| 1. Title: Smart RISUG: a potential new contraceptive and its magnetic field-mediated sperm interaction. Author: Jha RK; Jha PK; Guha SK Source: International Journal of Nanomedicine. 2009;4(1):55-64. Abstract: The rationale and technique underlying a novel concept of noninvasive fertility control by a new Cuproferrogel contraceptive drug, iron oxide-copper-styrene maleic anhydride-dimethyl sulphoxide (Fe3O4-Cu-SMA-DMSO) composite named 'Smart RISUG' (smart reversible inhibition of sperm under guidance) in presence of pulsed magnetic field (PMF; 1 mT to 800 mT) is explained. It was synthesized by dispersing iron oxide particles and copper particles into SMA-DMSO (male contraceptive RISUG) and characterized for particle distribution, particle size measurement and transmittance peaks, etc. Interaction of the RISUG particles as well as Smart RISUG particles with Albino rat sperm cell was studied in presence as well as absence of PMF. To find an explanation to increased reaching of the Smart RISUG drug into sperm under influence of magnetic field, the transport properties were characterized by high resolution transmission electron microscopy and atomic force microscopy. Smart RISUG could be mobilized into sperm cell membrane at the PMF, 760 mT in about 50 seconds. Adoption of novel drug Smart RISUG involving new technique may open the pathway for non surgical control of drug distribution, detection and restoration of the normal fertility after removal of the contraceptive from the male/female reproductive tube in presence of electromagnetic field. Language: English Keywords: INDIA | RESEARCH REPORT | LABORATORY PROCEDURES | REPRODUCTIVE TECHNOLOGIES | FERTILITY CONTROL, POSTCONCEPTION | SPERM TRANSPORT | DRUGS | Asia, Southern | Asia | Developing Countries | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Family Planning | Treatment Document Number: 341052 |
2.  Peer Reviewed Title: Silent rupture of unscarred uterus: an unusual presentation at second trimester abortion. Author: Malhotra N; Chanana C Source: Archives of Gynecology and Obstetrics. 2007 Apr;275(4):283-285. Abstract: Rupture of unscarred uterus during the second trimester is rare. A case of ruptured uterus in a multiparous woman is presented. To our knowledge, this might be the first reported case in the English literature of uterine rupture during second trimester termination of pregnancy using ethacridine lactate. This case is also rare as uterine rupture is presented with an insidious course rather than acute, thus delaying the diagnosis. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | PREGNANCY, SECOND TRIMESTER | ABORTION | ULTRASONICS | PARITY | FERTILITY CONTROL, POSTCONCEPTION | OXYTOCIN | OBSTETRICAL SURGERY | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Measurements | Fertility | Population Dynamics | Pituitary Hormones | Hormones | Endocrine System | Physiology | Biology | Surgery | Treatment Document Number: 313026 Notification |
3.  Title: Assessment of fertility control efforts in a selected area of Karachi, Pakistan. Author: Shirmeen A; Khan MF; Khan KH; Khan KH Source: Ulster Medical Journal. 2007 Sep;76(3):144-145. Abstract: The aims were to investigate the impact of fertility control efforts on reducing fertility and to study the contributory role of fertility inhibiting factors viz, age of the marriage, breast feeding and post-partum amenorrhea, abortion and use of contraceptives in selected area in Karachi, Pakistan. The aim was to estimate the gap between knowledge of contraceptives and its practice i.e. KAP-GAP as well as to determine the level of unmet need in the PIB colony in Karachi. A sample survey was conducted in PIB colony in Karachi from October 2005 to November 2005 by interviewing 340 married women in reproductive ages. The data was tabulated and John Bongaarts technique was used to analyse the success of fertility control efforts in the selected area. Of the total of 340 respondents, 38% were currently using contraceptive methods with 26% using OCP's and 12% were condom users. A slight reduction in total fertility (TFR) was noticed. The population policy of Pakistan envisages achieving population stabilization in 2020 by reducing the annual rate of population growth from 1.9% to 1.3% and TFR at 2.1. This target requires strenuous efforts to make the concept of small family an accepted milieu through an eagerly designed communication and education campaign. Concentration on proximate determinants of fertility particularly breast feeding and prolonging birth interval will not generate opposition from the community because these concepts are in accordance with Islamic injunctions and teachings. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | INTERVIEWS | WOMEN | CURRENTLY MARRIED | FERTILITY CONTROL, POSTCONCEPTION | CONTRACEPTIVE USAGE DETERMINANTS | KNOWLEDGE | BREASTFEEDING | MARRIAGE AGE | ABORTION | AMENORRHEA | Developing Countries | Asia, Southern | Asia | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Family Planning | Contraceptive Usage | Contraception | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Marriage Patterns | Marriage | Menstruation Disorders | Diseases Document Number: 320807 Notification |
| 4. Peer Reviewed Title: Contraception and abortion attitudes and practices of western Ukraine women. Author: Muscato L; Kidd RS Source: European Journal of Contraception and Reproductive Health Care. 2003 Jun;8(2):80-86. Abstract: Objectives: To assess the attitudes and practices of contraceptive behaviors of Western Ukraine women. Methods: A survey of 500 women in the Oblast was conducted to assess their knowledge, attitudes and practices on a variety of health topics. Convenience sampling was used to access the subjects in 16 different towns/villages in nine rayons throughout the Oblast. Respondents were asked more than 100 questions pertaining to their knowledge, attitudes and practices on a variety of health topics, including stress, contraception, breast health, sexually transmitted diseases, parity, abortion, nutrition, alcohol and tobacco use, domestic violence, and depression and mental health. Results: Of married women, 44% (112/256) would terminate their pregnancy while 56% (144/256) said they would keep their baby. Of unmarried women, 35% (31/88) would abort while 65% (57/88) would keep their baby. A large proportion of married women (82%; 222/271) and unmarried women (70%; 52/74) did not use condoms at all. Conclusion: These results suggest lack of birth control education and contribution to poor protection from sexually transmitted infections. Higher abortion practices may also play a role in the infertility issues that Ukrainian women currently face. (author's) Language: English Keywords: UKRAINE | RESEARCH REPORT | KAP SURVEYS | WOMEN | ABORTION RATE | FERTILITY CONTROL, POSTCONCEPTION | CONTRACEPTIVE METHODS CHOSEN | KNOWLEDGE | ATTITUDES | CONTRACEPTIVE EFFECTIVENESS | MATERNAL MORTALITY | ABORTION | DECISION MAKING | AGE FACTORS | MARITAL STATUS | USAID | TECHNICAL ASSISTANCE | Europe, Eastern | Europe | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Family Planning | Contraceptive Usage | Contraception | Psychological Factors | Behavior | Mortality | Population Dynamics | Population Characteristics | Nuptiality | Government Agencies | Organizations | Programs | Organization and Administration Document Number: 180668 Notification |
