidine, mono-acetyl benzidine, diacetyl benzidine, α,β-naphthylamine as well as the biological pollutants e.g., human cytomegalovirus (HCMV as risk factors for recurrent spontaneous abortion (RSA through determination of MDA as a marker of oxidative stress and determination of some antioxidant markers. The results of the current study revealed that the aborter mothers were being exposed to environmental pollutants as aromatic amines which were manifested by the presence of benzidine, mono-acetyl-benzidine, di-acetyl-benzidine, α,β-naphthylamine in most of their urine samples, where the level of aromatic amines were more 13.6, 10, 15, and 4-folds than the control group, respectively. Also, the data suggest that in early pregnancy failure there is an increase in markers of oxidative stress and a probable decrease in maternal antioxidant defenses (22 nmol/ml and 17 mg/l, 550 U/l, respectively. Generation of ROS in large quantities, in the first trimester placenta which has limited antioxidant defenses may cause DNA damage, oxidation of protein and lipid resulting in extensive cell death. Also, it was demonstrated that high elevation of HCMV inhibits cytotrophoblasts proliferation, migration invasion and matrix metalloproteins (MMP expression. Obviously, placental toxicological responses are partly due to pharmaco/toxico dynamic responses to the chemicals. Conclusively, the aforementioned findings emphasis that, the exposures to environmental chemical and/or biological risk factors are implicated in the pathogenesis of recurrent spontaneous abortion.
Full Text Available Background: Carriers of structural chromosomal rearrangements such as Robertsonian or reciprocal translocations have an increased risk of spontaneous abortion and producing offspring with genetic abnormalities. Case Report: We report a man with balanced chromosomal translocations located at 6p22, and 7q22. His wife has a history of four spontaneous abortions. Conclusion: Couples with a history of abortions should be investigated cytogenetically, after other causes of miscarriages are excluded. The possibility of spontaneous abortions can be reduced with preimplantation genetic diagnosis (PGD before embryo transfer.
Hjollund, N H; Bonde, J P; Jensen, T K
Male-mediated spontaneous abortion has never been documented for humans. The welding of stainless steel is associated with the pulmonary absorption of hexavalent chromium, which has genotoxic effects on germ cells in rodents. Clinical and early subclinical spontaneous abortions were examined among...
Bech, Bodil Hammer; Kjaersgaard, Maiken Ina Siegismund; Pedersen, Henrik Søndergaard
Dette studie undersøger, om brugen af antiepileptika under graviditeten kan øge risikoen for spontan abort eller dødfødsel. Resultaterne viser, at 16 ud af 100 gravide kvinder, som brugte antiepileptika, mistede fostret ved en spontan abort, mens det kun var 13 ud af 100 gravide kvinder, som ikke...
Henriksen, T.B.; Hjollund, N.H.; Jensen, Tina Kold
The authors studied the association between female and male alcohol intakes at the time of conception and the risk of spontaneous abortion, including early pregnancy loss detected by urinary human chorionic gonadotropin. After a nationwide mailing to about 50,000 members of four trade unions...... in Denmark in 1992-1994, 430 couples without previous pregnancy attempts were enrolled when birth control was discontinued, and they were followed until a clinically recognized pregnancy or for six menstrual cycles. Alcohol intake and potential confounding factors were reported in monthly questionnaires...... with no intake were statistically significant. Both male and female alcohol intakes during the week of conception increased the risk of early pregnancy loss....
Buss, L; Tolstrup, J; Munk, C
-based prospective cohort study comprising 11,088 women and data from a linkage of the cohort with the Hospital Discharge Register to compare spontaneous abortions as reported in the interview with those identified in the register. Based on interview data, we estimated the rate of spontaneous abortion during the two......-year follow-up. Finally, risk determinants for incident spontaneous abortion were analyzed by means of logistic regression. RESULTS: A total of 654 spontaneous abortions before enrolment in the study were reported by the women compared to 531 abortions found in the register. More than 80% of the spontaneous...... abortions identified from both sources were recorded in the same year. During follow-up a total of 20.9% of pregnancies intended to be carried to term ended as a spontaneous abortion. In the risk factor analysis, we found that previous spontaneous abortion, being single, never having used oral...
YAN Chun-fang; YU Xue-wen; JIN Hui; LI Xu
To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua andconcentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneous abortion,threatened abortion, and compare the levels with healthy pregnant women. Methods: Thirty-seven women with unexplainedearly spontaneous abortion, 27 women with threatened abortion, and 34 healthy pregnant women undergoing artificial abortionof pregnancy at 6 - 10 weeks of gestation were selected. Decidual samples were collected when women were undergoing arti-ficial abortion, and blood samples were collected at the same time. The level of membrane tumor necrosis factor receptor 1 indecidua was detected by flow cytometer, and the concentration of soluble tumor necrosis factor receptor 1 in sera was mea-sured with an enzyme-linked immunosorbent assay. Results: The ercentages of membrane tumor necrosis factor receptor 1positive decidual cells were 16.42 ± 7.10 Mean ± SD for women with unexplained early spontaneous abortion and 13.14 ±6.30 for healthy pregnant women ( P ＜ 0.05). Serum oncentration of soluble tumor necrosis factor receptor 1 was signifi-cantly higher in women with unexplained early spontaneous abortion than in healthy pregnant women and in women withthreatened abortion, and no difference was found between healthy pregnant women and women with threatened abortion.Conclusion: Women with unexplained early spontaneous abortion present significantly higher expression of tumor necrosisfactor receptor 1 than healthy pregnant women, suggesting that over-expression of tumor necrosis factor receptor 1 may cont-ribute to the development of early spontaneous abortion.
Janosević, Dragana Radović; Lilić, Vekoslav; Basić, Hakija; Pavlović, Aleksandra Tubić; Stefanović, Milan; Milosević, Jelena
A repeated or habitual miscarriage (PSP) is defined as three or more consecutive losses of pregnancy. In the first three months of pregnancy, habitual miscarriages occur in about 1% of pregnant women, out of which 50% are of an unknown etiology. It is believed that among them, the greatest number is the consequence of an inadequate alloimmune response of a women to the pregnancy. The endocrine and immune systems are in a close interaction during the implantation and maintaining of pregnancy. This communication is the most obvious on endometrium of pregnancy decidua. The aim of the study was to identify the number and the subpopulation distribution of the decidual NK cells in the decidua by using an immunohistochemical method. The research included a group of 30 women who had had two spontaneous miscarriages consecutively in the first three months of their pregnancy, while the curettage after the third spontaneous abortion was histopathologically and immunohistochemically analyzed. The control group consisted of 20 women without a problematic reproductive anamnesis, who had had their pregnancy terminated for social reasons. The criteria for the eliminating from the research were the diagnosed uterus anomalies, positive screening on thrombophilia, as well as women suffering from diabetes melitus and the ones with the thyroid gland function disorder. The number and the phenotype structure of the uterus NK cells were significantly different between the decidua of a normal pregnancy and that in PSP. In the decidua in PSP, there were much more NK cells with the phenotype of the peripheral circulation CD57 and CD56dim, while in the decidua of the control group the dominant cells were the typical uNK cell subpopulation CD56bright. The above mentioned results show that the disregulation of the immunocompetent cells of the decidua, by creating an inadequate cytokine milieu, is one of the mechanism of rejecting the semiallogeneic blastocyst.
Modvig, J; Schmidt, L; Damsgaard, M T
The concepts, methods, and problems of measuring spontaneous abortion risk are reviewed. The problems touched on include the process of pregnancy verification, the changes in risk by gestational age and maternal age, and the presence of induced abortions. Methods used in studies of spontaneous...... abortion risk include biochemical assays as well as life table technique, although the latter appears in two different forms. The consequences of using either of these are discussed. It is concluded that no study design so far is appropriate for measuring the total risk of spontaneous abortion from early...... conception to the end of the 27th week. It is proposed that pregnancy may be considered to consist of two or three specific periods and that different study designs should concentrate on measuring the conditional risk within each period. A careful estimate using this principle leads to an estimate of total...
Full Text Available In the present study, using immunohistochemistry, we studied the expression of CD30 and CD30-L in 35 deciduas obtained from women following elective abortion during normal physiological gestation and in 60 deciduas obtained from women after spontaneous abortion with or without signs of inflammation. The main difference was noticed in the first trimester of gestation in which was found a decrease in CD30/CD30-L-positive decidual glandular and stromal cells in a greater number of cases of spontaneous abortions with respect to cases of physiological pregnancies (70% vs 50%, p<0.05. In addition, deciduas from spontaneous abortions with inflammation and without inflammation reacted similarly. The reduced expression of CD30 and CD30-L and their cellular pattern detected in the deciduas from spontaneous abortions suggest that the CD30/CD30-L system is crucial for preventing abortions in the first trimester. And furthermore, the distinctive expression of CD30/CD30- L in deciduas from physiological pregnancies may indicate that the CD30/CD30-L system exerts its main role in the first trimester.
Rahbar, Nahid; Vali Zadeh, Saeid; Ghorbani, Raheb; Kheradmand, Pegah
Human parvovirus B19 is a very common viral infection especially in school-aged children. The infection during pregnancy can affect the fetus due to lack of mother's immunity. Although, there is still no evidence of fetal teratogenic effects with parvovirus B19, but non-immune fetal hydrops and abortion may be caused by vertical transmission of the virus during pregnancy. This study was aimed to assess the prevalence of parvovirus B19-specific antibody (IgM) in pregnant women who had a spontaneous abortion. This cross-sectional study was carried out in all pregnant women who referred due to a spontaneous abortion. All demographic information such as age, occupation, and gestational age, last history of abortion, gravity, and presence of children below the age of six was recorded and a blood sample was provided for all the women. Then, the blood samples were tested to assay parvovirus B19-specific antibody (IgM) by EuroImmune ELISA kit. Among 94 pregnant women with the mean age of 28.4 years who had a spontaneous abortion, parvovirus B19 specific antibody (IgM) was detected in 17 participants (18.1%). Meanwhile, 14 women (14.9%) were suspected for presence of the antibody in their blood sample. There was no significant difference between the presence of antibody and age of pregnant women, occupation, gestational age, number of previous abortion, presence of children below the age of six and number of pregnancy. These findings revealed that a high percentage of pregnant women are probably non-immune against parvovirus B19, and also there might be a number of spontaneous abortions in which parvovirus infection caused fetal death. However, more studies are needed to prove the absolute role of parvovirus B19 in these abortions.
Lohse, Sarah Rytter; Farkas, Dóra Körmendiné; Lohse, Nicolai
PURPOSE: The purpose of this study is to validate the diagnosis of spontaneous abortion (SA) recorded in the Danish National Registry of Patients (DNRP). METHODS: We randomly selected patients registered in the DNRP with a diagnosis of SA between 1980 and 2008 from hospitals in the county of North...... the three patients with available data who did not fulfill the criteria for SA, one had an induced abortion and two had threatened abortion but did not miscarry. CONCLUSION: Registration of SA in the DNRP accurately reflects the diagnoses recorded in medical charts. The DNRP is a suitable source of data...
Rasch, V; Mary, V; Urassa, E
The objective of this study was to create sexual history profiles of women with illegally induced abortion (IA) and women with spontaneous abortion (SA) and describe the women's knowledge of, attitude to, and practice of contraception. The study was carried out in two settings, Temeke District...... the rate of ever users of contraception was low in both groups, although significantly lower among IA women than among SA women. Outcome of first pregnancy had been an induced abortion in significantly higher proportion of IA than of SA women. In conclusion, sexual intercourse before marriage is common...
Full Text Available Introduction & Objective: Nowadays, some studies indicate the adverse effects of exposure to chemicals, especially organic solvents on the reproductive system of females. This study aimed to assess the relationship between spontaneous abortion with occupational exposure to organic solvents in pharmaceutical industry. Materials & Methods: This is a cross-sectional and descriptive-analytical study which was carried out in 2010 in one of the pharmaceutical factories located in the suburbs of Tehran. During the study, married women who were working in the factory laboratory units and were exposed to mixed organic solvents were compared with married women who were working in the packing units of the factory without occupational exposure to organic solvents. Frequency of spontaneous abortion and duration of pregnancy were assessed in both two groups. Collected data were analyzed with the SPSS software using t-test, logistic regression, and chi-square test. Results: In the present study, the frequency of spontaneous abortion in employees with exposure to organic solvents mixture was 10.7%. This study showed that even after adjustment for confounding factors, there was a significant correlation between spontaneous abortion and occupational exposure to organic solvents mixture and this correlation increased with increasing levels of exposure to organic solvents. Moreover, a significant correlation was observed between occupational exposure to mixed organic solvents and waiting time to become pregnant (TTP. Furthermore, this study showed that even after adjustment for confounding variables, shift workers were significantly more affected by spontaneous abortion compared to daytime workers (P < 0.001. Conclusion: According to the results of this study, since there is probability of spontaneous abortion resulting from occupational exposure to various chemicals including organic solvents, review of the status of occupational exposure of workers can be helpful
Wilson, E L
If you are pregnant and near 40 years old there is 1/137 chance that your child may have Down's syndrome, or 1/65 chance he will have a physical or mental problem. There are tests that can indicate these problems but they increase the risk of spontaneous abortion. A woman should not be forced to carry an unwanted child, and the needs of childless couples should not be addressed in abortion discussions. The Roe v. Wade case made the distinction of not having to determine when life begins, but when it can be sustained outside the body. The Missouri statute states that human life begins at conception, an unborn child has protectable life interests and the parents of that child have protectable life interests of the unborn child in relation to life, health and its well being. States that are really concerned with the interests of unborn children should improve prenatal care, educate teens on contraception, AIDS, and be concerned about violent behavior and smoking. Voters in Michigan and Arkansas approved a law to stop the use of public funds for abortion, other than saving the mother's life. Pro- choice advocates are concerned that the conservative appointees to the supreme court will reverse the previous decision.
Full Text Available Context: Bacterial vaginosis (BV is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. Aims: The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. Materials and Methods: The study population consisted of 200 fertile women. Sixty one (30.5% of 200 women had the history of a spontaneous abortion in the last six months (N = 30 and at least three recurrent pregnancy losses (N = 31. BV was diagnosed either by using Papanicolaou staining, Gram staining, or by culturing with BV-associated bacteria, Gardnerella vaginalis. Results: The presence of BV was statistically associated with the history of a spontaneous abortion in the last 6 months (P 0.05. These women were also evaluated in view of periods of gestation. Forty-seven (77% of 61 women had first trimester miscarriage (≤12 weeks and 14 (23% of 61 women had second trimester miscarriage (>12 weeks. There was a statistically significant relationship between BV and second trimester miscarriage (P 0.05. Conclusion: BV may contribute to spontaneous abortion and second trimester miscarriage.
Kim, Heechan; Kwon, Ho-Jang; Rhie, Jeongbae; Lim, Sinye; Kang, Yun-Dan; Eom, Sang-Yong; Lim, Hyungryul; Myong, Jun-Pyo; Roh, Sangchul
This study investigated the relationship between job type and the risk for spontaneous abortion to assess the reproductive toxicity of female workers in the semiconductor industry. A questionnaire survey was administered to current female workers of two semiconductor manufacturing plants in Korea. We included female workers who became pregnant at least 6 months after the start of their employment with the company. The pregnancy outcomes of 2,242 female workers who experienced 4,037 pregnancies were investigated. Personnel records were used to assign the subjects to one of three groups: fabrication process workers, packaging process workers, and clerical workers. To adjust for within-person correlations between pregnancies, a generalized estimating equation was used. The logistic regression analysis was limited to the first pregnancy after joining the company to satisfy the assumption of independence among pregnancies. Moreover, we stratified the analysis by time period (pregnancy in the years prior to 2008 vs. after 2009) to reflect differences in occupational exposure based on semiconductor production periods. The risk for spontaneous abortion in female semiconductor workers was not significantly higher for fabrication and packaging process workers than for clerical workers. However, when we stratified by time period, the odds ratio for spontaneous abortion was significantly higher for packaging process workers who became pregnant prior to 2008 when compared with clerical workers (odds ratio: 2.21; 95% confidence interval: 1.01-4.81). When examining the pregnancies of female semiconductor workers that occurred prior to 2008, packaging process workers showed a significantly higher risk for spontaneous abortions than did clerical workers. The two semiconductor production periods in our study (prior to 2008 vs. after 2009) had different automated processes, chemical exposure levels, and working environments. Thus, the conditions prior to 2008 may have increased the
Gurevich, Pavel; Elhayany, Asher; Milovanov, Andrey P; Halperin, Reuvit; Kaganovsky, Ella; Zusman, Itzhak; Ben-Hur, Herzel
Morphologic changes in the placental barrier in spontaneous early abortions under the maternal-embryonic immune conflict, and the role of maternal immunoglobulins (Igs) in these changes. We examined chorionic villi and other tissues obtained from 54 aborts between weeks 3.5 and 8 of pregnancy. Material was divided into two groups. Group 1 (control) contained 15 medically recommended and spontaneous early aborts with no signs of inflammations or pathologic immune processes. Group 2 contained 39 spontaneous early aborts with acute chorionic villitis. Immunohistochemical and morphometric methods were used to study the Igs, different types of immunocompetent cells, and apoptosis-related components of the placental barrier. Acute villitis was found to be characterized by the destruction of all components of the chorionic villi, thrombovasculitis with apoptosis of the endothelium of capillaries and erythroblasts, mucous swelling of the basal membrane, and coagulation of the blood proteins. Due to destruction of the capillaries, the number of avasculate villi increased, and the average number of capillaries per villus decreased. The extremely high number of phagolysosomes with IgG and IgA in the villous monocytes in the group 2 indicates an increase in the phagocytic activity of monocytes against maternal Igs and may reflect the presence of mother-embryo immune conflict. Apoptosis of monocytes and a high number of promonocytes were seen accompanied by a high concentration of p53 protein. A large disturbance in the trophoblast occurred with disappearance of bcl-2 and the appearance of Fas ligand. Massive destruction of maternal Igs in embryonic monocytes and acute villitis in the placental barrier are manifested during the mother-embryo immune conflict, and this may be one of the reasons of spontaneous early abortions.
Objective:To analyze and investigate the change state of T, B lymphocyte subsets and Th1/Th2 indexes of patients with recurrent spontaneous abortion. Methods: A total of 92 patients with recurrent spontaneous abortion in our hospital from June 2013 to July 2015 were selected as the observation group and 92 women with health delivery history at the same time were selected as the control group,then the peripheral blood T, B lymphocyte subsets and Th1/Th2 indexes of two groups were detected and compared and the peripheral blood T, B lymphocyte subsets and Th1/Th2 indexes of patients with different gestational age at abortion and abortion times were compared too. Results:The peripheral blood T, B lymphocyte subsets and Th1/Th2 indexes of observation group and control group all had obvious differences,and those blood indexes levels' differences of patients with different gestational age at abortion and abortion times were obvious too, all P<0.05 and the differences were significant. Conclusions: The T, B lymphocyte subsets and Th1/Th2 indexes of patients with recurrent spontaneous abortion show abnormal state and the differences of detection results of patients with different gestational age at abortion and abortion times are relatively obvious,so those indexes should be monitored and improved intentinonally.
Lauszus, Finn; Viftrup-Lund, Mette; Gade, Melina
Objective: We sought to determine whether metformin affects the rate of first trimester spontaneous abortions and congenital malformations in women with PCOS. Design. Consecutive series of metformin treated women with a questionnaire followup. Setting. Department of Gynecology and Obstetrics at H...... is comparable with the risk in the general population. Our low incidence of malformations warrants further investigation on adverse and beneficial effects of metformin during pregnancy....
Andersen, Stine Linding; Olsen, Jørn; Wu, Chun Sen; Laurberg, Peter
Objectives Pregnancy loss in women suffering from hyperthyroidism has been described in case reports, but the risk of pregnancy loss caused by maternal hyperthyroidism in a population is unknown. We aimed to evaluate the association between maternal hyperthyroidism and pregnancy loss in a population-based cohort study. Study Design All pregnancies in Denmark from 1997 to 2008 leading to hospital visits (n = 1,062,862) were identified in nationwide registers together with information on maternal hyperthyroidism for up to 2 years after the pregnancy [hospital diagnosis/prescription of antithyroid drug (ATD)]. The Cox proportional hazards model was used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI) for spontaneous abortion (gestational age hyperthyroidism was diagnosed before/during the pregnancy (n = 5,229), spontaneous abortion occurred more often both in women treated before the pregnancy alone [aHR 1.28 (95% CI 1.18-1.40)] and in women treated with ATD in early pregnancy [1.18 (1.07-1.31)]. When maternal hyperthyroidism was diagnosed and treated for the first time in the 2-year period after the pregnancy (n = 2,361), there was a high risk that the pregnancy under study had terminated with a stillbirth [2.12 (1.30-3.47)]. Conclusions Both early (spontaneous abortion) and late (stillbirth) pregnancy loss were more common in women suffering from hyperthyroidism. Inadequately treated hyperthyroidism in early pregnancy may have been involved in spontaneous abortion, and undetected high maternal thyroid hormone levels present in late pregnancy may have attributed to an increased risk of stillbirth. PMID:25538898
Yamada, H; Kishida, T; Kobayashi, N; Kato, E H; Hoshi, N; Fujimoto, S
The aim of this trial was to investigate the efficacy of massive i.v. immunoglobulin (MIVIg) treatment for women with a history of recurrent spontaneous abortion (RSA) due to unexplained aetiology. The study included nine women (11 pregnancies) with a history of four or more consecutive RSA with unexplained aetiology and no live births. The mean number of fetal losses was 4.5 (range 4-6 abortions). Over the course of 5 days, immunoglobulin (20 g/day) was infused i.v. at gestational weeks 4-7. No additional infusions were carried out. Two pregnancies out of the 11 conceptions resulted in missed abortions at gestational weeks 6 and 7 respectively. Mosaicism (46XX/ 48XX, +16, +20), and tetraploidy (92XXXX) were found by chromosome analyses of the two aborti. Eight out of the other nine pregnancies resulted in full term deliveries of healthy neonates. One pregnancy developed intrauterine growth retardation and fetal distress, resulting in a premature delivery (30 gestational weeks) by Caesarean section. Thus, excluding the two abortions with chromosome aberrations, the MIVIg treatment was effective in all nine pregnancies of RSA women with unexplained aetiology. This MIVIg treatment (100 g administered in early gestation) may be a beneficial alternative to previous IVIg infusion methods, and should be further evaluated in a multicentric, placebo-controlled study, employing a larger number of homogeneous patients who fall into a high risk category of first trimester abortions.
Full Text Available Varicocele is still an enigma. Its effects on semen analysis, fertility and, more re-cently, early ejaculation and spontaneous abortion in spouses are not yet fully understood. In this retrospective study, we evaluated these four parameters (semen analysis, fertility, early ejacu-lation and spontaneous abortion among spouses in relation to varicocele and varicocelectomy during a 13-year period. A total of 1,711 patients with varicocele underwent varicocelectomy by high inguinal method (251 cases, subinguinal method (1,375 cases, scrotal method (34 cases, and subinguinal method with local anesthesia (38 cases. Our complication rate was acceptable. Sperm count, motility and morphology increased three months post operation in 55, 51, and 46%, respectively (P value 0.000, 0.000, and 0.015, respectively. Paternity was 56% after one year of post varicocelectomy follow-up. Only 7 out of 82 azoospermic men had sperm in their semen after varicocelectomy and only one of them with mild spermatogenic hypoplasia became a father. The spontaneous abortion rate in the spouses of respondents was 59%. Early ejaculation improved in 75% of the respondents. In conclusion, varicocelectomy does not improve sperm parameters in all men, but it improves pregnancy rate, early ejaculation, and scrotal pain.
He, Wenjie; Greenwell, Robert J; Brooks, Diane M; Calderón-Garcidueñas, Lilian; Beall, Howard D; Coffin, J Douglas
Arsenic is an abundant toxicant in ground water and soil around areas with extractive industries. Human epidemiological studies have shown that arsenic exposure is linked to developmental defects and miscarriage. The placenta is known to utilize vasculogenesis to develop its circulation. The hypothesis tested here states the following: arsenic exposure causes placental dysmorphogenesis and defective placental vasculogenesis resulting in placental insufficiency and subsequent spontaneous abortion. To test this hypothesis, pregnant mice were exposed to sodium arsenite (AsIII) through drinking water from conception through weanling stages. Neonatal assessment of birth rates, pup weights, and litter sizes in arsenic exposed and control mothers revealed that AsIII-exposed mothers had only 40% the fecundity of controls. Preterm analysis at E12.5 revealed a loss of fecundity at E12.5 from either 20 ppm or greater exposures to AsIII. There was no loss of fecundity at E7.5 suggesting that spontaneous abortion occurs during placentation. Histomorphometry on E12.5 placentae from arsenic-exposed mice revealed placental dysplasia especially in the vasculature. These results suggest that arsenic toxicity is causative for mammalian spontaneous abortion by virtue of aberrant placental vasculogenesis and placental insufficiency.
Goldhaber, M K; Staub, S L; Tokuhata, G K
A study was conducted to determine whether the incidence of spontaneous abortion was greater than expected near the Three Mile Island (TMI) nuclear power plant during the months following the March 28, 1979 accident. All persons living within five miles of TMI were registered shortly after the accident, and information on pregnancy at the time of the accident was collected. After one year, all pregnancy cases were followed up and outcomes ascertained. Using the life table method, it was found that, given pregnancies after four completed weeks of gestation counting from the first day of the last menstrual period, the estimated incidence of spontaneous abortion (miscarriage before completion of 16 weeks of gestation) was 15.1 per cent for women pregnant at the time of the TMI accident. Combining spontaneous abortions and stillbirths (delivery of a dead fetus after 16 weeks of gestation), the estimated incidence was 16.1 per cent for pregnancies after four completed weeks of gestation. Both incidences are comparable to baseline studies of fetal loss.
Goldhaber, M.K.; Staub, S.L.; Tokuhata, G.K.
A study was conducted to determine whether the incidence of spontaneous abortion was greater than expected near the Three Mile Island (TMI) nuclear power plant during the months following the March 28, 1979 accident. All persons living within five miles of TMI were registered shortly after the accident, and information on pregnancy at the time of the accident was collected. After one year, all pregnancy cases were followed up and outcomes ascertained. Using the life table method, it was found that, given pregnancies after four completed weeks of gestation counting from the first day of the last menstrual period, the estimated incidence of spontaneous abortion (miscarriage before completion of 16 weeks of gestation) was 15.1 per cent for women pregnant at the time of the TMI accident. Combining spontaneous abortions and stillbirths (delivery of a dead fetus after 16 weeks of gestation), the estimated incidence was 16.1 per cent for pregnancies after four completed weeks of gestation. Both incidences are comparable to baseline studies of fetal loss
To investigate the relationship between inducible nitric oxide synthase (iNOS) and the early spontaneous abortion. , in situ hybridization and immunohistochemistry were used to detect the expression of iNOS in trophoblasts in the early pregnancy with and without spontaneous abortion (group Ⅰ and group Ⅱ ). By light microscopy and computer color magic image analysis system (CMIAS), light density (D) and the positive cell number per statistic square (N/S) in situ hybridization were used to analyze the positive cell index, while total positive cells (N) and the positive unit (Pu) were used in immunohistochemistry. By in situ hybridization, D and N/S in trophoblasts were 0. 35±0. 028, 0. 07±0. 011 respectively in group Ⅰ and 0. 18±0. 016,0. 015±0. 003 in group Ⅱ . In terms of immunohistochemical staining, N and Pu were 0. 058±±0. 007, 11. 94±2. 01 in group Ⅰ and 0. 013±0. 009, 1. 08±0. 35 in group Ⅱ in trophoblasts. Significant differences existed between two groups. It is concluded that the higher nitric oxide produced by the higher expression of iNOS in trophoblasts might play an important role in the early spontaneous abortion.
An abortion is a procedure to end a pregnancy. It uses medicine or surgery to remove the embryo or ... personal. If you are thinking of having an abortion, most health care providers advise counseling.
Maia S. Marin
Full Text Available Bovine Herpesvirus type 5 (BoHV-5 has not been conclusively demonstrated to cause bovine abortion. Brain lesions produced by Neospora caninum and Bovine Herpesvirus type 1 (BoHV-1 exhibit common features. Therefore, careful microscopic evaluation and additional diagnostic procedures are required to achieve an accurate final etiological diagnosis. The aim of the present work was to investigate the occurrence of infections due to BoHV-1, BoHV-5 and N. caninum in 68 cases of spontaneous bovine abortions which showed microscopic lesions in the fetal central nervous system. This study allowed the identification of 4 (5.9% fetuses with dual infection by BoHV-5 and N. caninum and 33 (48.5% cases in which N. caninum was the sole pathogen identified. All cases were negative to BoHV-1. The results of this study provide evidence that dual infection by BoHV-5 and N. caninum occur during pregnancy in cattle; however, the role of BoHV-5 as a primary cause of bovine abortion needs further research. Molecular diagnosis of BoHV-5 and N. caninum confirmed the importance of applying complementary assays to improve the sensitivity of diagnosing bovine abortion.
The Alan Guttmacher Institute's State Reproductive Health Monitor "Legislative Proposals and Actions" provides US legislative information on abortion. The listing contains information on pending bills: the state, the identifying legislative number, the sponsor, the committee, the date the bill was introduced, a description of the bill, and when available the bill's status. The bills cover: 1) clinic licensing, e.g., requiring outpatient health care facilities in which abortions are performed, to have malpractice liability insurance; 2) comprehensive statues, which require parental notification before minor may obtain abortions, mandate abortion counseling to all women 24 hours before the abortion can be performed and prohibit disciplining or discharging a state employee for refusing to provide abortion counseling; 3) fetal personhood and rights, e.g. providing that life is vested in each person at fertilization; 4) fetal research and remains; 5) gender of fetus, which regulate abortions relative to sex selection in pregnancies; 6) harassment regulation; 7) informed consent and waiting periods detailing the risks and alternatives to abortion, and the 24-hour waiting period; 8) insurance coverage, e.g., eliminating language banning the coverage of abortions for state workers, and prohibiting disclosure by a health insurance carrier to the employer of a claimant that the claimant had a surgical abortion; 9) legality of abortion, urging Congress to reject he Freedom of Choice Act; 10) parental consent and notification; 11) postviability requirements; 12) public funding; 13) reporting requirements; 14) reproductive rights, and 15) spousal and paternal consent and notification.
Objective:To study the metabolism abnormality of homocysteine(Hcy) in unexplained repeated spontaneous abortion(URSA).Methods:The level of Hcy in sera was measured with hyperpressure liquid chromatography(HPLC);Folic acid and vitamin B12 were detected by radioimmune assay;anticardiolipin antibody (ACA) was detected by ELISA.Results:(1)The level of serum Hcy in URSA group was significantly higher than that in control group,showing a statistical significant difference(P＜0.01).The level of Hcy was correlated with ages,but not correlated with areas,numbers of miscarriage,gestation age,primary or secondary abortions.(2)The levels of folic acid and vitamin B12 in URSA group were significantly lower than those in control group.The levels of serum folic acid and vitamin B12 were not correlated with age,area,numbers of miscarriage and abortion periods.(3)ACA positive rate in URSA was significantly higher than that in control group.The level of Hcy in ACA(+) group was significantly higher than that in ACA(-) group among URSA patients.Conclusions:Hyperhomocysteinemia,low folic acid state,and ACA were all the independent risk factors for URSA.Lacking of folic acid and vitamin B12 is one of the important causes of hyperhomocysteinemia.ACA and hyperhomocysteinemia may have synergistic action in the occurrence of URSA.
Tolstrup, J S; Kjær, S. K.; Munk, C
BACKGROUND: Consumption of caffeine and alcohol is suspected to affect pregnancy outcome. Use of both stimulants is widespread and even minor effects on fetal viability are of public health interest. METHODS: We performed a nested case-control study using prospective data from a population.......72 (1.00-2.96) for a pre-pregnancy intake on 75-300, 301-500, 501-900 and >900 mg caffeine per day respectively (P = 0.05 for trend). A pre-pregnancy intake of alcohol was not a predictor for spontaneous abortion. CONCLUSIONS: A high intake of caffeine prior to pregnancy seems to be associated......-based cohort comprising 11088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n = 303) or who gave birth (n = 1381) during follow-up [mean time: 2.1 years (range: 1.6-3.4)] were selected. Associations between self-reported exposures to caffeine and/or alcohol...
Full Text Available Abstract The pathogenesis of human spontaneous abortion involves a complex interaction of several genetic and environmental factors. The firm association between increased homocysteine concentration and neural tube defects (NTD has led to the hypothesis that high concentrations of homocysteine might be embryotoxic and lead to decreased fetal viability. There are several genetic polymorphisms that are associated with defects in folate- and vitamin B12-dependent homocysteine metabolism. The methylenetetrahydrofolate reductase (MTHFR 677C>T and 1298A>C polymorphisms cause elevated homocysteine concentration and are associated with an increased risk of NTD. Additionally, low concentration of vitamin B12 (cobalamin or transcobalamin that delivers vitamin B12 to the cells of the body leads to hyperhomocysteinemia and is associated with NTD. This effect involves the transcobalamin (TC 776C>G polymorphism. Importantly, the biochemical consequences of these polymorphisms can be modified by folate and vitamin B12 supplementation. In this review, I focus on recent studies on the role of hyperhomocysteinemia-associated polymorphisms in the pathogenesis of human spontaneous abortion and discuss the possibility that periconceptional supplementation with folate and vitamin B12 might lower the incidence of miscarriage in women planning a pregnancy.
Frazier, Tyralynn; Hogue, Carol J Rowland; Bonney, Elizabeth A; Yount, Kathryn M; Pearce, Brad D
The Weathering Effect is a theory that links stress exposure, over the life-course, with racial disparities in reproductive outcomes, through the effects of social adversity on a woman's body. The concept of maternal "weathering" captures cumulative somatic and psychological adversities that can exacerbate the effects of aging. Much of the evidence for weathering comes from observational studies linking self-report measures with reproductive outcomes. The purpose of this review is to explore biological mechanisms that underlie these observations. We focus on spontaneous abortion because this event is understudied despite evidence of racial disparities in this outcome. Spontaneous abortion is the most common pregnancy failure, and it happens early in pregnancy. Early pregnancy is a time most susceptible to the harmful effects of immune dysregulation that may, in part, result from adversities experienced before pregnancy begins. In exploring these mechanisms, we draw on well-defined signaling processes observed in the stressor-depression relationship. Pro-inflammatory dysregulation, for example, has particular relevance to immunological control occurring early in pregnancy. Early pregnancy immunologic changes affect the trajectories of pregnancy via control of trophoblastic invasion. Within the first few weeks of pregnancy, uterine derived cytokines operate within cytokine networks and play a critical role in this invasion. Programming for pro-inflammatory dysregulation can occur before conception. This dysregulation, brought into early pregnancy, has implications for viability and success of the index pregnancy. These patterns suggest early pregnancy health is susceptible to stress processing pathways that influence this immunologic control in the first six to eight weeks of pregnancy. In this review, we discuss the known mediating role of immune factors in the stressor-depression relationship. We also discuss how adversity experienced before the index pregnancy, or
Ji-fen HU; Hong-chu BAO; Feng-chuan ZHU; Cai-ling YOU
Objective To investigate the aberrant expressions of TNF-α and TGF-β1 in peripheral blood mononuclear cells (PBMCs) and placental tissues in patients with early spontaneous abortionMethods Using the technique of semi-quantitative reverse transcript-polymerase chain reaction (RT-PCR), TNF-α mRNA and TGF-β1 mRNA in PBMCs were measured in spontaneous abortion group (30 cases), normal pregnancy group (25 cases) and nonpregnant group (25 cases). The expressive intension of TNF-α protein and TGF-β1 protein in placental tissues was also identified by immunohistochemistry.Results Both levels of TNF-α mRNA and TGF-β1 mRNA expressed in PBMCs were significantly different between the three groups respectively (P＜0. 05). Levels of TNF-α in syncytiotrophoblastic and cytotrophoblastic cells of the two aborted groups were substantially higher than those of the non-pregnant group (P＜0. 01), but the levels of TGF-β1 in syncytiotrophoblastic cells of the two aborted groups were markedly lower than those of the non-pregnant group (P＜0. 01).Conclusion There is potential relation between TGF-β1 at the fetomaternal interface and spontaneous abortion. TGF-β1 may contribute to the maintenance of pregnancy,and low-level expression of TGF-β1 may be associated with pregnancy failure.
Liu Jingzhu; Hu Jing; Zhang Shiping; Zhang Shuang; Lin Li; Fan Jing
Objective: To explore the relationship between recurrent spontaneous abortion (RSA) and anti-β 2 - glycoprotein I (anti-β 2 -GP I) antibody. Methods: The levels of anti-β 2 -GP I antibody in serum from 81 RSA patients and 39 normal women were detected by ELISA. Results: The positive rate of anti-β 2 -GP I in RSA patients (42.0%) was obviously higher than that in normal women (7.7 %) (P 2 -GP I IgG in statistics between RSA patients (40.8%) and normal women (7.7%) (P 2 -GP I IgM in statistics between RSA patients and normal women (P>0.05). There was no difference of the positive rate of anti-β 2 -GP I in statistics between early and late, as well as between 2 times and more than 2 times abortions of RSA (P>0.05). Conclusion: The anti-β 2 -GP I antibody is related to RSA, and it may be regarded as a immunological assistant diagnostic index for RSA. (authors)
Full Text Available Although a history of first-trimester recurrent spontaneous abortion (FRSA is regarded as a risk factor in antenatal care, the characteristic of subsequent pregnancy outcome is not clearly elucidated. Here, a retrospective analysis was performed on the clinical data of 492 singleton pregnant women. 164 of them with the history of FRSA were enrolled in study group, compared to 328 deliveries without the history of FRSA. For maternal outcomes, patients in the study group delivered earlier with mean gestational age and the incidences of cesarean section and postpartum hemorrhage were higher compared to the control group. For placental outcomes, the incidence of placenta-mediated pregnancy complications (PMPC in the study group increased in terms of late-onset preeclampsia, oligohydramnios, early-onset fetal growth restriction, and second-trimester abortion. Patients in the study group were more likely to suffer from placenta accreta, placenta increta, and placenta percreta. For perinatal outcomes, the proportion of birth defects of newborns in the study group was greater. At last, logistic regression analyses showed that the history of FRSA was an independent risk factor for cesarean section and pregnancy complications. In conclusion, women with the history of FRSA are often exposed to an elevated incidence of maternal-placental-perinatal adverse pregnancy outcomes.
Shabani, Zahra; Esghaei, Maryam; Keyvani, Hossein; Shabani, Fateme; Sarmadi, Fateme; Mollaie, Hamidreza; Monavari, Seyed Hamidreza
Infection with parvovirus B19 may cause fetal losses including spontaneous abortion, intrauterine fetal death and non-immune hydrops fetalis. The aim of this study is to determine the frequency of parvovirus B19 in formalin fixed placental tissues in lost fetuses using real-time PCR method. In this cross-sectional study, 100 formalin fixed placental tissues with unknown cause of fetal death were determined using real-time PCR method after DNA extraction. Six out of 100 cases (6%) were positive for parvovirus B19 using real-time PCR. Gestational age of all positive cases was less than 20 weeks with a mean of 12.3 weeks. Three cases have a history of abortion and all of positive cases were collected in spring. Mean age of positive cases were 28 years. Parvovirus B19 during pregnancy can infect red precursor cells and induces apoptosis or lyses these cells that resulting in anemia and congestive heart failure leading to fetal death. Management of parvovirus B19 infection in pregnant women is important because immediate diagnosis and transfusion in hydropsic fetuses can decrease the risk of fetal death.
Janerich, D.T.; Stark, A.D.; Greenwald, P.; Burnett, W.S.; Jacobson, H.I.; McCusker, J.
The New York State Department of Health was asked in September 1978 of investigate a cluster of leukemias and lymphomas in a rural town in western New York State of less than 1,000 people. Four cases of these diseases had been diagnosed in the town's population in the previous 10 months. Residents were concerned about environmental hazards such as background radiation and contamination of their water supply. A total environmental study of the area was not feasible or warranted, but certain environmental studies of the area were conducted. No environmental health hazards were identified. Incidence rates for towns in the four-county area (population 281,000) surrounding the study town were analyzed, based on data from the New York State Cancer Registry. These four counties had been severely affected by the flood following the 1972 Hurricane Agnes. Examination of annual leukemia and lymphoma incidence rates for these counties for 1966--77 revealed that the rates for towns in the river valley (population 102,000), but not for nonriver-valley towns, were 20 to 50 percent above the statewide rates for 1972--77. All other cancer rates remained level throughout both periods. An analysis of spontaneous abortion rates for the four counties for 1968--77 showed a significant peak in 1973, but not for the rest of upstate New York. The peak was concentrated in the towns in the river valley. The apparent time-space cluster of leukemias and lymphomas in conjunction with a marked increase in the spontaneous abortion rate suggests an unidentified flood-related environmental exposure
Nunes, J P
Abortion is the interruption of a dynamic process in a final and irreversible form. The legalization of abortion is applied to human ontogenesis, that is, the development of the human being. However, the embryo that is growing in the uterus is not a human being because a human being is a complex organism with differentiated systems, its own identity and intrinsic autonomy in its process of development. There are basically four levels of the analysis of the problem of abortion: 1) fundamental emotional arguments; 2) profound ignorance of technical and scientific facts; 3) rational positions obfuscated by the dramatic intensity of everyday situations; and 4) the conjunction of deliberated position where culpability is avoided with solidarity for all subjects of the process with a socially oriented view. The phenomenon of abortion from an epidemiological point of view summons the facts with which it is associated: poverty, illiteracy, shortage or lack of community health resources, absence of centers for adolescents, degradation of the environment, and precariousness of employment.
Tavasolian, Fataneh; Abdollahi, Elham; Samadi, Morteza
Recurrent spontaneous abortion (RSA) is defined as three or more consecutive abortions before the 20th week of gestation. There is increasing evidence to support an immunological mechanism for the occurrence of RSA. The purpose of our study was to examine whether single-nucleotide polymorphisms (SNPs) of the interleukin-4 receptor gene IL4R influence susceptibility to, recurrent spontaneous abortion. This is a case-control study. We recruited 200 patients with RSA (case group) using established diagnostic criteria and 200, normal individuals (control group) at the fertility and infertility center in Yazd city and Isfahan city during 2012 to 2013. We screened the I50V variant in IL-4R in patients and controls by PCR-RFLF method, and we performed an association analysis between I50V variant and RSA.the data was analyzed by spss 16 software using Chi-square test. No differences in the genotype and allele frequencies of the I50V SNPs were identified between patients with RSA and healthy controls. The frequency of SNP in IL-4 receptor (I50V) in patients with recurrent spontaneous abortion did not differ significantly compared with the control group. Analysis of IL4R SNP haplotypes or complex alleles suggested no dominant protection in patients with RSA.
Hong, Y; Xie, Q X; Chen, C Y; Yang, C; Li, Y Z; Chen, D M; Xie, M Q
Insulin resistance (IR) has been reported to play an important role in recurrent spontaneous abortion (RSA) among patients with polycystic ovary syndrome (PCOS). However, scanted materials exist regarding the independent effect of IR on RSA. The aim of this study is to investigate the status of IR in first trimester pregnant patients with normal pre-pregnant glucose tolerance and history of RSA. This two-center case-control study enrolled totally 626 first trimester pregnant women including 161 patients with a history of recurrent spontaneous abortion, who were pre-pregnantly glucose-tolerant according to oral glucose tolerance test (OGTT), and 465 women with no history of abnormal pregnancies of any kind. Clinical, biochemical and hormonal parameters were simultaneously measured in all participants. Serum beta-HCG, estradiol, progesterone, fasting plasma glucose and fasting plasma insulin levels, as well, the calculated homeostasis model assessment of insulin resistance index (HOMA-IR), fasting plasma glucose/insulin ratio(G/I) and pregnancy outcome were analyzed and compared. Serum beta-HCG and progesterone were found to be significantly lower in RSA group compared to controls. Subjects in RSA group were found to have higher HOMA-IR and lower G/I ratio than those in control group. Serum beta-HCG and progesterone were negatively correlated with HOMA-IR, and positively with G/I ratio even after adjustment for BMI. The spontaneous abortion rate within first trimester pregnancy of RSA patients was significantly higher than that in controls. In conclusion, woman with recurrent spontaneous abortion and normal pre-pregnant glucose metabolism tends to be more insulin resistant during first trimester pregnancy than healthy controls, no matter whether she has PCOS or not. Insulin resistance might be one of the direct causes that lead to recurrent abortion.
Having read Professor Peter Huntingford's letter (25 August, p 496), I am more convinced than ever that reduction to the simplest possible terms will always clarify an issue, and I am at one with him in deploring the terms "serious," "grave," and "substantial." His last paragraph approximates to such clarify when he says "the right of women to choose freely whether or not they bear a child"--but I fear that the phrase is slanted and ignores an essential ingredient in the abortive act. Whereas the secondary effect of abortion is certainly that the woman will not bear a child, the primary effect is the killing of that child, admittedly small and defenceless. Maybe there are many who will seek to justify the killing of their fellow members of the human race on the grounds that they are not wanted, or might be handicapped; if so, let them proclaim these views "in good set terms." But if the principle of getting rid of the unwanted by killing them is to expand its application further, who among us will be safe when someone else can decide our fate? Even the advocates of euthanasia usually insist that it be voluntary. Who yet has asked a fetus whether it wants to live or be killed?
Parveen, Shagufta; Panicker, M M; Gupta, Pawan Kumar
A major cause of spontaneous abortions is chromosomal abnormality of foetal cells. We report the generation of an induced pluripotent stem cell line from the fibroblasts isolated from chorionic villi of an early spontaneously aborted foetus with Turner syndrome. The Turner syndrome villus induced pluripotent stem cell line is transgene free, retains the original XO karyotype, expresses pluripotency markers and undergoes trilineage differentiation. This pluripotent stem cell model of Turner syndrome should serve as a tool to study the developmental abnormalities of foetus and placenta that lead to early embryo lethality and profound symptoms like infertility in 45 XO survivors. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
Nicolaidis, P; von Beust, G; Bugge, M; Karadima, G; Vassilopoulos, D; Brøndum-Nielsen, K; Petersen, M B
To determine the origin of the extra chromosome in trisomy 8 in spontaneous abortions. We analyzed 4 cases of nonmosaic trisomy 8 in 1st-trimester spontaneous abortions and their parents with DNA polymorphism analysis using microsatellite DNA markers. In 3 cases the extra chromosome was maternal in origin and in 1 case paternal in origin. In 2 of the cases the nondisjunction had occurred in maternal meiosis, while the other 2 cases were consistent with a postzygotic (mitotic) origin of the additional chromosome. Although a small number of cases studied, these results suggest differences from the common autosomal trisomies 21, 18, 16, and 13 where the vast majority of cases are due to errors in maternal meiosis.
Elliott, R C; Jones, J R; McElvenny, D M; Pennington, M J; Northage, C; Clegg, T A; Clarke, S D; Hodgson, J T; Osman, J
The UK Health and Safety Executive (HSE) conducted a study to examine the risk of spontaneous abortion (SAB) in British female semiconductor industry workers, following reports from the USA which suggested an association between risk of SAB and work in fabrication rooms and/or exposure to ethylene glycol ethers. A nested case-control study based on 2,207 women who had worked at eight manufacturing sites during a 5-year retrospective time frame was established; 36 cases were matched with 80 controls. The overall SAB rate in the industry was 10.0%. (65 SABs/651 pregnancies) The crude odds ratio (OR) for fabrication work was 0.65 (95% CI 0.30-1.40). This was essentially unchanged after adjustment for a range of potential confounding factors in the first 3 months of pregnancy and was reduced to 0.58 (95% CI 0.26-1.30) after adjustment for smoking in the previous 12 months. There were no statistically significantly elevated ORs for any work group or any specific chemical or physical exposure in the industry. There is no evidence of an increased risk of SAB in the British semiconductor industry. Am. J. Ind. Med. 36:557-572, 1999. Published 1999 Wiley-Liss, Inc.
Full Text Available BACKGROUND: Studies on the risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology (ART are relatively controversial and insufficient. Thus, to obtain a more precise evaluation of the risk of embryonic chromosomal abnormalities in first-trimester miscarriage after ART, we performed a meta-analysis of all available case-control studies relating to the cytogenetic analysis of chromosomal abnormalities in first-trimester miscarriage after ART. METHODS: Literature search in the electronic databases MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL based on the established strategy. Meta-regression, subgroup analysis, and Galbraith plots were conducted to explore the sources of heterogeneity. RESULTS: A total of 15 studies with 1,896 cases and 1,186 controls relevant to the risk of chromosomal abnormalities in first- trimester miscarriage after ART, and 8 studies with 601 cases and 602 controls evaluating frequency of chromosome anomaly for maternal age≥35 versus <35 were eligible for the meta-analysis. No statistical difference was found in risk of chromosomally abnormal miscarriage compared to natural conception and the different types of ART utilized, whereas the risk of fetal aneuploidy significantly increased with maternal age≥35 (OR 2.88, 95% CI: 1.74-4.77. CONCLUSIONS: ART treatment does not present an increased risk for chromosomal abnormalities occurring in a first trimester miscarriage, but incidence of fetal aneuploidy could increase significantly with advancing maternal age.
Aldridge, Tiara D; Hartmann, Katherine E; Michels, Kara A; Velez Edwards, Digna R
We tested whether antihistamine exposure during early pregnancy is associated with spontaneous abortion (SAB) or preterm birth (PTB). Women were enrolled in Right from the Start (2004-2010), a prospective pregnancy cohort. Data about first-trimester antihistamine use were obtained from screening and first-trimester interviews. Self-reported outcomes included SAB and PTB and were verified by medical records. Cox proportional hazards models were used to test for an association between antihistamine use and each outcome, both performed adjusting for confounders. Among the 2685 pregnancies analyzed, 14% (n = 377) reported use of antihistamines. Among antihistamine users, 12% (n = 44) experienced SABs, and 6% (n = 21) had PTBs. Antihistamine exposure was not associated with SAB (adjusted hazard ratio [aHR] = 0.88, 95% confidence interval [CI] 0.64, 1.21) or PTB, which was modified by maternal race (aHR = 1.03, 95%CI 0.61, 1.72 among White women and aHR = 0.43, 95%CI 0.14, 1.34 among Black women). Despite the biologic plausibility that antihistamine use may influence pregnancy outcomes, we did not detect evidence of an association with SAB or PTB. These data demonstrate the utility of large prospective cohorts for evaluating drug safety in pregnancy when concerns are raised from animal models. Copyright © 2014 John Wiley & Sons, Ltd.
Fotoohi, Maryam; Ghasemi, Nasrin; Mirghanizadeh, Seyed Ali; Vakili, Mahmood; Samadi, Morteza
Human leukocyte antigen-E (HLA-E)is a non-classical major histocompatibility complex (MHC) class I antigens which expressed on extra villous cytotrophoblast, which interacts with NKG2A, is an inhibitory receptor on natural killer (NK) cells and leading to down regulation of immune response in the maternal-fetal interface and provides maternal immune tolerance of the fetus. This study was designated to investigate the gene frequencies of E0101 and E0103 in HLA-E gene in Iranian women with recurrent spontaneous abortion (RSA). Amplification Refractory Mutation System (ARMS-PCR) technique was carried out to detect polymorphism in exon 3 of the HLA-E gene in women with RSA and controls (n=200). Differences between groups were analyzed by SPSS19 software using (2) test. There was no significant difference in the allele frequencies of the HLA-E polymorphism between RSA and fertile controls but HLA-E 0101/0103 heterozygous genotype was found to be significantly higher in RSA group (p=0.006, OR=1.73), so this genotype might confer susceptibility to RSA. Our results suggest that HLA-E 0101/0103 heterozygous genotype leads to increase of RSA risk. It seems that by genotyping of HLA-E polymorphism, we can predict the risk of RSA in infertile women.
