South African abortion attitudes from 2007-2016: the roles of religiosity and attitudes toward sexuality and gender equality

ABSTRACT

Abortion is legal in South Africa, but negative abortion attitudes remain common and are poorly understood. We used nationally representative South African Social Attitudes Survey data to analyze abortion attitudes in the case of fetal anomaly and in the case of poverty from 2007 to 2016 (n = 20,711; ages = 16+). We measured correlations between abortion attitudes and these important predictors: religiosity, attitudes about premarital sex, attitudes about preferential hiring and promotion of women, and attitudes toward family gender roles. Abortion acceptability for poverty increased over time (b = 0.05, p < .001), but not for fetal anomaly (b = ?0.008, p = .284). Highly religious South Africans reported lower abortion acceptability in both cases (Odds Ratio (OR)_anomaly = 0.85, p = .015; OR_poverty = 0.84, p = .02). Premarital sex acceptability strongly and positively predicted abortion acceptability (OR_anomaly = 2.63, p < .001; OR_poverty = 2.46, p < .001). Attitudes about preferential hiring and promotion of women were not associated with abortion attitudes, but favorable attitudes about working mothers were positively associated with abortion acceptability for fetal anomaly ((OR_anomaly = 1.09, p = .01; OR_poverty = 1.02, p = .641)). Results suggest negative abortion attitudes remain common in South Africa and are closely tied to religiosity, traditional ideologies about sexuality, and gender role expectations about motherhood.     

Mifepristone in Italy: the case of a drug trapped between ethics and clinical practice

In Italy mifepristone is not yet marketed. Gynaecologists in our hospital asked to use this medication as a less traumatic method for voluntary abortions. We followed the standard procedure defined by the Italian Health Ministry (IMH) for purchasing drugs from abroad but encountered several unexpected barriers. Starting from this case, this paper is aimed at identifying these barriers which we found to be not only professional, but also ethical, religious and moral.     

异丙酚无痛人工流产时静脉注射缩宫素可致血液循环严重波动

目的　观察异丙酚无痛人工流产时静脉注射缩宫素对血压和心率的影响。　方法　将 90例Ⅰ级 (美国麻醉协会麻醉术前分级 )早期宫内妊娠的患者随机分为 3组 :A组 30例 ,应用 2～ 3mg/kg异丙酚和 1μg/kg枸橼酸芬太尼进行无痛人工流产术 ,手术后期注射缩宫素 1ml,于注射后的 3min内观察收缩压、舒张压和心率变化 ;B组 30例 ,用相同麻醉方法进行无痛人工流产 ,术中不用缩宫素 ,观察指标与方法同于A组 ;C组 30例 ,不用任何麻醉药物进行人工流产 ,在与A组相同的时间注射缩宫素 ,观察指标与方法同于A组。　结果　A组在注射缩宫素后 0 5min ,血压显著下降 ,心率显著增加 ,注射后 2 .5min时 ,血压和心率基本恢复到注射前水平。B组和C组无明显血压下降。　结论　异丙酚无痛人工流产时注射常规剂量缩宫素后可致血液循环短暂严重波动 ,应引起临床妇产科医师高度重视 ,特别是对心功能储备较差的患者更应关注。     

表皮生长因子及其受体与流产关系的探讨

采用放射免疫竞争抑制饱和分析法，检测４７例难免流产患者，６５例人工流产及２０例健康非孕妇女血清表皮生长因子（ＥＧＦ）水平；同时采用免疫组织化学法检测流产者胚胎组织中表皮生长因子受体（ＥＧＦＲ）表达程度。结果：人工流产组血清ＥＧＦ水平高于自然流产及非孕妇女，而自然流产与非孕妇女差异无显著性；胚胎组织中ＥＧＦＲ阳性表达率人工流产组明显高于自然流产组。提示：ＥＧＦ通过与其受体结合对妊娠维持、胚胎及胎儿的     

早孕妇女人工流产方式意向的临床调查研究

人工流产(简称人流)是各种避孕失败的主要补救措施,目前早孕妇女人流的主要方式有吸刮术与药物流产两种。本文通过对天津市黄河医院意外早孕妇女选择人流方式意向的临床调查研究,探讨现阶段该两种人流方式的可接受性,结果:1000例早孕妇女中选择药物流产(简称药流)者666例(66.6％),吸刮术者334例(33.4％)。本组选择人流方式的理由,其中519例(51.9％)认为药流痛苦少,占第一位,认为手术干脆而选择吸刮术的217例(21.7％),占第二位,其它依次为吸刮术费用低、药流不必手术、吸刮术流产完全、药流不需请假、吸刮术出血时间短、药流安全、吸刮术副作用少、药流保密。药流是近年来使用的流产新方法,本组研究资料及意向选择只反映现阶段早孕妇女的接受状况。     

Determinantion and evaluation of antisperm antibodies and seminal immunosuppressive material in recurrent aborting couples

Circulating antisperm antibodies (AsAb) and immunosuppressive material in seminal plasma (SPIM)were determined by solid-phase enzyme staining assay and anticomplement test respectively in 686 patients with abortion (including 285 couples) . 241 fertile couple served as control. It's found that the positive rate of AsAb in infertile patients was significantly higher than that in fertile control,being 36.6% vs 3.3% (P<0.001). AsAb was even more offen detected in recurrent aborting patients. Male patients whose spouses aborted 2-6 fetuses had significantly less SPIM than control, sperm count and sperm motility were also significantly decreased. But the incidence of pyospermia was significantly greater than that in control. It is concluded that AsAb and SPIM have played an important role in the development of recurrent abortions.     

