Inaug.-Diss. - Erlangen.

A RESEARCH REPORT SUBMITTED TO THE UNIVERSITY OF THE WITWATERSRAND IN FULFILLMENT OF THE MASTER OF MEDICINE DEGREE / Introduction South Africa has a high prevalence of unintended pregnancies and HIV. Sixty eight thousand women die due to unsafe abortion annually worldwide, making it a leading cause of maternal mortality. In SA the maternal mortality has decreased from TOP. Maternal mortality from HIV is the leading cause of maternal mortality in South Africa. Unintended pregnancies are mainly a consequence of inconsistent and incorrect contraceptive use. The condom is the only contraceptive method which has the dual ability of preventing HIV and unintended pregnancies. We postulate that the failure of barrier contraception is a risk for both HIV and unwanted pregnancy. This study describes the contraceptive methods used by women at a TOP clinic and evaluates the use of barrier contraceptives amongst women requesting TOP, and the prevalence of HIV. Methods CHBAH is tertiary hospital in Southern Gauteng. Women with medical or surgical comorbidities that request a TOP are referred to the hospital. A prospective study using a cross sectional study design was performed at the Chris Hani Baragwanath Academic Hospital TOP clinic between February and October 2011. Data was collected using interviews and medical files. Results One hundred and nineteen women were interviewed. Most women 56 (47.06%) did not use any contraception at the time of conception. The most common reason for TOP was financial constraints, followed by relationship conflict. Pregnancy despite condom use was 34.45% (n=41). The percentage of women with condom failure, who were HIV positive was 34.14% (n=14). True condom failure was experienced by 12 women (pregnancy due to breakage/slippage of the condom. Conclusion Unintended pregnancy is mainly associated with not using contraceptives. The male condom was the most widely used contraceptive. The HIV prevalence in the group with condom failure was higher than the general antenatal population. There is a need for education regarding correct and consistent use of contraception.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 92-100).

Thesis (M.S.)--University of Wisconsin. School of Nursing, 1975. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1996.

A Dissertation that is being submitted for an MMed in Obstetrics and Gynaecology in partial fulfilment of the FCOG (SA) Part II 07 April 2015 / Objectives: The main objective of this study was to characterise women who presented at Chris Hani Baragwanath Academic Hospital (CHBAH) between 12 and 20 weeks for termination of pregnancy (TOP). Secondary objectives were to determine time to abortion, compare sonar gestational age to gestational age by dates and reasons for late presentation. Method: This was a prospective cohort study of women over the age of 18 who were referred to CHBAH for second trimester TOP between August 2012 and May 2013. The exclusion criteria were pregnancies more advanced than 20 weeks gestation. Data was collected from the medical file and by interview. Demographics and reasons to terminate were extracted from the files. Outcome variables included bleeding, pain, and time to abortion. Results: One hundred and ninety one women (91.39%) aborted. The median age of women was 25.00 (IQR=21.00-31.00), range (18-43). Women older than 25 years were 33% less likely to abort than women less than 25 years of age. Ninety nine women (47.14%) bled severely. One woman had a uterine perforation following evacuation of the uterus. The median gestational age by sonar was14.71 (IQR=13.86-16.14), range (13.00-20.00). The median gestational age by dates was13.57 (IQR=12.29-15.00), range (4.14-26.28). One hundred and thirty five women (63.98%) had an MVA for RPOC using analgesia following medical induction. Two women (0.95%) needed hysterotomy following failed TOP. The median time to abortion was 11.50(IQR=8.67-17.92), range (3.50-69.33) and incidence rate of 0.5 per hour or 1 per 2hours. Conclusion: The majority of women (91%) aborted within 72 hours following medical induction with less complication rate and short induction to abortion time. This affirm misoprostol efficacy as the suitable drug for conducting second trimester medical TOP. / MT2016

Thesis (Ph. D.)--University of Washington, 1998. / Vita. Includes bibliographical references (leaves [84]-91).

