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At least 19 recordsLinked to original sources

PubMed1984

Immediate postabortal contraception with Norplant: levonorgestrel, gonadotropin, estradiol, and progesterone levels over two postabortal months and return of fertility after removal of Norplant capsules.

Six Silastic levonorgestrel-releasing capsules, Norplant, were introduced subcutaneously into the ventral aspect of the left forearm or upper arm of thirteen patients immediately after first trimester pregnancy termination. Blood samples were taken twice a week over two months after abortion and from one subject over one month after removal of Norplant capsules. Plasma concentrations of levonorgestrel were measured by radioimmunoassay and the effects of treatment on pituitary and ovarian function were determined by assaying plasma concentrations of LH, FSH, estradiol and progesterone. If removal of Norplant capsules took place because of planning pregnancy, the subjects were asked to inform us if they had become pregnant. During the first month after abortion the mean levonorgestrel concentration (489 pg/ml) was statistically significantly higher than during the second month (237 pg/ml). The mean estradiol values fell to prefollicular levels within four days, remaining a little suppressed. The mean progesterone concentrations were below 2 ng/ml three days after abortion. Three subjects had a transient increase in plasma progesterone concentrations nine days after abortion. Thereafter no ovulatory progesterone concentrations were seen. The LH concentrations ranged within normal values of the follicular phase and FSH values were just beneath the lower limit of follicular phase FSH values, apart from a few peaks, indicating mild suppression. After removal of Norplant capsules, progesterone concentrations increased to ovulatory levels fifteen days after removal. The Norplant capsules were removed from two subjects because of planning pregnancy and they delivered healthy babies 9.5 and 12.5 months after removal.

Abortion, Induced↗

PubMed1987

The role of vaginal secretory immunoglobulin A, Gardnerella vaginalis, anaerobes, and Chlamydia trachomatis in postabortal pelvic inflammatory disease.

In a prospective study of 129 women undergoing induced first-trimester abortion, 14 (10.9%) contracted postabortal pelvic inflammatory disease (PID). Samples of vaginal secretion for quantitation of secretory immunoglobulin A (sIgA) as well as isolates from cervix/urethra for the culture of anaerobes and aerobes, including Bacteroides fragilis et melaninogenicus and Gardnerella vaginalis, were obtained at the preoperative visit. Two blood samples from each woman with postabortal PID were analysed for antibodies against G. vaginalis. Twenty-five per cent of women with a history of PID developed postabortal PID, and 25% with vaginitis contracted postabortal infection (p less than 0.001 and p less than 0.005). Twenty-five per cent of women harboring C. trachomatis at the time of abortion developed infection. The presence of anaerobes or G. vaginalis was not associated with the frequency of postabortal PID (all p-values greater than 0.1). One woman with postabortal PID produced a culture positive for G. vaginalis and a rise in specific antibody titer. The levels of vaginal sIgA were not significantly associated with a positive history of PID (p greater than 0.6), with postabortal PID (p greater than 0.4) or with the presence of anaerobes or G. vaginalis at the time of abortion (p greater than 0.3). However, significantly elevated levels of sIgA were found in women harboring C. trachomatis (p less than 0.05). Thus, the study could not demonstrate any correlation between vaginal sIgA and PID, but increased sIgA in Chlamydia-positive women. A history of PID and vaginitis entailed a significant risk of contracting postabortal PID.

Abortion, Induced↗

PubMedDate not supplied

Improving the medical care and counseling of postabortion patients in Egypt.

This report analyzes the results of an operations research project carried out at two sites in Egypt to improve the medical care and counseling of postabortion patients. Preintervention and postintervention surveys and observations were conducted. After the introduction of vacuum aspiration under local anesthesia, the number of cases treated with dilatation and curettage under general anesthesia dropped from an average of 169 per month to 16. The majority of the remaining cases (an average of 119 per month) were treated with vacuum aspiration. Both providers' and women's knowledge about postabortion complications improved. Family planning information provided to postabortion patients increased as a result of the project's training program. The proportion of patients intending to use a contraceptive method increased by 30 percentage points due to the improved counseling. Future programs linking family planning and postabortion medical services should be prepared to improve the medical care of existing emergency health services and to add counseling services.

Abortion, Illegal↗

PubMed1986

Sequelae of induced first-trimester abortion. A prospective study assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics.

