PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Abortion, Selective”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1997

Safety, efficacy, and acceptability of medical abortion in China, Cuba, and India: a comparative trial of mifepristone-misoprostol versus surgical abortion.

OBJECTIVE: We investigated safety, efficacy, and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries. STUDY DESIGN: Women (n = 1373) with amenorrhea < or = 56 days chose either surgical abortion (as provided routinely) or 600 mg of mifepristone followed after 48 hours by 400 micrograms of misoprostol. This is the appropriate design for studying safety, efficacy, and acceptability among women selecting medical abortion over available surgical services. RESULTS: The medical regimen had more side effects, particularly bleeding, than did surgical abortion but very few serious side effects. Failure rates for medical abortion, although low, exceeded those for surgical abortion: 8.6% versus 0.4% (China), 16.0% versus 4.0% (Cuba), and 5.2% versus 0% (India). Nearly half of failures among medical clients were not true drug failures, however, but surgical interventions not medically necessary (acceptability failures or misdiagnoses). Women were satisfied with either method, but more preferred medical abortion. CONCLUSION: Medical abortion can be safe, efficacious, and acceptable in developing countries.

Abortifacient Agents↗
PubMed1990

Complications of first-trimester abortion: a report of 170,000 cases.

One hundred seventy thousand first-trimester abortions were performed in three free-standing clinics of Planned Parenthood of New York City from 1971-1987. Seventy percent of the procedures were done under local anesthesia; the remainder under intravenous methohexital. No preoperative medications or routine postoperative antibiotics were given. High-risk patients were referred to a hospital. The clinics operated under uniform written guidelines. Experienced physicians performed the procedures. There were no deaths in this series of patients. One hundred twenty-one patients were hospitalized (0.71 per 1000) for suspected perforation, ectopic pregnancy, hemorrhage, sepsis, or recognized incomplete abortion. There was no major extirpative surgery performed. There were an additional 1438 minor complications (8.46 per 1000). Overall, there were 9.05 complications per 1000 abortions. The complication rates for procedures done under general anesthesia and local anesthesia were similar. We conclude that outpatient abortion on selected patients to the 14th week from the last menstrual period is a safe procedure.

Abortion, Induced↗
PubMed2000

Induced abortion and low birthweight in the following pregnancy.

BACKGROUND: To examine whether induced abortion increases the risk of low birthweight in subsequent singleton live births. METHODS: Cohort study using the Danish Medical Birth Registry (MBR), the Hospital Discharge Registry (HDR), and the Induced Abortion Registry (IAR). All women who had their first pregnancy during 1980-1982 were identified in the MBR, the HDR, and the IAR. We included all 15,727 women whose pregnancy was terminated by a first trimester induced abortion in the induced abortion cohort and 46,026 women whose pregnancy was not terminated by an induced abortion were selected for the control cohort. All subsequent pregnancies until 1994 were identified by register record linkage. RESULTS: Low birthweight (<2500 g) in singleton term live births occurred more frequently in women with one, two, three or more previous induced abortions, compared with women without any previous induced abortion of similar gravidity, 2.2% versus 1.5%, 2.4% versus 1.7%, and 1.8% versus 1.6%, respectively. Adjusting for maternal age and residence at time of pregnancy, interpregnancy interval, gender of newborn, number of previous spontaneous abortions and number of previous low birthweight infants (control cohort only), the odds ratios (OR) of low birthweight in singleton term live births in women with one, two or more previous first trimester induced abortions were 1.9 (95% CI: 1.6, 2.3), and 1.9 (95% CI: 1.3, 2.7), respectively, compared with the control cohort of similar gravidity. High risks were mainly seen in women with an interpregnancy interval of more than 6 months. CONCLUSIONS: The findings suggest a positive association between one or more first trimester induced abortions and the risk of low birthweight in subsequent singleton term live births when the interpregnancy interval is longer than 6 months. This result was unexpected and confounding cannot be ruled out.

Abortion, Induced↗
PubMed1984

Spontaneous abortions among laboratory workers; a follow up study.

An investigation was conducted among all female laboratory workers in the county of Funen to test the hypothesis that work in laboratories during pregnancy increases the risk of spontaneous abortion. Laboratory workers from hospital, university, and other public laboratories and from laboratories in industry were investigated. A socially comparable reference group less exposed to chemicals at work included office workers, technical assistants and designers, physiotherapists, and occupational therapists. Information was obtained through a postal questionnaire study in May 1980 and from hospital records. Neither the occupation in any single category of laboratory nor the alleged exposure to any single chemical during pregnancy showed a significant increase in the odds ratio for spontaneous abortion. A selection bias was found among the non-respondents with respect to both occupation and outcome of pregnancy, but the influence on the results was slight, owing to the small number of non-respondents. The higher rates of hospital admission for spontaneous abortion among the cases compared with the controls indicates that register data are not more valid than self reported data. This leads to several methodological problems that ought to be studied in further detail.

