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PubMed2004

Pregnancy-associated mortality after birth, spontaneous abortion, or induced abortion in Finland, 1987-2000.

OBJECTIVE: To test the hypothesis that pregnant and recently pregnant women enjoy a "healthy pregnant women effect," we compared the all natural cause mortality rates for women who were pregnant or within 1 year of pregnancy termination with all other women of reproductive age. STUDY DESIGN: This is a population-based, retrospective cohort study from Finland for a 14-year period, 1987 to 2000. Information on all deaths of women aged 15 to 49 years in Finland (n=15,823) was received from the Cause-of-Death Register and linked to the Medical Birth Register (n=865,988 live births and stillbirths), the Register on Induced Abortions (n=156,789 induced abortions), and the Hospital Discharge Register (n=118,490 spontaneous abortions) to identify pregnancy-associated deaths (n=419). RESULTS: The age-adjusted mortality rate for women during pregnancy and within 1 year of pregnancy termination was 36.7 deaths per 100,000 pregnancies, which was significantly lower than the mortality rate among nonpregnant women, 57.0 per 100,000 person-years (relative risk [RR] 0.64, 95% CI 0.58-0.71). The mortality was lower after a birth (28.2/100,000) than after a spontaneous (51.9/100,000) or induced abortion (83.1/100,000). We observed a significant increase in the risk of death from cerebrovascular diseases after delivery among women aged 15 to 24 years (RR 4.08, 95% CI 1.58-10.55). CONCLUSION: Our study supports the healthy pregnant woman effect for all pregnancies, including those not ending in births.

Abortion, Induced↗
PubMed2004

[Induced abortion: women's free choice or impossibility of choice? Higher frequency of induced abortions among immigrant women in Sweden compared to native Swedish women].

During one year all women attending one of Sweden's largest clinics for induced abortion were interviewed. Out of 1,289 interviewed women 36 % (468) were born abroad, compared to 29% of women in corresponding ages in the local communities. The immigrant women had less experience of contraceptive methods, more born children and reported the partner relationship to be the reason for abortion more frequently than native Swedish women. Immigrant status was seen as independent risk factor for repeated induced abortion. In order to reduce the number of induced abortions it is necessary to increase family planning resources to immigrant women.

Abortion Applicants↗
PubMed1990

[Pathologico-anatomic findings in spontaneous abortion and induced abortion during the 2nd pregnancy trimester].

Reported in this paper are results obtained from morphological investigations of 200 fetal abortions which had occurred in the fourth to sixth months of pregnancy. They were spontaneous abortions and abortions induced primarily for fetal indications (31 cases). Causes are subdivided in this report by placental, fetal, and maternal factors. Fetal causes accounted for 18.5% of all cases (most of them fetal malformations, induced abortions included). Maternal causes accounted for 7.5%, among them edema-proteinuria-hypertension (EPH) gestosis and premature rupture of the amnion. No unambiguous clinical or morphological findings were established as causes in 36 cases, i.e. 18%. The majority of all causes, 55.5% was related to placental factors, among them impaired maturation of the placenta in 14.5%, disorders in maternal circulation in 17%, and inflammatory alterations in 23.5%. Early disorders in placentation accounted for a conspicuously high number of after-birth findings (complex early impairment of placental maturation in 28.6%), and so did maternal circulatory disorders, including retroplacental hemorrhage (55.2%), as well as decidual and membranous inflammations (43.4%).

Abortion, Induced↗
PubMedDate not supplied

[Coping behavior in women with miscarriage or spontaneous abortion and recurrent spontaneous abortion].

In a pilot study about medical, psychological and psychosocial factors in spontaneous and recurrent spontaneous abortions, coping strategies of 83 women were investigated and compared with a control group (n = 69). Two further subgroups were selected (31 women with recurrent spontaneous abortions and 30 without pregnancy complications). A modified form of a stress-investigation-scale (SVF from Janke et al.) was used. The results indicated that women with spontaneous abortions had increased depressive and lowered positive and cognitive coping modes. According to the hypothesis most psychological disturbances and depressive coping strategies were found in recurrent spontaneous abortions. In pregnancy depressive withdrawal, need of social support and information seeking was further increased, but emotional self-control lowered. A connection between psychological disturbances and negative coping strategies was shown. After pregnancy loss psychological support and building up positive and efficient coping strategies are therefore indicated.