不同部位静脉注射对无痛人工流产术的影响

目的 :观察不同部位静脉注射对无痛人工流产术的影响。方法 :随机将 2 0 0例要求行无痛人工流产术的患者分成二组 ,一组静脉注射部位为手背静脉组 ,另一组静脉注射部位为肘部浅静脉 (贵要静脉或肘正中静脉 )组 ,观察静脉推注异丙酚时患者的注射部位有无疼痛症状。结果 :肘部浅静脉注射部位疼痛感明显轻于手背静脉 ,肘部浅静脉注射部位的麻醉起效时间快于手背静脉 ,两组差异有显著性 (P <0 0 5 )。结论 :选择肘部浅静脉注射异丙酚可减轻患者注射部位的疼痛 ,可在短时间内取得理想的麻醉效果。     

流产鼠Caspase-3与laminin B和PAI-1的表达及对妊娠结局的影响

目的:研究阻断CD86协同刺激分子对自然流产模型孕鼠母胎界面Caspase-3、laminin B和PAI-1的表达及对妊娠结局的影响。方法:实验组于妊娠第4.5天腹腔注射大鼠抗小鼠CD86单抗,实验对照组注射大鼠同型IgG2b,正常妊娠组不作任何处理。于妊娠第13.5天计算胚胎吸收率,用免疫组化测定Caspase-3、laminin B和PAI-1的表达,并进行图像分析、检测免疫组化染色灰度值(A)。结果:①实验组的胚胎吸收率显著低于实验对照组(P<0.05);②实验组中Caspase-3蛋白灰度值明显高于实验对照组(P<0.05),实验组中laminin B和PAI-1蛋白灰度值均明显低于实验对照组(P<0.05)。结论:妊娠早期阻断CD86协同刺激分子可使母胎界面中的Caspase-3、laminin B和PAI-1分别通过各自不同的途径发挥免疫耐受作用并且使自然流产模型孕鼠的胚胎吸收率降低至正常妊娠水平。     

A case-control study of major congenital heart defects in Sweden — 1981–1986

This paper reports the results of a case-control study of major congenital heart defects (CHD) in Sweden. During the period 1981–1986, 1,324 such cases were identified and 2,648 controls were selected. Some common maternal characteristics and exposures were studied using information from prospectively collected data. Possible associations with CHD were found for previous perinatal death, maternal diabetes, epilepsy, hydramnios and disproportion between fetus and pelvis. More specific associations were observed between previous spontaneous abortion, epilepsy, hydramnios and truncus anomalies and between diabetes and septal anomalies. However, no associations were found with involuntary childlessness, contraceptive use, or smoking.Abbreviations ASD atrial septal defect - CHD congenital heart defect - CI confidence interval - CoA coarctation of the aorta - DORY double outlet right ventricle - ECD endocardial cushion defect - HLHS hypoplastic left heart syndrome - IUD intrauterine device - LMP last menstrual period - OC oral contraceptive - OR odds ratio - PDA patent ductus arteriosus - TGV transposition of the great vessels - VSD ventricular septal defect     

人工流产术中不同镇痛药物复合靶控输注异丙酚麻醉的效果多中心研究

目的比较人工流产术患者瑞芬太尼、芬太尼及舒芬太尼复合靶控输注异丙酚麻醉的安全性和有效性。方法采用前瞻性、多中心、开放、随机分组、对照研究的方法。4个研究中心共选择390例行人工流产手术患者,随机分为3组：芬太尼单次静脉注射组（F组,n=134）、瑞芬太尼血浆靶控输注组（R组,n=120）和舒芬太尼单次静脉注射组（S组,n=136）,分别复合异丙酚血浆靶控输注行全身麻醉,记录起效时间、恢复时间、准确定向时间、术中体动（程度和次数）、镇痛效果、呼吸抑制评分和HR、MAP、SpO2及术后并发症的发生情况等。结果3组间麻醉起效时间和准确定向力时间差异无统计学意义（P＞0．05）,R组麻醉恢复时间长于F组和S组（P＜0．01）,R组异丙酚总用量、术中最低SpO2、术中体动次数及术后恶心呕吐、嗜睡的例数均低于F组和S组（P＜0．05或0．01）,R组呼吸抑制评分高于F组和S组（P＜0．01）。结论与芬太尼和舒芬太尼相比,瑞芬太尼复合异丙酚靶控输注麻醉用于人工流产手术镇痛效果更好,但其呼吸抑制作用较明显。