FURTHER FOLLOW-UP ON HABITUAL ABORTION PATIENTS

Abstract

Abstract 1. 1. This follow-up report covers a period of over 20 years during which time 427 cases have been observed. These patients have had 1,627 pregnancies before treatment, of which 1,380 or 86.0 per cent had spontaneous abortions. 2. 2. After therapy was begun, 289 of these patients were treated in from one to 6 subsequent pregnancies for a total of 496, of which there were 112 abortions, or 23.5 per cent. 3. 3. The reversal of the habitual abortion tendency may be due to the treatment employed. The essentials of treatment for over 20 years have been early prenatal care, good nutrition, a high citrus diet, vitamin C and K supplements, and a good doctor-patient relationship. 4. 4. During the past 10 years, preconceptional care, uterine anodynes, and a more dynamic and positive type of psychotherapy have been added to the regimen. No improvement was observed in the second decade of the study, perhaps because the patients were older, the incompetent cervix was more common, more patients were in the perpetual abortion class, and more were undergoing psychoanalysis. 5. 5. The success rate between 75 and 80 per cent is in keeping with the results obtained with other regimens reported in the literature. Perhaps all of them have a common denominator, namely, improved nutrition and prenatal care. Yet some isolated factor like the hormones are often given the credit. 6. 6. The perinatal mortality before treatment was 20.9 per cent; afterward, it was 3.6 per cent. The incidence of fetal anomalies and defects was 3.7 per cent before treatment and 1.66 per cent afterward. 7. 7. Most of the cases exhibited psychic conflicts in the marital or environmental situations, yet divorces were few. Fear of a defective child was prominent. Yet the dread of the responsibility of rearing the child and reluctance to interrupt a career were also in evidence. There was little evidence of a desire for large families. Of the 427 patients, 138 never tried another pregnancy; 289 had only one additional pregnancy; 127 of these had two; 54 had three; 26 had four, and only 9 had 5 or more. Only 10 couples resorted to adoption.