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[Failed induced abortion. Pregnancy continuing after induced abortion].

Operations classified as induced abortion fail, i.e. the pregnancy continues, in approximately 0.05% of the cases. Termination procedures before 7-8 weeks of gestation and wrong assessment of the size of the uterus imply significantly increased risk of failed abortion. The article describes current methods for early termination of pregnancy, as well as preoperative procedures and postoperative advice aimed at avoiding or detecting failed induced abortions.

Abortion, Induced

Serum relaxin levels in prostaglandin E2 induced abortions.

Relaxin, a peptide hormone produced only by the corpus luteum of pregnancy, can be used as a marker of luteal function in human pregnancy. Serum immunoreactive relaxin levels were measured serially in six women having second trimester abortions induced with intravaginal prostaglandin E2 (PGE2) suppositories. All patients aborted within 17 hours of the first suppository. No significant changes were detectable in serum relaxin levels in any of the patients. It is concluded that PGE2 does not interfere with the corpus luteum's ability to secrete relaxin in the second trimester of human pregnancy.

Abortion, Induced

Chromosome studies of embryos from induced abortions in pregnant women age 35 and over.

Chromosome studies of embryos were done in abortions induced at the early stage of pregnancy in women 35 years of age and older who had no signs of threatened or spontaneous abortions and were considered to have oocytes of an advanced age. Karyotypes were successfully determined in 256 cases and the results were as follows: a) 2 of 123 cases in 35- to 39-year-old women showed an incidence of chromosomal anomalies as high as 1.6%; 7 of 117 cases in 40- to 44-year-old mothers an incidence of 6.0%; and 4 of 16 mothers in the 45- to 49-year-old age group an incidence of 25.0%; b) all chromosomal anomalies were trisomies, mainly trisomy 21 and 18. These results suggest that the incidence of chromosomal anomalies increases in older pregnant women, especially in premenopausal pregnancies, and that non-disjunction may occur during meiosis.

Abortion, Induced

Gestation, birth-weight, and spontaneous abortion in pregnancy after induced abortion. Report of Collaborative Study by W.H.O. Task Force on Sequelae of Abortion.

The outcome of pregnancy in 7228 women from eight European cities was studied. In two of the three city clusters, there was a significantly higher risk of adverse outcome in terms of either mid-trimester spontaneous abortion, preterm delivery, or low-birth-weight infant among women whose only previous pregnancy had been surgically terminated only previous pregnancy had been surgically terminated than among primigravidae or women whose only previous pregnancy had ended in live birth. In one city cluster in which surgical termination was accomplished both by conventional dilatation and currettage and by vacuum aspiration (V.A.), an increased risk of short gestation was noted for V.A., but the overall total risk of adverse outcome was not significantly increased. In the third city cluster, in which surgical termination was nearly entirely by V.A., induced abortion was not associated with any increased risk of adverse pregnancy outcome. The effects of spontaneous abortion on the subsequent pregnancy are similar to those of induced abortion.

Abortion, Induced

Hypokalemia and cardiac arrhythmia associated with prostaglandin-induced abortion.

Experience with 1 patient undergoing second trimester therapeutic abortion induced by prostaglandin F2alpha administration is described. Serious hypokalemia in association with cardiac arrhythmia followed intraamniotic administration of the drug. Further observations on a group of normal subjects receiving prostaglandin injections for induction of abortion showed a small but significant serum hypokalemia after treatment.

Abortion, Therapeutic

Characteristics of pregnant women who report previous induced abortions.

Associations between previous induced abortion and demographic and health factors in pregnancy were measured in 9 874 women who gave birth and who had been interviewed during pregnancy. Previous abortion was most rare among women having their first baby and increased with increasing birth order up to the fourth, thereafter decreasing. It was positively correlated with maternal age and negatively with age at marriage. There was no effect of years of schooling, when other variables were taken into account, but there were significant differences between ethnic groups, abortion being commonest among Jewish women from North African countries and more prevalent in those from western and Asian countries than in the second-generation Israel-born or in Arab women.Women who reported abortions were less likely to be strict as regards religious observance and less likely to have had a previous stillbirth or child death, other variables being equal. They were more likely to be smokers or former smokers and to be delivered of their babies in certain obstetric units. They more often reported vomiting, bleeding, and medication in early pregnancy. On the other hand, there was no significant association with diabetes, anaemia, blood groups, or season of birth.The findings show that women reporting previous induced abortions differ significantly from other pregnant women in a wide range of demographic and health characteristics. Such women may also be biased for complications of pregnancy and outcome, particularly if selected from a clinic population. Observations that indicate a deleterious effect of induced abortions on subsequent pregnancy outcomes must therefore be interpreted with considerable caution.

Abortion, Induced

Induced abortion and spontaneous abortion: no connection?

The hypothesis that spontaneous abortion is associated with prior induced abortion is tested in an epidemiologic study. The reproductive histories of a consecutive series of women admitted to hospital with spontaneous abortions were compared with those of a control series of women who delivered after 28 weeks gestation. There is no association between spontaneous abortion and prior induced abortion. The power of the analysis to detect a 30% excess in the frequency of induced abortion in cases as compared to controls is 82% at alpha = .05. The design and analysis effectually controlled for all potentially confounding factors.

