Incidence Of Illegal Abortion Research Articles

USE OF MIFEPRISTONE AND MISOPROSTOL COMBINATION FOR FIRST TRIMESTER MTP UP TO 9 WEEKS

In India about 6.7 million abortions takes place every year of which 4 million are induced and 2 millions are spontaneous. WHO estimates that unsafe abortion kills about 70,000 women annually, many more suffer serious injuries and permanent disability. In spite of legalization of medical termination of pregnancy in India, the incidence of illegal abortion is at time more common than legal abortion. Unsafe abortion is major cause of mortality among women in India accounting for 12% of all maternal death. One way of reducing mortality and morbidity associated with unsafe abortion is early decision by women for termination of pregnancy by use of combination of mifepristone and misoprostol for termination of pregnancy up to 9 weeks. So the present study aims to study the efficacy of mifepristone and misoprostol for medical termination of pregnancy up to 9 weeks of pregnancy. This is a prospective randomized study undertaken in 100 patients seeking MTP, in the reproductive age group with a history of less than or equal to 9 weeks gestation, attending Obstretic and Gynace OPD of Sir Takhsinhji Hospital attached to Govt. Medical College, Bhavnagar from March 2018 to August 2019. They were administered 200 mg of mifepristone followed by oral misoprostol 400 ug after 48 hours and another 400ug misoprostol after 24 hours. Results show Overall success rate of 92% abortion failure rate of 8% were achieved. This treatment regimen was more effective in earlier gestational age group.
 Keywords: Abortion, MTP, Mifepristone , Misoprostol

English

OBJECTIVES : To know the efficacy and outcome of single dose of vaginal Misoprostol 800Ug in first trimester abortion. MATERIAL AND METHODS : This study was conducted over a period of 3 yrs at Adichunchanagiri institute of medical sciences. A total of 200 pregnant women upto 12 wks of gestation wanting termination of pregnancy was recruited in this study. The efficacy, outcome, and induction abortion interval was studied in these cases. RESULTS: In our case study 76% of the patients had complete abortion with single dose of 800ug Misoprostol and 4 % underwent check curettage due to profuse bleeding and retained products in uterus on USG. 20% of the cases needed second dose of 200ug of Misoprostol. The mean induction to abortion interval was 11.38hrs. 96% of the patients had complete abortion with medical method and only 4% underwent surgical curettage due to profuse bleeding after the single dose. The mean haemoglobin prior to induction was 9.76gm% and post expulsion was 9.59gm % respectively. No statistical difference was noted .The incidence of side effects like nausea, vomiting and diarrhoea was minimal and transitory. No major complications noted. CONCLUSION: Vaginal PGE 1 analogue is very safe and effective method of termination of first trimester pregnancy. Single high dose of vaginal Misoprostol 800ug is found to be cost -effective with minimal side effects, shorter Induction Abortion interval and a day care procedure with good success rate and can be adopted at community and primary health care units to reduce the maternal morbidity and mortality in developing countries like India due to unwanted pregnancies and unsafe abortions INTRODUCTION: The incidence of illegal abortion is twice as high as that of legal MTP'S.Many incidences have not been reported. Unwanted pregnancies due to failure to obtain appropriate contraceptive services and also unwillingness of the women result in both legal and illegal abortions. The complications of unsafe abortions can vary from chronic infection and infertility to septic shock syndrome ,multiorgan failure and death. Medical abortion is a safe,effective means of terminating pregnancy provided the

Abortion, ectopic pregnancy and miscarriages in Sub Saharan Africa: Challenges of Rhesus isoimmunisation in Rhesus negative women

