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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy-four "high-risk" pregnant women interested in participating in a clinical trial comparing chorionic villi sampling and amniocentesis were initially assessed on five background measures and for anxiety, depression, hostility, and concern about abortion. The 61 women who then agreed to be randomized into the chorionic villi sampling and amniocentesis groups were assessed three additional times between 9 and 22 weeks' gestational age. Physical discomfort experienced during the diagnostic procedure was also assessed. Women in the chorionic villi sampling group underwent a reduction in anxiety up to 10 weeks earlier and reported less procedure-related discomfort than women in the amniocentesis group. The group X time interaction for depression was also significant, with women undergoing chorionic villi sampling reporting an earlier decrease in depression than women undergoing amniocentesis. No differences were found between the two groups in hostility or concern about abortion. Findings were discussed in the context of evidence linking prenatal maternal emotionality to an increased risk of obstetric complications.
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PMID:Emotional responses of pregnant women to chorionic villi sampling or amniocentesis. 331 65

Women who attempted suicides who were pregnant did not differ from nonpregnant women who attempted suicide in measures of depression, hopelessness, or suicidal intent. Three themes were noted in the pregnant women who attempted suicide: prior loss of children (by miscarriage, adoption, or death), potential loss of their lover, and the desire for an abortion.
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PMID:Attempted suicide and pregnancy. 276 66

This review briefly outlines the pharmacology of natural and synthetic estrogens, and synthetic progestins, and summarizes their beneficial and adverse effects for contraceptive and menopausal therapy. Currently, oral contraceptives contain 30-50 mc synthetic estrogen, and 1-5 mg nor-progestin; menopausal therapy may be either 0.625-1.25 mg natural estrogen or estrogen plus 10 mg medroxyprogesterone acetate daily if the woman has her uterus. The biologic effects of estrogens are : decrease in lipoproteins, increased blood coagulation factors, increased blood pressure, decreased glucose tolerance. Progestins increase blood lipids and increase insulin and glucose. Oral contraceptives increase the risk of cardiovascular disease, particularly in smokers and in women over 35, in proportion to dose. These studies should be recapitulated in more detail with the newer low-dose pills. Orals have far more beneficial effects, besides providing an inexpensive, effective method contraception. The death rate of users of oral contraceptives is 3.7/100,000 (1.8 in nonsmokers and 6.5 in smokers), but the risk is 5.5 times higher in nonusers exposed to pregnancy and childbirth. The risk for users of barrier methods backed up by abortion is lower, but pills are cheaper and more acceptable. If woman did not take oral contraceptives, they would not be protected from cancer of the breast, ovary, endometrium, and ovarian and breast cysts. Menopausal therapy puts woman at increased risk of endometrial cancer only if the estrogen is taken alone, not if progestin is combined with the estrogen. There are no other adverse effects except decreased glucose tolerance and possible comprise of lipoproteins if a norprogestin of menopausal estrogens effectively treat hot flashes, depression, vaginal atrophy and bones loss.
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PMID:The adverse effects of hormonal therapy. 351 31

Women members of a pre-paid health plan who had had therapeutic abortions during 3 years answered a questionnaire by mail on their reactions to the abortion experience. The procedure took 20 minutes, under general anesthesia, with a 36-hour hospital stay. 178 subjects submitted usable questionnaires. These included a wide range of ages, marital status, religious backgrounds, education and socioeconomic status. Most had abortions over 1.5 years before. Over 50% felt relieved after their abortions. Only 21% recalled feeling satisfaction at the time, but 45% were satisfied at the time of the survey. Nervousness, guilt or confusion were cited by 6, 14 and 11%. Over 50% reported an improved outlook on life after the abortion. Negative responses were reported by 9-12% for several items such as tension, anxiety, energy level and sleep problems and 17% for depression. 49% said that they would have another abortion in the event of a future unplanned pregnancy, compared to 25% who would keep the baby, 0% who would place it for adoption and 23% who did not know. The observation that some women recounted distress at the time of abortion suggests that counseling or psychotherapy should be provided to those in need.
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PMID:Women's self-reported responses to abortion. 357 35

