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H K Atrash

Publications and source records attributed to H K Atrash.

72 records · Page 4Linked to original sources
PubMed1987

Ectopic pregnancy mortality in the United States, 1970-1983.

Ectopic pregnancy is now the second leading cause of maternal mortality in the United States. We describe changes in ectopic pregnancy mortality and characterize the risk of death from ectopic pregnancy for different groups, using ectopic pregnancy deaths identified by the national Vital Statistics System for 1970-1983, ectopic pregnancy-related deaths investigated by the Centers for Disease Control for 1979-1982, and ectopic pregnancy cases estimated from the National Hospital Discharge Survey for 1970-1983. During both 1970-1976 and 1977-1983, women of black and other races were at significantly increased risk of death from ectopic pregnancy compared with white women. This increased risk held for all ages and all geographic regions. Little variation existed in the risk of death from ectopic pregnancy by age and geographic region. From 1970-1983, the risk of death from ectopic pregnancy declined among all races and ages in all regions. These data suggest that black women, and in particular teenagers and older women, may have inadequate access to gynecologic and prenatal services. Active outreach may reduce the risk of death from ectopic pregnancy.

Adolescent↗
PubMed1987

Abdominal pregnancy in the United States: frequency and maternal mortality.

From an analysis of 11 abdominal pregnancy-related deaths and an estimated 5221 abdominal pregnancies in the United States, we estimated that there were 10.9 abdominal pregnancies per 100,000 live births and 9.2 per 1000 ectopic pregnancies; the mortality rate was 5.1 per 1000 cases. Although the risk of having an ectopic pregnancy is rising, the risk of abdominal pregnancy, which is probably always a sequel of a missed ruptured ectopic pregnancy, is apparently declining; this may be due to improved prenatal care. However, only one of nine women who reached the hospital alive had an accurate preoperative diagnosis of abdominal pregnancy, which suggests that preventing abdominal pregnancy-related death may depend, at least in part, upon increasing physicians' awareness of its clinical features.

Adult↗
PubMed1986

Epidemiology of hydatidiform mole during early gestation.

Different methodologic approaches have resulted in a wide variability in the reported incidence of hydatidiform mole in the United States. We studied the epidemiology of hydatidiform mole among 84,318 women obtaining legal abortions in the United States during the period 1975 to 1978. Our estimated rate of 7.5 hydatidiform moles per 10,000 pregnancies was similar to most reported rates for the United States. The rate was significantly higher for women 14 years or younger and those 45 years or older. Race, number of previous pregnancies, and number of previous spontaneous abortions were not found to significantly affect the risk of having the disease. The incidence was slightly (but not significantly) higher for women obtaining abortions during the first trimester than for those obtaining abortions during later gestation. This study minimizes the errors encountered in estimating the total number of pregnancies and the number of hydatidiform moles at later stages of gestation. Hydatidiform mole, although relatively the number of hydatidiform moles at later stages of gestation. Hydatidiform mole, although relatively uncommon, represents a complication of pregnancy that is of public health importance.

Abortion, Induced↗
PubMed1985

Seroepidemiology of rubella in Bahrain.

Although the Ministry of Health of the State of Bahrain has set priorities for vaccination against a number of communicable diseases including the six target diseases of the Expanded Program of Immunization, no such policy for rubella immunization exists. The incidence of rubella in Bahrain is not precisely known nor is the magnitude of the problem of Congenital Rubella Syndrome. A survey of schoolchildren and primigravidae attending antenatal clinics was undertaken in Bahrain to determine the level of natural immunity against rubella in these groups, which we hope would help us in formulating a vaccination policy. We have found that 67.8% of the 6-7 year old children are susceptible to rubella and that by the age of 18 years susceptibility drops to 10.4%. The decrease in susceptibility was significant until the age of 14 years after which the change became minimal. Efforts should ideally be focused on immunizing all susceptible females before they get married. However, at present, it would be more economical to vaccinate all girls premaritally than to screen and vaccinate those susceptible. When a cheaper screening test for assessing immunity against rubella becomes available, a policy of premarital and post-partum screening followed by vaccination of susceptibles should be put into practice.

Adolescent↗
PubMed1982

The risk of death from combined abortion-sterilization procedures: can hysterotomy or hysterectomy be justified?

Clinicians have debated whether women who request permanent sterilization when they undergo elective abortion should have the two operations done concurrently. Moreover, if the procedures are performed concurrently, the appropriate surgical approach is unknown. To evaluate the latter issue, we identified all concurrent abortion-sterilization deaths in the United States in the period 1972 to 1978 from the Centers for Disease Control's nationwide surveillance of abortion mortality and divided them into two groups: those who had hysterotomy with tubal ligation or hysterectomy (H/H) and those who had curettage or instillation procedures, with tubal ligation by laparoscopy or laparotomy (other procedures). We then used data from the Joint Program for the Study of Abortion (JPSA/CDC) to estimate the number of procedures done in the United States in the period 1972 to 1978 and calculated death-to-case rates for each group. We found that the risk of dying from a concurrent abortion-sterilization procedure was 3.3 times higher if done by H/H. The relative risk for this group was highest during the first 12 weeks of gestation (4.6) and lowest at 13 weeks or later (1.3), regardless of the presence or absence of preexisting medical conditions. Except in the rare instances where the woman has an indication for hysterectomy other than fertility control, the performance of hysterectomy or hysterectomy for concurrent abortion-sterilization, particularly at less than 13 weeks' gestation, does not appear justified.

Abortion, Therapeutic↗
PubMed1982

Family planning and abortion: have they affected fertility in Tennessee?

In Tennessee between 1975 and 1978, birth rates among teenagers decreased while they increased among older age groups. This trend was unlike previous years and coincided temporally with the increased availability of legal abortion services in Tennessee and the special efforts to prevent unwanted pregnancies among teenagers. Increased use of family planning services was significantly associated with the drop in the fertility rate for Black teenagers; legal abortion use was significantly associated with the change in the fertility rate for Black females aged 20 years or older.

Abortion, Legal↗
PubMedDate not supplied

Birthweight-specific infant mortality risk in cesarean section.

The role of cesarean section in improving infant survival has not been clearly documented. We calculated birthweight- and race-specific infant, neonatal, and postneonatal mortality risks by method of delivery for single- and multiple-delivery infants, using data from 14 states, reported to the Centers for Disease Control through the 1980 National Infant Mortality Surveillance project. For single-delivery infants, the risk of death for infants delivered by cesarean section was 1.6 times higher than for infants delivered vaginally among blacks and 1.2 times higher among whites. The risk was 1.7 times higher during the neonatal period and 1.2 times higher during the postneonatal period. For infants with birthweight less than 1,000 grams, the risk of death was lower when infants were delivered by cesarean section. The risk of death among multiple-delivery infants born by cesarean section was significantly lower than for those born vaginally. This analysis demonstrates that, unlike other birthweight categories, infants with a very low birthweight may have better outcomes if delivered by cesarean section. However, we cannot recommend the routine use of cesarean section for delivering very low birthweight infants. Further studies are needed to determine survival of such infants after controlling for maternal and infant conditions that prompted delivery by cesarean section.

Black or African American↗