| 5. Title: Abortion: an emerging issue to meet son preference and fertility control in Bangladesh. Author: Bairagi R Source: Unpublished] 2001. Presented at the International Union for the Scientific Study of Population, IUSSP, 24th General Conference, Salvador, Brazil, August 18-24, 2001. 27 p. Abstract: The contraceptive prevalence rate (CPR) has been increasing, but the total fertility rate has been stable at 3.3 in Bangladesh for the last six or seven years. Abortion is on increase and son preference is thought to be a constraint on further fertility decline in this country. This study investigated the effects of son preference on contraceptive use, abortion, and fertility, and the trends of these effects during 1982-1995, a time when Bangladesh was undergoing a demographic transition. Data for the study came from the Matlab Demographic Surveillance System (DSS). Matlab is a rural area in Bangladesh and its DSS has been recording the vital events of a population of about 200,000 by bi-weekly household visits (monthly since 1997) by Community Health Workers (CHW) since 1966. A comprehensive maternal and child health and family planning (MCH-FP) project began in half of the DSS area in 1977, and the other half, known as Comparison area, remained under the usual health and family planning program of the government. The data on CPR, abortion, and fertility were available from the DSS and the record keeping system (RKS) in the area. The effect of son preference on the CPR, abortion and fertility was measured by the method suggested by Arnold (Demography 22:280-288, 1985). This method gives an estimate of an increase or decrease in the CPR, abortion, etc. that would happen in a population in the absence of any sex preference for children. The level of sex-selective abortion (abortion of female fetus) was measured by the deviation from the expected sex-ratio at birth. It is estimated that the increase in contraceptive prevalence rate (CPR) would be less than 9%, while decrease in fertility would be more than 12% in the complete absence of sex preference for children. Son preference had also an effect on abortion. However, there was no indication of sex-selective abortion in the area. It is estimated that the abortion ratio would increase by 36-52% in the absence of sex preference for children. The effects of son preference on fertility are mediated through both contraceptive use and abortion. A strong relationship between son preference and abortion found in this study is alarming. Elimination or reduction in son preference may increase the number of abortions initially. But it will reduce the possibility of sex-selective abortions and its related consequences. Son preference and abortion both should be discouraged. Improvement in the status of females and female children should be helpful in reducing son preference, and improvement in MCH-FP program should be helpful in reducing the number of abortions in Bangladesh. (author's) Language: English Keywords: BANGLADESH | RURAL AREAS | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | POPULATION | FERTILITY CONTROL, POSTCONCEPTION | ABORTION | SEX PREFERENCE | CONTRACEPTIVE USAGE | CONTRACEPTIVE PREVALENCE | FERTILITY DECLINE | Asia, Southern | Asia | Developing Countries | Geographic Factors | Demographic Surveys | Population Dynamics | Demographic Factors | Family Planning | Value Orientation | Psychological Factors | Behavior | Contraception | Fertility Changes | Fertility Document Number: 192598 Notification |
| 6. Title: Contraceptive vaccine: new hope for the overcrowded world? Author: Sinawat S Source: Journal of the Medical Association of Thailand. 2001 Sep;84(9):1336-1339. Abstract: The overall rate of fertilization in humans has contributed to sustained increases in the world population and the added urgency of the need to develop new, effective contraceptive strategies. One potential approach to preventing fertility is to disrupt sperm-egg interaction or embryonic-maternal communication during early pregnancy with immunological reagents. This has lead to the principal concept of "contraceptive vaccine" which may become available in the near future. (author's) Language: English Keywords: GLOBAL | LITERATURE REVIEW | CONTRACEPTIVE VACCINES | RESEARCH AND DEVELOPMENT | CONTRACEPTIVE MODE OF ACTION | FERTILITY CONTROL, POSTCONCEPTION | STANDARDS | Contraception, Immunological | Contraception | Family Planning | Technology | Economic Factors | Research Methodology Document Number: 176286 |
| 7. Title: Efficacy of methods for determining ovulation in a natural family planning program. Author: Guida M; Tommaselli GA; Palomba S; Pellicano M; Moccia G; Di Carlo C; Nappi C Source: FERTILITY AND STERILITY.. 1999 Nov;72(5):900-4. Abstract: This methodological study aims to evaluate the efficacy of methods used for determining ovulation in a natural family planning in comparison with pelvic ultrasonography. Prospective analysis of ovulation detection methods was conducted with 40 women. Ovulation-detection methods employed in the study include transvaginal ultrasonography, daily morning urinary luteinizing hormone (LH) determinations, determination of salivary beta-glucuronidase activity, salivary ferning test, determination of cervical mucus levels and characteristics, and measurement of rectal or oral basal body temperature. Results revealed a 100% correlation between urinary LH level and ovulation diagnosis obtained from ultrasonographic examination. Other ovulation-detection methods contain the following correlation results: mucus sensations and characteristics, 48.3%; alpha-glucuronidase, 27.7%; and salivary ferning test, 36.8%. These findings draw the researchers to conclude that self-determination of LH levels could be an excellent method in ovulation determination. Language: English Keywords: RESEARCH REPORT | PROSPECTIVE STUDIES | OVULATION DETECTION | NATURAL FAMILY PLANNING | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | EMERGENCY CONTRACEPTION | Studies | Research Methodology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Family Planning, Behavioral Methods | Contraception Document Number: 145815 |
| 8. Title: Abortion in Ljubljana, Slovenia: a method of contraception or an emergency procedure? Author: Kveder DO Source: In: Abortion in the developing world, edited by Axel I. Mundigo, Cynthia Indriso. London, England, Zed Books, 1999. :447-64. Published for World Health Organization [WHO]. Abstract: This cross-sectional survey, with a simultaneous collection of existing and retrospective data, examined whether women in Slovenia perceive abortion as a fertility regulating method or as an emergency procedure. Study participants comprised 473 women who were pregnant up to 10 weeks gestation and who sought abortion at the University Department of Gynecology and Obstetrics in Ljubljana during the period between March and August 1988. Overall, findings indicate that women do use abortion when contraception fails, but it is less clear that they rely on abortion as their only method of fertility regulation. The study has shown that most women did use contraception either permanently or only during a limited period of time prior to conception (95.8%) and at conception (90.9%). The high proportions indicate that easy accessibility of abortion did not reduce motivation to use contraception. The factors with the strongest effect on contraceptive use before conception were a women's perception of the effectiveness of the method used and the number of previous abortions; and to a lesser extent, the woman's educational level and educational aspirations. It is hoped that the study will stimulate family planning researchers to pay increased attention to the complex determinants and factors that explain sexual and reproductive behavior and specific contraceptive use patterns, including abortion. Language: English Keywords: SLOVENIA | RESEARCH REPORT | ABORTION | CONTRACEPTIVE USAGE | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | EMERGENCY CONTRACEPTION | Europe, Central | Europe | Developing Countries | Family Planning | Contraception Document Number: 156359 Notification |
