孕中期自愿堕胎的社会人口因素及指征

Socio-demographic factors and indications in second trimester voluntary abortion.

作者信息

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

机构信息

Department of Obstetrics and Gynecology II, University of Bari, Italy.

出版信息

Panminerva Med. 2000 Mar;42(1):33-7.

PMID:11019602

Abstract

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, teenagers 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.

摘要

背景

根据意大利法律，妊娠中期终止妊娠在危及生命的情况下或严重心理困扰时允许进行，无论是否与胎儿异常的产前诊断相关。已对与这种情况相关的社会人口因素进行了分析。

方法

检查了1988年至1997年期间因自愿妊娠中期流产而入住意大利巴里大学妇产科的330例患者的临床记录。几乎所有病例都给出了产妇精神方面的指征。在123例病例中，指征继发于因胎儿病变而患有精神障碍的女性。在205例病例中（社会条件较差的情况更常见），指征是基于与妊娠本身相关的精神障碍给出的。

结果

晚期流产女性中青少年（23.3%）和单身者（50%）的发生率显著更高。该组学生占16.4%。在主要精神指征中单身者占主导（74.4%），学生占23.6%，而在次要精神指征中已婚者占84.7%，学生仅占4.8%。在主要精神指征中，19岁及以下女性占32.5%，而在次要精神指征中这一比例为8%。

结论

在晚期流产的患者中，青少年、学生和单身者占多数，这些患者有明显更多与胎儿异常无关的主要精神指征。有主要精神指征的青少年比例较高可能取决于信息不足和社会服务不完善。通过干预这组年轻女性可以显著减少妊娠中期终止妊娠的情况。另一方面，在次要指征中，必须鼓励更早诊断胎儿异常（绒毛取样而非羊膜穿刺术），当胎儿病变轻微、可治疗或不太可能显著损害未来生活质量时，不鼓励进行流产。