Effect of emotion management and nursing on patients with painless induced abortion after operation

BACKGROUND With an estimated 121 million abortions following unwanted pregnancies occurring worldwide each year,many countries are now committed to protecting women’s reproductive rights.AIM To analyze the impact of emotional management and care on anxiety and contraceptive knowledge mastery in painless induced abortion(IA)patients.METHODS This study was retrospective analysis of 84 patients with IA at our hospital.According to different nursing methods,the patients were divided into a control group and an observation group,with 42 cases in each group.Degree of pain,rate of postoperative uterine relaxation,surgical bleeding volume,and postoperative bleeding volume at 1 h between the two groups of patients;nursing satisfaction;and mastery of contraceptive knowledge were analyzed.RESULTS After nursing,Self-Assessment Scale,Depression Self-Assessment Scale,and Hamilton Anxiety Scale scores were 39.18±2.18,30.27±2.64,6.69±2.15,respectively,vs 45.63±2.66,38.61±2.17,13.45±2.12,respectively,with the observation group being lower than the control group(P<0.05).Comparing visual analog scales,the observation group was lower than the control group(4.55±0.22 vs 3.23±0.41;P<0.05).The relaxation rate of the cervix after nursing,surgical bleeding volume,and 1-h postoperative bleeding volumes were 25(59.5),31.72±2.23,and 22.41±1.23,respectively,vs 36(85.7),42.39±3.53,28.51±3.34,respec tively,for the observation group compared to the control group.The observation group had a better nursing situation(P<0.05),and higher nursing satisfaction and contraceptive knowledge mastery scores compared to the control group(P<0.05).CONCLUSION The application of emotional management in postoperative care of IA has an ideal effect.

Prevalence of Induced Abortion among Female Students in Selected Tertiary Learning Institutions in Gaborone City, Botswana

Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abortion remains one of the leading causes of maternal deaths in developing countries with induced abortion being the key cause. In 2014 from January to August, 9 abortion related deaths occurred in Botswana. There are several reasons female students in tertiary institutions resort to seeking induced abortion which include the socio-demographics like age and socio-economic factors like financial instability. Parental fears, unintended pregnancy and pressure from the partner also force females to terminate pregnancy. Induced abortion has claimed many women’s lives especially in developing countries with very restrictive abortion laws like Botswana as women do not access safe abortion care services. The study intends to establish the determinants of induced abortion among female students in selected tertiary learning institutions in Gaborone City, Botswana. It concentrated primarily on determining the prevalence of induced abortion. This was a descriptive cross-sectional study using both quantitative and qualitative data collection techniques. Systematic random sampling technique was used to come up with 278 participants. Prior to commencement of data collection, all ethical and logistical prerequisites were satisfied. Informed consent was solicited from all the study participants and the purpose of the study was fully explained. A self-administered questionnaire was used to collect data. Microsoft Excel spread sheet was used to code, clean, and enter the data, which was then exported for analysis to the statistical package for social sciences version 24. Frequency distribution tables, percentages graphs, and pie charts were used to illustrate the descriptive information. The study revealed that prevalence of induced abortion among female students in Gaborone City is 7.9%. They even suggested that induced abortion be liberalized. Age was the only socio-demographic factor associated with induced abortion with p = 0.047 using Chi Square test χ2 = 7.609, df = 3. The study findings concluded that female students resort to induced abortion as a result of pressure from both parents and male partners especially when the pregnancy is unintended. The study recommends that the abortion law in Botswana be made liberal to ease access to safe abortion care services. It also recommends that contraceptive commodities should consistently be available in public health facilities.

Clinical Observation of Misoprostol before and after Painless Induced Abortion

Background: Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affects the operation and easily inducesabortion complications. Misoprostol can induce uterine contraction and soften the cervix. Objective: To investigate the clinical effect of misoprostol on abortion before and after painless induced abortion. Methods: 600 case pregnant women were divided into three groups: A, B and C, 200 case in each group. All patients were anesthetized. In group A, misoprostol 0.2 ug was placed in the posterior fornix of vagina 2 hours before the operation of induced abortion;in group B, misoprostol 0.2 ug was not only placed in the posterior fornix of vagina 2 hours before the operation of induced abortion but also taken orally 2 hours and 6 hours after the operation;in group C, misoprostol was not used before and after the operation. The operation time, intraoperative bleeding volume, postoperative bleeding, the percentage of cervical relaxation and the rate of incomplete abortion among the three groups were compared. Results: Compared with group A and group B, the operation time of group C was longer and the amount of bleeding was more (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The duration of bleeding in group B was less than that in group A (P < 0.05). The percentage of cervical relaxation in group A and B was higher than that in group C (P < 0.05). The rate of incomplete abortion in group B < group A < group C (P < 0.05), and there was no residual uterine cavity in group B. Conclusion: The use of misoprostol before and after painless induced abortion can not only shorten the time of operation, reduce intraoperative and postoperative vaginal bleeding, but also has not incurred incomplete abortion(primary outcome).

