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PubMedDate not supplied

Postpartum and postabortion use of the TCu-220C and Lippes Loop: A comparative study.

The postinsertion experience of 274 women with the TCu-220C and 522 women with the Lippes Loop in a university hospital family planning program in Bogotá, Colombia, has been studied by a life-table method. Pregnancy and continuation rates are similar for both devices. Although the expulsion rate of the TCu-220C is significantly lower than that of the Loop up to 12 months, higher removal rates for the TCu-220C account for the similarity in overall continuation.

Abortion, Spontaneous↗
PubMed1986

Mortality associated with sterilization: preliminary results of an international collaborative observational study.

Sterilization is the contraceptive method most widely used worldwide, yet the case-fatality rate of deaths attributable to sterilization is not known. We used data collected from 1971-1979 from 28 countries by Family Health International to estimate case-fatality rates. We adjusted these rates for individuals lost to follow-up. Of 41,834 sterilizations, 23 resulted in deaths temporally associated with the procedure used. The adjusted attributable case-fatality rates were 13.4 per 100,000 for interval procedures, 53.3 per 100,000 for postabortion procedures, and 43.4 per 100,000 sterilizations after vaginal delivery. Multiple factors contributed to the deaths, including pre-existing health problems, infection and anesthesia. Prevention of deaths resulting from sterilization depends on complete ascertainment of deaths associated with sterilization and careful investigation to determine preventable risk factors. We conclude that, overall, sterilization in these programs was conducted with very low attributable mortality.

Female↗
PubMed1978

Second trimester abortion with 5% intraamniotic saline--a pilot study.

The risk of hypernatremia and related postabortion complications resulting from the intraamniotic administration of a 20-25% hypertonic saline solution, a widely used procedure all over the world, prompted this trial of 5% saline. Midtrimester abortion was induced in 150 women with a 5% saline solution administered intraamniotically at the National Medical College, Calcutta, India, from August 1974 to October 1975. The abortion was complete within 48 hours in 90% of the cases. All the fetuses were delivered dead. In one case, hysterotomy was performed because of severe bleeding. The immediate complication rate was 36% (12% serious). The follow-up complication rate was 2%. One patient died on the seventh postabortal day due to severe, uncontrolled septicemia. The authors conclude that because this procedure is simple and low cost and because it reduces the risk of hypernatremia it should be a welcome addition to service programs in developing countries.

Abortion, Induced↗
PubMed1979

Rh hemolytic disease. Epidemiologic surveillance in the United States, 1968 to 1975.

Nationwide surveillance of Rh hemolytic disease of the newborn showed that associated infant mortality decreased from 941 deaths in 1968 to 269 deaths in 1975, or from 2.7 to 0.9 per 10,000 live births. The incidence of Rh hemolytic disease declined from 45 per 10,000 total births in 1970 to 21 per 10,000 in 1975. In 1970, an estimated 16,000 infants were affected, whereas in 1975, the number was 6,000. Several state-based Rh disease surveillance programs reported declining mortality and incidence and increasing use of Rh immune globulin. Rh immune globulin was administered to an estimated 80% of eligible Rh-negative women in 1974, eighty-one percent in 1975, and 82% in 1976. More concerted efforts are needed to determine the frequency of maternal sensitization and to identify and correct gaps in postpartum and postabortion use of Rh immune globulin.

Erythroblastosis, Fetal↗
PubMed1997

Multiple induced abortions: Danish experience.

Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family considerations). Though similar to first and second time aborters in their life situations and greater contraceptive risk-taking, third timers seemed to become pregnant more readily. They were also less willing to be interviewed. Related studies and suggestions for postabortion counseling are discussed.

Abortion, Induced↗
PubMed2001

Preventing adverse sequelae of bacterial vaginosis: a public health program and research agenda.

BACKGROUND: The cause of bacterial vaginosis remains poorly understood. Recent evidence strengthens the association between bacterial vaginosis and serious medical complications. GOAL: To review the evidence linking bacterial vaginosis with adverse pregnancy outcomes, complications after gynecologic procedures, and HIV infection, and to identify prevention strategies. METHODS: In March 1999, the Centers for Disease Control and Prevention organized a conference to accomplish this goal. RESULTS: Better understanding is needed concerning the etiology, epidemiology, and natural history of bacterial vaginosis. More efficacious treatment of bacterial vaginosis and strategies to reduce maternal complications associated with bacterial vaginosis, such as premature rupture of the fetal membranes, chorioamnionitis, premature labor and delivery, postdelivery endometritis, and postpartum infant complications should be developed. Recent evidence shows that screening and treatment of bacterial vaginosis before abortion reduces postabortion pelvic inflammatory disease, and that anaerobic coverage during hysterectomy reduces postoperative complications. Better understanding concerning the relation of bacterial vaginosis to acquisition of sexually transmitted diseases and HIV infection are needed as well as possible prevention strategies. CONCLUSIONS: A national prevention effort should be guided by the results of research that addresses current knowledge gaps.

Abortion, Induced↗
PubMed1999

Creating linkages between incomplete abortion treatment and family planning services in Kenya.

Postabortion care has received increasing emphasis as an important intervention to address part of the problem of unsafe abortion. Although a good deal of attention has been paid to improving emergency treatment of abortion complications, the other elements of postabortion care, including providing postabortion family planning services, have received less attention and are rarely found in health-care settings around the world. This report describes a study that was conducted in Kenya to test three different models of ways to provide postabortion family planning. The study shows that these new services are both feasible and acceptable to providers and patients, and also shows how effective they can be. Whereas only 7 percent of women received family planning counseling according to the baseline survey, this proportion increased to 68 percent in the postintervention period. In addition, 70 percent of women who decided to begin using contraceptives received a method, compared with only 3 percent at baseline. The provision of postabortion family planning counseling and methods on the gynecological ward by ward staff was found to be the preferred and most effective model.

Abortion, Illegal↗
PubMed1991

The effect of adding copper onto Lippes Loop IUDs: results from a ten-year study in Yugoslavia.

The present study is the first randomized ten-year comparison of the standard, non-medicated Lippes Loop D and the same device with the addition of 200 mm2 of copper in the form of copper sleeves. The devices were randomly inserted immediately after first trimester medical termination of pregnancy. Out of 400 postabortal IUD insertions, 371 were followed for up to ten years. Gross cumulative life-table accidental pregnancy rates after one year of use were 0.56 for the copper-bearing Lippes Loop and 4.63 for the standard Lippes Loop. After two, four and ten years, these rates were 1.24, 2.70 and 3.62 and 6.03, 7.58 and 14.94, respectively (in all comparisons, rates were significantly different at the 0.05 level or lower). At each time interval, expulsion/displacement rates were 4.49, 4.49, 5.23 and 6.32 for the copper-bearing Lippes Loop and 12.61, 13.29, 15.46 and 19.79 for the standard Lippes Loop (rates were significantly different at the 0.01 level or lower). Differences in removal rates for bleeding and/or pain were not significantly different at any of the follow-up intervals. The lower event rates for copper-bearing Lippes Loop D users indicates that the addition of copper to the Lippes Loop IUD may result in better long-term efficacy profiles for this device among postabortal women. The results also suggest that large, medicated IUDs may be more efficacious for women with larger uteri who often experience higher failure rates due to expulsion or displacement of smaller IUDs into the lower uterine segment.

Adolescent↗