Termination of pregnancy for maternal medical indications: Failings in delivery of contraceptive advice?

Barrett, Helen L.; Lust, Karin; Callaway, Leonie K.; Fagermo, Narella; Portmann, C.

doi:10.1111/j.1479-828x.2011.01371.x

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…There is no doubt that an important factor is the express prohibition of abortion for this cause in Article 120 of the Peruvian Criminal Code (6) . We examined the occurrence of TA in a country like Australia and verified in a report that the most frequent causes were related to psychiatric indications, cancer, and heart diseases (32) ; and when we examined the TA performed in Italy, the most common causes in the second trimester were related to genetic and congenital anomalies of a structural nature (33) .…”

Section: Discussionmentioning

confidence: 95%

“…No dudamos que un factor importante es la expresa prohibición del aborto por esta causa en el artículo 120 del Código Penal Peruano (6) . Examinamos la ocurrencia de AT en un país como Australia y verificamos en un reporte que las causales más frecuentes tuvieron que ver con indicaciones psiquiátricas, cáncer y enfermedades cardiacas (32) y cuando examinamos los AT atendidos en Italia, las causas más frecuentes en el segundo trimestre se relacionaron con anomalías genéticas y anomalías congénitas de carácter estructural (33) .…”

Section: Final Remarksunclassified

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Bareras para el aborto seguro en el marco de la ley peruana

Orozco¹,

Macharé²,

Angulo³

et al. 2016

Rev peru ginecol obstet.

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Objetivo: Examinar el proceso histórico para institucionalizar el aborto terapéutico en el Perú y precisar su situación actual. Metodología: Revisión de la información bibliográfica existente en el país en relación al proceso seguido por muchas instituciones hasta conseguir que el Ministerio de Salud apruebe la Guía Nacional para el Aborto Terapéutico. Luego el investigador principal convocó a 10 jefes de servicio/departamento de Ginecología y Obstetricia de igual número de hospitales que tienen regulada la prestación de servicios de aborto terapéutico mediante Guías o Protocolos locales desde 5 años antes, a quienes se les solicitó información. Resultados: La oficialización de la Guía Nacional para la prestación de servicios de aborto terapéutico por parte del Ministerio de Salud ha sido un trabajo persistente de muchas instituciones de la sociedad civil, pero los 10 hospitales convocados ya venían respondiendo a la demanda desde 5 años atrás. En los 5 años se atendió 257 abortos terapéuticos. La frecuencia del aborto terapéutico es aún baja, sin embargo se aprecia un aumento progresivo conforme avanzan los años. Es predominante la frecuencia de abortos terapéuticos en el segundo trimestre del embarazo, siendo la causa más frecuente las anomalías congénitas incompatibles con la vida. El uso del misoprostol en la evacuación del útero ha alcanzado el 95% de los casos y no se ha verificado más de 2% de complicaciones leves. Conclusión: El aborto legal por causales de salud se viene ofertando en forma restringida en el Perú.

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Section: Discussionmentioning

confidence: 95%

Section: Final Remarksunclassified

Bareras para el aborto seguro en el marco de la ley peruana

Orozco¹,

Macharé²,

Angulo³

et al. 2016

Rev peru ginecol obstet.

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show abstract

“…In the international literature, papers on other reasons for pregnancy termination for maternal indications are scarce. One study from Australia mentions psychiatric disorders, malignancies and cardiac disorders as the most common maternal indications for termination between 5 and 23 weeks gestation 17. In a recent paper by Piel et al from four hospitals in the Parisian area covering 95 000 deliveries between 2001 and 2010, the main reasons for terminating pregnancy for maternal reasons between 5 and 23 weeks of gestation were (in decreasing order of frequency): pre-eclampsia, malignancies, drug addiction, AIDS, risk of suicide, psychosis, rape, pre-existing maternal somatic or psychiatric diseases, uterine bleeding or risk of uterine rupture 18.…”