A nurse at the Center for Voluntary Pregnancy Interruption and Contraception in Angers, which receives 30 abortion requests each week, describes psychological aspects of nursing care for abortion patients. Abortion patients statistically are most likely to be married women around 27 years old with husbands aged 31 on average and with 2 children. Abortions are done under local anesthesia, so that there is no hiatus between the time "before" and that "after" the procedure. Women speak about their moral and physical suffering; their choice is respected by the staff. Despite the regret or mild depression that may follow an abortion, most women experience the greatest difficulty before the procedure and feel primarily relieved afterwards. Nursing work with abortion patients consists in being open to them and accompanying them for a few hours. The patients' comfort and postabortion morbidity depend largely on the reception and understanding they are given by the staff. After the procedure, the topic of contraception is discussed with the patient. Abortion and contraception cannot be dissociated because fertility regulation involves greater well-being for all members of the family. The abortion center is a place of life in which women and couples take responsibility for their sexuality and begin again. It is important not to impose beliefs or feelings about sexuality on the patient. A training which encouraged reflection on the grand problems of life and death as well as understanding of emotions, sentiments, and reactions would be helpful in gaining self knowledge and in living through events such as abortion. A meeting with a psychiatrist every 3 weeks is arranged for all staff members who desire it in order to maintain their emotional balance and work out troubling situations encountered at work. The work at the abortion center is 1 of listening and gaining the patient's confidence in order to dedramatize the abortion and permit the woman and the couple to elect an appropriate and effective contraceptive method.
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PMID:[Death is also life]. 384 46

This paper examines cognitive predictors of coping with a negative life event. Women undergoing 1st-trimester abortion were, before the procedure, surveyed regarding their attributions for their pregnancy, expectations for coping, the meaningfulness of the pregnancy, and the degree to which the pregnancy was intended. After the abortion, and again at a follow-up visit, affective state, physical complaints, anticipated negative consequences, and depression were assessed. As predicted, women who blamed their pregnancy on their character coped less well than low self-character blamers, but contrary to predictions, self-behavior blame was unrelated to coping. Subjects were 247 women who underwent vacuum aspiration at a free-standing, private abortion clinic in a large metropolitan area in New York State. 65% blamed no other person for their pregnancy; 43% blamed no aspect of their character; 34% blamed no aspect of their situation, and 21% blamed no aspect of chance. The items within a given attributional category tended to be blamed in a somewhat mutually exclusive manner. High situation blamers were significantly more depressed than low situation blamers; those who blamed others anticipated more severe negative consequences than did those who did not blame others; and high chance blamers tended to experience a worse affective state than low chance blamers. External blame was generally unrelated to coping in this study. Further research is clearly needed on the consequences of self-blame for coping and depression, with attention to the characteristics of the particular life event being experienced. The beneficial aspects of high coping expectations persisted 3 weeks after the abortion, even when immediate coping espectations were statistically controlled. Self-efficacy expectations are important factors in both the initiation and persistence of coping behaviors. Partner presence or absence at the abortion clinic had a significant impact on immediate coping responses. Surprisinly, women accompanied by their partners were significantly more depressed and reported more physical complaints than did women unaccompained by their partners. Women accompained by their partner were younger and had expected to cope less well with the abortion than those unaccompained by their partners.
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PMID:Attributions, expectations, and coping with abortion. 398 63

With the increasing use of cocaine in the United States, there has been growing concern regarding its effects on the fetuses and neonates of pregnant cocaine abusers. Twenty-three cocaine-using women enrolled in a comprehensive perinatal-addiction program were divided into two groups: those using cocaine only and those using cocaine plus narcotics. These two groups were compared with a group of women who had used narcotics in the past and were maintained on methadone during pregnancy, and with a group of drug-free women. All four groups were similar in maternal age, socioeconomic status, number of pregnancies, and cigarette, marijuana, and alcohol use. Their medical histories indicated that the cocaine-using women had a significantly higher rate of spontaneous abortion than the women in the other two groups. In the pregnancies under study, four cocaine-using women had onset of labor with abruptio placentae immediately after intravenous self-injection of cocaine. Neonatal gestational age, birth weight, length, and head circumference were not affected by cocaine use. However, the Brazelton Neonatal Behavioral Assessment Scale revealed that infants exposed to cocaine had significant depression of interactive behavior and a poor organizational response to environmental stimuli (state organization). These preliminary observations suggest that cocaine influences the outcome of pregnancy as well as the neurologic behavior of the newborn, but a full assessment will require a larger number of pregnancies and longer follow-up.
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PMID:Cocaine use in pregnancy. 402 59