Induced abortion in China and the advances of post abortion family planning service

This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.

Comparison of Depression and Anxiety between Unmarried Female Youth in Two Groups of Induced Abortion and None-Induced Abortion in Yibin City of China

Objectives To explore the risk factors influencing the mental status of unmarried female youth. Methods ,4 cross-sectional survey and a qualitative interview were adopted. 1200 unmarried female volunteers （600 with 1,4） who aged 15-29 years in Yibin city were investigated, and 8 focus group discussions （FGDs） and 8 in-depth interviews were conducted. Except the investigation of subject＇s personal information, econ-socio status, sexual behavior, contraception and reproductive health problems they face, two selfreporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results 1） Depression and anxiety among unmarried female youth investigated in current study are relatively common. Proportions of the females with depression and anxiety to the total sample are 27.4% and 33.4%, respectively; 2） Depression and anxiety of the females with 1,4 are more serious than that of the female without 1,4. Proportions of unmarried females with IA have depression and anxiety to the total unmarried females with 1,4 are 3.45 times and 2.61 times that of unmarried females without 1,4 have depression and anxiety to the total unmarried females without 1,4, respectively; 3） IA is one of the key risk factors influencing depression and anxiety of unmarried female youth. Other risk factors are lack on basic knowledge about sex/ STD/HIV/AIDS, reproductive tract infections, relatively lower income, age at sex debut is relatively younger, etc. In addition, multiple sex partners and repeat pregnancies were risk factors influencing anxiety of unmarried female youth. Conclusion Depession and anxiety was more popular in unmarried females with IA Intervention for improving mental health of unmarried females should be developred Key words：

Characteristics of Induced Abortion in China in the 1990s

Objective To understand the characteristics of induced abortion in China in the 1990s, and to find out the influential factors. Methods The overall number of induced abortions, calculate cohort induced abortion frequency, explore the impact of a child＇s sex and the number of previous children on induced abortions were estimated by using the data from the ＂National Poptdation and Reproductive Health Survey＂ conducted by the National Family Planning Commission in November 1997. Results Induced abortions in China had their own characteristics, which were far different from other countries. The main difference was led by the fact that the country was driven by an implemented family planning program and nationwide population policies. The key cause of induced abortions was due to an inconsistentT with the requirements of the family planning policy. However, as a result of effective and prevalent contraception, the rates of induced abortions were not quite high in the 1990s, when compared with other countries. Even though, in the early 1990s, the government had reinforced the family planning program through administration and legislation, unlike during the early 1980s when the one-child policy was implemented, the induced abortion rate and the number of induce abortions did not increase as the fertility rate substantially decreased. Conclusion This finding implies that the fertility declines in the 1990s were not caused by the number of induced abortions. The transition of the fertility ideology of the people has played an important role in the fertility decline, as institutional reform and socioeconomic development are implemented.

Use of Emergency Contraception could Halve Induced Abortion Ratein Shanghai, China

Objective To investigate and estimate the proportion of the induced abortion that could have been prevented by using emergency contraception in Shanghai Method Structured interviews were conducted in 606 women (413 married and 193 unmarried) aged 18-49 years, who were attending three health care centers in Shang- hai for termination of first trimester pregnancy. Results A total of 98.2% of the pregnancies were unwanted, and 63.7% of the women recognized that they were at risk of pregnancy soon after the intercourse. It is estimated that 52.2% of the induced abortion could have been prevented if the women had used levonorgestrel-only emergency contraception. Only 28.5% of the respondents were aware of emergency contraception. The most important sources of information about emergency contraception identified by respondents were books/newspapers/periodicals (38.2%), and relatives/friends (30.6%). Family planning health education on emergency contraception was noted by 28.9% of married women but only by 5.8% of unmarried women. A portion of 85.5% of all respondents reported they would be willing to use emergency contraception when needed. Those more willing to use emergency con- traception included younger, better educated, and unmarried women experiencing their first pregnancy. Women preferred drugstores (60.1%) than hospitals (30.2%) for obtaining emergency contraception. Conclusion Women’s needs for emergency contraception were enormous. Promotion of emergency contraception by providing information and improving service could have a substantial impact on reducing the rate of induced abortion in Shanghai.

