Induced abortion Health Dictionary

Abortion is de?ned as the expulsion of a FETUS before it is normally viable, usually before 24 weeks of pregnancy. (There are exceptional cases nowadays in which fetuses as young as 22 weeks’ gestation have survived.) (See also PREGNANCY AND LABOUR.)

Spontaneous abortion Often called miscarriage, this may occur at any time before 28 weeks; 85 per cent occur in the ?rst 12 weeks of pregnancy. Of all diagnosed pregnancies, 25 per cent end in spontaneous abortion.

Spontaneous abortions occurring in early pregnancy are almost always associated with chromosomal abnormalities of the fetus. Other causes are uterine shape, maternal disorders such as DIABETES MELLITUS, diseases of the thyroid gland (see under ENDOCRINE GLANDS), and problems with the immune system (see IMMUNITY). Recurrent spontaneous abortion (that is, three or more) seems to be a particular problem in women who have an abnormal response of their immune system to pregnancy. Other factors include being older, having had a lot of babies previously, cigarette smoking and spontaneous (but not therapeutic) abortions in the past.

Early ULTRASOUND scans have altered the management of spontaneous abortions. These make it possible to distinguish between threatened abortion, where a woman has had some vaginal bleeding but the fetus is alive; inevitable abortion, where the neck of the uterus has started to open up; incomplete abortion, where part of the fetus or placenta is lost but some remains inside the uterus; and complete abortion. There is no evidence that bed rest is e?ective in stopping a threatened abortion becoming inevitable.

Inevitable or incomplete abortion will usually require a gynaecologist to empty (evacuate) the uterus. (Complete miscarriage requires no treatment.) Evacuation of the uterus is carried out using local or general anaesthetic, usually gentle dilatation of the neck of the uterus (cervix), and curetting-out the remaining products of the pregnancy.

A few late abortions are associated with the cervix opening too early, abnormal structural abnormalities of the uterus, and possibly infection in the mother.

Drugs are often used to suppress uterine contractions, but evidence-based studies show that these do not generally improve fetal salvage. In proven cases of cervical incompetence, the cervix can be closed with a suture which is removed at 37 weeks’ gestation. The evidence for the value of this procedure is uncertain.

Therapeutic abortion In the UK, before an abortion procedure is legally permitted, two doctors must agree and sign a form de?ned under the 1967 Abortion Act that the continuation of the pregnancy would involve risk – greater than if the pregnancy were terminated – of injury to the physical and/or mental health of the mother or any existing child(ren).

Legislation in 1990 modi?ed the Act, which had previously stated that, at the time of the abortion, the pregnancy should not have exceeded the 24th week. Now, an abortion may legally be performed if continuing the pregnancy would risk the woman’s life, or the mental health of the woman or her existing child(ren) is at risk, or if there is a substantial risk of serious handicap to the baby. In 95 per cent of therapeutic terminations in the UK the reason is ‘risk of injury to the physical or mental health of the woman’.

There is no time limit on therapeutic abortion where the termination is done to save the mother’s life, there is substantial risk of serious fetal handicap, or of grave permanent injury to the health of the mother.

About 190,000 terminations are carried out in the UK each year and only 1–1.5 per cent are over 20 weeks’ gestation, with the vast majority of these late abortions being for severe, late-diagnosed, fetal abnormality.

The maternal mortality from therapeutic abortion is less than 1 per 100,000 women and, provided that the procedure is performed skilfully by experienced doctors before 12 weeks of pregnancy, it is very safe. There is no evidence that therapeutic abortion is associated with any reduction in future fertility, increased rates of spontaneous abortion or preterm birth in subsequent pregnancies.

Methods of abortion All abortions must be carried out in premises licensed for doing so or in NHS hospitals. The method used is either surgical or medical, with the latter being used more and the former less as time goes on. Proper consent must be obtained, signed for and witnessed. Women under 16 years of age can consent to termination provided that the doctors obtaining the consent are sure she clearly understands the procedure and its implications. Parental consent in the under-16s is not legally required, but counselling doctors have a duty to record that they have advised young people to inform their parents. However, many youngsters do not do so. The woman’s partner has no legal say in the decision to terminate her pregnancy.

MEDICAL METHODS A combination of two drugs, mifepristone and a prostaglandin (or a prostaglandin-like drug, misoprostol – see PROSTAGLANDINS), may be used to terminate a pregnancy up to 63 days’ gestation. A similar regime can be used between nine and 12 weeks but at this gestation there is a 5 per cent risk of post-treatment HAEMORRHAGE.

