Inmagic CS/WebPublisher PRO found 105 records

Your search found 105 record(s).
New Basic Search | New Advanced Search | POPLINE Document Delivery Policy

Subscription may be needed for full text

Peer Reviewed

Title: Manual versus electric vacuum aspiration for first-trimester abortion: A systematic review.
Author: Wen J; Cai QY; Deng F; Li YP
Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2008 Jan;115(1):5-13.
Abstract: As an alternative to electric vacuum aspirations (EVA), there is an increasing interest in using manual vacuum aspiration (MVA). The objective was to compare the safety, efficacy and acceptability of MVA with those of EVA for first-trimester abortion. We searched MEDLINE, EMBASE, Cochrane Library and Chinese Biomedical Database in all language, together with reference lists of retrieved papers. Randomised controlled trials comparing MVA with EVA for first-trimester abortion were included. The outcomes are complete abortion rate, uterine perforation rate, blood loss, pain perception and acceptability. Two reviewers independently extracted the data. Results from the trials were combined to calculate relative risks (RRs) or risk differences for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes, together with 95% CIs. Ten trials were included, involving 1660 women. Generally, the methodological quality was poor. There were no statistically significant differences, comparing MVA with EVA, in complete abortion rate (RR 1.00; 95% CI 0.99-1.02) and participants' satisfaction (RR 1.02; 95% CI 0.87-1.20). In participants with less than 50 days of gestational age, less blood loss (WMD -1.84; 95% CI -2.45 to -1.23) and less severe pain perception (RR 0.04; 95% CI 0.01-0.12) were reported during the MVA procedure, whereas the operation time was shorter (WMD 0.32; 95% CI 0.02-0.63) in the EVA procedure. There is some evidence that MVA is as effective and acceptable as EVA and might be safer than EVA. (author's)
Language: English
Keywords:
CHINA | LITERATURE REVIEW | CLINICAL RESEARCH | KAP SURVEYS | CLINICAL TRIALS | ABORTION | UTERINE ASPIRATOR | SAFETY | SATISFACTION | ABORTION RATE | UTERINE PERFORATION | BLEEDING | PAIN | Asia, Eastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Fertility Control, Postconception | Family Planning | Surgical Equipment | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Psychological Factors | Behavior | Perforations | Diseases | Signs and Symptoms
Document Number: 322751 Notification

Title: Prevalence of uterine synechia after abortion evacuation curettage.
Author: Salzani A; Yela DA; Gabiatti JR; Bedone AJ; Monteiro IM
Source: Sao Paulo Medical Journal. 2007 Sep 6;125(5):261-264.
Abstract: Intrauterine adhesion (IUA) is a possible complication of uterine curettage following abortion. Because IUA is an important cause of infertility, some investigators have been advocating its inclusion in the routine investigational workup after every abortion curettage procedure. The aim of this study was to evaluate the uterine cavity of patients subjected to abortion curettage, in order to ascertain the prevalence of IUA and its association with social and clinical factors. This was a cross-sectional study at the Human Reproduction Unit, Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp). A total of 109 women were enrolled. The investigators searched the records of Unicamp's hospital for patients who had been subjected to uterine curettage following abortion. The hysteroscopy was performed 3 to 12 months after the curettage. The correlations between patients' characteristics and the prevalence of IUA were assessed by means of chi-squared and Fisher's exact test calculations. The prevalence of IUA was 37.6%. The number of previous abortions and curettage procedures did not correlate with the presence of IUA. Most of the women (56.1%) presented IUA grade I. In the present study, 37.6% of the women subjected to curettage following abortion had IUA, which was mostly mucous and grade I. None of the demographic and clinic characteristics evaluated were found to be associated with IUA. From this study, there is no firm evidence to justify carrying out routine diagnostic hysteroscopy following abortion evacuation. (author's)
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | ABORTION | UTERINE ASPIRATOR | PREVALENCE | HYSTEROSCOPY | EXAMINATIONS AND DIAGNOSES | INFERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Surgical Equipment | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Endoscopy | Physical Examinations and Diagnoses | Reproduction
Document Number: 324112 Notification

Title: Tramadol versus nalbuphine in total intravenous anaesthesia for dilatation and evacuation.
Author: Siddiqui KM; Chohan U
Source: Journal of Pakistan Medical Association. 2007 Feb;57(2):67-70.
Abstract: The objective was to compare the results of Tramadol with Nalbuphine for dilatation and evacuation with total intravenous anaesthesia technique. A total of 70 patients (35 in each group) were included in this prospective, double blind randomized study. Intravenous tramadol 1.5mg/kg and nalbuphine 0.1mg/kg were compared in total intravenous anaesthesia (TIVA) using a propofol infusion in patients undergoing dilatation and evacuation (D and E). Changes in haemodynamic variables greater than 20% from the base line values were noted. There was no difference found in haemodynamic parameters. There was statistically significant difference found (p < 0.05) in postoperative recovery between the two groups. Quality of analgesia was better in nalbuphine group but both drugs provide suitable analgesic supplementation to TIVA. (author's)
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | DOUBLE-BLIND STUDIES | COMPARATIVE STUDIES | PREGNANT WOMEN | DRUGS | ADMINISTRATION AND DOSAGE | ANESTHESIA | SURGERY | CERVICAL DILATATION | UTERINE ASPIRATOR | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surgical Equipment | Equipment and Supplies
Document Number: 313223

Peer Reviewed

Title: Impact of formal family planning residency training on clinical competence in uterine evacuation techniques.
Author: Steinauer J; Silveira M; Lewis R; Preskill F; Landy U
Source: Contraception. 2007 Nov;76(5):372-376.
Abstract: The goal of this study was to assess the impact of formal opt-out family planning training on clinical competence in uterine evacuation. Residents who participated in newly established, routine opt-out family planning training completed surveys before and after their rotations. The surveys asked residents to report clinical experience and competence in family planning. One hundred ninety-six pre- and postrotation questionnaires were collected for a total response rate of 63%. After completing the rotation, residents reported higher competence in medical abortion, manual uterine aspiration, electric uterine aspiration and dilation and evacuation (p < .001). Residents also reported increased clinical experience with methods of termination, postabortion contraception, including intrauterine contraception, ultrasound and perioperative pain management. Participation in a formal opt-out family planning rotation results in increased clinical exposure to family planning and in reported competence in pregnancy termination. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | MEDICAL STUDENTS | WOMEN | ABORTION | UTERINE ASPIRATOR | TRAINING PROGRAMS | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Students | Education | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Surgical Equipment | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 321773 Notification

