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PubMed1997

[Occurrence of bacterial vaginosis among abortion seekers].

Bacterial vaginosis is the most common vaginal infection during the fertile period. The clinical diagnosis is based on three of Amsel's four criteria: thin, grey-white discharge, vaginal fluid pH above 4.5, a fishy odour on addition of 10% potassium hydroxide solution to the vaginal fluid, and the presence of clue cells on a saline wet mount. A probably more sensitive indicator of the diagnosis is based on Gram-stain, where the normal lactobacillus-dominated vaginal flora is changed to the lactobacillus deficient flora of bacterial vaginosis. The condition is probably associated with higher risk of complications in connection with pregnancy and gynaecological surgery. A prospective study of bacterial vaginosis based on microscopy of Gram-stained smears was conducted among 168 women applying for first trimester abortion. The prevalence of bacterial vaginosis was 24% and of Chlamydia trachomatis 8.4%. Four patients (10.3%) in the vaginosis group were treated with antibiotics for certain or suspected postabortal endometritis, as against six patients (5.4%) in the group without bacterial vaginosis.

Abortion Applicants↗
PubMed1977

[Morbidity and mortality due to infection in the obstetrico-gynecological field].

The following conclusions were derived from the data on obstetric and gynaecological and urologic morbidity and mortality caused by infection:--A law enacted in 1972, legalising abortion within the first twelve weeks of gestation, changed the proportion of legally induced abortions to all other types of abortion. As the law largely prevents illegally induced abortion, substantial decreases occured in the number of cases of postabortal sepsis and in the mortality from abortion.--In spite of a steady decline, pueral sepsis still accounts for a significant proportion of the maternal mortality. It occurred predominantly after Caesarean section.--Despite its relatively low current morbidity rate, the possible effect of puerperal mastitis should not be neglected.--The high incidence of urinary tract infections calls for wellbalanced, but effective preventive, diagnostic and therapeutic action.

Abortion, Induced↗
PubMed1997

Abortion in the framework of family planning in Estonia.

OBJECTIVE: To analyze the legal status of abortion and trends in childbirth, abortions and contraceptive use in Estonia. DESIGN: National statistical data on induced abortions, spontaneous abortions, births and contraceptive use in Estonia. RESULTS: Even though induced abortion is legal in Estonia, the abortion rate has been declining but is still high and in 1994 was 53.8 per 1000 women of fertile age. Among young women under 20 years of age, abortions decreased slightly in the period 1992-94 (from 55.5 to 41.5 per 1000). The birth rate has been declining rapidly in recent years, resulting in a net population reduction. The use of modern contraceptives is increasing but is still low. CONCLUSION: Survey on abortion and on contraceptive sales and use are needed. To improve family planning and prevent unwanted pregnancies it is important to increase awareness among the entire population--and especially among young people--by information, education and communication. A high standard of counseling, including pre- and postabortion counseling and in the youth services, is essential.

Abortion, Induced↗
PubMed1997

Genital mycoplasma infections.

Since 1937, 13 Mycoplasma species, two Acholeplasma species, and one Ureaplasma species have been isolated from humans. Six of these have the urogenital tract as the primary site of colonisation but others, which have the oropharynx and respiratory tract as the primary site, are found occasionally in the urogenital tract because of orogenital contact. Mycoplasma hominis was the first to be isolated and is most strongly associated with bacterial vaginosis (BV), together with a variety of other bacteria. Its involvement in pelvic inflammatory disease (PID) and other conditions may be as part of BV, although when isolated in pure culture from the blood of women who have postpartum or postabortal fever there is no reason to suspect its aetiological role. There is evidence for an aetiological role for Ureaplasma urealyticum organisms (ureaplasmas) in acute non-gonococcal urethritis (NGU) and particularly chronic NGU in men, but they rank third to Chlamydia trachomatis and M. genitalium. Whether the association of ureaplasmas with miscarriage and preterm labour is in the context of BV is not clear. Of no doubt, however, is the ability of ureaplasmas to cause septic arthritis in hypogammaglobulinaemic patients and there is evidence that they may cause some cases of sexually acquired reactive arthritis. The advent of polymerase chain reaction technology has seen an advance in the understanding of the role of M. genitalium; there is strong evidence that it is one of the causes of both acute and chronic NGU independent of C. trachomatis. There is some support for the role of M. genitalium in PID, but this needs to be substantiated. Other mycoplasmas, for example M. fermentans, M. pivum, M. primatum, M. penetrans, M. spermatophilum and even M. pneumoniae have the capacity to cause urogenital tract disease but there is no evidence to indicate that they do so.

