Second-Trimester Abortion: Perspectives After a Decade of Experience

342 Pages·1981·12.37 MB·English

by  Christopher Tietze (auth.)

Second-Trimester Abortion
Perspectives After a Decade
of Experience
Edited by
Gary S. Berger, MD, MSPH, FACOG
William E. Brenner, MD, FACOG
Louis G. Keith, MD, FACOG
Forewords by
Irvin M. Cushner, MD, MPH
and
Jeffrey E. Grossman
•
MARTINUS NIJHOFF PUBLISHERS
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Medicine is an ever-changing science. As new research and clinical experience broaden our
knowledge, changes in treatment and drug therapy are required. The editors and the
publisher of this work have made every effort to ensure that the treatment and drug dosage
schedules herein are accurate and in accord with the standards accepted at the time of
publication. Readers are advised, however, to check the product information sheet included
in the package of each drug they plan to administer to be certain that changes have not been
made in the recommended dose or in the indications and contraindications for administra
tion. This recommendation is of particular importance in regard to new or infrequently used
drugs.
Joint edition published by
MARTINUS NIJHOFF PUBLISHERS
P.O. Box 566,2501 CN The Hague, The Netherlands
and
John Wright. PSG Inc
545 Great Road
Littleton, Massachusetts 01460, U.S.A.
This volume is listed in the Library of Congress Cataloging in Publication Data
ISBN-13: 978-94-009-8295-6 e-ISBN-13: 978-94-009-8293-2
DOl: 10.1007/978-94-009-8293-2
Copyright © 1981 by Gary S. Berger, William E. Brenner and Louis G. Keith
Softcover reprint of the hardcover 1st edition 1981
All right reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, mechanical, photocopying, recording,
or otherwise, without the prior written permission of the publisher.
Martinus Nijhoff Publishers bv, P.O. Box 566,2501 CN The Hague, The Netherlands.
Dedication
This book is dedicated to Christopher Tietze, MD, who, over the
course of several decades, has pursued with scientific objectivity the
investigation of health problems facing women, their physicians and
society at large.
Photo © 1981 Warrell Mart'" Hem
Christopher Tietze moves among us as a colleague, friend, teacher,
constant student, world citizen, and inspiration to clear thought. He fixes a
steady and unyielding gaze on a landscape littered with random events and
helps us understand it with the power of his mind. He gives us courage by
staring down ignorance, showing us the way to marshal the facts that are
there, and demonstrating that a work of precision can be a witness to com
passion and the love of justice. He is the modern and timeless scholar
whose devotion to his craft will speak to us and demand the best from us as
long as we are searching for answers in this confused world.
Warren Martin Hem
iii
THE EDITORS
Dr. Gary S. Berger is Clinical Assistant Professor of Obstetrics and
Gynecology and Adjunct Associate Professor of Maternal and Child
Health at the University of North Carolina. Dr. Berger serves as the
Director of the Menstruation and Reproduction History Research Pro
gram at the Center for the Advancement of Reproductive Health,
Chapel Hill, North Carolina. He is a Diplomate of the American Board
of Preventive Medicine as well as the American Board of Obstetrics
and Gynecology.
Dr. William E. Brenner is Upjohn Distinguished Professor of
Obstetrics and Gynecology at the University of North Carolina. He is
a Diplomate of the American Board of Obstetrics and Gynecology.
Dr. Louis G. Keith is Professor of Obstetrics and Gynecology at
Northwestern University Medical School and The Prentice Women's
Hospital and Medical Center, Chicago, Illinois. He is also Executive
Director, The Charles A. Fields Medical Foundation, Chicago, Illinois.
Dr. Keith is a Diplomate of the American Board of Obstetrics and
Gynecology .
CONTRIBUTORS
Milagros F. Atienza, MD is a member of the Department of Gynecology and
Obstetrics, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Willem Beekhuizen, MD is a staff physician at the Center for Human
Reproduction, Leiden, The Netherlands.
Kurt Benirschke, MD is Professor of Pathology and Reproductive Medicine
at the University of California at San Diego, La Jolla, California.
Gary S. Berger, MD, MSPH, FACPM is Assistant Professor of Obstetrics
and Gynecology and Adjunct Associate Professor of Maternal and Child
Health at the University of North Carolina, Chapel Hill, North Carolina. He
also is the Director of the Menstruation and Reproduction History Research
Program of the Center for the Advancement of Reproductive Health, Chapel
Hill, North Carolina.