| 9. Title: Experiences in the diffusion of emergency contraception in Latin America. Author: Vernon R Source: In: Reproductive health operations research, [compiled by] Population Council. Latin America and the Caribbean Operations Research and Technical Assistance in Family Planning and Reproductive Health [INOPAL]. New York, New York, Population Council, INOPAL, 1998. :81-90. (USAID Contract No. CCP-95-C-00-00007-00) Abstract: This article presents the main results of studies and activities concerned with the diffusion of emergency contraception (EC) in Latin America. The studies were conducted by the Latin America and the Caribbean Operations Research and Technical Assistance in Family Planning and Reproductive Health III. Based on the experience of the participating organizations, only weak opposition to the dissemination of information and delivery of EC has been encountered. It was also shown that there is a rather limited potential market for EC. In addition, the introduction of EC as an element in the care of rape victims has proven very acceptable in all countries. Observations suggest that there was an increase in the number of requests for services after dissemination activities. Moreover, it was shown that some dissemination activities could be conducted very cheaply, such as the distribution of brochures at clinics, conferences and professional meetings, and by sending materials to the media. Such activities have been proven effective, given that a large proportion of physicians and pharmacists provided the service after receiving the brochures. Recommendations derived from these findings are also presented in the article. Language: English Keywords: LATIN AMERICA | CARIBBEAN | TECHNICAL REPORT | CONTRACEPTIVE AGENTS, POSTCOITAL | CONTRACEPTIVE DISTRIBUTION | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | EMERGENCY CONTRACEPTION | Developing Countries | Americas | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 141508 |
| 10. Title: Effect of two antiprogestins (mifepristone and onapristone) on endometrial factors of potential importance for implantation. Author: Cameron ST; Kelly RW; Critchley HO; Baird DT; Buckley CH Source: FERTILITY AND STERILITY. 1997 Jun;67(6):1046-53. Abstract: Further support for the use of mifepristone and onapristone as postovulatory fertility control agents was provided by a clinical study of 15 healthy volunteers with regular menstrual cycles. Of interest were the effects of these antiprogestins on endometrial factors that may affect implantation. Subjects were studied over control, treatment, and follow-up cycles. In the treatment cycle, women received either 200 mg of mifepristone or 400 mg of onapristone by mouth 48 hours after the onset of the luteinizing hormone surge in the urine. Five subjects agreed to undertake treatment with each antiprogestin, yielding a total of 20 treatment cycles. Treatment with either antiprogestin did not affect the length of the luteal phase between cycles or the follicular phase. The histologic appearance and immunohistochemistry of the endometrial biopsies taken 4 and 6 days post-ovulation after treatment with the antiprogestins indicated an adverse effect on uterine receptivity. After treatment with either agent, the endometrium was retarded and secretory changes were absent or poorly developed. These agents further inhibited the appearance of 15-hydroxyprostaglandin dehydrogenase and prevented the down-regulation of estrogen and progesterone receptors in the glands in the midluteal phase of the cycle. Both antiprogestins produced a significant suppression in serum levels of the endometrial protein glycodelin. Reduced immunostaining for leukemia inhibitory factor also was apparent. Neither agent exerted a significant effect on the pituitary-adrenal axis in the doses used in this study. Language: English Keywords: SCOTLAND | RESEARCH REPORT | CLINICAL RESEARCH | RU-486 | ENDOMETRIAL EFFECTS | IMPLANTATION SUPPRESSION | PROSTAGLANDINS | FERTILITY CONTROL, POSTCONCEPTION | Developed Countries | United Kingdom | Europe, Western | Europe | Research Methodology | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Contraceptive Mode of Action | Contraception | Family Planning Document Number: 125378 |
| 11. Title: The use of induced abortion in Mauritius: alternative to fertility regulation or emergency procedure? Author: Mauritius Family Planning Association Source: AFRICAN JOURNAL OF FERTILITY, SEXUALITY AND REPRODUCTIVE HEALTH. 1996 Mar;1(1):72-5. Abstract: Abortion is illegal in Mauritius, but despite these legal restrictions abortions are very much part of the reproductive health picture in Mauritius. To examine why Mauritius women are risking their lives, their health, and their reproductive futures by engaging in illegally induced abortions, the Mauritius Family Planning Association conducted a study of 475 women treated in 3 hospitals with abortion complications during the period of January-April 1992. Both qualitative and quantitative data collection approaches were employed. The primary reason for abortion was unwanted pregnancy, which was perceived as a threat to the individual and the family and often resulted from the improper use of contraceptive methods such as withdrawal and natural family planning or from the lack of use of any family planning method at all. About 92.9% of the subjects used a crude and/or self-induced method to abort, which explains why these women suffer complications. The picture that emerges from these data shows a group of women committed to the improvement of their ability to control fertility in the future. Recommendations for future actions are outlined. Language: English Keywords: MAURITIUS | RESEARCH REPORT | PREGNANCY, UNWANTED | ABORTION | PREGNANCY OUTCOMES | CONTRACEPTIVE USAGE | FERTILITY CONTROL, POSTCONCEPTION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Pregnancy | Reproduction | Contraception Document Number: 148349 Notification |
| 12. Title: Abortion: between freedom and necessity. Author: Hadley J Source: London, England, Virago, 1996. xiii, 238 p. Abstract: In this book, the author "considers abortion politics with an international perspective and explores some of the new issues affecting the abortion controversy, such as the abortion pill and prenatal testing for birth defects. She challenges many of the arguments offered by the pro-life and pro-choice advocates, arguing for a renewed feminist commitment to abortion as a fundamental element of sexual freedom." (EXCERPT) Language: English Keywords: GLOBAL | ABORTION | POLITICAL FACTORS | FERTILITY CONTROL, POSTCONCEPTION | FEMINISM | Family Planning Document Number: 252126 Notification |
