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Panminerva Medica 2000 March;42(1):33-7


lingua: Inglese

Socio-demographic factors and indications in second trimester voluntary abortion

Carriero C., Ceci O. R., Melilli G. A., Fanelli M. *, Nappi L., Di Gesù G., Ferreri R.

From the Department of Obstetrics and Gynecology II
*Department of Medical Statistics, Institute of Hygiene University of Bari, Italy


Background. According to Italian Law, sec­ond tri­mes­ter ter­mi­na­tion of preg­nan­cy is ­allowed for ­life threat­en­ing con­di­tions or for ­severe psy­cho­log­i­cal dis­tress, ­linked or not to pre­na­tal diag­no­sis of foe­tal abnor­mal­ities. Socio-dem­o­graph­ic fac­tors relat­ed to ­this con­di­tion ­have ­been ana­lysed.
Methods. Clinical ­records of 330 ­patients admit­ted dur­ing the ­years 1988-1997 to the Obstetrics and Gynaecology Department, University of Bari, Italy, for vol­un­tary sec­ond tri­mes­ter abor­tion, ­were exam­ined. Maternal psy­chi­at­ric indi­ca­tions ­have ­been giv­en in near­ly all of the cas­es. In 123 cas­es the indi­ca­tions ­were sec­on­dary to the wom­en suf­fer­ing a psy­chi­at­ric dis­or­der due to foe­tal pathol­o­gies. In 205 cas­es - ­where ­poor ­social con­di­tions ­were ­more fre­quent - the indi­ca­tion was giv­en on the ­ground of a psy­chi­at­ric dis­or­der ­linked to the preg­nan­cy ­itself.
Results. Significantly high­er inci­dence of teen­ag­ers (23.3%) and sin­gles (50%) in wom­en who under­went a ­late abor­tion. Students ­were 16.4% in ­this ­group. In pri­mary psy­chi­at­ric indi­ca­tion sin­gles pre­vail (74.4%) and stu­dents rep­re­sent 23.6% ­while in sec­on­dary psy­chi­at­ric indi­ca­tion the mar­ried ­were 84.7%, stu­dents ­only 4.8%. In pri­mary psy­chi­at­ric indi­ca­tion 32.5% of wom­en ­aged nine­teen or ­less, ­while in sec­on­dary psy­chi­at­ric indi­ca­tion ­this per­cent­age was 8%.
Conclusions. Among ­patients who ­have a ­late abor­tion, ­teen-­agers, stu­dents and sin­gles are prev­a­lent, ­these ­patients ­have sig­nif­i­cant­ly ­more pri­mary psy­chi­at­ric indi­ca­tions, not ­linked to foe­tal abnor­mal­ities. The ­high per­cent­age of ­teen­agers ­with pri­mary psy­chi­at­ric indi­ca­tion ­could ­depend on inad­e­quate infor­ma­tion and ­social ser­vice. Reduction of mid-tri­mes­ter ter­mi­na­tions of preg­nan­cy can be sig­nif­i­cant­ly ­achieved inter­ven­ing in ­this ­group of ­young wom­en. On the oth­er ­hand, in sec­on­dary indi­ca­tions ear­li­er diag­no­sis of foe­tal abnor­mal­ities ­must be encour­aged (vil­lo­cen­te­sis ­instead of amni­o­cen­te­sis) and abor­tion dis­cou­raged ­when the foe­tal pathol­o­gy is ­minor, treat­able or unlike­ly to sig­nif­i­cant­ly ­impair the ­future qual­ity of ­life.

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