PubMed HealthSearch

Biomedical subjects

W Cates

Publications and source records attributed to W Cates.

At least 19 recordsLinked to original sources

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

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

The health impact of restricting public funds for abortion. October 10, 1977--June 10, 1978.

The Center for Disease Control (CDC), Atlanta, Georgia implemented an eight-month prospective surveillance system in 24 hospitals distributed among states with and without public funding for abortion. Out of 3,157 visits for abortion-related complications, only 10 women gave a history of non-physician or self-induced abortion and none were Medicaid recipients. The small number of hospitals located in non-funded states and the smaller numbers of women served in these hospitals than in the funded states limited the power of out study. Women living along the Texas-Mexico border appeared more likely to have complications after illegal abortions than women from other areas of the country.

Abortion, Illegal

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

Late effects of induced abortion. Hypothesis or knowledge?

Recent local, state and federal regulations intending to provide "informed consent" for women considering termination of pregnancy have misrepresented the current state of knowledge about certain long-term complications: the alleged risks are presented to the patient as if they were scientific facts rather than still-unproven hypotheses. While it is possible that some late sequelae are associated with previously induced abortions, there is no agreement in the scientific literature on the magnitude of the risks, if any. Moreover, few studies adequately define the particular method of induced abortion whose effects they are investigating. The current data do not support firm conclusions about induced abortion either causing or not causing any of the alleged long-term complications.

Abortion, Induced

The comparative efficacy and safety of intraamniotic prostaglandin F2 alpha and hypertonic saline for second-trimester abortion. A review and critique.

Intraamniotic instillation of prostaglandin F2 alpha (PGF2 alpha) is considered by many to be safer than instillation of hypertonic saline for second-trimester abortion. To evaluate the validity of this hypothesis, we reviewed 15 comparisons of these two abortifacients published in the English literature since 1973. These reports suggest that while PGF2 alpha induces abortion faster than saline, PGF2 alpha is associated with higher rates of unpleasant gastrointestinal side effects, incomplete abortion, hemorrhage and surgical reevacuation. In addition, the rate of live-born fetuses after PGF2 alpha-induced abortion may be 5 to 40 times that of saline. The existing literature does not substantiate the claim that PGF2 alpha is superior to saline as an abortifacient.

Abortifacient Agents

Deaths caused by pulmonary thromboembolism after legally induced abortion.

Pulmonary thromboembolism is an infrequent but serious complication of induced abortion. Of the 104 abortion-related deaths reported to the Center for Disease Control in 1972 through 1975, 10 (9.6 per cent) involved fatal pulmonary embolism; eight of these cases were proved at autopsy. All but one of the women had pre-existing risk factors for thromboembolic disease, including obesity, previous thrombophlebitis, use of oral contraceptives, or type A blood. All but one case occurred in women who had received general anesthesia. In addition, four of the eight women had undergone a concurrent sterilization procedure at the time of the abortion. Preventive efforts should focus on identifying women at high risk for thromboembolic events prior to the abortion procedure and then selecting the abortion procedure least likely to produce postoperative embolism.

Abortion, Induced

Legalized abortion: effect on national trends of maternal and abortion-related mortality (1940 through 1976).

Both non-abortion-related maternal and abortion-related mortality declined prior to the Supreme Court decisions of 1973. In order to determine the effect of legalized abortion on maternal mortality, we have analyzed the secular trends in national abortion mortality ratios for 1940 through 1976, compared the trends to those maternal mortality ratios, and hypothesized reasons for differences between these trends. Between 1940 and 1950 and after 1965, deaths from abortion declined more rapidly than deaths from other causes associated with childbirth. However, between 1951 and 1965, maternal mortality related to pregnancy of childbirth declined more rapidly than abortion-related mortality. Five possible explanations exist for the more rapid decline in abortion deaths since 1965--selected underreporting, changes in coding practices, improved safety of illegal abortion, introduction of more effective contraception, and increased availability of legal abortion. We consider the last two explanations as the most likely reasons for the accelerated decline in abortion-related deaths.

Abortion, Legal