A follow-up study was undertaken in 493 women who had participated in a clinical, controlled trial with the object of assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics in the development of sequelae. Information about dysmenorrhea, dyspareunia, chronic pelvic pain, episodes of pelvic inflammatory disease, infertility, births, induced and spontaneous abortions, and ectopic pregnancies were obtained from 382 of the women and from 38 of 40 women who had contracted postabortal pelvic inflammatory disease during the previous study. Significantly elevated rates in women with postabortal pelvic inflammatory disease compared with women without this disease were found for spontaneous abortion (22% versus 5%, p less than 0.0005), secondary infertility (10% versus 2%, p less than 0.05), dyspareunia (20% versus 5%, p less than 0.005), and chronic pelvic pain (14% versus 2%, p less than 0.001). Nonsignificant differences were observed for ectopic pregnancy and dysmenorrhea. A new episode of pelvic inflammatory disease within the first year after abortion was observed more often in women with postabortal pelvic inflammatory disease than in women without infection (41% versus 5%, p less than 0.0001). Prophylactic antibiotics decreased the rates of spontaneous abortion and dyspareunia (p less than 0.05 in both instances).

Abortion, Induced↗

PubMed1982

Significance of cervical Chlamydia trachomatis infection in postabortal pelvic inflammatory disease.

The prevalence of Chlamydia trachomatis infection of the cervix uteri and its possible association with postabortal pelvic inflammatory disease (PID) were investigated in women subjected to first-trimester-induced abortion. None of the women had signs or symptoms of genital infection at the time of abortion. Chlamydia organisms were isolated from the cervix/urethra in 33 (10%) of 333 women. Women with a positive Chlamydia culture were comparable to women with a negative culture in regard to gestational age at the time of abortion. However, Chlamydia-positive women were significantly younger and had gonorrhea more often than Chlamydia-negative women. Two hundred seventy (81%) of the women were followed up 1 month after the abortion. Thirty-two of these developed postabortal PID. Eight (28%) of 29 women with a positive Chlamydia culture and 24 (10%) of 241 women with a negative culture developed postabortal PID. This difference is significant (P less than .025) and indicates that the presence of Chlamydia in the cervical canal at the time of abortion in asymptomatic women increases the risk of postabortal PID.

Abortion, Induced↗

PubMed1977

Postabortion insertions of the pleated membrane.

The pleated or intrauterine membrane (IUM) was designed to fit a range of uterine sizes and shapes and to adjust to transient changes resulting from uterine motility. The retention and contraceptive abilities of postabortion IUM insertions are analyzed in this study of 154 IUM insertions made within 3 days of treatment for an incomplete or inevitable abortion. Results indicate low 1-year net cumulative event rates for pregnancy (1.7 per 100 users), expulsion (7.2 per 100 users), and removal for bleeding and/or pain (3.9 per 100 users). These rates were similar to those reported in a study of interval insertions of the IUM; moreover, these results also compared favorably with corresponding rates of postabortion insertions reported in studies using other devices. Thus, the postabortion period is indicated as being an effective time for IUM insertion.

Abortion, Induced↗

PubMedDate not supplied

A comparison of the clip and ring techniques for laparoscopic sterilization of postabortion and postpartum patients.

The spring-loaded clip and the tubal ring techniques of laparoscopic female sterilization are compared for ease of performance, safety and effectiveness at the Kandang Kerbau Hospital in Singapore. The two techniques were randomly assigned to 299 postpartum patients and 300 postabortion patients. The assigned procedure could not be performed for two of the ring cases and three of the clip cases. Bleeding and equipment problems made laparotomy necessary in two clip cases and equipment problems caused a change in technique in the other clip case. Hydrosalpinx and adhesions were responsible for a change to laparotomy in the two ring cases. Surgical difficulties, chiefly the result of equipment problems, were significantly higher for both postpartum and postabortion clip procedures. Complications and complaints reported immediately after surgery and at the 7- to 21-day follow-up visit were low for all four groups. For both postabortion and postpartum patients, six- and 12-month data show that pregnancy rates are significantly higher for patients sterilized with the clip than with tubal rings.

Abortion, Induced↗

PubMed1996

Detailed analysis of menstrual bleeding patterns after postmenstrual and postabortal insertion of a copper IUD or a levonorgestrel-releasing intrauterine system.

