Login Register Cart 0
Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Therapeutic Abortion Methods in Women Referring to Educational and Medical Centers in Shiraz

Author(s): Sedighe Alipanahpour , Naeimeh Tayebi , Mahnaz Zarshenas and Marzieh Akbarzadeh*

Volume 18, Issue 3, 2022

Published on: 04 June, 2021

Article ID: e031121193865 Pages: 7

DOI: 10.2174/1573404817666210604110357

Price: $65

Abstract

Background: Abortion is one of the most common side effects of pregnancy, which has had shown a steady or even growing trend over the past few decades despite extensive efforts in prenatal care.

Objective: This study aimed to investigate medical interventions for abortions in pregnant women referring to educational and medical centers in Shiraz, Iran, in 2018.

Methods: In this cross-sectional study, 437 pregnant women referred to Shiraz Educational and Forensic Medicine Centers were selected. A questionnaire including demographic characteristics, midwifery information and types of medical interventions was completed for each. Data were analyzed by SPSS software using statistical tests.

Results: According to the results of the present study, most subjects were aged 31-40 years (202 (46%)), had a high school diploma (183 (41%)), and were housewives (331 (57%)). Most of their gestational age was in the range of 16-20 weeks (184 (41%)). There was also a significant positive relationship observed between maternal age and gestational age (p = 0.01). Misoprostol and cervical Foley were the most used methods in induced abortions with a forensic permit (44.3%), vaginal misoprostol was the most used method in induced abortions with other indications (43.9%), and most spontaneous abortions involved no intervention (41.9%).

Conclusion: Considering the importance of the medical abortion method, it is suggested to be considered for patients with different conditions in interventional studies. Also, the correct use of different family planning methods and identification of factors affecting the use of contraceptives are recommended after an abortion. Women’s education and men’s participation should be considered in the prevention of high-risk and unwanted pregnancies.

Keywords: Abortion, pregnancy, termination, misoprostol, cervical Foley, therapeutic, women, fetus.