Abortion, Spontaneous↗
PubMed1995

Evaluation of abortions in cattle attributable to neosporosis in selected dairy herds in California.

OBJECTIVE: To estimate the minimum rate of abortion attributable to infection with Neospora sp in selected California dairy herds. DESIGN: Prospective study. ANIMALS: Twenty-six dairy herds containing 19,708 cows were studied. Fourteen herds had a history of abortions attributable to neosporosis, and 12 were herds in which neosporosis had not been identified as a cause of abortions. PROCEDURE: During a 1-year period, all available aborted fetuses were submitted to veterinary diagnostic laboratories to determine the cause of abortion. Reproductive records of cows that aborted were reviewed. RESULTS: Neospora sp infection was the major cause of abortion identified (113/266 abortions, 42.5%). The majority (232/266, 87.2%) of the aborted fetuses were submitted from herds with a history of abortions attributable to neosporosis, and Neospora sp infection was identified as the causative agent in 101 of 232 (43.5%) of the abortions from these herds. Fewer aborted fetuses were submitted from the 12 herds that did not have a history of abortion attributable to Neospora sp; however, neosporosis was confirmed as a cause of abortion in 6 of these 12 herds and was identified as the causative agent in 12 of 34 (35.3%) abortions from these herds. The disease was widespread throughout the state (19/26 herds in our study). Available reproductive histories of cows that had abortions attributed to neosporosis were evaluated, and 4 cows were identified that twice aborted Neospora-infected fetuses. CLINICAL IMPLICATIONS: Abortion attributable to Neospora sp infections can be expected to be a continuing major cause of abortion in dairy herds with a history of neosporosis as well as in dairy herds that have a history of sporadic abortions, but for which Neospora sp infections have not been previously identified as a cause of abortion. Subsequent pregnancies in cows that abort a Neospora sp-infected fetus also are at risk of infection, suggesting that the immunity provided by an initial infection is inadequate to prevent repeat infection or that cows can be persistently infected with Neospora sp.

Abortion, Veterinary↗
PubMed1995

Missouri's parental consent law and teen pregnancy outcomes.

The Supreme Court decision of July 1989 upholding state regulation of abortion has led to numerous attempts to impose parental consent and/or parental notification legislation for females under the age of 18 seeking abortions. The effect of such legislation on teen pregnancy outcomes is hotly debated. Missouri vital statistics data from 1980 through 1992 are examined for the effect of such a law on pregnancy resolution choices among teens. The Missouri data suggest that since the enforcement of the parental consent statute in 1985 there has been a decrease in the selection of abortion as a pregnancy outcome, particularly among white teens. In addition there has been an increase in the percent of abortions among teens taking place in other states and an irregular but steady trend toward later abortions. The increasing number of births to unmarried mothers under the age of 18 suggest the need for specific services to help these young mothers cope.

Abortion, Induced↗
PubMed1975

Abortion, euthanasia, and care of defective newborns.

Growing use of abortion to prevent births of infants with unfavorable prenatal diagnoses raises ethical questions about active euthanasia for newborn infants with similar impairments. Two opposing ethical arguments are those of Paul Ramsey, who equates genetically indicated abortion with infanticide disapprovingly, and of Joseph Fletcher, who equates the morality of abortion with selective euthanasia approvingly. Though radically different, these arguments treat the ethical aspects of the prenatal and postnatal situations as essentially similar. There are, however, different moral features between the two situations, in that the postnatal situation is characterized by the independent physical existence of the infant, the possibility of treatment, and the formation of parental loyality to the infant. Thus, a decision for abortion after prenatal diagnosis does not necessarily commit parents to euthanasia in the management of a seriously damaged infant.

Abortion, Induced↗
PubMed2004

Improving population health or the population itself? Health technology assessment and our genetic future.