. Conclusão: para uma investigação completa dos fatores associados ao aborto espontâneo recorrente faz-se necessária a inclusão do fator aloimune, sem a qual a maior parte dos casos não terá etiologia esclarecida.Purpose: to identify recurrent spontaneous abortion- associated factors. Subjects: one hundred seventy-five outpatients were investigated from March 1993 to March 1997 at the "Ambulatório de Aborto Recorrente CAISM/UNICAMP". All of them had had three or more consecutive spontaneous abortions and/or two abortions and were 35 years or more old. Methods: the investigation protocol included: couple's karyotype; hysterosalpingography, serial plasma progesterone levels and/or endometrial biopsy; toxoplasmosis, listeriosis, brucelosis, lues and cytomegalovirus serum tests; Chlamydia trachomatis and Mycoplasma hominis cultures of cervical discharge; TSH and thyroid hormone levels; fasting glucose; autoantibody panel, anti-HLA antibody search by microlymphocytotoxicity crossmatch and one-way mixed lymphocyte culture with inhibitor factor detection. Husband's evaluation included: physical evaluation, lues, Chagas' disease, B and C hepatitis and AIDS serum tests, microlymphocytotoxicity crossmatch and one-way mixed lymphocyte culture with inhibitor factor detection. Results: alloimmune etiology was the most frequently found factor (86.3% of studied patients, represented by negative crossmatch and one-way mixed lymphocyte culture with inhibitor factor below 50%. The second most frequently found factor was cervical incompetence (22.8%, followed by hormonal factor (21.2%, mainly represented by luteal insufficiency. Some patients were found to have more than one etiologic factor. Conclusion: the investigation of recurrent spontaneous abortion-associated factors must include alloimmune etiology. Most cases will remain unexplained without this investigation.
Dastoorpoor, Maryam; Idani, Esmaeil; Goudarzi, Gholamreza; Khanjani, Narges
Living in areas with high air pollution may have adverse effects on human health. There are few studies about the association between breathing polluted air and adverse pregnancy outcomes in the Middle East. The aim of this study was to determine the relationship between air pollution and spontaneous abortion, premature birth, and stillbirth in Ahvaz. A time-series study was conducted. Data about spontaneous abortion, premature deliveries, and stillbirth was collected from Ahvaz Imam Khomeini Hospital. Air pollution data including NO, CO, NO 2 , PM 10 , SO 2 , O 3 , and climate data were, respectively, collected from the Environmental Protection Agency and the Khuzestan Province Meteorology Office from March 2008 until March 2015. The relationship between air pollutants with the number of abortions, premature births, and stillbirths was found using a quasi-Poisson distributed lag model, adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holidays. The average daily dust in Ahvaz on 7.2% days of the year was higher than 500 μg/m 3 (very dangerous). Findings from this study indicate a significant association between each 10-unit increase in SO 2 and spontaneous abortion in lag 0 and 9 days. There was a significant relation between each 10-unit increase in NO 2 and CO, and premature birth in lag 0. Also, we found a significant association between each 10-unit increase in CO and premature delivery in lag 1; PM 10 and premature delivery in lags 10, 11, and 12; and NO and premature delivery in lags 3, 4, 10, 11, 12, and 13 (p value polluted air during pregnancy may increase adverse pregnancy outcomes and stillbirth. Pregnant women should avoid polluted air.
Chiodo, Lisa M; Bailey, Beth A; Sokol, Robert J; Janisse, James; Delaney-Black, Virginia; Hannigan, John H
Alcohol consumption during pregnancy is one potential risk factor for spontaneous abortion (SAb). Prior research suggested that heavy drinking during pregnancy was associated with significantly increased rates of SAb, but results for lower levels of drinking have been inconsistent. We examined the association between different levels and patterns of prenatal alcohol consumption and SAb in a high-risk inner-city sample. We hypothesized that higher levels, binge patterns, and more frequent drinking would be associated with increased rates of SAb. The quantity and frequency of self-reported peri-conceptional and repeated in-pregnancy maternal drinking volumes per beverage type were assessed with semi-structured interviews in a prospective subsample of 302 African-American mothers. Relations between various measures of prenatal alcohol exposure and SAb were assessed using logistic regression. After controlling for various potential confounders, there was a significant positive relation between average absolute alcohol use per day across pregnancy and SAb. Greater frequency of drinking episodes also predicted SAb: an average of even one day of drinking per week across pregnancy was associated with an increase in the incidence of SAb. However, contrary to our hypothesis, neither the amount of alcohol drunk per drinking day nor a measure of binge drinking was significantly related to SAb after controlling for confounders. Differences in when women who drank at risk levels initiated antenatal care may have under-estimated the impact of alcohol on SAb in this low-SES urban African-American sample. Some drinking measures averaged across pregnancy may have under-estimated consumption and overestimated risk of SAb, but other risk drinking measures that avoid this limitation show similar relations to SAb. Identifying fetal risk drinking in pregnant women is critical to increasing the effectiveness of interventions that reduce risk level alcohol consumption and protect from
Harlow Sioban D
Full Text Available Abstract Background Research on the potentially adverse effects of occupational pesticide exposure on risk of spontaneous abortion (SAB is limited, particularly among female agricultural workers residing in developing countries. Methods Reproductive histories were obtained from 217 Ecuadorian mothers participating in a study focusing on occupational pesticide exposure and children's neurobehavioral development. Only women with 2+ pregnancies were included in this study (n = 153. Gravidity, parity and frequency of SAB were compared between women with and without a history of working in the cut-flower industry in the previous 6 years. Logistic regression analysis was conducted to assess the relation between SAB and employment in the flower industry adjusting for maternal age. Results In comparison to women not working in the flower industry, women working in the flower industry were significantly younger (27 versus 32 years and of lower gravidity (3.3 versus 4.5 and reported more pregnancy losses. A 2.6 (95% CI: 1.03-6.7 fold increase in the odds of pregnancy loss among exposed women was observed after adjusting for age. Odds of reporting an SAB increased with duration of flower employment, increasing to 3.4 (95% CI: 1.3, 8.8 among women working 4 to 6 years in the flower industry compared to women who did not work in the flower industry. Conclusion This exploratory analysis suggests a potential adverse association between employment in the cut-flower industry and SAB. Study limitations include the absence of a temporal relation between exposure and SAB, no quantification of specific pesticides, and residual confounding such as physical stressors (i.e., standing. Considering that approximately half of the Ecuadorian flower laborers are women, our results emphasize the need for an evaluating the reproductive health effects of employment in the flower industry on reproductive health in this population.
Borges, Ana Luiza Vilela; OlaOlorun, Funmilola; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura; Tsui, Amy Ong
Although it is well known that post-abortion contraceptive use is high when family planning services are provided following spontaneous or induced abortions, this relationship remains unclear in Brazil and similar settings with restrictive abortion laws. Our study aims to assess whether contraceptive use is associated with access to family planning services in the six-month period post-abortion, in a setting where laws towards abortion are highly restrictive. This prospective cohort study recruited 147 women hospitalized for emergency treatment following spontaneous or induced abortion in Brazil. These women were then followed up for six months (761 observations). Women responded to monthly telephone interviews about contraceptive use and the utilization of family planning services (measured by the utilization of medical consultation and receipt of contraceptive counseling). Generalized Estimating Equations were used to analyze the effect of family planning services and other covariates on contraceptive use over the six-month period post-abortion. Women who reported utilization of both medical consultation and contraceptive counseling in the same month had higher odds of reporting contraceptive use during the six-month period post-abortion, when compared with those who did not use these family planning services [adjusted aOR = 1.93, 95 % Confidence Interval: 1.13-3.30]. Accessing either service alone did not contribute to contraceptive use. Age (25-34 vs. 15-24 years) was also statistically associated with contraceptive use. Pregnancy planning status, desire to have more children and education did not contribute to contraceptive use. In restrictive abortion settings, family planning services offered in the six-month post-abortion period contribute to contraceptive use, if not restricted to simple counseling. Medical consultation, in the absence of contraceptive counseling, makes no difference. Immediate initiation of a contraceptive that suits women's pregnancy
María del Rosario Rodríguez-Guillén; Luisa Torres-Sánchez; Jia Chen; Marcia Galván-Portillo; Julia Blanco-Muñoz; Miriam Aracely Anaya; Irma Silva-Zolezzi; María A Hernández-Valero; Lizbeth López-Carrillo
OBJECTIVE: To asses the association between intake of folate and B vitamins and the incidence of spontaneous abortion (SA) according to the maternal methylenetetrahydrofolate reductase (MTHFR) polymorphisms (677 C>T and 1298 A>C). MATERIAL AND METHODS: We conducted a nested case-control study within a perinatal cohort of women recruited in the state of Morelos, Mexico. Twenty-three women with SA were compared to 74 women whose pregnancy survived beyond week 20th. Intake of folate and B vitami...
Full Text Available Background : Rejection of semiallogenic foetus in recurrent spontaneous abortion (RSA has been postulated to be a consequence of genetic and immunological phenomena. Aim: To evaluate the role of human leukocyte antigen (HLA alleles in RSA in Indian couples. Settings and Design : A case-control study. Materials and Methods : Eighty-one randomly selected couples with unexplained three or more RSAs and a control group of 97 couples with live birth belonging to the same ethnic background, referred to the Gynaecology Department, KEM Hospital were included in the case-control study. Serological HLA A and B typing was done followed by molecular subtypes, defined using PCR-SSOP technique for HLA A, B, and C in 40 couples and DRB1FNx01 and DQB1FNx01 in 28 couples which were then compared with appropriate case 46 and 88 controls. Results : Serologically A3 (15.43% vs . 4.43%; odds ratio (OR = 4.34; P = 0.0002 and B17 (25.3% vs . 11.34%; OR = 3.49; P = 0.0001 were increased. Haplotype A1-B17 was significantly increased. Molecular subtyping revealed that AFNx01030102 (11.25% vs . 4.34%; OR = 3.00; P = 0.07, BFNx015701 (11.25% vs . 1.08%; OR = 13.10; P = 0.003, CwFNx01120201 (25% vs . 4.34%; OR = 10.50; P = 2.05E-05, HLA DRB1FNx01030101 (17.85% vs . 3.40%; OR = 7.6; P = 0.0001, DRB1FNx01150101 (32.14% vs . 13.63%; OR = 4.8; P = 0.0003, and DQB1FNx01060101 (35.71% vs . 29.34%; OR = 2.3; P = 0.004 were significantly increased in patients. A differential association was noticed when compared with reported world RSA patients. Conclusion: The HLA alleles AFNx01030101, BFNx015701, CwFNx01120201, DRB1FNx01030101, and DRB1FNx01150101 as well as their associated ancestral haplotype may play a significant role in development of RSA in India.
Yang, Xuezhou; Quan, Xiaozhen; Lan, Yanli; Wei, Qipeng; Ye, Jinhai; Yin, Xiaofang; Ji, Zhisong; Xing, Hui; Yang, Ying
Insulin resistance (IR) was recognized as a risk factor for the occurrence of abortion in patients with polycystic ovary syndrome (PCOS). Chemerin was an adipokine which could induce IR and associated with reproductive process closely. However, few studies have inquired the relativity between chemerin and the occurrence of abortion in patients with PCOS. The aim of this study was to evaluate the relationship between serum chemerin and the occurrence of abortion in women with PCOS. We recruited 198 women with PCOS to participate in our study. On the third day of menstrual cycle or a random day in women with amenorrhea, we obtained their venous blood and measured the fasting insulin, fasting plasma glucose, total cholesterol, high density lipoprotein cholesterol, triglyceride, chemerin, and hormones including FSH, E2, P, PRL, LH, and T. Additionally, BMI, HOMA-IR and LH/FSH of each subject were calculated. Finally, 58 of them were included in the study, in which 30 of them had normal pregnancy and the other 28 had an early miscarriage. We compared the biochemical characteristics between the normal pregnancy group and abortion group by independent-samples t test. In our study, those with a normal pregnancy had a lower level of BMI, FINs, HOMA-IR, and chemerin compared to abortion patients (p PCOS patients (p PCOS. Thus, serum chemerin may serve as a biomarker to identify pregnant women with PCOS who are at particular risk for later abortion, and who may benefit from prevention strategies.
Zhou, Ya; Bian, Guohui; Zhou, Qiongxiu; Gao, Zhan; Liao, Pu; Liu, Yu; He, Miao
The relationship between viral infections and first-trimester spontaneous abortions is not well-understood. The study aim was to investigate the prevalence of cytomegalovirus (CMV), human parvovirus B19 (B19V), and herpes simplex virus-1/2 (HSV-1/2) infection by molecular and serological techniques in women experiencing spontaneous miscarriage in the first trimester of pregnancy. Plasma samples were examined for CMV, B19V, and HSV-1/2 DNA using real-time quantitative polymerase chain reaction (Real-time qPCR), and for specific IgG antibodies against B19V, CMV, and HSV-1/2 using serological assays. The abortion group consisted of women (n = 1,716) with a history of two or more first-trimester spontaneous abortions. Women younger than 30 years possess higher portion to experience spontaneous abortion. No specimens were positive for B19V or CMV DNA. Seven out of the 1,716 specimens were positive for HSV-1/2 DNA. By serology, 47.24% of patients were positive for B19V IgG, 39.66% for HSV IgG, 79.31% for CMV IgG, and 9.31% for B19V IgM. The high rate of positivity for CMV IgG suggests that the majority of women with first-trimester spontaneous abortions are not susceptible to primary CMV infection. The lack of virus DNA in the majority of cases indicates that B19V, CMV, and HSV-1/2 infection is not commonly associated with first-trimester spontaneous abortion. © 2015 Wiley Periodicals, Inc.
Lee, Bokim; Jung, Hye-Sun
The researchers conducted a cross-sectional survey to determine the relationship between handling heavy items during pregnancy and spontaneous abortion among working women in South Korea. One thousand working women were selected from a database of those eligible for maternity benefits under the National Employment Insurance Plan. Study results showed that handling heavy items during pregnancy was associated with an increased risk of spontaneous abortion after adjusting for general characteristics of the participants and their work environment. A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant. Copyright 2012, SLACK Incorporated.
Peng, Fanli; Ji, Wenliang; Zhu, Feng; Peng, Danhong; Yang, Miao; Liu, Ran; Pu, Yuepu; Yin, Lihong
Humans are widely exposed to phthalates, bisphenol A and nonylphenol owing to the ubiquitous use of these chemicals in consumer products. Increasing attention has been paid to exposure to phthalates, bisphenol A and nonylphenol because of their potential adverse effects on human fertility. A validated method was developed to investigate the three classes of environmental estrogen, mentioned above, in the urine of Chinese women of Nanjing area with unexplained recurrent spontaneous abortion. Solid-phase extraction coupled with ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) was used. In this method, amounts of bisphenol A (BPA), nonylphenol (NP) and four phthalate metabolites, mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP) and mono-2-ethylhexyl phthalate (MEHP), along with their isotope labeled internal standards, were measured using UPLC-MS/MS operated in negative electrospray ionization multiple reaction monitoring mode. The limits of detection were 0.3 ng/mL for the four phthalate metabolites, and 0.5 ng/mL for bisphenol A and nonylphenol. For women with unexplained recurrent spontaneous abortion, the mean concentrations of MBP, MiBP, MBzP, MEHP, BPA and 4-n-NP were 6.52±6.04, 5.51±4.19, 0.53±0.42, 10.12±4.16, 7.13±7.42, 0.41±0.49 ng/mL (mean±SD), respectively. For the control group, the mean concentrations of the corresponding analytes were 4.15±3.57, 2.96±3.30, 0.46±0.49, 6.50±2.81, 4.43±2.23,0.48±0.43 ng/mL (mean±SD), respectively. Levels of MiBP and MEHP were significantly different between the two groups, using Wilcoxon rank sum tests. This method can be applied in epidemiological studies to explore the association between exposure to environmental estrogens and relevant adverse outcomes. - Highlights: • Studied on the exposure level of six analytes in Chinese women with unexplained recurrent spontaneous abortion. • Differences in MEHP and MiBP urine levels were
Peng, Fanli [Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009 (China); Ji, Wenliang; Zhu, Feng [Jiangsu Center for Disease Control and Prevention, Nanjing 210009 (China); Peng, Danhong [Department of Obstetrics and Gynecology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing 210009 (China); Yang, Miao; Liu, Ran; Pu, Yuepu [Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009 (China); Yin, Lihong, E-mail: email@example.com [Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009 (China)
Humans are widely exposed to phthalates, bisphenol A and nonylphenol owing to the ubiquitous use of these chemicals in consumer products. Increasing attention has been paid to exposure to phthalates, bisphenol A and nonylphenol because of their potential adverse effects on human fertility. A validated method was developed to investigate the three classes of environmental estrogen, mentioned above, in the urine of Chinese women of Nanjing area with unexplained recurrent spontaneous abortion. Solid-phase extraction coupled with ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) was used. In this method, amounts of bisphenol A (BPA), nonylphenol (NP) and four phthalate metabolites, mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP) and mono-2-ethylhexyl phthalate (MEHP), along with their isotope labeled internal standards, were measured using UPLC-MS/MS operated in negative electrospray ionization multiple reaction monitoring mode. The limits of detection were 0.3 ng/mL for the four phthalate metabolites, and 0.5 ng/mL for bisphenol A and nonylphenol. For women with unexplained recurrent spontaneous abortion, the mean concentrations of MBP, MiBP, MBzP, MEHP, BPA and 4-n-NP were 6.52±6.04, 5.51±4.19, 0.53±0.42, 10.12±4.16, 7.13±7.42, 0.41±0.49 ng/mL (mean±SD), respectively. For the control group, the mean concentrations of the corresponding analytes were 4.15±3.57, 2.96±3.30, 0.46±0.49, 6.50±2.81, 4.43±2.23,0.48±0.43 ng/mL (mean±SD), respectively. Levels of MiBP and MEHP were significantly different between the two groups, using Wilcoxon rank sum tests. This method can be applied in epidemiological studies to explore the association between exposure to environmental estrogens and relevant adverse outcomes. - Highlights: • Studied on the exposure level of six analytes in Chinese women with unexplained recurrent spontaneous abortion. • Differences in MEHP and MiBP urine levels were
Results: Out of 51 subjects, 18 had positive Anti-TPO-Ab, of which -10 were among the cases and 8 belonged to the controls. Out of 18 women with positive AntiTG-Ab, 11 cases were in the control group and 7 were in the cases. The differences between the control group and the amounts of Anti-TPO-Abs (P=0.468 and Anti-TG-Abs (P=0.675 were not swignificant. Conclusion: The results revealed that there is no association between abortion and presence of antithyroid antibodies in mother’s serum. Other abortion causes such as various kinds of infections and smoking might be involved which requires more research.
Hemminki, K; Kyyroenen, P L; Lindbohm, M L
Nurses working in selected departments of general hospitals in Finland were collected from a central register on health personnel in Finland. Using the Hospital Discharge Register and the Register of Congenital Malformations, case nurses were selected who had had a spontaneous abortion (N = 217) or a malformed child (N = 46) between the years 1973 and 1979. Controls consisted of three nurses who had had a normal birth; the control nurses were matched for age and hospital of employment. Information on exposure in the first trimester of pregnancy was sought through the head nurses of the hospitals. No significant increase in risk of spontaneous abortion or of malformation was observed after exposure to anaesthetic gases (odds ratio for spontaneous abortion 1.2), sterilizing gases and soaps, or x-rays. Handling of cytostatic drugs did not affect the frequency of spontaneous abortion but was associated with malformations in the offspring. The odds ratio, based on eight cases, was 4.7 (p = 0.02) when the logistic model was adopted. The results suggest that the exposures investigated, other than cytostatic drugs, do not cause a strong reproductive risk. Further studies are needed, particularly on cytostatic drugs.
Abu-Gabal, Khadiga; Katta, Maha; Ibrahim, Raghda
Introduction Adenosine and deoxyadenosine metabolism is influenced by adenosine deaminase (ADA) enzyme. ADA increases in different diseases and is considered as one of the markers for cell-mediated immunity. Pregnancy is associated with depressed cell-mediated immunity. The level of ADA expression, which seems to play a key role in maintaining pregnancy, is influenced by adenosine deaminase G22A gene polymorphism. We aimed in our study to evaluate the association of ADA G22A gene polymorphism with recurrent spontaneous abortion (RSA) in Egyptian women. Material and methods Adenosine deaminase G22A gene polymorphism was genotyped in 40 patients (age range 22-39 years) with a history of RSA, selected from those attending the Gynaecology and Obstetrics Clinic of Beni-Suef University Hospital, and 20 age-matched healthy women as a control group, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results In our study, no statistically significant difference was found between RSA patients and control group as regards ADA G22A genotypes (p = 0.653) and alleles (p = 0.697). A comparison of the frequencies of ADA alleles in RSA patients as regards the below-35-years-old age group revealed that ADA 2(A) allele was associated with a low risk for RSA in patients aged 35 years old or younger (p = 0.008). Conclusions In conclusion, our study revealed an age-dependent protective value of ADA 2(A) allele in recurrent spontaneous abortions among the Egyptian population. PMID:29204093
Liu, Yudong; Zheng, Haiyan; Guo, Pingping; Feng, Shuxian; Zhou, Xingyu; Ye, Desheng; Chen, Xin; Chen, Shiling
The aim of this study was to explore the association of the DNA-methyltransferase (DNMT)-3A and DNMT3B promoter polymorphisms with the risk of human spontaneous abortion after assisted reproduction techniques (ARTs) and natural conception. We collected tissues from women who underwent abortion procedures: (a) chorionic villus samples (CVS) and muscle samples (MS) from spontaneous abortions conceived by ART and natural cycle (study group), n = 152; and (b) CVS and MS from normal early pregnancy and second trimester (control group), n = 155. The single-nucleotide polymorphism (SNP) -448A > G in the DNMT3A promoter region and -149C/T polymorphism of DNMT3B were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and confirmed by sequencing. The allele frequency of -448A among pregnancy loss group and control group was 34.2 % vs. 16.5 %, respectively. Compared with GG carriers, the DNMT3A -448AA homozygotes had an about 16-fold increased risk of spontaneous abortion [odds ratio (OR) = 16.130, 95 % confidence interval (CI), 3.665-70.984], and AG heterozygotes had an OR of 2.027 (95 % CI, 1.247-3.293). However, the distribution of -448A > G in individuals derived from ART pregnancies was not statistically significantly compared with those derived from spontaneous pregnancies (P = 0.661). For DNMT3B, we observed genotype frequencies of 100 % (TT) in the study group and the control group. The DNMT3A -448A > G polymorphism may be a novel functional SNP and contribute to its genetic susceptibility to spontaneous abortion in Chinese women, and ART may not affect the distribution of -448A > G in pregnancy loss and normal pregnancy. The observed TT genotype of DMNT3B suggests that this is the predominant genotype of this population. The findings provide new insights into the etiology of human spontaneous abortion.
Hashemi, Mohammad; Mokhtari, Mojgan; Yazdani-Shahrbabaki, Vajiheh; Danesh, Hiva; Bizhani, Fatemeh; Taheri, Mohsen
It has been proposed that transcobalamin 2 (TCN2) and the transcobalamin 2 receptor (TCN2R) are associated with idiopathic recurrent spontaneous abortion (RSA). The aim of the present study was to investigate the impact of TCN2 rs1801198 and TCN2R rs2336573 polymorphism on RSA in a sample of Iranian population. This case-control study was done on 92 RSA patients and 93 normal, fertile women. Genotyping of the TCN2 rs1801198 and TCN2R rs2336573 variants was done by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). The findings showed no significant association between the TCN2 rs1801198 and TCN2R rs2336573 polymorphisms and the risk/protection of RSA. Our results did not support an association between the TCN2 polymorphism and the risk of RSA in a sample of southeast Iranian population. Larger studies with different ethnicities are needed to evaluate the possible impact of TCN2 and TCN2R polymorphisms on the pathogenesis of RSA. Impact statement What is already known on this subject? Recurrent spontaneous abortion (RSA), a multifactorial condition, is one of the most common complications of pregnancy. It has been proposed that genetic polymorphisms play a role in the pathogenesis of RSA. Few studies have examined the association between TNC2 and TCN2R polymorphisms and the RSA risk and the findings were inconsistent. The aim of the current study was to determine the possible association between the TCN2 rs1801198 and TCN2R rs2336573 polymorphisms and the RSA in a sample of the southeast Iranian population. What do the results of the study add? The findings of the present case-control study did not support an association between the TCN2 rs1801198 and TCN2R rs2336573 polymorphisms and the risk of RSA in a sample of the Iranian population. What are the implications of these findings for clinical practice and future research? The findings of this study may provide a basis for future studies with larger sample sizes and different ethnicities
Full Text Available Esta reseña recapitula diversas circunstancias relativas al descubrimiento en 1958-1959 de la trisomía 21 propia del síndrome de Down y a la participación de los tres autores protagonistas. En particular, se subraya que fue Marthe Gautier quien en realidad hizo los cultivos celulares, analizó las metafases y se percató que los pacientes con síndrome de Down tenían 47 cromosomas. En consecuencia, es claro que su crucial contribución no había recibido, hasta la actualidad, el crédito apropiado.
Hong-Ying Du; Man-Zhen Zuo; Qiao-Ling Wang; Xiao-Juan Xie
Objective:To study miR-155 expression in villus tissue of patients with recurrent spontaneous abortion and its relationship with apoptosis molecules and angiogenesis molecules.Methods:40 cases of patients with unexplained recurrent spontaneous abortion were selected as URSA group, 30 cases of normal early pregnant women receiving artificial abortion were selected as control group, and villus tissue was collected to detect expression levels of miR-155, apoptosis molecules (Bcl-2, Bcl-xl, Bax, Bad, Fas and FasL) and angiogenesis molecules (HIF-1α, VEGF and sFlt-1).Results: MiR-155 expression level in villus tissue of URSA group was significantly lower than that of control group and the more the times of abortion, the lower the miR-155 expression level; pro-apoptosis molecules Bax, Bad, Fas and FasL expression levels in villus tissue of URSA group were higher than those of control group and negatively correlated with miR-155 expression level, and anti-apoptosis genes Bcl-2 and Bcl-xl expression levels were lower than those of control group and positively correlated with miR-155 expression level; HIF-1α and VEGF expression levels in villus tissue of URSA group were lower than those of control group and positively correlated with miR-155 expression level, and sFlt-1 expression level was higher than that of control group and negatively correlated with miR-155 expression level.Conclusions:MiR-155 is lowly expressed in villus tissue of patients with recurrent spontaneous abortion, and miR-155 may be involved in the occurrence and development of the disease through regulating the expression of apoptosis molecules and angiogenesis molecules.
Estudio citogenético y morfológico en productos de aborto espontáneo procedentes de diferentes servicios de ginecoobstetricia de la ciudad de Medellín Cytogenetic and morphologic study of spontaneous abortions products in Medellín, Colombia
Gonzálo Vásquez Palacio
Full Text Available En el período comprendido entre septiembre 1° de 1996 y octubre 1° de 1997, se recolectó para estudios morfológico y citogenético un total de 84 productos de aborto espontáneo del 1° y 2° trimestres de la gestación, en diferentes servicios de ginecoobstetricia de la ciudad de Medellín. Dieciséis de los 84 se descartaron por contaminación o ausencia de tejidos apropiados para el estudio. De los 68 productos restantes en 60 (88,2% se establecieron cultivos para estudio citogenético, los cuales fueron exitosos en 34 casos (56, 7%. Diecisiete de los anteriores (50% mostraron un cariotipo anormal con las siguientes alteraciones cromosómicas: monosomía X, 10 (58,8%, mosaicismos 5 (29,4%, trisomías 1 (5,9% y tetraploidía 1 (5,9%. En 21 de los 68 productos (30,9% (3 embriones y 18 fetos fue posible el estudio morfológico. Doce de éstos, (2 embriones y 10 fetos; 57, 1 % mostraron alteraciones morfológicas externas o internas. El presente estudio citogenético y morfológico en productos de aborto espontáneo con edad gestacional menor de 20 semanas es el primero que se informa en nuestro medio y sus resultados son similares a los obtenidos en otros reportes que aparecen en la literatura. Eighty tour spontaneous abortion products, with gestational age under 20 weeks, were collected in ditterent obstetric and gynecologic services trom Medellin-Colombia between September 1996 and October 1997; they were studied both morphologically and cytogenetically. Sixteen of those products were discarded because of contamination or absence of suitable tissues for the study In 60 of the remaining 68 products (88°/~ cultures for cytogenetic studies were establishedJ and they were succesful in 34 cases (56J7%. Seventeen of. these (50% showed an abnormal karyotype with the following chromosomal anomalies: X monosomies 10 (58J8%, mosaicisms 5 (29,4%J trisomies 1 (5,9%, and tetráploidy 1 (5J9%. From the 68 products, a morphologic study was performed in
Lo Presti, Damiano; Scala, Roberta Licia; Tiralongo, Grazia Maria; Pisani, Ilaria; Gagliardi, Giulia; Novelli, Gian Paolo; Vasapollo, Barbara; Valensise, Herbert
From early pregnancy, maternal hemodynamic profile begins to change. The absence of these changes leads to increased risk of complication during the gestation. Aim of this study is to understand in early pregnancy the behaviour of total vascular resistances (TVR) as a sign of maternal cardiovascular adaptation to pregnancy. A cross section study was conducted. We followed 160 healthy women with singleton pregnancy during the first trimester of gestation. We evaluated cardiac output (CO) and TVR at 7, 9 and 11 weeks of gestation. We obtained the following haemodynamic measurements with the USCOM system, a non invasive method: heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), CO and TVR. 160 healthy pregnant women were selected, 8 patients, were excluded for a bad signal. Absolute values of the haemodynamic measures are shown in Fig. 1. 41 patients underwent spontaneous embryonic demise. This last group of patients showed in 54% (group A) TVR values within the normal limits (TVR1200) and CO values below the normal adaptation to pregnancy. Table 1 shows hemodynamic measures for the group A and group B; we found differences in term of CO, TVR and PAS between the two groups. Elevated TVR might indicate an abnormal vascular adaptation already in first weeks of pregnancy. Moreover, in women who undergo to abortion, elevated TVR could be use to distinguish genetic or environmental causes of miscarriage. Copyright © 2013. Published by Elsevier B.V.
Li, Yin-Guang; You, Ze-Shan; Wu, Zai-Gui; Li, Zhu-Yu; Li, Jie; Zhang, Xiu-Ming; Fang, Li-Yuan; Jiang, Li
To investigate the association between the polymorphisms of signal transducer and activator of transcription 4 (STAT4) gene and the susceptibility to unexplained recurrent spontaneous abortion(URSA). PCR-restriction fragment length polymorphism (PCR-RFLP) was used to detect genotype 3 loca (rs7574865 G/T, rs10181656 C/G and rs16833431 C/T) polymorphism of STAT4 in 246 URSA cases (URSA group) and 183 normal controls (control group) . (1)The frequencies of rs7574865 were genotype G/G of 36.2% (89/246) in URSA group and 46.4% (85/183) in control group, genotype G/T of 47.2% (116/246) in URSA group and 45.4% (83/183) in control group, and genotype T/T of 16.7% (41/246) in URSA group and 8.2% (15/183) in control group, which reached statistical difference (P rs7574865 T allele and rs10181656 G allele increased the risk of URSA (OR = 1.51, 1.44, all P rs7574865 G/T and rs10181656 C/G showed haplotype G-T conferring the susceptibility to URSA (OR = 1.49, P < 0.01), but haplotype C-G could provide protection on URSA (OR = 0.68, P < 0.01). Polymorphisms of STAT4 gene might confer the susceptibility to URSA by altering STAT4 function and (or) its expression.
Abdollahi, Elham; Tavasolian, Fataneh; Ghasemi, Nasrin; Mirghanizadeh, Seyed Ali; Azizi, Mohammdareza; Ghoryani, Mohsen; Samadi, Morteza
Recurrent spontaneous abortion (RSA) is defined as three or more consecutive spontaneous abortions before the 20th week of gestation. The purpose of the present study was to investigate the association between a functional single nucleotide polymorphism (SNP) in the interleukin (IL)-23 receptor gene (IL-23R; rs11209026, 1142 G wild type → A reduced function, Arg381Gln, R381Q) and RSA. For the study, 200 RSA patients (confirmed using established diagnostic criteria) and 200 normal individuals in fertility and infertility centers in the cities of Yazd and Isfahan were recruited during a period from 2012-2013. Using PCR-RFLP, the R381Q variant was screened for in the IL-23R gene of the patients and controls. The results indicated there were significant differences in the frequency of this genetic variant in the patients versus the healthy controls, i.e. 2% and 7.5%, respectively (p value = 0.01; odds ratio = 0.25; CI = 95%). No significant difference was found for the G allelic frequency in patients with RSA and in the control group (p = 0.60). The A allelic frequency was significantly different between the two groups (p = 0.01). Based on these findings, it is concluded that the frequency of single nucleotide polymorphism in the IL-23 receptor (R381Q) in patients with recurrent spontaneous abortion (RSA) is less than that found in normal control women.
On, Stephen L.W.; Jensen, Tim Kåre; Bille-Hansen, Vivi
A study was conducted to determine the prevalence and possible significance of campylobacteria in pig abortions in Denmark, Surface-cauterised liver and kidney samples from 55 aborted pig fetuses submitted to the Danish Veterinary Laboratory were taken and a sensitive isolation procedure used...
María del Rosario Rodríguez-Guillén
Full Text Available OBJECTIVE: To asses the association between intake of folate and B vitamins and the incidence of spontaneous abortion (SA according to the maternal methylenetetrahydrofolate reductase (MTHFR polymorphisms (677 C>T and 1298 A>C. MATERIAL AND METHODS: We conducted a nested case-control study within a perinatal cohort of women recruited in the state of Morelos, Mexico. Twenty-three women with SA were compared to 74 women whose pregnancy survived beyond week 20th. Intake of folate and B vitamins respectively, was estimated using a validated food frequency questionnaire. Maternal MTHFR polymorphisms were determined by PCR-RFLP and serum homocysteine levels by HPLC. RESULTS: Carriers of MTHFR 677TT and 1298AC genotypes respectively showed an increased risk of SA (OR 677TT vs. CC/CT=5.0; 95% CI: 1.2, 20.9 and OR 1298 AC vs. AA=5.5; 95% CI: 1.1, 26.6. CONCLUSIONS: Our results support the role of MTHFR polymorphisms as a risk factor for SA, regardless of dietary intake of B vitamins.OBJETIVO: Evaluar la asociación entre aborto espontáneo (AE y el consumo dietético de vitaminas B en mujeres mexicanas portadoras de los polimorfismos de la metilentetrahidrofolato reductasa (MTHFR (677 C>T y 1298 A>C. MATERIAL Y MÉTODOS: Mediante un diseño de casos y controles anidados en una cohorte, se comparó la ingesta dietética materna de vitaminas B y folato, los polimorfismos maternos de la MTHFR y la concentración sérica de homocisteina de 23 casos de AE ( 20 semanas. RESULTADOS: Las portadoras de los genotipos MTHFR 677TT y 1298AC presentaron un incremento significativo en el riesgo de AE (RM 677TT vs. CC/CT=5.0; IC 95%: 1.2, 20.9 RM 1298 AC vs. AA=5.5; IC95%: 1.1, 26.6, respectivamente. CONCLUSIONES: Nuestros resultados apoyan el papel de la mutación de la MTHFR como posible factor de riesgo para el AE, independientemente del consumo de vitaminas B.
Full Text Available Background: Disorders in immune system regulation may result in pregnancy abnormalities such as recurrent spontaneous abortion (RSA. This study aims to determine the ratio of regulatory T (Treg and T helper (Th 17 cells in unexplained RSA (URSA women during proliferative and secretory phases of their menstrual cycles compared to healthy non-pregnant women. Materials and Methods: In this case control study, 25 women with URSA and 35 healthy, non-pregnant women were enrolled. The percentage of Th17 and Treg cells in participants peripheral blood were determined by flow cytometry. Results: The percentage of Th17 cells and their related cytokines in serum (IL-17A were higher in the proliferative and secretory phases of the menstrual cycles of URSA women compared to the control women. However, a lower percentage of Treg cells and their related cytokines in serum, transforming growth factor (TGF β1 and interleukin (IL-10 were detected in the proliferative but not the secretory phase of the URSA group. The ratio of Th17/CD4+ Treg was higher in the URSA group than the control group. We observed an increased ratio of Th17/CD4+ Treg during the proliferative and secretory phases in URSA women. Conclusion: The imbalance between Th17 and Treg cells during the proliferative phase of menstrual cycles in the URSA group may be considered a cause for spontaneous abortion.
Wang, Long; Yang, Ying; Liu, Fangchao; Yang, Aimin; Xu, Qin; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Yan, Donghai; Peng, Zuoqi; He, Yuan; Wang, Yuanyuan; Xu, Jihong; Zhao, Jun; Zhang, Hongguang; Zhang, Ya; Dai, Qiaoyun; Ma, Xu
To comprehensively evaluate the association of paternal smoking and spontaneous abortion. We conducted a population-based retrospective cohort study among 5 770 691 non-smoking rural Chinese women, along with their husbands, participating in the National Free Pre-Pregnancy Checkups Project, regarding outcome events that occurred in 2010-2016. The main outcome was spontaneous abortion (SA). Multivariable logistic regression was used to estimate OR and 95% CI, and restricted cubic spline was used to estimate the non-linear relationship. The multivariable-adjusted OR of exposure to paternal smoking for SA was 1.17 (95% CI 1.16 to 1.19), compared with women without exposure to paternal smoking; and corresponding OR of exposure to preconception paternal smoking for SA was 1.11 (95% CI 1.08 to 1.14), compared with women without exposure to preconception paternal smoking. The ORs of preconception paternal smoking also increased with increases in paternal smoking (p nonlinear 0.05). In addition, periconception paternal smoking cessation was associated with an 18% (15%-22%) lower risk of SA. Paternal smoking was associated with SA. The importance of tobacco control, specifically pertaining to paternal smoking, should be emphasised during preconception and pregnancy counselling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Hashemi, Mohammad; Danesh, Hiva; Bizhani, Fatemeh; Mokhtari, Mojgan; Bahari, Gholamreza; Tabasi, Farhad; Taheri, Mohsen
Recurrent spontaneous abortion (RSA) is a common health problem affecting women of reproductive age. Altered expression of vascular endothelial growth factor ( VEGF ) has been associated with spontaneous abortion. The present case-control study aimed to evaluate the impact of the 18-bp insertion/deletion (ins/del) polymorphism (rs35569394) in the promoter region of the VEGF gene on idiopathic RSA. Genomic DNA from 93 patients with RSA and 93 healthy fertile women of southeastern Iran was isolated using the salting-out method. Genotyping of the rs35569394 variant was performed by a polymerase chain reaction (PCR) method. The findings indicated that the VEGF 18-bp ins/del variant significantly increased the risk of RSA under codominant (ins/ins vs. del/del; OR=2.85, 95% CI=1.31-6.22, P=0.019), dominant (del/ins+ins/ins vs. del/del; OR=2.19, 95% CI=1.20-4.01, P=0.015) and allelic (ins vs. del; OR=1.90, 95% CI=1.25-2.88, P=0.003) inheritance models. In summary, the findings propose a significant association between the VEGF 18-bp ins/del polymorphism and risk of RSA in a sample of the southeast Iranian population. Further studies on larger sample sizes and different ethnicities are required to validate the present findings.
Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...
... Education & Events Advocacy For Patients About ACOG Induced Abortion Home For Patients Search FAQs Induced Abortion Page ... Induced Abortion FAQ043, May 2015 PDF Format Induced Abortion Special Procedures What is an induced abortion? What ...
Full Text Available Abstract Selective serotonin reuptake inhibitors (SSRIs are the most frequently used antidepressants during pregnancy. There are conflicting results about their influence on pregnancy outcomes. The goal of this study was to update our previous meta-analysis about pregnancy outcomes following exposure to SSRIs. For this purpose, all relevant databases were searched from 1990 to March 2012 for studies investigating the pregnancy outcomes following exposure to any therapeutic dosage of any SSRI (fluoxetine, paroxetine, citalopram, escitalopram, sertraline, fluvoxamine during pregnancy. Types of outcome investigated were spontaneous abortion, major malformations, cardiovascular malformations, and minor malformations. A total of 25 studies met our criteria and were included in the meta-analysis. The odds ratio (OD values are 1.87 (95% CI: 1.5 to 2.33, P
Yuan, Jing; Li, Jian; Huang, Shi-Yun; Sun, Xin
The objective was to investigate the subsets of natural killer T (NKT)-like cells and the expression of Th1/Th2 cytokines in the peripheral blood (PB) and/or decidual tissue of patients with unexplained recurrent spontaneous abortion (URSA). The percentages of NKT-like cells in the PB and deciduas of URSA patients in early pregnancy and in the PB of nonpregnant women were analyzed by flow cytometry. The expression of interferon (IFN)-γ (Th1 cytokine) and Th2 cytokines, interleukin (IL)-4 and IL-10, in the PB and decidual tissue was measured by quantitative RT-PCR and enzyme-linked immunosorbent assay (ELISA). Most percentages of subsets of NKT-like cells (CD3(+)CD56(+), CD3(+)CD56(+)CD16(+)) in the PB and deciduas were significantly greater in URSA patients than in normal pregnant and nonpregnant women. A cut-off value of 3.75% for the increased percentage of CD3(+)CD56(+)CD16(+) NKT-like cells in the PB appeared to be predictive of pregnancy failure. Moreover, we found that in the decidua, IFN-γ expression was significantly higher, while IL-4 and IL-10 expression was significantly lower in URSA patients compared with those with a normal pregnancy. The ratio of decidual Th1/Th2 cytokines in URSA patients was significantly increased compared with that in normal pregnant women. Decidual IL-4 expression correlated negatively with the percentages of blood CD3(+)CD56(+)CD16(+) NKT-like cells and the decidual CD3(+)CD56(+) and CD3(+)CD56(+)CD16(+) NKT-like cells. NKT-like cells may play an important role in maintaining normal pregnancy. Measurement of CD3(+)CD56(+)CD16(+) NKT-like cells in the PB may provide a potential tool for assessing patients' risk of spontaneous abortion. Copyright © 2015. Published by Elsevier Ireland Ltd.
Full Text Available Selective serotonin reuptake inhibitors (SSRIs are the most frequently used antidepressants during pregnancy. There are conflicting results about their influence on pregnancy outcomes.The goal of this study was to update our previous meta-analysis about pregnancy outcomes following exposure to SSRIs. For this purpose, all relevant databases were searched from 1990 to March 2012 for studies investigating the pregnancy outcomes following exposure to any therapeutic dosage of any SSRI (fluoxetine, paroxetine, citalopram, escitalopram, sertraline, fluvoxamine during pregnancy. Types of outcome investigated were spontaneousabortion, major malformations, cardiovascular malformations, and minor malformations. A total of 25 studies met our criteria and were included in the meta-analysis. The odds ratio (OD values are 1.87 (95% CI: 1.5 to 2.33, P< 0.0001 for spontaneous abortion, 1.272 (95%CI: 1.098 to 1.474, P = 0.0014 for major malformations, 1.192 (95% CI: 0.39 to 3.644, P=0.7578 for cardiovascular malformations, and 1.36 (95% CI: 0.61 to 3.04, P= 0.4498 for minor malformations. The results demonstrated that SSRIs increase the risk of spontaneousabortion and major malformations during pregnancy while they don’t increase the risk of cardiovascular malformations and minor malformations. Our previous meta-analysis only showed an increase in the risk of spontaneous abortion following the use of SSRIs duringpregnancy. This might be due to increase in the number of studies included or addition of two new SSRIs (citalopram and escitalopram. The message to researchers is to try considering SSRIs individually during pregnancy to reduce heterogeneity, although all are aware ofinevitable limitations to study on pregnant mothers.
Incidence and biomarkers of pregnancy, spontaneous abortion, and neonatal loss during an environmental stressor: Implications for female reproductive suppression in the cooperatively breeding meerkat.
Dimac-Stohl, Kristin A; Davies, Charli S; Grebe, Nicholas M; Stonehill, Alexandra C; Greene, Lydia K; Mitchell, Jessica; Clutton-Brock, Tim; Drea, Christine M
Meerkats are group-living, insectivorous herpestids in which subordinate members provide extensive care for the dominant female's young. In contrast to some cooperative breeders, subordinate female meerkats are physiologically able to reproduce and occasionally do so successfully; their attempts are more frequently 'suppressed' via eviction or infanticide by the dominant female. Spontaneous abortion and neonatal loss occur with some regularity, further negatively impacting reproductive success. Here, we compared the reproductive outcomes and endocrine profiles, including of serum progesterone (P 4 ), serum estradiol (E 2 ), and fecal glucocorticoid metabolites (fGCm), of dominant and subordinate dams residing within their clans in the Kalahari Desert of South Africa. Our study spanned years of drought, which reduced insect abundance and represented a substantial environmental stressor. Meerkat pregnancies were identified at mid-term and culminated either in spontaneous abortions or full-term deliveries, after which pups were either lost prior to emergence from the natal den (usually within 2days of birth) or emerged at 2-3weeks. Neonatal loss exceeded fetal loss for all females, and contributed to narrowing the status-related disparity in female reproductive output seen during less arid periods. Although E 2 concentrations were significantly lower in subordinate than dominant females, they were sufficient to support gestation. Absolute E 2 concentrations may owe to androgenic precursors that also attain highest concentrations in dominant dams and may mediate aggression underlying female reproductive skew. Pregnancies terminating in fetal loss were marked by significantly lower P 4 concentrations in mid-gestation and modestly lower E 2 concentrations overall. Consistently high fGCm concentrations further increased across trimesters, particularly (but not consistently) in subordinates and in aborted pregnancies. Environmental stressors may modulate reproductive
Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...
Nielsen, Gunnar Gissel; Scandalios, John G.
An association was found earlier between the Ep1 gene locus coding for an endopeptidase and the endosperm color gene Y1 on chromosome 6 of Zea mays. By employing primary trisomics we have unequivocally placed the Ep1 gene on chromosome 6, closely linked to the Y1 locus. Additionally we describe new...
Daniel Lorber Rolnik
Full Text Available OBJETIVO: Descrever as anormalidades cromossômicas em material de abortamento espontâneo. MÉTODOS: Realizou-se compilação retrospectiva da análise de cariótipo em lâmina corada com Banda G por microscopia óptica e em material de 428 produtos de abortamento encaminhados para estudo. RESULTADOS: Foram observados 145 resultados normais (33,9% e 237 resultados anormais (55,4%. Em 46 amostras não houve crescimento celular (10,7%. As anormalidades numéricas foram as mais frequentes, destacando-se a trissomia do 16 (41 casos, a triplodia (27 casos, a monossomia do X (26 casos, a tetraploidia (13 casos e a trissomia do 15 (13 casos. CONCLUSÃO: As alterações citogenéticas representam importante causa de perdas gestacionais e sua detecção auxilia o aconselhamento genético do casal. A trissomia do cromossomo 16 é a alteração mais frequentemente encontrada.OBJECTIVE: To describe chromosomal abnormalities in spontaneous abortion material. METHODS: A retrospective compilation of karyotype analysis of slides stained with Band G was carried out by optical microscopy with materials of 428 abortion products referred for study. RESULTS: There were 145 normal results (33.9% and 237 abnormal results (55.4%. In 46 samples there was no cell growth (10.7%. Numerical abnormalities were the most frequent, especially trisomy 16 (41 cases, triplodia (27 cases, monosomy X (26 cases, tetraploidy (13 cases and trisomy 15 (13 cases. CONCLUSION: Cytogenetic alterations are an important cause of pregnancy loss and their detection helps the genetic counseling to the couple. Trisomy 16 is the most often found change.
Active suppression of host-vs-graft reaction in pregnant mice. VII. Spontaneous abortion of allogeneic CBA/J x DBA/2 fetuses in the uterus of CBA/J mice correlates with deficient non-T suppressor cell activity
Clark, D.A.; Chaput, A.; Tutton, D.
The mammalian fetus has been viewed as an unusually successful type of allograft and unexplained spontaneous abortion as a possible example of maternal rejection. Previous studies have shown the presence of small lymphocytic suppressor cells in the murine decidua which block the generation and reactivation of anti-paternal cytotoxic T lymphocytes (CTL) and lymphokine-activated killer cells (LAK) by elaborating a factor that inhibits the response to interleukin 2 (IL 2). A deficiency of these suppressor cells was associated with implants of xenogeneic Mus caroli embryos in the Mus musculus uterus which are infiltrated by maternal lymphoid cells and aborted. A deficiency of such suppressor cells in the lymph nodes draining the uterus of CBA/J females in the process of aborting their semi-allogeneic CBA x DBA/2 F 1 progeny has also been shown. CBA/J females possess significantly lower levels of decidua-associated non-T suppressor cells on day 8.5 to 10.5 of allopregnancy than do mothers that will produce large litters of live babies. The F 1 embryos are infiltrated by maternal lymphocytes prior to abortion, and the infiltration and abortion rate appears to be augmented by pre-immunization with paternal DBA/2 spleen cells. The CBA/J x DBA/2J mating combination provides a model of spontaneous abortion in which immunologic factors play an important role and demonstrates that the association between deficiency of decidua-associated suppressor cells and xenopregnancy failure also holds true for the failure of allopregnancies resulting from natural within-species mating
Hosseini, Samira; Shokri, Fazel; Pour, Soheila Ansari; Khoshnoodi, Jalal; Jeddi-Tehrani, Mahmood; Zarnani, Amir-Hassan
Systemic monitoring of immune system may not precisely outline the local immune status in the uterus. This survey is a continuation of our previous studies on potential usefulness of menstrual blood (MB) immunophenotyping as a tool for investigation of immunological disturbances in pregnancy-related disorders. Peripheral blood (PB) and MB from healthy fertile (n = 15), unexplained recurrent spontaneous abortion (URSA; n = 15), and unexplained infertile women (n = 8) were collected simultaneously in the second day of their menstrual cycle and frequency of natural killer T (NKT)-like cell subpopulations were assessed by flow cytometry. Menstrual blood of all experimental groups contained higher percentage of TCRαβ + , CD45RO + , and CD16 - NKT-like cells compared to corresponding PB. Frequency of MB NKT-like cells in unexplained infertile participants was lower than fertile and URSA groups. Compared to normal participants, patients with URSA had lower frequency of PB TCRαβ + and higher CD16 + , while in infertile woman frequencies of PB CD45RO + , CD45RO - , CD16 - , IL17 + , and MB CD45RO + NKT-like cells were lower. Although, PB and MB seemingly have the same histological nature, our results showed that MB contained different composition of NKT-like subsets with different cytokine profiles and could be viewed as one potential biological sample for evaluation of patients with infertility and URSA.
Aruna, Meka; Dasgupta, Shilpi; Sirisha, Pisapati V. S.; Andal Bhaskar, Sadaranga; Tarakeswari, Surapaneni; Singh, Lalji; Reddy, B. Mohan
The aim of the present study was to investigate the role of CAG repeat polymorphism and X-chromosome Inactivation (XCI) pattern in Recurrent Spontaneous Abortions among Indian women which has not been hitherto explored. 117 RSA cases and 224 Controls were included in the study. Cases were recruited from two different hospitals - Lakshmi Fertility Clinic, Nellore and Fernandez Maternity Hospital, Hyderabad. Controls were roughly matched for age, ethnicity and socioeconomic status. The CAG repeats of the Androgen Receptor gene were genotyped using a PCR-based assay and were analysed using the GeneMapper software to determine the CAG repeat length. XCI analysis was also carried out to assess the inactivation percentages. RSA cases had a significantly greater frequency of allele sizes in the polymorphic range above 19 repeats (p = 0.006), which is the median value of the controls, and in the biallelic mean range above 21 repeats (p = 0.002). We found no evidence of abnormal incidence of skewed X-inactivation. We conclude that longer CAG repeat lengths are associated with increased odds for RSA with statistical power estimated to be ∼90%. PMID:21423805
Dong, Xiujuan; Yang, Long; Wang, Hui
The establishment and maintenance of successful pregnancy mainly depends on trophoblast cells. Their dysfunction has been implicated in recurrent spontaneous abortion (RSA), a major complication of pregnancy. However, the underlying mechanisms of trophoblasts dysfunction remain unclear. DNA-damage-induced cell apoptosis has been reported to play a vital role in cell death. In this study, we identified a novel microRNA (miR-520) in RSA progression via regulating trophoblast cell apoptosis. Microarray analysis showed that miR-520 was highly expressed in villus of RSA patients. By using flow cytometry analysis, we observed miR-520 expression was correlated with human trophoblast cell apoptosis in vitro, along with decreased poly (ADP-ribose) polymerase-1 (PARP1) expression. With the analysis of clinic samples, we observed that miR-520 level was negatively correlated with PARP1 level in RSA villus. In addition, overexpression of PARP1 restored the miR-520-induced trophoblast cell apoptosis in vitro. The status of chromosome in trophoblast implied that miR-520-promoted DNA-damage-induced cell apoptosis to regulate RSA progression. These results indicated that the level of miR-520 might associate with RSA by prompting trophoblast cell apoptosis via PARP1 dependent DNA-damage pathway.
