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[Results with laparoscopic tubal sterilization (author's transl)].

1245 laparoscopic tubal sterilizations were performed at the University Department of Obstetrics and Gynaecology in Graz over a period of six years. The "single-puncture technique" was used. Up to November 1979 coagulation of the tubes was carried out by unipolar, and subsequently by bipolar high-frequency current. The indications were family limitation in 71.9% of cases and medical in 28.1% of cases. In most cases (70.8%) the procedure was carried out as interval sterilization. Simultaneous abortion by vacuum aspiration was performed in 28.8% of patients. The average age of patients was 33.9% years. 85.2% of women had two or more living children. Intraoperative complications occurred in 2.3% of cases. The pregnancy rate was 0.49%. The indications and the operative technique are described in detail and discussed.

Austria↗

Pregnancy risk following laparoscopic sterilization in nongravid and gravid women.

A multicenter data set was analyzed to compare incidences of poststerilization pregnancies between women who were not pregnant and those who were pregnant at admission of laparoscopic sterilization. The 12-month life-table poststerilization pregnancy rate was 6.0 per 1,000 procedures for the 7,696 nongravid and 32.8 for the 1,703 gravid women, for a fivefold difference. The crude pregnancy rates were consistently higher for the gravid women when data were classified by tubal occlusion technique and by patients' sociodemographic characteristics. The difference in pregnancy rates between the two groups was reduced to 2.4-fold when analysis was limited to data sets from centers that admitted both groups of women and that performed sterilization by the same technique. Results of this analysis support previous studies suggesting that gravid women, especially postpartum patients, carry a higher pregnancy risk following sterilization.

Female↗

[A comparison of the psychosocial status of 125 abortion patients before and after the termination of pregnancy].

We described in a former study (Volume 3, 1982) the cases of 228 abortion patients, their psychosocial data and the conflicts from which the unwanted pregnancies, which are interrupted, arise. A follow-up study took place 18 to 24 months after the abortion. The crucial point of the follow-up investigation was the development of the relationship, newly wanted or unwanted pregnancies, the practice of contraception, the psychological coming to terms with the abortion as well as the re-evaluation of the conflict situations described in the earlier study. With these results we tried to understand the consequences of an abortion and to determine important parameters for the obligatory consultation prior to the abortion.

Abortion, Induced↗

[Abortion or contraception (author's transl)].

The period immediately following an abortion, spontaneous or induced, has been considered favourable to the initiation of high efficicy contraception: sterilization, oral contraceptives, or intrauterine devices. The rate of post-abortal complications associated with these contraceptive methods was evaluated using data drawn from published and unpublished studies. The following conclusions were reached: sterilization is advisable only for women who do not desire additional children, and is obviously not recommended for young nulliparous women. The effective use of oral contraceptives requires a high motivational level and is therefore advisable only in cases where such motivation exists. The insertion of an intrauterine device seems to be the most adequate contraceptive method for women with low motivational level.

Abortion, Spontaneous↗

Post-abortion family planning.

In many countries, reproductive health services do not actively include post-abortion family planning services for women who are treated for complications of unsafe abortion. This greatly increases the risk of further unintended pregnancies and unsafe abortions. The authors, drawing on the recommendations of a meeting of experts, make a plea for bridging the gap and dealing more realistically with this urgent need.

Abortion, Therapeutic↗