Littérature scientifique sur le sujet « Interruption of pregnancy »
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Articles de revues sur le sujet "Interruption of pregnancy"
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Cho, Seio Beom, Chul Joong Kim, Myung Gyu Kim, Young Rahn Lee, In Ho Cha, Nam Jun Lee et Kyoo Byung Chung. « Transcervical interruption of ectopic pregnancy ». Journal of the Korean Radiological Society 29, no 3 (1993) : 492. http://dx.doi.org/10.3348/jkrs.1993.29.3.492.
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Bugalho, Antonio, Cassimo Bique, Luisa Almeida et Staffan Bergström. « Pregnancy Interruption by Vaginal Misoprostol ». Gynecologic and Obstetric Investigation 36, no 4 (1993) : 226–29. http://dx.doi.org/10.1159/000292634.
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Burhanuddin, A. F. M. « Interruption of Pregnancy by Indigenous Method ». Journal of The Asian federation of Obstetrics and Gynaecology 5, no 1 (24 mai 2010) : 1–5. http://dx.doi.org/10.1111/j.1447-0756.1975.tb00021.x.
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David, Henry P. « Acceptability of Mifepristone for Early Pregnancy Interruption ». Law, Medicine and Health Care 20, no 3 (septembre 1992) : 188–94. http://dx.doi.org/10.1111/j.1748-720x.1992.tb01187.x.
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Bewley, Susan, et Andrew Shennan. « HYPITAT and the fallacy of pregnancy interruption ». Lancet 375, no 9709 (janvier 2010) : 119. http://dx.doi.org/10.1016/s0140-6736(10)60043-8.
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Edmonston, Barry. « Interruption of breastfeeding by child death and pregnancy ». Social Biology 37, no 3-4 (septembre 1990) : 233–50. http://dx.doi.org/10.1080/19485565.1990.9988763.
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Deliveliotis, Ch, B. Argyropoulos, M. Chrisofos et C. A. Dimopoulos. « Shockwave Lithotripsy in Unrecognized Pregnancy : Interruption or Continuation ? » Journal of Endourology 15, no 8 (octobre 2001) : 787–88. http://dx.doi.org/10.1089/089277901753205744.
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Agostino, Bengtsson, et V. Wahlberg. « Interruption of Pregnancy : Motives, Attitudes and Contraceptive Use ». Gynecologic and Obstetric Investigation 32, no 3 (1991) : 139–43. http://dx.doi.org/10.1159/000293015.
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Rodríguez-Calvo, María Sol, Isabel María Martínez-Silva, José Luis Soto, Luis Concheiro et José Ignacio Muñoz-Barús. « University students’ attitudes towards Voluntary Interruption of Pregnancy ». Legal Medicine 14, no 4 (juillet 2012) : 209–13. http://dx.doi.org/10.1016/j.legalmed.2012.02.002.
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Brandão, Andreia, Eliana Pereira, Filipe Portela, Manuel Filipe Santos, António Abelha et José Machado. « Managing Voluntary Interruption of Pregnancy Using Data Mining ». Procedia Technology 16 (2014) : 1297–306. http://dx.doi.org/10.1016/j.protcy.2014.10.146.
Texte intégralThèses sur le sujet "Interruption of pregnancy"
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Shulz, Jessica. « Entre honte et culpabilité, méandres de la maternalité chez la femme enceinte suite à une interruption médicale de grossesse ». Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCB190/document.
Texte intégralRésumé :
La recherche explore les traces et remaniements du deuil prénatal au cours d'une grossesse suivant une Interruption Médicale de Grossesse (IMG) pour raison fœtale. Le statut du fœtus/bébé y est triplement complexe: entre humain et non humain sur le plan légal ; objet perceptible mais non directement visible dans la réalité matérielle ; à la fois prolongement narcissique et objet interne - partiel et potentiellement total dans la réalité psychique. Cet extrême paradoxe constitue un défi majeur du travail psychique du deuil prénatal. Selon le contexte culturel et les choix singuliers, maternels et paternels, face à ces possibles, les pratiques autours de sa mort seront différentes et aboutiront à des processus de deuil contrastés. Dans le cas particulier d'une IMG, l'expérience clinique nous invite à envisager deux aspects fondamentaux. D'un côté, la décision prise par la mère avec le choix qui s'impose à elle d'interrompre ou non la grossesse - et par là la vie du fœtus/bébé - interroge d'emblée ses éventuelles traces actualisées de culpabilité. De l'autre, être enceinte d'un fœtus porteur d'une pathologie grave représente pour la femme une blessure narcissique renvoyant au concept de honte. Dans leur articulation avec les processus narcissiques et objectaux, la honte et la culpabilité sont des prismes pertinents pour étudier les spécificités d'une grossesse suivant une IMG au cours de laquelle les liens entre objets internes, objets externes, sujet et groupe sont mis en exergue. Dans ce contexte, trois questions constituent la problématique de cette étude: le mode d'investissement du fœtus/bébé décédé est-il réactualisé par l'investissement du fœtus/bébé de la grossesse actuelle ? La grossesse active-t-elle de manière particulières des traces de honte et de culpabilité que nous nommons pour les singulariser vivances ? De quelle façon ces vivances s'articulent-elles avec les mouvements psychiques de la femme dans les processus de deuil ? Méthodologie: Cette recherche qualitative se réfère à une méthodologie hypothético-déductive et s'inscrit dans un référentiel psychanalytique. La population est constituée de 11 femmes (primipares et multipares) enceintes après avoir vécu une IMG pour raison fœtale après 15 Semaines d'Aménorrhée (SA). Des entretiens semi-structurés ont été menés auprès de ces femmes aux trois trimestres de la grossesse. Elles ont également rempli des auto-questionnaires à chaque temps de la recherche (PAI, PGS, EPDS, STAI, DAS, PCLS). L'analyse des entretiens, audio-enregistrés, croise une observation approfondie de chaque cas avec une analyse de contenu thématique, prenant en compte le vécu subjectif de chaque femme, afin de répondre aux