6.
Peer Reviewed

Title: Comparison of oral and vaginal misoprostol for cervical ripening before manual vacuum aspiration of first trimester pregnancy under local anesthesia: a randomized placebo-controlled study.
Author: Cakir L; Dilbaz B; Caliskan E; Dede FS; Dilbaz S
Source: Contraception. 2005;71:337-342.
Abstract: The objective of this prospective randomized placebo-controlled study was to determine the effectiveness of 400 Ag oral and 400 Ag vaginal misoprostol administration for cervical priming 3 h prior to manual vacuum aspiration (MVA) under local anesthesia for voluntary termination of pregnancy before 10 weeks of gestation in comparison with placebo oral or placebo vaginal administration (n = 40 in each group). Postmedication cervical dilatation was similar in the oral (mean, 6.6 � 1.5) and vaginal (mean, 7.2 � 0.8) misoprostol groups but significantly higher compared with the oral (mean, 3.4 � 0.2) and vaginal (mean, 3.6 � 1.9) placebo groups. Duration of the procedure was also significantly shorter in the misoprostol groups in comparison with their placebo counterparts. Preoperative bleeding and side effects were more common in the misoprostol groups, but none required medical intervention. Intraoperative bleeding was less in the vaginal misoprostol group compared with the placebo groups. There was no significant difference in terms of visual analogue scores during the procedure, patient satisfaction, days of postoperative bleeding and rate of postoperative complications among the groups. Cervical priming with misoprostol administered orally or vaginally 3 h before MVA for termination of pregnancy under local anesthesia facilitates the procedure by decreasing the need for cervical dilatation and by shortening its duration without improving patients� pain perception and satisfaction mainly due to side effects. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | PREGNANT WOMEN | PREGNANCY, FIRST TRIMESTER | ABORTION | MISOPROSTOL | ADMINISTRATION AND DOSAGE | BLEEDING | CERVICAL DILATATION | UTERINE ASPIRATOR | Developing Countries | Europe, Southeastern | Europe | Clinical Research | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Drugs | Treatment | Signs and Symptoms | Diseases | Surgical Equipment | Equipment and Supplies
Document Number: 284462 Notification

7.
Peer Reviewed

Title: Medical abortion at 9-13 weeks' gestation: a review of 1076 consecutive cases.
Author: Hamoda H; Ashok PW; Flett GM; Templeton A
Source: Contraception. 2005;71:327-332.
Abstract: The aim of the study was to assess the use, efficacy and factors influencing the outcome of medical abortion at 9�13 weeks� gestation. Retrospective chart review of consecutive women undergoing medical abortion at 9�13 weeks� gestation was done. A total of 1927 abortions were carried out at 9�13 weeks� gestation, of which 1076 (55.8%) were undertaken medically. Efficacy decreased with increasing gestation (p=.02). Surgical evacuation was carried out in 45 (4.2%) women including 10 (2.7%) at 64�70 days, 11 (3.3%) at 71�77 days, 10 (5.1%) at 78�84 days and 14 (8.0%) at 85�91 days of gestation (p=.02). Indications for surgery included continuing pregnancy [16 (1.5%) women], retained sac [5 (0.5%)], incomplete abortion [20 (1.9%)] and emergency curettage for bleeding [4 (0.4%)]. The number of misoprostol doses used and the induction-to-abortion interval both significantly increased with gestation (p < .001), while analgesia requirements did not vary with increasing gestation (p=.18). Medical abortion at 9�13 weeks� gestation is an effective alternative to surgery. Medical methods should be offered routinely at these gestations, thus increasing women�s choice. (author's)
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | PREGNANCY, FIRST TRIMESTER | ABORTION | RU-486 | MISOPROSTOL | GESTATIONAL AGE | BLEEDING | UTERINE ASPIRATOR | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Prostaglandins | Fetus | Signs and Symptoms | Diseases | Surgical Equipment | Equipment and Supplies
Document Number: 284460 Notification

8.
Peer Reviewed

Title: Misoprostol as the primary agent for medical abortion in a low-income urban setting.
Author: Borgatta L; Mullally B; Vragovic O; Gittinger E; Chen A
Source: Contraception. 2004;70:121-126.
Abstract: The purpose of this study was to assess the outcomes of early medical abortion in an inner-city hospital abortion service, using misoprostol as the primary agent. This was a retrospective chart review from July 2001 through December 2002. Women were eligible if they had a viable pregnancy with gestational age 8 weeks or less by transvaginal ultrasound and no medical contraindications. Two doses of 800 �g misoprostol were administered vaginally, 24 h apart. Initial follow-up was scheduled 2�3 days later. Of the 440 women who underwent medical abortion, 373 (90.8%, 95% confidence interval (CI) 88�94%) completed abortion medically, 38 (9.2%) had uterine aspiration and the remainder had incomplete or no follow-up. Of uterine aspirations, 11 were medically indicated, giving a rate of indicated aspiration of 2.7%. Gestational age, age, gravidity, parity, past abortion history, ethnic group and payer did not significantly correlate with overall rate of aspiration or rate of follow-up, but gestational age was correlated with medically indicated aspiration. Among 57 women who reported a time of tissue passage, the mean time from initial misoprostol dose was 8.5 h (95% CI 6.5�13 h). (author's)
Language: English
Keywords:
MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | RETROSPECTIVE STUDIES | LOW INCOME POPULATION | URBAN POPULATION | PREGNANT WOMEN | MISOPROSTOL | ABORTION | PREGNANCY, FIRST TRIMESTER | UTERINE ASPIRATOR | ULTRASONICS | GESTATIONAL AGE | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Surgical Equipment | Equipment and Supplies | Fetus
Document Number: 273587 Notification

9.
Peer Reviewed

Title: Which cannulae fit the Ipas manual vacuum aspiration syringe?
Author: Orbach D; Schaff E
Source: Contraception. 2004 Feb;69(2):171-173.
Abstract: The Ipas� double-valve manual vacuum aspiration (MVA) syringe is an alternative to electrical vacuum aspiration. This study determines which US cannulae (flexible, rigid-straight and rigid-curved) work with the Ipas MVA syringe. Cannulae from Ipas, MedGyn�, Berkeley� and Milex�, in sizes 6 �12 mm, were randomized and affixed to the MVA syringe. A pressure gauge was attached to the cannula with rubber tubing. Pressure readings were recorded initially and over 30 s. Milex cannulae were not compatible. For the remaining brands, initial vacuum pressures ranged from 55 to 65 mmHg. Flexible cannulae from Ipas, Berkeley and MedGyn maintained initial pressures without leaks, as did the 6�12-mm straight- and curved-rigid cannulae by Berkeley. Eight of the 13 tested MedGyn rigid cannulae lost _10% pressure over 30 s. Several US manufacturers produce cannulae that fit on the Ipas MVA syringe without a leak, including Ipas flexible cannula; Berkeley flexible, rigid-straight and rigid-curve cannulae and MedGyn flexible cannula, but not their rigid cannulae. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | ABORTION | CANNULA | TESTING | UTERINE ASPIRATOR | North America | Americas | Developed Countries | Fertility Control, Postconception | Family Planning | Equipment and Supplies | Measurement | Research Methodology | Surgical Equipment
Document Number: 190274 Notification