Abortion, Habitual↗
PubMed1985

The incidence of major abdominal surgery after septic abortion--an indicator of complications due to illegal abortion.

That there is a high morbidity associated with illegal abortion is well known, but its exact extent is difficult to assess, since detailed statistics are not available and the nature of the morbidity is diffuse. We have assumed that abortal sepsis is a consequence of illegal interference with pregnancy. The incidence of major abdominal surgery after a septic abortion is used as an indicator of serious complications. This incidence is compared with that following legal abortion.

Abortion, Illegal↗
PubMed1977

Prostaglandins and abortion. I. intramuscular administration of 15-methyl prostaglandin F2alpha for induction of abortion in weeks 10 to 20 of pregnancy. World Health Organization Task Force on the Use of Prostaglandins for the Regulation of Fertility.

A multicenter, multinational study of intramuscular 15-methyl prostaglandin F2alpha in 515 patients is described. Abortion of the fetus occurred in 79.3 per cent (408 patients) after 24 hours and 84.9 per cent (437 patients) after 30 hours. The abortion was complete in 35 per cent. The incidence of vomiting and diarrhea was high, 2.9 and 2.8 episodes per patient, respectively. Three patients had cervical laceration (0.6 per cent). There were no other serious side effects. It is concluded that this method has limited value as a primary method for induction of abortion but may be of value to finalize the abortion process when another method has failed.

Abortion, Induced↗
PubMedDate not supplied

The bad old days: clandestine abortions among the poor in New York City before liberalization of the abortion law.

In surveys of poverty neighborhoods in New York City conducted in 1965 and 1967, it became apparent that clandestine abortions were more frequently reported as occurring when the woman was married and had one to three children than before marriage or after three children had already been born. Knowledge of persons who could induce an abortion was not very common among the women interviewed, and most of those who were known did not have any specialized medical training. Physicians were involved in only two percent of the respondents' own reported abortion attempts and in six percent of those among their friends, relatives and acquaintances. There was a fairly large variety of methods known and used that were supposed to provoke an abortion. The largest proportion of these were substances taken by mouth--some of which, like turpentine, Chlorox and massive doses of quinine, are quite dangerous. The next largest group involved uterine insertions. Other types of methods like massage and baths were quite rare. The popularity of the oral route of administration may be relevant to biomedical researchers who are developing new fertility regulating methods and are concerned about their acceptability.

Abortion, Illegal↗
PubMed2006

Provider practice models for and costs of delivering medication abortion -- evidence from 11 US abortion care settings.

PURPOSE: Understanding practice models and provider costs for medication abortion (MAB) provision may elucidate ways to facilitate MAB integration into a larger arena of health care services. This study provides descriptive data on the diverse MAB practice models currently being utilized by US health care providers and the costs associated with the components of those models. METHOD: Data were gathered from a sample of 11 abortion care settings, using clinic administrative records and patient satisfaction surveys. RESULTS: Practice models varied dramatically, with a wide range in the type of staff employed to provide MAB. The total episode cost for providing MAB ranged from 252 to 460 US Dollars, and patient satisfaction was high across all practices. CONCLUSION: Information from this study can be used to guide decisions regarding MAB integration into practices not currently providing abortion or which provide only aspiration abortions. The information may also be useful for providers wishing to refine their MAB services.

Abortifacient Agents, Steroidal↗
PubMed1997

Thyroid antibodies and their relation to antithrombin antibodies, anticardiolipin antibodies and lupus anticoagulant in women with recurrent spontaneous abortions (antithyroid, anticardiolipin and antithrombin autoantibodies and lupus anticoagulant in habitual aborters).

OBJECTIVE: This study was undertaken to evaluate the incidence of thyroid autoantibodies in women with a history of recurrent spontaneous abortions (RSA) and to investigate their relationship to non-organ specific autoantibodies. STUDY DESIGN: 28 euthyroid non-pregnant habitual aborters were analysed for thyreoglobulin (TG), thyroid peroxidase antibodies (TPO), and autoantibodies to thromboplastin, cardiolipin and lupus anticoagulant. 28 multigravidae without previous abortions or endocrine dysfunctions served as controls. RESULTS: 11 of 28 women with recurrent spontaneous miscarriage (39%), but only 2 of 28 controls (7%) (Chi square test: p < 0.01) demonstrated positive titres of TG, TPO, or both antibodies, 12 patients were positive for antithrombin antibodies and 3 for anticardiolipin. Only one women was lupus anticoagulant positive. No significant correlation between thyroid antibody positivity and positivity for antiphospholipids (Fisher's exact test: p = 0.441), anticardiolipin (p = 0.664) or lupus coagulant (p = 0.607) was found. CONCLUSIONS: The incidence of thyroid antibodies in euthyroid women with recurrent pregnancy loss appears to be significantly increased compared with controls of reproductive age without previous abortions. No correlation between the presence of thyroid autoantibodies and non-organ specific autoantibodies could be established.