Graphical Abstract

[1]
Moradi B, Meshkat Z. Evaluation of tuberculosis infection in pregnant women and its effects on newborns: An overview. Majallah-i Zanan, Mamai va Nazai-i Iran 2015; 18(178): 21-36.
[http://dx.doi.org/10.22038/ijogi.2016.6498]
[2]
Jurkovic D, Overton C, Bender-Atik R. Diagnosis and management of first trimester miscarriage. BMJ 2013; 346: f3676.
[http://dx.doi.org/10.1136/bmj.f3676] [PMID: 23783355]
[3]
Charostad J, Mokhtari-Azad D V M T, Mph , et al. Detection of human herpes viruses 1-5 in miscarriage: A case-control study. Int J Reprod Biomed (Yazd) 2020; 18(7): 501-8.
[http://dx.doi.org/10.18502/ijrm.v13i7.7367] [PMID: 32803115]
[4]
El Hachem H, Crepaux V, May-Panloup P, Descamps P, Legendre G, Bouet PE. Recurrent pregnancy loss: Current perspectives. Int J Womens Health 2017; 9: 331-45.
[http://dx.doi.org/10.2147/IJWH.S100817] [PMID: 28553146]
[5]
Sedgh G, Bearak J, Singh S, et al. Abortion incidence between 1990 and 2014: Global, regional, and subregional levels and trends. Lancet 2016; 388(10041): 258-67.
[http://dx.doi.org/10.1016/S0140-6736(16)30380-4] [PMID: 27179755]
[6]
Erfani A. Induced abortion in Tehran, Iran: Estimated rates and correlates. Int Perspect Sex Reprod Health 2011; 37(3): 134-42.
[http://dx.doi.org/10.1363/3713411] [PMID: 21988789]
[7]
Yogi A, K C P, Neupane S. Prevalence and factors associated with abortion and unsafe abortion in Nepal: A nationwide cross- sectional study. BMC Pregnancy Childbirth 2018; 18(1): 376.
[http://dx.doi.org/10.1186/s12884-018-2011-y] [PMID: 30223798]
[8]
Mouri MI, Rupp TJ. Threatened Abortion.StatPearls. Treasure Island, FL: StatPearls Publishing 2020. Updated 2019 May 6 Internet Available from: https://www.ncbi.nlm.nih.gov/books/NBK430747/
[9]
Lee HJ, Park TC, Kim JH, Norwitz E, Lee B. The influence of oral dydrogesterone and vaginal progesterone on threatened abortion: A systematic review and meta-analysis. BioMed Res Int 2017; 2017: 3616875.
[http://dx.doi.org/10.1155/2017/3616875] [PMID: 29392134]
[10]
Nabavizadeh SL, Zare Nejad M, Khorsandian MA, Nabavizadeh SH, Gholamzadeh S. A Criticism on the Single Article of Legal Abortion 2018; 7(3): 1-20. Available from: http://ce.mazums.ac.ir/article-1-367-fa.html
[11]
Ghodrati F. Controversial issues of abortion license according to religious and jurisprudential laws in Iran: A systematic review. Curr Womens Health Rev 2020; 16(2): 87-94.
[http://dx.doi.org/10.2174/1573404816666200206112854]
[12]
Fatemeh Ghodrati. Importance and necessity of training the medical team regarding religious-moral doctrines related to abortion, a narrative review. current women's health reviews 2020.
[13]
Badieian Mosavi N, Hejazi S, Sadeghipour F, Fotovat A, Hoseini M. Examination of fetal indications in 548 cases of abortion therapy permissions issued by forensic medicine center of Razavi Khorasan, Iran, in 2015. Majallah-i Zanan, Mamai va Nazai-i Iran 2018; 21(5): 6-13.
[http://dx.doi.org/10.22038/ijogi.2018.11380]
[14]
Abubeker FA, Lavelanet A, Rodriguez MI, Kim C. Medical termination for pregnancy in early first trimester (≤ 63 days) using combination of mifepristone and misoprostol or misoprostol alone: A systematic review. BMC Womens Health 2020; 20(1): 142.
[http://dx.doi.org/10.1186/s12905-020-01003-8] [PMID: 32635921]
[15]
Kulier R, Kapp N, Gülmezoglu AM, Hofmeyr GJ, Cheng L, Campana A. Medical methods for first trimester abortion. Cochrane Database Syst Rev 2011; (11): CD002855.
[http://dx.doi.org/10.1002/14651858.CD002855.pub4] [PMID: 22071804]
[16]
Lemmers M, Verschoor MA, Kim BV, et al. Medical treatment for early fetal death (less than 24 weeks). Cochrane Database Syst Rev 2019; 6(6): CD002253.
[http://dx.doi.org/10.1002/14651858.CD002253.pub4] [PMID: 31206170]
[17]
Black KI, de Vries BS, Moses F, Pelosi M, Cong A, Ludlow J. The impact of introducing medical management on conservative and surgical management for early pregnancy miscarriage. Aust N Z J Obstet Gynaecol 2017; 57(1): 93-8.
[http://dx.doi.org/10.1111/ajo.12573] [PMID: 28251638]
[18]
Lemmers M, Verschoor MA, Hooker AB, et al. Dilatation and curettage increases the risk of subsequent preterm birth: A systematic review and meta-analysis. Hum Reprod 2016; 31(1): 34-45.
[http://dx.doi.org/10.1093/humrep/dev274] [PMID: 26534897]
[19]
Hooker AB, Lemmers M, Thurkow AL, et al. Systematic review and meta-analysis of intrauterine adhesions after miscarriage: Prevalence, risk factors and long-term reproductive outcome. Hum Reprod Update 2014; 20(2): 262-78.
[http://dx.doi.org/10.1093/humupd/dmt045] [PMID: 24082042]
[20]
Raymond EG, Harrison MS, Weaver MA. Efficacy of misoprostol alone for first-trimester medical abortion: A Systematic review. Obstet Gynecol 2019; 133(1): 137-47.
[http://dx.doi.org/10.1097/AOG.0000000000003017] [PMID: 30531568]
[21]
Schreiber CA, Creinin MD, Atrio J, Sonalkar S, Ratcliffe SJ, Barnhart KT. Mifepristone pretreatment for the medical management of early pregnancy loss. N Engl J Med 2018; 378(23): 2161-70.
[http://dx.doi.org/10.1056/NEJMoa1715726] [PMID: 29874535]
[22]
Zhang J, Gilles JM, Barnhart K, Creinin MD, Westhoff C, Frederick MM. A comparison of medical management with misoprostol and surgical management for early pregnancy failure. N Engl J Med 2005; 353(8): 761-9.