10.
Peer Reviewed

Title: Ability of the clinician and patient to predict the outcome of mifepristone and misoprostol medical abortion.
Author: Rossi B; Creinin MD; Meyn LA
Source: Contraception. 2004;70:313-317.
Abstract: We performed this analysis to evaluate the ability of both women and their clinicians to predict pregnancy expulsion after using mifepristone and misoprostol for medical abortion up to 63 days gestation. Women who participated in a multicenter, randomized trial comparing misoprostol 6�8 h vs. 23�25 h after mifepristone attended a follow-up visit approximately 7 days after mifepristone treatment. Each subject was asked if she felt she had expelled the gestational sac. Clinicians also assessed if the sac had been expelled based on the woman�s history. Vaginal ultrasonography was then performed to assess the uterine cavity. Of the 1080 women enrolled in the multicenter study, 931 (86.2%) who attended the first follow-up visit by study day 12 and did not have a uterine suction aspiration prior to this visit were included in this analysis. Vaginal ultrasonography at the first follow-up visit demonstrated expulsion in 915 [98.3%, 95% confidence interval (CI): 97.2�99.0] women. Overall, sensitivity, specificity, and positive and negative predictive values for subjects were 96.5%, 31.3%, 98.8% and 13.5%, respectively. When both the clinician and patient felt that the gestational sac had passed (n = 880 [94.5%, 95% CI: 92.9 �95.9]), expulsion was confirmed by sonography in 99.1% (95% CI: 98.2�99.6) of cases. Women and clinicians are very accurate at determining expulsion of gestational sac during medical abortion with mifepristone and misoprostol without ultrasonography or a physical examination. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | PREGNANT WOMEN | MISOPROSTOL | RU-486 | ABORTION | TIME FACTORS | ULTRASONICS | UTERINE ASPIRATOR | CONTRACEPTIVE EFFECTIVENESS | North America | Americas | Developed Countries | Clinical Research | Research Methodology | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | Fertility Control, Postconception | Family Planning | Population Dynamics | Surgical Equipment | Equipment and Supplies | Contraception
Document Number: 274831 Notification

11.
Title: Performing uterine evacuation with Ipas manual vacuum aspiration (MVA) instruments: instructional booklet.
Author: Abernathy M; Frankel N
Source: Chapel Hill, North Carolina, Ipas, 2003. 27 p.
Abstract: This booklet is intended for use by clinicians knowledgeable about the anatomy, physiology and medical procedures of the uterus, and skilled in transvaginal intrauterine procedures such as sharp curettage, electric vacuum aspiration, IUD insertion, hysteroscopy or endometrial biopsy. Further, users of this manual need to possess the following skills: the ability to perform a pelvic examination; the ability to accurately assess the size and position of a uterus, including assessing abnormalities and the duration of gestation in first-trimester pregnancies; the ability to diagnose and manage pregnancy-related conditions and the stages of miscarriage .%. demonstrated knowledge of infection-prevention techniques including standard/universal precautions, no-touch technique and processing of medical instruments; the ability to assess the need for and provide appropriate pain management; the ability to diagnose, stabilize and refer patients with ectopic pregnancy; the ability to manage complications of uterine evacuation and pain medications, including incomplete evacuation, cervical and abdominal injury, uterine perforation, uterine atony, infection, failed abortion, and medication-related reactions; or the ability to stabilize the patient and establish a mechanism for referral. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | MANUAL | PHYSICIANS | WOMEN | UTERINE ASPIRATOR | INSTRUCTION | CLINIC ACTIVITIES | NONGOVERNMENTAL ORGANIZATIONS | Developed Countries | North America | Americas | Health Personnel | Delivery of Health Care | Health | Demographic Factors | Population | Surgical Equipment | Equipment and Supplies | Education | Program Activities | Programs | Organization and Administration | Organizations
Document Number: 275872

12.
Title: Comparison of the incision and aspiration methods for the diagnosis of placental malaria infection.
Author: Sowunmi A; Abohweyere AE
Source: Journal of Obstetrics and Gynaecology. 1996 Sep;16(5):[7] p..
Abstract: A safe and efficient method for obtaining blood smears for the diagnosis of placental malaria infection is required in order to reduce the risks associated with direct blood contact. We describe a simple and safe method of needle aspiration of the placenta for the diagnosis of placental malaria infection. The method was compared with the conventional incision method in 60 consecutive placentae obtained at term. The quality of the blood smears prepared with the methods were similar. There was a significant correlation between parasite counts from samples prepared with both the incision and aspiration methods. Altman-Bland analysis of the counts revealed narrow limits of agreement with an insignificant bias. The method is useful for obtaining blood smears from the placenta for the diagnosis of placental malaria infection and reducing contact with potential pathogens in blood. (excerpt)
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | MALARIA | LABORATORY EXAMINATIONS AND DIAGNOSES | BLOOD | MOTHER-TO-CHILD TRANSMISSION | MALARIA PREVENTION | HYGIENE | UTERINE ASPIRATOR | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Parasitic Diseases | Diseases | Examinations and Diagnoses | Hemic System | Physiology | Biology | Public Health | Health | Surgical Equipment | Equipment and Supplies
Document Number: 193958

13.
Title: [Induced abortion: surgical technique] L'interruption volontaire de grossesse. Technique chirurgicale.
Author: Champion J; Negre-Garnier C
Source: SOINS. GYNECOLOGIE, OBSTETRIQUE, PUERICULTURE, PEDIATRIE. 1994 Mar;(154):8-11.
Abstract: Vacuum aspiration has replaced curettage as the surgical means to terminate pregnancy. In France, 15% of the 240,000 women who undergo voluntary induced abortion each year have repeat abortions. Surgical abortion must preserve fertility and minimize perioperative complications. Sterilized materials for voluntary surgical abortion include: a Colin speculum; Pozzi forceps to grasp the cervix to straighten the uterus; compresses and long forceps to sterilize the vagina; plastic dilators with half-centimeter increments; 4-8 mm diameter, straight, 2-windowed plastic Karmann cannulas; 6-12 mm diameter, curved, uni-windowed plastic Berkeley cannulas; and a cuff between the cannula and the vacuum equipment. The vacuum aspirator needs to allow depression to 70 mm Hg. It should be able to collect the conceptus. To avoid faintness, the operating table should be put in the Trendelenburg position. The cardioscope allows perioperative surveillance of the heart beat. A blood pressure cuff allows one to control blood pressure. The surgery consists of two stages: cervical dilatation and aspiration of the uterus. The cervix should be dilated to a diameter in mm equal to the gestational age minus 2 (e.g., 9 weeks gestation would require a dilation of 7 mm). One should never use the cannula like a curette. Women have three possible choices with regard to anesthesia: no anesthesia, local anesthesia, or general anesthesia. Physicians must discuss these choices with the patients beforehand. After the operation, they should counsel them about what to expect (bleeding for 5-6 days) and what requires a medical visit (e.g., fever for more than 24 hours). They need to tell the women what they can and cannot do to be safe. Around days 3-5, 20% of abortion cases have a fever, blood clots, and uterine contractions. This fifth-day syndrome lasts no more than 12 hours. 10-12 days after the abortion, the women must return for a control visit.
Language: French
Keywords:
FRANCE | ABORTION | SURGICAL EQUIPMENT | UTERINE ASPIRATOR | CERVICAL DILATATION | ANESTHESIA | COUNSELING | PRESCRIPTIONS | CLINIC VISITS | Europe, Western | Europe | Developed Countries | Fertility Control, Postconception | Family Planning | Equipment and Supplies | Treatment | Clinic Activities | Program Activities | Programs | Organization and Administration | Distributional Activities | Service Statistics
Document Number: 103159 Notification