| 13. Title: Mifepristone (RU486) and emergency contraception [letter] Author: Hewitt I Source: MEDICAL JOURNAL OF AUSTRALIA. 1995 Jan 16;162(2):110. Abstract: To the Editor: Healy and Evans have misrepresented RU486 as a contraceptive throughout their article. Regardless of where one stands on the use of this drug, it does not act to prevent conception, defined as "the onset of pregnancy, marked by implantation of the blastocyst"; rather, it is an abortifacient. Be honest, call a spade a spade. (full text) Language: English Keywords: RU-486 | FERTILITY CONTROL, POSTCONCEPTION | ABORTION | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Family Planning Document Number: 103977 Notification |
| 14. Title: Surveys find lack of knowledge limits use of morning-after pill. Author: Kolata G Source: NEW YORK TIMES. 1995 Mar 29;:A14. Abstract: The administration of high doses of ordinary birth control pills, high doses of minipills, or use of a copper IUD, depending upon when used by the woman, either prevents fertilization or stops a fertilized egg from implanting. The Kaiser Family Foundation, with the collaboration of Louis Harris & Associates, recently surveyed a national sample of 300 obstetrician-gynecologists and 270 American women aged 18 years and older at particular risk of unplanned pregnancies about the knowledge of such emergency contraception. 77.5% of the obstetrician-gynecologists were very familiar with emergency contraception and 22% were somewhat familiar with it. Most considered the approach to be safe and effective, and 86% of those who refuse to perform abortions for ethical, moral, or religious reasons said they would prescribe the contraceptives. These practitioners, however, seldom prescribe emergency contraception unless their clients ask for it. 60% of the women at risk had heard of emergency contraceptives, but only 20% knew they were effective up to 72 hours after intercourse. Most women therefore do not know enough about emergency contraception to ask for it. More women should know about this contraceptive option. These data were presented at a news conference in New York on March 29, 1995. Concurrently, a book was released which describes emergency contraception methods and lists 1400 centers and doctors willing to provide the oral contraceptive pills or IUDs to women who want them. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | KNOWLEDGE | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | CONTRACEPTIVE AGENTS, POSTCOITAL | EMERGENCY CONTRACEPTION | WOMEN | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Demographic Factors | Population Document Number: 112573 |
| 15. Title: Emergency contraception [letter] Author: Ziebland S; Garcia P Source: BRITISH JOURNAL OF GENERAL PRACTICE. 1995 Feb;45(391):108-9. Abstract: In 1994, a random sample of 30 general practices in the London district health authority of Camden and Islington was taken to ascertain the material available in waiting rooms concerning "emergency contraception." The Family Planning Association 1992 leaflet was found in eight practices, while the 1984 Family Planning Association leaflet on the morning-after pill was found in another two. The practices were visited, rather than surveyed by mail, to determine the impact of the material presented; while some practices displayed prominent posters, others placed out-of-date leaflets at the back of racks. In order to locate innovative materials, a postal survey of young peoples' advice centers and clinics throughout the United Kingdom was conducted; 30% of the 79 responses still used the 1984 leaflet. Some clinics had posters and credit-card sized reminders specifically designed for them. General practitioners should provide individual advice to users of barrier methods and conspicuous, well-designed, informative, and accurate materials for the public in their waiting rooms. Language: English Keywords: UNITED KINGDOM | SURVEYS | FAMILY PLANNING EDUCATION | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | PHYSICIAN'S OFFICE | FAMILY PLANNING CENTERS | PRINTED MEDIA | EMERGENCY CONTRACEPTION | United Kingdom | Europe, Western | Europe | Developed Countries | Sampling Studies | Studies | Research Methodology | Education | Family Planning | Health Facilities | Delivery of Health Care | Health | Mass Media | Communication | Contraception Document Number: 105473 |
| 16. Title: Steroid antagonists and receptor-associated proteins. Author: Lebeau MC; Baulieu EE Source: HUMAN REPRODUCTION. 1994 Mar;9(3):437-44. Abstract: In research to control human reproduction, after the discovery of the progesterone receptor, an idea emerged about a molecule that could compete with progesterone for its binding site on the receptor, and at the same time block the receptor in a non-functional conformation to prevent or even terminate pregnancy. Among new progesterone antagonists tested, Roussel-UCLAF's RU-486 or mifepristone was the most fascinating. Currently in France (in 1993), a woman pays 4 visits over a 3-week period in a licensed hospital to terminate an unwanted pregnancy. She is given 3 x 200 mg pills of RU-486. 48 hours later, she receives the oral prostaglandin Misoprostol (2 x 200 mcg). She remains for 4 hours at the center, during which time 70% of the women abort. If expulsion does not occur, a third Misoprostol 200 mcg tablet is given. A fourth control visit takes place 10-15 days later. This protocol achieved > 98% efficacy in pregnancies of < 49 days of amenorrhea, but it is currently not applicable to heavy smokers or women over 35 years old. Other uses for RU-486: 1) Cervical ripening in second or third trimester abortions with a dose of 200-600 mg RU-486. 2) Initiation of labor in women for medical indications. 3) Contraception: a) late luteal postcoital administration of 400 or 600 mg RU-486 once or twice for 2 days before menses, b) monthly late luteal phase, premenstrual administration of a low-dose of RU-486 plus Misoprostol 2 days before menses, c) emergency postcoital contraception in a single 600 mg dose after unprotected intercourse within 72 hours, d) once a month anti-implantation with 200 mg of RU-486 given 2 days after unprotected intercourse, e) suppression of ovulation, f) endometrial contraception. After more than 10 years of administration to more than 150,000 women, RU-486, particularly in association with Misoprostol, is an excellent and safe agent for termination of pregnancy under the mandatory supervision of a physician. Language: English Keywords: FRANCE | LITERATURE REVIEW | ABORTION | RU-486 | PROSTAGLANDINS, SYNTHETIC | LICENSING | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | EMERGENCY CONTRACEPTION | KNOWLEDGE | Europe, Western | Europe | Developed Countries | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins | Product Approval | Legislation | Contraception Document Number: 094875 Notification |
| 17. Title: Current concepts in fertility regulation and reproduction. Author: Puri CP; van Look PF Source: New Delhi, India, Wiley Eastern/New Age International, 1994. xix, 641 p. Abstract: This volume contains 53 papers presented at the International Conference on Fertility Regulation held in Bombay, India, November 5-8, 1992. The papers are organized under the following topics: hormonal contraceptives for women, male fertility regulation, antifertility vaccines, termination of early pregnancy, fertilization and implantation, follicular development and corpus luteum function, reproductive physiology, clinical reproductive endocrinology and infertility, and reproduction of farm animals. (ANNOTATION) Language: English Keywords: INDIA | GLOBAL | CONFERENCES AND CONGRESSES | FERTILITY | FERTILITY AGENTS | FERTILITY CONTROL, POSTCOITAL | FERTILITY CONTROL, POSTCONCEPTION | CORPUS LUTEUM HORMONES | HORMONES | CONTRACEPTIVE AGENTS, MALE | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTIVE VACCINES | FERTILIZATION | REPRODUCTION | INFERTILITY | EMERGENCY CONTRACEPTION | Asia, Southern | Asia | Developing Countries | Population Dynamics | Demographic Factors | Population | Reproductive Control Agents | Family Planning | Endocrine System | Physiology | Biology | Contraceptive Agents | Contraception | Contraception, Immunological Document Number: 251146 |