Planned Parenthood: Supply Induced Demand for Abortion in the US

The rate and number of induced abortions in the US has declined steadily for nearly three decades. In contrast to this overall reduction, Planned Parenthood Federation of America abortion providers exhibit a persistent increase in both abortions and their market share percentage of total abortion procedures. For the period 1995-2014, estimated annual and cumulative excess abortions are calculated (Planned Parenthood Abortion Inflation Effect—PPAIE) to indicate the number of abortions which would have been averted if the PP utilization experience had been identical to that of Non-PP abortion providers. PP excess abortions grew steadily each year from 21,000 in 1996 to 258,200 in 2014, 28% of total abortions that year. The cumulative number of abortions added by the PPAIE from 1995-2014 was 3,025,560 or 12.5% of the 24,112,600 performed. Planned Parenthood has had a long-term and accelerating inflationary effect on the incidence and prevalence of abortion in the US.

Improving Sexual and Contraceptive Behaviours of Unmarried Female Youth with First Trimester Induced Abortion in Sichuan,China

Objectives To understand the changes on sexual and contraceptive behaviours of unmarried induced abortion（IA） youth by intervention in Sichuan, China; and to find a way to improve sexual and contraceptive behaviours of unmarried IA youth. Methods Intervention epidemiological surveys （baseline and evaluation） plus qualitative interview were used. During July 2002 and July 2003, 2 484 unmarried female volunteers who aged 15-29 years and come to clinics seeking abortion were recruited by cluster random sampling from the four selected regions of Sichuan, 48 volunteers were interviewed for 8 focusgroup discussions （FGDs） and 16 in-depth interviews equally for each survey. Information, education anol communication（IEC） materials, education sessions, trainings and counseling were given to subjects and service providers during the project implementation. Questionnaires for surveys and guidelines for qualitative interviews were used. Results Comparison of the after with the before intervention. 1） the proportion of respondents having knowledge about sexuality was increased by 13%. Among them, the proportion of respondents got part and most of the knowledge was increased by 43%. Maximum number of sex partners the respondents have decreased from 9 to 4. Respondents＇partnerships have gradually changed from more acquaintances/school mates/boyfriends to fianés mainly; 2） respondents＇ contraceptive use rate was increased by 20%. Among them, the condom use rate increased rapidly to 80%. Purposes of condom use were changed from only for contraception to for prevention of HIV/AIDS/STDs and pregnancy. And most of respondents stabilised their method use - condoms. Most of respondents suggested condoms was the method most suitable for unmarried IA youth, this proportion was increased by 44%; 3） proportion of respondents knowing more about consequences of induced abortion was increased by 24%; and 4） proportions of respondents having depression and anxiety symptoms were decreased by 66% and by 61%, respectively. Conclusion The intervention including IEC materials, education, training and counseling was effective in improving sexual and contraceptive behaviours of unmarried IA youth.

Voluntary Induced Abortion in Cameroon: Prevalence, Reasons, and Complications

In Cameroon, induced abortion is permitted when a woman’s life is at risk, to preserve her physical and mental health and on the grounds of rape or incest. Objectives: The aim of this study was to determine the prevalence, reasons and complications of voluntary induced abortion among women attending the obstetrics and gynecology services in an urban area, Yaoundé and in a rural area, Wum in Cameroon. Methods: We carried out a cross sectional study, with 509 women recruited between August 1, 2011 and December 31, 2011 in three health facilities in Cameroon. We appreciated the frequency, complications and reasons for Voluntary induced abortions. Results: The prevalence of voluntary induced abortion was 26.3% (134/509) globally;25.6% (65/254) in urban area and 27.1% (69/255) in rural area. One hundred and eleven (83%) cases of induced abortions were carried out in a health structure and 23 (17%) cases in private homes. Medical doctors and nurses were the most frequent abortion providers in both urban (84.7%) as well as rural setting (77.2%). The three main reasons for induced abortion were to pursue their studies (34.3%), not yet married (22.6%) and fear of parents (13.9%). Complications were reported by 20% (27/134) of respondents who had carried out voluntary induced abortion. Excessive bleeding was the most reported complication (70.4%). Conclusion: Despite its illegality in Cameroon, the prevalence of voluntary induced abortion was high in this study.

Problematic of Clandestine Induced Abortions in Three Maternity Hospitals of Chad

Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complications were dominated by the anaemia (62.1%). Conclusion: The clandestine induced abortion is a frequent situation in the Chad and is cause of numerous complications.