An ultrasound scan is ?rst done to con?rm pregnancy and gestation. The sac containing the developing placenta and fetus must be in the uterus; the woman must be under 35 years of age if she is a moderate smoker, but can be over 35 if she is a non-smoker. Reasons for not using this method include women with diseases of the ADRENAL GLANDS, on long-term CORTICOSTEROIDS, and those who have a haemorrhagic disorder or who are on ANTICOAGULANTS. The drugs cannot be used in women with severe liver or kidney disease, and caution is required in those with CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), disease of the cardiovascular system, or prosthetic heart valves (see PROSTHESIS), as well as with those who have had a CAESAREAN SECTION or an ECTOPIC PREGNANCY in the past or who are being treated for HYPERTENSION.

Some clinics use this drug combination for pregnancies older than 12 weeks. In pregnancies approaching viability (20 weeks), pretreatment fetocide (killing of the fetus) with intrauterine drug therapy may be required.

SURGICAL METHODS Vacuum curettage is a method used up to 14–15 weeks. Some very experienced gynaecologists will perform abortions surgically by dilating the cervix and evacuating the uterine contents up to 22 weeks’ gestation. The greater the size of the pregnancy, the higher the risk of haemorrhage and perforation of the uterus. In the UK, illegal abortion is rare but in other countries this is not the case. Where illegal abortions are done, the risks of infection and perforation are high and death a de?nite risk. Legal abortions are generally safe. In the USA, partial-birth abortions are spoken of but, in fact, there is no such procedure recorded in the UK medical journals.... abortion

See MUNCHAUSEN’S SYNDROME.... fabricated and induced illness

Medically induced termination of pregnancy. Abortion may be performed if continuation of the pregnancy would risk the woman’s life, if the mental or physical health of the woman or her existing children is at risk, or if there is a substantial risk of handicap to the baby.

Depending on the stage of pregnancy, termination may be induced by using drugs or by the surgical technique of vacuum suction curettage, under either a general or local anaesthetic, during which the fetal and placental tissues are removed.

Complications are rare.... abortion, induced

Abortion is a medical procedure of ending a pregnancy during its first 24 weeks. There are several reasons why this medical process is carried out: a fetus’ or woman’s health issue or, most frequent, there are personal considerations which impede the woman to keep the baby. No matter the reasons of an abortion, it should be made by a physician. Also, the woman’s post-abortion state requires medical observation, because there have been acknowledged physical and psychological effects after this medical condition. Like any other medical procedure, abortion implies risks, like losing a large amount of blood (haemorrhage) or inflammation of the pelvis. Studies revealed that further miscarriages can be associated with earlier abortions, as the surgery may lead to the damage of the womb. A pregnancy can be ended by a medical procedure or, by a traditional method, like drinking teas causing abortion. How Tea for Abortion works There are two categories of tea which lead to ending a pregnancy: emmenagogue and abortifacient teas. The first type of tea induces woman’s period to start, whereas the second one causes painful contractions of the uterus, followed by abortion. Teas leading to Abortion Please read the list of some of the teas you should not drink if you are pregnant or, you try to become pregnant. Blue Cohosh is a wood plant, growing in New England (United States) and also in Canada. It has anti-inflammatory and antispasmodic properties. It is generally used to treat rheumatism and to prevent osteoporosis. Muscles aches caused by physical effort are relieved by taking Blue Cohosh as tea, tincture or decoction. It cannot stimulate the estrogen production thus, the body is not able to provide the endometrial and uterine growth, leading to contractions of the uterine and, finally, to a painful abortion. Unfortunately, Blue Cohosh tea has been used for a long period of time as a medicinal and home-made beverage for abortion. Pennyroyal is a plant from the mint family, whose essential oil is toxic if taken internally. In the past, women were poisoning themselves in the attempt of ending the pregnancy. Taken as an infusion, the plant is efficient in mitigating the unpleasant feelings of the upset stomach, abdominal cramps , as well as colds. Pennyroyal tea should not be drunk by pregnant women or by those who want to become pregnant, because it irritates the uterus, causing contractions and, of course, abortion. Tansy is a herbaceous plant, originating from Europe, but also cultivated in the United States. It is best known for its action as an insect repellant, being used as treatment against worms. It is a digestion adjuvant as well as a migraine reliever. Tansy tea provides contractions of the uterus and abortion, which can be so violent that causes death, just like the above mentioned teas causing abortion. Uterine bleeding, nausea and loss of consciousness are some of the signs displayed by people who had ingested a large dose of the beverage. Women should bear in mind that these three types of tea are scientifically proven to cause abortion. So, they should not consume them! Furthermore, women should ask their doctor for a list of the edible products while pregnancy, in order to avoid unpleasant situations of any kind.  ... teas causing abortion