Detailed information on the menstrual bleeding patterns in users of copper-releasing intrauterine devices (IUDs) and levonorgestrel-releasing intrauterine systems (IUSs) is lacking. Even less is known about the menstrual bleeding patterns associated with postabortal insertion of IUDs. We postulated that the scarcity of IUD studies including detailed analysis of bleeding could be a result of the lack of an easy-to-use computer program designed for this purpose. We therefore developed a set of graphical user interface (Windows) programs for entering, editing, and analyzing menstrual diary data. With these programs, we reanalyzed the menstrual diaries of the subjects of one of the hospital clinics that participated in a previous multicenter study comparing copper IUDs and LNg IUSs. The group included patients who had the IUD inserted postabortally. Copper IUD users had patterns of bleeding that were stable over time, and clearly more bleeding than LNg IUS users, many of whom had either infrequent bleeding, bleeding completely replaced by regularly occurring spotting, or amenorrhea. Postabortal insertion of LNg IUSs was associated with slightly better patterns of bleeding than postmenstrual insertion. Detailed statistics on bleeding help clinicians in counseling patients regarding these methods. The statistics permit assumptions to be made about the probabilities of specific menstrual disturbances and their changes over time.

Abortion, Induced↗

PubMed1989

The influence of cervical dilatation by laminaria tent and with Hegar dilators on the intrauterine microflora and the rate of postabortal pelvic inflammatory disease.

In a prospective study, 519 women were randomly selected for cervical dilatation by laminaria tents or Hegar dilators before scheduled vacuum aspiration. In other 68 women randomly divided into a laminaria group and a control (Hegar) group, placenta, decidua and blood were separately aspirated from the uterine cavity before the vacuum aspiration and cultured for micro-organisms. The rate of postabortal inflammatory disease (PID) was significantly lower after pretreatment with laminaria tent irrespective of patient's age and parity. However, a higher risk of postabortal PID was found in gestational age of 10-12 weeks than of 5-9 weeks. Previous PID and abortion did not increase the risk of postabortal PID. Vaginal/cervical micro-organisms were, irrespective of method for cervical dilatation, identified in two thirds of the patients.

Abortion, Induced↗

PubMed1986

Postabortal endometritis and isolation of Chlamydia trachomatis.

A prospective study of 505 unselected women presenting for induced abortion was undertaken to determine the prevalence of Chlamydia trachomatis and to determine if cervical isolation of C trachomatis before abortion increases the risk of postabortal endometritis. A comparison of direct fluorescent antibody (slide) test with tissue culture for diagnosing C trachomatis infection also was evaluated in this population. C trachomatis was identified by culture in 89 patients (17.6%) and by direct slide test in 85 patients (16.8%). Six of 17 patients with postabortal endometritis were culture positive for C trachomatis, with a significant correlation between C trachomatis infection and development of endometritis observed (P less than .05). These data suggest C trachomatis may play an important role in postabortal endometritis.

Abortion, Induced↗

PubMed1994

Postabortal sepsis.

A review of postabortal sepsis following a 2-year study undertaken at the Department of Obstetrics and Gynaecology, SSG Hospital, Baroda is presented here with a view to know the incidence of postabortal sepsis and septic induced abortions and to re-evaluate the effectiveness of the MTP services in reducing its impact on maternal morbidity and mortality, since the implementation of the MTP Act in 1972. It has been observed that postabortal sepsis is a major cause of maternal mortality even now and MCH service is to be improved to reduce the same.

Abortion, Illegal↗

PubMed1986

Postabortal insertion of IUD.

During 1983, 823 first trimester therapeutic abortions were performed at the University Hospital of Trondheim, Norway. Of these patients, 229 had an IUD inserted at the end of the operative procedure. The remaining 594 patients served as controls. Microbiological samples were taken from the cervix and the urethra. No prophylactic antibiotic treatment was given. Compared to the group of patients not selecting an IUD as contraception, there was no increase in readmission frequency due to immediate postabortal IUD insertion. There were no positive cultures for N. gonorrhoeae, and the relative number of positive chlamydia cultures was the same in both groups. In the IUD group we did not find any increase in complications such as bleeding, pain, perforations or infections. During the first year of observation, 3 pregnancies occurred in the IUD group, giving a Pearl index of 1.3 pregnancies per year. Continuation rate after one year was 72.8%. We recommend immediate postabortal insertion of an IUD after first trimester abortion as a practical and safe procedure.

Abortion, Therapeutic↗

PubMed1980

Differences in hormonal patterns during the first postabortion menstrual cycle after two techniques of termination of pregnancy.

Fifteen patients underwent first-trimester abortion by one of two techniques. In group P, seven patients received prostaglandin vaginal suppositories during the 12 hours prior to vacuum aspiration, whereas eight patients in group V were aborted by aspiration alone. During the first postabortion menstrual cycle, daily peripheral blood levels of several hormones, including follicle-stimulating hormone (FSH), luteinizing hormone, human chorionic gonadotropin, estradiol, and progesterone, were determined. Patients in group P demonstrated a more rapid fall in progesterone levels following pregnancy termination (P less than 0.01). They also experienced a more physiologic first postabortion cycle as evidenced by a larger preovulatory estradiol peak (P less than 0.05) and a more normal luteal phase as judged by both the duration and elevation of progesterone levels. Certain endocrine changes common to both groups but different from those of normally menstruating women were also observed. These consisted of short-term spurts of progesterone secretion in many patients (10 of 15) prior to ovulation and exaggerated levels of FSH during the early follicular phase.