| 18. Title: A report of 131 cases of multifetal pregnancy reduction. Author: Tabsh KM Source: OBSTETRICS AND GYNECOLOGY. 1993 Jul;82(1):57-60. Abstract: Between February 1987 and September 1992, an obstetrician-gynecologist performed 131 transabdominal multifetal pregnancy reductions at a surgical outpatient unit in southern California. The physician injected potassium chloride into the fetal heart, if possible, otherwise into the thorax, to bring about cardiac arrest. Once fetal death was confirmed, the needle aspirated the free fluid surrounding the fetus. One woman presented with twins while 53% presented with triplets, 36% with quadruplets, 9 with quintuplets, 3 with sextuplets, and 1 with septuplets. Most women (75%) conceived via surgical intervention. The remaining women conceived with the help of fertility drugs. 103 women delivered. 7 women lost the entire pregnancy, 5 before viability. 3 of these 5 pregnancies were lost within 2 days of amniocentesis. 98 women delivered 196 living fetuses with 192 surviving the neonatal period. There were no losses within the first 4 weeks after the reduction procedure. Mean gestational age at delivery was 37.5 for twins, and 35 weeks for triplets (mean, 35.5 weeks). These mean gestational ages were at least equal to those of nonreduced multiple pregnancies. Just 0.5% of the women experienced fetal growth retardation and 2% experienced intrauterine death of one twin. Maternal and fetal complications occurred at the same rate as those from nonreduced multiple pregnancies. These findings indicated that multifetal pregnancy reduction is safe, especially when the physician has considerable experience and the women receive prenatal care from a physician who has experience in managing multifetal gestations. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | PREGNANCY, MULTIPLE | LIVE-BIRTH PREGNANCY RATE | AMNIOCENTESIS | FERTILIZATION | EMBRYO TRANSFER | FERTILITY CONTROL, POSTCONCEPTION | ABORTION | IN VITRO | North America | Americas | Developed Countries | Pregnancy | Reproduction | Pregnancy Rate | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Reproductive Technologies | Family Planning | Clinical Research | Research Methodology Document Number: 083467 Notification |
| 19. Title: Experimental study of anti-fertility activity with liposome-encapsulated sperm membrane antigen. Author: Zhang XC Source: Reproduction and Contraception. 1992 Feb;12(1):60-61. Abstract: Up to now, in the study of contraceptive immunology, NT-fertility experiments on animals have always been accomplished through the use of the Fu antigen. Because of serious side effects associated with the Fu antigen, it is inappropriate for use in humans. Therefore, it has become an urgent task to discover an immunization antigen for human use. It was recently discovered that the liposome-encapsulated antigen is a new immunization enhancer without original immunization character and toxicity that can degrade automatically inside the body. Therefore, it is hopeful that the liposome-encapsulated antigen can become an enhancer for contraceptive immunization. This study uses liposome-encapsulated antigen as an enhancer for human sperm membrane protein and observed its effect on the immunization and fertility of mice in comparison to Fu enhancer of the same antigen. (excerpt) Language: Chinese Keywords: RESEARCH REPORT | FERTILITY CONTROL, POSTCONCEPTION | CONTRACEPTION, IMMUNOLOGICAL | INHIBITION OF FERTILIZATION | CONTRACEPTION RESEARCH | ANIMALS | LABORATORY | Family Planning | Contraception | Contraceptive Mode of Action | Natural Resources | Environment | Equipment and Supplies Document Number: 090266 |
| 20. Title: Breastfeeding: a natural method for child spacing. Author: Howie PW Source: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY. 1991 Dec;165(6 Pt 2):1990-1. Abstract: Breastfeeding as a natural method for child spacing is identified as having 4 areas of research agreement. These ideas contribute to the justification that breastfeeding needs to be protected and promoted as an international health objective. 1) It is formally recognized that breastfeeding is associated with reduced fertility through the duration of amenorrhea, which could be at its longest 2 years. 2) Inhibition of ovulation through gonadotropin suppression is an important factor in lactational amenorrhea. After the return of menses, fertility may only be slightly reduced. 3) Suckling dependency is very important in order to maintain lactational amenorrhea. Although no minimum level of suckling has been defined for universal practice to maintain lactational amenorrhea, it has been found that those mothers who suckle frequently for long periods and breastfeed at night have a longer lactational amenorrhea. 4) Lactational amenorrhea is a significant contributor to reduced fertility in terms of completed family size and birth spacing. This is important in countries where artificial contraception is low. Future research is discussed in terms of the progress made in the Bellagio Concensus statement. This statement affirms that if in the 1st 6 months mother maintain full breastfeeding and amenorrhea, the pregnancy rate is <2%. Guidelines have been developed for the lactational amenorrhea method (LAM). Research needs are to test these guidelines in field studies in different cultural settings, in order to provide a stronger base upon which to advise postpartum mothers. Another priority is to define more completely the factors affecting the duration of lactational amenorrhea; i.e., maternal nutrition, racial differences, individual biologic variation, and maternal illness. At present there is a multicenter study conducting such exploration among 500 women/center. Funding and support are from the WHO and the Institute for International Studies in Natural Family Planning. Future studies need to address the interface between LAM and other family planning methods in order to determine when to optimally introduce artificial contraception. Using LAM contributes to cost savings. The last research priority is to disseminate accurate and effective information on LAM to health workers and breastfeeding mothers. Operations research is necessary to determine the best ways to use LAM in developed and developing countries. Language: English Keywords: DEVELOPED COUNTRIES | DEVELOPING COUNTRIES | RECOMMENDATIONS | BREASTFEEDING | PREGNANCY INTERVALS | LACTATIONAL AMENORRHEA METHOD | POSTPARTUM AMENORRHEA | FERTILITY CONTROL, POSTCONCEPTION | TIME FACTORS | Infant Nutrition | Nutrition | Health | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning, Behavioral Methods | Family Planning | Puerperium | Reproduction Document Number: 069759 |