Disruptive termination of pregnancy before twenty-eighth week. Too premature expulsion of contents of the pregnant womb may be spontaneous, habitual, or by intentional therapy. Untimely onset of uterine contractions with dilation of cervical os (mouth of the womb) dispose to abortion. Essential that services of a suitably qualified doctor or obstetrician be engaged. It would be his responsibility to ensure that the embryo (unborn baby) and the placenta (after birth) are completely expelled.

Alternatives. Tea: equal parts – Agnus Castus, Ladysmantle, Motherwort, Raspberry leaves, 1-2 teaspoon to each cup boiling water; infuse 5-10 minutes; 1 cup 2-3 times daily.

Tablets/capsules. Cramp bark, Helonias.

Powders. Formula. Combine Blue Cohosh 1; Helonias 2; Black Haw 3. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.

Practitioner. Tincture Viburnum prunifolium BHP (1983), 20ml; Tincture Chamaelirium luteum BHP (1983) 20ml; Tincture Viburnum opulus BHP (1983), 20ml; Tincture Capsicum, fort, BPC 1934, 0.05ml. Distilled water to 100ml. Sig: 5ml tds pc c Aq cal.

Black Cohosh. Liquid Extract Cimicifuja BP 1898, 1:1 in 90 per cent alcohol. Dosage: 0.3-2ml. OR: Tincture Cimicifuja, BPC 1934, 1:10 in 60 per cent alcohol. Dosage: 2-4ml.

Squaw Vine (mother’s cordial) is specific for habitual abortion, beginning soon after becoming pregnant and continuing until the seventh month. Also the best remedy when abortion threatens. If attended by a physician for abortion, a hypodermic of morphine greatly assists; followed by Liquid Extract 1:1 Squaw Vine. Dosage: 2-4ml, 3 times daily.

Liquid extracts. Squaw Vine, 4 . . . Helonias, 1 . . . Black Haw bark, 1 . . . Blue Cohosh, 1. Mix. Dose: One teaspoon every 2 hours for 10 days. Thereafter: 2 teaspoons before meals, 3 times daily. Honey to sweeten, if necessary. (Dr Finlay Ellingwood)

Abortion, to prevent: Cramp bark, (Dr John Christopher)

Evening Primrose. Two 500mg capsules, at meals thrice daily.

Diet: High protein.

Vitamins. C. B6. Multivitamins. E (400iu daily).

Minerals. Calcium. Iodine. Iron. Selenium, Zinc. Magnesium deficiency is related to history of spontaneous abortion; magnesium to commence as soon as pregnant.

Enforced bed rest. ... abortion – to prevent

(PIH) raised blood pressure (>140/90 mmHg) developing in a woman during the second half of pregnancy. It usually resolves within six weeks of delivery and is associated with a better prognosis than *pre-eclampsia.... pregnancy-induced hypertension

Hearing loss caused by prolonged exposure to excessive noise or by brief exposure to intensely loud noise.

Exposure to a sudden, very loud noise, usually above 130 decibels, can cause immediate and permanent damage to hearing. Normally, muscles in the middle ear respond to loud noise by altering the position of the ossicles (the chain of bones that pass vibrations to the inner ear), thus damping down the intensity of the noise. If these protective reflexes have no time to respond, the full force of the vibrations is carried to the inner ear, severely damaging the delicate hair cells in the cochlea. Occasionally, loud noises can rupture the eardrum.

More commonly, noise damage occurs over a period of time by prolonged exposure to lower levels of noise. Any noise above 85–90 decibels may cause damage, with gradual destruction of the hair cells of the cochlea, leading to permanent hearing loss. Prolonged exposure to loud noise leads initially to a loss of the ability to hear certain high tones. Later, deafness extends to all high frequencies, and the perception of speech is impaired. Eventually, lower tones are also affected.

Sounds at 85–90 decibels or above may cause pain and temporary deafness. Prolonged tinnitus (ringing or buzzing in

the ears) occurring after a noise has ceased is an indication that some damage has probably occurred.... noise-induced hearing loss