Induced Abortion, Mortality, and the Conduct of Science

There is no credible scientific opposition to the fact that a genetically distinct human life begins at conception and that an induced abortion is a death. Yet, abortion is not reported as a cause of death in the U.S. vital statistics system. Mortality patterns have profound implications for public policy. As a cause of death, we found abortion to be highly consequential, with large racial and ethnic disparities. Abortion represented 16.4% of non-Hispanic White deaths, but 61.1% and 64.0% of non-Hispanic Black and Hispanic deaths respectively. For Years of Potential Life Lost (YPLL), the ubiquitous measure of premature death, abortion accumulated 63.1% of non-Hispanic White YPLL and 86.5% and 87.4% of non-Hispanic Black and Hispanic YPLL respectively. Further, as measured by the availability of valid data and resources allocated for research, there is evidence that the science community is not appropriately engaged on this crucial public health problem.

Application of the painless technique for visual induced abortion in early pregnancy clinic female

Objective: This project is to analyze and evaluate the efYect of the painless technique in the visual induced abortion. Methods: 300 pregnant women who needed induced abortion and had no contraindication were selected as the research objects. Under the condition of the informed consent of the pregnant women, they were divided into two groups according to the different methods of the induced abortion. 150 cases in the observation group were treated with the painless technique for visual abortion, and 150 cases in the control group were treated with the painless technique for the blind curettage. Relevant surgical indicators and complications were compared between the two groups. Results: The operation time, the vaginal bleeding time, the induced abortion syndrome, the uterine aspiration incompleteness, and the postoperative infection in the observation group were significantly lower than those in the control group. The difference between the two groups was significant (P 0.05), with the statistical significance. The incidence of complications in the observation group (8.33%) was significantly lower than that in the control group (37.50%). The difference between the two groups was significant (P 0.05), with the statistical significance. Conclusion: The visual induced abortion with the painless technique is of great value in the outpatient induced abortion, and it is worth adopting and applying.

Effect of Chinese Herbs Bu-shen on PRLR, PR, ER mRNA of Decidue in Bromocriptine-induced Hypoprolac- tin Rat Abortion Model

Objective To explore the effect of Chinese herbs on PRLR, PR, ER mRNA of decidue in Bromocriptine-induced hypoprolactin abortion rat model from gene transcription level, and observe the changes of blood PRL, P, E2.Methods RT-PCR method was taken to analyses the differences of PRLR, PR, ER mRNA in decidue between model group (A group) and model + herbs group (A + H group); RIA was taken to measure the serum levels of PRL, P, E2. Results PRLR, PR mRNA expression in decidue of Group A was significantly lower than the A + H group (P<0. 01) , no difference in ER mRNA expression (P>0. 05); the abortion rate of Group A was 67 %, Group A+H was 17% , the difference was significant; as for the PRL and P level of day 7-1.0, the A group was significantly lower than the A+H group (P<0. 05).Conclusion Bromocriptine could induce abortion by declining the blood PRL, P level and downregulating PRLR, PR mRNA expression in decidue. Chinese herbs might maintain pregnancy by promoting PRL, P secretion and upregulating PRLR, PR mRNA expression in decidue.

Recent advances in the diagnosis of drug-induced liver injury

Drug-induced liver injury(DILI)is a major problem in the United States,commonly leading to hospital admission.Diagnosing DILI is difficult as it is a diagnosis of exclusion requiring a temporal relationship between drug exposure and liver injury and a thorough work up for other causes.In addition,DILI has a very variable clinical and histologic presentation that can mimic many different etiologies of liver disease.Objective scoring systems can assess the probability that a drug caused the liver injury but liver biopsy findings are not part of the criteria used in these systems.This review will address some of the recent updates to the scoring systems and the role of liver biopsy in the diagnosis of DILI.