14.
Title: Endometrial suction in luteal phase as a method of late postcoital contraception.
Author: Harel L; Kaplan B
Source: CONTRACEPTION. 1993 May;47(5):469-74.
Abstract: The Pipelle disposable endometrial biopsy suction catheter was used on 25 women for postcoital contraception 1-7 days after exposure to unprotected coitus occurring 12-16 days before the next expected menses. 35 women entered the study and were offered estrogen/progestogen, an IUD, or endometrial suction. The 25 women who chose suction were aged 18-38. 16 were fertile. All had informed consent and a pelvic exam but no antibiotics or analgesia. The pipelle catheter was introduced as often as 4 times, until no more tissue was obtained. All patients were followed with beta-hCG at 10-12 days and 3 weeks and were seen at 2 and 4 weeks. All tissue was post-ovulatory as judged by pathology. There were no complications or pregnancies. This method of postcoital pregnancy termination deserves more study, since it is relatively painless and does not require subsequent visits or compliance on the part of the patient.
Language: English
Keywords:
ISRAEL | RESEARCH REPORT | CLINICAL RESEARCH | CONTRACEPTION RESEARCH | ENDOMETRIUM | FERTILITY CONTROL, POSTCOITAL | MENSTRUAL REGULATION | CURETTAGE | UTERINE ASPIRATOR | PREIMPLANTATION PHASE | OVULATION | EMERGENCY CONTRACEPTION | Middle East | Developed Countries | Research Methodology | Contraception | Family Planning | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Obstetrical Surgery | Surgery | Treatment | Surgical Equipment | Equipment and Supplies | Implantation | Pregnancy, First Trimester | Pregnancy | Reproduction
Document Number: 082671

15.
Title: Clinical guidelines for the use of manual vacuum aspiration in managing incomplete abortion.
Author: International Projects Assistance Services [IPAS]
Source: Carrboro, North Carolina, IPAS, [1990]. [5], 36 p. RH Training Materials
Abstract: This illustrated booklet is a training manual for medical practitioners in developing countries for treatment of incomplete spontaneous or induced abortion using the manual vacuum aspiration syringe and flexible cannulas. The equipment made by International Projects Assistance Services (IPAS) is featured, but similar devices can be used if the manufacturer's directions are followed. 1st presenting signs and symptoms are described with a general review of the treatment. Preoperative evaluation checks are listed, emphasizing that the method is not used if the uterus is larger than 12 weeks LMP or cannot be assessed, or there is possibility of ectopic pregnancy, shock or severe anemia. The syringes and cannulae are diagrammed, with other equipment and supplies. Operation of the syringe to effect a vacuum is illustrated. The process of counseling and examining the patient, both by bimanual exams and cervical inspection, then preoperative cleansing of the cervix and vagina and cervical block anesthesia are shown and described in detail. The procedure of uterine aspiration is shown stepwise with drawings of how to hold and manipulate the instruments. Danger warnings about pushing the plunger while the cannula and syringe are in place, and how to manage technical difficulties are given. Directions on how to inspect the tissue returned, how to deal with complications, and proper postoperative care complete the section. A sample pamphlet with discharge directions for illiterate clients is included, with the advice to test it on local women. The booklet ends with directions on how to cleans and disinfect the equipment for re-use.
Language: English
Keywords:
TEACHING MATERIALS | MANUAL | ON-THE-JOB TRAINING | ILLITERATES | ABORTION | MENSTRUAL REGULATION | ABORTION, SPONTANEOUS | PELVIC INFECTIONS | PREGNANCY, FIRST TRIMESTER | SYRINGE | CANNULA | ANESTHESIA | UTERINE ASPIRATOR | CERVICAL DILATATION | PHYSICAL EXAMINATIONS AND DIAGNOSES | SIZE | PREOPERATIVE PROCEDURES | POSTOPERATIVE PROCEDURES | MATERNAL HEALTH SERVICES | PHYSICIANS | COUNSELING | WOMEN | Training Programs | Education | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Control, Postconception | Family Planning | Fertility Control, Postcoital | Pregnancy Complications | Diseases | Infections | Pregnancy | Reproduction | Equipment and Supplies | Treatment | Surgical Equipment | Examinations and Diagnoses | Surgery | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Personnel | Clinic Activities | Program Activities | Programs | Organization and Administration | Demographic Factors | Population
Document Number: 065138 Notification

16.
Title: Is evacuation of the uterus necessary after middle trimester abortion?
Author: Bigrigg A; Henshaw R; Fleming C
Source: JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 1990;10(5):444-5.
Abstract: To assess the importance of uterine evacuation after prostaglandin- induced mid-trimester abortion, the results of management with and without this procedure were compared. The gestational age of study participants was 15 weeks (range, 12-18 weeks). The procedure involved insertion of a Foley catheter through the cervical canal and infusion of a solution of prostaglandin E2 into the extra-amniotic space. Complete abortion was considered to have occurred if the placenta and products appeared intact, the uterus was well contracted, and there was no excessive bleeding. If complete abortion has occurred, the patients were randomly assigned to have uterine evacuation under general anesthesia (9 patients) or no uterine evacuation (22 patients). The 37 patients who were diagnosed clinically has having incomplete abortion also underwent uterine evacuation. Women who had evacuation of the uterus performed after clinically complete abortion were more likely to visit their general practitioner (4.9 cases) and to require antibiotics (4 cases) than those who did not undergo evacuation (4/22 and 4 cases, respectively). In 1 of the 9 cases where complete abortion was judged to have occurred, a moderate amount of retained placental tissue was found. However, the possible complications of uterine evacuation after an apparently complete abortion--the need for general anesthesia, and the danger of introducing infection into the uterine cavity--suggest that this procedure is not a advisable component of the management of prostaglandin-induced mid-trimester abortions.
Language: English
Keywords:
COMPARATIVE STUDIES | ABORTION | PROSTAGLANDINS | UTERINE ASPIRATOR | GYNECOLOGIC SURGERY | STANDARDS | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Endocrine System | Physiology | Biology | Surgical Equipment | Equipment and Supplies | Urogenital Surgery | Surgery | Treatment
Document Number: 065629 Notification