Abortion, Induced

Induced abortion: 1975 factbook.

This report presents an overview of current international data on induced abortion, primarily from the demographic and public health points of view. Statistical tabulations make up the major part of the report, with the text providing background information. Opening sections review definitions, sources of data, and concepts of statistical analysis. Major topics for which data are presented include the legal status of abortion (Table 1); incidence of abortion (Tables 2-20); incidence of repeat abortions (Tables 21-23); period of gestation and abortion procedures (Tables 24-27); incidence of abortion with concurrent sterilization (Table 28); complications (Tables 29-31); and mortality (Table 32). The relationships between abortion and contraception (Tables 33-35) and the effects of changes in abortion policies on trends in the numbers of legal abortions, illegal abortions, total induced abortions, and births are evaluated in the final sections (Table 36). Two technical questions are discussed in the appendix (Tables 37-38).

Abortion, Induced

The potential reduction of medical complications from induced abortion.

Reducing medical complications resulting from induced abortion by identifying the safest and most appropriate procedures(s) for each gestational age is the purpose of this study. Data on all women who had induced abortions at all hospitals in the State of Hawaii where such procedures were performed between March 11, 1970, when the new abortion law went into effect, and June 30, 1974 were analyzed. Study findings show that if the abortion procedure with the least risk of complications at each length of gestation were selected a reduction in the complication rate of nearly 30% could result.

Abortion, Induced

Thyroid function before and after induced abortion in normal pregnant women.

We assessed thyroid function before and after induced abortion in 25 normal pregnant women. Serum TSH was significantly increased (P less than 0.02), and serum hCG-beta was significantly reduced (P less than 0.001) 1 week after induced abortion, compared with the levels before induced abortion. There was a significant negative correlation between hCG-beta and TSH, and a positive one between hCG-beta and FT4 before induced abortion (P less than 0.02). No difference was observed in thyroid hormones before and 1 week after induced abortion. The results suggest that hCG stimulates the thyroid gland, gaining an advantage over TSH, in normal pregnant women.

Abortion, Induced

Extra-amniotic 15 (S)-15 methyl PGF2alpha to induce abortion: a study of three administration schedules.

Abortion was induced in 60 patients between 8 and 18 weeks gestation using 15(S)-15 methyl PGF2alpha in one of three extra-amniotic administration schedules: 1.0 mg in viscous medium (Tylose), 1 mg in viscous medium (Hyskon) or 0.5 mg in non-viscous medium repeated at 12 hours. Eighty per cent of patients aborted within 24 hours in each group. The overall mean induction-abortion interval (+/- S.E.) was 17.6 +/- 2.0: there was no significant difference between the three groups. Twenty patients treated with 1.0 mg in viscous medium had the catheter removed immediately following the prostaglandin injection and the success rate was not significantly altered. Gastro-intestinal side effects (vomiting in 50%, diarrhoea in 32.5%) were more frequent in the patients treated with the larger dose though the difference was not statistically significant. No significant haematological or biochemical changes were detected during the 24 hours following the start of treatment in 24 patients investigated. Thirty seven of the 60 patients (61.5%) aborted completely and did not require surgical evacuation, and none lost more than 500 ml of blood, nor required transfusion. It is concluded that abortion can be induced with a single extra-amniotic injection of 1 mg of 15(S)-15 methyl PGF2alpha in viscous medium in a large percentage of patients but that the incidence of side effects is high.

Abortion, Induced

The influence of induced abortion on Taiwanese fertility.

Data on the outcomes of more than 15,000 pregnancies originating between May 1966 and February 1969 were analyzed. The accuracy of the data was evaluated, rates of induced abortion and stillbirth were reported, and the demographic effect of induced abortion was estimated. The demographic effect was defined as the percentage increase in fertility that would have occurred in the absence of induced abortion, assuming no compensating change in alternative fertility control practices. Our principal findings were as follows: 1. We were unable to determine the completeness with which induced abortion was reported in the Registration Study. During the three years covered by the study, rates of induced abortion increased by 54 percent, reflecting a trend in the incidence or in the reporting of events or in both. We concluded that, in any case, the data for the final year of the study, 1968, were more complete than for the earlier two years. 2. Age-specific rates of induced abortion for 1968 displayed a strong urban-rural gradient, being much higher in the city areas than in the rural areas. Within each urban--rural stratum, the rates increases monotonically with age and reached maximum values in the age group 40 and older (553, 436, and 374 per 1,000 pregnancies for city, urban, and rural areas, respectively). 3. Estimates of the demographic effect indicated that, in the absence of induced abortion, the TFR for all Taiwan would have been 12 percent higher in 1968. Under the same assumption, it was estimated that the TFR would have been higher by 16 percent in city areas, 11 percent in urban areas, and 9 percent in rural areas. This urbanization gradient implies that induced abortion contributed to urban-rural fertility differentials. We estimated that about one-third of those differentials were due to induced abortion. 4. Estimates of the demographic effect were also made after adjusting the rates of induced abortion for an assumed level of underreporting of 50 percent. The adjusted estimate of the demographic effect for all Taiwan in 1968 was 19 percent.

Abortion, Induced