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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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