17.
Title: Abortion practice.
Author: Hern WM
Source: Philadelphia, Pennsylvania, J.B. Lippincott, 1990. xviii, 340 p.
Abstract: This guide to abortion practice and the operation of an abortion facility in textbook form covers patient evaluation and counseling, diagnosis of gestation, operative procedures for vacuum aspiration, dilatation and evacuation and instillation abortions through 24 weeks' gestation, nursing, postoperative procedures, management of complications, staffing, operation, facilities, and legal aspects. The introductory chapter on the epidemiological foundations of abortion practice argues the view that if term pregnancy is considered a medically managed condition that is more risky than contraception (except for oral contraception in smokers over age 35) or abortion, and indeed unlimited reproduction endangers the survival of humanity and other species, childbirth is the elective treatment of pregnancy. Prevention and termination is the indicated treatment of pregnancy, unless it is desired for reproduction, as opposed to self-expression or status-affirmation. Thus there is no social, political, or economic justification for withholding abortion. The guidelines on abortion practice are detailed with photographs and descriptions such as how the operator should hold instruments. These instructions are needed because abortion procedures are not generally taught in medical training. The use of laminaria is recommended to dilate the cervix for all types of terminations if not contraindicated, and local anesthesia for its safety and better feedback from the patient. Extensive sections on management and training of staff, handling emergencies, program evaluation, legal issues, and public relations will be helpful to those operating or planning an abortion service.
Language: English
Keywords:
UNITED STATES OF AMERICA | MANUAL | ABORTION | ABORTION LAW | ABORTION RATE | CURETTAGE | PHYSICIAN'S OFFICE | CLINICS | HEALTH FACILITY PLANNING | NURSES AND NURSING | PARAMEDICAL PERSONNEL | COUNSELORS | ORGANIC CHEMICALS | HYPERTONIC SALINE SOLUTION | SURGICAL EQUIPMENT | FORCEPS | UTERINE ASPIRATOR | PREGNANCY TESTS | ANESTHESIA | LAMINARIA TENTS | POSTABORTAL PROGRAMS | HEALTH SERVICES EVALUATION | SEX EDUCATION | PREGNANCY COMPLICATIONS | PREGNANCY, ECTOPIC | PRODUCTS OF CONCEPTION, RETENTION | North America | Americas | Developed Countries | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Health Facilities | Delivery of Health Care | Health | Health Services Administration | Management | Organization and Administration | Health Personnel | Counseling | Clinic Activities | Program Activities | Programs | Ingredients and Chemicals | Equipment and Supplies | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Cervical Dilatation | Family Planning Programs | Program Evaluation | Education | Diseases
Document Number: 074384 Notification

18.
Title: Menstrual regulation.
Author: Chaudhuri SK
Source: In: Practice of fertility control: a comprehensive textbook. 2nd ed., [by] S.K. Chaudhuri. New Delhi, India, B.I. Publications, 1988. :193-204.
Abstract: Menstrual regulation has come to imply treatment of the delayed menstrual period up to 14 days with the hand-held 50-ml syringe and special plastic cannula. Other terms for the procedure are menstrual extraction, endometrial aspiration, mini-suction, and mini-abortion; other equipment sometimes used includes hand or foot-operated or electrically powered aspiration machines. Good history taking is imperative, indeed up to 50% of women up to 7 days after the missed period are not pregnant. A general practitioner or even with special training, a paramedic, can perform the procedure. Although proximity to referral services is required, menstrual regulation can be done in any clean, well-lit room. The design and sterilization of the Karmen syringe and cannulae are described. Typically no anesthesia is used, although some operators apply paracervical block. The procedure is described in detail. The immediate and late complication rates obtained in multicenter trials are 0.85% and 0.5-4% respectively. Over half of the complications are vomiting, pain, fainting and moderate bleeding. No mortality has yet been reported. Menstrual regulation should not be taken as a regular contraceptive method, but as a back-up method in case of failure of a barrier method, for example. It is legal in all countries where abortion is allowed, or in countries where abortion is not considered a crime until pregnancy tests are positive. Menstrual regulation is safe, effective and inexpensive, and developing countries should explicitly exclude it from their legal codes applying to abortion.
Language: English
Keywords:
FAMILY PLANNING | CONTRACEPTION | FERTILITY CONTROL, POSTCOITAL | MENSTRUAL REGULATION | MORBIDITY | EQUIPMENT AND SUPPLIES | CANNULA | SYRINGE | SURGICAL EQUIPMENT | UTERINE ASPIRATOR | LITERATURE REVIEW | ABORTION | EMERGENCY CONTRACEPTION | Diseases | Fertility Control, Postconception
Document Number: 047679 Notification

19.
Title: [Abortion at 10 to 12 weeks gestation using plastic syringe or electric aspirator] Prekid trudnoce od 10 do 12 tjedna plasticnom strcaljkom ili elektricnim aspiratorom.
Author: Borko E; Braznik R; Ivanisevic V; Kokos Z
Source: Jugoslavenska Ginekologija i Opstetricija. 1983 Jan-Apr;23(1-2):17-20.
Abstract: This study included 170 women subjected to menstrual regulation. The double-valve band syringe was used in 96 cases and the electric pump (the vacuum source usually used at the Department) in 74 cases. Nearly all procedures were performed under general anesthesia using 8 mm, 10 mm, or 12 mm plastic rigid cannulae. 3 abortions with the hand syringe also required dilatation and curettage and all 3 women suffered blood loss exceeding 100 ml. There was 1 cervical laceration surgically repaired and a case of adnexitis reported among the hand syringe group. Immediate complications occured in 7.3% of the cases using the hand syringe and in 4.1% of those using the electric pump. The mean procedural time was 4.2 minutes and 4.0 minutes, respectively, with the hand syringe and the electric pump. Only 3 women reported complications or complaints at the follow-up visit, all of them from the electric pump group. (author's modified) (summary in ENG)
Language: Croatian
Keywords:
MENSTRUAL REGULATION | SURGICAL EQUIPMENT | FERTILITY CONTROL, POSTCOITAL | FAMILY PLANNING | CANNULA | UTERINE ASPIRATOR | ABORTION | PREGNANCY, FIRST TRIMESTER | EMERGENCY CONTRACEPTION | SIDE EFFECTS | ANESTHESIA | BLEEDING | CERVICAL EFFECTS | ADNEXITIS | Equipment and Supplies | Fertility Control, Postconception | Pregnancy | Reproduction | Contraception | Treatment | Signs and Symptoms | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Pelvic Inflammatory Disease | Reproductive Tract Infections | Infections
Document Number: 021465 Notification