The implementation of a program on routine antenatal anti-D prophylaxis (RAADP) in the developed world has led to a significant decline in the residual numbers of Rhesus negative women becoming sensitized. However, a significant number of Rhesus D negative women in SSA are not fortunate because of lack of access to prophylactic immunoglobulin D and thus they continue to be affected. The management of Rhesus negative pregnancy in Sub-Saharan Africa is associated with several daunting challenges: absence of a policy on universal access to Rh D immunoglobulin, lack of fetomaternal testing facilities, unaffordability of prophylactic anti-D immunoglobulin, poor uptake of quality antenatal care, poor health infrastructure, sub optimal management of potentially sensitizing events during pregnancy, shortage of qualified medical personnel, poor data management, high incidence of illegal abortion and quackery. There is a need for the formulation of necessary guidelines on Rhesus immunoprophylaxis in SSA. Health authorities need to implement evidence-based policy on universal access to anti-D immunoglobulin. There is also the need to optimize the knowledge of obstetricians on anti-D prophylaxis, implementation of the readily available and affordable Kleihauer fetomaternal haemorrhage testing for all women who experience a potentially sensitizing event antenatally post 20 weeks gestation and postnatally. These factors can facilitate the effective management of Rh negative pregnancy in the region and reduce the risk of Rhesus D immunization and Rhesus D haemolytic disease of the foetus and newborn.

BEBERAPA ASPEK ABORSI

Abortion is prohibited by the law in Indonesia and it is permitted only on narrow medical grounds, i.e. to save the life of the pregnant woman. The Moslem religious leaders hold the same view.The incidence of illegal abortion is unknown. However, research findings in hospitals show that induced abortion is increasing. Contraceptive failure is one of the important factors for married women which is associated to the motivation to have a relatively small family. Another factor is the changing sexual behaviour of unmarried women. People are much mobile nowadays and are experiencing more sexual stimulations through the mass media, films, and various entertainments.In order to prevent abortion among the unmarried there is thus a growing need for family planning information and services. It is, however, a very sensitive issue, and is unlikely that the government or the non government organizations would provide such services. Even those who experience contraceptive failures in the government family planning program have, in general, no access to save abortion.

Illegal abortion: an attempt to assess its cost to the health services and its incidence in the community.

This article describes a study designed to test a method for assessing the cost to the health services of illegally induced abortion and the feasibility of estimating the incidence of induced abortion by a field interviewing approach. The participating centers included three hospitals in Ankara, Turkey; three hospitals in Ibadan, Nigeria; one hospital in Caracas and one in Valencia, Venezuela; and two hospitals in Kuala Lumpur, Malaysia. Hospitalized abortion cases were classified as induced or spontaneous or as "probably induced," "possibly induced," or "unknown" according to a classification scheme comprising certain medical criteria. The sociodemographic characteristics of induced and spontaneous abortion cases were subjected to discriminant function analysis and the discriminating variables best characterizing the induced versus the spontaneous abortion groups were identified for each center. On the basis of this analysis, the "probably" and "possibly" induced and "unknown" categories were further classified as induced or spontaneous abortion, with stated probabilities. Thus an overall estimate is made of the proportion of all hospitalized abortions that can be considered illegally induced outside the hospital. Selected results on costs of induced and spontaneous abortion are shown. The method further tested the feasibility of obtaining valid survey data on abortion from the communities studied by re-interviewing the women hospitalized for induced and spontaneous abortion six months later in their homes. This exercise showed a degree of under-reporting of abortion that varied widely among centers, even among women who had admitted illegal induction at the time of hospitalization. The feasibility of estimating the incidence of illegal abortion by field studies is discussed in the light of these findings.

Abortion: world perspectives in the mid-1980s.

Abortion is recognized as an essential component of any successful population policy and thus far no country intent on decreasing its rate of population growth has been able to ignore it. Focus in this discussion is on the legal status of therapeutic abortion in Western and Eastern Europe the US and Canada Asia Africa and Latin America. In Western Europe the thrust of legislation has been towards liberalization. The Nordic nations took the 1st definitive steps in this direction long before the outbreak of World War II. The most recent Danish statute of the 1973 allows abortion on request during the first 3 months of pregnancy for all women irrespective of age or parity. The Swedish law of 1975 guarantees the womans right in the absence of a specific medical contraindication to have an induced abortion up to the 18th week of gestation. Norway and Finland further liberalized their laws in 1979. A liberalizing abortion law was introduced in the UK in 1967. France liberalized its abortion law in 1975 and the Dutch government passed a bill in 1981 authorizing abortion at the request of the pregnant woman. A liberal abortion law was introduced in the USSR soon after the Bolshevik Revolution of 1971. In the 1930s the statute became more restrictive but 2 decades later the Soviet government in common with most other Eastern European countries repealed it and reintroduced liberal practice. Yugoslavia is the only country in Eastern Europe in which a womans free decision on abortion is enshrined in the constitution. Liberalization of the US abortion law was given considerable impetus in 1970 when Alaska Hawaii and New York State authorized what was tantamount to abortion on request. Then in 1973 the Supreme Court handed down its decision that during the first 10 weeks of pregnancy a woman should decide in consultation with her doctor whether or not an abortion should be performed. Yet the overall response of the US health services has been patchy and by 1982 the joint federal/state medical assistance to pay for abortions had been gradually whittled down with the result that only 15 states and the District of Columbia were providing a reasonable service. In Canada a restrictive law was operating until 1969 after which it was moderately liberalized. The new statute permitted abortion in hospitals with the approval of a committee of at least 3 physicians. India and China have had a population policy in operation for several years with abortion as an important component. Elsewhere in Asia the pattern of abortion varies greatly. Restrictive laws against abortion operate throughout Africa. The only major exception is Tunisia which incorporated a social clause in 1965. In most of Latin America strong religious opposition to abortion exists and the official stance of many of the governments remain staunchly pronatalist but the incidence of illegal abortion is very high.