Ronald T. Burkman, MD is Associate Professor of Gynecology and
Obstetrics, at the Johns Hopkins Medical Institutions and Director of the
Johns Hopkins Program for International Education in Gynecology and
Obstetrics, Baltimore, Maryland.
Marc A. Bygdeman, MD, PhD is Professor of Obstetrics and Gynecology at
the Karolinska Hospital, Stockholm, Sweden.
Willard Cates, Jr, MD, MPH is the Chief of the Abortion Surveillance Branch,
Family Planning Evaluation Division, Bureau of Epidemiology, Department of
Health and Human Services, Public Health Service, Centers for Disease Con
trol, Atlanta, Georgia.
Elizabeth B. Connell, MD is a Lecturer in Obstetrics and Gynecology at the
Northwestern University Medical School, Chicago, Illinois.
Henry P. David, PhD is Associate Clinical Professor of Psychiatry at the
University of Maryland Medical School; and Director, Transnational Family
Research Institute, Baltimore, Maryland.
Marijke du Plessis-Alb las, MD is a staff physician at the Center for Human
Reproduction, Leiden, The Netherlands.
David A. Edelman, PhD is Adjunct Associate Professor of Obstetrics and
Gynecology at the University of North Carolina, Chapel Hill, North Carolina
and Associate Director for Research, International Fertility Research Program,
Research Triangle Park, North Carolina.
Julian Gold, MB, BS is Epidemic Intelligence Service Officer with the Abor
tion Surveillance Branch, Family Planning Evaluation Division, Bureau of
Epidemiology, Department of Health and Human Services, Public Health
Service, Centers for Disease Control, Atlanta, Georgia.
vii
viii
David A. Grimes, MD is Clinical Assistant Professor of Gynecology and
Obstetrics at Emory University School of Medicine and Assistant Chief, Abor
tion Surveillance Branch, Family Planning Evaluation Division, Bureau of
Epidemiology, Department of Health and Human Services, Public Health
Service, Centers for Disease Control, Atlanta, Georgia.
Charles H. Hendricks, MD is Professor and Chairman Emeritus of the
Department of Obstetrics and Gynecology at the University of North Carolina,
Chapel Hill, North Carolina.
Nancy B. Kaltreider, MD is Associate Clinical Professor of Psychiatry at the
University of California at San Francisco, San Francisco, California.
Louis G. Keith, MD is Professor of Obstetrics and Gynecology at
Northwestern University Medical School and The Prentice Women's Hospital
and Maternity Center; he also is Executive Director of The Charles A. Fields
Medical Foundation, Ltd., Chicago, Illinois.
Thomas D. Kerenyi, MD is Professor of Clinical Obstetrics and Gynecology,
Chief of Obstetrics and Director of the Division of Perinatology at the Mount
Sinai School of Medicine, City University of New York, New York.
Evert Ketting, PhD is Research Director of STIMEZO (Netherlands National
Abortion Federation) and Research Fellow, NISSO (Netherlands Institute for
Socio-Sexological Research), Zeist, The Netherlands.
Theodore M. King, MD is Professor and Chairman of the Department of
Obstetrics and Gynecology at the Johns Hopkins Medical Institutions,
Baltimore, Maryland.
Jean Pakter, MD, MPH is Director of the Bureau of Maternity Services and
Family Planning of the New York City Department of Health, New York.
Malcolm Potts, MB, B Chir, PhD, D Obst is Executive Director of the Inter
national Fertility Research Program, Research Triangle Park, North Carolina.
Jack W. Provonsha, MD is Professor of Philosophy of Religion and Christian
Ethics and Co-Director of the Student Health Services at the Lorna Linda
University, Lorna Linda, California.
Judith P. Rooks, CNM, MS, MPH is with the Office of the Assistant
Secretary for Health in the Department of Health and Human Services,
Washington, DC.
Carol J. Rowland Hogue, PhD is Associate Professor of Biometry at the
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Jeannie I. Rosoff is President of the Alan Guttmacher Institute, Washington,
DC.
ix
Rudy E. Sabbagha, MD is Associate Professor of Obstetrics and Gynecology
and Director of the Diagnostic Ultrasound Center at Northwestern University
Medical School and The Prentice Women's Hospital and Maternity Center,
Chicago, Illinois.
Kenneth F. Schulz, MBA is Assistant Chief of the Statistical Services Branch,
Family Planning Evaluation Division, Bureau of Epidemiology, Department of
Health and Human Services, Public Health Service, Centers for Disease
Control, Atlanta, Georgia.
Richard M. Selik, MD is an Abortion Surveillance Officer with the Abortion
Surveillance Branch, Family Planning Evaluation Division, Bureau of
Epidemiology, Department of Health and Human Services, Public Health
Service, Centers for Disease Control. Atlanta, Georgia.