| 21. Title: A mystery from China's census: where have young girls gone? Author: Kristof ND Source: NEW YORK TIMES. 1991 Jun 16;:A1, A8. Abstract: The 1990 Chinese census data reveals that 5% of girls born in China are unaccounted for, based on 111.3 boys/100 girls < 1 year old. The normal universal ratio and the pre-one-child policy in the 1964 census was 103.8 to 100. Succeeding births are increasingly proportionately higher until the 5th born at 125 males to 100 females. The State Family Planning Commission argues that some nationalities have higher ratios. The explanation of why is that boys are preferred because they do more farm work, inheritance passes through sons, and boys are designated as the ones to care for parents in old age. The one-child policy, which was instituted 12 years ago, with its risks of heavy fines and stiff punishment, challenges social tradition when the 1st child is a girl. It is speculated that couples may choose a variety of alternatives. If the 1st is a daughter, the choices are 1) to keep the child and find a legal or illegal way to have another, 2) to give the child up for adoption and not register the birth, 3) to send the child to be raised by relatives in other areas, and 4) to raise the daughters at home without registering them, or 5) infanticide. 2 Swedish researchers are reported as finding that 50% (250,000) are in fact adopted informally, which was also supported by some villages. It is argued even by those critical of China's policy that infanticide accounts for a small proportion and occurs in rural areas where home delivery is practiced. Statistics support that with increasing age, there is a decline in a ratio; i.e., school age children are 107 to 100. A new development that contributes to controlling the sex of the child is the use of ultrasound. Even though a 1987 law forbids disclosure, doctors are reported as providing the information. Language: English Keywords: CHINA | CRITIQUE | MORTALITY DETERMINANTS | INFANT MORTALITY | CHILD MORTALITY | INFANTICIDE | DAUGHTERS | SONS | POPULATION AT RISK | DIFFERENTIAL MORTALITY | FERTILITY CONTROL, POSTCONCEPTION | SEX RATIO | ONE CHILD POLICY | ADOPTION | SEX PREFERENCE | POPULATION STATISTICS | WOMEN | Developing Countries | Asia, Eastern | Asia | Mortality | Population Dynamics | Demographic Factors | Population | Crime | Social Problems | Family Relationships | Family Characteristics | Family and Household | Research Methodology | Family Planning | Sex Distribution | Sex Factors | Population Characteristics | Antinatalist Policy | Population Policy | Social Policy | Policy | Child Rearing | Behavior | Value Orientation | Psychological Factors Document Number: 066747 |
| 22. Title: Overview and summary: the interface of breastfeeding, natural family planning, and the lactational amenorrhea method. Author: Labbok MH; Howie PW Source: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY. 1991 Dec;165(6 Pt 2):2013-4. Abstract: The article provides a summary of the 3rd session on the interface between breastfeeding, natural family planning, and the lactational amenorrhea methods. The focus was on 2 issues: the efficacious use of natural family planning (NFP) during breastfeeding, and whether a better understanding of lactational amenorrhea (LAM) could be part of the solution to unintended pregnancy and solutions incorporated into NFP teaching. The advantages of LAM or NFP are its independence from a device or medication; i.e., once the logistics are taught and understood, the method is easily available for life. Several outcomes occurred as a result of the proceedings. There was concensus among participants and speakers that the LAM needs to be included in NFP. The issue of proper identification of the return of fertility during lactation was identified as a problem. For instance, in the Bellagio guidelines 6 months is the recommended safe period for LAM, but in communities with different breastfeeding patterns, there is a longer LAM period. Articles provided for these sessions provide a better understanding of some of the issues surrounding the fertility suppressive effects of lactation, and LAMs incorporation in NFP teaching. Language: English Keywords: BREASTFEEDING | NATURAL FAMILY PLANNING | POSTPARTUM AMENORRHEA | FERTILITY CONTROL, POSTCONCEPTION | LACTATIONAL AMENORRHEA METHOD | PREGNANCY, UNPLANNED | CONFERENCES AND CONGRESSES | Infant Nutrition | Nutrition | Health | Family Planning, Behavioral Methods | Family Planning | Puerperium | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 069765 |
| 23. Title: Counseling the adolescent about pregnancy options. Author: American Academy of Pediatrics. Committee on Adolescence Source: PEDIATRICS. 1989 Jan;83(1):135-7. Abstract: The Committee on Adolescence of the American Academy of Pediatrics has issued a statement of principles on how to counsel adolescents about pregnancy. The general guiding principles in the preamble to the statement advise that it is an unbiased guide, that not all of the suggestions apply in each case, and that both doctor and patient must be given freedom to come to a decision. Identification of pregnancy in an adolescent depends on uterine size and detection of a fetus, as well as lab tests, since menstrual history is not always reliable, and denial may be present. Communication of a confirmed pregnancy should be done privately in person, not by telephone. Parents, other adults or the father should only be involved with the patient's permission. Plans for the pregnancy include the options of continuing the pregnancy and keeping the child, releasing it for adoption, and abortion. All options should be explored in an open, informative and non-preemptory manner. If the patient is reluctant to reveal the identity of the father, sexual abuse or incest must be suspected. If referral for abortion or abortion counseling is against the moral code of the pediatrician, he must explain this. Immediate referral to obstetrical care should be urged on the patient, and she should be followed to ensure that there has been no adverse outcome to the gynecological referral or termination process, and to discuss future contraception. Language: English Keywords: UNITED STATES OF AMERICA | NORTH AMERICA | IEC | COMMUNICATION | CONFIDENTIAL INFORMATION | INTERPERSONAL RELATIONS | PHYSICIAN-PATIENT RELATIONS | REPRODUCTIVE BEHAVIOR | PREGNANCY | ADOLESCENT PREGNANCY | ADOLESCENTS | FAMILY PLANNING | FERTILITY CONTROL, POSTCONCEPTION | ABORTION | RECOMMENDATIONS | PROGRAM ACTIVITIES | CLINIC ACTIVITIES | COUNSELING | Americas | Developed Countries | Programs | Organization and Administration | Ethics | Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Reproduction | Youth | Age Factors | Population Characteristics Document Number: 055769 Notification |