Abortion, Habitual↗
PubMed1995

Placebo-controlled trial of treatment of unexplained secondary recurrent spontaneous abortions and recurrent late spontaneous abortions with i.v. immunoglobulin.

The aim of this trial was to investigate whether infusions of i.v. immunoglobulins (Ig) to women with secondary recurrent spontaneous abortions and recurrent second trimester spontaneous abortions can increase the rate of successful pregnancy. In a prospective, double-blind, placebo-controlled trial, infusions of i.v. Ig (Nordimmun) or placebo were given during pregnancy to 34 women with a history of either unexplained recurrent spontaneous abortion subsequent to a birth or including at least one second trimester miscarriage. The success rate was 52.9% in the i.v. Ig group compared with 29.4% in the placebo group (not significantly different, therapeutic gain 23.5%, 95% confidence interval -8.6 to 55.7%). No changes in autoantibody concentrations or major lymphocyte subsets were induced by i.v. Ig treatment. In conclusion, an expected 55% therapeutic gain of i.v. Ig in recurrent spontaneous abortion could not be confirmed using the treatment regimen tested. However, to determine whether the trend of therapeutic gain of i.v. Ig in these women may be statistically significant, a larger trial is in progress.

Abortion, Habitual↗
PubMed1975

Outpatient laparoscopic sterilization with therapeutic abortion versus abortion alone.

Records of 108 patients undergoing combined vacuum aspiration and laparoscopic sterilization in an outpatient surgical program were reviewed and compared with those of 195 patients who underwent abortion only in the same outpatient program. Mean operating time for the combined procedure was 30 minutes; total mean hospitalization time was 5 hours and 7 minutes. Complication rates for the combined procedure and for abortion alone were 9.2 and 7.2 per cent, respectively. Subsequent hospitalization was necessary for 4.7 per cent of patients undergoing the combined procedure and 3.1 per cent of those having abortion only. Laparoscopic sterilization has been found to add no significant morbidity but has markedly reduced cost and hospitalization for the patient desiring permanent contraception following first trimester abortion.

Abortion, Therapeutic↗
PubMed2001

High NK cell activity in early pregnancy correlates with subsequent abortion with normal chromosomes in women with recurrent abortion.

PROBLEM: The aim of this study was to assess the role of natural killer (NK) cells in pregnant women with a history of recurrent spontaneous abortion (RSA). METHOD OF STUDY: Consecutive 66 pregnant women with a history of RSA were prospectively assessed for peripheral NK cell activity, percentage of the NK cell subsets, and subsequent pregnancy outcome. RESULTS: NK cell activity in women with subsequent live birth (group I) at 4-5 gestational weeks (GW) (mean +/- SD, 32.5 +/- 12.31%) significantly decreased at 6-7 GW (28.1 +/- 12.1%) and at 8 9 GW (28.0 +/- 11.8%). NK cell activity in women with subsequent abortion with normal chromosomes (group II) at 6 7 GW (41.2 +/- 19.0%) was significantly higher than that in group I women, while NK cell activity at 6-7 GW in women with subsequent abortion with abnormal chromosomes (group III) was the same as the level in group I women. CONCLUSIONS: High NK cell activity at 6-7 GW correlates with subsequent abortion with normal chromosomes.

Abortion, Habitual↗
PubMed1982

Ovine enzootic abortion: the acquisition of infection and consequent abortion within a single lambing season.