Jack C. Smith, MS is Chief of the Statistical Services Branch of the Family
Planning Evaluation Division, Bureau of Epidemiology, Department of Health
and Human Services, Public Health Service, Centers for Disease Control,
Atlanta, Georgia.
Phillip G. Stubblefield, MD is Assistant Professor of Obstetrics and
Gynecology at the Harvard Medical School and Chief of the Division of
Ambulatory and Community Medicine of the Department of Obstetrics and
Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.
Christopher Tietze, MD is a Senior Consultant of The Population Council,
New York, New York.
Carl W. Tyler, Jr, MD is Director of the Family Planning Evaluation Divi
sion, Bureau of Epidemiology, Department of Health and Human Services,
Public Health Service, Centers for Disease Control. Atlanta, Georgia.
Louise B. Tyrer, MD is Vice President for Medical Affairs of Planned Parent
hood Federation of America, New York, New York.
Dirk A.F. van Lith, MD, DPH is a staff physician at the Center for Human
Reproduction, Leiden, The Netherlands.
Kees J. van Schie, MD is a staff physician at the Center for Human
Reproduction, Leiden, The Netherlands.
Judith A. Widdicombe, RN, BA is Executive Director of Reproductive
Health Service in St. Louis, Missouri.
Gerald I. Zatuchni, MD is Associate Clinical Professor of Obstetrics and
Gynecology and Director of Technical Assistance with the Program for
Applied Research on Fertility Regulation at Northwestern Unviersity Medical
School and The Prentice Women's Hospital and Maternity Center, Chicago,
Illinois.
CONTENTS
Contributors vii
Foreword Irvin M. Cushner xv
Foreword Jeffrey E. Grossman xix
Preface xxi
PART I Overview
1 Second-Trimester Abortion: A Global View 1
Christopher Tietze
2 Second-Trimester Induced Abortion
in the United States 13
Carl W. Tyler, Jr., Willard Cates, Jr., Kenneth F. Schulz,
Richard M. Selik, and Jack C. Smith
3 The Availability of Second-Trimester Abortion
Services in the United States 27
Jeannie 1. Rosoff
PART II The Second Trimester of Pregnancy
4 Anatomy 39
Kurt Benirschke
5 Ultrasonic Evaluation 57
Rudy E. Sabbagha
6 Physiology 69
Charles H. Hendricks
PART III Methods of Second-Trimester Abortion
7 Hypertonic Saline Instillation 79
Thomas D. Kerenyi
8 Prostaglandin Procedures 89
Marc A. Bygdeman
9 Hyperosmolar Urea 107
Ronald T. Burkman, Theodore M. King, and
Milagros F. Atienza
10 Dilatation and Evacuation 119
David A. Grimes and Willard Cates, Jr.
xi
xii
11 Laminaria and Other Adjunctive Methods 135
Phillip G. Stubblefield
PART IV Evaluation
12 Morbidity and Mortality 163
Willard Cates, Jr. and David A. Grimes
13 Future Reproduction 179
Carol J. Rowland Hogue
14 The Role of Health Agencies 189
Jean Pakter and Julian Gold
15
Recommended Procedures for Evaluation
of Abortion Techniques 205
David A. Edelman
PART V Related Issues
16 How Much is a Fetus Worth? 213
Jack W. Provonsha
17 Social Issues 221
Henry P. David
18 Psychological Impact on Patients and Staff 239
Nancy B. Kaltreider
19 Emotional Issues for Professionals 251
Judith P. Rooks
20 Counseling Issues 259
Judith A. Widdicombe
21 Postabortal Contraception 265
Louis G. Keith and Gary S. Berger
PART VI International Considerations:
The Dutch Abortion Experience
22 Second-Trimester Abortion Services
in the Netherlands 285
Evert Ketting
23 Aspirotomy 295
Dirk A.F. van Lith, Willem Beekhuizen, Kees J. van Schie,
and Marijke du Plessis-Alblas
24 Complications of Aspirotomy 301
Willem Beekhuizen, Dirk A.F. van Lith, Kees J. van Schie,
and Marijke du Plessis-Alblas
xiii
PART VII Future Directions
25 The Future of Second-Trimester Abortion
in the United States 309
Louise B. Tyrer
26 The Future of Second-Trimester Abortion
Throughout the World 315
Malcolm Potts
27 Preventing the Need for Second-Trimester
Abortion 325
Elizabeth B. Connell
28 Contragestational Agents 331
Gerald I. Zatuchni
Index 337