Midtrimester abortion.
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To evaluate the role of the early pregnancy milieu in inducing postpartum refractoriness of the hypothalamic-pituitary-ovarian axis, pregnancies in rhesus monkeys were terminated on either day 35 of gestation or near term at 162 days. Non-nursing mothers with gestations interrupted near term resumed ovulation at a mean of 56 +/- 12 (mean +/- SE) days postpartum, in contrast to the 17 +/- 2 days required for the females having had abortions at day 35. These results demonstrate that the early pregnancy milieu is not determinant of the hypothalamic-pituitary-ovarian refractoriness observed in non-nursing mothers delivering at term.
The principle of non-directiveness in genetic counselling is embraced by all relevant professional bodies. Little is known about the extent to which it is endorsed by geneticists, or incorporated into their clinical practice. The aim of the current study is to document how geneticists in three European countries, Germany, Portugal and the UK, report counselling women at risk for having children with a range of conditions. While geneticists in all three countries reported counselling in a largely non-directive style, this varied both across genetic conditions and between countries. German and Portuguese geneticists were significantly more directive than UK geneticists, although they differed in the way in which they were directive. German geneticists were more likely to encourage continuation of pregnancies, while Portuguese geneticists were more likely to encourage termination of affected pregnancies. There was no strong consensus on approaches to counselling for any of the genetic conditions, defined as agreement between 70% of all three groups of geneticists. Despite strong professional codes of non-directiveness, geneticists report being somewhat directive in some counselling situations. Future research needs to focus on what geneticists are trying to achieve in genetic counselling, how they actually counsel, and with what effects.
When conducting inferential and epidemiologic studies, researchers are often interested in the distribution of time until the occurrence of some specified event, a form of incidence calculation. Furthermore, this interest often extends to the effects of intervening factors on this distribution. In this paper we impose the assumption that the phenomena being investigated are governed by a stationary Markov chain and review how one may estimate the above distribution. We then introduce and relate two different methods of investigating the effects of intervening factors. In particular, we show how an investigator may evaluate the effect of potential intervention programs. Finally, we demonstrate the proposed methodology using data from a population study.
OBJECTIVE: To determine the knowledge, attitudes, and interest in providing medical abortion reported by family physicians and residents in rural and urban settings. DESIGN: A self-administered mailed survey using the modified Dillman method. SETTING: Hamilton and Thunder Bay County in Ontario. PARTICIPANTS: Family medicine residents (n = 93) and physicians (n = 234) in predominantly urban (Hamilton) and rural (Thunder Bay) settings. All faculty family physicians at McMaster University practising general family medicine and all family physicians in Thunder Bay County were surveyed. MAIN OUTCOME MEASURES: Knowledge of, attitudes toward, and interest in providing medical abortion. RESULTS: Overall response rate to the survey was 62.7% (n = 327); 74.2% (69/93) of residents responded; 58.1% (136/234) of physicians responded. Physicians and residents rated their knowledge about medical abortion as poor, but most were interested in receiving more information and training in this area. Many (83.1%, 157/189) reported that medical abortion was an acceptable procedure for family physicians to perform, and 52.0% (64/123) of the physicians would consider providing medical abortions for their patients. Residents training in the more rural Thunder Bay program were less likely to support first-trimester abortions for both medical and nonmedical reasons than those training in Hamilton (P < .05). Male respondents were significantly less supportive of abortion for nonmedical reasons and were less likely to consider providing medical abortions for their patients (P < .05). CONCLUSION: Most family physicians and residents showed interest in receiving more information about and training in medical abortion.
During the period Jan 1978 to Dec 1988, 41,867 deliveries took place at the University of Chile Hospital. Among them, 148 babies were found to have malformations of the central nervous system, an incidence of 3.6 per 1000 live births. A longitudinal study from 1969 to 1988 suggests a yearly increment of 0.1% in the incidence rate of these malformations. The comparison of some quantitative variables, such as gestational age, birthweight, number of previous abortions and some risk factors like maternal illness, bleeding, radiation exposure, drug ingestion during the first trimester of pregnancy and instructional level of both parents show significant differences between the malformed and the control newborns. No significant differences were found for maternal age, sex nor seasonal variation.