Expression of Apoptosis and Inducible Nitric Oxide Synthase in Trophoblastic Cells in Early Spontaneous Abortion

Objective To investigate the effect of apoptosis and inducible nitric oxide (iNOS) on the early spontaneous abortion Methods TUNEL method was used to detect the apoptosis in trophoblast cells in early pregnancy with and without spontaneous abortion (the experiment group and the control group), while iNOS was detected by both in situ hybridization and immunohistochemistry. By computer color magic image analysis system(CMIAS), positive cell indexes were represented by D (density) and N/S(number/square) in both apoptosis and in situ hybridization, in immunohistochemistry were N/S and PU(positive unit). Results Positive cell indexes of apoptosis D and N/S were significntly higher in the experiment group (0.48±0.004, 0.045±0.002) than that in the control group(0.35+0.06, 0.031±0.003. P<0.001). D and N/S of inducible nitric oxide synthase in situ hybridization were 0.33±0.028, 0.074±0.001 respectively in the experiment group and 0.13±0.015, 0.019±0.004 respectively in the control group. N/S and PU were significantly higher in the experiment group(0.058±0.007, 11.94±2.01) than that in the control group (0.007±0.001, 1.18±0.35, P<0.01). There existed a positive correlation between iNOS and apoptosis too. Conclution Apoptosis and iNOS in trophoblasts might play an important role in early spontaneous abortion and there was a positive correlation between apoptosis and iNOS.

Studies on Relationship between Serum Nitric Oxide and Plasma Cyclic Guanosine Monophosphate and Prolonged Bleeding after Medical Abortion as well as Prophylaxis and Treatment of Bleeding with Traditional Chinese Medicine

Objectives To study the relationship between serum nitric oxide (NO and plasma cyclic guanosine monophosphate (cGMP) and prolonged bleeding after medical abortion. Methods A total of 120 women having received medical abortions at random were recruited and divided into two groups: the one (Group A,n=60) taking 'Gong Fu Mixture(Uterus Recovering Mixture)' and the other (Group B,n=60) not taking it after abortion. On d 10, 20 and 30 after medical abortion, serum NO and plasma cGMP were tested before and after mifepristone administration and 10 d later by Gresis reaction method and radioimmunoassay respectively. Results NO concentration in serum and cGMP concentration in plasma decreased significantly after taking mifepristone given (P<0.05). Ten days later, the number of those with bleeding discontinuation in the group A was significantly greater than that in the group B (P<0.05). Serum NO level and plasma cGMP level in the group A decreased more significantly than those in the group B (P<0.05). Conclusion The slow decrease of serum NO and plasma cGMP is closely related to prolonged bleeding after medical abortion. “Gong Fu Mixture (uterus recovering mixture)” is effective in prevention and treatment of prolonged bleeding.

The Clinical and Experimental Studies of ChanLe Chongji for Reducing Bleeding after Abortion

ChanLe Chongji (ChanLe dissolvable granule preparation) is a mixed Chinese traditional medicine composed of Prunus persica Batsch, Carthamus tinctorius, Angelica sinensis Diels, Typha angustifolia Bory. et Chaub., Prunus mume Sieb. et Zucc., etc. which could clear fever and remove blood stasis. The bleeding days in vagina after abortion by drug and the complete abortion rate were observed. 100 cases were selected randomly from the treated group and the control group respectively. The results showed that the mean bleeding period in the treated group was 8.4 days, while 13.3 days in the control. Although the mean complete abortion rate had no distinct difference between these two groups, the absolute level was higher in the treated group. The results of animal experiments showed that ChanLe Chongji could increase the contraction of uterus, stop bleeding, resist bacteria and diminish inflammation, thus providing its potentiality for clinical application.

Regulative effect of Taohong Siwu decoction(桃红四物汤) on extracellular matrix of endometrium in drug-induced abortion

OBJECTIVE: To explore the effects of Taohong Siwu decoction(桃红四物汤, THSWD) on the extracellular matrix of endometrium in rats following drug-induced abortion.METHODS: Thirty-six pregnant female rats were administered mifepristone and misoprostol to induce abortion, and amounts of uterine bleeding were recorded. Pathological damage and collagen accumulation were detected by hematoxylin-eosin staining and Masson’s trichrome staining in uterus, respectively. Myeloperoxidase was evaluated by immunohistochemistry.The expression levels of fibronectin, laminin, matrix metalloproteinase 9(MMP-9), and tissue inhibitor of metalloproteinase 1(TIMP-1) were quantified using western blotting.RESULTS: THSWD could promote endometrial protection in rats following drug-induced abortion.The contents of cellulose and myeloperoxidase were significantly decreased in uterine tissue of THSWD-treated groups. Moreover, THSWD significantly decreased the expression levels of fibronectin, laminin, and TIMP-1. THSWD also significantly increased MMP-9 expression and the MMP-9/TIMP-1 ratio.CONCLUSION: THSWD plays a critical role in endometrial protection by reducing extracellular matrix deposition and uterine fibrosis. These effects may have been achieved by increasing MMP-9, reducing TIMP-1, and/or altering the ratio of MMP-9/TIMP-1.