| 24. Peer Reviewed Title: Menstrual regulation by intramuscular injections of 16-phenoxy-tetranor PGE2 methyl sulfonylamide (sulprostone). A multicentre study. Author: World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Post-Ovulatory Methods for Fertility Regulation Source: BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 1989 Feb;96(2):207-12. Abstract: In a previous study, the authors have shown that 3 intramuscular injections of 0.5 mg of the prostaglandin analogue, sulprostone (16-phenoxy-W-17,18,19,20-tetranor PGE2 methyl sulfonylamide) were equally effective as vacuum aspiration for menstrual regulation in women with a delay of up to 21 days in the onset of expected menses. To assess whether lower doses of the PG could be effective if treatment were restricted to women with a delay in menses of up to 14 days, a multicenter trial investigated the effect of 2 injections of 0.25 mg sulprostone given with a 4-hour interval. After an interim analysis showed a clinically unacceptable low rate of complete abortion (41%) among the 64 pregnant women thus treated, the dose was doubled to 2 injections of 0.5 mg. In the group of 51 pregnant women treated with the increased dose, the frequency of complete abortion (67%) was significantly higher although still well below the 91% success rate achieved in the previous study. Both the duration and subjective vaginal blood loss were greater in women with complete abortion than in those with incomplete abortion or continuing pregnancy. It is concluded that the sulprostone dose used in our previous study (3 x 0.5 mg) represents the minimal, required dose for menstrual regulation. (author's) Language: English Keywords: COMPARATIVE STUDIES | RESEARCH METHODOLOGY | MENSTRUAL REGULATION | EVALUATION | FERTILITY CONTROL, POSTCOITAL | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | CARBOXYLIC ACIDS | ORGANIC CHEMICALS | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | WHO | UN | INTERNATIONAL AGENCIES | LABORATORY EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND DIAGNOSES | DATA ANALYSIS | PROSTAGLANDINS | EMERGENCY CONTRACEPTION | SIDE EFFECTS | Studies | Family Planning | Endocrine System | Physiology | Biology | Ingredients and Chemicals | Organizations | Contraception | Treatment Document Number: 054563 Notification |
| 25. Title: A 15-year study of illegally induced abortion mortality at Ilorin, Nigeria. Author: Adetoro OO Source: International Journal of Gynecology and Obstetrics. 1989 May;29(1):65-72. Abstract: The pattern of illegally induced abortion mortality was analyzed over a 15-year period (1972-86) at Nigeria's University of Ilorin Teaching Hospital. In this period, there were 173,521 live births at the hospital, 12,736 cases of abortion, and 53 deaths resulting from illegal abortions. The causes of death in these 53 cases were septicemia (66%), hemorrhage (21%), native drug intoxication (8%), tetanus (4%), and embolism (2%). 32% of the deaths involved women 15-19 years of age; an additional 25% involved women 20-24 years of age. 28 women (53%) were nulliparous, 3 (6%) were parity 1, 6 (11%) were parity 2, and the remaining 16 (30%) were parities 3 and above. The incidence rate for abortion (both spontaneous and induced) at Ilorin Hospital was 2.1/1000 population in 1972-86, with a low of 1.3 in 1984 and a high of 3.7 in 1980. The abortion ratio at Ilorin Hospital in this period was 73.4/1000 live births. The abortion mortality rate at Ilorin in 1972-86 averaged 0.9/100,000, while the abortion mortality ratio was 4.2/1000 abortions. Illegally induced abortion was responsible for 7.1% of all the maternal deaths occurring at the hospital in the study period. Moreover, it is probable that these findings represent a gross underestimate of the extent of abortion mortality in Ilorin since many such deaths are not reported or included under other causes. The majority of the patients in this study were young unmarried students without children who resorted to illegal abortion because contraception was not accessible, pregnancy was grounds for expulsion from school, and legal abortions were unavailable. The most important preventive measure for decreasing the mortality related to illegal abortion is to make this procedure safe and legal. Since illegal abortion is 10-250 times more hazardous than any kind of family planning method, it is also important that contraceptives and family planning education be more widely available. Language: English Keywords: NIGERIA | RETROSPECTIVE STUDIES | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | MATERNAL MORTALITY | MORTALITY | CAUSES OF DEATH | AGE FACTORS | PARITY | ABORTION RATE | MEASUREMENT | ABORTION LAW | COMPARATIVE STUDIES | STATISTICAL STUDIES | RESEARCH REPORT | NEEDS | COMPLICATIONS | SIDE EFFECTS | PREVENTION AND CONTROL | CHANGES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Dynamics | Demographic Factors | Population | Population Characteristics | Fertility Measurements | Fertility | Economic Factors | Diseases | Treatment | Social Change Document Number: 056182 Notification |
| 26. Title: Webster and the politics of abortion. Author: Annas GJ Source: HASTINGS CENTER REPORT. 1989 Mar-Apr;19(2):36-8. Abstract: Recent legal disputes regarding the constitutionality of statutes restricting abortion in the US center around whether women and their physicians will make decisions about abortions or whether such decisions will be the domain of state legislatures. In 1989, the Missouri 8th Circuit Court of Appeals heard a case (Webster) involving a state statute designed to restrict access to abortion. The statute under question included an assumption that life begins at conception, a hospitalization requirement, the requirement that a physician determine viability, a ban on use of public funds for abortion, and restrictions on the use of public facilities for pregnancy terminations. A federal trial court declared these provisions unconstitutional; however, Missouri is seeking Supreme Court review of the Webster decision. Since abortion has become the most frequently performed medical procedure in the US, it is unlikely to be outlawed. However, a narrowing of abortion rights seems inevitable. In addition to further restrictions on indirect government support in terms of facilities and funding, there will likely be efforts to add restrictions to minors seeking abortions and to confine abortions to earlier points in pregnancy. Language: English Keywords: MISSOURI | UNITED STATES OF AMERICA | NORTH AMERICA | ABORTION LAW | LEGISLATION | POLITICAL FACTORS | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | OPPOSITION TO FAMILY PLANNING | ATTITUDES | CHANGES | Developed Countries | Americas | Interest Groups | Psychological Factors | Behavior | Social Change Document Number: 055204 Notification |
| 27. Title: What would recriminalising abortion achieve? [editorial] Author: Bromham DR Source: British Journal of Family Planning. 1989 Jan;14(4):109. Abstract: Proponents of abortion recriminalization in the UK base their arguments on the need to protect innocent intrauterine life. This approach neglects, however, the tendency of women who are faced with an unplanned, unwanted pregnancy to resort to dangerous illegal abortions when the procedure cannot be obtained through legal means. Rather than save fetal lives, recriminalization of abortion would lead to thousands of unnecessary maternal deaths from illegal septic abortions. Thus, the choice currently facing the UK is not between pro-life and pro-choice ideologies, but rather between a legal, safer process under medical supervision or something far less acceptable in the hands of criminal abortionists. A more productive approach to this issue would focus on the underlying causes of unwanted pregnancy and the pressures faced by potential abortees. Language: English Keywords: UNITED KINGDOM | EUROPE, NORTHERN | EUROPE | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | ABORTION LAW | LEGISLATION | POLITICAL FACTORS | ETHICS | PRO-CHOICE GROUPS | ATTITUDES | BEHAVIOR | OPPOSITION TO FAMILY PLANNING | PREGNANCY, UNWANTED | PREGNANCY | PREVENTION AND CONTROL | SIDE EFFECTS | Developed Countries | Europe, Western | Interest Groups | Psychological Factors | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Reproduction | Diseases | Treatment Document Number: 054552 Notification |