[http://dx.doi.org/10.1056/NEJMoa044064] [PMID: 16120856]
[23]
Serdinšek T, Reljič M, Kovač V. Medical management of first trimester missed miscarriage: The efficacy and complication rate. J Obstet Gynaecol 2019; 39(5): 647-51.
[http://dx.doi.org/10.1080/01443615.2018.1535577] [PMID: 30917727]
[24]
Tang J, Kapp N, Dragoman M, de Souza JP. WHO recommendations for misoprostol use for obstetric and gynecologic indications. Int J Gynaecol Obstet 2013; 121(2): 186-9.
[http://dx.doi.org/10.1016/j.ijgo.2012.12.009] [PMID: 23433680]
[25]
Murphy D. Women in England will be allowed to take second early medical abortion pill at home. BMJ 2018; 362: k3675.
[http://dx.doi.org/10.1136/bmj.k3675] [PMID: 30154075]
[26]
Kumari P, Preethi RN, Abraham A, et al. A prospective observational study of the follow-up of medical management of early pregnancy failure. J Family Med Prim Care 2019; 8(12): 3998-4002.
[http://dx.doi.org/10.4103/jfmpc.jfmpc_585_19] [PMID: 31879649]
[27]
Lui MW, Ho PC. First trimester termination of pregnancy. Best Pract Res Clin Obstet Gynaecol 2020; 63: 13-23.
[http://dx.doi.org/10.1016/j.bpobgyn.2019.06.004] [PMID: 31420315]
[28]
Sundaram A, Juarez F, Bankole A, Singh S. Factors associated with abortion-seeking and obtaining a safe abortion in Ghana. Stud Fam Plann 2012; 43(4): 273-86.
[http://dx.doi.org/10.1111/j.1728-4465.2012.00326.x] [PMID: 23239247]
[29]
Gao GP, Zhang RJ, Zhang XJ, et al. Prevalence and associated factors of induced abortion among rural married women: A cross-sectional survey in Anhui, China. J Obstet Gynaecol Res 2015; 41(3): 383-91.
[http://dx.doi.org/10.1111/jog.12547] [PMID: 25332104]
[30]
Mote CV, Otupiri E, Hindin MJ. Factors associated with induced abortion among women in Hohoe, Ghana. Afr J Reprod Health 2010; 14(4 Spec no.): 110-6.
[31]
Ilboudo PG, Somda SM, Sundby J. Key determinants of induced abortion in women seeking postabortion care in hospital facilities in Ouagadougou, Burkina Faso. Int J Womens Health 2014; 6: 565-72.
[http://dx.doi.org/10.2147/IJWH.S60709] [PMID: 24920938]
[32]
Maina BW, Mutua MM, Sidze EM. Factors associated with repeat induced abortion in Kenya. BMC Public Health 2015; 15: 1048.
[http://dx.doi.org/10.1186/s12889-015-2400-3] [PMID: 26459344]
[33]
Rezk MA, Sanad Z, Dawood R, Emarh M, Masood A. Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. J Matern Fetal Neonatal Med 2015; 28(1): 93-6.
[http://dx.doi.org/10.3109/14767058.2014.905909] [PMID: 24635496]
[34]
Ercan Ö, Köstü B, Özer A, Serin S, Bakacak M. Misoprostol versus misoprostol and foley catheter combination in 2nd trimester pregnancy terminations. J Matern Fetal Neonatal Med 2016; 29(17): 2810-2.
[http://dx.doi.org/10.3109/14767058.2015.1105950] [PMID: 26452400]
[35]
Abediasl Z, Sheikh M, Pooransari P, Farahani Z, Kalani F. Vaginal misoprostol versus intravenous oxytocin for the management of second-trimester pregnancies with intrauterine fetal death: A randomized clinical trial. J Obstet Gynaecol Res 2016; 42(3): 246-51.
[http://dx.doi.org/10.1111/jog.12910] [PMID: 26663590]
[36]
Ghasemi M, Arbabzadeh T, Baradaran Z, Sarvi F. Comparison of two dosing regimens of intravaginal misoporostol for second-trimester abortion. Majallah-i Zanan, Mamai va Nazai-i Iran 2018; 21(4): 19-24.
[http://dx.doi.org/10.22038/ijogi.2018.11216]
[37]
Dadhwal V, Garimella S, Khoiwal K, Sharma KA, Perumal V, Deka D. Mifepristone followed by misoprostol or ethacridine lactate and oxytocin for second trimester abortion: a randomized trial. Eurasian J Med 2019; 51(3): 262-6.
[http://dx.doi.org/10.5152/eurasianjmed.2019.18341] [PMID: 31692613]
[38]
Lerma K, Blumenthal PD. Current and potential methods for second trimester abortion. Best Pract Res Clin Obstet Gynaecol 2020; 63: 24-36.
[http://dx.doi.org/10.1016/j.bpobgyn.2019.05.006] [PMID: 31281014]
[39]
Henkel Andrea, Shaw Kate A. Advances in the management of early pregnancy loss, Current Opinion in Obstetrics and Gynecology 2018; 30(6): 419-24.
[40]
Şık A, Bilecan S, Kumbasar S, Akpak YK, Aba YA. Does feticide shorten termination duration in second trimester pregnancy terminations? Afr Health Sci 2019; 19(1): 1544-53.
[http://dx.doi.org/10.4314/ahs.v19i1.28] [PMID: 31148982]
[41]
Jamali M, Bakhtiyari M, Arab F, Mirzamoradi M. Misoprostol complications in second-trimester termination of pregnancy among women with a history of more than one cesarean section. Obstet Gynecol Sci 2020; 63(3): 323-9.
[http://dx.doi.org/10.5468/ogs.2020.63.3.323] [PMID: 32489977]
[42]
Bello FA, Fawole B, Oluborode B, et al. Trends in misoprostol use and abortion complications: A cross-sectional study from nine referral hospitals in Nigeria. PLoS One 2018; 13(12): e0209415.
[http://dx.doi.org/10.1371/journal.pone.0209415] [PMID: 30596683]
[43]
Hagos G, Tura G, Kahsay G, Haile K, Grum T, Araya T. Family planning utilization and factors associated among women receiving abortion services in health facilities of central zone towns of Tigray, Northern Ethiopia: A cross sectional Study. BMC Womens Health 2018; 18(1): 83.
[http://dx.doi.org/10.1186/s12905-018-0582-4] [PMID: 29871631]

Rights & Permissions Print Cite
Article Metrics
13
© 2025 Bentham Science Publishers | Privacy Policy