A review of the prelegal abortion scene in the US precedes discussion of the effect of injected soap, phenol, cresol, and their compounds. The latter is based on a review of 4 toxicology books. There is little difference in the symptoms after the instillation of phenols, cresols, or soaps. Any one of those agents can cause vaginal bleeding, abdominal pain and distension, nausea, vomiting, and cramps. The damage produced by the use of Lysol thus is due to both the phenol and soap components of the compound. Following instillation into the uterus, there is coagulation necrosis of the decidua and placental site. The toxin will invariable cause thrombosis of the intrauterine and parametrial veins. The thrombosis may spread to the entire pelvic vein plexus and paravaginal, paracervical, and ovarian veins. The liver and kidney are affected by the toxin. Icterus and bile pigments in the urine and clinical evidence of liver damage are seen often. Pulmonary edema has been described as have microscopic to massive pulmonary oil emboli and thrombosis. Depression of all bone marrow elements due to toxin has been reported. The red blood cells are further depressed in number because of hemolysis. Cerebral changes include oil emboli, cerebral coagulation, necrosis, and petechial hemorrhages. Until Studdiford and Douglas described gram-negative sepsis causing shock, patients admitted with hypotension accompanying septic abortion were thought to have concealed blood loss. Studdiford and Douglas showed that gram-negative septicemia could produce hypotension. With the advent of massive antibiotic therapy for septic abortion and septic shock, most of these patients could be saved. The kidneys, after exposure to phenolic-soap comounds, show mainly lower nephron changes. As long as the toxin is in the system those changes continue until irreversible renal damage occurs. It is essential to remove the source of the poison (the affected uterus) and then remove the circulating toxins. the main problem is removal of the circulating toxin. In addition to the problems produced by fixed and circulating toxin, it has been shown that most phenol-soap induced abortions are infected. Thus it is necessary to employ the optimal antibiotic therapy for septic incomplete abortion. The initial management phase moves along classic lines. First is monitoring the vital state and supporting the systems. This includes maintaining an intravenous solution with a large-bore needle, monitoring central venous pressure, measuring urinary output, monitoring the vital signs, maintaining adequate oxygenation, and supporting the blood pressure with blood vasopressors or other agents, as needed. Second is diagnosing the extent of the illness. Third is the initial treatment, which includes reestablishment of the blood volume with blood transfusions; aggressive coverage with double or triple antibiotic therapy; correction of hypofibrinogenemia with cryoprecipitate, fresh whole blood or fresh frozen plasma, as indicated; and avoidance of overhydration in the presence of actual or suspected renal failure. After antibiotic coverage has been established, removal of retained products of conception is indicated.
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PMID:Treatment of women who have undergone chemically induced abortions. 404 35

The article reports upon the characteristics of 300 abortion applicants in Arkansas manifesting significant stress from unwanted pregnancy between May 1, 1970 and June 30, 1971. The sample is limited by the fact that all of these women had been willing to seek medical aid. Patients ranged from ages 13-47, 131 of them ages 17-21. 35% had had some college education; another 29% were high school graduates. 50.6%, 20.6%, and 27.3% were single, divorced, and married, respectively. 59.6% of the patients were primiparas. 18.3%, 9.6%, and 12.3% were classified as being neurotic, having psychophysiologic tendencies (gastrointestinal problems, obesity, chronic headaches), and having sociopathic features (passive-aggressive, frankly rebellious, delinquent, antisocial, alcoholic), respectively. 12 women had noticeable schizoid features; 4 women had mildly active schizophrenia. Fathers of the women were usually blue-collar workers (55.3%) or white-collar workers (24.6%). The most frequent ordinal sibling position among the women was oldest child (38%). Parental instability (1 or both parents lost through death, divorce, father usually away working, chronic alcoholism, etc.) was reported by 39.6% of the patients. Patients' attitudes toward the unwanted pregnancy included dislike of inexpediency of the situation (82.6%), self-depreciation (55.6%), and aversion (28.6%). Precipitated psychiatric disorders were for the greatest part mild. Manifesting symptoms included depression (66.7%), anxiety (21%), and mixed anxiety and depression (12.2%). Suicidal threats and gestures were made by 22 and 8 patients, respectively. In summary, the study reveals a group of predominantly Caucasian women from unstable, middle-class urban families who were going through an adjustment reaction to adolescence or adult life.
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PMID:Abortion applicants in Arkansas. 426 12

The psychosomatic and psychological reactions of 75 women applying for a therapeutic abortion were compared with those of 33 women in the same state of pregnancy but not requesting an abortion. The abortion applicants differed significantly from the control group on 8 of the 10 scales tested. The abortion applicants had more prepregnancy health problems and more psychosomatic symptoms than the control group. They also showed more fears for themselves and the baby, less desire for pregnancy, more irritability and tension, less maternal feeling, and more depression and withdrawal than the control group. Parity was not as important in determining responses to the questionnaire as was the patients' abortion status. Literature on the use of pregnancy research questionnaires is reviewed. The possible transience of psychological compared to psychosomatic symptoms is suggested.
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PMID:Therapeutic abortion: a prospective study. II. 440 33


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