The spread of enzootic abortion was observed in a flock of 37 unvaccinated Scottish blackface ewes, in mid-pregnancy at the start of the trial. Eight ewes were infected with the ZC 26 strain of chlamydia and allowed to run with 29 untreated controls until lambing was completed. All eight inoculated ewes aborted between 26 and 51 days after infection and chlamydial infection was demonstrated in seven of the abortions. Complement fixing antibodies were not detected in the controls until nine days after the first infected abortion, but within four weeks 69 per cent of the control ewes had developed significant complement fixation titres. Ten of the control ewes lost lambs, chlamydial infection was demonstrated in seven cases, two were undiagnosed and one was attributed to dystocia. The seven infected cases occurred between 69 and 87 days after the start of the trial and coincided with a further rise in the percentage of seropositive controls to a maximum of 90 per cent by the end of lambing.

Abortion, Veterinary↗
PubMed1979

Response of low income women and abortion facilities to restriction of public funds for abortion: a study of a large metropolitan area.

During the first five months after the restriction of public funds for abortion, a large percentage of low-income women seeking abortions in a metropolitan area in Texas obtained abortion that were partially subsizied using a combination of reduced clinic fees and public funds for ancillary non-abortion services. Their own personal funds made up the difference between the subsidy and the full cost of the procedure.

Abortion, Induced↗
PubMed1978

Laparoscopic sterilization with therapeutic abortion versus sterilization or abortion alone.

Records of 606 therapeutic abortions performed by suction curettage, 693 interval laparoscopic sterilizations, and 442 combined procedures were analyzed and compared. The following conclusions were obtained: 1) Abortion alone and abortion with laparoscopic sterilization are similar in rates of postoperative morbidity (4.3 and 7%, respectively) and early complications (3.3 and 2.9%, respectively). 2) The risks in laparoscopic sterilization alone are significantly lower for postoperative morbidity (2.2%) and early complications (0.9%) than for abortion alone or for the combined procedure.

Abortion, Therapeutic↗
PubMed2004

Circulating cytokines during early pregnancy in women with recurrent spontaneous abortion: decreased TNF-alpha levels in abortion with normal chromosome karyotype.

OBJECTIVE: The aim of the present study was to assess whether or not serum cytokine concentrations during early pregnancy are related to the subsequent outcomes in women with recurrent spontaneous abortion (RSA). PATIENTS AND METHODS: Serum concentrations of five cytokines--tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, interleukin (IL)-4, IL-6, and IL-10--were measured by ELISA methods. Sera were collected from 73 RSA women at 6-7 weeks of gestation. Of the 73 pregnancies, 10 subsequently ended in abortion with normal fetal chromosome karyotype (AbNK), 12 ended in abortion with abnormal karyotype (AbAK), and the other 51 pregnancies ended in live birth (Lb). RESULTS: The serum TNF-alpha concentration in women with AbNK (mean 0 pg/ml) was lower than that in women with subsequent AbAK (0.06 pg/ml) (p < 0.05). The TNF-alpha positive percentage among women with AbNK (0%) was also lower than that among women with AbAK (50.0%) (p < 0.05). CONCLUSIONS: Decreased serum TNF-alpha concentration during early pregnancy might be associated with subsequent abortion in RSA women.

Abortion, Habitual↗
PubMed1991

[Local estrogen premedication reduces the abortion time in prostaglandin E1 analogue-induced abortion in the 2nd trimester].

Twenty-eight patients (median gestational age 17 weeks) referred for induction of second trimester abortion, were randomized to intracervical preliminary treatment by either 50 mg 17 beta-oestradiol or placebo. Abortion was then induced by 1 mg prostaglandin E1 vagitories. The preliminary treatment caused a significant rise in cervical score and a significant reduction in induction-abortion time especially by reducing the number of patients with prolonged induction-abortion time.

Abortion, Induced↗
PubMed1990

[The role of the male partner in contraception and the decision for abortion. A questionnaire study among women applying for abortion and their male partners].

Over a period of 12 months, 96 women who sought legal abortion and 52 of their male partners answered a questionnaire about contraception and abortion. Almost none of them had wanted a pregnancy from the start. Nevertheless two thirds had not used any contraceptives, mainly because they thought the chance of pregnancy was very small. Many stated that they had intended to use a condom, yet they did not do so. The majority of the women told their male partner about the pregnancy as soon as they knew of it themselves. A quarter of the women and about half of the men stated that both partners agreed that she should choose abortion. Two fifths of the women and about half of the men said that the woman's decision weighed most heavily. Many of the women said that the attitude of the partner to the pregnancy was important for their choice. Half of the women, however said that they would have chosen an abortion independent of the attitude of their partner.

Abortion Applicants↗