| 28. Title: Reducing late abortions. Author: Diggory P Source: BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 1989 Feb;96(2):132-4. Abstract: The report of a meeting organized by the Birth Control Trust and focusing on reducing late abortion indicates that referral and assessment for abortion takes longer within the National Health Services (NHS) than in the private and charitable sectors. The NHS performs only 21% of all its abortions prior to the 9th week in comparison with 44% in the private sector. The NHS emerges as reluctant to perform 2nd-trimester abortion when the indications are social factors threatening mental health. The report covers many specific issues including the need for better provision of early pregnancy testing in general practice and in community clinics, the early detection of fetal abnormality, and the great regional variations in the provision of abortion within the NHS. It describes how NHS can provide good abortion facilities and includes examples from several centers in England. There is considerable difference between abortion performed early in pregnancy and when a delay has occurred. The woman's feelings change. Initially, she knows only that her period is late, realizing subsequently she is pregnant and only later coming to feel that she is going to have a baby. This is why, until modern times, abortion was not viewed as a crime up until the time when the woman felt quickening. Regarding the actual procedures, abortion using suction is a simple and safe procedure best performed on an outpatient basis within the first 12 weeks of pregnancy. Early abortion uses fewer health resources, involves less time off work or away from the family, and is far more acceptable to the woman. When considering the basic causes of delay, the attitude and behavior of the woman herself is important, but much responsibility for delay lies with the medical profession. That the medical profession is failing to cope is shown by the fact that the NHS performs fewer than half of all those abortions performed in women who are UK residents. Politicians who genuinely want to minimize late abortion should consider altering the Abortion Act to remove the current restrictions upon early abortion and the bureaucratic overtones which cause delays while retaining the present regulations for later procedures. Language: English Keywords: UNITED KINGDOM | EUROPE, NORTHERN | EUROPE | NATIONAL HEALTH SERVICES | GOVERNMENT PROGRAMS | ABORTION | TIME FACTORS | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | PREGNANCY, FIRST TRIMESTER | PREGNANCY, SECOND TRIMESTER | ATTITUDES | BEHAVIOR | POLITICAL FACTORS | PSYCHOSOCIAL FACTORS | PHYSICIANS | Developed Countries | Europe, Western | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Psychological Factors | Health Personnel Document Number: 054560 Notification |
| 29. Title: Obstetrics and gynecology. Author: Huggins GR Source: JAMA. 1989 May 19;261(19):2864-5. Abstract: Many recent advances in human reproduction have been influenced by political, legal, moral, and economic forces more than by a rational assessment of their safety and potential contributions. For example, percutaneous blood sampling and chorionic villus sampling--2 new advances in the field of prenatal diagnosis--have been attacked by pro-life forces as techniques that encourage voluntary abortion. In the field of fertility control, rising liability insurance costs affect the decision to develop and market a new contraceptive device. These factors have been extremely effective in blocking research and removing accepted technologies such as IUDs from the options available to US women. The concern about the relationship between IUD use and pelvic inflammatory diseases (PID) is valid; however, women who have only 1 sexual partner are not placed at increased risk of tubal infertility by the use of devices such as the Copper T380A IUD. Pro-life forces have also been successful in blocking the use of the synthetic progesterone antagonist RU 486 in developing countries. In much of the developing world, abortion is the major method of slowing population growth. RU 486's use in the termination of early pregnancies is 90-100% effective and is simpler, safer, and cheaper than surgical methods of abortion. This drug, and other antiprogesterone agents, may have other important uses in obstetrics and gynecology such as inducing labor, treating endometriosis, and inhibiting ovulation. Unfortunately, the controversy over its abortifacient properties may delay or block research efforts in these important areas. The intensifying impact of political factors on the medical field suggests that researchers in obstetrics and gynecology may have to focus more on their ability to shape public opinion. Language: English Keywords: UNITED STATES OF AMERICA | NORTH AMERICA | POLITICAL FACTORS | ABORTION | OPPOSITION TO FAMILY PLANNING | ATTITUDES | GENETIC TECHNIQUES | LABORATORY EXAMINATIONS AND DIAGNOSES | IUD | RU-486 | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | RESEARCH METHODOLOGY | Americas | Developed Countries | Interest Groups | Psychological Factors | Behavior | Examinations and Diagnoses | Contraceptive Methods | Contraception | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology Document Number: 056288 Notification |
| 30. Title: Biochemical changes in human cervical connective tissue during pretreatment with laminaria tents in legal first trimester abortions. Author: Jonasson A; Larsson B Source: International Journal of Gynecology and Obstetrics. 1989 Apr;28(4):361-4. Abstract: At Sweden's Huddinge Hospital, mechanical dilatation of the cervix in 1st-trimester abortion has been replaced by pretreatment with laminaria tents for 16-20 hours before the scheduled vacuum aspiration. The present study collected biopsy specimens from the cervix before insertion and before removal of the laminaria tent in 14 patients in order to determine whether dilatation by this procedure induces any changes in cervical connective tissue. The mean collagen concentration decreased from 15.4 to 14.0 mcg hydroxyproline/mg wet weight during pretreatment with the laminaria tents, although this difference was not of statistical significance. In terms of the 3 major subfractions, acetic acid extractable collagen decreased by an average of 0.03, pepsin extractable collagen decreased by 1.17, and nonextractable collagen increased by 0.33 mcg hydroxyproline/mg--none of which were statistically significant changes. Pretreatment with the tents resulted in cervical dilatations ranging from H10-H14. The decrease of collagen concentration recorded in this study resembled the effect of intracervical application of prostaglandin E gel for softening of the cervix. Overall, it appears that pretreatment by laminaria tent induces a gentle ripening process of the cervix that has a less traumatic effect than forcible mechanical dilatation with Hegar dilators. Language: English Keywords: SWEDEN | EUROPE, NORTHERN | EUROPE | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | LAMINARIA TENTS | SURGICAL EQUIPMENT | CERVIX | UTERUS | CERVICAL EFFECTS | UTERINE EFFECTS | PREOPERATIVE PROCEDURES | Developed Countries | Cervical Dilatation | Treatment | Equipment and Supplies | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Surgery Document Number: 056274 Notification |
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