The province of British Columbia (BC), Canada is developing its first population-wide prenatal genetic screening program, known as triple-marker screening (TMS). TMS, initiated with a simple blood test, is most commonly used to screen for fetuses with the chromosomal abnormality known as Down syndrome or neural tube disorders. Women testing TMS-positive are offered diagnostic amniocentesis and, if the diagnosis is confirmed, selective second-trimester abortion. The project described in this study was initiated to address the broad range of issues arising from this testing technology and provides an example of the new type of health technology assessment (HTA) contribution emerging (and likely to become increasing necessary) in health policy development. With the advent of prenatal genetic screening programs, would-be parents gain the promise of identifying target conditions and, hence, the option of selective abortion of affected fetuses. There is considerable awareness that these developments pose challenges in every dimension (ethical, political, economic, and clinical) of the health-care environment. In the effort to construct an appropriate prenatal screening policy, therefore, administrators have understandably sought guidance from within the field of HTA. The report authors concluded that, within the restricted path open to it, the role of government is relatively clear. It has the responsibility to maintain equal access to prenatal testing, as to any other health service. It should also require maintenance of medical standards and evaluation of program performance. At the same time, policy-makers need actively to support those individuals born with disabilities and their families.

British Columbia↗
PubMedDate not supplied

Health services utilization after induced abortions in Ontario: a comparison between community clinics and hospitals.

The purpose of this study was to compare postabortion health services utilization of hospital abortion patients with community clinic abortion patients using administrative databases. The study was a retrospective cohort study. The study group consisted of patients with induced abortions (n = 41,039) performed in hospitals or community clinics recorded in the 1995 Ontario Health Insurance Plan claims (OHIP) database. An age-matched cohort of 39,220 women who did not undergo induced abortions was selected from the same data source to serve as controls. The main outcome measures were health services utilization indicators constructed from OHIP data within 3 months postabortion from office consultations, emergency room consultations, and hospital admissions. Hospitalization indicators were constructed from Canadian Institute for Health Information hospital discharge data within 3 months postabortion and included data on hospitalizations for infection, certain surgical events, or psychiatric problems. Postabortion health services utilization and hospitalization were higher in the patient population, regardless of service location, than in the age-matched cohort. Within the abortion patient population, hospital day-surgery patients had higher rates of postabortion utilization and hospitalization than did community clinic patients. Multivariate analysis revealed that hospital day surgery patients had a higher risk of subsequent post-abortion hospitalizations for infections (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.23-2.28), surgical events (OR 1.70, 95% CI 1.30-3.24) and psychiatric problems (OR 2.65, 95% CI 1.77-3.98) than community clinic patients. The rates of postabortion health services utilization and risk of hospitalization were lower in community clinic abortion patients than in hospital day-surgery patients. However, it is not possible to fully control for important confounding variables when using these administrative data.

Abortion, Induced↗
PubMed2004

The Golden Rule and the potentiality principle: future persons and contingent interests.

Duties to future persons are central to numerous key ethical issues including contraception, abortion, genetic selection, treatment of the environment, and population control. Nevertheless, we still seem to be lacking Parfit's 'Theory X', a general theory of beneficence whose appropriateness extends to future generations. Starting from the Golden Rule (TGR), R.M. Hare purportedly derived counterintuitive duties to potential people and 'the potentiality principle'. However, I argue that Hare's derivation involves a hidden and unjustifiable extension from TGR, and show how the most plausible form of TGR is compatible with multiple contradictory principles for the treatment of future persons. I appeal to our own preferences to argue that one extension of TGR follows the spirit of TGR, while the other is deeply implausible. Using the plausible extension, I derive a Contingent Interests Principle (CIP) that offers much promise as Parfit's elusive Theory X. In contrast to Hare's interpretation of TGR, this application provides solid justification for rejecting the potentiality principle.

Abortion, Induced↗
PubMed1990

The effects of RU-38486 on cervical ripening. Clinical studies.

One hundred eighty pregnant patients, 17 to 39 years old (mean (+)/- SEM: 25.1 (+)/- 0.39), with an amenorrhea of 7 to 12 weeks (mean (+)/- SEM: 9.4 (+)/- 0.10), and requesting a therapeutic abortion, were selected according to general good health and gave their informed consent to the study. Mifepristone (RU-486; Roussel UCLAF, Paris, France) an antiprogestin steroid, was administered at random in doses of 0, 50, 100, 200, 400, or 600 mg. Clinical evaluations and measurements of cervical dilatation were done before the study and repeated at 24 hours after administration of Mifepristone and at 48 hours, at which time the aspiration was performed. Significant increases in cervical dilatation were observed at 48 hours with all doses of Mifepristone above 50 mg. The increases were significantly greater in patients with a gestational age greater than 10 weeks than in those less than 10 weeks' gestational age. Parity had no influence on cervical dilatation at 48 hours. Bleeding was observed significantly more often with 100 to 600 mg doses of Mifepristone than with 0 to 50 mg. No influence of gestational age or parity on bleeding could be detected. Abdominal cramps were reported more frequently with 200, 400, and 600 mg of Mifepristone at 48 hours and their occurrence appeared to parallel cervical dilatation.