Section: Commentmentioning

confidence: 99%

Termination of pregnancy for maternal indications at the limits of fetal viability: a retrospective cohort study in the Dutch tertiary care centres

et al. 2014

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ObjectiveMaternal morbidity, either pregnancy related or pre-existent, can become life threatening and of such severity as to warrant termination of pregnancy (TOP). In this situation, chances of fetal survival are usually poor, either because of low gestational age and/or because of the fetal effects of the maternal condition. Examples include severe growth restriction in pre-eclampsia and intrauterine infection due to the very early preterm prelabour rupture of membranes. There are very few reports on the prevalence of TOP for maternal indication at the limits of fetal viability. We investigated the prevalence of and indications for TOP on maternal indication in the 10 tertiary care centres in the Netherlands during the past decade.Study designWe conducted a retrospective review of the medical records of all women who underwent TOP for maternal indications between 22 and 27 completed weeks of gestation in all 10 tertiary care centres from 2000 to 2009.ResultsDuring the study period, there were 1 929 470 deliveries; 163 052 (8.4%) of these took place in one of the 10 tertiary care centres and 177 pregnancies were terminated for severe maternal disease, 131 for hypertensive disorders, 29 for intrauterine infection and 17 for other reasons. The mean gestational age at TOP was 171 days (243/7)±10 days. No maternal deaths were recorded. The overall perinatal mortality was 99.4%.ConclusionsOver a 10-year period, TOP for maternal indications was performed in 1 in 1000 deliveries in the 10 Dutch tertiary care centres. Hypertensive disorders comprised three-quarters of the cases.

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“…However, unmet need for contraceptives continues to undermine the potential benefits of contraceptive use [ 19 ]. Studies show that 40–65% of pregnancies among women with CVD are unintended [ 18 , 20 ] and cardiac illness is one of the most common medical indications for termination of pregnancy [ 21 ]. Preexisting cardiac disease is the leading cause of maternal mortality in the developed world.…”

Section: Introductionmentioning

confidence: 99%

Unmet need for contraception and associated factors among women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: a cross-sectional study

Mechal

Negash

Bizuneh

et al. 2022

Contracept Reprod Med

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Background Unmet need for contraception refers to the proportion of women who want to postpone or stop childbearing but are not using a contraceptive method. Addressing unmet need is especially important for women with medical conditions such as cardiovascular disease (CVD). Preventing unintended pregnancy is crucial to improve pregnancy outcomes and minimize complications of CVD during pregnancy. However, unmet need for contraceptives continues to undermine the potential benefits of contraceptive use. This research aimed to determine the rate of unmet need for contraceptives and associated factors among women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was conducted from February 1 to May 31/2020. A total of 284 reproductive age women with cardiovascular disease having follow-up at the cardiac clinic of SPHMMC were enrolled consecutively until the desired sample size was reached. Data was collected through an exit interview using a structured and pretested questionnaire. Descriptive, bivariate, and multivariable methods were used to analyze the level of unmet need and its associated factors. Results The overall unmet need for contraception was 36.0% (95% CI: 30.4–41.5). The majority of the respondents lack counseling on contraception use. The most common reasons for non-use of a contraceptive method were fear of drug side effects and drug interaction. Unmet need for contraception was found to be more likely among those who have not been counseled on contraceptive utilization (AOR 6.7, CI 1.8–24.7) and those who lack partner support on contraception use (AOR = 6.2, CI: 1.91–19.8). Unmet need was also found to be more likely among women who have never used contraception before (AOR = 3.2, CI 1.12–8.92). Conclusion Unmet need for contraception was high in this high-risk population group. The cardiac follow-up clinic should implement client-centered counseling by a multidisciplinary team to address the needs of women and prevent consequences of unintended pregnancy. Furthermore, there is a need to initiate interventions that encourage communication between couples and increase male partner involvement through a renewed focus on couples counseling.

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Termination of pregnancy for maternal medical indications: Failings in delivery of contraceptive advice?

Abstract: Contraceptive rates in this at risk group appear to be poor and require attention.

Cited by 11 publications

References 18 publications

Bareras para el aborto seguro en el marco de la ley peruana

Bareras para el aborto seguro en el marco de la ley peruana

Termination of pregnancy for maternal indications at the limits of fetal viability: a retrospective cohort study in the Dutch tertiary care centres

Unmet need for contraception and associated factors among women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: a cross-sectional study

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