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W Cates

Publications and source records attributed to W Cates.

At least 127 records · Page 7Linked to original sources
PubMed1981

Fatal septic abortion in the United States, 1975-1977.

In 1975 through 1977, 36 women in the United States died of septic abortion (12 legal, 15 spontaneous, 8 illegal, and 1 unclassified). The respective estimated death-to-case rates for septic abortion are 0.4 and 0.6 deaths per 100,000 legal and spontaneous abortions. Unmarried teenagers who undergo incomplete abortion at 16 weeks' gestation or more by intrauterine placement of a foreign body appear to have the highest risk of death from infection after legal abortion. Three of these risk factors (gestational age at the time of abortion, method, and completeness of abortion) can be influenced by medical personnel. Complete abortion by safe techniques early in pregnancy can help eliminate deaths from infection after legal abortion.

Abortion, Incomplete↗
PubMed1981

Deaths from second trimester abortion by dilatation and evacuation: causes, prevention, facilities.

In 1978, dilatation and evacuation (D & E) became the leading method of abortion at 13 weeks' gestation or later in the United States. The increasing popularity of D & E reflects its relative advantages in safety, convenience, expense, and speed when compared with alternate methods. The authors reviewed all reported deaths from D & E in the United States between January 1, 1972, and December 31, 1978. The predominant causes of death were infection and hemorrhage. both race and gestational age significantly influence the death:case rate for D & E procedures. White women had a threefold lower risk of dying from D & E than women of other races. D & E procedures performed at 13 to 15 weeks' gestation were nearly 3 times safer than those performed at 16 weeks or later. D & E performed in nonhospital settings did not have higher death:case rates than those performed in hospitals. Comparative mortality data suggest abortion by D & E at 13 weeks' gestation or later is more dangerous than suction curettage performed earlier in gestation, but safer than instillation techniques performed later. The advantage of D & E occurs largely in the 13- to 15-week gestation interval, that is, at the beginning of the second trimester. Policy makers should reconsider laws requiring all second trimester abortions to be performed in hospitals. Based on these data, 16 weeks' gestation would be more appropriate threshold at present.

Abortion, Induced↗
PubMed1981

Behavioral factors contributing to abortion deaths: a new approach to mortality studies.

One hundred six women were reported to have died from abortions (55 legal, 10 illegal, and 41 spontaneous) in the United States from 1975 through 1977. In reviewing these deaths, the authors developed a new approach to mortality studies. A catalogue was compiled of behavioral factors (including actions by physicians, patients, communities, and institutions) that in the authors' judgment increased the risk of death from abortion. The proportion of abortion deaths to which each behavioral risk factor contributed was determined. Of the 199 different behavioral factors, 5 contributed to more than 10% of legal abortion deaths, 5 to more than 10% of illegal abortion deaths, and 3 to more than 10% of spontaneous abortion deaths. The most frequent factors involved were delay in obtaining a legal abortion until 13 weeks' gestation or later, incomplete abortion, and inappropriate choice of antibiotics for septic abortion. Assessing the proportion of abortion deaths to which each factor contributed can help identify which factors deserve priority in prevention.

Abortion, Legal↗
PubMed1980

Fatal ectopic pregnancy after attempted legally induced abortion.

From 1973 through 1978, the Center for Disease Control identified ten deaths caused by ruptured ectopic pregnancy after attempted legal abortions for those pregnancies. The women ranged in age from 18 to 31 years, seven were black, three were white, and five were nulliparous. The estimated gestational age was 16 menstrual weeks or earlier. In seven cases tissue obtained at abortion was sent for outside microscopic pathological examination; attempts to contact four of the patients when no products of conception were found were unsuccessful. An important factor in preventing fatal ectopic pregnancy for women who have legal abortions is the identification of products of conception at the time of the abortion procedure while the patient is still available for reexamination and recurretage.

Abortion, Legal↗
PubMed1980

Rapid assessment of health status and preventive-medicine needs of newly arrived Kampuchean refugees, Sa Kaeo, Thailand.

In the disaster relief programme for Kampuchean refugees in Thailand, epidemiological techniques were incorporated into the health-planning process during the first 2 weeks of the refugee influx. The findings influenced not only health care in the first refugee camp but also the delivery of medical services in subsequent camps. The mortality rate in the first week of refugee settlement was 9.1/10 000/day, and fell to 0.71/10 000/day by the fifth week. Children aged 4 and under had the highest risk of death. Fever/malaria was the main cause of morbidity and mortality. Simple epidemiological techniques, if initiated early in the relief effort, can influence medical decisions and lead to more effective use of health resources.

Adolescent↗
PubMed1980

Oxytocin augmentation of second-trimester abortion: safe or hazardous?