Abortion, Induced↗
PubMed1992

Parental sex effect in spina bifida: a role for genomic imprinting?

Fifty families (491 individuals in 137 sibships) with more than one living case of isolated, nonsyndromic spina bifida (SB) were analyzed genetically. There were twice as many gene-carrier females (56) as gene-carrier males (28) (P < 0.005). This was not an artifact of ascertainment bias because the sex ratio of gene-carriers was the same whether the pedigree was obtained through the proband's father or mother. Also, this effect was not observed in other disorders analyzed by the same method. Neither was the effect due to differential fertility because the number and sex of affected and unaffected children per gene-carrier parent were not different for male or female gene-carrier parents. There was no evidence that the missing male gene-carriers were lost by selective spontaneous abortion. There was no deficit of male-to-male or male-to-female transmission, excluding simple X-linked or simple mitochondrial inheritance. If genomic imprinting plays a role in the unequal female and male carrier frequencies in SB, penetrance should differ with parental sex. Penetrance was higher for offspring of female parents than of male parents, but the difference was not statistically significant. In addition, both male and female gene-carriers were frequently found in the same pedigree. Thus, the present data suggest a possible role for imprinting in SB.

Female↗
PubMed1990

Selection of patients with habitual abortion for paternal leucocyte immunization.

After potentiation of the immune response in habitual aborters 75-85% of subsequent pregnancies are claimed to result in healthy term infants. However, all publications to date have either been based on the authors concept of the immune processes involved or an attempt to demonstrate the efficacy of treatment either empirically or by matched trials. As immunization is coming into wider clinical use, it is necessary to determine which patients will benefit from this form of treatment. This paper presents our experience with paternal leucocyte immunization over the period 1985-1988. 207 patients were classified on a clinical basis and by immunological testing. 143 patients have been immunised, 129 pregnancies have occurred in 108 patients. The vast majority of our patients have recurrent missed abortions. Only six women habitually aborted live fetuses. Two had subsequent live births. Secondary aborters seem to do well in subsequent pregnancies, whether immunized or not. The patient most likely to benefit from immunization is the Primary missed aborter who does not possess antipaternal antibody (APCA), but is induced to produce APCA by immunization. Using these criteria, 75% success rates are observed in the subsequent pregnancy. This success rate is irrespective of HLA antigen sharing or in-vitro mixed lymphocyte reactivity.

Abortion, Habitual↗
PubMed2006

Deafness, genetics and dysgenics.

It has been argued by some authors that our reaction to deaf parents who choose deafness for their children ought to be compassion, not condemnation. Although I agree with the reasoning proposed I suggest that this practice could be regarded as unethical. In this article, I shall use the term "dysgenic" as a culturally imposed genetic selection not to achieve any improvement of the human person but to select genetic traits that are commonly accepted as a disabling condition by the majority of the social matrix; in short as a handicap. As in eugenics, dysgenics can be achieved in a positive and a negative way. Positive dysgenics intends to increase the overall number of people with a particular genetic trait. Marriage between deaf people or conceiving deaf children through reproductive technology are examples of positive dysgenics. Negative dysgenics can be obtained through careful prenatal or pre-implantation selection and abortion (or discarding) of normal embryos and foetuses. Only deaf children would be allowed to live. If dysgenics is seen as a programmed genetic intervention that undesirably shapes the human condition--like deliberately creating deaf or dwarf people--the professionals involved in reproductive technologies should answer the question if this should be an accepted ethical practice because the basic human right to an open future is violated.

Deafness↗
PubMed1994

Monozygotic twinning: an evolutionary hypothesis.

Monozygotic twinning is rare within populations yet taxonomically widespread. We explore the evolution of monozygotic twinning by modeling an allele in a newly formed offspring that causes it to undergo mitosis and separation to form one or more clones (twins), potentially in conflict with the parents' best interest. The success of this twinning allele in our haploid models depends on the balance of the benefit of increased frequency in the clutch and the cost of reduced survival resulting from limited parental resources. The trait reaches high frequency in a broad range of plausible conditions but also fails to spread or is kept at low frequency in others when the survival cost is high (e.g., in small clutch sizes). Interestingly, there are two reasonable conditions that predict high frequency of the trait but low visibility: random parental abortion and selection for low penetrance. Thus our models suggest reasons why monozygotic twinning might be rare, or alternatively, be common yet appear rare. In addition, we discuss the implications for sex-linked twinning, dizygotic twinning, and twinning by gametes.

Animals↗