20.
Title: Suction curettage.
Author: English EC
Source: Journal of Family Practice. 1983 Dec;17(6):1065-70.
Abstract: In the decade after the legalization of elective abortion by a Supreme Court decision in January 1973, suction curettage has been widely used and accepted as a safe outpatient procedure for 1st trimester abortion. Evaluation of the patient for feasibility of the procedure requires careful assessment of gestational age and the determination of the absence of an ectopic pregnancy and conditions which might contraindicate local anesthesia. Counseling clarifies the patient's options and ensures her understanding of the implications of abortion so that she can give informed consent. Suction curettage is performed under local anesthesia using a sterile plastic cannula or curette inserted through a progressively dilated cervix with aspiration of the uterine contents by an electric pump. The procedure is completed by the physician's examination of the aspirate for the presence of placental villi. Postoperative instructions include contraception and monitoring for hemorrhage and infection prior to a return visit in 10-14 days. Complications can be reduced by careful selection of the patients with appropriate duration of pregnancy, use of gentle operative technique, antibiotics for prophylaxis of infection, and a continued maintenance of experience and procedural skill by the physician. (author's)
Language: English
Keywords:
CURETTAGE | EVALUATION | EQUIPMENT AND SUPPLIES | CANNULA | UTERINE ASPIRATOR | SURGERY | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | COMPLICATIONS | ANESTHESIA | Obstetrical Surgery | Treatment | Surgical Equipment | Diseases
Document Number: 020412 Notification

21.
Peer Reviewed

Title: Early office termination of pregnancy by soft cannula vacuum aspiration.
Author: Meyer JH Jr
Source: American Journal of Obstetrics and Gynecology. 1983 Sep 15;147(2):202-7.
Abstract: This report documents the results of an ongoing study of the first 454 consecutive outpatient abortions by the menstrual extraction technique performed over a span of 8 years by the author. All patients had positive preevacuation pregnancy tests and the procedure was employed up to 9+ weeks from the 1st day of the last menstrual period. All procedures were carried out in an outpatient setting under local anesthesia. Pathologic evaluation revealed decidua and villi in all but 10 cases. Major complications were encountered in 2.6% of cases and in only 2 was laparotomy necessitated--1 for ruptured corpus luteum cyst and the other for an unruptured ectopic cornual pregnancy. The current application for the procedure is suggested by its technical simplicity and relative safety in populations presenting for early pregnancy termination. (author's modified)
Language: English
Keywords:
PREGNANCY, FIRST TRIMESTER | PREGNANCY | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | MENSTRUAL REGULATION | EQUIPMENT AND SUPPLIES | FERTILITY CONTROL, POSTCOITAL | CANNULA | UTERINE ASPIRATOR | HISTOLOGY | EMERGENCY CONTRACEPTION | UTERINE PERFORATION | CERVICAL EFFECTS | PREGNANCY, ECTOPIC | AGE FACTORS | BODY WEIGHT | PARITY | INFECTIONS | Reproduction | Surgical Equipment | Biology | Contraception | Perforations | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Pregnancy Complications | Population Characteristics | Demographic Factors | Population | Fertility Measurements | Fertility | Population Dynamics
Document Number: 017736 Notification

22.
Title: Contraception: the health provider's guide.
Author: Porter CW; Waife RS; Holtrop HR
Source: New York, N.Y., Grune and Stratton, 1983. 290 p.
Abstract: This book is intended to be a comprehensive, concise, and up-to-date guide to the provision of contraception as an essential health service. The 1st chapter discusses the counseling and education aspects of family planning in reference to its implications, follow-up and referral, and importance in regard to adolescents. Oral contraceptives is the main topic of chapter 2. It specifically discusses the types of pills, its associated physiology, its beneficial effects, selection and follow-up requirements. Chapter 3 discusses intrauterine devices in regard to its history, effectiveness and effects, device design, and insertion procedure. The following chapter on barrier methods considers its indications, effectiveness, diaphragms, condoms and vaginal spermicides. Uterine aspiration is the main subject of chapter 5. Primarily used for spontaneous and induced abortion, uterine aspiration is discussed in regard to its current technology, history, equipment and facilities, procedure and follow-up requirements. Chapter 6 is intended to prepare the provider for counseling and referring the client who chooses sterilization as a family planning method. Dicussed are female and male sterilization, its advantages and disadvantages. The last chapter is a guideline for referral for other health problems such as gynecological conditions, vaginal and urinary infections, sexually transmitted diseases and other common health problems such as anemia, diabetes, hypertension, hepatitis, and nutritional deficiencies. Tables, charts and figures illustrate each chapter.
Language: English
Keywords:
COUNSELING | FAMILY PLANNING EDUCATION | ORAL CONTRACEPTIVES | CONTRACEPTIVE IMPLANTS | BARRIER METHODS | IUD | CONTRACEPTIVE METHODS CHOSEN | FEMALE STERILIZATION | MALE STERILIZATION | UTERINE ASPIRATOR | ABORTION | ABORTION, SPONTANEOUS | UROGENITAL EFFECTS | GENITAL EFFECTS, FEMALE | CONTRACEPTION | FAMILY PLANNING | TECHNICAL REPORT | SEXUALLY TRANSMITTED DISEASES | CONTRACEPTIVE USE-EFFECTIVENESS | REVERSIBILITY | Clinic Activities | Program Activities | Programs | Organization and Administration | Education | Contraceptive Methods | Contraceptive Usage | Sterilization, Sexual | Surgical Equipment | Equipment and Supplies | Fertility Control, Postconception | Pregnancy Complications | Diseases | Urogenital System | Physiology | Biology | Genitalia, Female | Genitalia | Reproductive Tract Infections | Infections | Contraceptive Effectiveness
Document Number: 267225 Notification

23.
Title: Abortion. 2. Medical techniques.
Author: Plaskon V
Source: In: Ross JA, ed. International encyclopedia of population. Vol. 1. New York, Free Press, 1982. :8-11.
Abstract: Current medical procedures for inducing abortion are instrumental evacuation, stimulation of uterine contractions, and major surgery. There are 4 methods of instrumental evacuation: 1) suction curettage (performed up to the 12th week of pregnancy), involving a dilatation of the cervical canal using laminaria and then a systematic removal of the products of conception by vacuum aspiration with a suction cannula and an electrical pump; 2) dilatation and curettage (performed up to 12 weeks gestation), involving a dilatation of the cervix and then a systematic scraping of the uterine cavity with a sharp metal curette; 3) endometrial aspiration, performed in the 1st 2 weeks after a missed menstrual period and done by inserting a small cannula attached to a syringe through the cervix into the uterus and withdrawing the contents by suction; 4) dilatation and evacuation (done between 13-16 weeks gestation) involving dilatation of the cervical canal, evacuation of the uterus using forceps, suction cannula, and sharp curette. The latter method becomes more difficult the later in pregnancy it is performed. Stimulation of uterine contractions is used for induction of 2nd trimester abortion, the methodology being intraaminiotic or extraamniotic infusions of various compounds or the extraamniotic insertion of mechanical devices. The 2 main compounds used are: 1) saline solution and 2) prostaglandins, of PGE2, PGF2alpha and 15-methyl-PGF2alpha are the most commonly used. Other compounds such as urea, Rivanol and hypertonic glucose have been used with little success. Mechanical stimulation of uterine contractions involve the placement of 2 or 3 laminaria in the cervix for 24 hours followed by the insertion of an inert device, the metreurynter (small rubber bag) between the amniotic sac and the wall of the lower uterine segment. The metreurynter is inflated until the cervix is dilated. Both hysterectomy and hysterotomy are considered major abdominal surgery but are declining as methods of abortion, being performed only when other methods fail. In the U.S., between 1972-78 these precedures had a combined death-to-case ratio of 41.3/100,000 abortions, carrying a relative risk of death almost 32 times higher than suction curettage.
Language: English
Keywords:
ABORTION | HYSTERECTOMY | HYSTEROTOMY | CURETTAGE | PROSTAGLANDINS | UTERINE ASPIRATOR | CANNULA | SALINE SOLUTION, HYPERTONIC | PROSTAGLANDINS, SYNTHETIC | Fertility Control, Postconception | Family Planning | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Obstetrical Surgery | Endocrine System | Physiology | Biology | Surgical Equipment | Equipment and Supplies | Ingredients and Chemicals
Document Number: 009188 Notification