The role of oxytocin in augmenting the uterine activity of second-trimester instillation abortions is controversial. To evaluate the efficacy and safety of oxytocin augmentation, we studied 10,013 women who underwent hypertonic saline instillation procedures and 1,241 women who underwent prostaglandin F2a (PGF2a) instillation procedures in the United States in the period 1971 through 1975. Data were obtained through the Joint Program for the Study of Abortion under the auspices of the Center for Disease Control, a multi-center, prospective, cohort study. We found that concurrent administration of oxytocin was associated with a significantly shorter instillation-to-abortion time for hypertonic saline, but with a significantly longer time for PGF2a. For hypertonic saline, use of concurrent oxytocin did not affect either the success rate or the major complication rate; however, it did not affect the specific type of complication that occurred. For PGF2a, use of concurrent oxytocin was associated with a lower success rate and a higher major complication rate than when PGF2a was used alone; however, the relatively small number of observations and limitations in our study design may have affected our results. When we compared the 2 main abortifacients, even when we controlled for concurrent oxytocin augmentation, unaugmented PGF2a had higher major complication rates than hypertonic saline.

Abortion, Induced↗
PubMed1980

Adolescent abortions in the United States.

Despite the fact that adolescent females have a more negative reaction to abortion than older women, they are apparently more likely to use legal abortion to prevent unplanned births. The most important variable affecting abortions among teenagers is the significantly later gestational age at which their procedures are performed. After adjusting for this factor, teenagers have generally lower morbidity and mortality rates from legally induced abortions than do older women. The scientific literature is inconclusive about whether present abortion methods will have any harmful effect on subsequent desired pregnancies. Current efforts to restrict abortion services for teenagers will probably produce a negative public health impact by encouraging delay in obtaining abortions after deciding to terminate a pregnancy.

Abortion, Induced↗
PubMed1980

Fatal myocarditis associated with abortion in early pregnancy.

Primary myocardial disease in early pregnancy is a rare phenomenon. We describe four abortion-related deaths in the United States from 1975 through 1978 which were attributed at postmortem examination to myocarditis in the first trimester of pregnancy. Three of the four deaths were associated with conditions which have a presumed immunologic mechanism.

Abortion, Induced↗
PubMed1980

A cluster of septic complications associated with illegal induced abortions.

Between August 7 and October 14, 1977, Clostridium perfringens organisms were isolated from endometrial and/or blood specimens from 3 women who had been hospitalized in McAllen, Texas, after having had illegal induced abortions. One of the women died of clostridial septicemia. A single abortionist was suspected in these 3 cases. The authors investigated the illnesses of these 3 women and those of 6 other women who were hospitalized at some time from January through October 1977 after having had illegal abortions but did not identify a common abortionist. The patient who died was a Medicaid-eligible woman who had had an abortion performed by a nonphysician after public funding of abortion was restricted in Texas as of August 5, 1977. The authors examined the medical records of all 230 women hospitalized in McAllen General Hospital with abortion complications from 1977 through January 1978. The local effect of restriction of public funds for abortion was to be studied. The incidence of women admitted to the hospital with febrile abortion complications after August 5, 1977, did not differ from that of women admitted from January 1 through August 4, 1977. However, the incidence of hospitalization of Medicaid-eligible women with abortion-related complications was greater after August 5 than it was in the earlier period.

Abortion, Illegal↗
PubMed1979

Local versus general anesthesia: which is safer for performing suction curettage abortions?

The relative safety of suction curettage abortions performed with either local or general anesthesia has not been clearly established. To compare the safety of these two anesthetic techniques, we studied 36,430 women who received local anesthetics and 17,725 who received general anesthetics for this operation in the United States from 1971 through 1975. The aggregated major complication rates for the two groups were similar, but there were significant differences between local and general anesthesia for specific complications and treatments. Local anesthesia was associated with higher rates of febrile and convulsive morbidity; however, general anesthesia was associated with higher rates of hemorrhage, cervical injury, and uterine perforation. Both anesthetic techniques appear to be safe, with similar degrees of overall safety, although each is associated with a different spectrum of complications.

Abdomen↗
PubMed1979

Sudden collapse and death of women obtaining abortions induced with prostaglandin F2alpha.

Two recent cases of sudden collapse and eventual death of the woman after induction of abortion with prostaglandin F2alpha (PGF2alpha) have been reported to the Center for Disease Control as part of the epidemiologic surveillance of deaths due to abortion. We present these cases in order to document this event associated with the use of PGF2alpha. The etiology of the sudden collapse is still unknown. Nonetheless, the deaths of these two healthy young women undergoing induced abortions with PGF2alpha should heighten clinicians' awareness of some possible risks associated with these new abortifacients.

Abortifacient Agents↗