20-alpha-Dihydroprogesterone↗

PubMed1985

Birth control use by teenagers. One and two years postabortion.

A prospective study was undertaken of the contraceptive behavior of adolescent women following a first-trimester abortion. Each women had an individual counseling session, including birth-control counseling. Effective birth control was used by 77% of the 182 respondents one year postabortion. Two years after abortion, 79% of those who remained in the study group continued to use reliable birth control methods. The repeat abortion rate for all respondents was 7% in the first year and 11% in the second year. These results suggest that teenagers who obtain abortions do not rely on the procedure as a method of contraception. Instead, they are more likely to be using reliable methods of birth control postabortion than they were before the unplanned pregnancy.

Abortion, Induced↗

PubMed1993

A survey of hospital postpartum and postabortion rubella vaccination policies in Los Angeles County, 1992.

OBJECTIVE: To determine the proportion of Los Angeles County (LAC) hospitals offering obstetrical services that have postpartum and postabortion rubella vaccination policies. DESIGN: A survey was sent to the infection control practitioners (ICPs) of all operational acute care hospitals (N = 133) in LAC in 1992. A remainder and second survey was mailed to ICPs who did not respond to the first mailing. RESULTS: Of 75 hospitals with obstetrical departments, 56 (75%) responded. Thirty-four (61%) of the 56 respondent hospitals had post-partum rubella vaccination policies. Of the 34 hospitals with policies, 30 (88%) accepted only a written record of rubella seropositivity as proof of immunity, 30 (88%) screened women with unknown immunity status before hospital discharge, and 32 (94%) vaccinated susceptible women before hospital discharge. Of the 32 hospitals that performed induced abortions, only two (6%) provided screening and vaccination services for these women. CONCLUSION: Only 61% of hospitals in LAC offering obstetrical services had postpartum rubella vaccination policies while only minimal screening and vaccination occurred in association with abortion services. Widespread implementation of postabortion screening and vaccination, and more stringent compliance with Advisory Committee on Immunization Practices recommendations for postpartum screening and vaccination in hospitals offering obstetrical services would reduce the number of rubella-susceptible women who have been missed by other prevention strategies.

Female↗

PubMed1990

Postabortion dysphoria and religion.

This study explores psychosocial factors, especially religion, in women identified as dysphoric 1 to 15 years after abortion. The Millon Clinical Multiaxial Inventory (MCMI) and a demographic questionnaire were mailed to patient-led support groups for women who had poorly assimilated a previous abortion experience. Of the 150 surveys mailed, 71 (47%) were returned. Thirty-three women (46%) stated they had changed to a Fundamentalist or Evangelical church. On the MCMI, members of these conservative denominations scored significantly lower on the subscales for passive-aggressive behavior, ethanol abuse, and avoidance. Religion was strongly perceived by the women as playing a healing role. These findings suggest that conservative personal values may be more critical in understanding attitudes toward abortion than other demographic characteristics. Previous follow-up studies that reported no change in postabortion religiosity may have been too short to detect changes in religion. Implications for treatment of postabortion dysphoria include sensitivity to patients' religious beliefs, with support for the healing aspects of their religion.

Abortion, Induced↗

PubMed1997

Accurate diagnosis of postabortal placental remnant by sonohysterography and color Doppler sonographic studies.

The decision whether to perform uterine curettage for postabortal bleeding depends on the ability to demonstrate placental remnants in the uterine cavity. However, diagnosis of postabortal trophoblastic residua by conventional ultrasonography may be inconclusive. We report our experience with the use of combined sonohysterography and color Doppler to demonstrate a placental polyp after early pregnancy termination.

Abortion, Induced↗

PubMed1976

Postabortal and postpartum tetanus. A review of 19 cases.

The occurrence of postabortal and postpartum tetanus over a 7 1/2-year period at Groote Schuur Hospital, Cape Town, is reviewed. Of all the women between the ages of 15 years and 50 years who were admitted with tetanus, 34,7% were admitted after abortions. The mortality rate was 15,8%, which appears to be the lowest thus far reported. Possible methods of preventing postabortal tetanus are discussed.

Abortion, Incomplete↗