Li, Jing; Li, Fan-fan; Zuo, Wei; Zhou, Yuan; Hao, Hai-yan; Dang, Jing; Jiang, Min; He, Meng-zhou; Deng, Dong-rui
The relationship between T cell immunoglobulin domain and mucin domain protein 3 (Tim-3)/Galectin (Gal)-9 pathway and recurrent spontaneous abortion (RSA) was studied. Thirty-one pregnant women with RSA and 27 normal early gravidas were investigated to detect the levels of Tim-3 and Gal-9 in villi and deciduas by Western blotting. Meanwhile, the concentration of interleukin (IL)-4 and IL-12 in peripheral blood plasma was determined by ELISA in 25 healthy fertile non-pregnant controls, the normal early gravidas and pregnant women with RSA mentioned above, respectively. It was found that the relative expression levels of Tim-3 and Gal-9 in villi and deciduas were significantly increased in pregnant women with RSA as compared with those in the normal early gravidas. The concentration of IL-4 in peripheral blood plasma of pregnant women with RSA was lower than that of the normal early gravidas (Ppregnant controls (Ppregnant women with RSA was significantly higher than that of the normal early gravidas (Ppregnant controls (P<0.05). It was suggested that the overexpression of Tim-3/Gal-9 pathway may be related to the pathogenesis of RSA.
Honorato, Talita; Hoek, Annemieke; Henningsen, Anna-Karina
A low number of antral follicles may result in the selection of suboptimal oocytes that are prone to meiotic errors. The aim of this case-control study was to evaluate women receiving IVF treatment with low oocyte yield (defined as three or fewer oocytes retrieved after ovarian stimulation) who...... are at an increased risk of a trisomic pregnancy. Data were obtained from Danish and Dutch medical registries between 1983 and 2011. Analyses were carried out in 105 cases and 442 controls matched by age and year of IVF treatment. Cases were women with a trisomic pregnancy (trisomies 13, 18 or 21) resulting from...... fresh IVF treatment and confirmed by karyotyping. Cases were included regardless of pregnancy outcome. Controls were women with a live born child without a trisomy, resulting from fresh IVF treatment. Low oocyte yield was observed in 6.6% (29/440) of the women, of which 8.4% (7/83) were cases and 6...
Full Text Available OBJETIVO: investigar se polimorfismos dos genes que codificam o receptor de progesterona (PROGINS estão relacionados à ocorrência de aborto espontâneo de repetição (AER. MÉTODOS: em estudo caso-controle, foram selecionados 85 pacientes com antecedente de pelo menos três abortos precoces sem etiologia definida (Grupo Caso e 157 mulheres com história de pelo menos duas gestações de termo sem intercorrências e sem passado de abortamento (Grupo Controle. Realizada coleta de 10 mL de sangue por punção venosa periférica e extração de DNA pela técnica DTAB/CTAB. As genotipagens foram feitas por reação em cadeia de polimerase (PCR, nas condições de ciclagem específica para o polimorfismo em estudo, seguida de amplificação em gel de agarose a 2%. A visualização das bandas foi feita sob luz ultravioleta e os géis foram fotografados. As diferenças genotípicas e alélicas entre os dois grupos para o polimorfismo PROGINS foram calculadas pelo teste de χ2, adotando-se como nível de significância valores de pPURPOSE: to assess a possible association between polymorphism of the progesterone receptor gene (PROGINS and recurrent spontaneous abortion (RSA. METHODS: in this case-control study, 85 women with at least three previous spontaneous abortions without an identifiable cause (RSA Group and 157 women with at least two previous term pregnancies without pathologies and no previous miscarriage (Control Group were selected. An amount of 10 mL of peripheral blood was collected by venipuncture and genomic DNA was extracted by the DTAB/CTAB method, followed by the polymerase chain reaction (PCR under specific conditions for this polymorphism and by amplification by 2% agarose gel electrophoresis. The bands were visualized with an ultraviolet light transilluminator and the gels were photographed. Differences in the PROGINS genotype and allele frequencies between groups were analyzed by the χ2 test, with the level of significance set
Reproductive Hazards Still Persist in the Microelectronics Industry: Increased Risk of Spontaneous Abortion and Menstrual Aberration among Female Workers in the Microelectronics Industry in South Korea
Kim, Inah; Kim, Myoung-Hee; Lim, Sinye
Objectives Despite the global expansion of supply chains and changes to the production process, few studies since the mid-1990s and 2000s have examined reproductive risks of the microelectronics industry; we examined the reproductive risks among female microelectronics workers in South Korea. Methods Based on claim data from the National Health Insurance (2008–2012), we estimated age-specific rates of spontaneous abortion (SAB) and menstrual aberration (MA) among women aged 20 to 39 years. We compared data between microelectronics workers and three different control groups: economically inactive women, the working population as a whole, and workers employed in the bank industry. For an effect measure, age-stratified relative risks (RRs) were estimated. Results Female workers in the microelectronics industry showed significantly higher risk for SAB and MA compared to control groups. The RRs for SAB with reference to economically inactive women, working population, and bank workers in their twenties were 1.57, 1.40, and 1.37, respectively, and the RRs for MA among females in their twenties were 1.54, 1.38, and 1.48, respectively. For women in their thirties, RRs for SAB were 1.58, 1.67, and 1.13, and those for MA were 1.25, 1.35, and 1.23 compared to the three control populations, respectively. All RRs were statistically significant at a level of 0.05, except for the SAB case comparison with bank workers in their thirties. Conclusions Despite technical innovations and health and safety measures, female workers in microelectronics industry in South Korea have high rates of SAB and MA, suggesting continued exposure to reproductive hazards. Further etiologic studies based on primary data collection and careful surveillance are required to confirm these results. PMID:25938673
Reproductive Hazards Still Persist in the Microelectronics Industry: Increased Risk of Spontaneous Abortion and Menstrual Aberration among Female Workers in the Microelectronics Industry in South Korea.
Full Text Available Despite the global expansion of supply chains and changes to the production process, few studies since the mid-1990 s and 2000s have examined reproductive risks of the microelectronics industry; we examined the reproductive risks among female microelectronics workers in South Korea.Based on claim data from the National Health Insurance (2008-2012, we estimated age-specific rates of spontaneous abortion (SAB and menstrual aberration (MA among women aged 20 to 39 years. We compared data between microelectronics workers and three different control groups: economically inactive women, the working population as a whole, and workers employed in the bank industry. For an effect measure, age-stratified relative risks (RRs were estimated.Female workers in the microelectronics industry showed significantly higher risk for SAB and MA compared to control groups. The RRs for SAB with reference to economically inactive women, working population, and bank workers in their twenties were 1.57, 1.40, and 1.37, respectively, and the RRs for MA among females in their twenties were 1.54, 1.38, and 1.48, respectively. For women in their thirties, RRs for SAB were 1.58, 1.67, and 1.13, and those for MA were 1.25, 1.35, and 1.23 compared to the three control populations, respectively. All RRs were statistically significant at a level of 0.05, except for the SAB case comparison with bank workers in their thirties.Despite technical innovations and health and safety measures, female workers in microelectronics industry in South Korea have high rates of SAB and MA, suggesting continued exposure to reproductive hazards. Further etiologic studies based on primary data collection and careful surveillance are required to confirm these results.
Reproductive Hazards Still Persist in the Microelectronics Industry: Increased Risk of Spontaneous Abortion and Menstrual Aberration among Female Workers in the Microelectronics Industry in South Korea.
Kim, Inah; Kim, Myoung-Hee; Lim, Sinye
Despite the global expansion of supply chains and changes to the production process, few studies since the mid-1990 s and 2000s have examined reproductive risks of the microelectronics industry; we examined the reproductive risks among female microelectronics workers in South Korea. Based on claim data from the National Health Insurance (2008-2012), we estimated age-specific rates of spontaneous abortion (SAB) and menstrual aberration (MA) among women aged 20 to 39 years. We compared data between microelectronics workers and three different control groups: economically inactive women, the working population as a whole, and workers employed in the bank industry. For an effect measure, age-stratified relative risks (RRs) were estimated. Female workers in the microelectronics industry showed significantly higher risk for SAB and MA compared to control groups. The RRs for SAB with reference to economically inactive women, working population, and bank workers in their twenties were 1.57, 1.40, and 1.37, respectively, and the RRs for MA among females in their twenties were 1.54, 1.38, and 1.48, respectively. For women in their thirties, RRs for SAB were 1.58, 1.67, and 1.13, and those for MA were 1.25, 1.35, and 1.23 compared to the three control populations, respectively. All RRs were statistically significant at a level of 0.05, except for the SAB case comparison with bank workers in their thirties. Despite technical innovations and health and safety measures, female workers in microelectronics industry in South Korea have high rates of SAB and MA, suggesting continued exposure to reproductive hazards. Further etiologic studies based on primary data collection and careful surveillance are required to confirm these results.
Full Text Available Introduction: Undoubtedly, reproduction is a necessity for survival and successful pregnancy is an immunological paradox. In the present study, we investigated the proportional changes of CD4+CD25bright T cells, CD4+CD25dim T cells in peripheral blood in unexplained recurrent spontaneous abortions (URSA and compared it with normal pregnant women by antibody monoclonal method. Methods: The study group comprised of women with miscarriages of unexplained etiology who had normal karyotypes, anticardiolipin antibodies, prolactin levels and normal spousal spermograms. They did not have polycystic ovaries and also did not receive any drugs at the time of the study. PBLs lymphocytes were isolated, then FITC-conjugated and anti-CD4 and PE-conjugated anti-CD25 antibody levels were measured. Then results of the study and control group were analyzed and compared. Results: The absolute number of CD25 bright cells in the CD4+T cells in peripheral blood was statistically significantly lower in the study group as compared to the control group(P=0.000. The absolute number of CD4+CD25dimT cells in peripheral blood was statistically significantly higher in the study group as compared to the control group (P=0.000. Conclusion: As decrease in the number of CD4+CD25+Tcells or their functional deficiency may be linked with miscarriage, CD4+CD25+ Tells could serve as a novel biomarker for monitoring in URSA patients, but more studies are needed in this field.
Bastit i Costa, M A
Abortion is the termination of pregnancy prior to the 180th day, during which time the fetus is not yet viable outside the womb. Spontaneous abortion is the body's expulsion of a fetus during the 1st months of pregnancy. It is usually not very painful, does not involve much bleeding, and is rarely complicated by infection. Spontaneous abortion is much more frequent at the outset of pregnancy and may occur unnoticed. Its causes are unknown in over half of cases. The most important causes are developmental problems in the products of conception. Causes of spontaneous abortions of maternal etiology are most frequently uterine malposition or malformation. Serious illness in the mother is a less common cause of spontaneous abortion than once believed. Induced abortion is caused by the destruction of a normally implanted and healthy embryo. Its complications are related to the amount of bleeding or the introduction of germs from outside which can spread rapidly. Placental retention is a danger of all induced abortions. Induced abortion is common and in some countries it even creates demographic problems. Abortion is legal in many countries as an expression of the right to choose, but in others it is only legal on therapeutic grounds. Defenders and detractors of abortion have written extensively about it, with some works being sincere and some only tactical. The great majority of moralists are opposed to abortion, while biologists and scientists are divided on the question. The Spanish penal code punishes all persons who cause the death of a fetus or impede the process of gestation. The Catholic Church has considered abortion a homicide and against divine and natural laws. Legal or illegal, it is certain that the number of abortions increases each day. In the face of this reality, the need is for measures to avoid abortion whenever possible. Sex education in schools, full information on contraceptive methods and creation of family planning centers are some means of
目的：探讨生殖道沙眼衣原体和解脲支原体感染与自然流产的关系。方法选取我院自然流产患者（自然流产组）及人工流产患者（对照组），各60例。两组均采集宫颈分泌物及蜕膜组织进行沙眼衣原体和解脲支原体培养，分析结果。结果自然流产组宫颈分泌物及蜕膜组织中沙眼衣原体、解脲支原体、沙眼衣原体＋解脲支原体感染率均高于对照组（ P＜0．01）。结论生殖道沙眼衣原体和解脲支原体感染率与自然流产关系密切，可作为确定自然流产病因的指标。%Objective To explore the corelation of genital chlamydia trachomatis and ureaplasma urealyticum infection with spontaneous abortion,and provide clinical reference for the prevention and control of spontaneous abortion .Methods Patients with spontaneous abortion were selected as spontaneous abortion group ( n =60) and artificial abortion group ( n =60), and cervical se-cretions and decidual tissue of chlamydia trachomatis and ureaplasma urealyticum were cultured and the results were analyzed .Results Infection rate of chlamydia trachomatis in cervical secretion of the natural abortion group ,ureaplasma urealyticum,chlamydia trachom-atis infection +UU rates of the natural abortion group were higher than that of the control group ( P <0.01).Conclusion Infection rate of genital chlamydia trachomatis and ureaplasma urealyticum infection rate and spontaneous abortion have a close relationship , which may be one of the causes of spontaneous abortion .
Dongol, A; Mool, S; Tiwari, P
Threatened abortion is the most common complication in the first half of pregnancy. Most of these pregnancies continue to term with or without treatment. Spontaneous abortion occurs in less than 30% of these women. Threatened abortion had been shown to be associated with increased incidence of antepartum haemorrhage, preterm labour and intra uterine growth retardation. This study was to asses the outcome of threatened abortion following treatment. This prospective study was carried out in Dhulikhel Hospital - Kathmandu University Hospital from January 2009 till May 2010. Total 70 cases of threatened abortion were selected, managed with complete bed rest till 48 hrs of cessation of bleeding, folic acid supplementation, uterine sedative, and hormonal treatment till 28 weeks of gestation. Ultrasonogram was performed for diagnosis and to detect the presence of subchorionic hematoma. Patients were followed up until spontaneous abortion or up to delivery of the fetus. The measures used for the analysis were maternal age, parity, gestational age at the time of presentation, previous abortions, presence of subchorionic hematoma, complete abortion, continuation of pregnancy, antepartum hemorrhage, intrauterine growth retardation and intrauterine death of fetus. Out of 70 cases subchorionic haematoma was found in 30 (42.9%) cases. There were 12 (17.1%) patients who spontaneously aborted after diagnosis of threatened abortion during hospital stay, 5 (7.1%) aborted on subsequent visits while 53 (75.8%) continued pregnancy till term. Among those who continued pregnancy intrauterine growth retardation was seen in 7 (13.2%), antepartum hemorrhage in 4 (7.5%), preterm premature rupture of membrane in 3 (5.66%) and IUD in 3 (5.66%). Spontaneous abortion was found more in cases with subchorionic hematoma of size more than 20 cm2. In cases of threatened abortion with or without the presence of subchorionic hematoma, prognostic outcome is better following treatment with bed rest
Leonard, J.C.; Merz, T.
Recently, Athanasiou and colleagues (1981) reported a deficiency in the capacity of lymphocytes from persons with Down's syndrome to repair single-strand DNA breaks. They found that 1 h after exposure to 160 Gray, repair processes had restored the sedimentation profile of DNA from normal lymphocytes to control values, whereas the relative average molecular weight of DNA from irradiated lymphocytes from persons with Down's syndrome showed no increase during the repair interval. They have suggested that their data, in conjunction with the earlier data concerning the frequencies of induced chromosomal aberrations in lymphocytes from persons with Down's syndrome, reflect a decreased efficiency in some aspect of DNA repair in trisomic cells. However, for further studies of this hypothesis, it is more appropriate to study the rejoining of DNA single-strand breaks after doses comparable to those used in tests for chromosomal aberrations. (orig.)
Christiansen, Connie; Schmidt, Garbi; Christoffersen, Mogens
Gennem en række interview om kvinders oplevelse og erfaringer med provokert abort, samt ved at bruge data fra en stor forløbsundersøgelse af kvinder født i 1966, giver forfatterne bag denne rapport et præcist signalement af de kvinder, der vælger at få foretaget en provokeret abort og de eventuelle...... for sundhedspersonale og andre socialarbejdere. Den statistiske undersøgelse viser, at hver fjerde danske kvinde vil komme i den situation at skulle have en abort. Især kvinder med vanskelige opvækstvilkår er i risikogruppen. Tilgengæld er der næsten ingen langvarige fysiske og psykiske virkninger abort af abort, med...
Márcia Melo Laet Rodrigues
. The narrative analysis was the research method. The narratives of seventeen men were analysed. The spontaneous abortion related feelings were the loss related anguish and, the provoked abortion, the culpability related feelings and its consequences. Men who share the abortion experience with their partners require sensibility and professionals involvement. Their main care demands were related to the desire of favorable reception, to get emotional support as well as a whole and correct information about the process.
Tongsong, T; Srisomboon, J; Wanapirak, C; Sirichotiyakul, S; Pongsatha, S; Polsrisuthikul, T
Pregnancy with visible fetal heart beat complicated by first trimester threatened abortion had significant increased risk of subsequent spontaneous abortion compared with normal pregnancy. To compare pregnancy outcomes in cases complicated by first trimester threatened abortion with those that were not. Prospective cohort study of 255 cases of first trimester threatened abortions but with visible heart beat and 265 other normal pregnancies. Spontaneous abortion rates of 5.5% (with relative abortal risk of 2.91) was found for study group, compared to 1.88% for controls (p abortion rate than those without.
Fromer, M J
Nurses have opinions about abortion, but because they are health professionals and their opinions are sought as such, they are obligated to understand why they hold certain views. Nurses need to be clear about why they believe as they do, and they must arrive at a point of view in a rational and logical manner. To assist nurses in this task, the ethical issues surrounding abortion are enumerated and clarified. To do this, some of the philosophic and historic approaches to abortion and how a position can be logically argued are examined. At the outset some emotion-laden terms are defined. Abortion is defined as the expulsion of a fetus from the uterus before 28 weeks' gestation, the arbitrarily established time of viability. This discussion is concerned only with induced abortion. Since the beginning of recorded history women have chosen to have abortions. Early Jews and Christians forbade abortion on practical and religious grounds. A human life was viewed as valuable, and there was also the practical consideration of the addition of another person to the population, i.e., more brute strength to do the necessary physical work, defend against enemies, and ensure the continuation of the people. These kinds of pragmatic reasons favoring or opposing abortion have little to do with the Western concept of abortion in genaeral and what is going on in the U.S. today in particular. Discussion of the ethics of abortion must rest on 1 or more of several foundations: whether or not the fetus is a human being; the rights of the pregnant woman as opposed to those of the fetus, and circumstances of horror and hardship that might surround a pregnancy. Viability is relative. Because viability is not a specific descriptive entity, value judgments become part of the determination, both of viability and the actions that might be taken based on that determination. The fetus does not become a full human being at viability. That occurs only at conception or birth, depending on one's view
Urquia, Marcelo L; Moineddin, Rahim; Jha, Prabhat; O'Campo, Patricia J; McKenzie, Kwame; Glazier, Richard H; Henry, David A; Ray, Joel G
Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking. We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and spontaneous abortions were linked to Canadian immigration records. We determined associations of male:female infant ratios with maternal birthplace, sex of the previous living sibling(s) and prior spontaneous or induced abortions. Male:female infant ratios did not appreciably depart from the normal range among Canadian-born women and most women born outside of Canada, irrespective of the sex of previous children or the characteristics of prior abortions. However, among infants of women who immigrated from India and had previously given birth to 2 girls, the overall male:female ratio was 1.96 (95% confidence interval [CI] 1.75-2.21) for the third live birth. The male:female infant ratio after 2 girls was 1.77 (95% CI 1.26-2.47) times higher if the current birth was preceded by 1 induced abortion, 2.38 (95% CI 1.44-3.94) times higher if preceded by 2 or more induced abortions and 3.88 (95% CI 2.02-7.50) times higher if the induced abortion was performed at 15 weeks or more gestation relative to no preceding abortion. Spontaneous abortions were not associated with male-biased sex ratios in subsequent births. High male:female ratios observed among infants born to women who immigrated from India are associated with induced abortions, especially in the second trimester of pregnancy. © 2016 Canadian Medical Association or its licensors.
Introduction. Septic sacroilitis is a rare complication of abortion. 1 . Pregnant women are often at risk of developing varying degree of sacroiliac joint dysfunction due to laxity of the ligaments; this laxity is hormonally induced. Pregnancy arthropathy, which is the commonest cause of hip and pelvic pain in pregnancy, must be ...
Virk, Jasveer; Zhang, Jun; Olsen, Jørn
BACKGROUND: The long-term safety of surgical abortion in the first trimester is well established. Despite the increasing use of medical abortion (abortion by means of medication), limited information is available regarding the effects of this procedure on subsequent pregnancies. METHODS: We...... identified all women living in Denmark who had undergone an abortion for nonmedical reasons between 1999 and 2004 and obtained information regarding subsequent pregnancies from national registries. Risks of ectopic pregnancy, spontaneous abortion, preterm birth (at ... weight (abortion were compared with risks in women who had had a first-trimester surgical abortion. RESULTS: Among 11,814 pregnancies in women who had had a previous first-trimester medical abortion (2710 women...
Singh, M; Jha, R
To see whether advocacy for abortion law and comprehensive abortion care (CAC) sites after legalization of abortion in Nepal is adequate among educated people (above school leaving certificate). 150 participants were assigned randomly who agreed to be in the survey and were given structured questionnaires to find out their perception of abortion and CAC sites. Majority know abortion is legalized and majority have positive attitude about legalization of abortion, however majority are not aware of abortion service in CAC sites and none knew the cost of abortion service. Proper and adequate advocacy of the new abortion law and CAC service is essential.
Tarokhian, Batoul; Sherkat, Roya; Nasr Esfahani, Mohamma Hossein; Adib, Minoo; Kiani Esfahani, Abbas; Ataei, Behrooz
Some evidence has shown a relationship between primary human cytomegalovirus (CMV) infection and pregnancy loss. The impact of CMV infection reactivation during pregnancy on adverse pregnancy outcomes is not completely understood. It is proposed that altered immune response, and therefore, recurrence or reactivation of latent CMV infection may relate to recurrent spontaneous abortion (RSA); however, few data are available in this regard. To find out about any cell mediated defect and reactivation of latent CMV infection in women with RPL, cellular immunity to the virus has been evaluated by specific cytotoxic T lymphocyte (CTL) response to CMV. In a case control study, CTL CD107a expression and in- tercellular IFN-γ production in response to CMV pp65 antigen and staphylococcus enterotoxin B (SEB) in women with RSA were assessed by flow cytometric analysis. Forty-four cases with history of recurrent pregnancy and forty-four controls with history of successful pregnancies were included. The FACSCaliber flow cytometer were used for analysis. No significant difference was observed between CD107a expression and IFN-γ production in response to CMV PP65 antigen in RPL patients and control group. How- ever, the cytotoxic response to SEB antigen in patients with RPL was significantly lower than control group (p=0.042). The results of this study show that impaired CD107a expression and IFN-γ production as CTL response to CMV does not appear to be a major contrib- uting and immune incompetence factor in patients with RPL, but cytotoxic T cell response defect to other antigens requires to be assessed further in these patients.
Maina, Beatrice W; Mutua, Michael M; Sidze, Estelle M
Over six million induced abortions were reported in Africa in 2008 with over two million induced abortions occurring in Eastern Africa. Although a significant proportion of women in the region procure more than one abortion during their reproductive period, there is a dearth of research on factors associated with repeat abortion. Data for this study come from the Magnitude and Incidence of Unsafe Abortion Study conducted by the African Population and Health Research Center in Kenya in 2012. The study used a nationally-representative sample of 350 facilities (level II to level VI) that offer post-abortion services for complications following induced and spontaneous abortions. A prospective morbidity survey tool was used by health providers in 328 facilities to collect information on socio-demographic charateristics, reproductive health history and contraceptive use at conception for all patients presenting for post-abortion services. Our analysis is based on data recorded on 769 women who were classified as having had an induced abortion. About 16 % of women seeking post abortion services for an induced abortion reported to have had a previous induced abortion. Being separated or divorced or widowed, having no education, having unwanted pregnancy, having 1-2 prior births and using traditional methods of contraception were associated with a higher likelihood of a repeat induced abortion. The findings point to the need to address the reasons why women with first time induced abortion do not have the necessary information to prevent unintended pregnancies and further induced abortions. Possible explanations linked to the quality of post-abortion family planning and coverage of long-acting methods should be explored.
Kumar, Anuradha; Hessini, Leila; Mitchell, Ellen M. H.
Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor 'essential' and relies
Baril, Laurence; Rosillon, Dominique; Willame, Corinne; Angelo, Maria Genalin; Zima, Julia; van den Bosch, Judith H; Van Staa, Tjeerd; Boggon, Rachael; Bunge, Eveline M; Hernandez-Diaz, Sonia; Chambers, Christina D
We assessed the risk of spontaneous abortion (SA) after inadvertent exposure to HPV-16/18-vaccine during pregnancy using an observational cohort design. The study population included women aged 15-25 years registered with the Clinical Practice Research Datalink General Practice OnLine Database in the United Kingdom (UK), who received at least one HPV-16/18-vaccine dose between 1st September 2008 and 30th June 2011. Exposed women had the first day of gestation between 30 days before and 45 days (90 days for the extended exposure period) after any HPV-16/18-vaccine dose. Non-exposed women had the first day of gestation 120 days-18 months after the last dose. SA defined as foetal loss between weeks 1 and 23 of gestation (UK definition). The frequency of SA was 11.6% (among 207 exposed) and 9.0% (632 non-exposed), women: hazard ratio (HR) adjusted for age at first day of gestation 1.30 (95% confidence interval: 0.79-2.12). Sensitivity analysis per number of doses administered (-30 to +45-day risk period) showed a HR for SA of 1.11 (0.64-1.91) for 18/178 women with one dose during the risk period versus 2.55 (1.09-5.93) in 6/29 women with two doses within a 4-5 weeks period. The proportion of pre-term/full-term/postterm deliveries, small/large for gestational age infants, and birth defects was not significantly different between exposed and non-exposed women. Results were consistent using a (United States) SA definition of foetal loss between weeks 1-19 and/or the extended risk period. There was no evidence of an increased risk of SA and other adverse pregnancy outcomes in young women inadvertently HPV-16/18-vaccinated around gestation. Nevertheless, women who are pregnant or trying to become pregnant are advised to postpone vaccination until completion of pregnancy. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Abstract Background Corynebacterium aurimucosum is a slightly yellowish, non-lipophilic, facultative anaerobic member of the genus Corynebacterium and predominantly isolated from human clinical specimens. Unusual black-pigmented variants of C. aurimucosum (originally named as C. nigricans continue to be recovered from the female urogenital tract and they are associated with complications during pregnancy. C. aurimucosum ATCC 700975 (C. nigricans CN-1 was originally isolated from a vaginal swab of a 34-year-old woman who experienced a spontaneous abortion during month six of pregnancy. For a better understanding of the physiology and lifestyle of this potential urogenital pathogen, the complete genome sequence of C. aurimucosum ATCC 700975 was determined. Results Sequencing and assembly of the C. aurimucosum ATCC 700975 genome yielded a circular chromosome of 2,790,189 bp in size and the 29,037-bp plasmid pET44827. Specific gene sets associated with the central metabolism of C. aurimucosum apparently provide enhanced metabolic flexibility and adaptability in aerobic, anaerobic and low-pH environments, including gene clusters for the uptake and degradation of aromatic amines, L-histidine and L-tartrate as well as a gene region for the formation of selenocysteine and its incorporation into formate dehydrogenase. Plasmid pET44827 codes for a non-ribosomal peptide synthetase that plays the pivotal role in the synthesis of the characteristic black pigment of C. aurimucosum ATCC 700975. Conclusions The data obtained by the genome project suggest that C. aurimucosum could be both a resident of the human gut and possibly a pathogen in the female genital tract causing complications during pregnancy. Since hitherto all black-pigmented C. aurimucosum strains have been recovered from female genital source, biosynthesis of the pigment is apparently required for colonization by protecting the bacterial cells against the high hydrogen peroxide concentration in
Palle, C; Andersen, J W; Tabor, A
Forty-seven twin pregnancies among 3676 patients who had a genetic amniocentesis between 1973 and 1979, are reported. The detection rate of twins at the time of amniocentesis was 62 per cent. Five (17 per cent) of the 29 women with detected twin pregnancy aborted spontaneously, these are compared...... in at least one sac aborted, while 3 of 20 twin pregnancies with one puncture in each sac aborted (15 per cent). One of 18 (6 per cent) twin pregnancies, where only one sac was punctured, because the twin pregnancies were undetected, aborted. Amniocentesis of both sacs in twin pregnancies seems associated...... with an increased risk of spontaneous abortion. The indications for amniocentesis in twin pregnancies should be critically evaluated....
Perez Duarte, A E
Analysis of abortion in Mexico from a juridical perspective requires recognition that Mexico as a national community participates in a double system of values. Politically it is defined as a liberal, democratic, and secular state, but culturally the Judeo-Christian ideology is dominant in all social strata. This duality complicates all juridical-penal decisions regarding abortion. Public opinion on abortion is influenced on the 1 hand by extremely conservative groups who condemn abortion as homicide, and on the other hand by groups who demand legislative reform in congruence with characteristics that define the state: an attitude of tolerance toward the different ideological-moral positions that coexist in the country. The discussion concerns the rights of women to voluntary maternity, protection of health, and to making their own decisions regarding their bodies vs. the rights of the fetus to life. The type of analysis is not objective, and conclusions depend on the ideology of the analyst. Other elements must be examined for an objective consideration of the social problem of abortion. For example, aspects related to maternal morbidity and mortality and the demographic, economic, and physical and mental health of the population would all seem to support the democratic juridical doctrine that sees the clandestine nature of abortion as the principal problem. It is also observed that the illegality of abortion does not guarantee its elimination. Desperate women will seek abortion under any circumstances. The illegality of abortion also impedes health and educational policies that would lower abortion mortality. There are various problems from a strictly juridical perspective. A correct definition of the term abortion is needed that would coincide with the medical definition. The discussion must be clearly centered on the protected juridical right and the definition of reproductive and health rights and rights to their own bodies of women. The experiences of other
Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu
We use unique data on abortions performed in New York State from 1971–1975 to demonstrate that women travelled hundreds of miles for a legal abortion before Roe. A100- mile increase in distance for women who live approximately 183 miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830 miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233
Cockrill, Kate; Weitz, Tracy A
Most states regulate abortion differently than other health care services. Examples of these regulations include mandating waiting periods and the provision of state-authored information, and prohibiting private and public insurance coverage for abortion. The primary purpose of this paper is to explore abortion patients' perspectives on these regulations. We recruited 20 participants from three abortion providing facilities located in two states in the U.S. South and Midwest. Using a survey and semistructured interview, we collected information about women's knowledge of abortion regulation and policy preferences. During the interviews, women weighed the pros and cons of abortion regulations. We used grounded theory analytical techniques and matrix analysis to organize and interpret the data. We discovered five themes in these women's considerations of regulation: responsibility, empathy, safe and accessible health care, privacy, and equity. Women in the study generally supported policies that they felt protected women or informed decisions. However, most women also opposed laws mandating two-day abortion appointments for women who were traveling long distances. Women tended to favor financial coverage of abortion, arguing that it could help poor women afford abortion or reduce state expenditures. Overall the study participants' opinions on abortion policy reflect key values for advocates and policy makers to consider: responsibility, empathy, safe and accessible health care, privacy, and equity. Future work should examine abortion regulations in light of these shared values. Laws that promote misinformation or prohibit accommodations of unique circumstances are not consistent the positions articulated by the subjects in our study. Copyright 2010 Jacobs Institute of Women
... Simplified (Mandarin dialect)) PDF Reproductive Health Access Project Emergency Contraceptive Pill and the Abortion Pill: What's the Difference? - English PDF Emergency Contraceptive Pill and the Abortion Pill: What's the Difference? - ...
Kant, Shashi; Srivastava, Rahul; Rai, Sanjay Kumar; Misra, Puneet; Charlette, Lena; Pandav, Chandrakant S
Induced abortion has been legal in India on a broad range of medical and social grounds since 1980s. Often, induced abortion is resorted to as a means for contraception, and has a potential to be misused for sex selective feticide. We assessed the rates, trends, causes and determinants of induced abortions from 2008-12 in a rural community of northern India. Present study is a secondary data analysis of pregnancy outcomes at Ballabgarh Health and Demographic Surveillance System from 2008-12. The data was retrieved from the Health and Management Information System maintained at Ballabgarh. Cause of abortion was self-reported by the women who underwent abortion. Of the 11,102 pregnancies, 1,226 (11%) culminated as abortions of which 425 (3.8%) were induced abortions. Spontaneous abortion rate (7.2%) was twice that of induced abortion rate (3.8%). Both abortion rates had an increasing trend during the course of the study period. Self-reported reasons for opting for induced abortions were bleeding per vaginum (23%), unwanted pregnancy (16%), and unviable fetus diagnosed by ultrasonography (11%). Eight percent of the induced abortions were due to the female sex of the fetus. About 11% of the abortions were performed beyond 20 weeks of gestation which was the upper legal permissible gestational age for performing induced abortions in India. About 10% of the abortions were performed by unqualified practitioners. Caste, wealth index, birth order and size of the village population were the factors that were significantly associated with induced abortion. Though the abortion rate was low, the proportionate contribution of induced abortion was more than what could be expected. Unsafe and sex selective abortion, though illegal, was prevalent. Upper caste and higher socio-economic status families were more likely to opt for induced abortion.
Conti, Jennifer A; Brant, Ashley R; Shumaker, Heather D; Reeves, Matthew F
To review the status of antiabortion restrictions enacted over the last 5 years in the United States and their impact on abortion services. In recent years, there has been an alarming rise in the number of antiabortion laws enacted across the United States. In total, various states in the union enacted 334 abortion restrictions from 2011 to July 2016, accounting for 30% of all abortion restrictions since the legalization of abortion in 1973. Data confirm, however, that more liberal abortion laws do not increase the number of abortions, but instead greatly decrease the number of abortion-related deaths. Several countries including Romania, South Africa and Nepal have seen dramatic decreases in maternal mortality after liberalization of abortion laws, without an increase in the total number of abortions. In the United States, abortions are incredibly safe with very low rates of complications and a mortality rate of 0.7 per 100 000 women. With increasing abortion restrictions, maternal mortality in the United States can be expected to rise over the coming years, as has been observed in Texas recently. Liberalization of abortion laws saves women's lives. The rising number of antiabortion restrictions will ultimately harm women and their families.
Adler, Nancy E.; Ozer, Emily J.; Tschann, Jeanne
Reviews the current status of abortion laws pertaining to adolescents worldwide, examining questions raised by parental consent laws in the United States and by the relevant psychological research (risk of harm from abortion, informed consent, consequences of parental involvement in the abortion decision, and current debate). Discusses issues…
Melese, Tadele; Habte, Dereje; Tsima, Billy M.; Mogobe, Keitshokile Dintle; Chabaesele, Kesegofetse; Rankgoane, Goabaone; Keakabetse, Tshiamo R.; Masweu, Mabole; Mokotedi, Mosidi; Motana, Mpho; Moreri-Ntshabele, Badani
Background Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications. Methods A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients’ records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed. Result A total of 619 patients’ records were reviewed with a mean (SD) age of 27.12 (5.97) years. The majority of abortions (95.5%) were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%). Offensive vaginal discharge (17.9%), tender uterus (11.3%), septic shock (3.9%) and pelvic peritonitis (2.4%) were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2%) of the cases followed by hypovolemic and septic shock 65 (10.5%). There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively). Conclusion Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for
Full Text Available Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications.A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients' records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed.A total of 619 patients' records were reviewed with a mean (SD age of 27.12 (5.97 years. The majority of abortions (95.5% were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%. Offensive vaginal discharge (17.9%, tender uterus (11.3%, septic shock (3.9% and pelvic peritonitis (2.4% were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2% of the cases followed by hypovolemic and septic shock 65 (10.5%. There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively.Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for clinical audit on post-abortion care
Bromham, D R; Oloto, E J
It is known that, since antiquity, women confronted with an unwanted pregnancy have used abortion as a means of resolving their dilemma. Although undoubtedly widely used in all historical ages, abortion has come to be regarded as an event preferably avoided because of the impact on the women concerned as well as considerations for fetal life. Policies to reduce numbers and rates of abortion must acknowledge certain observations. Criminalization does not prevent abortion but increases maternal risks. A society's 'openness' in discussing sexual matters inversely correlates with abortion rates. Correlation between contraceptive use and abortion is also inverse but relates most closely to the efficacy of contraceptive methods used. 'Revolution' in the range of contraceptive methods used will have an equivalent impact on abortion rates. Secondary or emergency contraceptive methods have a considerable role to play in the reduction of abortion numbers. Good sex (and 'relationships') education programs may delay sexual debut, increase contraceptive usage and be associated with reduced abortion. Finally, interaction between socioeconomic factors and the choice between abortion and ongoing pregnancy are complex. Abortion is not necessarily chosen by those least able to support a child financially.
Abortion has become something to hide, something you can't tell other people, something you have to expiate forever. Besides, abortion is more and more difficult to achieve because of the raising average of consciencious objection (from 70 to 90% of health care providers are conscientious objectors, 2014 data, Ministero della Salute) and illegal abortion is "coming back"from the 70s, when abortion was a crime (Italian law n. 194/1978). Abortion is often blamed as a murder, an unforgivenable sin, even as genocide. Silence against shouting "killers!" to women who are going to have an abortion: this is a common actual scenario. Why is it so difficult to discuss and even to mention abortion?
Wang, P D; Lin, R S
Induced abortion is widely practised in Taiwan; however, it had been illegal until 1985. It was of interest to investigate induced abortion practices in Taiwan after its legalization in 1985 in order to calculate the prevalence rate and ratio of induced abortion to live births and to pregnancies in Taiwan. A study using questionnaires through personal interviews was conducted on more than seventeen thousand women who attended a family planning service in Taipei metropolitan areas between 1991 and 1992. The reproductive history and sexual behaviour of the subjects were especially focused on during the interviews. Preliminary findings showed that 46% of the women had a history of having had an induced abortion. Among them, 54.8% had had one abortion, 29.7% had had two, and 15.5% had had three or more. The abortion ratio was 379 induced abortions per 1,000 live births and 255 per 1,000 pregnancies. The abortion ratio was highest for women younger than 20 years of age, for aboriginal women and for nulliparous women. When logistic regression was used to control for confounding variables, we found that the number of previous live births is the strongest predictor relating to women seeking induced abortion. In addition, a significant positive association exists between increasing number of induced abortions and cervical dysplasia.
Conti, Jennifer A; Cahill, Erica
To review updates in how abortion care is depicted and analysed though various media outlets: news, television, film, and social media. A surge in recent media-related abortion research has recognized several notable and emerging themes: abortion in the news media is often inappropriately sourced and politically motivated; abortion portrayal in US film and television is frequently misrepresented; and social media has a new and significant role in abortion advocacy. The portrayal of abortion onscreen, in the news, and online through social media has a significant impact on cultural, personal, and political beliefs in the United States. This is an emerging field of research with wide spread potential impact across several arenas: medicine, policy, public health.
Nonnenmacher, Daniele; Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Azevedo, George Dantas de; Dutra, Elza Maria do Socorro; Rebouças, Melina Séfora Souza; Luci, Mara Cristina Souza de; Francisco, Rossana Pulcineli Vieira
to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p women who induced an abortion referred to the partner as the person who could not find out about the abortion (pindependence, women still regard male participation in the abortion process as an important factor. The specifics of each capital denote the influence of the geographic and cultural dimension, indicating the need to take into account the particulars of each region in Brazil while considering a holistic approach to women's health.
Diniz, D; Gonzalez Velez, A C
Although abortion has been the most debated of all issues analyzed in bioethics, no moral consensus has been achieved. The problem of abortion exemplifies the difficulty of establishing social dialogue in the face of distinct moral positions, and of creating an independent academic discussion based on writings that are passionately argumentative. The greatest difficulty posed by the abortion literature is to identify consistent philosophical and scientific arguments amid the rhetorical manipulation. A few illustrative texts were selected to characterize the contemporary debate. The terms used to describe abortion are full of moral meaning and must be analyzed for their underlying assumptions. Of the four main types of abortion, only 'eugenic abortion', as exemplified by the Nazis, does not consider the wishes of the woman or couple--a fundamental difference for most bioethicists. The terms 'selective abortion' and 'therapeutic abortion' are often confused, and selective abortion is often called eugenic abortion by opponents. The terms used to describe abortion practitioners, abortion opponents, and the 'product' are also of interest in determining the style of the article. The video entitled "The Silent Scream" was a classic example of violent and seductive rhetoric. Its type of discourse, freely mixing scientific arguments and moral beliefs, hinders analysis. Within writings about abortion three extreme positions may be identified: heteronomy (the belief that life is a gift that does not belong to one) versus reproductive autonomy; sanctity of life versus tangibility of life; and abortion as a crime versus abortion as morally neutral. Most individuals show an inconsistent array of beliefs, and few groups or individuals identify with the extreme positions. The principal argument of proponents of legalization is respect for the reproductive autonomy of the woman or couple based on the principle of individual liberty, while heteronomy is the main principle of
To find the latest and most accurate information on aspects of induced abortion. A literature survey was carried out in which five aspects of abortion were scrutinised: risk to life, risk of breast cancer, risk to mental health, risk to future fertility, and fetal pain. Abortion is clearly safer than childbirth. There is no evidence of an association between abortion and breast cancer. Women who have abortions are not at increased risk of mental health problems over and above women who deliver an unwanted pregnancy. There is no negative effect of abortion on a woman's subsequent fertility. It is not possible for a fetus to perceive pain before 24 weeks' gestation. Misinformation on abortion is widespread. Literature and websites are cited to demonstrate how data have been manipulated and misquoted or just ignored. Citation of non-peer reviewed articles is also common. Mandates insisting on provision of inaccurate information in some US State laws are presented. Attention is drawn to how women can be misled by Crisis Pregnancy Centres. There is extensive promulgation of misinformation on abortion by those who oppose abortion. Much of this misinformation is based on distorted interpretation of the scientific literature.
Che, Yan; Liu, Xiaoting; Zhang, Bin; Cheng, Linan
Abstract Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. However, limited data exist supporting the effective use of OCs postabortion. We conducted this systematic review and meta-analysis in the present study reported immediate administration of OCs or combined OCs postabortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, increase endometrial thickness 2 to 3 weeks after abortion, and reduce the risk of complications and unintended pregnancies. A total of 8 major authorized Chinese and English databases were screened from January 1960 to November 2014. Randomized controlled trials in which patients had undergone medical or surgical abortions were included. Chinese studies that met the inclusion criteria were divided into 3 groups: administration of OC postmedical abortion (group I; n = 1712), administration of OC postsurgical abortion (group II; n = 8788), and administration of OC in combination with traditional Chinese medicine postsurgical abortion (group III; n = 19,707). In total, 119 of 6160 publications were included in this analysis. Significant difference was observed in group I for vaginal bleeding time (P = 0.0001), the amount of vaginal bleeding (P = 0.03), and menstruation recovery period (P abortion (P abortion, and reduce the risk of complications and unintended pregnancies. PMID:27399060
Jillian T Henderson
Full Text Available Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion.We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001-2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001-2003, early implementation (2004-2006, and later implementation (2007-2010.23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85. Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75.Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women's health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve
Henderson, Jillian T; Puri, Mahesh; Blum, Maya; Harper, Cynthia C; Rana, Ashma; Gurung, Geeta; Pradhan, Neelam; Regmi, Kiran; Malla, Kasturi; Sharma, Sudha; Grossman, Daniel; Bajracharya, Lata; Satyal, Indira; Acharya, Shridhar; Lamichhane, Prabhat; Darney, Philip D
Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion. We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001-2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001-2003), early implementation (2004-2006), and later implementation (2007-2010). 23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75). Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women's health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve access. Other
Henderson, Jillian T.; Puri, Mahesh; Blum, Maya; Harper, Cynthia C.; Rana, Ashma; Gurung, Geeta; Pradhan, Neelam; Regmi, Kiran; Malla, Kasturi; Sharma, Sudha; Grossman, Daniel; Bajracharya, Lata; Satyal, Indira; Acharya, Shridhar; Lamichhane, Prabhat; Darney, Philip D.
Background Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion. Methods We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001–2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001–2003), early implementation (2004–2006), and later implementation (2007–2010). Results 23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75). Conclusion Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women’s health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance
Agerholm, Jørgen Steen; Pedersen, Hanne Gervi; McEvoy, Fintan
and hydrocephalus is reported in an equine foetus spontaneously aborted at gestation day 224. The cause of abortion was considered to be intrauterine death caused by umbilical cord torsions and subsequent compromised blood flow, but the aetiology of the malformation could not be determined. A detailed history...
Campbell, Nancy B.; And Others
Explored differences between 35 women who had abortions as teenagers and 36 women who had abortions as adults. Respondents reported on their premorbid psychiatric histories, the decision-making process itself, and postabortion distress symptoms. Antisocial and paranoid personality disorders, drug abuse, and psychotic delusions were significantly…
The preabortion interview required by French law takes place between the medical consultation and the aspiration or administration of RU-486. The three marriage counselors at the Center for Social Gynecology in Marseilles have each undertaken a course of personal therapy to enable them to understand their own reactions and motivations as a way of improving their effectiveness with clients. The preabortion interview is an opportunity to listen to and support women who may be experiencing anguish, sadness, ambivalence, or aggressivity. Each client determines the content of the interview. Often the reason for the abortion is given, frequently in terms of economic problems, unemployment, or other justification. The women almost always state that they "cannot", not that they "do not want", to continue the pregnancy, as if external circumstances had made their decision. The decision is usually made with little discussion. Young adolescents are often astounded to find themselves pregnant. Among young girls, the pregnancy may represent an appeal to the parents for attention or understanding. Sometimes the abortion represents a repetition or a reminder of some difficult event in the past, such as a previous abortion or the death of a child. Often the abortion exacerbates problems in the couple's relationship. The mother often experiences rejection of the pregnancy by the father as rejection of herself. Repeat abortions raise questions about whether some aspect of counseling was neglected. The abortion request always occasions a great feeling of guilt, both for being pregnant and for refusing the pregnancy. The interview permits the client to express her feelings and may help her make sense of the experience.
This review of abortion history considers sacred and secular practice and traces abortion in the US, the legacy of the 19th century, and the change that occurred in the 20th century. Abortion has been practiced since ancient times, but its legality and availability have been threatened continuously by forces that would denigrate women's fundamental rights. Currently, while efforts to decrease the need for abortion through contraception and education continue, access to abortion remains crucial for the well-being of millions of women. That access will never be secure until profound changes occur in the whole society. Laws that prohibit absolutely the practice of abortion are a relatively recent development. In the early Roman Catholic church, abortion was permitted for male fetuses in the first 40 days of pregnancy and for female fetuses in the first 80-90 days. Not until 1588 did Pope Sixtus V declare all abortion murder, with excommunication as the punishment. Only 3 years later a new pope found the absolute sanction unworkable and again allowed early abortions. 300 years would pass before the Catholic church under Pius IX again declared all abortion murder. This standard, declared in 1869, remains the official position of the church, reaffirmed by the current pope. In 1920 the Soviet Union became the 1st modern state formally to legalize abortion. In the early period after the 1917 revolution, abortion was readily available in state operated facilities. These facilities were closed and abortion made illegal when it became clear that the Soviet Union would have to defend itself against Nazi Germany. After World War II women were encouraged to enter the labor force, and abortion once again became legal. The cases of the Catholic church and the Soviet Union illustrate the same point. Abortion legislation has never been in the hands of women. In the 20th century, state policy has been determined by the rhythms of economic and military expansion, the desire for cheap
Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal’s national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in nearly 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion
Hart, T M
The enactment of the Eugenic Protection Act in Japan was followed by many changes. The population explosion was stemmed, the birth rate was halved, and while the marriage rate remained steady the divorce rate declined. The annual total of abortions increased until 1955 and then slowly declined. The highest incidence of abortions in families is in the 30 to 34 age group when there are four children in the family. As elsewhere abortion in advanced stages of pregnancy is associated with high morbidity and mortality. There is little consensus as to the number of criminal abortions. Reasons for criminal abortions can be found in the legal restrictions concerning abortion: Licensing of the abortionist, certification of hospitals, taxation of operations and the requirement that abortion be reported. Other factors are price competition and the patient's desire for secrecy. Contraception is relatively ineffective as a birth control method in Japan. Oral contraceptives are not yet government approved. In 1958 alone 1.1 per cent of married women were sterilized and the incidence of sterilization was increasing.
AJRH Managing Editor
In Ghana, despite the availability of safe, legally permissible abortion services, high rates of morbidity and mortality from unsafe abortion persist. Through interviews with Ghanaian physicians on the front lines of abortion provision, we begin to describe major barriers to widespread safe abortion. Their stories illustrate the ...
Awoyemi, Bosede O; Novignon, Jacob
While induced abortion is considered to be illegal and socially unacceptable in Nigeria, it is still practiced by many women in the country. Poor family planning and unsafe abortion practices have daunting effects on maternal health. For instance, Nigeria is on the verge of not meeting the Millennium development goals on maternal health due to high maternal mortality ratio, estimated to be about 630 maternal deaths per 100,000 live births. Recent evidences have shown that a major factor in this trend is the high incidence of abortion in the country. The objective of this paper is, therefore, to investigate the factors determining the demand for abortion and post-abortion care in Ibadan city of Nigeria. The study employed data from a hospital-based/exploratory survey carried out between March to September 2010. Closed ended questionnaires were administered to a sample of 384 women of reproductive age from three hospitals within the Ibadan metropolis in South West Nigeria. However, only 308 valid responses were received and analysed. A probit model was fitted to determine the socioeconomic factors that influence demand for abortion and post-abortion care. The results showed that 62% of respondents demanded for abortion while 52.3% of those that demanded for abortion received post-abortion care. The findings again showed that income was a significant determinant of abortion and post-abortion care demand. Women with higher income were more likely to demand abortion and post-abortion care. Married women were found to be less likely to demand for abortion and post-abortion care. Older women were significantly less likely to demand for abortion and post-abortion care. Mothers' education was only statistically significant in determining abortion demand but not post-abortion care demand. The findings suggest that while abortion is illegal in Nigeria, some women in the Ibadan city do abort unwanted pregnancies. The consequence of this in the absence of proper post-abortion
Background While induced abortion is considered to be illegal and socially unacceptable in Nigeria, it is still practiced by many women in the country. Poor family planning and unsafe abortion practices have daunting effects on maternal health. For instance, Nigeria is on the verge of not meeting the Millennium development goals on maternal health due to high maternal mortality ratio, estimated to be about 630 maternal deaths per 100,000 live births. Recent evidences have shown that a major factor in this trend is the high incidence of abortion in the country. The objective of this paper is, therefore, to investigate the factors determining the demand for abortion and post-abortion care in Ibadan city of Nigeria. Methods The study employed data from a hospital-based/exploratory survey carried out between March to September 2010. Closed ended questionnaires were administered to a sample of 384 women of reproductive age from three hospitals within the Ibadan metropolis in South West Nigeria. However, only 308 valid responses were received and analysed. A probit model was fitted to determine the socioeconomic factors that influence demand for abortion and post-abortion care. Results The results showed that 62% of respondents demanded for abortion while 52.3% of those that demanded for abortion received post-abortion care. The findings again showed that income was a significant determinant of abortion and post-abortion care demand. Women with higher income were more likely to demand abortion and post-abortion care. Married women were found to be less likely to demand for abortion and post-abortion care. Older women were significantly less likely to demand for abortion and post-abortion care. Mothers’ education was only statistically significant in determining abortion demand but not post-abortion care demand. Conclusion The findings suggest that while abortion is illegal in Nigeria, some women in the Ibadan city do abort unwanted pregnancies. The consequence of this
Boersma, A. A.; Meyboom-de Jong, B.