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Tratou-se de estudo com abordagem quantitativa, transversal, do tipo levantamento, que teve como objetivo geral investigar sobre a prÃtica do aborto provocado e sua relaÃÃo com a gravidez nÃo planejada, comparativamente com o aborto espontÃneo e como objetivos especÃficos analisar aspectos demogrÃficos, socioeconÃmicos e reprodutivos comparativamente ao aborto provocado e espontÃneo; verificar o conhecimento e a prÃtica anticoncepcional prÃvia a gestaÃÃo interrompida por aborto provocado e por aborto espontÃneo e conhecer os meios utilizados na prÃtica do aborto provocado e os motivos determinantes. Foi realizado no Hospital Distrital Gonzaga Mota da Barra do Cearà e no Hospital Geral Dr. Cesar Cals (HGCC), de junho a dezembro de 2011. A populaÃÃo correspondeu Ãs mulheres em abortamento com idade maior ou igual a 18 anos atendidas nos respectivos hospitais no perÃodo da coleta de dados. A entrevista seguiu um formulÃrio estruturado, que foi prÃ-testado. Finalizou-se o estudo com 70 participantes, sendo 33 (47,1%) mulheres que tiveram aborto provocado e 37 (52,9%) aborto espontÃneo. Os dados receberam tratamento estatÃstico descritivo e as comparaÃÃes das mÃdias dessas variÃveis e o tipo de aborto foram realizados por meio do teste t de Student para dados independentes e com variÃncia desiguais (analisadas pelo teste de Levene). Compararam-se, somente para aborto provocado, as porcentagens das variÃveis dicotÃmicas por meio do teste z para proporÃÃes. As anÃlises de associaÃÃes entre tipo de abortamento e as variÃveis nominais foram realizadas por meio do &#61539;2 e de razÃo de verossimilhanÃa. Calcularam-se as razÃes de chances (RC) com seus respectivos IC95% entre tipo de abortamento e essas variÃveis. Consideraram-se como estatisticamente significantes as analises com p<0,05. Dentre as variÃveis demogrÃficas e socioeconÃmicas, somente a mÃdia do nÃmero de pessoas na famÃlia apresentou associaÃÃo com o tipo de aborto (p= 0,042). Com relaÃÃo Ãs variÃveis reprodutivas e condiÃÃo de uniÃo, houve associaÃÃo entre planejamento da gravidez e tipo de aborto (p<0,001) (RC=2,4; IC95%: 1,7-3,3). Isto evidencia que a gravidez nÃo planejada foi um fator de risco para o aborto provocado. A mÃdia do tempo de uniÃo das que tiveram aborto espontÃneo foi maior do que aquelas de aborto provocado (p= 0,041). ParticipaÃÃo masculina na decisÃo pelo aborto mostrou-se como fator de risco para o aborto provocado (p=0,002). Nenhuma variÃvel relacionada à informaÃÃo e acesso ao MAC em uso prÃvio ao aborto foi significativa para o tipo de aborto. Houve associaÃÃo entre uso de AOC e tipo de aborto, sendo o uso de AOC fator protetor ao aborto provocado (p=0,040). Pensamento mÃgico de acreditar que a gravidez nÃo ocorreria consigo foi significante com o tipo de aborto (p=0,003). ChÃs e misoprostol foram os meios mais referidos pelas mulheres para provocar o aborto, sendo os motivos para provocÃ-lo a baixa condiÃÃo financeira, seguida do relacionamento instÃvel e do despreparo para cuidar da crianÃa. Concluiu-se que promover aÃÃes efetivas de planejamento familiar, com prioridade para as populaÃÃes mais carentes e com estratÃgias que garantam a participaÃÃo masculina representam meios para reduzir o aborto provocado. / This is a research study with quantitative and transversal approach aiming to investigate the induction of abortion and its relationship with an unplanned pregnancy, in comparison with natural abortion. It also aimed to analyse the demographic, socioeconomic and reproductive aspects of both methods of abortion; verify the knowledge and use of contraceptive methods prior to the interrupted pregnancy through induced and natural abortion and know which methods are used for induced abortion and it motifs. The study took place at the District Hospital Gonzaga Mota in Barra do Cearà and General Hospital Dr. Cesar Cals (HGCC), from June until December of 2011. The population consisted of women in abortion and over 18 years of age who were being assisted at the hospitals during data collection. The interview followed a structured questionnaire that was previously tested. The study consisted in the end with 70 participants, being 33 (47,1%) women who induced abortion and 37 (52,9%) with natural abortion. The data were analysed with descriptive statistics and the comparison of the means of these variables and the type of abortion were done with the Student t test for independent data and with unequal variance (analysed with Leveneâs test). It was compared only for induced abortion, the percentage of dichotomous variables with the z test for proportions. The association analysis between the type of abortion and the nominal variables were conducted with &#61539;2 and likelihood ratio. It was calculated the chance ratios (CR) with its respective IC95% between the type of abortion and these variables. It was considered as statistically significant, analysis with p<0,05. Amongst the demographic and socioeconomic variables, only the average number of people in the family presented association with the type of abortion (p= 0,042). Regarding reproductive variables and marital status, there was an association between planning of a pregnancy and abortion (p<0,001) (RC=2,4; IC95%: 1,7-3,3). This shows that an unplanned pregnancy was a risk factor for induced abortion. The average time of union with their partner was higher in women with natural abortion than in those with induced abortion (p= 0,041). It was shown that the male participation in the decision of an abortion is a risk factor for induced abortion (p= 0,002). Variables regarding information and access to contraceptive methods prior to the abortion were not significant to the type of abortion. There was an association between the use of AOC and type of abortion, being the use of AOC a protective factor to induced abortion (p= 0,040). The belief that a pregnancy would not occur with themselves was significant with the type of abortion (p= 0,003). Herbal teas and misoprostol were the most frequent methods mentioned by the women to induce an abortion, being their low economical situation, followed by an unstable relationship and unpreparedness to take care of a child the main reasons to render towards these methods. It was concluded that promoting effective methods of family planning, prioritizing poorer populations, with strategies that assures male participation represent means to reduce induced abortions.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 6 uppsatser.