24.
Title: [Aspiration of uterine contents using the Vakutage apparatus] Zkusenosti s aspiraci obsahu dutiny delozni jednorazovou pomuckou Vakutage.
Author: Sracek J; Uzel R; Honek L
Source: Ceskoslovenska Gynekologie. 1982 Jun;47(5):367-70.
Abstract: This study describes the Vakutage, a single-use, disposable apparatus for uterine aspiration under conditions of outpatient care. The set consists of 2 different size containers for the collection of the uterine contents (335 ml and 110 ml) and catheters of 4, 6, 8 and 10 mm in diameter. The Vakutage was used to treat dysfunctional bleeding, menstruation irregularity, and for endometrial biopsies in the diagnosis of fertility disorders and endometrial carcinoma. These procedures were performed in ambulatory care facilities. In 44 hospitalized women, the Vakutage was used to perform abortions and to treat incomplete and missed abortions. There were no preoperative or postoperative complications and no incidence of equipment failure during any of the procedures.
Language: Czech
Keywords:
ABORTION | EQUIPMENT AND SUPPLIES | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | SURGICAL EQUIPMENT | UTERINE ASPIRATOR | BLEEDING | MENSTRUATION DISORDERS | MENSTRUATION | ENDOMETRIAL CANCER | Signs and Symptoms | Diseases | Reproduction | Cancer | Neoplasms
Document Number: 011767 Notification

25.
Title: Dilatation and evacuation by aspirotomy for termination of pregnancy.
Author: Beekhuizen W; du Plessis M; van Schie KJ; Van Lith Leiden DA
Source: In: Hingorani V, Pandit RD, Bhargava VL, ed. Proceedings of the Third International Seminar on Maternal and Perinatal Mortality Pregnancy Termination and Sterilization, New Delhi, India, 3rd to 5th October 1980. Bombay, India, Federation of Obstetric and Gynaecological Societies of India [1981?] :632.
Abstract: Aspirotomy (AT) is the name of the second trimester abortion technique which is in use since April 1976 at the Center for Human Reproduction in Leiden, Holland. It is one of the procedures which internationally are known as dilatation and evacuation. The fundamental characteristics of AT is the low degree of cervical dilatation; no more than 10-11 mm. in 90% of the cases of 14-17 weeks gestation. This is contrary to the considerable (2-5 cm.) cervical dilatation required for expulsion of an undamaged fetal caput with instillation techniques (prostaglandins, saline). Further characteristics of the AT procedure are: outpatient, no sedatives, combined para- and intracervical block with lidocaine/adrenalin and a suction-crushing technique with AT forceps of different sizes (8-9-10 mm.). The immediate major complication rate of 3390 patients with pregnancies of 14-23 weeks treated during 1977-79 was 0.47/100 AT procedures. Complications were more serious and about 5 times more frequent in the 17 weeks or more group, compared to the early midtrimester (14-16 weeks) patients. This indicates that the preferable method of terminating pregnancies of 17 menstrual weeks and more remains to be determined. AT is a safe D & E procedure for all patients who are 14, 15 and 16 weeks pregnant. It does not imitate the birth process. It is an outpatient procedure and therefore psychologically, socially and economically preferable. (author's modified)
Language: English
Keywords:
UTERINE ASPIRATOR | ABORTION | NETHERLANDS | PREGNANCY, SECOND TRIMESTER | EUROPE, WESTERN | EUROPE | CONFERENCES AND CONGRESSES | RESEARCH REPORT | TIME FACTORS | Surgical Equipment | Equipment and Supplies | Fertility Control, Postconception | Family Planning | Developed Countries | Pregnancy | Reproduction | Population Dynamics | Demographic Factors | Population
Document Number: 267216 Notification

26.
Title: A review of techniques of induced abortion.
Author: Hepburn S
Source: Family Planning Information Service. 1981 Apr;1(6):16-9.
Abstract: Various techniques are available for inducing abortion. Evacuation of the uterus through the vagina is generally the preferred method in first trimester pregnancies. Dilation of the cervical canal by inserting rod dilators or laminaria tents allows the withdrawal of the fetus. Suction procedures (vacuum aspiration, uterine aspiration, or suction curettage) are possible since the decidua are separable from the basal layer of endometrium. This removal by force does not damage other maternal tissue. A cannula is introduced into the uterine cavity through the dilated cervix and its operator is then connected to a pump by way of a flexible tube which delivers negative pressure of about 600 mm of mercury. When the fetus is withdrawn, the uterus is felt to contract onto the cannula. The average time for this procedure is 5 minutes. Surgical curettage or dilatation and evacuation first dilates the cervical canal and then removes fetal parts and tissue from ovum forceps; a sharp curette does the rest. Anesthesia for these procedures may be general, local, or spinal. The techniques of menstrual regulation is used before pregnancy can be confirmed. However with the advent of the RIA test for the beta subunit of HCG this procedure is rarely indicated. Induction of premature labor is used in the later 1/2 of the second trimester and utilizes prostaglandins. Intraamniobor usually begins within 24 hours. Hysterotomy and hysterectomy are surgical procedures used in abortions.
Language: English
Keywords:
ABORTION | CANNULA | UTERINE ASPIRATOR | CURETTAGE | MENSTRUAL REGULATION | FERTILITY CONTROL, POSTCOITAL | SURGERY | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | LAMINARIA TENTS | EMERGENCY CONTRACEPTION | PREGNANCY, FIRST TRIMESTER | ANESTHESIA | SALINE SOLUTION, HYPERTONIC | HYSTEROTOMY | HYSTERECTOMY | PREGNANCY, SECOND TRIMESTER | Fertility Control, Postconception | Family Planning | Equipment and Supplies | Surgical Equipment | Obstetrical Surgery | Treatment | Prostaglandins | Endocrine System | Physiology | Biology | Cervical Dilatation | Contraception | Pregnancy | Reproduction | Ingredients and Chemicals | Gynecologic Surgery | Urogenital Surgery
Document Number: 004404 Notification