Acholeplasma↗
PubMed1998

Prenatal sonographic diagnosis of nasal malformations.

The aim of this study was to describe the prenatal detection of fetal nasal abnormalities by ultrasound. Transvaginal and transabdominal sonography was used for the detection of fetal malformations in 25, 114 cases. The fetal nose was visualized in all the fetuses in an oblique section and in the lateral profile of the face. Fifteen cases of fetal nasal malformations were detected between the 12th and 27th week of gestation. All but two, who had dilatation and curettage, were confirmed by postabortal or postnatal examination. Dyskaryosis (trisomies 18 and 21, triploidy, and tetrasomy 12 p) was diagnosed in six cases (40 per cent). The nasal malformations were isolated in four cases, one of them being associated with tetrasomy 12 p. The fetal nose should also be a target in the prenatal sonographic screening for malformations in the early mid-trimester. The incidence of fetal nasal anomalies is 1:1674 fetuses (15:25, 114). The fetal nose should be visualized by ultrasound in both an oblique plane and a lateral profile to identify its abnormalities.

Adult↗
PubMed1976

Intrauterine extra-amniotic 15(s)-15-methyl prostaglandin f2 alpha for induction of early midtrimester abortion.

Twenty-six patients 13 to 15 weeks pregnant received extraovular 15(S)-15-methyl prostaglandin F2 alpha in a dosage of 1 mg every 18 to 24 hours for three doses. Twenty-five (96%) of the patients aborted; fifteen patients aborted incompletely. The mean induction-to-abortion time was 15.8 hours. A decrease in plasma progesterone levels could not be consistently correlated with abortifacient activity, and there was no statistically significant relationship between abortion time and parity or gestational age. One patient failed to abort after 36 hours of therapy and was aborted by curettage. She was the only patient who developed a postabortion uterine infection. Results with the extraovular technique appear to be similar to those with the intra-amniotic and the intramuscular prostaglandin techniques. Therefore, extraovular administration may be useful for inducing abortion in patients who are in the early midtrimester of pregnancy.

Abortion, Induced↗
PubMed1989

Abortion counseling: to benefit maternal health.

This Note examines how both the law and the health care profession neglect women's needs for abortion counseling before, during and after an abortion. Part I analyzes the health care profession's view of counseling, the psychological effects of abortion and how counseling both positively and negatively influences those effects. Part II reviews Supreme Court cases and state law regarding abortion counseling, critizing both the Court's narrow view of counseling and the states' failure to use the legislative process to create laws which benefit maternal health. Part III recommends an expanded role for abortion counseling, in which the counselor can provide emotional support from before the day of an abortion until a woman emotionally recovers from an abortion. This expanded role would be state-mandated, but would remain within constitutional boundaries by providing flexibility for counselors to give individual treatment while respecting a woman's privacy.

Abortion, Induced↗
PubMed1992

The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality.

A retrospective study to investigate the psychosocial sequelae of a second-trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described. After appropriate consent was obtained, 84 women and 68 spouses were visited 2 years after the event and asked to complete an extensive questionnaire. Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP. In the same period, there was increased marital disharmony in which 12 per cent of the couples separated for a while and one couple obtained a divorce. These problems could be attributed to a lack of synchrony in the grieving process. Confusing and conflicting feelings led to social isolation and lack of communication. Difficulties in coming to terms with the fetal loss were not found to be linked to the type of fetal abnormality or religious beliefs but were related to parental immaturity, inability to communicate needs, a deep-rooted lack of self-esteem before the pregnancy, lack of supporting relationships, and secondary infertility. Suggestions for improved management are given.

Abortion, Therapeutic↗
PubMed1985

IUD insertion following induced abortion.

In a multicenter survey, women who received an IUD immediately after abortion were compared with abortion patients who started using oral contraception. Additionally, women receiving a Nova T were compared with women receiving a Multiload 250. Follow-up data were gathered after 6 weeks. Pain was a common phenomenon post-abortum. In the study group of IUD users, complaints about pain were not more frequent than among controls, but if pain was experienced, it was more intense and of longer duration among IUD users. Bleeding immediately following the induced abortion was less frequent among IUD users, but if bleeding occurred, it tended to last longer. The first menstrual period after the induced abortion was heavier and more painful among IUD users. Expulsion of the IUD occurred in 10 cases (3.3%), all of them with the Nova T, none with Multiload. The study did not generate evidence for an increased risk of PID in women receiving an IUD after an induced abortion.

Abortion, Induced↗