We describe jive pitfalls of medical abortion: ectopic pregnancy not terminated after misoprostol, but without negative side-effects; long-term vaginal blood loss with suspicious retained products which disappeared spontaneously; a patient with uterus myomatatosus with severe pain and retained
Lee, Eun Ju; Ryu, Hee Sug; Ji, Hoon; Suh, Jung Ho
Cervical abortion is a spontaneous abortion of an intrauterine pregnancy into the cervical canal where the abortus is retained by a closed external os, causing distension of the cervical canal. Cervical abortion should be distinguished from the cervical pregnancy. We present a case of cervical abortion diagnosed preoperatively by transvaginal sonography and color doppler imaging, and treated by dilatation and curettage. Charateristic transvaginal sonographic findings and identification of subtrophoblastic blood flow by color doppler imaging could allow differentiation of the cevical aborition from the cervical pregnancy
Togzhan Yezlankyzy; Shokan Niazbekov
Abortion is one of the most controversial and talked problem of our time. It is discussed in classrooms, work places and even on the internet. The definition of abortion is the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus as the spontaneous expulsion of a human fetus during the first 12 weeks of gestation. Kazakhstan’s health organization records 300 thousand abortions every year. Abortion problem is unlikely to care a...
Full Text Available OBJECTIVE: To assess the Outcome of pregnancy in patients with threatened abortion. METHODS: A Prospective observational study was done on 106 pregnant women with threatened abortion. Out comes in the form of antenatal complications, mode of delivery and postnatal co mplications were noted. Analysis of the data was done using SPSS version 13. RESULTS: In the study of 106 patients 18% had spontaneous abortion. Pre - labour rupture of membranes were seen in 20% of patients and 21% had preterm labour. Threatened abortion di d not affect mode of delivery. PPROM, preterm births were more in women presenting with first trimester bleeding; PIH, PROM, and postpartum complications were more in women presenting beyond 20 weeks gestation though statistically not significant. 13.2% of women had heavy bleeding at admission out of which 50% aborted subsequently – significantly higher than the light bleeding group. CONCLUSION: The overall maternal and perinatal outcome in women with threatened abortion is suboptimal. Women with heavy blee ding are more likely to abort than women with light bleeding. Among the prognostic factors, only the amount of bleeding had significant prognostic accuracy
There is general agreement that uncertainty persists regarding the psychological sequelae of abortion. Inconsistencies of interpretation stem from a lack of consensus about the symptoms, severity, and duration of mental disorder. In addition, opinions differ based on individual case studies and there is no national reporting system or adequate follow up system. Frequently, reviews combine studies conducted prior to and after the 1973 Supreme Court decision, mix elective abortion with those induced for medical reasons, or fail to distinguish between abortions performed early or late in gestation. The literature reveals methodological problems, a lack of controls, and sampling inadequacies. A review of the available literature and the files of "Abortion Research Notes" suggests that women at particular risk for postabortion stress reactions are those who terminate an originally wanted pregnancy, are strongly ambivalent, come very late in their pregnancy, or lack the support of significant others.
Henshaw, S K; Singh, S; Haas, T
Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Health care workers and policymakers need information on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women's health. Numbers and rates of induced abortions were estimated from four sources: official statistics or other national data on legal abortions in 57 countries; estimates based on population surveys for two countries without official statistics; special studies for 10 countries where abortion is highly restricted; and worldwide and regional estimates of unsafe abortion from the World Health Organization. Approximately 26 million legal and 20 million illegal abortions were performed worldwide in 1995, resulting in a worldwide abortion rate of 35 per 1,000 women aged 15-44. Among the subregions of the world, Eastern Europe had the highest abortion rate (90 per 1,000) and Western Europe to the lowest rate (11 per 1,000). Among countries where abortion is legal without restriction as to reason, the highest abortion rate, 83 per 1,000, was reported for Vietnam and the lowest, seven per 1,000, for Belgium and the Netherlands. Abortion rates are no lower overall in areas where abortion is generally restricted by law (and where many abortions are performed under unsafe conditions) than in areas where abortion is legally permitted. Both developed and developing countries can have low abortion rates. Most countries, however, have moderate to high abortion rates, reflecting lower prevalence and effectiveness of contraceptive use. Stringent legal restrictions do not guarantee a low abortion rate.
Smith, T W
In the US attitudes toward abortion in the 1980s seem to have reached a more liberal plateau, much more favored than in the 1960s or earlier, but not longer moving in a liberal direction. Catholic attitudes basically have followed the same trend. Traditionally Catholic support has been slightly lower than Protestant, and both are less inclined to support abortion than Jews or the nonreligious. During the 1970s support among non-black Catholics averaged about 10 percentage points below non-black Protestants. Blacks tend to be anti-abortion and thereby lower support among Protestants as a whole. A comparison of Protestants and Catholics of both races shows fewer religious differences -- about 7 percentage points. There are some indications that this gap may be closing. In 1982, for the 1st time, support for abortions for social reasons, such as poverty, not wanting to marry, or not wanting more children, was as high among Catholics as among Protestants. 1 of the factors contributing to this narrowing gap has been the higher level of support for abortion among younger Catholics. Protestants show little variation on abortion attitudes, with those over age 65 being slightly less supportive. Among Catholics, support drops rapidly with age. This moderate and possibly vanishing difference between Catholics and Protestants contrasts sharply with the official positions of their respective churches. The Catholic Church takes an absolute moral position against abortion, while most Protestant churches take no doctrinaire position on abortion. Several, such as the Unitarians and Episcopalians, lean toward a pro-choice position as a matter of social policy, though fundamentalist sects take strong anti-abortion stances. Few Catholics agree with their church's absolutist anti-abortion position. The big split on abortion comes between what are sometimes termed the "hard" abortion reasons -- mother's health endangered, serious defect in fetus, rape, or incest. Support among Catholics
Kimport, Katrina; Weitz, Tracy A; Freedman, Lori
Roe v. Wade was heralded as an end to unequal access to abortion care in the United States. However, today, despite being common and safe, abortion is performed only selectively in hospitals and private practices. Drawing on 61 interviews with obstetrician-gynecologists in these settings, we examine how they determine which abortions to perform. We find that they distinguish between more and less legitimate abortions, producing a narrative of stratified legitimacy that privileges abortions for intended pregnancies, when the fetus is unhealthy, and when women perform normative gendered sexuality, including distress about the abortion, guilt about failure to contracept, and desire for motherhood. This stratified legitimacy can perpetuate socially-inflected inequality of access and normative gendered sexuality. Additionally, we argue that the practice by physicians of distinguishing among abortions can legitimate legislative practices that regulate and restrict some kinds of abortion, further constraining abortion access. © American Sociological Association 2016.
Grimes, David A
An estimated 19 million unsafe abortions occur worldwide each year, resulting in the deaths of about 70,000 women. Legalization of abortion is a necessary but insufficient step toward improving women's health. Without skilled providers, adequate facilities and easy access, the promise of safe, legal abortion will remain unfulfilled, as in India and Zambia. Both suction curettage and pharmacological abortion are safe methods in early pregnancy; sharp curettage is inferior and should be abandoned. For later abortions, either dilation and evacuation or labour induction are appropriate. Hysterotomy should not be used. Timely and appropriate management of complications can reduce morbidity and prevent mortality. Treatment delays are dangerous, regardless of their origin. Misoprostol may reduce the risks of unsafe abortion by providing a safer alternative to traditional clandestine abortion methods. While the debate over abortion will continue, the public health record is settled: safe, legal, accessible abortion improves health.
Full Text Available Abortion is seen as an immoral and unjust act by many. Nonetheless these views are under pressure to conform to the learned opinion on abortion. A variety of prestigious in the field of applied ethics support abortion in one way or another. And it is a dogma of modern liberalism that even if one is personally opposed to abortion, one must accept the neutral solution of its public permissibility. The present article defends the thesis that abortion is immoral and unjust against these contentions. With regards to the moral status of abortion, it argues that the prohibition of abortion is off a piece with the prohibition of killing generally, which is characterized by protecting all human beings equally. With regards to the compatibility of abortion permissibility with liberalism, the article argues that such a compromise is not neutral, but heavily rigged in favor of the interests and world-views of abortion proponents.
Stephenson, Rob; Jadhav, Apoorva; Winter, Amy; Hindin, Michelle
The prevalence of domestic violence and abortion in India is high, yet little is known about the relationship between these experiences. Data from two linked data sets, India's 1998-1999 National Family Health Survey (NFHS-2) and a follow-up survey in 2002-2003, were analyzed. The analysis examines how the experience of physical violence affects the subsequent uptake of abortion, and how the experience of abortion affects subsequent experience of physical, sexual, and verbal violence. Women who experienced physical violence have significantly higher odds of reporting a subsequent induced abortion, whereas women who had an induced abortion have significantly higher odds of reporting subsequent sexual and verbal violence. There was no significant relationship between domestic violence and spontaneous abortion. © The Author(s) 2016.
In the UK in 1988, 13.3% of abortions were performed at 13 weeks' gestation or later. Reasons for this delay, in addition to the diagnosis through amniocentesis of a fetal abnormality, include late recognition of pregnancy, a change of mind about completing the pregnancy, a failure of primary care physicians to entertain the diagnosis of pregnancy, travel or financial problems, and referral difficulties and scheduling delays. Women with little education and very young women are most likely to present for late abortions. From 13-16 weeks, dilatation and evacuation is the safest method of pregnancy termination. The procedure can be made easier through preparation of the cervix with a prostaglandin pessary or Foley catheter. After 16 weeks, an instillation method is recommended; prostaglandin administration can be intro- or extra-amniotic. Complication rates at 13-19 weeks are 14.5/1000 for vaginal methods of abortion and 7.2/1000 for prostaglandin methods. The risk of complications is 3 times higher for women who have 2nd-trimester abortions through the National Health Service. Although it is not realistic to expect that late abortions ever can be eliminated, improved sex education and contraceptive reliability as well as reforms in the National Health Service could reduce the number substantially. To reduce delay, it is suggested that the National Health Service set up satellite day care units and 1-2 central units in each region to deal quickly with midtrimester abortions. Delays would be further reduced by legislation to allow abortion on request in at least the 1st trimester of pregnancy.
Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Kumbia, Antonia; Mola, Glen D L; Whittaker, Andrea
In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion. Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information. Case notes were reviewed for 56% (67/119) of women presenting for post abortion care. At least 24% (28/119) of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported. In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion.
Vallely, Lisa M.; Homiehombo, Primrose; Kelly-Hanku, Angela; Kumbia, Antonia; Mola, Glen D. L.; Whittaker, Andrea
Background In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion. Methods Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information. Findings Case notes were reviewed for 56% (67/119) of women presenting for post abortion care. At least 24% (28/119) of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported. Conclusion In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion. PMID:25329982
Bulienko, S.D.; Fogel, P.I.
Significant changes are shown to occur in the level of sex hormones in blood at the risk of spontaneous abortion, missed abortion, or the mole. Determining the levels of estradiol, progesterone, chorial gonadotropin and testosterone in the blood serum using RIA yields immediate information on the hormonal function of the fetoplacental unit. This has diagnostic significance and can be used as a criterion for the application of complementary hormonal therapy when there is a risk of abortion or premature delivery. (author)
A table showing the current status of abortion in the world based on two recent and detailed studies is presented. Countries are categorized according to whether they totally prohibit abortion, permit it to save the mother's life, permit it to preserve her physical health or mental health, permit it for maternal socioeconomic reasons, or provide it at the mother's request. The countries are grouped into 5 geographic areas: America and the Caribbean; Central Asia, Middle East, and North Africa; East and South Asia and the Pacific; Europe; sub-Saharan Africa. The trend toward liberalization of laws is clear. The development of abortion laws is moving in the direction of complete legalization, that is, the creation of health norms that facilitate abortion for all women, with guarantees of medical safety. There are still countries that move to restrict access to abortion, and in a few cases, such as Colombia and Poland, legalization and prohibition have alternated depending on the social and political circumstances of the moment. In the past 12 years, 28 countries liberalized their laws in some way, while 4 countries with close ties to the Vatican restricted or prohibited access.
In Jewish law right and wrong, good and evil, are absolute values which transcend time, place, and environment. They defy definition by human intuition or expediency. Jewish law derives from the Divine revelation at Mount Sinai as expounded by sages faithful to, and authorized by, its writ. The Talmud rules that if a woman is in hard travail, and her life must be saved, the child must be aborted and extracted. The mother's life comes first. The fetus is not a human life until it is born. But 19th century Rabbinical works state that it is immoral to destroy a monster child. Modern rabbis are unanimous in condemning abortion, feticide, or infanticide as an unconscionable attack on human life. However, Jewish law allows abortion if the pregnancy will cause severe psychological damage to the mother. No civilized society could survive without laws which occasionally cause some suffering or personal anguish. One human life is worth a million lives, because each life is infinite in value. In cases of rape or incest Jewish law still does not sanction abortion. Man's procreative responsibilities are serious and carry rights and obligations which would be upset by liberalized abortion laws. If a person kills a person who is mortally wounded, the killer is guilty of a moral offense.
Rhodes, A M
The right to abortion is confirmed in the Roe versus Wade case, by the US Supreme Court. It is a fundamental right of privacy but not an absolute right, and must consider state interests. During the first trimester of pregnancy abortion is a decision of the woman and her doctor. During the second trimester of pregnancy the state may control the abortion practice to protect the mothers health, and in the last trimester, it may prohibit abortion, except in cases where the mother's life or health are in danger. The states enacted laws, including one that required parents to give written consent for a unmarried minor's abortion. This law was struck down by the US Court, but laws on notification were upheld as long as there was alternative procedures where the minor's interests are upheld. Many of these law have been challenged successfully, where the minor was judged mature and where it served her best interests. The state must enact laws on parental notification that take into consideration basic rights of the minor woman. Health professionals and workers should be aware of these laws and should encourage the minor to let parents in on the decision making process where possible.
Full Text Available Introduction: - The biological definition of miscarriage is the expulsion of the conceptus before viability has been achieved. The definition of recurrent miscarriage is three or more consecutive spontaneous abortions. The risk factors for recurrent miscarriage are epidemiological, genetic, anatomical disorders, endocrinal, reproductive tract infections, thrombophilic disorders, disorders of materno-fetal alloimmune relationships, environmental effects and psychological causes. About 50% to 60% of all first trimester abortions are associated with derangement of one or more chromosomal complements. Aim: - The aim of this study was to assess frequency and increasing the awareness of physician about the nature of chromosomal aberration that contribute to the occurrence of repeated abortions. Material & Methods: - Patient of recurrent abortion was investigated by history taking, examination and investigations. For present study 20 women having two or more consecutive spontaneous abortions, who attended outdoor & indoor patient department, were selected and karyotyping was done. In 10 of the above cases karyotype study of both partners was done. So in total 30 individuals (20 females & 10 males were selected for Cytogenetic study. In all cases relevant history and clinical findings and other investigations were noted. Blood samples were obtained and karyotype study was performed at Genetic Laboratory, B. J. Medical College, Ahmedabad. Results and Conclusions: - Cytogenetic evaluation by karyotypes revealed robertsonian translocation in one (5% female; this patient had a history of 2 spontaneous abortions and two times IVF failure, she had history of chocolate cyst of ovary and family history of infertility. No numerical anomaly; mosaicism or inversions were found in this study; 23 cases had normal karyotype and remaining 6 cases came out inconclusive.
In Ghana, abortion mortality constitutes 11% of maternal mortality. Empirical studies on possible disparities in abortion experience and access to safe abortion services are however lacking. Based on a retrospective survey of 1,370 women aged 15-49 years in two districts in Ghana, this paper examines disparities in ...
Wang, Yao; Sun, Yun; Di, Wen; Kuang, Yan-Ping; Xu, Bing
To establish an effective and safe clinical fertility strategy by investigating the relationship between abortion history and pregnancy outcomes of in vitro fertilization (IVF) treatment. In the present retrospective cohort study, data from IVF treatment cycles performed at a reproductive center in China between October 1, 2014, and October 31, 2015, were assessed. Outcomes were compared between women with a history of induced abortion and those without. There were 1532 IVF treatment cycles included; 454 patients had a history of induced abortion and 1078 did not. The spontaneous abortion rate was significantly higher (30/170 [17.6%] vs 41/420 [9.8%]; P=0.002) and the endometrium was significantly thinner (8.8 ± 1.8 vs 9.7 ± 1.8 cm; P=0.001) among patients with a history of induced abortion compared with those without. In a subgroup analysis of patients with a history of induced abortion, women who had undergone surgical abortions had a lower live delivery rate compared with medical abortions (29/76 [38%] vs 101/378 [27%]; P=0.039). Further, women who had a history of more than two surgical abortions had lower live delivery and clinical pregnancy rates (both Pabortion was associated with worse IVF outcomes, especially a history of more than two surgical abortions. © 2018 International Federation of Gynecology and Obstetrics.
Carle, Allan; Pedersen, Inge Buelow; Knudsen, Nils
: In conditional multivariate logistic regression models, we analyzed the associations between the development of autoimmune hypothyroidism and age at menarche/menopause, years of menstruations, pregnancies, spontaneous and induced abortions, live births, and years on oral contraceptives and postmenopausal hormone...
Aug 14, 1971 ... abortion on the demand of any pregnant woman. Although .... Of these abortions 55% were in single, widowed, divorced or separated women and the ... gists found reluctance in nursing staff for the performance of therapeutic ...
In this article we address the issue, with a tentative empirical application to the Italian data, of the relationship, very debated mainly in north America, between abortion legalization and reduction of crime rates of youth. The rationale of this relationship is that there is a causal factor at work: the more unwanted pregnancies aborted, the less unwanted children breeding their criminal attitude in an hostile/deprived family environment. Many methodological and empirical criticisms have been raised against the proof of the existence of such a relationship: our attempt to test if this link is valid for Italy cannot endorse its existence. The data we used made necessary some assumptions and the reliability of official estimates of crime rates was debatable (probably downward biased). We conclude that, at least for Italy, the suggested relationship is unproven: other reasons for the need of legal abortion have been and should be put forward.
The author sets forth some of the most recent demographic data, important directions of legal documents as regards abortion, tackling medical and ethical problems of abortion. Some essentials particulars are also given as to the embryonic and foetal development. The whole paper concerns the problems of legal abortion during the first three months of pregnancy. The second part of the paper relates to the consequences of abortion affecting the physical and mental health of a woman as show...
Criminal Aspects of Artificial Abortion This diploma thesis deals with the issue of artificial abortion, especially its criminal aspects. Legal aspects are not the most important aspects of artificial abortion. Social, ethical or ideological aspects are of the same importance but this diploma thesis cannot analyse all of them. The main issue with artificial abortion is whether it is possible to force a pregnant woman to carry a child and give birth to a child when she cannot or does not want ...
Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.
presentation, she noticed coital bleeding; it was mildI self with no associated dizziness or dyspareunis. She had been treated with drugs on many occasions at hospitals as well as over the counter medicaiions with no improvement. Eight years prior to presentation, she had an induced abortion at about 14 weeks of gestaiion ...
Di Nucci, Ezio
This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis's argument against abortion fail. Strong's basic idea is that there are cases--for example, terminally ill patients--where killing an adult human being is prima facie seriously morally...
14 Aug 1971 ... The literature on the pros and cons of therapeutic abortion must by now virtually fill an average- sized library. Every expert in every field has had his say, sometimes by invitation and sometimes unasked, yet we seem to be no nearer the answer than when we started. The legal boffins have put their case, the ...
Claudia Escobar García
This work explains that the discourses opposing the criminalization ofabortion and that reject the constitutional rules that protect human life,are an artificially constructed ideology made only to justify abortion,and hide the asymmetrical relations of power between women and theunborn. In order for this purpose, these arguments are identified andsubjected to critical analysis, demonstrating that it is purely emotionaland lacking fundaments.
Jun 1, 2014 ... 95% of women would have had an induced abortion. (10), which ... who were fluent in both English and the local language were chosen ... the woman and society. The Muslims ... that “traditional methods are only effective at the early stages of ... modern and traditional family planning services. However ...
Ogland, Curtis P; Verona, Ana Paula
This study examines the association between religion and attitudes toward the practice of abortion and abortion policy in Brazil. Drawing upon data from the 2002 Brazilian Social Research Survey (BSRS), we test a number of hypotheses with regard to the role of religion on opposition to the practice of abortion and its legalization. Findings indicate that frequently attending Pentecostals demonstrate the strongest opposition to the practice of abortion and both frequently attending Pentecostals and Catholics demonstrate the strongest opposition to its legalization. Additional religious factors, such as a commitment to biblical literalism, were also found to be significantly associated with opposition to both abortion issues. Ultimately, the findings have implications for the future of public policy on abortion and other contentious social issues in Brazil.
The field of abortion counseling originated in the abortion rights movement of the 1970s. During its evolution to the present day, it has faced significant challenges, primarily arising from the increasing politicization and stigmatization of abortion since legalization. Abortion counseling has been affected not only by the imposition of antiabortion statutes, but also by the changing needs of patients who have come of age in a very different era than when this occupation was first developed. One major innovation--head and heart counseling--departs in significant ways from previous conventions of the field and illustrates the complex and changing political meanings of abortion and therefore the challenges to abortion providers in the years following Roe v Wade.
Claudia Escobar García
Full Text Available This work explains that the discourses opposing the criminalization ofabortion and that reject the constitutional rules that protect human life,are an artificially constructed ideology made only to justify abortion,and hide the asymmetrical relations of power between women and theunborn. In order for this purpose, these arguments are identified andsubjected to critical analysis, demonstrating that it is purely emotionaland lacking fundaments.
Edwards, R B
This essay seeks to reveal the weakness in arguments against public funding of abortions and abortion counseling in the US based on economic, ethico-religious, anti-racist, and logical-consistency objections and to show that public funding of abortion is strongly supported by appeals to basic human rights, to freedom of speech, to informed consent, to protection from great harm, to justice, and to equal protection under the law. The first part of the article presents the case against public funding with detailed considerations of the economic argument, the ethico/religious argument, the argument that such funding supports racist genocide or eugenic quality control, and arguments that a logical inconsistency exists between the principles used to justify the legalization of abortions and arguments for public funding. The second part of the article presents the case for public funding by discussing the spending of public funds on morally offensive programs, arguments for public funding of abortion counseling for the poor, and arguments for public funding of abortions for the poor. It is concluded that it is morally unacceptable and rationally unjustifiable to refuse to expend public funds for abortions for low income women, because after all most money for legal abortions for the poor comes from welfare payments made to women. If conservative forces want to insure that no public funds pay for abortions, they must stop all welfare payments to pregnant women.
Shoesmith, Gary L.
This article disaggregates Donohue and Levitt’s (DL’s) national panel-data models to the state level and shows that high concentrations of teenage abortions in a handful of states drive all of DL’s results in their 2001, 2004, and 2008 articles on crime and abortion. These findings agree with previous research showing teenage motherhood is a major maternal crime factor, whereas unwanted pregnancy is an insignificant factor. Teenage abortions accounted for more than 30% of U.S. abortions in the 1970s, but only 16% to 18% since 2001, which suggests DL’s panel-data models of crime/arrests and abortion were outdated when published. The results point to a broad range of future research involving teenage behavior. A specific means is proposed to reconcile DL with previous articles finding no relationship between crime and abortion. PMID:28943645
Hunt, M E
A female Catholic theologian imagines a just society that does not judge women who decide to undergo an abortion. The Church, practitioners, and the courts must trust that women do make person-enhancing choices about the quality of life. In the last 15 years most progress in securing a woman's right to abortion has been limited to white, well-educated, and middle or upper middle class women. A just society would consider reproductive options a human right. Abortion providers are examples of a move to a just society; they are committed to women's well-being. There are some facts that make one pessimistic about achieving abortion in a just society. The US Supreme Court plans to review important decisions establishing abortion as a civil right. Further, some men insist on suing women who want to make their own reproductive decisions--an anti-choice tactic to wear away women's right to reproductive choice. Bombings of abortion clinics and harassment campaigns by anti-choice groups are common. These behaviors strain pro-choice proponents emotionally, psychically, and spiritually. Their tactics often lead to theologians practicing self-censorship because they fear backlash. Abortion providers also do this. Further, the reaction to AIDS is that sex is bad. Anti-abortion groups use AIDS to further their campaigns, claiming that AIDS is a punishment for sex. Strategies working towards abortion in a just society should be education and persuasion of policymakers and citizens about women's right to choose, since they are the ones most affected by abortion. Moreover, only women can secure their rights to abortion. In a just society, every health maintenance organization, insurance company, and group practice would consider abortion a normal service. A just society provides for the survival needs of the most marginalized.
Informed consent mandates for abortion providers may infringe the First Amendment's freedom of speech. On the other hand, they may reinforce the physician's duty to obtain informed consent. Courts can promote both doctrines by ensuring that compelled physician speech pertains to medical facts about abortion rather than abortion ideology and that compelled speech is truthful and not misleading. © 2015 American Society of Law, Medicine & Ethics, Inc.
Wiebe, Ellen R; Sandhu, Supna
Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Women presenting for abortion over a two-month period at two free-standing abortion clinics, one publicly funded and the other private, were invited to participate in the study. Phase I of the study involved administration of a questionnaire seeking information about demographics, perceived barriers to access to abortion, and what the women wanted from abortion services. Phase II involved semi-structured interviews of a convenience sample of women to record their responses to questions about access. Responses from Phase I questionnaires were compared between the two clinics, and qualitative analysis was performed on the interview responses. Of 423 eligible women, 402 completed questionnaires, and of 45 women approached, 39 completed interviews satisfactorily. Women received information about abortion services from their physicians (60.0%), the Internet (14.8%), a telephone directory (7.8%), friends or family (5.3%), or other sources (12.3%). Many had negative experiences in gaining access. The most important issue regarding access was the long wait time; the second most important issue was difficulty in making appointments. In the private clinic, 85% of the women said they were willing to pay for shorter wait times, compared with 43.5% in the public clinic. Physicians who failed to refer patients for abortion or provide information about obtaining an abortion caused distress and impeded access for a significant minority of women requesting an abortion. Management of abortion services should be prioritized to reflect what women want: particularly decreased wait times for abortion and greater ease and convenience in booking appointments
Dalvie, Suchitra S
This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services. Based on personal experiences and personal communications from other doctors since 1993, when I began working as an abortion provider, the practical realities of second trimester abortion and case histories of women seeking second trimester abortion are also described. Recommendations include expanding the cadre of service providers to non-allopathic clinicians and trained nurses, introducing second trimester medical abortion into the public health system, replacing ethacridine lactate with mifepristone-misoprostol, values clarification among providers to challenge stigma and poor treatment of women seeking second trimester abortion, and raising awareness that abortion is legal in the second trimester and is mostly not requested for reasons of sex selection.
An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy
Feng Chenxia; Zhou Weimin; Leng Yongbin
Beam abort signal is a timing signal of the SSRF (Shanghai Synchrotron Radiation Facility) storage ring. It is used to synchronize BPM processor Libera logging beam position data to identify beam abort source and improve the stability of accelerator. The concept design and engineering design of beam abort trigger module are introduced in this paper, and lab test results of this module using RF signal source also presented. Online beam test results show that this module has achieved design goal, could be used to log beam position data before beam abort. (authors)
Stotland, N L
US anti-abortion groups have used misinformation on the long-term psychological impact of induced abortion to advance their position. This article reviews the available research evidence on the definition, history, cultural context, and emotional and psychiatric sequelae of induced abortion. Notable has been a confusion of normative, transient reactions to unintended pregnancy and abortion (e.g., guilt, depression, anxiety) with serious mental disorders. Studies of the psychiatric aspects of abortion have been limited by methodological problems such as the impossibility of randomly assigning women to study and control groups, resistance to follow-up, and confounding variables. Among the factors that may impact on an unintended pregnancy and the decision to abort are ongoing or past psychiatric illness, poverty, social chaos, youth and immaturity, abandonment issues, ongoing domestic responsibilities, rape and incest, domestic violence, religion, and contraceptive failure. Among the risk factors for postabortion psychosocial difficulties are previous or concurrent psychiatric illness, coercion to abort, genetic or medical indications, lack of social supports, ambivalence, and increasing length of gestation. Overall, the literature indicates that serious psychiatric illness is at least 8 times more common among postpartum than among postabortion women. Abortion center staff should acknowledge that the termination of a pregnancy may be experienced as a loss even when it is a voluntary choice. Referrals should be offered to women who show great emotional distress, have had several previous abortions, or request psychiatric consultation.
Bettahar, K; Pinton, A; Boisramé, T; Cavillon, V; Wylomanski, S; Nisand, I; Hassoun, D
Updated clinical recommendations for medical induced abortion procedure. A systematic review of French and English literature, reviewing the evidence relating to the provision of medical induced abortion was carried out on PubMed, Cochrane Library and international scientific societies recommendations. The effectiveness of medical abortion is higher than 95% when the protocols are adjusted to gestational age (EL1). Misoprostol alone is less effective than a combination of mifepristone and misoprostol (EL1). Gemeprost is less effective than misoprostol (EL2). The dose of 200mg of mifepristone should be preferred to 600mg (NP1, Rank A). Mifepristone can be taken at home (professional agreement). The optimum interval between mifepristone and misoprostol intake should be 24 to 48 hours (EL1, grade A). Before 7 weeks LMP, the dose of 400μg misoprostol should be given orally (EL1, grade A) eventually repeated after 3hours if no bleeding occurs. For optimal effectiveness between 7 and 14 LMP, the interval between mifepristone and misoprostol should not be shortened to less than 8hours (grade 1). An interval of 24 to 48hours will not affect the effectiveness of the method provided misoprostol dosage is 800μg (EL1). Vaginal, sublingual or buccal routes of administration are more effective and better tolerated than the oral route, which should be abandoned (EL1). An amount of 800μg sublingual or buccal misoprostol route has the same effectiveness than the vaginal route but more gastrointestinal side effects (EL1, grade A). Between 7 and 9 LMP, it does not seem necessary to repeat misoprostol dose whereas it should be repeated beyond 9 SA (grade B). Between 9 and 14 LMP, the dose of 400μg misoprostol given either vaginally, buccally or sublingually should be repeated every 3hours if needed (with a maximum of 5 doses) (EL2, grade B). There is no strong evidence supporting routine antibiotic prophylaxis for medical abortion (professional agreement). Rare contraindications
Watter, W W
There is no scientific evidence to support the hypothesis put forth by Dr. Philip Ney in a recent article published in the Canadian Journal of Psychiatry that induced abortion is associated with an increase in child abuse. There are, however, numerous studies which support the contention that mandatory motherhood adversely affects the mental health of both the mother and the offspring. Studies conducted in Sweden, Scotland, and Czechoslovakia revealed that women who were refused abortions frequently experienced serious psychosocial difficulties for long periods of time following abortion refusal. Case controlled follow-up studies, conducted in Sweden and Czechoslovakia, of offspring born to women who were refused abortions demonstrated that a higher proportion of the unwanted children required psychiatric services, engaged in criminal behavior, and did less well in school than the controlled children. These studies have implications for the current Canadian law which permits a woman to obtain an abortion if pregnancy continuation will endanger her health. In view of the above statistical evidence, and the fact that mortality and morbidity are known to be lower for abortion than for childbirth, any person who denies a woman the right to have an abortion is increasing the risk that the health of the woman will be endangered. By law, therefore, all abortion requests should be honored.
John Donohue; Steven Levitt
We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly 18 years after abortion legalization. The 5 states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater crime reductions in the 1990s. In high abortion states, only arrests of those born after abortion legaliz...
Edelman, Benjamin; Geradin, Damien
Platform businesses such as Airbnb and Uber have risen to success partly by sidestepping laws and regulations that encumber their traditional competitors. Such rule flouting is what the authors call “spontaneous private deregulation,” and it’s happening in a growing number of industries. The authors
Nyong'o, D; Oodit, G
Despite a contraceptive prevalence rate of 75% Mauritius has a high incidence of unsafe abortions because of unprotected intercourse experienced by many young women in a rapidly industrializing environment. The Mauritius Family Planning Association (MFPA) tackled the issue of unsafe abortion in 1993. Abortion is illegal in the country, and the Catholic Church also strongly opposes modern family planning methods, thus the use of withdrawal and/or calendar methods have been increasing. The MFPA organized an advocacy symposium in 1993 on unsafe abortion with the result of revealing the pressure the Church was exerting relative to abortion and contraceptives. The advocacy campaign of the MFPA consists of having abortion legalized on health grounds and improving family planning services, especially for young unmarried women and men. The full support of the media was secured on the abortion issue: articles appeared, meetings were attended by the press, and public relations support was also received from them. The MFPA worked closely with parliamentarians. A motion was tabled in 1994 in the National Assembly which called for legalization of abortion on health grounds, but the Church squelched its debate. In March 1994 MFPA hosted the IPPF African Regional Conference on Unsafe Abortion in Mauritius with the participation of over 100 representatives from 20 countries, and subsequently a second motion was tabled without parliamentary debate. The deliberations were covered by the media and the Ministry of Women's Rights recognized abortion as an urgent issue as outlined in a white paper prepared for the Fourth World Conference on Women held in Beijing in 1995. The campaign changed the policy climate favorably making the public more conscious of unsafe abortion. The Ministry of Health decided to collect more data and the newly elected government seems to be more open about this issue.
目的：探讨药物流产和人工流产的临床效果，并分析不同患者相应的护理方法。方法选取我院于2012年9月～2014年9月收治的68例需要实施流产的患者，按照患者意愿的不同将其分为药物流产组和人工流产组，观察两组患者流产后的临床特征及表现，并对其护理情况进行分析。结果通过对两组患者施以不同流产方法，人工流产组34例患者均为完全流产，药物流产组完全流产为30例，数据对比差异有统计学意义（P＜0.05）。结论通过研究发现，药物流产和人工流产两种方案各有优缺点，应根据孕妇的具体情况制定合适的流产方案，并给予患者相应的护理措施，缓解患者的情绪，促进患者的康复。%Objective To explore the clinical effect of drug abortion and artificial abortion, and analyze the nursing methods of patients with different corresponding. Methods Select our hospital from September 2012 to September 2014 patients treated 68 cases need to implement an abortion, according to the wishes of patients with different it can be divided into medical abortion and artiifcial abortion group, two groups of patients with spontaneous abortion after the clinical features and performance, and analyze the nursing status.ResultsBy means of two groups of patients with different methods of abortion, abortion group of 34 patients were completely abortion, complete abortion of 30 cases of medical abortion group, data contrast significant difference was statistically significant (P<0.05).Conclusion Through the study found that medical abortion and abortion two plans each have advantages and disadvantages, should be based on appropriate abortion of pregnant women, patients and give corresponding nursing measures, alleviate the mood of patients, promote the recovery of patients.
KAMYAB S.D. AZARI S.D. NATEGH R
Full Text Available Two hundred pa t ient s o f t he l ow socioe conomic g roup wi th an aborti on o f the f i r s t t r i mest e r were stud 1ed . The s ter i l e produc ts o f concept ion were c ul t ured on Gr e e n Monke y Kidney ti s sue cul t ure f or v i r a l de t e c - tion. Four po s i t i ve Herpe s virus, two positive Rubella"nv~ru s and t hree pos i tive unidentifie d Entero v irus l ike Vlrus were obtained The sera of 192 of these patients were titrated for Rubella antibody. The sera of a control group of 150 normal pregnant women were titrated for Rubella antibody and 8.8 per cent of these patients had a negative titre and 21.3 per cent , 1 had a tltre over 40
Hviid, T V; Hylenius, S; Hoegh, A M
% of the RSA women carried the HLA-G*0106 allele compared to 2% of the control women. The 14 bp deletion polymorphism in exon 8 was investigated separately. There were a greater number of heterozygotes for the 14 bp polymorphism in the group of fertile control women than expected, according to Hardy-Weinberg...
Hviid, T V; Hylenius, S; Hoegh, A M
% of the RSA women carried the HLA-G*0106 allele compared to 2% of the control women. The 14 bp deletion polymorphism in exon 8 was investigated separately. There were a greater number of heterozygotes for the 14 bp polymorphism in the group of fertile control women than expected, according to Hardy-Weinberg...... equilibrium. Furthermore, the HLA-G alleles without the 14 bp sequence were prominent in the RSA males in contrast to the RSA women in whom alleles including the 14 bp sequence were frequently observed, especially as homozygotes. These results are discussed in relation to two hypotheses concerning HLA...
Korejo, Razia; Noorani, Khurshid Jehan; Bhutta, Shereen
To determine the frequency of induced abortion and identify the role of sociocultural factors contributing to termination of pregnancy and associated morbidity and mortality in hospital setting. Prospective observational study. The study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi from January 1999 to June 2001. The patients who were admitted for induced abortion were interviewed in privacy. On condition of anonymity they were asked about the age, parity, family setup and relationships, with particular emphasis on sociocultural reasons and factors contributing to induction of abortion. Details of status of abortionist and methods used for termination of pregnancy, the resulting complications and their severity were recorded. Out of total admissions, 57(2.35%) gave history of induced abortion. All women belonged to low socioeconomic class and 59.6% of them were illiterate. Forty-three (75.5%) of these women had never practiced contraception. Twenty-four (42%) were grandmultiparae and did not want more children. In 29 women (50.9%) the decision for abortion had been supported by the husband. In 25 women (43.8%) abortion was carried out by Daiyan (traditional midwives). Serious complications like uterine perforation with or without bowel injury were encountered in 25 (43.8%) of these women. During the study period illegally induced abortion accounted for 6 (10.5%) maternal deaths. Prevalence of poverty, illiteracy, grand multiparity and non-practice of contraception are strong determinants of induced abortion.
Korejo, R.; Noorani, K.J.; Bhutta, S.
Objective: To determine the frequency of induced abortion and identity the role of sociocultural factors contributing to termination of pregnancy and associated morbidity and mortality in hospital setting. Subjects and Methods: The patients who were admitted for induced abortion were interviewed in privacy. On condition of anonymity they were asked about the age, parity, family setup and relationships, with particular emphasis on sociocultural reasons and factors contributing to induction of abortion. Details of status of abortionist and methods used for termination of pregnancy, the resulting complications and their severity were recorded. Results: Out of total admissions, 57(2.35%) gave history of induced abortion. All women belonged to low socioeconomic class and 59.6% of them were illiterate. Forty-three (75.5%) of these women had never practiced concentration. Twenty-four (42%) were grandmultiparae and did not want more children. In 29 women (50.9%) the decision for abortion had been supported by the husband. In 25 (43.8%) abortion was carried out by Daiyan (traditional midwives). Serious complications like uterine perforation with or without bowel injury were encouraged in 25 (43.8%) of these women. During the study period illegally induced abortion accounted for 6 (10.5%) maternal deaths. Conclusion: Prevalence of poverty, illiteracy, grand multiparity and non-practice of contraception are strong determinants of induced abortion. (author)
Family planning centres are structures designed to receive and care for women requesting elective abortions. Here the specially trained, dedicated teams offer personalised care. The instrumental elective abortion is prepared in the same way as a surgical procedure and is subject to the same monitoring. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
A federal appeals court has affirmed lower court rulings that substantial portions of the Illinois' 1975 Abortion Act and 1977 Abortion Parental Consent Act are unconstitutional. The 7th Court adopted an April 12, 1978 district court opinion that invalidated several sections of the Illinois 1975 abortion statute, including parental and spousal consent requirements and provisions requiring that a woman be informed of the "physical competency" of the fetus at the time the abortion was to be performed. The appeals court specifically addressed the statute's provision making a liveborn fetus resulting from an abortion a ward of the state, unless the abortion was performed to save the woman's life. Regarding the 1977 Parental Consent Act, the 7th Circuit reaffirmed its August 1978 ruling that it is unconstitutional to require an unmarried minor to have the consent of both parents or, if they refused consent, a circuit court judge before undergoing an abortion. The appeals court also agreed with the lower court's November 2nd ruling that the Act's requirement of a 48-hour delay between the time the minor gives her consent and the performance of an abortion violated the equal protection clause of the 14th amendment.
Geary, Cynthia Waszak; Gebreselassie, Hailemichael; Awah, Paschal; Pearson, Erin
Despite Zambia's relatively progressive abortion law, women continue to seek unsafe, illegal abortions. Four domains of abortion attitudes - support for legalization, immorality, rights, and access to services - were measured in 4 communities. A total of 668 people were interviewed. Associations among the 4 domains were inconsistent with expectations. The belief that abortion is immoral was widespread, but was not associated with lack of support for legalization. Instead, it was associated with belief that women need access to safe services. These findings suggest that increasing awareness about abortion law in Zambia may be important for encouraging more favorable attitudes. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Henshaw, S K
This article presents current estimates of the number, rate, and proportion of abortions for all countries which make such data available. 76% of the world's population lives in countries where induced abortion is legal at least for health reasons. Abortion is legal in almost all developed countries. Most developing countries have some laws against abortion, but it is permitted at least for health reasons in the countries of 67% of the developing world's population. The other 33%--over 1 billion persons--reside mainly in subSaharan Africa, Latin America, and the most orthodox Muslim countries. By the beginning of the 20th century, abortion had been made illegal in most of the world, with rules in Africa, Asia, and Latin America similar to those in Europe and North America. Abortion legislation began to change first in a few industrialized countries prior to World War II and in Japan in 1948. Socialist European countries made abortion legal in the first trimester in the 1950s, and most of the industrialized world followed suit in the 1960s and 1970s. The worldwide trend toward relaxed abortion restrictions continues today, with governments giving varying reasons for the changes. Nearly 33 million legal abortions are estimated to be performed annually in the world, with 14 million of them in China and 11 million in the USSR. The estimated total rises to 40-60 million when illegal abortions added. On a worldwide basis some 37-55 abortions are estimated to occur for each 1000 women aged 15-44 years. There are probably 24-32 abortions per 100 pregnancies. The USSR has the highest abortion rate among developed countries, 181/1000 women aged 15-44, followed by Rumania with 91/1000, many of them illegal. The large number of abortions in some countries is due to scarcity of modern contraception. Among developing countries, China apparently has the highest rate, 62/1000 women aged 15-44. Cuba's rate is 59/1000. It is very difficult to calculate abortion rates in countries
Martin, Lisa A; Hassinger, Jane A; Debbink, Michelle; Harris, Lisa H
Researchers have described the difficulties of doing abortion work, including the psychosocial costs to individual providers. Some have discussed the self-censorship in which providers engage in to protect themselves and the pro-choice movement. However, few have examined the costs of this self-censorship to public discourse and social movements in the US. Using qualitative data collected during abortion providers' discussions of their work, we explore the tensions between their narratives and pro-choice discourse, and examine the types of stories that are routinely silenced - narratives we name "dangertalk". Using these data, we theorize about the ways in which giving voice to these tensions might transform current abortion discourse by disrupting false dichotomies and better reflecting the complex realities of abortion. We present a conceptual model for dangertalk in abortion discourse, connecting it to functions of dangertalk in social movements more broadly. Copyright © 2017 Elsevier Ltd. All rights reserved.
Lipper, Irene; Cvejic, Helen; Benjamin, Peter; Kinch, Robert A.
A study was carried out at the Adolescent Unit of The Montreal Children's Hospital from September 1970 to December 1972, the focus of which evolved from the pregnant teenager in general to the short- and long-term effects of her abortion. Answers to a questionnaire administered to 65 pregnant girls to determine the psychosocial characteristics of the pregnant teenager indicated that these girls are not socially or emotionally abnormal. A follow-up study of 50 girls who had an abortion determined that the girls do not change their life styles or become emotionally unstable up to one year post-abortion, although most have a mild, normal reaction to the crisis. During the study period the clinic services evolved from mainly prenatal care to mainly abortion counselling, and then to providing the abortion with less counselling, placing emphasis on those cases which require other than medical services. PMID:4750298
In Slovenia abortion will continue to be available during the first 10 weeks of pregnancy as it has been since 1978. The Slovenian Constitutional Court passed this decision in December, 1991 calling the right to abortion a basic human right. T he ruling was a setback both for the government's conservative parties and the Catholic church. In Croatia, where the Catholic church is campaigning against abortion, the situation is quite different. Zagreb is full of stickers and posters with anti-abortion messages branding abortion murder and spreading inaccurate information in announcements. In 1990, there were 56,000 abortions. For every child that was born, one was aborted. The largest Croatian newspaper publicizes the Catholic view. They want pro-choice women of the volunteer group Tresnjevka to stop their struggle. The church and conservative women's groups press for inclusion of abortion in the Constitution. They are very powerful, and the fear is that might soon succeed in restricting or outlawing abortion. Tresnjevka is making efforts to organize a coordination and information center for women in Zagreb where there are 350,000 women and children refugees. Informative brochures are printed on natural healing methods in gynecology, as drugs are very scarce, and addresses for gynecological emergency care are also provided. Abortion has been legally available on demand during the 1st 10 weeks of pregnancy since 1978. Fore year Tresnjevka has worked for women, trying to raise funds from personal donations and from the government for their activities. Funds from foreign countries have never been received. At present many of the group's activities are on hold because of lack of funds, nevertheless the determination to continue fighting is alive.
Hanschmidt, Franz; Linde, Katja; Hilbert, Anja; Riedel-Heller, Steffi G; Kersting, Anette
Although stigma has been identified as a potential risk factor for the well-being of women who have had abortions, little attention has been paid to the study of abortion-related stigma. A systematic search of the databases Medline, PsycArticles, PsycInfo, PubMed and Web of Science was conducted; the search terms were "(abortion OR pregnancy termination) AND stigma * ." Articles were eligible for inclusion if the main research question addressed experiences of individuals subjected to abortion stigma, public attitudes that stigmatize women who have had abortions or interventions aimed at managing abortion stigma. To provide a comprehensive overview of this issue, any study published by February 2015 was considered. The search was restricted to English- and German-language studies. Seven quantitative and seven qualitative studies were eligible for inclusion. All but two dated from 2009 or later; the earliest was from 1984. Studies were based mainly on U.S. samples; some included participants from Ghana, Great Britain, Mexico, Nigeria, Pakistan, Peru and Zambia. The majority of studies showed that women who have had abortions experience fear of social judgment, self-judgment and a need for secrecy. Secrecy was associated with increased psychological distress and social isolation. Some studies found stigmatizing attitudes in the public. Stigma appeared to be salient in abortion providers' lives. Evidence of interventions to reduce abortion stigma was scarce. Most studies had limitations regarding generalizability and validity. More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals. Copyright © 2016 by the Guttmacher Institute.
Morgenthau, J E
The issue of abortion, except when it is rendered moot because the fetus endangers the life of the mother, is not really a medical issue. The physician's role is to help patients achieve and maintain their maximum potential for physical, mental, and social well-being. To accomplish this, the physician must acquire a constantly evolving database of scientific knowledge, must evaluate this information in a critical and ethical manner, and must be prepared to apply what is learned. In the realm of applied ethics, no particular religion, profession, culture, class, or sex should be thought of as having all the answers in the realm of applied ethics. This physician's actions are predicated on the belief that, to a large extent, ethical precepts reflect the broader social and economic issues of the period in which they are articulated. If this is the case, then in today's world the population explosion, the postindustrial society, the women's rights movement, inequality of access, and the ability to perform prenatal diagnosis are all factors which have molded the approach to the issue of abortion. Only the last 3 of these can in any way be considered as medical. When considering the role of a physician in dealing with the issue of abortion in the adolescent, this individual relies on the concept articulated by the World Health Association (WHA): promoting the physical, emotional, and social well-being of one's patients. Each year in the US over 1 million 15-19 year olds become pregnant, resulting in over 600,000 births. Most of these pregnancies are unintentional, yet approximately 90% of the infants are kept in the home by mothers who are ill prepared to be parents. What is most disturbing is that the pregnancy rate for the younger mother, 16 years or under, is accounting for an ever increasing percentage of the total. Studies at the Adolescent Health Center of the Mount Sinai Hospital in New York City as well as national studies suggest that the younger teens are more
The topic of this article is the use of unsafe abortion for unwanted pregnancies among adolescents. The significance of unsafe abortion is identified as a high risk of serious health problems, such as infection, hemorrhage, infertility, and mortality, and as a strain on emergency room services. The World Health Organization estimates that at least 33% of all women seeking hospital care for abortion complications are aged under 20 years. 50 million abortions are estimated to be induced annually, of which 33% are illegal and almost 50% are performed outside the health care system. Complications are identified as occurring due to the procedure itself (perforation of the uterus, cervical lacerations, or hemorrhage) and due to incomplete abortion or introduction of bacteria into the uterus. Long-term complications include an increased risk of ectopic pregnancy, chronic pelvic infection, and infertility. Mortality from unsafe abortion is estimated at 1000/100,000 procedures. Safe abortion mortality is estimated at 0.6/100,000. When infertility results, some cultures ascribe an outcast status or marriages are prevented or prostitution is assured. The risk of complications is considered higher for adolescents. Adolescents tend to delay seeking an abortion, lack knowledge on where to go for a safe procedure, and delay seeking help for complications. Peer advice may be limited or inadequate knowledge. Five studies are cited that illustrate the impact of unsafe abortion on individuals and health care systems. Abortions may be desired due to fear of parental disapproval of the pregnancy, abandonment by the father, financial and emotional responsibilities of child rearing, expulsion from school, or inability to marry if the child is out of wedlock. Medical, legal, and social barriers may prevent women and girls from obtaining safe abortion. Parental permission is sometimes a requirement for safe abortion. Fears of judgmental or callous health personnel may be barriers to
Ilboudo, Patrick Gc; Somda, Serge Ma; Sundby, Johanne
Despite the universal recognition of unsafe abortion as a major public health problem, very little research has been conducted to document its precipitating factors in Burkina Faso. Our aim was to investigate the key determinants of induced abortion in a sample of women who sought postabortion care. A cross-sectional household survey was carried out from February to September 2012 in Ouagadougou, Burkina Faso. Data of 37 women who had had an induced abortion and 267 women who had had a spontaneous abortion were prospectively collected on sociodemographic characteristics, pregnancy and birth history, abortion experience, including previous abortion experience, and selected clinical information, including the type of abortion. A two-step regression analysis consisting of a univariate and a multivariate logistic regression was run on Stata version 11.2 in order to identify the key determinants of induced abortion. The findings indicated that 12% of all abortions were certainly induced. Three key factors were significantly and positively associated with the probability of having an induced abortion: whether the woman reported that her pregnancy was unwanted (odds ratio [OR] 10.45, 95% confidence interval [CI] 3.59-30.41); whether the woman reported was living in a household headed by her parents (OR 6.83, 95% CI 2.42-19.24); and if the woman reported was divorced or widowed (OR 3.47, 95% CI 1.08-11.10). On the contrary, being married was protective against induced abortion, with women who reported being married having an 83% (OR 0.17, CI 0.03-0.89) lower chance of having an induced abortion, even when the pregnancy was unwanted. This study has identified three major determinants of induced abortion in Ouagadougou, Burkina Faso. Improved targeted programs on family planning counseling, methods of contraception, and availability of contraceptives should be widely promoted.
Sánchez-Siancas, Luis E; Rodríguez-Medina, Angélica; Piscoya, Alejandro; Bernabe-Ortiz, Antonio
This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated. A cross-sectional study enrolling women aged 18-25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%-49.3%), and 17.4% (95%CI: 13.1%- 21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81-3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14-3.30) after controlling for confounders. There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed.
Bruckner, Tim A.; Mortensen, Laust H.; Catalano, Ralph A.
by 1 month a rise in the number of spontaneous abortions (β = 33.19 losses/month, 95% confidence interval: 8.71, 57.67). An attendant analysis that used consumption of durable household goods as an indicator of financial insecurity supported the inference from our main test. Changes over time...