27.
Title: Laminaria versus isapgol tent dilatation and evacuation of early midtrimester abortion.
Author: Jayashree; Murthy LK; Eduljee SV
Source: In: Hingorani V, Pandit RD, Bhargava VL, ed. Proceedings of the Third International Seminar on Maternal and Perinatal Mortality Pregnancy Termination and Sterilization, New Delhi, India, 3rd to 5th October 1980. Bombay, India, Federation of Obstetric and Gynaecological Societies of India [1981?] :635.
Abstract: A comparative study of the efficacy of laminaria tent versus Isapgol tent (Isaptent) for dilatation and evacuation in early midtrimester gestation was studied in 125 patients. Cervical dilation was accomplished by overnight placement of the tents. The average dilatation achieved was 9 to 13 mm. Suction evacuation was carried out by the usual Berkely Uterine aspirator without anesthesia. It was found that this method was almost 100% successful, safe, with minimal complications. (author's modified)
Language: English
Keywords:
ABORTION | INDIA | LAMINARIA TENTS | PREGNANCY, SECOND TRIMESTER | CONFERENCES AND CONGRESSES | RESEARCH REPORT | UTERINE ASPIRATOR | Fertility Control, Postconception | Family Planning | Asia, Southern | Asia | Developing Countries | Cervical Dilatation | Treatment | Pregnancy | Reproduction | Surgical Equipment | Equipment and Supplies
Document Number: 267207 Notification

28.
Title: Midtrimester abortion by curettage procedures: an overview.
Author: Stubblefield PG
Source: In: Hodgson JE, ed. Abortion and sterilization: medical and social aspects. London, Academic Press, 1981. :277-95.
Abstract: Curettage abortion is recommended as the safest early midtrimester abortion procedure. No woman presenting at 13-15 weeks gestation should be counselled to wait for an amnioinfusion after 16 weeks. The literature has descriptions of several different techniques for performing curettage abortion in midtrimester. The main choice in the U.S. is between a 1-stage procedure which includes forcible dilatation of the cervix and extraction of the ovum with crushing forceps and a 12 or 14 mm vacuum cannula or a 2-stage procedure involving placement of multiple small laminaria tents followed after 24 hours by extraction of the embryo. Slow dilatation with laminaria tents is preferable to forcible dilatation with metal dilators because: 1) this will reduce the risk of perforation; and 2) this reduces the chance for subsequent premature deliveries. The type of forceps and vacuum cannulae recommended for midtrimester procedures is discussed. The Center for Disease Control has collected statistics showing that the rate of complications is similar with local and general anesthesia used in induced abortion; local anesthesia was more often associated with convulsions while general anesthesia was associated with perforation. This author favors local anesthesia. The recommended procedure is described and commonly experienced problems, e.g., bleeding and possible perforation, are mentioned.
Language: English
Keywords:
UNITED STATES OF AMERICA | ABORTION | CURETTAGE | CERVICAL EFFECTS | LAMINARIA TENTS | SURGICAL EQUIPMENT | FORCEPS | CANNULA | LITERATURE REVIEW | COMPLICATIONS | PREGNANCY, SECOND TRIMESTER | UTERINE ASPIRATOR | ANESTHESIA | PERFORATIONS | BLEEDING | INFECTIONS | CERVICAL LACERATION | INFANT, PREMATURE | North America | Americas | Developed Countries | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cervical Dilatation | Equipment and Supplies | Diseases | Pregnancy | Reproduction | Signs and Symptoms | Infant | Youth | Age Factors | Population Characteristics | Demographic Factors | Population
Document Number: 003099 Notification

29.
Title: Outpatient termination of early pregnancies using syringe and plastic cannula.
Author: Marshall BR; McGeachin SG; Hepler JK; Hayden DJ
Source: WESTERN JOURNAL OF MEDICINE. 1980 Mar;132(3):186-8.
Abstract: Experience with outpatient termination of early pregnancies (menstrual regulation) using a Milex cannula-curette is summarized. 543 women not more than 8 weeks pregnant were aborted with a 50-ml syringe and a Karman-type cannula-curette on an outpatient basis. Paracervical block analgesia and atropine were given intravenously during the procedure to minimize vagal reactions. .9% (n=5) of pregnancies were missed by the procedure, and 2.4% (n=13) of the procedures were incomplete. Only 1 instance of postoperative sequelae was found, and that was a pelvic infection. 4.9% of the women were not pregnant at the time of procedure, and the preoperative procedure was modified to include routine urine pregnancy testing before menstrual regulation to reduce the percentage of nongravid. The procedure was well-tolerated and inexpensive.
Language: English
Keywords:
CLINICAL RESEARCH | CLINICS | SYRINGE | CANNULA | UTERINE ASPIRATOR | MENSTRUAL REGULATION | Research Methodology | Health Facilities | Delivery of Health Care | Health | Equipment and Supplies | Surgical Equipment | Fertility Control, Postcoital | Family Planning
Document Number: 801502

30.
Title: Reproduction research and health. Pt. 3. Fertility Health.
Author: Sinnathuray TA
Source: Mikrobiyoloji Bulteni. 1980 Mar;34(3):307-13.
Abstract: Recent advances in fertility regulation and infertility management were described. New forms of oral contraceptives, which minimize some of the negative side effects associated with the earlier types of oral contraceptives, were developed in recent years. The newer oral contraceptives are safe and effective if patients are properly screened and monitored. Sterilization techniques were greatly improved in recent years through the use of fiber optic endoscopes and cold light sources. Research also helped remove many of the misconceptions surrounding sterilization and this greatly enhanced the popularity of sterilization. Techniques for performing abortions improved in recent years and this led to a growing acceptance of legal abortion. Major advances relating to abortion were 1) the recognition that menstrual regulation could be adequately performed by paramedical personnel on an outpatient basis; 2) the development of the dilatation suction cannula; and 3) the use of prostaglandins for performing late abortions. In regard to infertility management, recent advances in endocrinology and in biochemistry led to the development of new therapeutic drugs for increasing fertility and for inducing ovulation. The use of microsurgical techniques and tubal transplants improved the chances of successfully treating certain types of infertility. Recent research efforts directed toward the production of test tube babies also led to success; however, the cost of these procedures is prohibitive. Funds in developing countries should rather be spent on developing techniques which will benefit a broader segment of the population.
Language: English
Keywords:
RESEARCH AND DEVELOPMENT | ORAL CONTRACEPTIVES, SIDE EFFECTS | STERILIZATION, SEXUAL | ABORTION | MENSTRUAL REGULATION | INFERTILITY | UTERINE ASPIRATOR | CANNULA | PROSTAGLANDINS | CONTRACEPTIVE METHODS | SIDE EFFECTS | Technology | Economic Factors | Contraceptive Safety | Safety | Public Health | Health | Family Planning | Fertility Control, Postconception | Fertility Control, Postcoital | Reproduction | Surgical Equipment | Equipment and Supplies | Endocrine System | Physiology | Biology | Contraception | Treatment
Document Number: 802753 Notification


	Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy