Abortion in the Structure of Causes of Maternal Mortality.

OBJECTIVE: To study the structure of maternal mortality caused by abortion in the Tula region. METHODS: The medical records of deceased pregnant women, childbirth, and postpartum from January 01, 2001, to December 31, 2015, were analyzed. RESULTS: Overall, 204,095 abortion cases were recorded in the Tula region for over 15 years. The frequency of abortion was reduced 4-fold, with 18,200 in 2001 to 4,538 in 2015. The rate of abortions per 1,000 women (age 15-44 years) for 15 years decreased by 40.5%, that is, from 46.53 (2001) to 18.84 (2015), and that of abortions per 100 live births and stillbirths was 29.5%, that is, from 161.7 (2001) to 41.5 (2015). Five women died from abortion complications that began outside of the hospital, which accounted for 0.01% of the total number. In the structure of causes of maternal mortality for 15 years, abortion represented 14.3% of the cases. Lethality mainly occurred in the period from 2001 to 2005 (4 cases). Among the maternal deaths, many women died in rural areas after pregnancy termination at 18 to 20 weeks of gestation (n = 4). In addition, three women died from sepsis and two from bleeding. CONCLUSION: The introduction of modern, effective technologies of family planning has reduced maternal mortality due to abortion.

OBJETIVOS: Estudar a estrutura da mortalidade materna causada pelo aborto na região de Tula. MéTODOS: Os registros médicos de mulheres grávidas falecidas, de parto e de pós-parto, de 01 de janeiro de 2001 a 31 de dezembro de 2015, foram analisados. RESULTADOS: No geral, 204.095 casos de aborto foram registrados na região de Tula, em um período de 15 anos. A frequência de aborto foi reduzida a 1/4, passando de 18.200 abortos em 2001 para 4.538 em 2015. A taxa de abortos a cada 1.000 mulheres (com idades entre 15 e 44 anos) diminuiu 40,5% em 15 anos, isto é, de 46,53 (2001) para 18,84 (2015), e a taxa de abortos a cada 100 nascidos vivos e natimortos foi de 29,5%, isto é, de 161,7 (2001) para 41,5 (2015). Cinco mulheres morreram de complicações do aborto que começaram fora do hospital, o que representou 0,01% do número total. No quadro geral de causas de mortalidade materna neste período de 15 anos, o aborto representou 14,3% dos casos. A letalidade ocorreu, principalmente, no período de 2001 a 2005 (4 casos). Entre as mortes maternas, muitas mulheres morreram em áreas rurais após a interrupção da gravidez, com 18 a 20 semanas de gestação (n= 4). Além disso, três mulheres morreram por sepse, e duas, por sangramento. CONCLUSãO: Com a introdução de tecnologias de planejamento familiar modernas e eficazes, a mortalidade materna devido ao aborto vem sendo reduzida.

Abortion in the structure of causes of maternal mortality / Aborto na estrutura das causas da mortalidade materna

Abstract Objective To study the structure ofmaternalmortality caused by abortion in the Tula region. Methods The medical records of deceased pregnant women, childbirth, and postpartum from January 01, 2001, to December 31, 2015, were analyzed. Results Overall, 204,095 abortion cases were recorded in the Tula region for over 15 years. The frequency of abortion was reduced 4-fold, with 18,200 in 2001 to 4,538 in 2015. The rate of abortions per 1,000 women (age 15-44 years) for 15 years decreased by 40.5%, that is, from 46.53 (2001) to 18.84 (2015), and that of abortions per 100 live births and stillbirths was 29.5%, that is, from 161.7 (2001) to 41.5 (2015). Five women died from abortion complications that began outside of the hospital, which accounted for 0.01% of the total number. In the structure of causes of maternal mortality for 15 years, abortion represented 14.3% of the cases. Lethality mainly occurred in the period from 2001 to 2005 (4 cases). Among thematernal deaths, many women died in rural areas after pregnancy termination at 18 to 20 weeks of gestation (n = 4). In addition, three women died from sepsis and two from bleeding. Conclusion The introduction of modern, effective technologies of family planning has reduced maternal mortality due to abortion.

Resumo Objetivos Estudar a estrutura damortalidadematerna causada pelo aborto na região de Tula. Métodos Os registros médicos de mulheres grávidas falecidas, de parto e de pósparto, de 01 de janeiro de 2001 a 31 de dezembro de 2015, foram analisados. Resultados No geral, 204.095 casos de aborto foram registrados na região de Tula, em um período de 15 anos. A frequência de aborto foi reduzida a 1/4, passando de 18.200 abortos em2001 para 4.538 em 2015. A taxa de abortos a cada 1.000 mulheres (com idades entre 15 e 44 anos) diminuiu 40,5% em 15 anos, isto é, de 46,53 (2001) para 18,84 (2015), e a taxa de abortos a cada 100 nascidos vivos e natimortos foi de 29,5%, isto é, de 161,7 (2001) para 41,5 (2015). Cinco mulheres morreram de complicações do aborto que começaram fora do hospital, o que representou 0,01% do número total. No quadro geral de causas de mortalidade materna neste período de 15 anos, o aborto representou 14,3% dos casos. A letalidade ocorreu, principalmente, no período de 2001 a 2005 (4 casos). Entre as mortes maternas, muitas mulheres morreram em áreas rurais após a interrupção da gravidez, com 18 a 20 semanas de gestação (n= 4). Além disso, três mulheres morreram por sepse, e duas, por sangramento. Conclusão Com a introdução de tecnologias de planejamento familiar modernas e eficazes, a mortalidade materna devido ao aborto vem sendo reduzida.

Human papillomavirus 16/18 types among young women from tula (Russia).

OBJECTIVE.: To study the prevalence of human papillomavirus 16/18 types among sexually active young women. STUDY DESIGN.: From October 1998 until May 1999 we examined 160 women between the ages of 15 and 24 (mean = 19.5 +/- 2.5) years. Histology and colposcopy verified diagnoses of cervical pathology were present in 19 cases (11.9%) of cervical intraepithelial neoplasia (CIN) 1,2. At each visit, we collected information about lifestyle and sexual behavior. Human papillomavirus-DNA typing of cervical scrapes was performed by polymerase chain reaction. RESULTS.: Positive results of DNA test were present in 39 cases (24.4%): 27 of 141 with cytologically normal women (19.1%), 12 of 19 with CIN 1,2 (63.2%). An increased risk of human papillomavirus infection was significantly associated with increased number of vaginal-sex partners and smoking. A protective effect was noted from the use of condoms. CONCLUSIONS.: This data showed a high frequency of human papillomavirus 16/18 infection.