Mouniq, C; Moron, P
Results are presented of a literature review to identify social and psychological aspects of abortion. The literature does not provide a true profile of women requesting abortions, but some characteristics emerge. Reasons for requesting abortion include economic problems, difficult previous pregnancies, general medical contraindications to pregnancy, marital conflicts, feelings of loneliness, professional aspirations, problems with existing children, and feelings of insecurity about the future. However, the same feelings are found among women carrying their pregnancies to term. Unplanned pregnancies are more common during periods of depression. Most authors have found about 1/2 of women seeking abortions to be single and about 1/2 to be under 25 years old. Religion does not appear to be a determining factor. 1 study of psychological factors in abortion seekers found that a large number of single women seeking abortion had suffered traumatic experiences in childhood and were seeking security in inappropriate amorous relationships. Helene Deutsch stressed the destructive impulses latent in all pregnancies. Others have cited the ambivalence of the desire for pregnancy and feelings of loss after abortion. Studies published after legalization of abortion in the US and France however have stressed the nearly total absence of moderate or severe psychiatric symptoms after abortion. Responses immediately after the abortion may include feelings of relief, guilt, indifference, or ambivalence. Secondary affects appear minor to most authors. Psychological effects do not appear to be influenced by age, marital status, parity, intelligence, occupation, existence of a later pregnancy, or concommitant sterilization. "Premorbidity" and coercion by spouse or family were most closely associated with psychological symptoms. Numerous authors have found about twice as many negative reactions among women undergoing abortion for medical reasons. Most patients undergoing abortions for
Torres, A; Forrest, J D
Most respondents to a survey of abortion patients in 1987 said that more than one factor had contributed to their decision to have an abortion; the mean number of reasons was nearly four. Three-quarters said that having a baby would interfere with work, school or other responsibilities, about two-thirds said they could not afford to have a child and half said they did not want to be a single parent or had relationship problems. A multivariate analysis showed young teenagers to be 32 percent more likely than women 18 or over to say they were not mature enough to raise a child and 19 percent more likely to say their parents wanted them to have an abortion. Unmarried women were 17 percent more likely than currently married women to choose abortion to prevent others from knowing they had had sex or became pregnant. Of women who had an abortion at 16 or more weeks' gestation, 71 percent attributed their delay to not having realized they were pregnant or not having known soon enough the actual gestation of their pregnancy. Almost half were delayed because of trouble in arranging the abortion, usually because they needed time to raise money. One-third did not have an abortion earlier because they were afraid to tell their partner or parents that they were pregnant. A multivariate analysis revealed that respondents under age 18 were 39 percent more likely than older women to have delayed because they were afraid to tell their parents or partner.
Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie
Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15-49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Abortion. 551.23 Section 551.23 Judicial..., Pregnancy, Child Placement, and Abortion § 551.23 Abortion. (a) The inmate has the responsibility to decide either to have an abortion or to bear the child. (b) The Warden shall offer to provide each pregnant...
Karcher, H L
The German Bundestag has passed a compromise abortion law that makes an abortion performed within the first three months of pregnancy an unlawful but unpunishable act if the woman has sought independent counseling first. Article 218 of the German penal code, which was established in 1871 under Otto von Bismarck, had allowed abortions for certain medical or ethical reasons. After the end of the first world war, the Social Democrats tried to legalize all abortions performed in the first three months of pregnancy, but failed. In 1974, abortion on demand during the first 12 weeks was declared legal and unpunishable under the social liberal coalition government of chancellor Willy Brandt; however, the same year, the German Federal Constitution Court in Karlsruhe ruled the bill was incompatible with article 2 of the constitution, which guarantees the right to life and freedom from bodily harm to everyone, including the unborn. The highest German court also ruled that a pregnant woman had to seek a second opinion from an independent doctor before undergoing an abortion. A new, extended article 218, which included a clause giving social indications, was passed by the Bundestag. When Germany was unified, East Germans agreed to be governed by all West German laws, except article 218. The Bundestag was given 2 years to revise the article; however, in 1993, the Federal Constitution Court rejected a version legalizing abortion in the first 3 months of the pregnancy if the woman sought counsel from an independent physician, and suggested the recent compromise passed by the Bundestag, the lower house of the German parliament. The upper house, the Bundesrat, where the Social Democrats are in the majority, still has to pass it. Under the bill passed by the Bundestag, national health insurance will pay for an abortion if the monthly income of the woman seeking the abortion falls under a certain limit.
Full Text Available This essay will analyze some of the debates around abortion in the National Congress due to the Constitutional Amendment Bill – PEC25/95, by Deputy Severino Cavalcanti (PPB/PE, where the main issue was precisely life defense. The discursive blocks that present the debate in relation to pregnancy interruption, the religious principles or biological determinism on which those debates are based, and the ways in which such discourses are maintained will be identified. Distinct understandings of life, as a result of the points used in such discourses, which are aligned with the position of the Catholic Church and the Feminist Movement - the social actors of this debate- are also discussed here.
Romans-Clarkson, S E
This article reviews the scientific literature on the psychological sequelae of induced abortion. The methodology and results of studies carried out over the last twenty-two years are examined critically. The unanimous consensus is that abortion does not cause deleterious psychological effects. Women most likely to show subsequent problems are those who were pressured into the operation against their own wishes, either by relatives or because their pregnancy had medical or foetal contraindications. Legislation which restricts abortion causes problems for women with unwanted pregnancies and their doctors. It is also unjust, as it adversely most affects lower socio-economic class women.
Tangtrakul, S; Thongjerm, M; Suthutvoravuth, S; Phromboon, S; Chaturachinda, K
To determine whether or not a previous abortion has a deleterious effect on the outcome of a subsequent pregnancy, 6443 delivery records at Ramathibodi hospital between January and December 1982 were reviewed. The 2 study groups consisted of 143 women who had previously had an induced abortion and 315 women who had previously had a spontaneous abortion. Control groups were women having a 2nd child after a normal 1st pregnancy. The 1st study group had fewer women under 19 and over 35 and a lower educational level. Group 2 had more women with a pregnancy interval of less than 2 years. There was no difference between the study groups and the controls in premature rupture of fetal membranes, placenta previa, cesarean sections, manual removal of placenta, retained secundine, postpartum hemorrhage, low birth weight, Apgar score less than 6, congenital abnormalities, or perinatal mortality. The only difference between both study groups and the controls was that there was a higher percentage of assisted deliveries in both study groups. This finding is probably the result of the fact that these were 1st births and is totally unrelated to previous abortion.
Jandová, A; Cifra, M; Pokorný, J; Nedbalová, M; Dohnalová, A; Kobilková, J; Cocek, A
Biochemical research of biological systems is highly developed, and it has disclosed a spectrum of chemical reactions, genetic processes, and the pathological development of various diseases. The fundamental hypothesis of physical processes in biological systems, in particular of coherent electrically polar vibrations and electromagnetic activity, was formulated by H. Fröhlich; he assumed connection of cancer process with degradation of coherent electromagnetic activity. But the questions of cellular structures capable of the coherent electrical polar oscillation, mechanisms of energy supply, and the specific role of the endogenous electromagnetic fields in transport, organisation, interactions, and information transfer remained open. The nature of physical disturbances caused by some diseases (including the recurrent abortion in humans and the cancer) was unknown. We have studied the reasons of recurrent abortions in humans by means of the cell mediated immunity (using immunologic active RNA prepared from blood of inbred laboratory mice strain C3H/H2K, infected with the lactate dehydrogenase elevating virus-LD V) and the cytogenetic examination from karyotype pictures. The recurrent abortion group contained women with dg. spontaneous abortion (n = 24) and the control group was composed of 30 healthy pregnant women. Our hypothesis was related to quality of endometrium in relation to nidation of the blastocyst. The energetic insufficiency (ATP) inhibits normal development of fetus and placenta. We hope that these ideas might have impact on further research, which could provide background for effective interdisciplinary cooperation of malignant and non-malignant diseases.
Jandová, A.; Nedbalová, M.; Kobilková, J.; Čoček, A.; Dohnalová, A.; Cifra, M.; Pokorný, J.
Biochemical research of biological systems is highly developed, and it has disclosed a spectrum of chemical reactions, genetic processes, and the pathological development of various diseases. The fundamental hypothesis of physical processes in biological systems, in particular of coherent electrically polar vibrations and electromagnetic activity, was formulated by H. Fröhlich he assumed connection of cancer process with degradation of coherent electromagnetic activity. But the questions of cellular structures capable of the coherent electrical polar oscillation, mechanisms of energy supply, and the specific role of the endogenous electromagnetic fields in transport, organisation, interactions, and information transfer remained open. The nature of physical disturbances caused by some diseases (including the recurrent abortion in humans and the cancer) was unknown. We have studied the reasons of recurrent abortions in humans by means of the cell mediated immunity (using immunologic active RNA prepared from blood of inbred laboratory mice strain C3H/H2K, infected with the lactate dehydrogenase elevating virus-LD V) and the cytogenetic examination from karyotype pictures. The recurrent abortion group contained women with dg. spontaneous abortion (n = 24) and the control group was composed of 30 healthy pregnant women. Our hypothesis was related to quality of endometrium in relation to nidation of the blastocyst. The energetic insufficiency (ATP) inhibits normal development of fetus and placenta. We hope that these ideas might have impact on further research, which could provide background for effective interdisciplinary cooperation of malignant and non-malignant diseases.
Bhatti, Khadijah Z; Nguyen, Antoinette T; Stuart, Gretchen S
Medical abortion is a safe, effective, and acceptable option for patients seeking an early nonsurgical abortion. In 2014, medical abortion accounted for nearly one third (31%) of all abortions performed in the United States. State-level attempts to restrict reproductive and sexual health have recently included bills that require physicians to inform women that a medical abortion is reversible. In this commentary, we will review the history, current evidence-based regimen, and regulation of medical abortion. We will then examine current proposed and existing abortion reversal legislation. The objective of this commentary is to ensure physicians are armed with rigorous evidence to inform patients, communities, and policy makers about the safety of medical abortion. Furthermore, given the current paucity of evidence for medical abortion reversal, physicians and policy makers can dispel bad science and misinformation and advocate against medical abortion reversal legislation. Copyright © 2017 Elsevier Inc. All rights reserved.
Rasch, Vibeke; Wielandt, Hanne; Knudsen, Lisbeth B
AIMS: This study describes women with induced abortion and thereby elucidates how living conditions and contraceptive failure are associated with the choice of induced abortion in a population of Danish pregnant women. METHODS: The study population consisted of pregnant women attending Odense...... University Hospital. They were categorized in two groups: women with induced abortion (n = 373) and a reference group consisting of women with spontaneous abortion and antenatal care attendees (n = 2,176). The two groups were compared by use of a case-referent design. The variables studied comprise age......, number of children, partner relationship, education, occupation, economical situation, and contraceptive use. RESULTS: Being single, aged 15-24 or 35 and above, having either no children or two or more children, and the experience of contraceptive failure were parameters which were associated...
Wu, Jun-Qing; Li, Yu-Yan; Ren, Jing-Chao; Zhao, Rui; Zhou, Ying; Gao, Er-Sheng
To determine whether induced abortion (IA) increases breast cancer (BC) risk. A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency- matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. The results suggest that a history of induced abortions may not increase the risk of breast cancer.
Full Text Available Objective: to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in São Paulo-SP and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in São Paulo. In Natal-RN, induced abortion was associated with the partner's absence at the time pregnancy was confirmed (p = 0.02 and, in Sao Paulo-SP, with their negative reaction to news of the pregnancy (p = 0.04 and lack of participation in the abortion process (p < 0.01. Conclusion: despite having achieved independence, women still regard male participation in the abortion process as an important factor. The specifics of each capital denote the influence of the geographic and cultural dimension, indicating the need to take into account the particulars of each region in Brazil while considering a holistic approach to women's health.
Stotland, Nada L
Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past.
Across four decades of political and social action, Nepal changed from a country strongly enforcing oppressive abortion restrictions, causing many poor women's long imprisonment and high rates of abortion-related maternal mortality, into a modern democracy with a liberal abortion law. The medical and public health communities supported women's rights activists in invoking legal principles of equality and non-discrimination as a basis for change. Legislative reform of the criminal ban in 2002 and the adoption of an Interim Constitution recognizing women's reproductive rights as fundamental rights in 2007 inspired the Supreme Court in 2009 to rule that denial of women's access to abortion services because of poverty violated their constitutional rights. The government must now provide services under criteria for access without charge, and services must be decentralized to promote equitable access. A strong legal foundation now exists for progress in social justice to broaden abortion access and reduce abortion stigma. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Wiebe, Ellen R; Littman, Lisa; Kaczorowski, Janusz; Moshier, Erin L
Misinformation about the risks and sequelae of abortion is widespread. The purpose of this study was to examine whether women having an abortion who believe that there should be restrictions to abortion (i.e., that some other women should not be allowed to have an abortion) also believe this misinformation about the health risks associated with abortion. We carried out a cross-sectional survey of women presenting consecutively for an abortion at an urban abortion clinic in Vancouver, British Columbia, between February and September 2012. Of 1008 women presenting for abortion, 978 completed questionnaires (97% response rate), and 333 of these (34%) favoured abortion restrictions. More women who favoured restrictions believed that the health risk of an abortion was the same as or greater than the health risk of childbirth (84.2% vs. 65.6%, P abortion caused mental health problems (39.1% vs. 28.3%, P abortion caused infertility (41.7% vs. 21.9%, P abortion should not be restricted was found to be a significantly correlated with correct answers about health risks, mental health problems, and infertility. Misinformed beliefs about the risks of abortion are common among women having an abortion. Women presenting for abortion who favoured restrictions to abortion have more misperceptions about abortion risks than women who favour no restrictions.
The sort of ethical theory derived from Aristotle, variously described as virtue ethics, virtue-based ethics, or neo-Aristotelianism, is becoming better known, and is now quite widely recognized as at least a possible rival to deontological and utilitarian theories. With recognition has come criticism, of varying quality. In this article I shall discuss nine separate criticisms that I have frequently encountered, most of which seem to me to betray an inadequate grasp either of the structure of virtue theory or of what would be involved in thinking about a real moral issue in its terms. In the first half I aim particularly to secure an understanding that will reveal that many of these criticisms are simply misplaced, and to articulate what I take to be the major criticism of virtue theory. I reject this criticism, but do not claim that it is necessarily misplaced. In the second half I aim to deepen that understanding and highlight the issues raised by the criticisms by illustrating what the theory looks like when it is applied to a particular issue, in this case, abortion.
Full Text Available The central issue in the abortion debate is the moral status of the conceptus. There are two positions that argue this issue. At one extreme are the views of the pro-life group which argues that human life begins at the moment of conception whilst at the other are views of the pro-choice group that argues in favour of a woman’s right to self-determination. Two basic principles come into conflict in this debate, namely the Value of Life and that of Self-determination. In this paper the arguments forwarded by each group in justification of its position are presented. Also discussed is the moderate developmental viewpoint which accepts that the genetic basis of an individual is established at conception. Some development, however, has to occur before the conceptus can be called a person. The fact that an entity is a potential person is a prima facie reason for not destroying it. On the other hand, we need not conclude that a person has a right to life by virtue of that potentiality. Simultaneously we should recognise that the right a potential entity has, may be nullified by the woman’s right to self-determination.
Full Text Available This research was conducted at Saint Francis at Saint Francis Hospital over a period of four months (from September 22nd 2014 to January 23rd 2015. 168 women aged 12 to 46 years admitted and treated for incomplete abortion in Gynecology ward were interviewed. 63 participants (37.5% had induced abortions and 105 participants (62.5% had spontaneous abortions. All induced abortions were the results of unplanned pregnancies. The majority of all abortions (57.1% resulted from unplanned pregnancies as compared to only 42.9% resulting from planned pregnancies (p<0.05. Both married and single participants had increased unmet needs for family planning. 57.3% of women had used contraceptives in the past and also had unintended pregnancies resulting in abortions. A significant number of induced abortions (22.2% were incidentally caused by inappropriate use of contraceptives by providers. Sexual activities start as early as 9 years in Katete. Most youths with induced abortions were involved in unstable relationships, desired to continue with education, feared to ruin their future, and had limited knowledge and inconsistent use of contraceptive methods. The major determinants for induced abortions amongst participants were unplanned/unintended pregnancies. Other determinants such as illiteracy, lack of information, young age, poverty, and unsafe sex need to be addressed. There is need to promote consistent and correct use of contraceptives, to strengthen the health care delivery system and maintain the cold chain of contraceptive supply for sustainable availability and accessibility. Conjugated efforts by health care providers, community leaders, policy makers and politicians are needed to extirpate negative believes (on modern contraceptives and cultural norms that promote unhealthy sexual and reproductive life.
Full Text Available Late termination of pregnancy (LTOP is defined as an abortion carried out beyond 24 gestational weeks, when the fetus has arguably attained viability. In Taiwan, the current abortion law, bearing a eugenic title, allows LTOP on certain medical grounds. However, the fetal and maternal conditions that constitute medical grounds are not clarified and remain legally untested. Professional debate on the abortion issue is also lacking in academia in Taiwan, despite societal concerns. With the advent of technology to detect fetal abnormalities, obstetricians are now confronted more frequently with acute dilemmas regarding LTOP. Quite often, they sail in an uncharted sea with no clinical guidelines from their professional societies or affiliated hospitals. Recently, LTOP at 35 gestational weeks for a fetus with Down syndrome, complicated with polyhydramnios and tetralogy of Fallot, triggered media scrutiny and aroused much public attention. Although the clinical decision making for pregnancies with fetal abnormalities entails increasingly balanced information and consideration in terms of the medical, ethical, legal, psychologic, and societal aspects, society at large is unaware of the complexity and intertwined nature of various abortion issues, especially LTOP. Obstetricians are now in a vulnerable position in Taiwanese society, where litigations relevant to the practice of early abortions are not rare. Therefore, a global and in-depth look into abortion issues from legal and ethical dimensions is indispensable for modern obstetric practice. This review considers the core issues in LTOP, including what conditions constitute a “serious” fetal abnormality to justify LTOP, the incidence of LTOP, legislation regarding LTOP in Western countries, and recent research on ambivalent fetal pain. It will also present procedures, some under the auspices of the ethical committee of a Presbyterian hospital in Taiwan, for clinical decision making, particularly
AJRH Managing Editor
Compared with women seeking their first abortion, significantly more repeat abortion clients had ever used contraceptives ... findings, the level of repeat abortions in Europe, .... and contraceptive history, and post-abortion ..... working women.
Ellorhaoui, M; Schultze, W
On the basis of a survey is attempted to describe mode of development, symptomatology, individual forms and the different possibilities of therapy of the spontaneous hypoglycaemias. A particularly broad range was devoted to the cerebral sequelae, since in these cases--according to our experience--on account of simulation of neurologico-psychiatric symptoms at the soonest wrong diagnoses are to be expected. Furthermore, it is attempted to classify the hypoglycemias according to their development, in which cases their incompleteness was evident from the very beginning. The individual forms of appearance are treated according their to significance. Out of the inducible hypoglycaemias a particular attention is devoted to the forms caused by insulin and oral antidiabetics, since these most frequently participate in the development. Finally the author inquires into diagnostic measures for recognition of special forms of hypoglycaemia. In this place the diagnostics of hyperinsulinism conditioned by adenomatosis or tumours of other kinds is of particular importance. Finally conservative and operative possibilities of the therapy of these tumours are discussed,whereby the only recently tested treatment with streptotocin is mentioned.
The decision to seek an abortion is never easy. Women have different reasons for choosing an abortion and their social, economic and religious background may influence how they cope. Furthermore, once pregnant, the alternatives of childbirth and adoption or keeping the baby may not be psychologically neutral. Research studies in this area have been hampered by methodological problems, but most of the better-quality studies have shown no increased risk of mental health problems in women having an abortion. A consistent finding has been that of pre-existing mental illness and subsequent mental health problems after either abortion or childbirth. Furthermore, studies have shown that only a minority of women experience any lasting sadness or regret. Risk factors for this include ambivalence about the decision, level of social support and whether or not the pregnancy was originally intended. More robust, definitive research studies are required on mental health after abortion and alternative outcomes such as childbirth. Copyright 2010 Elsevier Ltd. All rights reserved.
Gupta, A S; Datta, N; Ghosh, D
A case of inversion of the uterus following abortion is reported. The 35-year old patient, admitted October 10, 1978 to the Medical College and Hospitals in Calcutta, India was referred by a private practitioner with a history of amenorrhea for 16 weeks, bleeding for 3 days, expulsion of the fetus 3 days earlier, and something coming down per vaginum for 2 days. The patient was para 4+0 (all full term normal deliveries) and home delivery for the last child 1 1/2 years earlier. She had a history of regular menstrual periods. Her general condition was poor. The examination revealed a gangrenous mass coming out of the vulva with a very offensive smell. There was a raw surface on which placenta like tissue was attached. No active bleeding was seen. Fundus and cervix of the uterus could not be felt. On rectal examination the uterus could not be felt, a cup-like depression was felt at the site of the uterus. The provision diagnosis was inversion of uterus following abortion. Treatment was started with sedatives and antibiotics, and arrangements were made for a blood transfusion. The vaginal mass was covered with glycerine and acriflavine gauze, and a hysterectomy was decided upon after improvement of her general condition and control of the infection. On October 14th, the patient was placed in knee chest position and posterior vaginal wall was retracted with Sims' speculum when the inverted lump was spontaneously reduced within the vagina. The inverted uterus was felt in the region of the vaginal vault. Glycerine acriflavine pack was given which was taken out and repack was given daily until the operation. The hysterectomy was performed on October 23rd. The abdomen was opened up by a transverse incision and the pelvis was explored. In the region of the uterus a cup-shaped depression was noted. Tubes and ovaries of both sides were seen hanging laterally from the cupped area. The left tube was found congested and thickened. Reduction of uterus was done by making a vertical
Behroozi-Lak, T; Derakhshan-Aydenloo, S; Broomand, F
Abortion, spontaneous or induced, is a common complication of pregnancy and exploration of available and safe regimens for medical abortion in developing countries seems crucial. The present study was aimed to assess the effect of letrozole in combination with misoprostol in women eligible for legal therapeutic abortion with gestational age ≤14weeks. This clinical randomized trial was conducted on 78 women who were candidate of medical abortion and eligible for legal abortion with gestational age ≤14 weeks that were randomly divided into two groups of case and controls. Case group received daily oral dose of 10mg letrozole for three days followed by vaginal misoprostol. In control group the patients received only vaginal misoprostol. The rate of complete abortion, induction-of-abortion time, and side-effects were assessed. Complete abortion was observed in 30 patients (76.9%) in case group and 9 (23.1%) cases were failed. In control group there was 16 (41.03%) complete abortions and 23 (58.97%) cases were failed to abort. Patients with gestational age of between 6 and 10 weeks did not show significant difference in both groups (P=0.134). Regarding pregnancy remnants there were significant differences between two groups (P=0.034). The time form admission to discharge in case groups were significantly shorter than those in control group (P=0.001). The indication for curettage in case group was significantly less than control group (P=0.001). A 3-day course of letrozole (10mg/daily) followed by misoprostol was associated with a higher complete abortion and lower curettage rates and reduction in time from admission to discharge in women with gestational age ≤14 weeks compared to misoprostol alone. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Anjos, Karla Ferraz dos; Santos, Vanessa Cruz; Souzas, Raquel; Eugênio, Benedito Gonçalves
Discussing the abortion theme in Brazil is highly problematic since it involves ethical, moral and legal precepts. The criminalization of abortion in Brazil favors a clandestine and unsafe practice and can lead to serious consequences to women´s health. In this perspective, this research deals with the legal context in which the abortion problem is inscribed in Brazil, coupled to the specific aims in pinpointing complications caused by the criminalization of clandestine abortion besides deali...
Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn
The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…
60% of more than 2000 women surveyed by the Picker Institute who underwent induced abortion procedures rated the quality of their care as excellent. Another third reported their care as being either very good or good. The survey also found that the quality of abortion care is comparable to other outpatient surgery. However, the high quality of care women receive from abortion providers is lost in the hostile anti-abortion climate created by threatening protesters outside of clinics and the murder of 7 clinic workers and physicians who performed abortions. Abortion opponents fail to acknowledge that legal abortion is a medical procedure which protects women's health and saves their lives. Before abortion was legalized in the US, countless women were either rendered unable to reproduce or died from abortion-related complications. Efforts to outlaw abortion persist despite it being widely recognized by medical experts as one of the most safe medical procedures currently performed in the US. When state legislatures target abortion providers with unduly strict regulations, abortion becomes prohibitively expensive and difficult to obtain.
Daling, J R; Malone, K E; Voigt, L F; White, E; Weiss, N S
cancer was associated with a spontaneous abortion (RR = 0.9; 95% CI = 0.7-1.2). Our data support the hypothesis that an induced abortion can adversely influence a woman's subsequent risk of breast cancer. However, the results across all epidemiologic studies of this premise are inconsistent--both overall and within specific subgroups. The risk of breast cancer should be reexamined in future studies of women who have had legal abortion available to them throughout the majority of their reproductive years, with particular attention to the potential influence of induced abortion early in life.
Keogh, Sarah C; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola
Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence. To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar). A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology. In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15-49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone. The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies.
Full Text Available History of present illness: A 16-year-old male with asthma was brought to the emergency department by his parents for increasing right-sided chest pain associated with cough and mild dyspnea over the past week. Albuterol inhaler did not provide relief. He denied recent trauma, fever, sweats, and chills. The patient’s vitals and oxygen saturations were stable. Physical exam revealed a tall, slender body habitus with no signs of chest wall injuries. Bilateral breath sounds were present, but slightly diminished on the right. A chest radiograph was ordered to determine the etiology of the patient’s symptoms. Significant findings: Initial chest radiograph showed a 50% right-sided pneumothorax with no mediastinal shift, which can be identified by the sharp line representing the pleural lung edge (see arrows and lack of peripheral lung markings extending to the chest wall. While difficult to accurately estimate volume from a two-dimensional image, a 2 cm pneumothorax seen on chest radiograph correlates to approximately 50% volume.1 The patient underwent insertion of a pigtail pleural drain on the right and repeat chest radiograph showed resolution of previously seen pneumothorax. Ultimately the pigtail drain was removed and chest radiograph showed clear lung fields without evidence of residual pneumothorax or pleural effusion. Discussion: Pneumothorax is characterized by air between the lungs and the chest wall.2 Spontaneous pneumothorax (SP occurs when the pneumothorax is not due to trauma or any discernable etiology. 3 SP is multifactorial and may be associated with subpleural blebs, bullae, and other connective tissue changes that predispose the lungs to leak air into the pleural space.4 SP can be further subdivided into primary (no history of underlying lung disease or secondary (history of chronic obstructive pulmonary disease, tuberculosis, cystic fibrosis, lung malignancy, etc..2 It is estimated that the incidence of SP among US pediatric
Trussell, J; Ellertson, C
Comparisons of the efficacy of different regimens of medical abortion are difficult because of the widely varying protocols (even for testing identical regimens), divergent definitions of success and failure, and lack of a standard method of analysis. In this article we review the current efficacy literature on medical abortion, highlighting some of the most important differences in the way that efficacy has been analyzed. We then propose a standard conceptual approach and the accompanying statistical methods for analyzing clinical trials of medical abortion and to explain how clinical investigators can implement this approach. Our review reveals that research on the efficacy of medical abortion has closely followed the conceptual model used for analysis of surgical abortion. The problem, however, is that, whereas surgical abortion is a discrete event occurring in the space of a few minutes or less, medical abortion is a process typically lasting from several days to several weeks. In this process, two events may occur that are not possible with surgical abortion. First, the woman can opt out of the process before a fair determination of efficacy can be made. Second, the process of medical abortion allows time for surgical interventions that may be convenient for the clinician but not strictly necessary from a medical perspective. Another difference from surgical abortions is that, for medical abortions, different medical abortion protocols specify different waiting periods, giving the drugs less time to work in some studies than in others before a determination of efficacy is made. We argue that, when analyzing efficacy of medical abortion, researchers should abandon their close reliance on the analogy to surgical abortion. In fact, medical abortion is more appropriately analyzed by life table procedures developed for the study of another fertility regulation technology; contraception. As with medical abortion, a woman initiating use of a contraceptive method can
Background The study aimed to describe the overall and age-specific trends of induced abortions from 1996 to 2011 with an emphasis on socio-demographic characteristics and contraceptive use of women having had repeat abortions in Estonia. Methods Data were retrieved from the Estonian Medical Birth and Abortion Registry and Statistics Estonia. Total induced abortion numbers, rates, ratios and age-specific rates are presented for 1996–2011. The percentage change in the number of repeat abortions within selected socio-demographic subgroups, contraception use and distribution of induced abortions among Estonians and non-Estonians for the first, second, third, fourth and subsequent abortions were calculated for the periods 1996–2003 and 2004–2011. Results Observed trends over the 16-year study period indicated a considerable decline in induced abortions with a reduction in abortion rate of 57.1%, which was mainly attributed to younger cohorts. The percentage of women undergoing repeat abortions fell steadily from 63.8% during 1996–2003 to 58.0% during 2004–2011. The percentage of women undergoing repeat abortions significantly decreased over the 16 years within all selected socio-demographic subgroups except among women with low educational attainment and students. Within each time period, a greater percentage of non-Estonians than Estonians underwent repeat abortions and obtained third and subsequent abortions. Most women did not use any contraceptive method prior to their first or subsequent abortion. Conclusion A high percentage of women obtaining repeat abortions reflects a high historical abortion rate. If current trends continue, a rapid decline in repeat abortions may be predicted. To decrease the burden of sexual ill health, routine contraceptive counselling, as standard care in the abortion process, should be seriously addressed with an emphasis on those groups - non-Estonians, women with lower educational attainment, students and women with children
Wahyudi, A.; Jacky, M.; Mudzakkir, M.; Deprita, R.
An on-going debate of whether or not to legalize abortion has not stopped the number of abortion cases decreases. New practices of abortion such as online abortion has been a growing trend among teenagers. This study aims to determine how teenagers use social media such as Facebook, YouTube and Wikipedia for the practice of abortion. This study adopted online research methods (ORMs), a qualitative approach 2.0 by hacking analytical perspective developed. This study establishes online teen abortion as a research subject. This study finds patterns of online abortions among teenagers covering characteristics of teenagers as perpetrators, styles of communication, and their implication toward policy, particularly Electronic Transaction Information (ETI) regulation. Implications for online abortion behavior among teenagers through social media. The potential abortion client especially girls find practical, fast, effective, and efficient solutions that keep their secret. One of prevention patterns that has been done by some people who care about humanity and anti-abortion in the online world is posting a anti-abortion text, video or picture, anti-sex-free (anti -free intercourse before marriage) in an interesting, educative, and friendly ways.
Guiahi, Maryam; Lim, Sahnah; Westover, Corey; Gold, Marji; Westhoff, Carolyn L
Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program. We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites. We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites. Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel. Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.
Koonin, L M; Smith, J C; Ramick, M
From 1980 through 1991, the number of legal induced abortions reported to CDC remained stable, varying each year by 1969, CDC has compiled abortion data received from 52 reporting areas: 50 states, the District of Columbia, and New York City. In 1991, 1,388,937 abortions were reported--a 2.8% decrease from 1990. The abortion ratio was 339 legal induced abortions per 1,000 live births, and the abortion rate was 24 per 1,000 women 15-44 years of age. Women who were undergoing an abortion were more likely to be young, white, and unmarried; most had had no previous live births and had been obtaining an abortion for the first time. More than half (52%) of all abortions were performed at or before the 8th week of gestation, and 88% were before the 13th week. Younger women (i.e., women may partially account for this decline. An accurate assessment of the number and characteristics of women who obtain abortions in the United States is necessary both to monitor efforts to prevent unintended pregnancy and to identify and reduce preventable causes of morbidity and mortality associated with abortions.
Ney, P G; Wickett, A R
This survey of studies which relate to the emotional sequelae of induced abortion, draws attention to the need for more long-term, in-depth prospective studies. The literature to this point finds no psychiatric indications for abortion, and no satisfactory evidence that abortion improves the psychological state of those not mentally ill; abortion is contra-indicated when psychiatric disease is present, as mental ill-health has been shown to be worsened by abortion. Recent studies are turning up an alarming rate of post-abortion complications such as P.I.D., and subsequent infertility. The emotional impact of these complications needs to be studied. Other considerations looked at are the long-term demographic implications of abortion on demand and the effect on the medical professions.
Aspects of legal and illegal abortion in Switzerland are discussed. About 110,000 births, 25,000 therapeutic abortions (75% for psychiatric indications) and an estimated 50,000 illegal abortions occur annually in Switzerland. Although the mortality and morbidity of therapeutic aborti on are similar to those of normal births (1.4 per 1000 and 11%, respectively) the mortality and morbidity of criminal abortions are far greater (3 per 1000 and 73%, respectively). In the author's view, too strict an interpretatiok of Swiss abortion law (which permits abortion to avoid serious harm to the mother's health) does not take into account the severe and lasting emotional and psychological damage which may be caused by unwanted pregnancy, birth, and childraising. In the present social situation, the social and psychological support required by these women is not available; until it is, abortion is to be preferred.
Horvath, Sarah; Schreiber, Courtney A
The early medical literature on mental health outcomes following abortion is fraught with methodological flaws that can improperly influence clinical practice. Our goal is to review the current medical literature on depression and other mental health outcomes for women obtaining abortions. The Turnaway Study prospectively enrolled 956 women seeking abortion in the USA and followed their mental health outcomes for 5 years. The control group was comprised of women denied abortions based on gestational age limits, thereby circumventing the major methodological flaw that had plagued earlier studies on the topic. Rates of depression are not significantly different between women obtaining abortion and those denied abortion. Rates of anxiety are initially higher in women denied abortion care. Counseling on decision-making for women with unintended pregnancies should reflect these findings.
Spinelli, A; Grandolfo, M E
This article discusses the legal and epidemiologic status of abortion in Italy, and its relationship to fertility and contraception. Enacted in May 1978, Italy's abortion law allows the operation to be performed during the 1st 90 days of gestation for a broad range of health, social, and psychological reasons. Women under 18 must receive written permission from a parent, guardian, or judge in order to undergo an abortion. The operation is free of charge. Health workers who object to abortion because of religious or moral reasons are exempt from participating. Regional differences exist concerning the availability of abortion, easy to procure in some places and difficult to obtain in others. After an initial increase following legalization, the abortion rate was 13.5/1000 women aged 15-44 and the abortion ratio was 309/1000 live births -- an intermediate rate and ratio compared to other countries. By the time the Abortion Act of 1978 was adopted, Italy already had one of the lowest fertility levels in Europe. Thus, the legalization of abortion has had no impact on fertility trends. Contrary to initial fears that the legalization of abortion would make abortion a method of family planning, 80% of the women who sought an abortion in 1983-88 were using birth control at the time (withdrawal being the most common method used by this group). In fact, most women who undergo abortions are married, between the ages of 25-34, and with at least one child. Evidence indicates widespread ignorance concerning reproduction. In a 1989 survey, only 65% of women could identify the fertile period of the menstrual cycle. Italy has no sex education in schools or national family planning programs. Compared to most of Europe, Italy still has low levels of reliable contraceptive usage. This points to the need to guarantee the availability of abortion.
Sisson, Gretchen; Kimport, Katrina
Popular discourse on abortion in film and television assumes that abortions are under- and misrepresented. Research indicates that such representations influence public perception of abortion care and may play a role in the production of social myths around abortion, with consequences for women's experience of abortion. To date, abortion plotlines in American film and television have not been systematically tracked and analyzed. A comprehensive online search was conducted to identify all representations of pregnancy decision making and abortion in American film and television through January 2013. Search results were coded for year, pregnancy decision and mortality outcome. A total of 310 plotlines were identified, with an overall upward trend over time in the number of representations of abortion decision making. Of these plotlines, 173 (55.8%) resulted in abortion, 80 (25.8%) in parenting, 13 (4.2%) in adoption and 21 (6.7%) in pregnancy loss, and 16 (5.1%) were unresolved. A total of 13.5% (n=42) of stories ended with the death of the woman who considered an abortion, whether or not she obtained one. Abortion-related plotlines occur more frequently than popular discourse assumes. Year-to-year variation in frequency suggests an interactive relationship between media representations, cultural attitudes and policies around abortion regulation, consistent with cultural theory of the relationship between media products and social beliefs. Patterns of outcomes and rates of mortality are not representative of real experience and may contribute to social myths around abortion. The narrative linking of pregnancy termination with mortality is of particular note, supporting the social myth associating abortion with death. This analysis empirically describes the number of abortion-related plotlines in American film and television. It contributes to the systematic evaluation of the portrayal of abortion in popular culture and provides abortion care professionals and
Foot-and-mouth disease (FMD) is a highly contagious and economically important viral disease of cloven-hoofed animals, including domestic as well as more than 70 wild host species. During recent FMD outbreaks in India, spontaneous abortions were reported amongst FMD-affected and asymptomatic cows. T...
Full Text Available Patrick GC Ilboudo,1–3 Serge MA Somda,4 Johanne Sundby3 1Département de Santé Publique, Unité de Recherche sur les Politiques et Systèmes de Santé, Centre Muraz, Bobo-Dioulasso, Burkina Faso; 2Agence de Formation, de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté, Bobo-Dioulasso, Burkina Faso; 3Department of Community Medicine, University of Oslo, Oslo, Norway; 4Département des Maladies Non Transmissibles, Unité de Formation et d'Appui Méthodologique, Centre Muraz, Bobo-Dioulasso, Burkina Faso Introduction: Despite the universal recognition of unsafe abortion as a major public health problem, very little research has been conducted to document its precipitating factors in Burkina Faso. Our aim was to investigate the key determinants of induced abortion in a sample of women who sought postabortion care. Materials and methods: A cross-sectional household survey was carried out from February to September 2012 in Ouagadougou, Burkina Faso. Data of 37 women who had had an induced abortion and 267 women who had had a spontaneous abortion were prospectively collected on sociodemographic characteristics, pregnancy and birth history, abortion experience, including previous abortion experience, and selected clinical information, including the type of abortion. A two-step regression analysis consisting of a univariate and a multivariate logistic regression was run on Stata version 11.2 in order to identify the key determinants of induced abortion. Results: The findings indicated that 12% of all abortions were certainly induced. Three key factors were significantly and positively associated with the probability of having an induced abortion: whether the woman reported that her pregnancy was unwanted (odds ratio [OR] 10.45, 95% confidence interval [CI] 3.59–30.41; whether the woman reported was living in a household headed by her parents (OR 6.83, 95% CI 2.42–19.24; and if the woman reported was divorced or widowed (OR 3.47, 95
Jacobson, J L
In 1984, the Reagan administration announced in Mexico City a reversal in the US international family planning policy. The new policy strictly forbids any international family planning group that receives US funds from providing abortion services or counseling. An immediate impact on family planning programs in developing countries was that it prevented the opening of much needed clinics in the poorest, most rapidly growing countries in the world, such as Bangladesh. The University of Michigan School of Public Health estimates an additional 380,000 unwanted pregnancies, resulting in 311,000 births, 69,000 abortions, and 1200 maternal deaths in the next 3 years. Not only did the US change its policy, but congress decreased funding for international family planning programs 20% between 1985 and 1987. The majority of the funding goes to the US Agency for International Development (USAID), and in 1988 the Reagan administration allowed USAID to funnel about $75 million of this money to other projects, e.g. general African development fund. Fewer contraceptives are available due to the reduced funding, and therefore more women seek an abortion as a last resort against unwanted pregnancy. An additional effect of this 1984 policy reversal is that fewer nongovernmental organizations (NGOs) are eligible for grants, so USAID gives its family planning funds to government agencies who are not the most effective users of funds and are not always trusted by the people served.
Shrestha, Dirgha Raj; Regmi, Shibesh Chandra; Dangal, Ganesh
Unsafe abortion is affecting a lot, in health, socio-economic and health care cost of many countries. Despite invention of simple technology and scientifically approved safe abortion methods, women and girls are still using unsafe abortion practices. Since 2002, Nepal has achieved remarkable progress in developing policies, guidelines, task shifting, training human resources and increasing access to services. However, more than half of abortion in Nepal are performed clandestinely by untrained or unapproved providers or induced by pregnant woman herself. Knowledge on legalization and availability of safe abortion service among women is still very poor. Stigma on abortion still persists among community people, service providers, managers, and policy makers. Access to safe abortion, especially in remote and rural areas, is still far behind as compared to their peers from urban areas. The existing law is not revised in the spirit of current Constitution of Nepal and rights-based approach. The existence of abortion stigma and the shifting of the government structure from unitary system to federalism in absence of a complete clarity on how the safe abortion service gets integrated into the local government structure might create challenge to sustain existing developments. There is, therefore, a need for all stakeholders to make a lot of efforts and allocate adequate resources to sustain current achievements and ensure improvements in creating a supportive social environment for women and girls so that they will be able to make informed decisions and access to safe abortion service in any circumstances.
Jilozian, Ann; Agadjanian, Victor
As in other post-Soviet settings, induced abortion has been widely used in Armenia. However, recent national survey data point to a substantial drop in abortion rates with no commensurate increase in modern contraceptive prevalence and no change in fertility levels. We use data from in-depth interviews with women of reproductive age and health providers in rural Armenia to explore possible underreporting of both contraceptive use and abortion. While we find no evidence that women understate their use of modern contraception, the analysis suggests that induced abortion might indeed be underreported. The potential for underreporting is particularly high for sex-selective abortions, for which there is growing public backlash, and medical abortion, a practice that is typically self-administered outside any professional supervision. Possible underreporting of induced abortion calls for refinement of both abortion registration and relevant survey instruments. Better measurement of abortion dynamics is necessary for successful promotion of effective modern contraceptive methods and reduction of unsafe abortion practices. © 2016 The Population Council, Inc.
Reproductive governance operates through calculating demographic statistics that offer selective truths about reproductive practices, bodies, and subjectivities. Post-abortion care, a global reproductive health intervention, represents a transnational reproductive regime that establishes motherhood as women's primary legitimate reproductive status. Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I illustrate how post-abortion care accomplishes reproductive governance in a context where abortion is prohibited altogether and the US is the primary bilateral donor of population aid. Reproductive governance unfolds in hospital gynecological wards and the national health information system through the mobilization and interpretation of post-abortion care data. Although health workers search women's bodies and behavior for signs of illegal abortion, they minimize police intervention in the hospital by classifying most post-abortion care cases as miscarriage. Health authorities deploy this account of post-abortion care to align the intervention with national and global maternal health policies that valorize motherhood. Although post-abortion care offers life-saving care to women with complications of illegal abortion, it institutionalizes abortion stigma by scrutinizing women's bodies and masking induced abortion within and beyond the hospital. Post-abortion care reinforces reproductive inequities by withholding safe, affordable obstetric care from women until after they have resorted to unsafe abortion.
Jones, Rachel K; Jerman, Jenna
To assess the prevalence of abortion among population groups and changes in rates between 2008 and 2014. We used secondary data from the Abortion Patient Survey, the American Community Survey, and the National Survey of Family Growth to estimate abortion rates. We used information from the Abortion Patient Survey to estimate the lifetime incidence of abortion. Between 2008 and 2014, the abortion rate declined 25%, from 19.4 to 14.6 per 1000 women aged 15 to 44 years. The abortion rate for adolescents aged 15 to 19 years declined 46%, the largest of any group. Abortion rates declined for all racial and ethnic groups but were larger for non-White women than for non-Hispanic White women. Although the abortion rate decreased 26% for women with incomes less than 100% of the federal poverty level, this population had the highest abortion rate of all the groups examined: 36.6. If the 2014 age-specific abortion rates prevail, 24% of women aged 15 to 44 years in that year will have an abortion by age 45 years. The decline in abortion was not uniform across all population groups.
The Soviet legacy of widespread reliance on induced abortion is of critical importance to reproductive trends and policies in post-Soviet nations, especially as they strive to substitute contraception for abortion. Using data from two Demographic and Health Surveys conducted in 1995 and 1999, this study analyzes and compares trends in abortion and contraception, women's attitudes toward abortion, and their perceptions of problems associated with abortion and contraception in Kazakhstan. Despite an overall decline in abortion and an increase in contraceptive use since Kazakhstan's independence in 1991, abortion has remained a prominent part of the country's reproductive culture and practices. This study shows how abortion-related views reflect the long-standing ethnocultural differences between the indigenous Kazakhs and Kazakhstan's residents of European roots, as the latter continue to have significantly higher levels of abortion. The study, however, also reveals the internal diversity among Kazakhs with respect to abortion experiences and views, stemming from decades of the Soviet sociocultural influence in Kazakhstan. In addition, the analysis points to some generational differences in views concerning abortion and contraception. Finally, the study demonstrates parallels in attitudes toward abortion and toward contraception, thereby questioning straightforward assumptions about the replacement of abortion with contraception.
DREES, A.; AHRENS, L.; III FLILLER, R.; GASSNER, D.; MCINTYRE, G.T.; MICHNOFF, R.; TRBOJEVIC, D.
During the RHIC Au-run in 2001 the 200 MHz storage cavity system was used for the first time. The rebucketing procedure caused significant beam debunching in addition to amplifying debunching due to other mechanisms. At the end of a four hour store, debunched beam could account for approximately 30%-40% of the total beam intensity. Some of it will be in the abort gap. In order to minimize the risk of magnet quenching due to uncontrolled beam losses at the time of a beam dump, a combination of a fast transverse kicker and copper collimators were used to clean the abort gap. This report gives an overview of the gap cleaning procedure and the achieved performance
Walter E. Block
Full Text Available I have published more than just a few papers on the abortion issue. Instead of taking either the pro choice or the pro life position, I offer a third alternative: evictionism. I claim that this perspective, which, as it happens is a principled compromise between the other two positions, is the only one compatible with libertarianism. Wisniewski (2010 offers several not unreasonable challenges to my thesis. The present paper is my attempt to refute each and every one of them.
Political change in Bulgaria has meant the beginning of the recognition of the reproduction rights of women. Abortion, for example, was legalized in 1990. Women in Bulgaria, however, still lack the information they need on basic hygiene and sex. It is impossible to promulgate a progressive strategy in Bulgaria if one ignores the isolation of the Turkish and Gypsy ethnic communities. In addition, an economic crisis exists, and no real measures have been undertaken to mitigate the situation. The new democratic institutions have settled comfortably into the structures of the former communist rule, even to the point of adopting the same extensive demagogic terminology which perpetrates the old gap between words and deeds. For example, although a new birth control strategy and plan for sex education was announced 2 years ago, nothing definite has been done. One development, however, has been the legalization of abortion, which was accompanied by an immediate drop in the abortion rate (still 1.5 abortions/birth). Because of a lack of sex education, 900 children are born to girls under age 15 each year. Bulgaria is just starting to embrace modern values and must update its attitudes towards women. Bulgaria's formal institutions seem to be unable to face this issue, and many societies and foundations have emerged to work for women's rights, to protect out-of-wedlock children, and to fight disease (including AIDS) and drug addiction. However, these organizations are not producing real results and are simply providing shelter to representatives of the old nomenclature. Real efforts to overcome these problems will continue despite the current discouraging state of affairs.
Abortion is a common and widespread form of fertility regulation the world over. Legal and illegal abortion is very common throughout the developing countries. Since abortions are often not legal in the developing countries, unsafe abortions are an important cause of female mortality. The widespread incidence of abortions ...
For many years, illegal abortion has been denounced in Spain. The estimate of 300,000 abortions annually is widely quoted but poorly founded in fact. Weekend "charters" to London and Amsterdam for women seeking abortions have been commented upon, denounced, and caricatured. The evidence indicates that abortions occur in Spain despite their illegality, just as they occur in every other country and have always occurred. Poor women abort in a poor way, with traditional healers, while rich women abort in a rich way, with physicians. "Charters" are the solution of the middle class. Proposed legislation in Spain would permit abortion on 3 grounds: rape, fetal malformation, and risk to the woman's life if the pregnancy continued. Excesses have been committed both by those opposing abortion and by those struggling for liberalization of laws. Defenders of abortion, such as radical feminists, appear to forget that abortion is a medical procedure with possible dangerous psychophysical consequences, and that preventive measures such as sex education and diffusion of contraception or social measures such as assistance for unwed mothers and their children would be preferrable to abortion. There is the question of whether medical personnel should be excused from assisting in abortions on grounds of conscience and whether those who do assist in abortions automatically become "progressive" by doing so. The staunchest defenders of fetal life are not moved to contribute anything beyond words to improvement of the plight of the many millions of already born who live in miserable conditions of hunger and want. Abortion is a violent act against the fetus and the pregnant woman. Its criminalization is a violent act against the woman and a social intrusion into matters better left to personal ethics. The government which proposes abortion on a few grounds fails to initiate a program to promote life through social protection of single mothers and their children or of families in general
Mahnken, A.H.; Brandenburg, V.M.; Haage, P.; Guenther, R.W. [Dept. of Diagnostic Radiology, Univ. Hospital, Univ. of Technology, Aachen (Germany); Frank, R.D. [Dept. of Nephrology and Immunology, Univ. of Technology, Aachen (Germany)
Antiphospholipid antibodies are associated with arterial and venous thromboses, recurrent pregnancy loss, and organ infarction. Any vascular region can be affected. We present a 20-year-old woman suffering from secondary antiphospholipid syndrome with a unique combination of multifocal venous thromboses, pulmonary embolism, spontaneous abortion, and splenic infarction. Diversity of clinical symptoms and diagnostic imaging modalities are discussed with emphasis on cross-sectional imaging. The syndrome should be suspected in patients with thromboses and organ infarctions of otherwise undetermined etiology. (orig.)
Mahnken, A.H.; Brandenburg, V.M.; Haage, P.; Guenther, R.W.; Frank, R.D.
Antiphospholipid antibodies are associated with arterial and venous thromboses, recurrent pregnancy loss, and organ infarction. Any vascular region can be affected. We present a 20-year-old woman suffering from secondary antiphospholipid syndrome with a unique combination of multifocal venous thromboses, pulmonary embolism, spontaneous abortion, and splenic infarction. Diversity of clinical symptoms and diagnostic imaging modalities are discussed with emphasis on cross-sectional imaging. The syndrome should be suspected in patients with thromboses and organ infarctions of otherwise undetermined etiology. (orig.)
To observe plasma β-endorphin(β-EP)and gonadotrophin releasing hormone(GnRM),human chorionic gonadotrophin(hCG),progesterone (P4) levels in women with early threatened abortion and with a history of recurrent spontaneous abortions(RSA).Twenty patients with threatened abortion at 7-8 weeks of gestation were re-cruited,all of them had a history of 3 or more recurrent unexplained abortions.They were treated with psychological consultation accompanied by traditional Chinese herbs.Blood samples were taken to measure β-EP,GnRM,hCG and P4 levels by radioim-munoassay(RIA).The treatments were continued till 10-12 weeks,blood was taken during this period to compare changes in these peptides/hormones.Twenty normal pregnant women at 7-8 and 10-12weeks and 20patients with incomplete abortion at 10- 12weeks were recruited for comparative studies.Results:(1)In normal pregnant women,plasma β-EP,GnRH,hCG and P4 levels at 10-12 weeks were significantly higher than that at 7-8 weeks(P0.05).(3)Plasma β-EP levels in patients with incomplete abortions at 10-12 weeks were dramatically higher and GnRH,hCG and P4levels were lower than in normal pregnant women(P<0.01).β-EP might play a role in the pathophysiology of spontaneous abortion.