Legalized Abortion: The Singapore Experience

Abortion has been legal since 1970 in Singapore. This report traces the events leading to the liberalization of abortion laws and examines women's changing attitudes toward abortion, in Singapore. The method of abortion practiced by obstetricians, postabortal sterilization, and the effect of legalized abortion on the incidence of illegal abortion in the country are also examined.

Human life symposium: a synopsis and critique.

A brief summary of the major issues raised by each address during the Human Life Symposium is presented and critiqued by the author. Multidisciplinary perspectives were solicited concerning the possibility of ascribing personhood status to a fetus. Several speakers addressed the issue of the ability of science to define "person." Science may be able to define stages in an organism's development, but cannot decide what rights and obligations should be accrued at any given stage. In philosophy, a single concept of person does not exist, however science, according to 1 speaker, should be able to develop a definition. The author points out that scientific definitions are generally utilitarian and are molded to fit their eventual purpose and questions the role of science in solving the abortion debate in the US. Waste in the reproductive process was reviewed in terms of the number of ova, sperm, fertilized ova, and implanted embryos that nature prohibits from attaining full reproductive potential as a viable pregnancy. Medical technology has allowed many parents to selectively have offspring free of genetic disease who would not have opted to conceive or continue a pregnancy. Medical advances in fetal treatment and surgery raise new ethical dilemmas including the right of the mother to not consent to treatment or in the case of multiple pregnancy, the right of other fetuses not to be jeopardized to save the life of one fetus. The expected impact of bestowing personhood on a fetus would be seen in the abolition of screening programs, of parents' rights to bear only healthy children, in the increased prevalence of children with abnormalities, in the dilemma which would arise in providing necessary treatment to a woman that would endanger the fetus, in the banning of contraceptives which act after fertilization, and in the incidence of illegal abortion. Attempts to define life in terms of legally accepted definitions of death, i.e., loss of capacity and future potential of brain function, are irrelevant because in a fetus, the potential exists before the capacity. Historically, the legal definition of personhood has been pragmatically applied and varies with the intent of different laws. 1 speaker suggests that the abortion issues will not be resolved by defining personhood but through compromise of the competing social values. The history of abortion legislation is reviewed and it is suggested that the consequences sought from abortion law be determined and then the law be written to achieve those consequences. The severity of the ramifications of the passage of a human life bill were presented from both ends of the continuum. Aside from confusion and much litigation, 1 speaker suggested that the impact would be limited because the ban on abortions would need to be decided in each state and the legal conflict between 2 persons (mother and fetus) could be resolved using the legal analogy that one has no duty to rescue a stranger in distress. Another speaker felt the impact would be enormous, effecting at least 10 different areas of the law. A geographic and historic comparison of abortion laws concluded that laws were merely neutral vehicles to express cultural and ethical values. The theory of utilitarianism and the role of religious attitudes were discussed. The development of new technology in the field of genetics is expected to raise additional issues when more genetic diseases are treatable and when termination of a pregnancy is no longer synonymous with the death of a fetus.

On the Incidence of Illegal Abortion: With a Reply to Dr. W. H. James

On the Incidence of Illegal Abortion: With a Reply to Dr. W. H. James

The Incidence of Illegal Abortion

The Incidence of Illegal Abortion