Deaths From Spontaneous Abortion in the United States

Abstract

Little is known about maternal deaths after spontaneous abortion. We studied 122 such deaths reported to the Centers for Disease Control from 1972 through 1980; 21 were intrauterine (contraceptive) device related. The number of non-IUD-related deaths decreased from 15 in 1972 to six in 1980; the mortality ratio (deaths per million live births) decreased from 4.6 in 1972 to 1.7 in 1980. Non-IUD-related deaths were results of infection (48%), hemorrhage (21%), embolism (11%), and other causes (20%). Risk factors for these deaths were age over 29 years, being of minority race, and unmarried status. Most deaths (58%) occurred between 12 and 19 weeks' gestation. The risk of death was much higher for abortion in the second trimester than in the first. Deaths following spontaneous abortion, although rare, do occur; older, black, and unmarried women are at higher risk.

Second trimester abortion as a cause of maternal death: a case report

“…All over the world, most deaths (58%) occurred between 12 and 19 weeks′ gestation. The risk of death was much higher for abortion in the second trimester compared with first trimester [ 9 ]. In the present case report, patient was older than 29 years, had missed abortion at second trimester, which were risk factors for abortion.…”

“…In a research, it was determined that infection (48%), hemorrhage (21%), embolism (11%), and other causes (20%) may lead to mortality due to spontaneous abortion [ 9 ]. Again in another study investigating deaths due to spontaneous abortions in United States during 1981-1991, found that, deaths mostly occurred due to infection (59%) and hemorrhage (18%) [ 10 ].…”

Pregnancies Averted Among U.S. Teenagers by the Use of Contraceptives

“…9 Contraceptive use increases with age, with 72% of sexually active 15-17-year-olds and 84% of comparable 18-19-year-olds practicing contraception. 10 Contraceptive use at first intercourse is also more common among adolescents now than in the past: In 1976, 61% of sexually experienced women aged [15][16][17][18][19] used no method at first intercourse, compared with 25% in 1990. 11 Thus, although a large number of teenage pregnancies occur each year in the United States, today's adolescents have increased their efforts to prevent unintended pregnancies.…”

“…14 In addition, in 1989, about 1% of pregnancies among 15-24-year-old women were ectopic. 15 Maternal mortality for these outcomes is about 6.0 per 100,000 for live births, 16 0.9 per 100,000 for abortions, 17 0.85 per 100,000 for miscarriages 18 and 38 per 100,000 for ectopic pregnancies. 19 Unintended pregnancies that occur despite the use of contraceptives are more likely to end in abortion, 20 but it is difficult to know whether adolescents who are denied access to contraceptives would act more like contraceptive users or more like nonusers in how they resolve a pregnancy.…”

“…An additional nine individuals were excluded because they were not at risk of becoming pregnant in the previous 12 months for other reasons, such as already being pregnant. Thus, the final sample consisted of 651 adolescent women, and represented almost 4.0 million U.S. women aged [15][16][17][18][19].…”