Lara, Diana; García, Sandra G; Wilson, Kate S; Paz, Francisco
Misoprostol was used by women across Mexico to induce abortion even before 2007, when first-trimester abortion was legalized in Mexico City. Pharmacy vendors' misoprostol recommendation practices across subregions of Mexico after abortion legalization warrant examination. Overall, 192 pharmacies in four regions of Mexico were randomly selected and visited by simulated clients presenting three scenarios (a young woman, an adult woman and a male partner). Bivariate and multivariate analyses were used to explore associations between pharmacy, vendor and client characteristics and drug access. In 558 encounters with simulated clients, 78% of vendors provided information about misoprostol-18% recommended it spontaneously and 60% recommended it only after the client asked specifically for the drug. Fifteen percent of vendors recommended a potentially effective misoprostol dosing regimen. Mexico City-based pharmacies and those in the Central region were significantly less likely than those in the North region to require a prescription to sell misoprostol (odds ratios, 0.2 and 0.3, respectively). Independent pharmacies and those from low-?income areas were significantly more likely to sell misoprostol by the pill than chain pharmacies and those in medium-income areas (3.2 and 2.7, respectively). Access to misoprostol is influenced by neighborhood socioeconomic level, pharmacy location and pharmacy type. The frequently inaccurate and incomplete information provided to clients about using misoprostol for abortion suggests the need to improve pharmacy vendor training in medication abortion options and to develop ways to directly inform women about misoprostol use.
Krishnan, Shweta; Dalvie, Suchitra
Although unsafe abortion continues to be a leading cause of maternal mortality in many countries in Asia, the right to safe abortion remains highly stigmatized across the region. The Asia Safe Abortion Partnership, a regional network advocating for safe abortion, produced an animated short film entitled From Unwanted Pregnancy to Safe Abortion to show in conferences, schools and meetings in order to share knowledge about the barriers to safe abortion in Asia and to facilitate conversations on the right to safe abortion. This paper describes the making of this film, its objectives, content, dissemination and how it has been used. Our experience highlights the advantages of using animated films in addressing highly politicized and sensitive issues like abortion. Animation helped to create powerful advocacy material that does not homogenize the experiences of women across a diverse region, and at the same time emphasize the need for joint activities that express solidarity. Copyright © 2015. Published by Elsevier Ltd.
Keshavarzi, Hamideh; Sadeghi-Sefidmazgi, Ali; Kristensen, Anders Ringgaard
Abortions, especially those occurring during late pregnancy, lead to considerable economic losses. To estimate the financial losses related to pregnancy loss, at first the influencing factors on abortion need to be identified. Thus, the objective of this study was to determine and quantify the risk...... factors and their interactions for abortion in Iranian dairy herds. Based on data from 6 commercial herds, logistic regression was used to identify the risk factors for abortion. The basic time unit used in the study was a 3-week period corresponding to an estrus cycle. Thus, stage of lactation...... factors were herd effect, pregnancy stage, previous abortion, calving month, cumulative fat corrected milk (FCM) yield level, mastitis in current 3-weeks in milk, accumulated number of mastitis and all 2-way interactions. Pregnancy tests were performed between 35 and 50 days after insemination. Abortion...
García-Romero, H; González-González, A; Galicia, J; Garcia-Barrios, C
We revised ethical concepts related to abortion from the points of view of the mothers; life, health, and considerations are made concerning the embryo or fetus as a biological, ontological, moral, and potential person. Certain religious matters on abortion are described and commented on. Effects of abortion penalization in Mexico and the legislation in the Mexican states are examined, as well as the motives of depenalization in certain countries.
Brown, D; Elkins, T E; Larson, D B
Although flawed by methodological problems, the research literature tends to provide support for the assumption that induced abortion in the 1st trimester is not accompanied by enduring negative psychological sequelae. In cases where such sequelae are reported, the morbidity is attributed to a pre-existing psychiatric condition or circumstances precipitating the choice of abortion. However, detailed descriptive letters from 45 women prepared in response to a request by a pastor of an upper-middle-class Protestant congregation in Florida indicate that prolonged grieving after abortion may be more widespread phenomenon than previously believed. Letter writers ranged in age from 25-60 years; 75% were unmarried at the time of the procedure and 29% aborted before the legalization of abortion in the US. The most frequently cited long-term sequela, especially among those who felt coerced to abort, was a continued feeling of guilt. Fantasies about the aborted fetus was the next most frequently mentioned experience. Half of the letter writers referred to their abortions, as "murder" and 44% voiced regret about their decision to abort. Other long-term effects included depression (44%), feelings of loss (31%), shame (27%), and phobic responses to infants (13%). For 42% of these women, the adverse psychological effects of abortion endured over 10 years. Since letter-writers came from a self-selected population group with a known bias against abortion and only negative experiences were solicited, these experiences must be regarded as subjectives and anecdotal. However, they draw attention to the need for methodologically sound studies of a possible prolonged grief syndrome among a small percentage of women who have abortions, especially when coercion is involved.
Von Baross, J
The commentary on West German abortion law, particularly in illegal abortion in the Netherlands, finds the law restrictive and in violation of the dignity and rights of women. The Max-Planck Institute in 1990 published a study that found that a main point of prosecution between 1976 and 1986, as reported by Der Spiegal, was in border crossings from the Netherlands. It is estimated that 10,000 annually have abortions abroad, and 6,000 to 7,000 in the Netherlands. The procedure was for an official to stop a young person and query about drugs; later the woman would admit to an abortion, and be forced into a medical examination. The German Penal Code Section 218 stipulates abortion only for certain reasons testified to by a doctor other than the one performing the abortion. Counseling on available social assistance must be completed 3 days prior to the abortion. Many counseling offices are church related and opposed to abortions. Many doctors refuse legally to certify, and access to abortion is limited. The required hospital stay is 3-4 nights with no day care facilities. Penal Code Section 5 No. 9 allows prosecution for uncounseled illegal abortion. Abortion law reform is anticipated by the end of 1992 in the Bundestag due to the Treaty or the Unification of Germany. The Treaty states that the rights of the unborn child must be protected and that pregnant women relieve their distress in a way compatible with the Constitution, but improved over legal regulations from either West or East Germany, which permits abortion on request within 12 weeks of conception without counseling. It is hoped that the law will be liberalized and Penal Code Section 5 No. 9 will be abolished.
Bernabé-Ortiz, Antonio; White, Peter J; Carcamo, Cesar P; Hughes, James P; Gonzales, Marco A; Garcia, Patricia J; Garnett, Geoff P; Holmes, King K
Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially
Fergusson, David M; Horwood, L John; Boden, Joseph M
There has been continued interest in the extent to which women have positive and negative reactions to abortion. To document emotional reactions to abortion, and to examine the links between reactions to abortion and subsequent mental health outcomes. Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30. Abortion was associated with high rates of both positive and negative emotional reactions; however, nearly 90% of respondents believed that the abortion was the right decision. Analyses showed that the number of negative responses to the abortion was associated with increased levels of subsequent mental health disorders (Pabortion and reporting negative reactions had rates of mental health disorders that were approximately 1.4-1.8 times higher than those not having an abortion. Abortion was associated with both positive and negative emotional reactions. The extent of negative emotional reactions appeared to modify the links between abortion and subsequent mental health problems.
Margolis, A J; Davison, L A; Hanson, K H; Loos, S A; Mikkelsen, C M
To determine the long-range psychological effects of therapeutic abortion, 50 women (aged from 13-44 years), who were granted abortions between 1967 and 1968 Because of possible impairment of mental and/or physical health, were analyzed by use of demographic questionnaires, psychological tests, and interviews. Testing revealed that 44 women had psychiatric problems at time of abortion. 43 patients were followed for 3-6 months. The follow-up interviews revealed that 29 patients reacted positively after abortion, 10 reported no significant change and 4 reacted negatively. 37 would definitely repeat the abortion. Women under 21 years of age felt substantially more ambivalent and guilty than older patients. A study of 36 paired pre- and post-abortion profiles showed that 15 initially abnormal tests had become normal. There was a significant increase in contraceptive use among the patients after the abortion, but 4 again became pregnant and 8 were apparently without consistent contraception. It is concluded that the abortions were therapeutic, but physicians are encouraged to be aware of psychological problems in abortion cases. Strong psychological and contraceptive counselling should be exercised.
Johansson, A; Nga, N T; Huy, T Q; Dat, D D; Holmgren, K
This study analyzes the involvement of men in abortion in Vietnam, where induced abortion is legal and abortion rates are among the highest in the world. Twenty men were interviewed in 1996 about the role they played in their wives' abortions and about their feelings and ethical views concerning the procedure. The results showed that both husbands and wives considered the husband to be the main decisionmaker regarding family size, which included the decision to have an abortion, but that, in fact, some women had undergone an abortion without consulting their husbands in advance. Parents and in-laws were usually not consulted; the couples thought they might object to the decision on moral grounds. Respondents' ethical perspectives on abortion are discussed. When faced with an unwanted pregnancy, the husbands adopted an ethics of care and responsibility toward family and children, although some felt that abortion was immoral. The study highlights the importance of understanding husbands' perspectives on their responsibilities and rights in reproductive decisionmaking and their ethical and other concerns related to abortion.
After the fall of Communism in Poland, the Catholic church exerted pressure to increase its influence in public life. One way in which this pressure has manifested itself has been in the passing of a restrictive abortion bill which was signed into law on February 15, 1993. Abortion had been legalized in Poland in 1956 and was used as a means of birth control because of a lack of availability and use of contraceptives. The number of abortions performed was variously reported as 60,000 - 300,000/year. In 1990, the Ministry of Health imposed restrictions on abortions at publicly funded hospitals, and 3 deaths were reported from self-induced abortions. In 1 year (1989-90), the number of induced abortions at 1 hospital dropped from 71 to 19, while the number of self-induced abortions increased from 48 to 85. Further restrictions were introduced in May 1992 as part of the "Ethical Code for Physicians," which allows abortions only in cases where the mother's life or health is in danger or in cases or rape. This code brought abortions to a halt at publicly funded hospitals and doubled or even tripled the cost of private abortions. Women have been refused abortions in tragic and life=threatening situations since the code was adopted. When an outright anti family planning bill was drafted in November 1992, the Polish citizenry collected 1,300,000 signatures to force a referendum. The referendum was not held, but the bill was defeated. The amended bill which passed allows abortions in publicly funded hospitals only when the mother's life or health is in danger and in cases of rape, incest, or incurable deformity of the fetus. The implications of this law remain unclear, since its language is strange and vague. The reproductive rights of Polish women face a further threat because the Catholic church is working to limit the availability of contraceptive methods which they deem to be "early abortives." On the other side of the issue, the Federation for Women and Planned
Rothstein, D S
"This paper uses econometric multiple regression techniques in order to analyze the socioeconomic factors affecting the demand for abortion for the year 1985. A cross-section of the 50 [U.S.] states and Washington D.C. is examined and a household choice theoretical framework is utilized. The results suggest that average price of abortion, disposable personal per capita income, percentage of single women, whether abortions are state funded, unemployment rate, divorce rate, and if the state is located in the far West, are statistically significant factors in the determination of the demand for abortion." excerpt
Buga, G A B
Unsafe abortion causes 13% of maternal deaths worldwide. Safe abortion can only be offered under conditions where legislation has been passed for legal termination of unwanted pregnancy. Where such legislation exists, accessibility of safe abortion depends on the attitudes of doctors and other healthcare workers to induced abortion. Medical students as future doctors may have attitudes to abortion that will affect the provision of safe abortion. Little is known about the attitudes of South African medical students to abortion. To assess sexual practices and attitudes of medical students to induced abortion and to determine some of the factors that may influence these attitudes. A cross-sectional analytic study involving the self-administration of an anonymous questionnaire. The questionnaire was administered to medical students at a small, but growing, medical school situated in rural South Africa. Demographic data, sexual practices and attitudes to induced abortion. Two hundred and forty seven out of 300 (82.3%) medical students responded. Their mean age was 21.81 +/- 3.36 (SD) years, and 78.8% were Christians, 17.1% Hindus and 2.6% Muslims. Although 95% of the respondents were single, 68.6% were already sexually experienced, and their mean age at coitarche was 17.24+/-3.14 (SD) years. Although overall 61.2% of the respondents felt abortion is murder either at conception or later, the majority (87.2%) would perform or refer a woman for abortion under certain circumstances. These circumstances, in descending order of frequency, include: threat to mother's life (74.1%), in case of rape (62.3%), the baby is severely malformed (59.5%), threat to mother's mental health (53.8%) and parental incompetence (21.0%). Only 12.5% of respondents would perform or refer for abortion on demand, 12.8% would neither perform nor refer for abortion under any circumstances. Religious affiliation and service attendance significantly influenced some of these attitudes and beliefs
Latham, Stephen R
On the fourth day of his presidency, Donald Trump reinstated and greatly expanded the "Mexico City policy," which imposes antiabortion restrictions on U.S. foreign health aid. In general, the policy has prohibited U.S. funding of any family-planning groups that use even non-U.S. funds to perform abortions; prohibited aid recipients from lobbying (again, even with non-U.S. money) for liberalization of abortion laws; prohibited nongovernment organizations from creating educational materials on abortion as a family-planning method; and prohibited health workers from referring patients for legal abortions in any cases other than rape, incest, or to save the life of the mother. The policy's prohibition on giving aid to any organization that performs abortions is aimed at limiting alleged indirect funding of abortions. The argument is that if U.S. money is used to fund nonabortion programs of an abortion-providing NGO, then the NGO can simply shift the money thus saved into its abortion budget. Outside the context of abortion, we do not reason this way. And the policy's remaining three prohibitions are deeply troubling. © 2017 The Hastings Center.
Full Text Available This was a descriptive study aimed at exploring the personal experiences of women who induce abortion and the circumstances surrounding induced abortion. The study was conducted in six public hospitals in four different provinces: Baragwanath (Gauteng, Groote Schuur and Tygerberg (Western Cape, King Edward and R.K. Khan (Kwa-Zulu/Natal and Livingstone (Eastern Cape. In-depth interviews were conducted with 25 African, Indian and Coloured women admitted to the hospitals following backstreet abortions. The study gave women the opportunity to "speak for themselves" about "why" and "how" and the context in which the unscfe induced abortions occurred
Abbasi, Mahmoud; Shamsi Gooshki, Ehsan; Allahbedashti, Neda
Abortion traditionally means, "to miscarry" and is still known as a problem which societies has been trying to reduce its rate by using legal means. Despite the pregnant women and fetuses have being historically supported; abortion was firstly criminalized in 1926 in Iran, 20 years after establishment of modern legal system. During next 53 years this situation changed dramatically, so in 1979, the time of Islamic Revolution, aborting fetuses before 12 weeks and therapeutic abortion (TA) during all the pregnancy length was legitimate, based on regulations that used medical justification. After 1979 the situation changed into a totally conservative and restrictive approach and new Islamic concepts as "Blood Money" and "Ensoulment" entered the legal debates around abortion. During the next 33 years, again a trend of decriminalization for the act of abortion has been continuing. Reduction of punishments and omitting retaliation for criminal abortions, recognizing fetal and maternal medical indications including some immunologic problems as legitimate reasons for aborting fetuses before 4 months and omitting the fathers' consent as a necessary condition for TA are among these changes. The start point for this decriminalization process was public and professional need, which was responded by religious government, firstly by issuing juristic rulings (Fatwas) as a non-official way, followed by ratification of "Therapeutic Abortion Act" (TAA) and other regulations as an official pathway. Here, we have reviewed this trend of decriminalization, the role of public and professional request in initiating such process and the rule-based language of TAA.
Meddahi, M; Boccardi, A; Butterworth, A; Fisher, A S; Gianfelice-Wendt, E; Goddard, B; Hemelsoet, G H; Höfle, W; Jacquet, D; Jaussi, M; Kain, V; Lefevre, T; Shaposhnikova, E; Uythoven, J; Valuch, D
Unbunched beam is a potentially serious issue in the LHC as it may quench the superconducting magnets during a beam abort. Unbunched particles, either not captured by the RF system at injection or leaking out of the RF bucket, will be removed by using the existing damper kickers to excite resonantly the particles in the abort gap. Following beam simulations, a strategy for cleaning the abort gap at different energies was proposed. The plans for the commissioning of the beam abort gap cleaning are described and first results from the beam commissioning are presented.
Stålhandske, Maria L; Ekstrand, Maria; Tydén, Tanja
To explore Swedish women's experiences of clinical abortion care in relation to their need for existential support. Individual in-depth interviews with 24 women with previous experience of unwanted pregnancy and abortion. Participants were recruited between 2006 and 2009. Interviews were analysed by latent content analysis. Although the women had similar experiences of the abortion care offered, the needs they expressed differed. Swedish abortion care was described as rational and neutral, with physical issues dominating over existential ones. For some women, the medical procedures triggered existential experiences of life, meaning, and morality. While some women abstained from any form of existential support, others expressed a need to reflect upon the existential aspects and/or to reconcile their decision emotionally. As women's needs for existential support in relation to abortion vary, women can be disappointed with the personnel's ability to respond to their thoughts and feelings related to the abortion. To ensure abortion care personnel meet the physical, psychological and existential needs of each patient, better resources and new lines of education are needed to ensure abortion personnel are equipped to deal with the existential aspects of abortion care.
Decision ambivalence is a key concept in abortion literature, but has been poorly operationalised. This study explored the concept of decision ambivalence via an Abortion Decision Balance Sheet (ADBS) articulating reasons both for and against terminating an unintended pregnancy. Ninety-six women undergoing an early abortion for psychosocial…
Wiegerinck, Melanie M. J.; Jones, Heidi E.; O'Connell, Katharine; Lichtenberg, E. Steve; Paul, Maureen; Westhoff, Carolyn L.
Background: Little is known about clinical implementation of medical abortion in the United States following approval of mifepristone as an abortifacient by the Food and Drug Administration (FDA) in 2000. We collected information regarding medical abortion practices of National Abortion Federation
Wiegerinck, Melanie M. J.; Jones, Heidi E.; O'Connell, Katharine; Lichtenberg, E. Steve; Paul, Maureen; Westhoff, Carolyn L.
Little is known about clinical implementation of medical abortion in the United States following approval of mifepristone as an abortifacient by the Food and Drug Administration (FDA) in 2000. We collected information regarding medical abortion practices of National Abortion Federation (NAF) members
Gelman, Amanda; Rosenfeld, Elian A; Nikolajski, Cara; Freedman, Lori R; Steinberg, Julia R; Borrero, Sonya
Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women's responses to them. Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. Women's reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women's abortion experiences. Copyright © 2016 by the Guttmacher Institute.
Faúndes, Anibal; Shah, Iqbal H
Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be "in favor of abortion," by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. Copyright © 2015. Published by Elsevier Ireland Ltd.
Ojha, N; Sharma, S; Paudel, J
Abortion has been legalized in Nepal since September 2002 by 11th amendment to the Muluki Ain. The present study was conducted in Paropakar Shree Panch Indra Rajya Laxmi Devi Maternity Hospital to assess the magnitude of induced abortion, its causes and the types of complications, in the post legalization phase. Prospective descriptive analyses of the patients who were admitted with history of induced abortion from 16th Dec 2003 to 13th March 2004 was carried out. A total of 305 cases of abortion complications were admitted during the three-month study period, which is 39.7% of the total gynaecological admissions (768). Of these 31 (10.25%) patients had history of induced abortion. Half of the induced abortion cases (52%) were of age group 21-29 yrs and 42% had three or more children. 39% of the cases had history of induced abortion at more than 12 weeks and almost half of the cases (48%) had history of family planning. The most common reason for seeking abortion was too many children (59%) followed by illegitimate pregnancy (16%). Twenty-one patients gave history of abortion being performed by doctors and the most common method used was D and C (75%). 77% of cases presented as incomplete abortion and one case presented with uterine perforation, bowel injury and peritonitis. Twenty patients had evacuation under sedation while five had manual vacuum aspiration (MVA); one patient required laparatomy. In two third of the patients intravenous fluid and antibiotics were used. Four patients required blood transfusion. Abortion complications constitute almost 40% of the total gynaecological admissions. Ten percent of the abortion cases had history of induced abortion. Medical persons, mainly doctors, performed most of the cases of induced abortion and D and C was the most commonly used method. However the patients had faced various types of complications. Untrained provider, resulting in serious life threatening injuries, performed more than a third of the cases of
This article presents the history and grounds of the official position of the Roman Catholic Church that abortion under any circumstances, including abortion to save the life of the mother, should be prohibited. After an introduction that deplores the lack of mercy shown to killers of abortionists while Catholic priests threatened by pro-abortion forces are not offered protection, the article traces the historic development of the Catholic abortion policy and rebuts arguments that abortion was permitted in the early Christian Church. The next section explains Catholic views on the personhood of a conceptus and refutes the contentions of Joseph Donceel that early abortion should be permitted because of uncertainty about the nature of the conceptus and the possibility of delayed animation. The fourth section of the paper debates the points raised by Susan Teft Nicholson who maintains that the Catholic position regarding abortion rests on the Church's animosity towards sexual pleasure. The paper goes on to criticize Nicholson's claims that the Roman Catholic position on abortion is inconsistent with the Church's own understanding of the Principle of Double Effect because the Church fails to allow abortion in many cases where it would be permissible under the Principle. Section 6 describes the underlying motive of the Roman Catholic Church's abortion position as an attempt to protect the innocent fetus from deliberate death and to justify the Church's application of protection from deliberate killing to those who are innocent of aggressive action. This discussion is followed by a justification of the Church's prohibition of abortion in cases of aggression, such as the aggression ascribed to a fetus when a pregnancy imperials the life of a mother. It is concluded that the US will likely legalize suicide and mercy killing as it has the killing of innocent fetuses who are probably ensouled with personhood and are not formal aggressors.
In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted.
Cook, R J
It is common to find the term illegal abortion misused. Often times this misuse is perpetrated by antiabortion advocates who wish to reinforce negative stereotypes and thus apply pressure on doctors to refrain from performing abortions. Until a practitioner is prosecuted and convicted of performing an abortion contrary to the law, the procedure should not be referred to as illegal. Instead the legally neutral term, abortion, should be used instead. This would better serve the interests of women's reproductive health. There is no legal system that makes abortion illegal in all circumstances. For example, abortion is often legal if the life of the mother in danger. This includes a perception on behalf of the practitioner that the women may be suicidal or attempt to terminate the pregnancy by herself. A practitioner performing an abortion in such circumstances is not doing so illegally. The use of the term illegal abortion ignores the fact that in criminal law one is presumed innocent until proven guilty. A prosecutor must prove 1st that an intervention was performed and 2nd that a criminal intent accompanied the intervention. It is this 2nd criterion that is often the hardest to prove, since the practitioner must only testify that the intervention was indicated by legally allowed circumstances to be innocent. The prosecutor must show bad faith in order to gain a justified conviction. Even abortion by unqualified practitioners may not be illegal if doctors refuse to perform the intervention because it is still indicated. Accurate description of abortions would clarify situations in which abortion can be legally provided.
Li Ying; Cheng Yi-ming; Huang Na; Guo Xin; Wang Xian-mi
This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.
Full Text Available The debates and feminist actions in favor of the legalization of abortion in Brazil were characterized by progresses and regressions, and above all by countless political negotiations. From the omission of the word “abortion”, in the mid-seventies, to the political choice of decriminalization and application of the cases foreseen by law, Brazilian feminism has been marked by the choice of negotiation. The article concludes that these negotiations have succeeded politically but failed to reach society and heighten public awareness at a large scale.
Zou, Guobin; Sha, Xia
To evaluate the associations between birth order, maternal abortion and mode of delivery and childhood acute leukemia risk. Multiple electronic databases were searched to identify relevant studies up to March 2013 using the search terms "childhood leukemia", "acute lymphoblastic leukemia", "acute myeloid leukemia","birth order", "abortion", "miscarriage", "cesarean", "birth characteristics" and "prenatal risk factor". Data from cohort and case-control studies were analyzed using the Stata software. Twenty-three studies were included in this meta-analysis according to the selection criteria. No significant associations were identified for birth order and mode of delivery (birth order = 2: OR = 0.97, 95%CI: 0.89-1.05; birth order = 3: OR = 1.00, 95%CI: 0.91-1.11; birth order ≥ 4: OR = 1.02, 95%CI: 0.87-1.20; mode of delivery: OR = 1.05, 95%CI: 0.96-1.15). However, there was a significant association between maternal abortion and childhood acute leukemia risk (spontaneous abortion: OR = 1.21, 95%CI: 1.05-1.41; induced abortion: OR = 1.23, 95%CI: 1.07-1.43). Furthermore, the stratified analysis by disease subtypes showed that spontaneous and induced abortions were significantly associated with the risks of childhood acute myeloid leukemia (OR = 1.71, 95%CI: 1.09-2.70) and acute lymphoblastic leukemia (OR = 1.23, 95%CI: 1.05-1.42), respectively. This meta-analysis revealed that maternal abortion might contribute to the childhood acute leukemia risk.
Ntontis, Evangelos; Hopkins, Nick
Social psychological research on activism typically focuses on individuals' social identifications. We complement such research through exploring how activists frame an issue as a social problem. Specifically, we explore anti-abortion activists' representation of abortion and the abortion debate's protagonists so as to recruit support for the anti-abortion cause. Using interview data obtained with UK-based anti-abortion activists (N = 15), we consider how activists characterized women having abortions, pro-abortion campaigners, and anti-abortion campaigners. In particular, we consider the varied ways in which emotion featured in the representation of these social actors. Emotion featured in different ways. Sometimes, it was depicted as constituting embodied testament to the nature of reality. Sometimes, it was depicted as blocking the rational appraisal of reality. Our analysis considers how such varied meanings of emotion shaped the characterization of abortion and the abortion debate's protagonists such that anti-abortion activists were construed as speaking for women and their interests. We discuss how our analysis of the framing of issues as social problems complements and extends social psychological analyses of activism. © 2018 The British Psychological Society.
Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn
The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental Health and Abortion (2008). Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however. It is important that women's varied experiences of abortion be recognized, validated, and understood. 2009 APA.
Ethical investment funds have traditionally boycotted the arms industry, companies known to pollute the environment, and those involved in animal research. However, recent newspaper reports suggest that some investment funds plan to also boycott hospitals and pharmaceutical companies involved in abortion-related activities. Ethical Financial, anti-abortion independent financial advisors, are encouraging a boycott of investment in private hospitals and manufacturers of equipment involved in abortions, and pharmaceutical firms which produce postcoital contraception or conduct embryo research. Ethical Financial claims that Family Assurance has agreed to invest along anti-abortion lines, Aberdeen Investment is already boycotting companies linked to abortion, and Hendersons ethical fund plans to follow suit. There is speculation that Standard Life, the largest mutual insurer in Europe, will also refuse to invest in abortion-related concerns when it launches its ethical fund in the spring. Managers of ethical funds should, however, understand that, contrary to the claims of the anti-choice lobby, there is extensive public support for legal abortion, emergency contraception, and embryo research. Individuals and institutions which contribute to the development of reproductive health care services are working to alleviate the distress of unwanted pregnancy and infertility, laudable humanitarian goals which should be encouraged. Those who try to restrict the development of abortion methods and services simply show contempt for women, treating them as people devoid of conscience who are incapable of making moral choices.
An analysis of the Roman Catholic Church's arguments against abortion rights suggests that its opposition is grounded more in outmoded views regarding women's roles than in concern for protecting fetal life. The 1st argument raised by Catholics and other anti-abortion forces is that abortion represents the unjustifiable destruction of a human life. A 2nd argument focuses on the status of the fetus as a person from the moment of conception, making abortion murder. A 3rd equates the fetus's potential for personhood with the pregnant woman's actual personhood. Despite the vehement sentiments expressed by Catholic leaders against abortion, the majority of Catholics support legal abortion. The assignment of personhood status to the fetus is contraindicated by actual practice in the Church, where aborted or miscarried products of early pregnancy are not baptized. Also, the Church does not forbid the taking of human life in war or to preserve political freedom. Finally, in countries such as Poland where abortion has been made illegal through religious pressure, there have been drastic cuts in health care and child care programs.
Suction v. conventional curettage in incomplete abortion. A randomised controlled trial. D. A. A. VERKUYL, C. A. CROWTHER .Abstract This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients ...
Christensen, Anne Vinggaard; Petersson, Birgit
tilknytning og fagligt tilhørsforhold påvirker holdningerne. Antallet af sene provokerede aborter stiger i takt med, at fosterdiagnostikken udvikles, og der er derfor behov for forskning, der kan kaste lys over, hvordan det danske sundhedspersonale forholder sig til sene provokerede aborter....
Ngoc, Nguyen Thi Nhu; Shochet, Tara; Blum, Jennifer; Hai, Pham Thanh; Dung, Duong Lan; Nhan, Tran Thanh; Winikoff, Beverly
Complications following spontaneous or induced abortion are a major cause of maternal morbidity. To manage these complications, post-abortion care (PAC) services should be readily available and easy to access. Standard PAC treatment includes surgical interventions that are highly effective but require surgical providers and medical centers that have the necessary space and equipment. Misoprostol has been shown to be an effective alternative to surgical evacuation and can be offered by lower level clinicians. This study sought to assess whether 400 mcg sublingual misoprostol could effectively evacuate the uterus after incomplete abortion and to confirm its applicability for use at lower level settings. All women presenting with incomplete abortion at one of three hospitals in Vietnam were enrolled. Providers were not asked to record if the abortion was spontaneous or induced. It is likely that all were spontaneous given the legal status and easy access to abortion services in Vietnam. Participants were given 400 mcg sublingual misoprostol and instructed to hold the pills under their tongue for 30 minutes and then swallow any remaining fragments. They were then asked to return one week later to confirm their clinical status. Study clinicians were instructed to confirm a complete expulsion clinically. All women were asked to complete a questionnaire regarding satisfaction with the treatment. Three hundred and two women were enrolled between September 2009 and May 2010. Almost all participants (96.3%) had successful completions using a single dose of 400 mcg misoprostol. The majority of women (87.2%) found the side effects to be tolerable or easily tolerable. Most women (84.3%) were satisfied or very satisfied with the treatment they received; only one was dissatisfied (0.3%). Nine out of ten women would select this method again and recommend it to a friend (91.0% and 90.0%, respectively). This study confirms that 400 mcg sublingual misoprostol effectively evacuates
Sedgh, Gilda; Sylla, Amadou Hassane; Philbin, Jesse; Keogh, Sarah; Ndiaye, Salif
CONTEXT Abortion is highly restricted by law in Senegal. Although women seek care for abortion complications, no national estimate of abortion incidence exists. METHODS Data on postabortion care and abortion in Senegal were collected in 2013 using surveys of a nationally representative sample of 168 health facilities that provide postabortion care and of 110 professionals knowledgeable about abortion service provision. Indirect estimation techniques were applied to the data to estimate the incidence of induced abortion in the country. Abortion rates and ratios were calculated for the nation and separately for the Dakar region and the rest of the country. The distribution of pregnancies by planning status and by outcome was estimated. RESULTS In 2012, an estimated 51,500 induced abortions were performed in Senegal, and 16,700 (32%) resulted in complications that were treated at health facilities. The estimated abortion rate was 17 per 1,000 women aged 15–44 and the abortion ratio was 10 per 100 live births. The rate was higher in Dakar (21 per 1,000) than in the rest of the country (16 per 1,000). Poor women were far more likely to experience abortion complications, and less likely to receive treatment for complications, than nonpoor women. About 31% of pregnancies were unintended, and 24% of unintended pregnancies (8% of all pregnancies) ended in abortion. CONCLUSIONS Unsafe abortion exacts a heavy toll on women in Senegal. Reducing the barriers to effective contraceptive use and ensuring access to postabortion care without the risk of legal consequences may reduce the incidence of and complications from unsafe abortion. PMID:25856233
Sedgh, Gilda; Sylla, Amadou Hassane; Philbin, Jesse; Keogh, Sarah; Ndiaye, Salif
Abortion is highly restricted by law in Senegal. Although women seek care for abortion complications, no national estimate of abortion incidence exists. Data on postabortion care and abortion in Senegal were collected in 2013 using surveys of a nationally representative sample of 168 health facilities that provide postabortion care and of 110 professionals knowledgeable about abortion service provision. Indirect estimation techniques were applied to the data to estimate the incidence of induced abortion in the country. Abortion rates and ratios were calculated for the nation and separately for the Dakar region and the rest of the country. The distribution of pregnancies by planning status and by outcome was estimated. In 2012, an estimated 51,500 induced abortions were performed in Senegal, and 16,700 (32%) resulted in complications that were treated at health facilities. The estimated abortion rate was 17 per 1,000 women aged 15-44 and the abortion ratio was 10 per 100 live births. The rate was higher in Dakar (21 per 1,000) than in the rest of the country (16 per 1,000). Poor women were far more likely to experience abortion complications, and less likely to receive treatment for complications, than nonpoor women. About 31% of pregnancies were unintended, and 24% of unintended pregnancies (8% of all pregnancies) ended in abortion. Unsafe abortion exacts a heavy toll on women in Senegal. Reducing the barriers to effective contraceptive use and ensuring access to postabortion care without the risk of legal consequences may reduce the incidence of and complications from unsafe abortion.
Jun, Soon Ae; Ahn, Myoung Ock; Cha, Kwang Yul; Lee, Young Doo
To investigate predictable ultrasonographic findings of early abortion. To investigate objective rules for the screening of abortion. Ultrasonographic examination of 111 early pregnancies between the sixth and ninth week in women who had regular 28 day menstrual cycles was performed. Ultrasonographic measurements of the gestational sac, crown rump length and fetal heart rate were performed using a linear array real time transducer with doppler ultrasonogram. All measurements of 17 early abortions were compared to those of 94 normal pregnancies. Most of early aborted pregnancies were classified correctly by discriminant analysis with G-SAC and CRL (G-SAC=0.5 CRL + 15, sensitivity 76.5%, specificity 96.8%). With the addition of FHR, 94.1% of early abortions could be predicted. In conclusion, ultrasonographic findings of early intrauterine growth retardation, small gestational sac and bradycardia can be predictable signs suggestive of poor prognosis of early pregnancies
Rasch, V; Muhammad, H; Urassa, E
OBJECTIVES: This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania. METHODS: A cross-sectional questionnaire study was conducted in 2 phases at 3 hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion......, and phase 2 included 823 such patients. RESULTS: In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9% to 16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue...... and previously used clinical criteria were omitted, 30.9% to 60.0% of the cases were classified as induced abortion. CONCLUSIONS: An empathetic dialogue improves the quality of data collected among women with induced abortion....
Full Text Available This article considers the legal issues surrounding induced late abortion in cases when severe medical, therapeutic or ethical reasons have not been in dispute. Generally discussing the essential question about abortion today, it means not anymore legality of abortion but, in the first place, safety of abortion. From the aspect of woman health the most important aim is to detect and avoid possible risks of medical intervention, such as late abortion present. This is the matter of medical law context and also the matter of the woman's reproductive rights, here observed through legislation and court practice. The gynecologist has an obligation to obtain the informed consent of each patient. Information's should be presented in reasonably understandable terms and include alternative modes of treatment, objectives, risks, benefits, possible complications, and anticipated results of such treatment. Pregnant woman should receive supportive counseling before and particularly after the procedure. The method chosen for all terminations should ensure that the fetus is born dead. This should be undertaken by an appropriately trained practitioner. Reform in abortion law, making it legally accessible to woman, is not necessarily the product of a belief in woman's rights, but can be a means of bringing the practice of abortion back under better control. Counseling and good medical practice in performing late abortion are the instruments to drive this point even further home. It does not undermine the woman who wants to make a positive decision about her life and its purpose is not to produce feelings of insecurity and guilt. It concludes that existing law should not be changed but that clear rules should be devised and board created to review late term abortion. In Serbia, this leads to creation and set up guidelines for reconciling medical justification for late abortion with existing law, especially with solutions which brings comparative law. .
Granberg, D; Burlison, J
The political opponents of legal abortion achieved considerable gains in the 1980 American elections. A president who was committed to a strong antiabortion position was elected, and antiabortion candidates prevailed in six out of seven Senate races that pitted supporters against opponents of legal abortion and in seven out of nine similar confrontations in the House races. However, it is not clear that abortion was an overriding or decisive factor in determining those outcomes. Democrats and Republicans, Carter voters and Reagan voters did not differ significantly in their attitudes toward abortion. The presidential voter groups were divided on several other issues, and along income and racial lines, to a far greater extent than they were on abortion. Voters were not likely to name abortion as one of the more important problems facing the nation. Carter supporters rated abortion as more important than did Reagan supporters. Although the party platforms and the presidential candidates were clearly differentiated in their abortion stands, these differences were not well communicated to the citizenry. When voters attempted to describe the position of each candidate on abortion, they displayed a great deal of uncertainty, error and confusion. In the key Senate races, those who voted for the prochoice candidates held more liberal abortion attitudes than those who voted for the right-to-life candidates. This difference, although statistically significant, was not great, and was smaller than the differences related to several other issues--such as attitudes toward the role of government, women's rights and economic policies.(ABSTRACT TRUNCATED AT 250 WORDS)
Currently Catholic bishops are applying an inconsistent ethical paradigm to the issues of war and abortion. Based on the seamless garment theory war, abortion and capital punishment are all immoral acts because they are of the same garment. They are all "killing acts" and as such they are immoral. However there is within the Catholic paradigm the idea of a just war. The just war theory states that the destruction of human life in war is justified if it is for a greater good. However abortion has no exceptions, there is no just abortion in the rules of the Catholic Church. The author takes the just war doctrine as presented by the Catholic Church and shows how it could easily apply to abortion. Both war and abortion involve the taking of a human life, but in the case of war the taking of a life is justified if it is done to protect your own life. The same exception in abortion would be to allow abortion when the mother's life is in danger. yet no such exception exists. The just war theory further states that was is necessary to protect national integrity, particularly if the violation erodes the quality of life for its citizens. The same exception for abortion would include allowing abortions for women who already have more children then they can care for or if having the child would erode the quality of life for the woman. Other aspects of the just war theory include the competence and goals of the national leaders. Women must also be allowed to be competent moral agents. Proponents of the seamless garment theory will bring up the fact that in a just war only combatants die yet the fetus is innocent. But no war has ever been fought without the loss of innocent civilians.
Noeldge, G.; Wimmer, B.; Kirchner, R.
Spontaneous perforation of the gallbladder is one complication of cholelithiasis. There is a greater occurence of free perforation in the peritoneal cavity with bilary pertonitis, followed by the perforation into the stomach, small intestine and colon. A single case of the nowadays rare spontaneous perforation in and through the abdominal wall will be reported. Spontaneous gallbladder perforation appears nearly asymptomatic in its clinical course because of absent biliary peritonitis. (orig.) [de
Chor, Julie; Hebert, Luciana E; Hasselbacher, Lee A; Whitaker, Amy K
To determine the prevalence and correlates of having a regular physician among women presenting for induced abortion. We conducted a retrospective review of women presenting to an urban, university-based family planning clinic for abortion between January 2008 and September 2011. We conducted bivariate analyses, comparing women with and without a regular physician, and multivariable regression modeling, to identify factors associated with not having a regular physician. Of 834 women, 521 (62.5%) had a regular physician and 313 (37.5%) did not. Women with a prior pregnancy, live birth, or spontaneous abortion were more likely than women without these experiences to have a regular physician. Women with a prior induced abortion were not more likely than women who had never had a prior induced abortion to have a regular physician. Compared with women younger than 18 years, women aged 18 to 26 years were less likely to have a physician (adjusted odds ratio [aOR], 0.25; 95% confidence interval [CI], 0.10-0.62). Women with a prior live birth had increased odds of having a regular physician compared with women without a prior pregnancy (aOR, 1.89; 95% CI, 1.13-3.16). Women without medical/fetal indications and who had not been victims of sexual assault (self-indicated) were less likely to report having a regular physician compared with women with medical/fetal indications (aOR, 0.55; 95% CI, 0.17-0.82). The abortion visit is a point of contact with a large number of women without a regular physician and therefore provides an opportunity to integrate women into health care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis ... who are on peritoneal dialysis for kidney failure. Peritonitis may have other causes . These include infection from ...
Gebrehiwot, Yirgu; Liabsuetrakul, Tippawan
Evidence from developed countries has shown that abortion-related mortality and morbidity has decreased with the liberalization of the abortion law. This study aimed to assess the trend of hospital-based abortion complications during the transition of legalization in Ethiopia in May 2005. Medical records of women with abortion complications from 2003 to 2007 were reviewed (n = 773). Abortion and its complications with regard to legalization were described by rates and ratios, and predictors of fatal outcomes were analyzed by logistic regression. The overall and abortion-related maternal mortality ratios (AMMRs) showed a non-statistically significant downward trend over the 5-year period. However, the case fatality rate of abortion increased from 1.1% in 2003 to 3.6% in 2007. Late gestational age, history of interference and presenting after new abortion legislation passed have been found to be significant predictors of mortality. Decreased trends of abortion ratio and the AMMR were identified, but the severity of abortion complications and the case fatality rate increased during the transition of legal revision.
Lamina, Mustafa Adelaja
Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of availability of contraceptive services. The aim of this study is to determine the rate of abortion and contraceptive use among women seeking repeat induced abortion in Western Nigeria. A prospective cross-sectional study utilizing self-administered questionnaires was administered to women seeking abortion in private hospitals/clinics in four geopolitical areas of Ogun State, Western Nigeria, from January 1 to December 31 2012. Data were analyzed using SPSS 17.0. The age range for those seeking repeat induced abortion was 15 to 51 years while the median age was 25 years. Of 2934 women seeking an abortion, 23% reported having had one or more previous abortions. Of those who had had more than one abortion, the level of awareness of contraceptives was 91.7% while only 21.5% used a contraceptive at their first intercourse after the procedure; 78.5% of the pregnancies were associated with non-contraceptive use while 17.5% were associated with contraceptive failure. The major reason for non-contraceptive use was fear of side effects. The rate of women seeking repeat abortions is high in Nigeria. The rate of contraceptive use is low while contraceptive failure rate is high.
Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I
Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.
Koop, C E
The available scientific literature on the health effects of abortion on women in the US neither supports nor refutes the premise that abortion contributes to psychological problems. The 250 studies that have considered the psychological aspects of abortion are all flawed methodologically. Needed to resolve this issue is a prospective study of a cohort of US women of childbearing age focused on the psychological effects of failure to conceive, as well as the physical and mental sequelae of pregnancy whether carried to delivery, miscarried, or terminated by abortion. The most desirable such study could be conducted for about US$100 million over a 5-year period; a less expensive yet satisfactory study could be conducted for $10 million over the same time frame. Before such a study can be undertaken, a survey instrument must be designed to eliminate the discrepancy between the number of abortions on record and the number of women who admit to having an abortion on survey. Another issue is that the health effects of abortion cannot easily be separated from the controversial social issues surrounding pregnancy termination.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...
The availability of abortion provides insurance against unwanted pregnancies since abortion is the only birth control method which allows women to avoid an unwanted birth once they are pregnant. Restrictive state abortion policies, which increase the cost of obtaining an abortion, may increase women's incentive to alter their pregnancy avoidance…
In Ghana, despite the availability of safe, legally permissible abortion services, high rates of morbidity and mortality from unsafe abortion persist. Through interviews with Ghanaian physicians on the front lines of abortion provision, we begin to describe major barriers to widespread safe abortion. Their stories illustrate the ...
Unverdorben, Laura; Haufe, Thomas; Santoso, Laura; Hofmann, Simone; Jeschke, Udo; Hutter, Stefan
Galectins are galactose binding proteins and, in addition, factors for a wide range of pathologies in pregnancy. We have analyzed the expression of prototype (gal-1, -2, -7, -10) and chimera-type (gal-3) galectins in the placenta in cases of spontaneous abortions (SPA) and recurrent abortions (RA) in the first trimester. Fifteen placental samples from healthy pregnancies were used as a control group. Nine placentas were examined for spontaneous abortions, and 12 placentas for recurrent abortions. For differentiation and evaluation of different cell types of galectin-expression in the decidua, immunofluorescence was used. For all investigated prototype galectins (gal-1, -2, -7, -10) in SPA and RA placenta trophoblast cells the expression is significantly decreased. In the decidua/extravillous trophoblast only gal-2 expression was significantly lowered, which could be connected to its role in angiogenesis. In trophoblasts in first-trimester placentas and in cases of SPA and RA, prototype galectins are altered in the same way. We suspect prototype galectins have a similar function in placental tissue because of their common biochemical structure. Expression of galectin 3 as a chimera type galectin was not found to be significantly altered in abortive placentas.
Rothstein, A A
The event of elective abortion to terminate unplanned pregnancies brought to the fore and allowed exploration of issues of fatherliness normally latent and, therefore, not observable in adolescence. This is consistent with the psychoanalytic view that fatherly development is an ongoing process begun long before actual parenthood, encompassing an array of conflicts and themes which are conscious to varying degrees in different developmental stages. Issues expressed by the group of adolescent boys studied were compared with those described in the psychoanalytic literature. Most prominent were regressive wishes for nurturance, competition with one's own father, and efforts to meet paternal ego ideals of maturity and responsibility. Parturition envy and strivings for immortality through offspring were not expressed in this group. Themes of fatherliness were not exclusive; they became intertwined with normal tasks of adolescence and individual dynamics as is illustrated with a clinical case.
Between December 1990 and May 1991 in Malaysia, clinicians at the Sultanah Aminah Hospital in Johor Bahru screened 200 women with a diagnosis of threatened miscarriage with ultrasound to determine whether ultrasound could evaluate the viability of the fetus and thus the outcome of pregnancy in cases of threatened abortion. A fetal heartbeat was absent in 65% of cases with the remaining 35% of cases having a fetal heartbeat. Nonviability of the fetus or an abnormal or very early pregnancy may have accounted for an absent fetal heartbeat. The pregnancy of 46% of cases continued while 41% experienced spontaneous abortion. Just 6.2% of cases with a fetal heartbeat suffered from spontaneous abortion compared with 69.7% of those without a fetal heartbeat. 93.8% of cases with a fetal heartbeat continued their pregnancies compared with 30.3% of those without a fetal heartbeat. Inability of ultrasound to detect fetal heartbeats during early pregnancy probably accounted for the somewhat high percentage of those without a fetal heartbeat who continued their pregnancies. Among patients with a fetal heartbeat, the number of pregnancies that continued. Ultrasound detected 13% abnormal pregnancies (i.e., molar pregnancy or ectopic pregnancy). Surgery on these cases confirmed the ultrasound findings. These results showed that ultrasound should be used in every case of threatened miscarriage and that a fetal heartbeat does indicate the viability of the fetus.
Uythoven, Jan [CERN; Boccardi, Andrea [CERN; Bravin, Enrico [CERN; Goddard, Brennan [CERN; Hemelsoet, Georges-Henry [CERN; Höfle, Wolfgang [CERN; Jacquet, Delphine [CERN; Kain, Verena [CERN; Mazzoni, Stefano [CERN; Meddahi, Malika [CERN; Valuch, Daniel [CERN; Gianfelice-Wendt, Eliana [Fermilab
To minimize the beam losses at the moment of an LHC beam dump the 3 μs long abort gap should contain as few particles as possible. Its population can be minimised by abort gap cleaning using the LHC transverse damper system. The LHC Run 1 experience is briefly recalled; changes foreseen for the LHC Run 2 are presented. They include improvements in the observation of the abort gap population and the mechanism to decide if cleaning is required, changes to the hardware of the transverse dampers to reduce the detrimental effect on the luminosity lifetime and proposed changes to the applied cleaning algorithms.
Uythoven, J; Bravin, E; Goddard, B; Hemelsoet, GH; Höfle, W; Jacquet, D; Kain, V; Mazzoni, S; Meddahi, M; Valuch, D
To minimise the beam losses at the moment of an LHC beam dump the 3 μs long abort gap should contain as few particles as possible. Its population can be minimised by abort gap cleaning using the LHC transverse damper system. The LHC Run 1 experience is briefly recalled; changes foreseen for the LHC Run 2 are presented. They include improvements in the observation of the abort gap population and the mechanism to decide if cleaning is required, changes to the hardware of the transverse dampers to reduce the detrimental effect on the luminosity lifetime and proposed changes to the applied cleaning algorithms.
I first replicate Donohue and Levitt's results for violent and property crime arrest rates. I apply their data and specification to an analysis of age-specific homicide rates and murder arrest rates. The coefficients on the abortion rate have the wrong sign for two of the four measures of crime and none is statistically significant at conventional levels. I then use the legalization of abortion in 1973 to exploit two sources of variation: between-state changes in abortion rates before and aft...
INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.
Thapa, K; Karki, Y; Bista, K P
Unsafe abortion remains a huge problem in Nepal even after legalization of abortion. Various myths and misconceptions persist which prompt women towards unsafe abortive practices. A qualitative study was conducted among different groups of women using focus group discussions and in depth interviews. Perception and understanding of the participants on abortion, methods and place of abortion were evaluated. A number of misconceptions were prevalent like drinking vegetable and herbal juices, and applying hot pot over the abdomen could abort pregnancy. However, many participants also believed that health care providers should be consulted for abortion. Although majority of the women knew that they should seek medical aid for abortion, they were still possessed with various misconceptions. Merely legalizing abortion services is not enough to reduce the burden of unsafe abortion. Focus has to be given on creating awareness and proper advocacy in this issue.
Faundes; Anibal; Shah; Iqbal H.
Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal con...
Sotheary, Khim; Long, Dianna; Mundy, Gary; Madan, Yasmin; Blumenthal, Paul D
To assess whether a social marketing initiative focusing on medicated abortion via a mifepristone/misoprostol "combipack" has contributed to reducing unsafe abortion in Cambodia. In a questionnaire-based cross-sectional study, annual household surveys were conducted across 13 Cambodian provinces in 2010, 2011, and 2012. One married woman of reproductive age who was not pregnant and did not wish to be within the next 2 years in each randomly selected household was approached for inclusion. Participants were interviewed using a structured questionnaire. The questionnaire was completed by 1843 women in 2010, 2068 in 2011, and 2059 in 2012. Manual vacuum aspiration was reported by 61 (72.6%) of 84 women surveyed in 2010 who reported an abortion in the previous 12 months, compared with only 28 (52.8%) of 53 in 2012 (P=0.001). The numbers of women undergoing medicated abortion increased from 22 (26.2%) of 84 in 2010 to 27 (49.1%) of 53 in 2012 (P=0.003), whereas the numbers undergoing unsafe abortion decreased from 4 (4.8%) in 2010 to 0 in 2012 (P=0.051). Social marketing of medication abortion coupled with provider training in clinical and behavioral change could have contributed to a reduction in the prevalence of unsafe abortion and shifted the types of abortion performed in Cambodia, while not increasing the overall number of abortions. © 2016 International Federation of Gynecology and Obstetrics.
Harris, Lisa H
Abortion is highly stigmatized in the United States and elsewhere. As a result, many women who seek or undergo abortion keep their decision a secret. In many regions of the world, stigma is a recognized contributor to maternal morbidity and mortality from unsafe abortion, even when abortion is legal. Women may self-induce abortion in ways that are dangerous, or seek unsafe clandestine abortion from inadequately trained health care providers out of fear that their sexual activity, pregnancy, or abortion will be exposed if they present to a safe, licensed facility. However, unsafe abortion rarely occurs in the United States, and accordingly, stigma as a cause of unsafe abortion in the United States context has not been described. I consider the relationship of stigma to two serious abortion complications experienced by U.S. patients. Both patients wished to keep their abortion decision a secret from family and friends, and in both cases, their inability to disclose their abortion contributed to life-threatening complications. The experiences of these patients suggest that availability of legal abortion services in the United States may not be enough to keep all women safe. The cases also challenge the rhetoric that "abortion hurts women," suggesting instead that abortion stigma hurts women.
Abstract: Reproductive and other sexual health indicators among adolescent young ... intensification of sex education, and provision of family planning information and ..... subjects were aware of pregnancy induced abortion methods and the.
Full Text Available Given the prevalence of sexual and gender-basedviolence in Darfur, why are safe abortion services andtreatment of complications resulting from unsafeabortions or miscarriages not provided at all refugee/IDP health facilities?
Agadjanian, V; Qian, Z
This study analyzes ethnic differences in induced abortion among ever-married women in Kazakstan, drawing on data from the 1995 Kazakstan Demographic and Health Survey. Instead of conventional ethnic markers, such as "Kazak" or "Russian," it focuses on more complex ethnocultural identities that combine ascribed ethnicity with language use. Because of the history of russification in Kazakstan, three ethnocultural groups are defined and compared--Kazak women who chose to be interviewed in Kazak, Kazak women who chose to be interviewed in Russian, and women of European background interviewed in Russian. Whereas women of European origin were the most likely to undergo induced abortion, the Russian-interviewed Kazaks had higher abortion ratios and were more likely to terminate their pregnancies than were the Kazak-interviewed Kazaks, net of other characteristics. The implications of the results for induced abortion trends and family planning policy in Kazakstan are discussed in addition to other findings.
China is to outlaw the selective abortion of female fetuses to correct an imbalance in the ratio of boys to girls that has grown since the family planning policy was introduced more than 20 years ago.
Fartoukh, Stéphane David; Shaposhnikova, Elena
Safe operation of the LHC beam dump relies on the possibility of firing the abort kicker at any moment during beam operation. One of the necessary conditions for this is that the number of particles in the abort gap should be below some critical level defined by quench limits. Various scenarios can lead to particles filling the abort gap. Time scales associated with these scenarios are estimated for injection energy and also coast where synchrotron radiation losses are not negligible for uncaptured particle motion. Two cases are considered, with RF on and RF off. The equilibrium distribution of lost particles in the abort gap defines the requirements for maximum tolerable relative loss rate and as a consequence the minimum acceptable longitudinal lifetime of the proton beam in collision.
Charles, Kerwin Kofi; Stephens, Melvin, Jr
We assess whether in utero exposure to legalized abortion in the early 1970's affected individuals' propensities to use controlled substances as adolescents. We exploit the fact that some states legalized abortion before national legalization in 1973 to compare differences in substance use for adolescents across birth cohorts in different states. We find that persons exposed to early legalization were, on average, much less likely to use controlled substances. We also assess how substance use...
Stigma taints individuals with a spoiled identity and loss of status or discrimination. This article is the first to examine the stigma attached to abortion and surrogacy and consider how law may stigmatize women for failing to conform to social expectations about maternal roles. Courts should consider evidence of stigma when evaluating laws regulating abortion or surrogacy to determine whether these laws are based on impermissible gender stereotyping. © 2015 American Society of Law, Medicine & Ethics, Inc.
In Greece modern contraceptive methods are used only in a very limited manner and abortion is the primary form of birth control. There are several social and psychological issues that are considered to be responsible. A 1985 study done for the Family Planning Center of Thessaloniki found that the ratio of live births is 1.3 and the ratio of abortion is 1.8/woman. 88% of women in the study had had an abortion while practicing coitus interruptus. 90% of the women never bought condoms. In a 1989 study only 6% of women had a positive attitude about condoms. Abortion is used as the primary method of birth control regardless of a woman's socioeconomic status. Further it was found that abortion did not correlate with other modern attitudes or the emancipation of women. The decision to abort was related to difficulties and constraints inherent in bring up a child. However positive attitudes toward contraception were related to educational and occupational levels. To complicate matters the information concerning contraceptives was problematic and related to the women's own lack of initiative to find out, and a lack of correct information offered from gynecologists. A 1990 study on knowledge, attitudes, beliefs and practices in relation to HIV infection indicated that the most favored method of contraception was condoms, but 60.8% of the men reported use versus 33.7% of the women. However these figures are not very representative because the survey was given in the context of HIV prevention and no attempt was made to distinguish between regular and irregular use patterns. Abortions is not a moral issue in Greece. It was legalized in 1986 only because it came to the attention of the government that the previous prohibition was being completely ignored. Abortion is strongly affected by social and psychological factors that are complex and result from cultural view points about fertility, maternal value, and life itself that are unique to the Greek culture.
Full Text Available Objective: The aim of this study was to investigate the opinions of women who presented to the hospital for elective abortion. Materials and Methods: This descriptive study was designed and conducted at our university hospital between March 2013-April 2013 by the method of face-to-face interviews with 500 women who presented to the hospital as patient or relatives of patients. Poll consisted of 6 questions about demographic characteristics and 14 questions evaluating the opinions and attitudes about abortion. Results: The age of the women who participated in the study was ranging between 18 and 75 years with the mean age of 31.5±11.9 years. Twenty-six women (5.2% were illiterate, while 109 (21.8% were university graduates. 70.8% of women stated that they were against elective abortion. Among the reasons against abortion on request were: “forbidden by the religion”-53.1% of women, “against human rights”-35.3%, and “unhealthy for the mother”-7.1% of women. About the prohibition of abortion, 82.4% of women said that “it may be performed under necessary conditions”, 9.6% “it should be completely forbidden”, and 8% stated that “it should never be forbidden”. Conclusion: A large number of respondents reported that they have negative attitude towards elective abortion, however, in case of medical necessity, abortion should be performed. During the legal arrangements done about situations that may affect the public health, such as abortion regulations, we believe it would be useful to assess the perspective of the society on this issue.
The study investigates the social background of teenagers before being teenage mothers or having an induced abortion. A discrete-time proportional hazard modelling was used to analyse the longitudinal observations of population-based registers covering all children born in Denmark in 1966...... and neglect, psychiatric disorder, and being in care during childhood. Results show a significant social gradient for teenage pregnancies. The teenage mothers were in a more disadvantaged position than pregnant teenagers who had an induced abortion...
F. Makorah; K. Wood; R. Jewkes
This was a descriptive study aimed at exploring the personal experiences of women who induce abortion and the circumstances surrounding induced abortion. The study was conducted in six public hospitals in four different provinces: Baragwanath (Gauteng), Groote Schuur and Tygerberg (Western Cape), King Edward and R.K. Khan (Kwa-Zulu/Natal) and Livingstone (Eastern Cape). In-depth interviews were conducted with 25 African, Indian and Coloured women admitted to the hospitals following backstreet...
The landmark case Roe v.Wade remains one of the most controversial and essential ones in American history. The divergent opinions on abortion also play a crucial part in American political arena.What factors are influencing the dispute about abortion? This essay will thoroughly discuss the factors:the value of freedom and pro-choice and the consideration on women’s self-development; Contrarily,the firm religious faith and the concerns for women’s health.
The landmark case Roe v.Wade remains one of the most controversial and essential ones in American history.The divergent opinions on abortion also play a crucial part in American political arena.What factors are influencing the dispute about abortion? This essay will thoroughly discuss the factors: the value of freedom and pro-choice and the consideration on women’s self-development; Contrarily,the firm religious faith and the concerns for women’s healt
Nyboe Andersen, A; Damm, P; Tabor, A
weeks; Group 3, no treatment. Fifty-two patients completed the study (bromocriptine n = 18, placebo n = 18 and no treatment n = 16). Placebo had no apparent influence on breast symptoms. In both the placebo group and the untreated group, breast pain and milk secretion peaked on days 3 to 7, and milk......Within 24 hours after abortion, 62 patients with a mean gestational age of 19 weeks, who had either induced (n = 50) or spontaneous (n = 12) abortions were randomly allocated to three groups: Group 1, bromocriptine 2.5 mg twice daily for 2 weeks; Group 2, placebo tablets 1 tablet twice daily for 2...... secretion often continued for 3 weeks. Only 3/34 (9%) of untreated and placebo treated patients were free of breast symptoms. Compared with placebo, bromocriptine caused a significant reduction in the objective assessment score of breast tenderness (p less than 0.05) and milk secretion (p less than 0...
Buckles, N B
Studies have shown that very few women experience significant depression in the weeks following abortion and most have strong feelings of relief and happiness; what mild feelings of guilt, regret, or remorse do exist immediately following abortion tend to diminish quickly. Traditionally attitudes were that abortion could even precipitate psychosis and cause infertility, depression, and sexual dysfunction. The findings of a 1963-65 study of 116 women who underwent abortions indicate that few women had regrets immediately. Studies done after the 1973 Supreme Court decision conclude that even psychiatrically disturbed women who undergo abortion remain stabilized or improved afterwards. Women who do have postabortion problems are usually those who were late aborters, who feel that the decision was not freely made, or that the pregnancy fulfilled certain needs. When working with these women clinicians use a variety of techniques, encouraging the women to express their feelings of loss and anger and supporting the choice that was made, while providing contraceptive and decision making education. The strategy in 3 cases described here involved the woman first saying goodbye to the fetus and her former relationship with it in a gestalt dialogue. The next part of the strategy is establishing positive remembrance of the significant meaning of the fetus to the woman. There are usually 5 sessions at the end of which the woman feels optimistic; the 6th session is a followup 6 months to 1 year later at which most women report no further symptoms.
Zhou, Wei Jin; Sørensen, Henrik Toft; Olsen, Jørn
OBJECTIVE: To examine whether induced abortion influences subsequent pregnancy duration. METHODS: Women who had their first pregnancies during 1980, 1981, and 1982 were identified in three Danish national registries. A total of 15,727 women whose pregnancies were terminated by first-trimester ind......OBJECTIVE: To examine whether induced abortion influences subsequent pregnancy duration. METHODS: Women who had their first pregnancies during 1980, 1981, and 1982 were identified in three Danish national registries. A total of 15,727 women whose pregnancies were terminated by first......-trimester induced abortions were compared with 46,026 whose pregnancies were not terminated by induced abortions. All subsequent pregnancies until 1994 were identified by register linkage. RESULTS: Preterm and post-term singleton live births were more frequent in women with one, two, or more previous induced...... abortions. After adjusting for potential confounders and stratifying by gravidity, the odds ratios of preterm singleton live births in women with one, two, or more previous induced abortions were 1.89 (95% confidence interval [CI] 1.70, 2.11), 2.66 (95% CI 2.09, 3.37), and 2.03 (95% CI 1.29, 3...
Abortion is one of the most widely discussed medical-ethical subjects in medical, legal, philosophical, and religious literature as well as in the lay press. There is hardly a religion or country in the world that is not currently concerned about this issue. The complexity of the topic relates to the fact that it deals with a being that is close to us but not identical to us. On the other hand, the fetus is not like a plant or even like a living being in the animal kingdom. Yet the fetus is not a complete and independent human being either. There are strongly opposing philosophical/religious viewpoints on abortion. On the one hand, pro-life groups and the Roman Catholic Church absolutely oppose abortion. They view the fetus as a full and independent human being, with absolute rights equal to those of the mother. According to this view, the right of the fetus to life can never be disregarded, and abortion is viewed as murder. On the other hand, the permissive, feminist, liberal view, emphasizes the basic right of a woman over her body. This right justifies abortion on demand solely dependent on the woman's wishes at any stage of pregnancy and for any reason whatsoever. This view totally ignores the rights of the fetus and views it as a part of the mother's body. This article deals with some aspects of the approaches of various religions to abortion due to fetal indications, in particular the Jewish viewpoint.
David, H P
Hoping to provide women other choice besides abortion as a way to regulate fertility, 220 experts from 27 mostly European countries met in Tbilisi, Georgia, USSR to discuss ways of increasing access to modern contraceptives. Held last October, the conference was sponsored by the United Nations Population Fund (UNFPA), the World Health Organization European Regional Office (WHO/EURO), the International Planned Parenthood Federation/Europe, and the Zhordania Institute of Human Reproduction, Tbilisi. The meeting produced the Tbilisi Declaration, which -- among other things -- recognizes that unwanted pregnancies and unsafe abortions pose a serious health and social problem. Criminalization, the experts agreed, does little to reduce the number of abortions, and only increases the number of unsafe operations. The Tbilisi Declaration also affirms women's right to decide freely on the number and spacing of children, their right to reproductive health, their right to self-determination in their sexual and reproductive lives, and the right of every child to be a wanted child. The participants addressed the high incidents of abortion in some European countries -- particularly the Soviet Union. With the highest rate of abortion in Europe, the Soviet Union recorded 6 million legal abortions in 1988, and estimates that another 6 million were performed illegally. Nonetheless, perestroika has begun to facilitate access to contraceptives. Participants also discussed new methods of early pregnancy termination, RU486 and menstrual regulation procedures (MR), neither of which is readily available. Increasing access to these methods would help reduce suffering and unnecessary deaths.
Keogh, L A; Newton, D; Bayly, C; McNamee, K; Hardiman, A; Webster, A; Bismark, M
In Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the intent and subsequent impact of the 2008 Victorian abortion law reform. Experts in abortion provision in Victoria were recruited for a qualitative semi-structured interview about the 2008 law reform and its perceived impact, until saturation was reached. Nineteen experts from a range of health care settings and geographic locations were interviewed in 2014/2015. Thematic analysis was conducted to summarise participants' views. Abortion law reform, while a positive event, was perceived to have changed little about the provision of abortion. The views of participants can be categorised into: (1) goals that law reform was intended to address and that have been achieved; (2) intent or hopes of law reform that have not been achieved; (3) unintended consequences; (4) coincidences; and (5) unfinished business. All agreed that law reform had repositioned abortion as a health rather than legal issue, had shifted the power in decision making from doctors to women, and had increased clarity and safety for doctors. However, all described outstanding concerns; limited public provision of surgical abortion; reduced access to abortion after 20 weeks; ongoing stigma; lack of a state-wide strategy for equitable abortion provision; and an unsustainable workforce. Law reform, while positive, has failed to address a number of significant issues in abortion service provision, and may have even resulted in a 'lull' in action. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Palagiano, A; Bulletti, C; Pace, M C; DE Ziegler, D; Cicinelli, E; Izzo, A
Fifty women with previous diagnosis of inadequate luteal phase and threatened abortion underwent a prospective, randomized, double-blind study in one medical center carried out with a parallel trial. The primary objective was to establish the effects of vaginal progesterone (Crinone 8%) in reducing both pain and uterine contractions (UCs). The gel with or without (placebo) vaginal progesterone was administered once a day since the diagnosis of threatened abortion and for 5 days. The efficacy on pain symptom amelioration was evaluated by a 5-score intensity gradation, while the UCs were evaluated by ultrasound. The secondary objective of the study was to evaluate the outcome of the pregnancies. The use of progesterone was effective both on pain relief and on the frequency of the UCs that decreased after 5 days of vaginal progesterone administration (P pregnancy and spontaneous abortion in both study groups after 60 days showed that 4 patients of group A and 8 patients of group B miscarried (P threatened abortion benefit from vaginal progesterone by a reduction of UCs and pain. The use of vaginal progesterone improved the outcome of pregnancies complicated by threatened abortion and previous diagnosis of inadequate luteal phase.
countries where women do not have legal access to abortion. Postabortion care focuses on treatment of incomplete abortion and provision of postabortion contraceptive services. To enhance women's access to postabortion care, focus is increasingly being placed on upgrading midlevel providers to provide......Forty percent of the world's women are living in countries with restrictive abortion laws, which prohibit abortion or only allow abortion to protect a woman's life or her physical or mental health. In countries where abortion is restricted, women have to resort to clandestine interventions to have...... an unwanted pregnancy terminated. As a consequence, high rates of unsafe abortion are seen, such as in sub-Saharan Africa where unsafe abortion occurs at rates of 18-39/1 000 women. The circumstances under which women obtain unsafe abortion vary and depend on traditional methods known and type of providers...
Mellerup, Natja; Sørensen, Bjarke Lund; Kuriigamba, Gideon K.
BACKGROUND: Complications of unsafe abortion are a major contributor to maternal deaths in developing countries. This study aimed to evaluate the clinical assessment for life-threatening complications and the following management in women admitted with complications from abortions at a rural...... abortion and by trimester. Actual management was compared to the audit criteria and presented by descriptive statistics. RESULTS: Fifty six per cent of the women were in second trimester. Abortion complications were distributed as follows: 53 % incomplete abortions, 28 % threatened abortions, 12...... % inevitable abortions, 4 % missed abortions and 3 % septic abortions. Only one of 238 cases met all criteria of optimal clinical assessment and management. Thus, vital signs were measured in 3 %, antibiotic criteria was met in 59 % of the cases, intravenous fluid resuscitation was administered to 35...
Pundel, J P
Most of this essay on the abortion problem in French-speaking western Europe concerns the Sermon of Hippocrates forbidding abortion; the discussion ends with an ethical discussion on abortion codes in a pluralist society. 1st, scholars question whether Hippocrates himself actually wrote the text of the Sermon, or whether his Pythagorean followers did. 2nd, probably abortion in Hippocrates' time was relegated to midwives and lithotomists. The meaning of the quotation "I do not give any abortive remedy" is obscure since in other contexts Hippocrates distinguished between abortive and contraceptive drugs and also abortive instruments. Finally, Hipoocrates specifically recommended abortion, e.g., to avoid pregnancy for prostitutes. Persons in authority, then, should not invoke Hippocrates or any other moral code to deprive a woman of medical abortion, especially in cases of rape, age, and failure of contraception. Divorce, for example, has been legalized in most countries, without forcing anyone to take advantage of it.
Schiavon, Raffaela; Collado, Maria Elena; Troncoso, Erika; Soto Sánchez, José Ezequiel; Zorrilla, Gabriela Otero; Palermo, Tia
In 2007, first trimester abortion was legalized in Mexico City, and the public sector rapidly expanded its abortion services. In 2008, to obtain information on the effect of the law on private sector abortion services, we interviewed 135 physicians working in private clinics, located through an exhaustive search. A large majority of the clinics offered a range of reproductive health services, including abortions. Over 70% still used dilatation and curettage (D&C); less than a third offered vacuum aspiration or medical abortion. The average number of abortions per facility was only three per month; few reported more than 10 abortions monthly. More than 90% said they had been offering abortion services for less than 20 months. Many women are still accessing abortion services privately, despite the availability of free or low-cost services at public facilities. However, the continuing use of D&C, high fees (mean of $157-505), poor pain management practices, unnecessary use of ultrasound, general anaesthesia and overnight stays, indicate that private sector abortion services are expensive and far from optimal. Now that abortions are legal, these results highlight the need for private abortion providers to be trained in recommended abortion methods and quality of private abortion care improved. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Cochrane, Rosemary A; Cameron, Sharon T
In Scotland, in contrast to the rest of Great Britain, abortion at gestations over 20 weeks is not provided, and provision of procedures above 16 weeks varies considerably between regions. Women at varying gestations above 16 weeks must travel outside Scotland, usually to England, for the procedure. To determine the views of professionals working within Scottish abortion care about a Scottish late abortion service. Delegates at a meeting for abortion providers in Scotland completed a questionnaire about their views on abortion provision over 16 weeks and their perceived barriers to service provision. Of 95 distributed questionnaires, 70 (76%) were analysed. Fifty-six respondents (80%) supported a Scottish late abortion service, ten (14%) would maintain current service arrangements, and five (7%) were undecided. Forty (57%) of the supporters of a Scottish service would prefer a single national service, and 16 (22%) several regional services. Perceived barriers included lack of trained staff (n = 39; 56%), accommodation for the service (n = 34; 48%), and perception of lack of support among senior management (n = 28; 40%). The majority of health professionals surveyed who work in Scottish abortion services support provision of abortion beyond 16 weeks within Scotland, and most favour a single national service. Further work on the feasibility of providing this service is required.
Center for Disease Control (DHEW/PHS), Atlanta, GA.
This report summarizes abortion information received by the Center for Disease Control from collaborators in state health departments, hospitals, and other pertinent sources. While it is intended primarily for use by the above sources, it may also interest those responsible for family planning evaluation and hospital abortion planning. Information…
Background: Abortion accounts for 35% of maternal mortality in Kenya. Kenya has reported an increase in the rate of unsafe abortions from 32 to 48 per 1000 women of reproductive age in 2002 and 2012 respectively. During the same period, women presented in public health facilities with severe complications indicating ...
Full Text Available BACKGROUND: Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students' attitudes toward abortion education and presents a case for including abortion education in medical schools. METHODS AND RESULTS: A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students' pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students' attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity. CONCLUSIONS: Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights.
Wylomanski, S; Winer, N
Ultrasound plays a fundamental role in the management of elective abortions. Although it can improve the quality of post-abortion care, it must not be an obstacle to abortion access. We thus studied the role of ultrasound in pregnancy dating and possible alternatives and analyzed the literature to determine the role of ultrasound in post-abortion follow-up. During an ultrasound scan, the date of conception is estimated by measurement of the crown-rump length (CRL), defined by Robinson, or of the biparietal diameter (BPD), as defined by the French Center for Fetal Ultrasound (CFEF) after 11 weeks of gestation (Robinson and CFEF curves) (grade B). Updated curves have been developed in the INTERGROWTH study. In the context of abortion, the literature recommends the application of a safety margin of 5 days, especially when the CRL and/or BPD measurement indicates a term close to 14 weeks (that is equal or below 80 and 27mm, respectively) (best practice agreement). Accordingly, with the ultrasound measurement reliable to±5 days when its performance meets the relevant criteria, an abortion can take place when the CRL measurement is less than 90mm or the BPD less than 30mm (INTERGROWTH curves) (best practice agreement). While a dating ultrasound should be encouraged, its absence is not an obstacle to scheduling an abortion for women who report that they know the date of their last menstrual period and/or of the at-risk sexual relations and for whom a clinical examination by a healthcare professional is possible (best practice agreement). In cases of intrauterine pregnancy of uncertain viability or of a pregnancy of unknown location, without any particular symptoms, the patient must be able to have a transvaginal ultrasound to increase the precision of the diagnosis (grade B). Various reviews of the literature on post-abortion follow-up indicate that the routine use of ultrasound during instrumental abortions should be avoided (best practice agreement). If it becomes
Hastings, P.J.; Quah, S.-K.; Borstel, R.C. von
It is stated that strains of yeast carrying mutations in many of the steps in pathways repairing radiation-induced damage to DNA have enhanced spontaneous mutation rates. Most strains isolated because they have enhanced spontaneous mutation carry mutations in DNA repair systems. This suggests that much spontaneous mutation arises by mutagenic repair of spontaneous lesions. (author)
Krebs, L; Johansen, A M; Helweg-Larsen, K
Up to 31st December 1994 all cases of legally induced abortions were notified by the physician responsible for the operation to the National Board of Health and recorded in the Register of Induced Abortions. Following this data, abortion statistics will rely on data concerning induced abortions...... in the Danish National Patient Register, which includes information based upon the unique personal number of all patients admitted to hospitals. The completeness of the Register of Induced Abortions and the National Patient Register as to induced abortions in 1994 was assessed to evaluate the impact...... of the change in method of monitoring on trends in the national and regional abortion rate. The complete number of induced abortions was estimated to be the sum of the number recorded in both registers, cases recorded only in the Register of Induced Abortions, cases recorded only in the National Patient...
Serrano Gil, A; García Casado, M L
The issue of conscientious objection in Spain has been used by pro-choice groups against objecting health personnel as one of the obstacles to the implementation of the abortion law, a misnomer. At present objection is massive in the public sector; 95% of abortions are carried out in private clinics with highly lucrative returns; abortion tourism has decreased; and false objection has proliferated in the public sector when the objector performs abortions in the private sector for high fees. The legal framework for conscientious objection is absent in Spain. Neither Article 417 of the Penal Code depenalizing abortion, nor the Ministerial Decree of July 31, 1985, nor the Royal Decree of November 21, 1986 recognize such a concept. However, the ruling of the Constitutional Court on April 11, 1985 confirmed that such objection can be exercised with independence. Some authors refer to the applicability of Law No. 48 of December 16, 1984 that regulates conscientious objection in military service to health personnel. The future law concerning the fundamental right of ideological and religious liberty embodied in Article 16.1 of the Constitution has to be revised. A draft bill was submitted in the Congress or Representatives concerning this issue on May 3, 1985 that recognizes the right of medical personnel to object to abortion without career repercussions. Another draft bill was introduced on April 17, 1985 that would allow the nonparticipation of medical personnel in the interruption of pregnancy, however, they would be prohibited from practicing such in the private hospitals. Neither of these proposed bills became law. Professional groups either object unequivocally, or do not object at all, or object on an ethical level but do not object to therapeutic abortion. The resolution of this issue has to be by consensus and not by imposition.
Singh, Susheela; Shekhar, Chander; Acharya, Rajib; Moore, Ann M; Stillman, Melissa; Pradhan, Manas R; Frost, Jennifer J; Sahoo, Harihar; Alagarajan, Manoj; Hussain, Rubina; Sundaram, Aparna; Vlassoff, Michael; Kalyanwala, Shveta; Browne, Alyssa
Summary Background Reliable information on the incidence of induced abortion in India is lacking. Official statistics and national surveys provide incomplete coverage. Since the early 2000s, medication abortion has become increasingly available, improving the way women obtain abortions. The aim of this study was to estimate the national incidence of abortion and unintended pregnancy for 2015. Methods National abortion incidence was estimated through three separate components: abortions (medication and surgical) in facilities (including private sector, public sector, and non-governmental organisations [NGOs]); medication abortions outside facilities; and abortions outside of facilities and with methods other than medication abortion. Facility-based abortions were estimated from the 2015 Health Facilities Survey of 4001 public and private health facilities in six Indian states (Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu, and Uttar Pradesh) and from NGO clinic data. National medication abortion drug sales and distribution data were obtained from IMS Health and six principal NGOs (DKT International, Marie Stopes International, Population Services International, World Health Partners, Parivar Seva Santha, and Janani). We estimated the total number of abortions that are not medication abortions and are not obtained in a health facility setting through an indirect technique based on findings from community-based study findings in two states in 2009, with adjustments to account for the rapid increase in use of medication abortion since 2009. The total number of women of reproductive age and livebirth data were obtained from UN population data, and the proportion of births from unplanned pregnancies and data on contraceptive use and need were obtained from the 2015–16 National Family Health Survey-4. Findings We estimate that 15·6 million abortions (14·1 million–17·3 million) occurred in India in 2015. The abortion rate was 47·0 abortions (42·2–52·1) per
Bhattacharya, Siladitya; Lowit, Alison; Bhattacharya, Sohinee; Raja, Edwin Amalraj; Lee, Amanda Jane; Mahmood, Tahir; Templeton, Allan
To investigate reproductive outcomes in women following induced abortion (IA). Retrospective cohort study. Hospital admissions between 1981 and 2007 in Scotland. Data were extracted on all women who had an IA, a miscarriage or a live birth from the Scottish Morbidity Records. A total of 120 033, 457 477 and 47 355 women with a documented second pregnancy following an IA, live birth and miscarriage, respectively, were identified. Obstetric and perinatal outcomes, especially preterm delivery in a second ongoing pregnancy following an IA, were compared with those in primigravidae, as well as those who had a miscarriage or live birth in their first pregnancy. Outcomes after surgical and medical termination as well as after one or more consecutive IAs were compared. IA in a first pregnancy increased the risk of spontaneous preterm birth compared with that in primigravidae (adjusted RR (adj. RR) 1.37, 95% CI 1.32 to 1.42) or women with an initial live birth (adj. RR 1.66, 95% CI 1.58 to 1.74) but not in comparison with women with a previous miscarriage (adj. RR 0.85, 95% CI 0.79 to 0.91). Surgical abortion increased the risk of spontaneous preterm birth compared with medical abortion (adj. RR 1.25, 95% CI 1.07 to 1.45). The adjusted RRs (95% CI) for spontaneous preterm delivery following two, three and four consecutive IAs were 0.94 (0.81 to 1.10), 1.06 (0.76 to 1.47) and 0.92 (0.53 to 1.61), respectively. The risk of preterm birth after IA is lower than that after miscarriage but higher than that in a first pregnancy or after a previous live birth. This risk is not increased further in women who undergo two or more consecutive IAs. Surgical abortion appears to be associated with an increased risk of spontaneous preterm birth in comparison with medical termination of pregnancy. Medical termination was not associated with an increased risk of preterm delivery compared to primigravidae.
The author discusses his view of driven versus spontaneous. There is a close link between ''spontaneous'' and ''instability.'' One of the prominent examples for instability is the thermal convection instability. Just to remind you, if you heat a fluid layer from below, it takes a certain Rayleigh number to make it unstable. Beyond the onset point you find qualitatively new features. That is called ''spontaneous,'' and this is a bit more than semantics. It's a new qualitative property that appears and it is spontaneous although we have an energy flux through the system. It's a misconception, to call this ''driven'' pointing at the energy flux through it. Of course, the convection would not exist without this energy flux. But what makes it ''spontaneous'' is that without any particular external signal, a new qualitative feature appears. And this is what is called an ''instability'' and ''spontaneous.'' From these considerations the author got a little reassured of what distinction should be made in the field of the magnetosphere. If we have a smooth energy transport into the magnetosphere and suddenly we have this qualitatively new feature (change of B-topology) coming up; then, using this terminology we don't have a choice other than calling this spontaneous or unstable, if you like. If we ''tell'' the system where it should make its neutral line and where it should make its plasmoids, then, it is driven. And this provides a very clear-cut observational distinction. The author emphasizes the difference he sees is a qualitative difference, not only a quantitative one
Abstract The aim of this paper is to provide a panoramic view of laws and policies on abortion around the world, giving a range of country-based examples. It shows that the plethora of convoluted laws and restrictions surrounding abortion do not make any legal or public health sense. What makes abortion safe is simple and irrefutable—when it is available on the woman’s request and is universally affordable and accessible. From this perspective, few existing laws are fit for purpose. However, the road to law reform is long and difficult. In order to achieve the right to safe abortion, advocates will need to study the political, health system, legal, juridical, and socio-cultural realities surrounding existing law and policy in their countries, and decide what kind of law they want (if any). The biggest challenge is to determine what is possible to achieve, build a critical mass of support, and work together with legal experts, parliamentarians, health professionals, and women themselves to change the law—so that everyone with an unwanted pregnancy who seeks an abortion can have it, as early as possible and as late as necessary. PMID:28630538
Stotland, Nada L
Induced abortion is widely believed - by the public, healthcare professionals, and policy-makers - to lead to adverse mental health sequelae. This belief is false, as it applies both to adult women and adolescents. However, it has been used to rationalize, and been quoted in, restrictive and intrusive legislation in several states and in proposed federal legislation. It is essential for gynecologists to have accurate information, as clinicians, for their patients, and, as key experts, for policy makers. New articles concluding that there are adverse psychological outcomes from induced abortion continue to be published. The methodological flaws in these articles are so serious as to invalidate those conclusions. Several recent scholarly analyses detail these flaws. Methodologically sound studies and reviews continue to demonstrate that psychosocial problems play a role in unwanted conception and the decision to abort unwanted pregnancies but are not the result of abortion. Clinicians may have to reassure patients making decisions about their pregnancies that abortion does not cause psychiatric illness. They can do so on the basis of recent analyses substantiating that finding. (C) 2011 Lippincott Williams & Wilkins, Inc.
Borgatta, L; Burnhill, M S; Tyson, J; Leonhardt, K K; Hausknecht, R U; Haskell, S
To evaluate the introduction of an early medical abortion program with methotrexate and misoprostol, using a standardized protocol. A total of 1973 women at 34 Planned Parenthood sites participated in a case series of early medical abortion. Ultrasound was used to confirm gestational age of less than 49 days from the first day of the last menstrual period. Women were given intramuscular methotrexate 50 mg/m(2) of body surface area on day 1, and then they inserted misoprostol 800 microg vaginally at home on day 5, 6, or 7. Women were advised to have a suction curettage if the pregnancy appeared viable 2 weeks after methotrexate or if any gestational sac persisted 4 weeks after methotrexate. Outcomes were complete medical abortion and suction curettage. Sixteen hundred fifty-nine women (84.1%) had a complete medical abortion, and 257 (13.0%) had suction curettage. The most common reason for curettage was patient option (8.9%). At 2 weeks after methotrexate use, 1.4% of women had curettage because of a viable pregnancy; at 4 weeks, 1.6% of women had curettage because of a persistent but nonviable pregnancy. One percent of women had curettage because of physician recommendation, most commonly for bleeding. Suction curettage rates decreased with site experience (P <.006) and were lower at early gestational ages (P <.004) and in nulliparous women (P <.004). Medical abortion with methotrexate and misoprostol is safe and effective and can be offered in a community setting.
In Algeria, the epidemiology of cattle abortions is not well understood. Therefore, the present study aims to estimate the prevalence of abortion in 75 Algerian cattle herds and correlate its possible association with brucellosis positivity and some managerial risk factors. The cattle abortion herd prevalence was 41.33% [95% CI 30.16-52.5%]. As for brucellosis, the serological evidence of brucellosis exposure was observed in 9 out of 75 herds accounting for 12% [95% CI 4.65-19.35] herd seroprevalence. The risk factor analysis using the univariable analysis followed by multivariable logistic regression did confirm that brucellosis positivity (OR = 5.19), mixed herd (OR = 2.5), contact with other herd (OR = 2.91), presence of dog in the herd (OR = 2.89), imported cattle (OR = 1.91), and farmers with less than 2 years' experience (OR = 2.69) as risk factors for abortion in Algerian cattle herds. Targeting these factors using a comprehensive control measure is needed to improve animal welfare and reduce economic losses associated with abortion in dairy cattle.
Yamane, Kanji; Yoshimoto, Hisanori; Harada, Kiyoshi; Uozumi, Tohru [Hiroshima Univ. (Japan). School of Medicine; Kuwabara, Satoshi
The authors experienced a case of spontaneous ventriculocisternostomy diagnosed by CT scan with metrizamide and Conray. Patient was 23-year-old male who had been in good health until one month before admission, when he began to have headache and tinnitus. He noticed bilateral visual acuity was decreased about one week before admission and vomiting appeared two days before admission. He was admitted to our hospital because of bilateral papilledema and remarkable hydrocephalus diagnosed by CT scan. On admission, no abnormal neurological signs except for bilateral papilledema were noted. Immediately, right ventricular drainage was performed. Pressure of the ventricle was over 300mmH/sub 2/O and CSF was clear. PVG and PEG disclosed an another cavity behind the third ventricle, which was communicated with the third ventricle, and occlusion of aqueduct of Sylvius. Metrizamide CT scan and Conray CT scan showed a communication between this cavity and quadrigeminal and supracerebellar cisterns. On these neuroradiological findings, the diagnosis of obstructive hydrocephalus due to benign aqueduct stenosis accompanied with spontaneous ventriculocisternostomy was obtained. Spontaneous ventriculocisternostomy was noticed to produce arrest of hydrocephalus, but with our case, spontaneous regression of such symptoms did not appeared. By surgical ventriculocisternostomy (method by Torkildsen, Dandy, or Scarff), arrest of hydrocephalus was seen in about 50 to 70 per cent, which was the same results as those of spontaneous ventriculocisternostomy. It is concluded that VP shunt or VA shunt is thought to be better treatment of obstructive hydrocephalus than the various kinds of surgical ventriculocisternostomy.
Hansen, S K; Birkebaek, J S; Husfeldt, C; Munck, C B; Nøddebo, S M; Petersson, B H
The object of this study was to describe a group of women applying for legal abortion in relation to their use of contraception and reasons for choosing an abortion. During a period of 13 months (1991-92) a questionnaire was distributed to women applying for legal abortion at Hillerød Hospital in Denmark. Three hundred and thirty-nine women participated. Fifty-nine percent of the women had become pregnant although they had used contraception. As seen in other studies, women still state demographic factors as their most important reasons for choosing an abortion. Women with two or more children do not want to have more children. Single women do not want children without being in a stable relationship. Furthermore occupation and education were frequently stated as important reasons for having an abortion. Economy and housing were not main reasons but contributory factors. Thirty percent of the women expressed ambivalence about the choice of abortion at the time when the abort was due.
Costescu, Dustin; Guilbert, Édith
This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care. Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs. Women with an unintended or abnormal first or second trimester pregnancy. PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched. The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request. IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. All rights reserved.
Malhotra, S; Devi, P K
Abortion was legalized in many states in India in April 1972. This study deals with 2 groups of patients admitted to P.G.I., Chadigarh, with problems of induced septic abortion. Group 1 consisted of 88 patients admitted during the 2 1/2 year period from 1 July 1969 to 31 December 1971, before the legalization of abortion. Group 2 consists of 133 patients admitted during the 2 1/2 year period from 1 July 1973 to 31 December 1975. 1 year after the new abortion law had been in force. Not only has there been an increase in the total number of patients, there has been an increase in the severity of infection. Evidently, the liberalization of the law has encouraged more patients to seek abortions and has encouraged more doctors, lacking proper qualifications, to perform them. The morbidity and mortality with induced septic abortion can only be reduced if enough public propaganda makes the people especially in rural areas conscious of the hazards of induced abortion by "dais" and unqualified personnel, simultaneously making them aware of the provision of law and facilities available at different centers. Meanwhile, the law against unskilled and untrained personnel should be rigorously enforced.
Between February 2012 and March 2015, the claim that sex selection abortion was taking place in Britain and that action needed to be taken to stop it dominated debate in Britain about abortion. Situating an analysis in sociological and social psychological approaches to the construction of social problems, particularly those considering “feminised” re-framings of anti-abortion arguments, this paper presents an account of this debate. Based on analysis of media coverage, Parliamentary debate and official documents, we focus on claims about grounds (evidence) made to sustain the case that sex selection abortion is a British social problem and highlight how abortion was problematised in new ways. Perhaps most notable, we argue, was the level of largely unchallenged vilification of abortion doctors and providers, on the grounds that they are both law violators and participants in acts of discrimination and violence against women, especially those of Asian heritage. We draw attention to the role of claims made by feminists in the media and in Parliament about “gendercide” as part of this process and argue that those supportive of access to abortion need to critically assess both this aspect of the events and also consider arguments about the problems of “medical power” in the light of what took place. PMID:28367000
Between February 2012 and March 2015, the claim that sex selection abortion was taking place in Britain and that action needed to be taken to stop it dominated debate in Britain about abortion. Situating an analysis in sociological and social psychological approaches to the construction of social problems, particularly those considering "feminised" re-framings of anti-abortion arguments, this paper presents an account of this debate. Based on analysis of media coverage, Parliamentary debate and official documents, we focus on claims about grounds (evidence) made to sustain the case that sex selection abortion is a British social problem and highlight how abortion was problematised in new ways. Perhaps most notable, we argue, was the level of largely unchallenged vilification of abortion doctors and providers, on the grounds that they are both law violators and participants in acts of discrimination and violence against women, especially those of Asian heritage. We draw attention to the role of claims made by feminists in the media and in Parliament about "gendercide" as part of this process and argue that those supportive of access to abortion need to critically assess both this aspect of the events and also consider arguments about the problems of "medical power" in the light of what took place.
Harper, Cynthia; Darney, Philip; Henderson, JT; Puri, M; Blum, M; Harper, CC; Rana, A; Gurung, G; Pradhan, N; Regmi, K; Malla, K; Sharma, S
Background: Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe
of cases of complicated unsafe abortion managed at the. Niger Delta University ... previous termination of pregnancy and 87.3% of the patients had ... and outcome were obtained. ... life-threatening complications, post- abortion family planning.
Stetson, Dorothy M; Githens, Marianne
" ... focuses on current abortion policy and practice in the United States, Canada, Europe, and Japan and aims to provide a comprehensive, stimulating, and balanced picture of current abortion politics...
Nikolajsen, Tine; Nielsen, Frank; Rasch, Vibeke
Women in Tanzania use plants to induce abortion. It is not known whether the plants have an effect.......Women in Tanzania use plants to induce abortion. It is not known whether the plants have an effect....
... PREGNANCY Pregnancy Choices: Raising the Baby, Adoption, and Abortion • What are my options if I find out ... is financial help available? • If I am considering abortion, what should I know about my state’s laws? • ...
Zhou, Wei Jin; Nielsen, Gunnar Lauge; Larsen, Helle
Background. To study the risk of placenta complications following an induced abortion as a function of the interpregnancy interval. Methods. This study is based on three Danish national registries; the Medical Birth Registry, the Hospital Discharge Registry, and the Induced Abortion Registry. All...... primigravida women from 1980 to 1982 were identified in these three registries. A total of 15,727 women who terminated the pregnancy with a first trimester induced abortion were selected to the abortion cohort, and 46,026 women who did not terminate the pregnancy with an induced abortion constituted...... or the Medical Birth Registry records. Results. A slightly higher risk of placenta complications following an abortion was found. Retained placenta occurred more frequently in women with one, two or more previous abortions, compared with women without any previous abortion of similar gravidity. Adjusting...
A proposal to legalize abortion has been presented to the Italian parliament by Representative Loris Fortuna. Thus far, the bill has the whole-hearted support of only the Radical Party. The Vatican has already voiced its strong opposition to this legislation. "The proposal to legalize abortion, even in certain circumstances, must inevitably be met with resistance and refusal," said Father Concetti, the Vatican representative. Professor Emanuele Lauricella, secretary of the Italian Obstetrics and Gynecology Society, on the other hand, claimed that abortion should be permitted, not only when an immediate danger to the mother's life exists, but also when there are other, simpler health risks. The passage of the bill in the near future, however, is very doubtful.
Hertz, J B; Heisterberg, L
A prospectively collected group of 93 pregnancies complicated by threatened abortion was carefully monitored throughout pregnancy, during birth and in the perinatal period, and any deviation from a completely uneventful course was registered. Comparison was made with a selected group of 282 non-risk pregnant women. A significant association was found between threatened abortion and the overall number of complications in the second half of pregnancy requiring medical intervention and/or admission to hospital, impending pre-term birth requiring betamimetics, pre-term birth, retention of the placenta, birth weight below 2000 g, light-for-dates infants in case of pre-term birth or birth weight below 2000 g, and hyperbilirubinemia in infants with birth weight below 2000 g. The incidences of perinatal mortality and congenital malformations did not differ significantly from those of the control group. Pregnancies complicated by threatened abortion constitute a risk group requiring careful obstetric and perinatal supervision and follow-up.
Roberto Arriada Lorea
Full Text Available In Brazil, facing an issue like abortion requires a secular perspective since the freedom of conscience assured by the Federal Constitution places upon the State the need to regard not only different viewpoints of different religions, but more specifically assure the right to diversity existing within a same religion, as well as the right to exercise different views from those of the hierarchy of his/her own religion. As such, there is no legal barrier for the decriminalization of abortion in the country. It is up to legislators to reform the present law and decriminalize abortion, assuming the commitments Brazil has assumed with international human-rights organizations, thus assuring the efficacy of civil liberties.
Krafczyk, G.; Dugan, G.; Harrison, M.; Koepke, K.; Tilles, E.
Over the past several years, Fermilab has been operating with a single turn proton abort system in both the superconducting Tevatron and the conventional Main Ring. The abort kicker power supply for this system discharges a lumped capacitance into the inductive magnet load, causing the beam to enter the abort channel. A unique feature of this design is the high voltage, high current diode assembly used to clip the recharge of the capacitor bank. This allows the current to decay slowly with the L/R time constant of the magnet and diode series combination. Special attention will be given to the diode characteristics needed for this passive switching element. Operational experience and proposed upgrades will be given for the two operational systems
Tsikouras, Panagiotis; Vrachnis, Nikolaos; Grapsa, Anastasia; Tsagias, Nikolaos; Pinidis, Petros; Liberis, Anastasios; Ammari, Alexandros; Grapsas, Xenofon; Galazios, Georgios; Liberis, Vasileios
Approximately 21 days after an abortion, ovulation occurs in 50 % of women. Installation of an IUD directly after induced or spontaneous abortion offers immediate contraceptive protection. The purpose of the present study was to weigh up contraceptive safety and adverse reactions of IUD inserted directly after first-trimester abortion under general or paracervical anesthesia as against the fitting of IUD in the days of the next menstrual cycle without anesthesia. During the period May 1987 to October 2010, 73 women (Group A) underwent an immediate post-abortion insertion IUD after a first-trimester spontaneous or induced abortion under general or local paracervical anesthesia and 69 participants (Group B) received IUD during the next menstrual cycle without anesthesia. Questionnaires were completed by all the women of the study with respect to the effects of IUD. The women were examined every 3 months for 1 year after the fitting of the IUD in the out-patient department of the University Obstetrics Gynecological Department of Alexandroupolis, Democritus University of Thrace, Greece. The demographic characteristics of the women of the two groups were similar. The age of the women ranged between 19 and 44 years, while 61.98 % were women with one or two children and 38.02 % were women with three or more children. During the first menstrual cycles, with the exception of vaginal hemorrhages (5 %) and adnexitis (1 %), no serious adverse reactions were noted. During the transvaginal ultrasonography checks in both groups, no observation was made of any dislocation of the IUD, except for two cases in the subgroup of those women with paracervical anesthesia and one case in the women of Group B. As concerns the questionnaire with regard to the women's subjective evaluation of IUD, satisfactory answers were given. There were no differences between the two groups either with respect to the security of the supplied contraceptive methods or to the development of side effects.
According to international press reports, a law that would have allowed Portuguese women abortions through the 10th week of pregnancy and into the 16th week if their physical or mental health was at risk has been rescinded after a referendum to determine the statute's future was voided because of low voter turnout. Passed in February, the law was a liberalization of Portugal's strict anti-abortion laws, which ban all abortions except for narrowly defined medical reasons or in the case of rape (and those are permitted only until the 12th week of pregnancy). Because the issue is such a controversial one, politicians had turned to a national referendum asking Portuguese voters to overturn or ratify the new law. The referendum was the first in the country since the end of its right-wing dictatorship in 1974, and 50% participation was required. Only 31.5% of the country's 8.5 million eligible voters went to the polls on June 28. Of those voting, 50.9% voted against the liberalized new legislation. Sunny weather and World Cup soccer matches were both pointed to as reasons for the low turnout. Officials estimate there are some 20,000 illegal abortions annually in Portugal. Abortion-rights activists in the mostly Roman-Catholic country say hospitals see roughly 10,000 women a year suffering from complications from illegal abortions, and that at least 800 women die each year from the procedure. In the next day's Diario de Noticias, a daily paper in Portugal, the entire front page was filled with a giant question mark. "What now, lawmakers?" the headline read. full text
Krafczyk, G.; Dugan, G.; Harrison, M.; Koepke, K.; Tilles, E.
Over the past several years, Fermilab has been operating with a single turn proton abort system in both the superconducting Tevatron and the conventional Main Ring. The abort kicker power supply for this system discharges a lumped capacitance into the inductive magnet load, causing the beam to enter the abort channel. The characteristics of this current waveform are defined by the requirements of the machine operation. The standard fixed target running mode calls for 12 booster batches of beam which leaves a rotating gap in the beams of approx.1.8 μs. The current waveform is required to rise to 90% of I/sub max/ in this time to avoid beam loss from partially deflected beam. Aperture limitations in both the accelerator and the abort channel demand that the current in the magnets stays above this 90% I/sub max/ for the 21 μs needed to ensure all the beam has left the machine. The 25 mm displacement needed to cleanly enter the abort channel at 1 TeV corresponds to a maximum current in each of the 4 modules of approx.20 kA. Similar constraints are needed for the Main Ring and Tevatron antiproton abort systems. A unique feature of this design is the high voltage, high current diode assembly used to clip the recharge of the capacitor bank. This allows the current to decay slowly with the L/R time constant of the magnet and diode series combination. Special attention is given to the diode characteristics needed for this passive switching element. Operational experience and proposed upgrades are given for the two operational systems. 2 refs., 4 figs., 1 tab
Krafczyk, G.; Dugan, G.; Harrison, M.; Koepke, K.; Tilles, E.
Over the past several years, Fermilab has been operating with a single turn proton abort system in both the superconducting Tevatron and the conventional Main Ring. The abort kicker power supply for this system discharges a lumped capacitance into the inductive magnet load, causing the beam to enter the abort channel. The characteristics of this current waveform are defined by the requirements of the machine operation. The standard fixed target running mode calls for 12 booster batches of beam which leaves a rotating gap in the beam of about1.8 μs. The current waveform is required to rise to 90% of I /SUB max/ in this time to avoid beam loss from partially deflected beam. Aperture limitations in both the accelerator and the abort channel demand that the current in the magnets stays above this 90% I for the 21 μs needed to ensure all the beam has /SUP max/ left the machine. The 25 mm displacement needed to cleanly enter the abort channel at 1 TeV corresponds to a maximum current in each of the 4 modules of about20 kA. Similar constraints are needed for the Main Ring and Tevatron antiproton abort systems. A unique feature of this design is the high voltage, high current diode assembly used to clip the recharge of the capacitor bank. This allows the current to decay slowly with the L/R time constant of the magnet and diode series combination. Special attention will be given to the diode characteristics needed for this passive switching element. Operational experience and proposed upgrades will be given for the two operational systems
Lazarus, Jeff; Nielsen, Stine; Jakubcionyte, Rita
Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal.......Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal....
This work deals with the relationship between induced abortion and mental health with a special focus on the area of political controversy. This article explores the historical background of the abortion and its legislative implications in Europe with special reference to Bosnia and Herzegovina. This work is based on etnographich, analitical and historical aproaches. It explains abortion in medical terms and analyzes the psychological effects of the abortion. This is a significant and challan...
In the present study, the effect of electroecupuncture (EA) of acupoints of Ren, Spleen and Stomach Meridians on artificial abortion-induced side effects was observed in 100 artificial abortion women. In comparison with 45 artificial abortion women in the control group (who had not accepted EA treatment), EA possessed significant effects in relieving abdominal pain, reducing vaginal bleeding duration, lowering infection rate and infertility rate after artificial abortion operation.
Patterson, Benjamin Oliver; Itam, Sarah; Probst, Fey
We present a patient with sudden onset progressive shortness of breath and no history of trauma, who rapidly became haemodynamically compromised with a pneumothorax and pleural effusion seen on chest radiograph. He was treated for spontaneous tension pneumothorax but this was soon revealed to be a tension haemopneumothorax. He underwent urgent thoracotomy after persistent bleeding to explore an apical vascular abnormality seen on CT scanning. To our knowledge this is the first such case reported.Aetiology and current approach to spontaneous haemothorax are discussed briefly.
Morkos Iskander BSc, BMBS, MRCS, PGCertMedEd
Full Text Available Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.
Full Text Available Abstract We present a patient with sudden onset progressive shortness of breath and no history of trauma, who rapidly became haemodynamically compromised with a pneumothorax and pleural effusion seen on chest radiograph. He was treated for spontaneous tension pneumothorax but this was soon revealed to be a tension haemopneumothorax. He underwent urgent thoracotomy after persistent bleeding to explore an apical vascular abnormality seen on CT scanning. To our knowledge this is the first such case reported. Aetiology and current approach to spontaneous haemothorax are discussed briefly.
Rørbye, Christina; Nørgaard, Mogens; Vestermark, Vibeke
. The difference in short- and long-term success rates increased with increasing gestational age. The majority of failures (76%) were diagnosed more than 2 weeks after initiation of the abortion. At a 2-week follow-up visit, the women who turned out to be failures had a larger endometrial width, higher beta......-hCG values and smaller reductions of beta-hCG than those treated successfully. To optimize comparison of success rates after different medical abortion regimens, we suggest that the criteria for success are stated clearly, that the success rates are stratified according to gestational age...
Full Text Available This paper represents a case study of the types of fallacies that may occur in the argumentation stage of an ethical dispute over abortion. The theoretical framework I use is the pragma-dialectical theory of argumentation (van Eemeren and Grootendorst 1992, 2004 which conceives of fallacies as violations of the rules for critical discussion. I will focus on the fallacies resulting from the violation of the relevance rule in two fragments of argumentative texts illustrating opposing positions on abortion. I claim that these fallacies function as winning strategies in the ethical dispute in case.
HAHN, H.; DAVINO, D.
Kicker magnets typically represent the most important contributors to the transverse impedance budget of accelerators and storage rings. Methods of reducing the impedance value of the SNS extraction kicker presently under construction and, in view of a future performance upgrade, that of the RHIC abort kicker have been thoroughly studied at this laboratory. In this paper, the investigation of a potential improvement from using ferrite different from the BNL standard CMD5005 is reported. Permeability measurements of several ferrite types have been performed. Measurements on two kicker magnets using CMD5005 and C2050 suggest that the impedance of a magnet without external resistive damping, such as the RHIC abort kicker, would benefit
Kramer Hannah MC
Full Text Available Abstract Introduction Unwanted contraception through prolonged retention of fetal bone is a rare cause of secondary infertility. It is usually associated with a history of abortion, either spontaneous or induced. Case presentation We describe a case of intrauterine retention of fetal bone diagnosed 8 years after the termination of a pregnancy. The patient had no complaints of pain, irregular vaginal bleeding or discharge. A hysteroscopy was performed and irregular structures were removed. These fragments were fetal bones, which probably functioned as an intrauterine contraceptive device. After removal of the fetal bone fragments the patient conceived spontaneously within 6 months. Conclusion This case report stresses the importance of taking a thorough history and evaluation of the endometrium by transvaginal ultrasound or hysteroscopy in women with secondary infertility.
Bettarini, S S; D'Andrea, S S
Subsequent to the legalization of abortion in Italy in 1978, abortion; rates among Italian women first rose and then declined steadily, from a peak of 16.9 abortions per 1,000 women of reproductive age in 1983 to 9.8 per 1,000 in 1993. Abortion rates vary considerably by geographic region, with rates typically highest in the more secular and modernized regions and lowest in regions where traditional values predominate. Data from 1981 and 1991 indicate that age-specific abortion rates decreased during the 1980s for all age-groups, with the largest declines occurring in regions with the highest levels of abortion. Moreover, a shift in the age distribution of abortion rates occurred during the 1980s, with women aged 30-34 registering the highest abortion rate in 1991, whereas in 1981 the highest level of abortion occurred among those aged 25-29. The abortion rate among adolescent women was low at both times (7.6 per 1,000 in 1981 and 4.6 per 1,000 in 1991). These data are based only on reported legal abortions; the number of clandestine abortions remains unknown.
Reproductive Health and the Question of Abortion in Botswana: A Review. Stephanie S Smith. Abstract. The complications of unsafe, illegal abortions are a significant cause of maternal mortality in Botswana. The stigma attached to abortion leads some women to seek clandestine procedures, or alternatively, to carry the ...
abortion and 10(6.9%) with self-induced abortions. More women ..... 36%. 32%. I had this stigma associated with abortion so it delayed me. ... I faced pressure from family members and this delayed my decision to seek medical help. 3. 2. 2. 1.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vacuum abortion system. 884.5070 Section 884.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5070 Vacuum abortion system. (a) Identification. A vacuum abortion system is a device designed to...
Background. Despite South Africa's liberal abortion law permitting abortion on request in the first trimester and under restricted conditions for second-trimester pregnancies, the practice of unsafe self-induced abortion persists. However, the prevalence of this practice, the methods used and the reasons behind it are relatively ...
Debates on abortion have escalated following the implementation in 1997 of the new law that legalises abortion from the age of twelve years in South Africa. Very often the person that opts for an abortion is merely an adolescent, who is still en route to adulthood. The adolescent's teacher shares the responsibility of the ...
Background: Unsafe abortion accounts for a greater proportion of maternal deaths, yet it is often not adequately considered in discussions around reducing maternal mortality. Aim: The aim of this study is to determine the pattern of unsafe abortion and the extent to which unsafe abortion contributes to maternal morbidity and ...
Background: Mid trimester abortion constitutes 10-15% of all induced abortions worldwide and accounts for the majority of complications. In Africa, studies demonstrating the proportion of second trimester abortions are few. However to appropriately intervene with a view to reducing the morbidity and mortality due to mid ...
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three ...
In Hohoe, Ghana, induced abortion is the second highest cause of hospital admissions. We aimed to describe factors influencing induced abortion among 408 randomly selected women aged 15-49 years. 21% of the women had had an abortion; of those, 36% said they did not want to disrupt their education or employment; ...
Objectives: Abortion is associated with significant healthproblem with short- and long-term complications that affect the quality of life of those who are fortunate enough to escape mortality. This study evaluated the population of patients with complications of abortion, identified the abortion providers and the pattern of ...
Sanz, Teresa; Menendez, Javier; Rosique, Teresa
The present study contributes to the understanding of gross motor development in babies with Down's syndrome. Also, it facilitates the comprehension of the efficiency of the early motor stimulation as well as of beginning it as early as possible. We worked with two groups of babies with Down's syndrome, beginning the early motor training in each…
Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer
Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578
Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer
Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Resu...
Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber
Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.
Velkey, Bálint; Vitális, Eszter; Vitális, Zsuzsanna
Spontaneous bacterial peritonitis occurs most commonly in cirrhotic patients with ascites. Pathogens get into the circulation by intestinal translocation and colonize in peritoneal fluid. Diagnosis of spontaneous bacterial peritonitis is based on elevated polymorphonuclear leukocyte count in the ascites (>0,25 G/L). Ascites culture is often negative but aids to get information about antibiotic sensitivity in positive cases. Treatment in stable patient can be intravenous then orally administrated ciprofloxacin or amoxicillin/clavulanic acid, while in severe cases intravenous III. generation cephalosporin. Nosocomial spontaneous bacterial peritonitis often caused by Gram-positive bacteria and multi-resistant pathogens can also be expected thus carbapenem should be the choice of the empiric treatment. Antibiotic prophylaxis should be considered. Norfloxacin is used most commonly, but changes are expected due to increase in quinolone resistance. As a primary prophylaxis, a short-term antibiotic treatment is recommended after gastrointestinal bleeding for 5 days, while long-term prophylaxis is for patients with low ascites protein, and advanced disease (400 mg/day). Secondary prophylaxis is recommended for all patients recovered from spontaneous bacterial peritonitis. Due to increasing antibiotic use of antibiotics prophylaxis is debated to some degree. Orv. Hetil., 2017, 158(2), 50-57.
Seyed Mohammad Javad Mortazavi
Full Text Available With great interest, we have read the article by Abad et al. entitled “Association between electromagnetic field exposure and abortion in pregnant women living in Tehran” that is published in International Journal of Reproductive BioMedicine Vol. 14. No. 5. pp: 347-354, May 2016. In this article, the authors evaluated the possible associations between electromagnetic waves exposure level and the rate of miscarriage in pregnant women. The electromagnetic radiation, in this study, had a significant association with the increased abortion in women who were exposed to these radiations. These findings were based on the measurements of electromagnetic waves within the residential locations of the 413 samples, very close to the entrance door of their home, according to the standard instructions of ICNIRP. Over the past several years, our laboratories at the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC have expanded their focus on studying the health effects of exposure to some common and/or occupational sources of electromagnetic fields (EMFs such as cellular phones (1-9, mobile base stations (10, mobile phone jammers (11, 12, laptop computers (13, radars (2, dentistry cavitrons (14 and MRI (15, 16. Although the paper authored by Abad et al. is a well-structured article and addresses a very challenging issue, it has some major shortcomings. The first shortcoming of this paper comes from this cardinal point that the authors have simply ignored the role of exposure to extremely low frequency EMFs (e.g. exposure of the pregnant women living in houses close to power lines. It is worth noting that the NARDA SRM-3000 used in their study operates in the frequency range of 27MHz-3GHz and cannot measure extremely low frequency EMFs. It is also worth mentioning that previous studies conducted in Iran indicated that the exposure to extremely low frequency electromagnetic fields is probably related to early spontaneous abortions (17
Dastgiri, Saeed; Yoosefian, Maryam; Garjani, Mehraveh; Kalankesh, Leila R
Induced abortion accounts for 1 in 8 of approximately 600000 maternal deaths that occur annually worldwide. Induced abortion rate can be considered as one of the indicators for assessing availability of the appropriate reproductive health plans for women and identifying needs for appropriate related health policies and programs. Researchers searched Pubmed, Google Scholar, CINAHL, Embase, PsycINFO, Cochrane, Iranian Scientific Information Database (SID), Iranian biomedical journals (Iranmedex), and Iranian Research Institute of Information and Documentation (Irandoc) between January 2000 and June 2013, which reported induced abortion. Search terms from two categories including abortion and termination of pregnancy were compiled. The search terms were "induced abortion", "illegal abortion", "illegal abortion", "unsafe abortion", and "criminal abortion". The search was also conducted with "induced termination of pregnancy", "illegal termination of pregnancy", "illegal termination of pregnancy", "unsafe termination of pregnancy" and "criminal termination of pregnancy". Meta-analysis was carried out by using OpenMeta software. Induced abortion rates were calculated based on the random effect model. Overall induced abortion rate was obtained 58.1 per 1000 women (95%CI: 55.16-61.04). In continental level, rate of induced abortion was 14 per 1000 women (95%CI: 11-16). Nation-wide and local rates were obtained 67.27 per 1000 women (95% CI: 60.02-74.23) and 148.92 (95% CI: 140.06-157.79) respectively. Induced abortion is a major public health problem that occurs worldwide whether under the legal restriction or freedom, and it remains as reproductive health concern globally. To eliminate the need for induced abortion is at the core of any effort for preventing this issue. Option with the highest priority is to prevent unwanted pregnancies through promoting reproductive health plans for women of reproductive age. In case the prevention strategies fail, universal provision of
A brief study was carried out to determine the feasibility of a special kicker to produce a damped spiral beam at the beam dump for the beam abort system. There appears to be no problem with realizing this concept at a reasonably low cost.
Gutierrez Vazquez, Edith Y.; Parrado, Emilio A.
In 2007 abortion was legalized in the Federal District of Mexico, making the largest jurisdiction in Latin America, outside of Cuba, to allow women to have abortions on request during the first trimester of pregnancy. While the implications of the law for women's health and maternal mortality have been investigated, its potential association with fertility behavior has yet to be assessed. In this paper, we examine metropolitan area differences in overall and parity-specific, as well as the age pattern of childbearing between 2000 and 2010 to more precisely isolate the contribution of abortion legalization to fertility in Mexico. Our statistical specification applies difference-in-difference regression methods that control for concomitant changes in other socioeconomic predictors of fertility to assess the differential influence of the law across age groups. In addition, we account for prior fertility levels and change to better separate the effect of the law from preceding trends. Overall, the evidence suggests a systematic association between abortion legalization and fertility. The law appears to have contributed to lower fertility in Mexico City compared to other metropolitan areas and prior trends, though the influence is mostly visible among women aged 20-34 in connection with the transition to first and second child with limited impact on teenage fertility. There is some evidence that its effect might be diffusing to the greater Mexico City metropolitan area. PMID:27285423
Gutiérrez Vázquez, Edith Y; Parrado, Emilio A
In 2007 abortion was legalized in the Federal District of Mexico, making it the largest jurisdiction in Latin America, outside of Cuba, to allow women to have abortions on request during the first trimester of pregnancy. While the implications of the law for women's health and maternal mortality have been investigated, its potential association with fertility behavior has yet to be assessed. We examine metropolitan-area differences in overall and parity-specific childbearing, as well as the age pattern of childbearing between 2000 and 2010 to identify the contribution of abortion legalization to fertility in Mexico. Our statistical specification applies difference-in-difference regression methods that control for concomitant changes in other socioeconomic predictors of fertility to assess the differential influence of the law across age groups. In addition, we account for prior fertility levels and change to better separate the effect of the law from preceding trends. Overall, the evidence suggests a systematic association between abortion legalization and fertility. The law appears to have contributed to lower fertility in Mexico City compared to other metropolitan areas and prior trends. The influence is mostly visible among women aged 20-34 in connection with the transition to first and second child, with limited impact on teenage fertility. There is some evidence that its effect might be diffusing to the Greater Mexico City Metropolitan area. © 2016 The Population Council, Inc.
Ananat, Elizabeth Oltmans; Gruber, Jonathan; Levine, Phillip
The early-1970s abortion legalization led to a significant drop in fertility. We investigate whether this decline represented a delay in births or a permanent reduction in fertility. We combine Census and Vital Statistics data to compare the lifetime fertility of women born in early-legalizing states, whose peak childbearing years occurred in the…
A brief study was carried out to determine the feasibility of a special kicker to produce a damped spiral beam at the beam dump for the beam abort system. There appears to be no problem with realizing this concept at a reasonably low cost
This paper argues that the central issue in the abortion debate has not changed since 1967 when the English parliament enacted the Abortion Act. That central issue concerns the moral status of the human fetus. The debate here is not, it is argued, primarily a moral debate, but rather a metaphysical debate and/or a theological debate--though one with massive moral implications. It concerns the nature and attributes that an entity requires to have "full moral standing" or "moral inviolability" including a "right to life". It concerns the question when, in its development from newly fertilised ovum to unequivocally mature, autonomous morally inviolable person does a human being acquire that nature and those attributes, and thus a "right to life". The paper briefly reviews standard answers to these questions, outlining some problems associated with each. Finally there is a brief discussion of one way in which the abortion debate has changed since 1967--notably in the increasingly vociferous claim, especially from disability rights sectors, that abortion on grounds of fetal abnormality implies contempt for and rejection of disabled people--a claim that is rebutted.
Bergallo, Paola; Ramón Michel, Agustina
For most of the 20th Century, restrictive abortion laws were in place in continental Latin America. In recent years, reforms have caused a liberalizing shift, supported by constitutional decisions of the countries' high courts. The present article offers an overview of the turn toward more liberal rules and the resolution of abortion disputes by reference to national constitutions. For such purpose, the main legal changes of abortion laws in the last decade are first surveyed. Landmark decisions of the high courts of Argentina, Bolivia, Colombia, and Mexico are then analyzed. It is shown that courts have accepted the need to balance interests and competing rights to ground less restrictive laws. In doing so, they have articulated limits to protection of fetal interests, and basic ideas of women's dignity, autonomy, and equality. The process of constitutionalization has only just begun. Constitutional judgments are not the last word, but they are important contributions in reinforcing the legality of abortion. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
lack of knowledge about legal rights relating to sexual health and risks, particularly on ... had sex); (ii) a measure of abortion attitudes using a 7-point response format ranging from ... School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa ... gov.za/files/a1-08.pdf (accessed 10 April 2015). 5.
Ogwokhademhe, M. C.; Sowho, Paulina O.
Guidance and counseling are twin words that help people adjust to their psychological, emotional, social and psychosocial problems which tend to occur in human life. Abortion, which is a prevalent problem in Nigeria mostly among the teenage girls, has drawn the attentions of the counselors, teachers, guardians, administrators, researchers and the…
The study investigates the social background of teenagers before being teenage mothers or having an induced abortion. A discrete-time proportional hazard modelling was used to analyse the longitudinal observations of population-based registers covering all children born in Denmark in 1966...
This study explored adolescents' knowledge of the Choice on Termination of Pregnancy Act (No 92 of 1996) and attitudes toward abortion. A sample of 150 secondary school learners (aged 15 - 19 years), from a low socioeconomic area in Durban, KwaZulu-Natal Province, South Africa was surveyed. Twenty percent of the ...
Welsh, P; McCarthy, M; Cromer, B
The purpose of this study was to conduct a comparison, using qualitative analytic methodology, of perceptions concerning abortion among health care providers and administrators, along with politicians and anti-abortion activists (total n = 75) in Great Britain, Sweden, The Netherlands, and the United States. In none of these countries was there consensus about abortion prior to legalization, and, in all countries, public discussion continues to be present. In general, after legalization of abortion has no longer made it a volatile issue European countries have refocused their energy into providing family planning services, education, and more straightforward access to abortion compared with similar activities in the United States.
Tedesco, Mark B.; Evans, Bryan M.; Merritt, Deborah S.; Falck, Robert D.
The Crew Exploration Vehicle (CEV) is required to maintain continuous abort capability from lift off through destination arrival. This requirement is driven by the desire to provide the capability to safely return the crew to Earth after failure scenarios during the various phases of the mission. This paper addresses abort trajectory design considerations, concept of operations and guidance algorithm prototypes for the portion of the ascent trajectory following nominal jettison of the Launch Abort System (LAS) until safe orbit insertion. Factors such as abort system performance, crew load limits, natural environments, crew recovery, and vehicle element disposal were investigated to determine how to achieve continuous vehicle abort capability.
Abort trajectory is a passage that ensures the astronauts to return safely to the earth when an emergency occurs. Firstly,the essential elements of mission abort are analyzed entirely based on summarizing the existing studies. Then,abort trajectory requirement and rational selection for different flight phases of typical manned lunar mission are discussed specifically. Considering a trade-off between the two primary constrains of an abort,the return time of flight and energy requirement,a general optimizing method for mission abort is proposed. Finally,some suggestions are given for China’s future manned lunar landing mission.
Full Text Available "nObjective: abortion either medical or criminal has distinctive physical, social, and psychological side effects. Detecting types and frequent psychological side effects of abortion among post abortion care seeking women in Tehran was the main objective of the present study. "n Method: 278 women of reproductive age (15-49 interviewed as study population. Response rate was 93/8. Data collected through a questionnaire with 2 parts meeting broad socio-economic characteristics of the respondents and health- related abortion consequences. Tehran hospitals were the site of study. "nResults: The results revealed that at least one-third of the respondents have experienced psychological side effects. Depression, worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents. Decreased self-esteem, nightmare, guilt, and regret with 43.7%, 39.5%, 37.5%, and 33.3% prevalence rates have been placed in the lower status, respectively. "nConclusion: Psychological consequences of abortion have considerably been neglected. Several barriers made findings limited. Different types of psychological side effects, however, experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders, and women's health impact on family and population health.
Hopkins, Nick; Zeedyk, Suzanne; Raitt, Fiona
This paper presents an analysis of a recent UK anti-abortion campaign in which the use of fetal imagery--especially images of fetal remains--was a prominent issue. A striking feature of the texts produced by the group behind the campaign was the emphasis given to the emotions of those viewing such imagery. Traditionally, social scientific analyses of mass communication have problematised references to emotion and viewed them as being of significance because of their power to subvert the rational appraisal of message content. However, we argue that emotion discourse may be analysed from a different perspective. As the categorisation of the fetus is a social choice and contested, it follows that all protagonists in the abortion debate (whether pro- or anti-abortion) are faced with the task of constructing the fetus as a particular entity rather than another, and that they must seek to portray their preferred categorisation as objective and driven by an 'out-there' reality. Following this logic, we show how the emotional experience of viewing fetal imagery was represented so as to ground an anti-abortion construction of the fetus as objective. We also show how the arguments of the (pro-abortion) opposition were construed as totally discrepant with such emotions and so were invalidated as deceitful distortions of reality. The wider significance of this analysis for social scientific analyses of the abortion debate is discussed.
Steinberg, Julia R
Some abortion policies in the U.S. are based on the notion that abortion harms women's mental health. The American Psychological Association (APA) Task Force on Abortion and Mental Health concluded that first-trimester abortions do not harm women's mental health. However, the APA task force does not make conclusions regarding later abortions (second trimester or beyond) and mental health. This paper critically evaluates studies on later abortion and mental health in order to inform both policy and practice. Using guidelines outlined by Steinberg and Russo (2009), post 1989 quantitative studies on later abortion and mental health were evaluated on the following qualities: 1) composition of comparison groups, 2) how prior mental health was assessed, and 3) whether common risk factors were controlled for in analyses if a significant relationship between abortion and mental health was found. Studies were evaluated with respect to the claim that later abortions harm women's mental health. Eleven quantitative studies that compared the mental health of women having later abortions (for reasons of fetal anomaly) with other groups were evaluated. Findings differed depending on the comparison group. No studies considered the role of prepregnancy mental health, and one study considered whether factors common among women having later abortions and mental health problems drove the association between later abortion and mental health. Policies based on the notion that later abortions (because of fetal anomaly) harm women's mental health are unwarranted. Because research suggests that most women who have later abortions do so for reasons other than fetal anomaly, future investigations should examine women's psychological experiences around later abortions. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Upadhyay, Ushma D; Cartwright, Alice F; Johns, Nicole E
A proposed California law will require student health centers at public universities to provide medication abortion. To understand its potential impact, we sought to describe current travel time, costs, and wait times to access care at the nearest abortion facilities. We projected total medication abortion use based on campus enrollment figures and age- and state-adjusted abortion rates. We calculated distance and public transit time from campuses to the nearest abortion facility. We contacted existing abortion-providing facilities to determine costs, insurance acceptance, and wait times. We estimate 322 to 519 California public university students seek medication abortions each month. As many as 62% of students at these universities were more than 30 minutes from the closest abortion facility via public transportation. Average cost of medication abortion was $604, and average wait time to the first available appointment was one week. College students face cost, scheduling, and travel barriers to abortion care. Offering medication abortion on campus could reduce these barriers. Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Erdman, Joanna N
The legal regulation of abortion by gestational age, or length of pregnancy, is a relatively undertheorized dimension of abortion and human rights. Yet struggles over time in abortion law, and its competing representations and meanings, are ultimately struggles over ethical and political values, authority and power, the very stakes that human rights on abortion engage. This article focuses on three struggles over time in abortion and human rights law: those related to morality, health, and justice. With respect to morality, the article concludes that collective faith and trust should be placed in the moral judgment of those most affected by the passage of time in pregnancy and by later abortion-pregnant women. With respect to health, abortion law as health regulation should be evidence-based to counter the stigma of later abortion, which leads to overregulation and access barriers. With respect to justice, in recognizing that there will always be a need for abortion services later in pregnancy, such services should be safe, legal, and accessible without hardship or risk. At the same time, justice must address the structural conditions of women's capacity to make timely decisions about abortion, and to access abortion services early in pregnancy.
Jotkowitz, Alan; Zivotofsky, Ari Z
Abortion remains a highly contentious moral issue, with the debate usually framed as a battle between the fetus's right to life and the woman's right to choose. Often overlooked in this debate is the impact of the concurrent legalization of abortion and the development of new prenatal screening tests on the birth prevalence of many inherited diseases. Most proponents of abortion support abortion for fetuses with severe congenital diseases, but there has unfortunately been, in our opinion, too little debate over the moral appropriateness of abortion for much less severe congenital conditions such as Down's syndrome, deafness, and dwarfism. Due to scientific advances, we are looking at a future in which prenatal diagnosis will be safer and more accurate, raising the specter, and the concomitant ethical concerns, of wholesale abortions. Herein, we present a reframing of the abortion debate that better encompasses these conditions and offers a more nuanced position. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
M C Regmi
Full Text Available INTRODUCTION: Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. METHODS: A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. RESULTS: There were 70 unsafe abortion patients. Majority of them (52.8% were of high grade. Most of them recovered but there were total 8maternal deaths. CONCLUSIONS: Unsafe abortion is still a significant medical and social problem even in post legalization era of this country. Keywords: abortion, legalization, maternal death, unsafe.
Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B
Background Concern has been expressed about potential harm to women's mental health in association with having an induced abortion, but it remains unclear whether induced abortion is associated with an increased risk of subsequent psychiatric problems. Methods We conducted a population-based cohort......-trimester induced abortion or a first childbirth during that period. We estimated the rates of first-time psychiatric contact (an inpatient admission or outpatient visit) for any type of mental disorder within the 12 months after the abortion or childbirth as compared with the 9-month period preceding the event....... Results The incidence rates of first psychiatric contact per 1000 person-years among girls and women who had a first abortion were 14.6 (95% confidence interval [CI], 13.7 to 15.6) before abortion and 15.2 (95% CI, 14.4 to 16.1) after abortion. The corresponding rates among girls and women who had a first...
Bhilwar, Meenakshi; Lal, Panna; Sharma, Nandini; Bhalla, Preena; Kumar, Ashok
To document abortion practices and contraceptive use among women of reproductive age in an urban slum of Delhi. Data were collected as part of a cross-sectional study conducted in an urban resettlement colony in the North East District of Delhi between November 2010 and December 2011. Systematic random sampling was used to enroll 200 married women aged 15-49 years from each of the four blocks of the colony. Participants were interviewed and data were entered into a pretested semi-structured questionnaire. Among 802 participants, 284 (35.4%) reported at least one spontaneous or induced abortion, and 196 (24.4%) reported induced abortions. Unsupervised medical termination was reported by 78 (27.5%) of the 284 women. Overall, only 207 (25.8%) women practiced any type of contraception. The predominant decision maker regarding contraception was the husband for 95 (45.9%) women and the mother-in-law for 78 (37.7%). There is a need for focused community-based education to address specific issues, particularly regarding the dangers of unsafe abortion and choosing a method of contraception in consultation with a healthcare practitioner. © 2016 International Federation of Gynecology and Obstetrics.
Oriji, Vaduneme K; Jeremiah, Israel; Kasso, Terhemen
Induced abortion is the termination of pregnancy through a deliberate intervention intended to end the pregnancy. This practice is widespread in Nigeria despite the restrictive abortion laws in Nigeria. Many women still undergo induced abortion every year and endanger their health and lives as induced abortion can only be procured illegally in Nigeria. We hope to determine the proportion of undergraduate students who had induced abortion in the past and the contributing factors. To determine the proportion of the undergraduate students who support the restrictive abortion laws in Nigeria. A cross sectional questionnaire survey of undergraduate students of the University of Port Harcourt was done through a cluster sampling method along with focus group discussion with some of the respondents. 451 out of 500 administered questionnaires were retrieved and analyzed. The incidence of induced abortion amongst the respondents was 47.2%. About 40% had never used an effective form of contraception in the past and 13% were unaware of contraception. 77.9% of the induced abortion was by dilation and curettage and 1% by manual vacuum aspiration. Up to two third of the respondents were against legalization of abortion. Up to 47% of these undergraduates had performed abortion in the past. Protecting educational career was the single most important reason for this. Although most of these undergraduates are against legalizing abortion, they highly patronize unsafe abortion. Improving contraceptive awareness and usage will reduce unwanted pregnancy and induced abortion. This option appears next to total abstinence in reducing the morbidity and mortality from induced abortion in this country.
History of induced abortion in Denmark from 1200 to 1979 is reviewed. The 1st Danish law of 1200 did not touch upon the question of induced abortion. From the beginning of the 13th century to Religious Reformation in 1536, Roman Catholic law influenced every aspect of Danish life including induced abortion. In 1683 in King Christian V's constitution called Dansk Lov induced abortion was discussed. Immoral women who aborted fetuses or killed newborn babies were decapitated. In Copenhagen in the years 1624-1632 and 1638-1663 17 women were executed because of induced abortion or murder of newborn babies. Although Dansk Lov was effective till 1866, Danish kings came to treat female criminals less severely since about 1780-1800. For example, between 1855 and 1866 42 women convicted of murder of newborn babies or abortion were given pardon (12 years of imprisonment instead of life sentence). In 1866, abortion and murder of babies were treated separately in the Danish criminal law. Induced abortion meant up to 8 years of imprisonment and labor. In 1930 life sentence was abolished; induced abortion called for only up to 2 years of imprisonment, while those who assisted for money were punished more severely (up to 8 years in prison). In 1937 the Danes legalized induced abortion for medical, ethical, (e.g. rape case) and eugenic reasons. By 1973 legalized abortion was available, free of charge, to every Danish female resident within 12 weeks of pregnancy. In 1980 abortion rate was about 41% of total births. It is estimated 2/3 of Danish women experience abortion. Lastly, illegitimate births and miscarriages are on the rise due to changes in women's social status and role.
Ma, Hong-Xia; You, Zhao-Ling; Wang, Xiao-Yun
To explore the effect of total flavones from cuscuta chinensis (TFCC) on expression of Fas, PCNA and HB-EGF in SD rats model with bromocriptine-induced abortion. The model rats of bromocriptine during 6-8 d of pregnancy induced early abortion was established, adopting respectively herbs in high and low dosage and progesterone affect model rat and after 12 d, Immunohistochemical was applied to determine Fas, HB-EGF and PCNA in deciduas and placenta. Expression of PCNA on trophoblast and deciduas, HB-EGF on trophoblast, PR on deciduas in the model used Semen cuscutae flavonoid, proesterone and normal pregnacy, were significantlly higher than those of the pure model. Expression of Fas on trophoblast and deciduas in above four groups, were significantlly lower than those of the pure model. There were no expression of HB-EGF on deciduas. TFCC regulates the proliferation and apoptosis of the deciduas and cytotrophoblasts and prevents spontaneous abortions.
Patterson, Benjamin Oliver; Itam, Sarah; Probst, Fey
Abstract We present a patient with sudden onset progressive shortness of breath and no history of trauma, who rapidly became haemodynamically compromised with a pneumothorax and pleural effusion seen on chest radiograph. He was treated for spontaneous tension pneumothorax but this was soon revealed to be a tension haemopneumothorax. He underwent urgent thoracotomy after persistent bleeding to explore an apical vascular abnormality seen on CT scanning. To our knowledge this is the first such c...
Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.
With the advent of legalized abortion in the US in 1973, the innovation, adoption and dissemination of new and improved medical procedures for the voluntary termination of pregnancy became an important objective. 3 principal techniques were introduced: suction curettage, instillation procedures using saline solution or prostaglandin, and dilatation and evacuation (D and E). Suction curettage in the 1st trimester was readily adopted because the procedure was less traumatic than the traditional dilatation and curettage. Instillation procedures for abortions in the 2nd trimester were also readily adopted. Physicians preferred them to surgical procedures, were familiar with the delivery simulation, and were comfortable with the hospital setting in which the procedure was performed. D and E, an extension of the suction procedure to abortions in the 2nd trimester has lower complication rates than instillation procedures and can be performed early in the midtrimester. A 1981 membership survey conducted by the National Abortion Federation found that about 1/3 of the members performed D and E midtrimester abortions, a wider acceptance than was expected. In 1978, of the 2nd trimester abortions, 85% of the early midtrimester and 25% of the 16 weeks gestation or later abortions were done by D and E. Acceptance in some other countries is also increasing. A study of the relationship of a history of 2nd trimester abortions and subsequent adverse pregnancy outcomes was unable to identify any statistically significant relationship with the possible exception of low birth weight infants. According to a 1976 survey of teaching hospitals, less than 1/4 require their residents to perform midtrimester abortions. Very few medical schools include D and E procedures in their residency training programs. Residents should use the D and E technique only under supervision and after becoming experienced in 1st trimester suction curettage. A survey reported that D and E techniques can be learned
Gláucia Rosana Guerra Benute
Full Text Available OBJETIVOS: Caracterizar a população que sofreu abortamento; investigar a existência de ansiedade e depressão; verificar se existe ou não sentimento de culpa após o abortamento e comparar os resultados entre mulheres que sofreram abortamento espontâneo e as que provocaram-no. MÉTODOS: 50 mulheres com abortamento espontâneo e 50 com provocado foram entrevistadas 30 dias após o abortamento. Foi realizada entrevista com questões abertas e fechadas e aplicada a escala Hospital Anxiety and depression. RESULTADOS: As mulheres que viveram o abortamento espontâneo encontram-se mais culpadas (30% que as que provocaram-no (18%. No entanto, as mulheres que provocaram o abortamento encontraram-se mais ansiosas (média de 11 e mais deprimidas (média de 8,3 que as mulheres que viveram abortamento espontâneo (médias de 8,7 e 6,1; respectivamente, pBACKGROUND: Pregnancy has a symbolic meaning for each woman. It varies according to personality structure and is related to women's previous life experiences. OBJECTIVES: the aim was to characterize the women that suffered abortion, asking about anxiety and depression, looking for guilty feelings after abortion, and to compare results between women who suffered spontaneous abortion and those who had intentional abortion. METHODS: fifty women with spontaneous and fifty with induced abortion were interviewed 30 days after the procedure. A semistructured questionnaire with open and closed-end questions and Hospital Anxiety and Depression Scale were administered. RESULTS: woman who induced abortion revealed to be more anxious (mean 11 and depressed (mean 8.3 than woman with spontaneous abortion (means 8.7 and 6.1 respectively, p<0.05. CONCLUSIONS: women who presented induced abortion were more anxious and depressed, as shown by later life events, full of problematic feelings and the need fort sychological support.
Ramírez-Madera, Axel O; Miller, Nathan D; Spalding, Edgar P; Weng, Yiqun; Havey, Michael J
This is the first quantitative estimation of spontaneous polyploidy in cucumber and we detected 2.2% polyploids in a greenhouse study. We provide evidence that polyploidization is consistent with endoreduplication and is an on-going process during plant growth. Cucumber occasionally produces polyploid plants, which are problematic for growers because these plants produce misshaped fruits with non-viable seeds. In this study, we undertook the first quantitative study to estimate the relative frequency of spontaneous polyploids in cucumber. Seeds of recombinant inbred lines were produced in different environments, plants were grown in the field and greenhouse, and flow cytometry was used to establish ploidies. From 1422 greenhouse-grown plants, the overall relative frequency of spontaneous polyploidy was 2.2%. Plants possessed nuclei of different ploidies in the same leaves (mosaic) and on different parts of the same plant (chimeric). Our results provide evidence of endoreduplication and polysomaty in cucumber, and that it is an on-going and dynamic process. There was a significant effect (p = 0.018) of seed production environment on the occurrence of polyploid plants. Seed and seedling traits were not accurate predictors of eventual polyploids, and we recommend that cucumber producers rogue plants based on stature and leaf serration to remove potential polyploids.
Kabiru, Caroline W; Ushie, Boniface A; Mutua, Michael M; Izugbara, Chimaraoke O
Unsafe abortion is a leading cause of death among young women aged 10-24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12-24 years seeking abortion-related care in Kenya. We used data on 1,378 young women aged 12-24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form. Nine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %). Our study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post-abortion
Full Text Available Traditional inefficient contraception, incorporated to a large extent in the system of values, has become a natural part of sexual relations in Serbia and represents a rational preventive choice from the individual standpoint. However, when pregnancy is unwanted or cannot be accepted out of any reasons abortion is used as a resort. For this reason there is a long history of a large number of abortions in Serbia. Research findings in our country identify the following, as the most important factors for not accepting modern values in this sphere: traditional contraception and abortion have a firm social confirmation; there is a trans-generational transfer of psychological resistance towards the use of combined oral contraception pills and intrauterine devices; sexual education has never become a natural way of growing up in the family, nor is a constituent part of school programs and that distinct obstacles of various nature exist regarding contraception availability. A developed network of various types of family planning counseling is an important determinant of the accessibility of contraceptive means and methods. There are, however, numerous conditions which have to be fulfilled in order for the contraception counseling services to function properly. Among them, motivated personnel who acquired general and specific knowledge for work in this field are an especially important prerequisite. This theoretical assumption opens the question -whether gynecologists represent an important factor of slow transition of birth control in Serbia? We searched for the answer in the research analyses obtained through two in-depth surveys which either had to do with this theme or tried to determine the knowledge, attitude and practice of gynecologists. The first research regarding the determination of the causes for a large number of abortions in our country, was directed towards women who decided on abortion. Gynecologists were the target group in the second
Alberto Pereira Madeiro
Full Text Available Prostitutes are vulnerable to unplanned pregnancies and abortions. In Brazil, abortion is a crime and there is no data about unsafe abortions for this population. The study describes how prostitutes perform illegal abortions and the health consequences thereof. Semi-structured interviews with 39 prostitutes from three cities in Brazil with previous induced abortion experience were conducted. Sixty-six abortions, with between one and eight occurrences per woman, were recorded. The majority of the cases resulted from sexual activity with clients. The inconsistent use of condoms with regular clients and the consumption of alcohol during work were indicated as the main causes of unplanned pregnancies. The main method to perform abortion was the intravaginal and oral use of misoprostol, acquired in pharmacies or on the black market. Invasive measures were less frequently reported, however with more serious health complications. The fear of complaint to the police meant that most women do not inform the health team regarding induced abortion. The majority of prostitutes aborted with the use of illegally-acquired misoprostol, ending abortion in a public hospital with infection and hemorrhagic complications. The data indicate the need for a public policy focusing on the reproductive health of prostitutes.
Full Text Available This work deals with the relationship between induced abortion and mental health with a special focus on the area of political controversy. This article explores the historical background of the abortion and its legislative implications in Europe with special reference to Bosnia and Herzegovina. This work is based on etnographich, analitical and historical aproaches. It explains abortion in medical terms and analyzes the psychological effects of the abortion. This is a significant and challanging topic for those who find themselves facing the moral dilemma of whether or not to terminate a pregnancy. Problems of controversy are numerous. Is abortion a murder or not? Is fetus a person or not? When it becomes the one if ever till the birth? If abortion is not morally wrong, that doesn't mean that it's right to have an abortion. If abortion is morally wrong, that doesn't mean that it is always impermissible to have an abortion. The comon dilema is whether having an abortion is less wrong than the alternatives. These are some of the questions this paper deals with.
de Costa, Caroline; Douglas, Heather; Hamblin, Julie; Ramsay, Philippa; Shircore, Mandy
This article reviews the current legal status of abortion in Australia and its implications. Australian abortion law has been a matter for the states since before Federation. In the years since Federation there have been significant reforms and changes in the abortion laws of some jurisdictions, although not all. Across Australia there are now nine sets of laws, state and Commonwealth, concerned with abortion. The test of a lawful abortion varies greatly across jurisdictions. In a number of states and territories, it is necessary to establish a serious risk to the physical or mental health of the woman if the pregnancy was to continue. In some cases, the certification of two doctors is required, particularly for abortions at later gestations. There are also physical restrictions on access, such as in South Australia and the Northern Territory where abortion must take place in a hospital. Only in the ACT has abortion been removed from the criminal law altogether. Variations in the law and restrictions arising from these are not consistent with the aims and provision of the universal, accessible health care system aspired to in Australia. There is an urgent need for overall reform and the introduction of uniformity to Australia's abortion laws, including removal of abortion from the criminal law. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Sydsjö, Adam; Josefsson, Ann; Bladh, Marie; Muhrbeck, Måns; Sydsjö, Gunilla
Induced abortion is more frequent in Sweden than in many other Western countries. We wanted to investigate attitudes and knowledge about induced abortion among politicians responsible for healthcare in three Swedish counties. A study-specific questionnaire was sent to all 375 elected politicians in three counties; 192 (51%) responded. The politicians stated that they were knowledgeable about the Swedish abortion law. More than half did not consider themselves, in their capacity as politicians, sufficiently informed about abortion-related matters. Most politicians (72%) considered induced abortion to be primarily a 'women's rights issue' rather than an ethical one, and 54% considered 12 weeks' gestational age an adequate upper limit for induced abortion. Only about a third of the respondents were correctly informed about the number of induced abortions annually carried out in Sweden. Information and knowledge on induced abortion among Swedish county politicians seem not to be optimal. Changes aimed at reducing the current high abortion rates will probably not be easy to achieve as politicians seem to be reluctant to commit themselves on ethical issues and consider induced abortion mainly a women's rights issue.
Madeiro, Alberto Pereira; Diniz, Debora
Prostitutes are vulnerable to unplanned pregnancies and abortions. In Brazil, abortion is a crime and there is no data about unsafe abortions for this population. The study describes how prostitutes perform illegal abortions and the health consequences thereof. Semi-structured interviews with 39 prostitutes from three cities in Brazil with previous induced abortion experience were conducted. Sixty-six abortions, with between one and eight occurrences per woman, were recorded. The majority of the cases resulted from sexual activity with clients. The inconsistent use of condoms with regular clients and the consumption of alcohol during work were indicated as the main causes of unplanned pregnancies. The main method to perform abortion was the intravaginal and oral use of misoprostol, acquired in pharmacies or on the black market. Invasive measures were less frequently reported, however with more serious health complications. The fear of complaint to the police meant that most women do not inform the health team regarding induced abortion. The majority of prostitutes aborted with the use of illegally-acquired misoprostol, ending abortion in a public hospital with infection and hemorrhagic complications. The data indicate the need for a public policy focusing on the reproductive health of prostitutes.
The current abortion controversy has serious potential economic consequences for U.S. hospitals, from boycotts and other political actions, but also because of lack of reimbursement for procedures performed on indigent women. An example was given of a threatened boycott of a private hospital in Washington state by evangelical residents and their physicians. Another example of boycott of hospital blood donations was cited. 1078, or 28.7%, of 3752 U.S. hospitals that are equipped to perform abortions do so. 90% of abortions are done by 31% of U.S. hospitals. 90% of these are 1st trimester abortions, costing $200-300. Many employer-sponsored health insurance plans pay for abortions, but Medicaid programs pay for limited numbers of abortions: all abortions for poor women in 13 states, but only those need to save the woman's life in most states. The federal government paid $62,235 for 84 abortions in 13 states in 1988. California and New York have extensive abortion programs for the poor. Hospitals keep a low profile about abortion services, declining to advertise their activity.
Hirve, Siddhivinayak S
Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion services to the district level, punitive measures to deter provision of unsafe abortions, rationalisation of physical requirements for facilities to provide early abortion, and approval of medical abortion, have all aimed to expand safe services. Proposed amendments to the MTP Act to prevent sex-selective abortions would have been unethical and violated confidentiality, and were not taken forward. Continuing problems include poor regulation of both public and private sector services, a physician-only policy that excludes mid-level providers and low registration of rural compared to urban clinics; all restrict access. Poor awareness of the law, unnecessary spousal consent requirements, contraceptive targets linked to abortion, and informal and high fees also serve as barriers. Training more providers, simplifying registration procedures, de-linking clinic and provider approval, and linking policy with up-to-date technology, research and good clinical practice are some immediate measures needed to improve women's access to safe abortion care.
Duarte, Graciana Alves; Osis, Maria José Duarte; Faúndes, Anibal; Sousa, Maria Helena de
To analyze the opinion of judges and prosecutors concerning Brazilian abortion law and situations in which the abortion should be allowed. A cross-sectional study was performed with 1,493 judges and 2,614 prosecutors in Brazil between 2005 and 2006. Participants completed a structured questionnaire approaching sociodemographic characteristics, opinions about abortion law, and circumstances in which abortion is considered lawful. Bivariate and multivariate analyses of data were carried out through Poisson regression. The majority of participants (78%) found that the circumstances in which abortion is considered lawful should be broadened, or even that abortion should not be criminalized. The highest rates of pro-abortion opinions resulted from: risk to the life of the mother (84%), anencephaly (83%), severe congenital malformation of fetus (82%), and pregnancy resulting from rape (82%). Variables related to religion were strongly associated to the opinion of participants. There is a trend in considering the need of changing the current abortion law, in the sense of widening the circumstances in which abortion is considered lawful, or even toward decriminalizing abortion, regardless of the circumstances in which it takes place.
Moore, Ann M; Kibombo, Richard; Cats-Baril, Deva
While laws in Uganda surrounding abortion remain contradictory, a frequent interpretation of the law is that abortion is only allowed to save the woman's life. Nevertheless abortion occurs frequently under unsafe conditions at a rate of 54 abortions per 1000 women of reproductive age annually, taking a large toll on women's health. There are an estimated 148,500 women in Uganda who experience abortion complications annually. Understanding opinion leaders' knowledge and perceptions about unsafe abortion is critical to identifying ways to address this public health issue. We conducted in-depth, semi-structured interviews with 41 policy-makers, cultural leaders, local politicians and leaders within the health care sector in 2009-10 at the national as well as district (Bushenyi, Kamuli and Lira) level to explore their knowledge and perceptions of unsafe abortion and the potential for policy to address this issue. Only half of the sample knew the current law regulating abortion in Uganda. Respondents understood that the result of the current abortion restrictions included long-term health complications, unwanted children and maternal death. Perceived consequences of increasing access to safe abortion included improved health as well as overuse of abortion, marital conflict and less reliance on preventive behaviour. Opinion leaders expressed the most support for legalization of abortion in cases of rape when the perpetrator was unknown. Understanding opinion leaders' perspectives on this politically sensitive topic provides insight into the policy context of abortion laws, drivers behind maintaining the status quo, and ways to improve provision under the law: increase education among providers and opinion leaders. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.
Matthiessen, P C
Trends in fertility, abortion, and contraceptive practice in Denmark were analyzed, using previously compiled official statistics; the conclusion was drawn that easy access to abortion may contribute toward a decline in contraceptive practice depending on the level of contraceptive practice in the population and on the degree of confidence the population has in available contraceptive methods. In October 1973 Denmark passed a law permitting women to obtain free abortion on demand. The number of legal abortions increased from 16,500 in 1973 to 28,000 in 1975. This marked increase was not attributable to a decline in illegal abortion since that annual number had declined from 5,000 to 1,000 prior to the passage of the 1973 abortion on demand law. The increase in abortion observed from 1973-1975 was accompanied by a marked decrease in the number of oral contraceptive cycles sold. Annual sales decreased from 3.9 million cycles to 2.6 million. It was difficult to access the factors responsible for this decline. Although IUD insertions increased during this period, the increase could not adequately compensate for the reduction in oral contraceptive sales. The decline in oral contraceptive sales occurred at about the time the negative side effects associated with the pill received widespread news coverage. Some of the decline in pill usage was probably due to fear of side effects, but abortion availability also encouraged women to be more lax about taking the pill and encouraged them to rely on less effective methods of contraception. Tables provide data for Denmark in reference to: 1) number of legal abortions and the abortion rates for 1940-1977; 2) distribution of abortions by season, 1972-1977; 3) abortion rates by maternal age, 1971-1977; 4) oral contraceptive and IUD sales for 1977-1978; and 5) number of births and estimated number of abortions and conceptions, 1960-1975.
Olson, Rose McKeon; Kamurari, Solomon
A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Petitet, Pascale Hancart; Ith, Leakhena; Cockroft, Melissa; Delvaux, Thérèse
In 2010, following its approval by the Ministry of Health, the medical abortion combination pack Medabon (containing mifepristone and misoprostol) was made available at pharmacies and in a restricted number of health facilities in Cambodia. The qualitative study presented in this paper was conducted in 2012 as a follow-up to longer-term ethnographical research related to reproductive health and fertility regulation between 2008 and 2012. Observations were carried out at several clinic and pharmacy sites and in-depth interviews were conducted with a purposive sample of 20 women who attended two MSI Cambodia centres and 10 women identified through social networks; six men (women's male partners); eight health care providers at the two MSI centres and four pill sellers at private or informal pharmacies (who also provided health care services in private clinics). Although the level of training among the drug sellers and providers varied, their knowledge about medical abortion regimens, correct usage and common side effects was good. Overall, women were satisfied with the services provided. Medical abortion was not always a women-only process in this study as some male partners were also involved in the care process. The study illustrates positive steps forward being taken in making abortion safe and preventing and reducing unsafe abortion practices in Cambodia. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Requero Ibáñez, José Luís
The article focuses on the different factors and circumstances that have led to the reform of Spanish Abortion Law (1985). Judicial investigations of several abortion clinics have demonstrated that up until today there has been a widespread tendency of the clinics to practice beyond the limits established by the law. Nonetheless, the reaction of the government has not been to protect the life of the unborn. Its reaction has been, however, to cover the irregularities committed by the abortionists through the legalization of their abusive practices. Besides, the reform of the law has been inspired by elements of radical feminism. The author points out the major reasons that make this reform unconstitutional and offers alternative solutions for the protection of the mother and the unborn child.
Canário, Catarina; Figueiredo, Bárbara; Ricou, Miguel
Pregnancy interruption before fetal viability limit is inherent to a multidisciplinary reflection, due to the conflicts involved. Portuguese laws have been altered along time in the way of women's health protection, allowing the needed information and support towards a free, informed and enlightened decision. Deontological determinants about health professionals towards abortion indicate the practice accordingly the law. Nevertheless, it is safeguarded their right to consciousness objection. Ethical discussion about abortion, in its different ways, includes the concern about the value of intrauterine human life, and also the respect for individual autonomy. Even though the debate about intrauterine human life moral status is viewed from different theories and points of view, it is concluded that different perspectives about this matter are acceptable, in an interpersonal diversity valorization point of view.
de Weiss, S P; David, H P
An exploratory study of the perceptions of 156 abortion clients in Mexico suggests that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. "Too young" was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on average, equivalent to three to four weeks minimum wage; physicians' charges were about three times higher than those of nonphysicians.
Graduate Medical Education has directed obstetrical residents should be taught how to perform abortions, unless they have a moral or religious objection...of Violence Act 2004,” below.) Proponents note that such language would recognize the victimization of the child while in utero and afford...Victims of Violence Act of 2004 (Laci and Conner’s Law)” into law.81 Although intended to protect fetuses, this legislation contains a provision that
Full Text Available Abortion is still a very popular and controversial topic in recent years. Many esteemed people in our country have confessed to abortion. The changes that had taken place through the amendment of the anti-abortion law  contributed to the confession of famous personalities . Most of them show that it was not wrong. Most of the confessions of women who have made abortions come down to one sad conclusion: it is a decision that can not be reversed or changed. This decision imprints not only on the woman who takes her but also on the whole society. Especially since there is a solution for mothers who do not feel good to raise their child. There is even a window of life . They usually work in children's homes, monasteries or hospitals. They allow anonymous leave of a child in a place that is safe for him or her. Children go to adoption and their parents are not sought. In almost allEuropethere are "windows of life". The United Nations Committee on the Rights of the Child, appealed for the elimination of "windows of life", the idea of which violates the child's right to identity and is not in accordance with the Convention on the Rights of the Child. The Committee expressed "deep concern over the lack of regulation and the increasing number of baby windows that allow for anonymous abandonment of the baby." Thus, another dilemma arises between the right to identity and the right to life. He recommends "anonymous birth" in hospitals. This is a procedure used inter alia inGermany. During childbirth, the mother remains anonymous, although her data is kept in a designated office. The child is 16 years old, if he wants to know her identity. [29
Every year in France, almost 210 000 women request a termination of an unwanted pregnancy. Two thirds of them were however using a form of contraception, hence the importance, for caregivers, of encouraging women to find the method which works best for them. The right to abortion is the fruit of a long fight for a woman's right to control her own body. It is a right which must be protected. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
?akmak, B?lent; Metin, Fulya Zeynep; ?zsoy, Asker Zeki; ??t?l, R?za; ?nder, Yal??n; Y?lmaz Do?ru, Hatice
Objective: The aim of this study was to investigate the opinions of women who presented to the hospital for elective abortion. Materials and Methods: This descriptive study was designed and conducted at our university hospital between March 2013-April 2013 by the method of face-to-face interviews with 500 women who presented to the hospital as patient or relatives of patients. Poll consisted of 6 questions about demographic characteristics and 14 questions evaluating the opinions and attitude...
N. Vega Mata
Full Text Available Some infantile hemangiomas called in literature “minimal or arrested growth hemangiomas” or “abortive hemangiomas” are present at birth and have a proliferative component equaling less than 25% of its total surface area. Often, they are mistaken for vascular malformation. We present five patients (three girls and two boys with abortive hemangiomas diagnosed between January 2010 and December 2015 localized in acral part of the extremities. They were congenital lesions resembling precursor of hemangiomas but did not show proliferation phase. Immunohistochemical Glut-1 was performed in all of them as a way to confirm the abortive hemangioma diagnosis. The most common appearance was a reticulated erythematous patch with multiple fine telangiectasias on the surface. We remark that one of them presented a segmental patch with two different morphologies and evolutions. The proximal part showed pebbled patches of bright-red hemangioma and presented proliferation and the distal part with a reticulated network-like telangiectasia morphology remained unchanged. We detected lower half of the body preference and dorsal region involvement preference without ventral involvement. The ulceration occurred in three patients with two different degrees of severity.
DREES, A.; FLILLER, R.III.; FU, W.; MICHNOFF, R.
Since the RHIC Au-Au run in the year 2001 the 200 MHz cavity system was used at storage and a 28 MHz system during injection and acceleration. The rebucketing procedure potentially causes a higher debunching rate of heavy ion beams in addition to amplifying debunching due to other mechanisms. At the end of a four hour store, debunched beam can easily account for more than 50% of the total beam intensity. This effect is even stronger with the achieved high intensities of the RHIC Au-Au run in 2004. A beam abort at the presence of a lot of debunched beam bears the risk of magnet quenching and experimental detector damage due to uncontrolled beam losses. Thus it is desirable to avoid any accumulation of debunched beam from the beginning of each store, in particular to anticipate cases of unscheduled beam aborts due to a system failure. A combination of a fast transverse kickers and the new 2-stage copper collimator system are used to clean the abort gap continuously throughout the store with a repetition rate of 1 Hz. This report gives. an overview of the new gap cleaning procedure and the achieved performance
Plaisier, M.; Dennert, I.; Rost, E.; Koolwijk, P.; Hinsbergh, V.W.M. van; Helmerhorst, F.M.
BACKGROUND : Decidual vascular development is important for implantation. This study analysed decidual vascular adaptation to implantation in correlation with miscarriage in decidual secretory endometrium (DSE), decidua parietalis (DP) and decidua basalis (DB) of miscarriage patients and matched
Nielsen, Stine Yde; Hjøllund, Niels Henrik Ingvar; Andersen, Anne-Marie Nybo
Q fever is a bacterial zoonosis caused by infection with Coxiella burnetii. It is well established that Q fever causes fetal loss in small ruminants. The suspicion has been raised that pregnant women may also experience adverse pregnancy outcome when the infection is acquired or reactivated during...