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

<正>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.     

Prenatal diagnosis and selective abortion.

The Abortion and Sterilisation Act, 1975, has been in force for 1 year. Experience gained in the Johannesburg area in the operation of the Act with respect to termination of pregnancies for abnormalities of the unborn child, is outlined. Relatively few abortions have, in fact, been carried out for this reason, but the number is likely to increase. Prenatal diagnosis of disease in the fetus, although not possible in all cases, has greatly facilitated the management of families in which a child with a heritable disorder may be born.     

Amniotic fluid removal prior to saline abortion.

To evaluate whether removal of the amniotic fluid prior to the instillation of 200 ml of 20% hypertonic saline has any effect on the success, speed, and safety of the abortion process, 192 patients at 15--20 weeks' gestation were aborted according to one of the following procedures: 1) instillation of 200 ml saline without removal of the amniotic fluid (92 subjects), 2) removal of 100 ml of amniotic fluid prior to saline instillation (46 subjects), and 3) removal of 150 ml of amniotic fluid prior saline instillation (54 subjects). The study indicated that there are no apparent advantages to the removal of the amniotic fluid prior to the instillation of 200 ml of hypertonic saline. The median times from instillation to abortion and rates of incomplete abortion were similar for the three groups of patients. Rates of specific complications, except for fever, were similar for the three groups.     

Spontaneous abortion

As a result of improved investigation and treatment techniques, understanding of all aspects of spontaneous abortion has improved. The term "threatened abortion" is often a misnomer, for the fate of the pregnancy is decided when bleeding occurs. A dilated cervix indicates that abortion is inevitable. If the cervix is not dilated, pelvic ultrasonography will usually show the following: a live fetus, an anembryonic pregnancy, incomplete abortion or missed abortion. If fetal heart movement is seen, no further treatment is needed and the prognosis is excellent (98% fetal survival). In other cases, the uterus must be evacuated, with a Karman catheter if the uterus is small, with a suction curette if the uterus is large. Forceful dilation of the cervix is avoided through the use of Laminaria.     

Therapeutic abortion on psychiatric grounds. Part II. The continuing debate.

Over the past few decades, attitudes towards therapeutic abortion have gradually changed in many countries from denial and punishment to acceptance. The debate on this emotionally laden subject still continues. In this article, we review some of the recent literature covering therapeutic abortion on psychiatric grounds, including studies of women granted termination as well as those refused. Other related areas, such as the long-term effect on children born after the refusal of termination and the relevance of this to preventative psychiatry, are also considered.     

Spontaneous abortion in perspective. A 7-year study

Ten per cent of all pregnancies end in spontaneous abortion. Only by thorough history taking, physical examination and selected biochemical and biological investigations can potential causes of abortion be recognized and treated. The lesser known factors concerned with abortion are emphasized, and the role played by human chorionic gonadotrophin therapy in selected cases is considered.     

The use of human chorionic gonadotropin in recurrent abortion.

Important unresolved problems associated with recurrent abortion are aetiology, prognosis and management. This communication describes hormonal monitoring in pregnancy of groups of patients treated with human chorionic gonadotropin (HCG). The outcome is compared with that in an untreated normal group and an untreated group with recurrent abortions.     

Treatment of abortion

1.

1. The history, the findings and the treatment of the various types of abortion are reviewed.     

Incidence of aerobic and anaerobic infection in patients with incomplete abortion.

The incidence of infection in 100 cases of abortion was studied. Intra-uterine swabs and products of conception were cultured both aerobically and anaerobically. Significant potentially-pathogenic organisms were cultured from 94 of 100 intra-uterine swabs and from all 100 samples of the products of conception. Anaerobes were cultured from 70 intra-uterine swabs and from 56 products of conception. The spectrum and relative proportion of organisms isolated resemble those found in the normal vagina and cervical os. In addition, positive blood cultures were obtained from 24 patients, 8 on admission and 17 after evacuation. With this high incidence of infection, routine antimicrobial therapy for aerobic and anaerobic organisms should be given to all patients with abortion.