hypothèses de recherche. Résultats : Les résultats mettent en avant une réactualisation du processus de deuil au cours de la grossesse suivante. Ils vont dans le sens de la confirmation de la portée heuristique et clinique de l'étude de la honte et de la culpabilité lors d'une grossesse suivant une IMG. La honte se manifeste chez ces femmes par des vécus de dévoilement et d'exclusion, un sentiment de perte de contrôle, voire d'emprise, et un vécu d'échec et d'indignité. L'élaboration des vivances de honte est un bon marqueur de la possible résolution des dimensions narcissiques et développementales du processus de deuil. La culpabilité est très présente, en lien avec la pathologie fœtale, la décision d'interrompre la grossesse et vis-à-vis du bébé de la grossesse actuelle. Dans ce contexte, la honte et la culpabilité sont à comprendre comme les deux pôles d'un gradient continu. Sur le terrain périnatal, l'articulation sémiologique et psychopathologique de la dialectisation entre honte et culpabilité lors d'une grossesse suivant une IMG, permet de donner des repères cliniquement organisateurs dans le cadre d'une prévention transdisciplinaire médico-psycho-sociale des troubles de la parentalité et des dysharmonies relationnelles précocesThe aim of this research is to explore the traces and updates of prenatal grief during a pregnancy subsequent to a Medical Termination of Pregnancy (MTP). The status of the fetus is triply complex: between human and non-human on a legal dimension ; perceptible object but that cannot directly be seen in the plan of material reality; both narcissistic extension and internal object - partial and potentially total - in psychic reality. This extreme paradox is the major challenge of the psychic work during prenatal bereavement. Depending on the cultural background and singular maternal and paternal choices among those possibilities, the practices surrounding the death of the baby will be different and lead to contrasting grieving processes. In the particular case of MTP, the clinical experience leads us to consider two fundamental aspects. On one hand, the decision taken by the mother with the choice that she has to make to interrupt the pregnancy or not - and thereby the fetus/baby's life - questions on possibles feelings of guilt. From the other hand, being pregnant with a fetus with a severe pathology represents a narcissistic injury referring to the concept of shame. Shame and guilt, because of their relationship with narcissistic and object-relation processes seem to be quite relevant to study the specificities of a pregnancy following a MTP. In this context, three main questions constitutes the problematic of this study : Is the investment of the dead fetus/baby updated by the investment of the current fetus/baby ? Is the pregnancy activating in a particular way feelings of shame and guilt ? What is the articulation of these feelings with the grieving process ? Methodology: This qualitative research refers to a hypothetical-deductive method and lays on a psychoanalytic background. Our population is composed with 11 women (primiparous and multiparous) pregnant after a MTP for fetal reasons occurred after 15 weeks of amenorrhea (WA). Semi-structured interviews were conducted on the three trimestre of the pregnancy. They also each time completed self-questionnaires (PAI, PGS, EPDS, STAI, DAS, PCLS). The analysis of the interviews, that were recorded, crosses a thorough observation of each case with a thematic content analysis, taking into account the subjective experience of each woman, in order to answer the research hypotheses. Results: The results highlight an updating of the grieving process during the following pregnancy. They are in line with the confirmation of the heuristic and clinical significance of the study of shame and guilt in a pregnancy following a MTP. For these women, shame is manifested by a feeling of unveiling and exclusion, loss of control, and an experience of failure and unworthiness. The elaboration of shame is a good marker for possible resolution of narcissistic and developmental dimensions of the grieving process. Guilt is very present, connected with fetal pathology, the decision to terminate the pregnancy and towards the baby of the current pregnancy. Shame and guilt can be understood as the two poles of a continuous gradient. Their study in the context of a pregnancy following a medically terminated one makes possible to offer pertinent semiological and psychopathological markers in the framework of primary and secondary prevention of troubles in parentality and in early relational dysharmonies
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PAGOTTO, TANIA. « Un accomodamento sostenibile : l'interruzione di gravidanza in Italia, Spagna e Messico ». Doctoral thesis, Università Ca' Foscari, Venezia, 2019. https://hdl.handle.net/10281/397182.
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The doctoral thesis deepens, through comparative law, the topic of conscientious objection to interruption of pregnancy in Italy, Spain and Mexico (Mexico City). The legal theoretical framework lies at the crossroad between the need to maintain pluralism and
conscientious objection and the need to guarantee access to a public service. The dissertation is divided into three main sections. The first section provides definitions and contextualizes freedom of conscience and conscientious objection within the constitutional traditions and the regional systems of protection of human rights (the European Court of Human Rights and the Inter-American Court of Human Rights). The second section faces conscientious objections in the field of interruption of pregnancy, describing the evolution of national laws, the jurisprudence and the most recent reforms.
Therefore, it identifies the main problems related to the application of these laws, trying to explain the reasons of the social resistance and the still controversial nature. The third and last part describes the fragilities of the current accommodation system and proposes
some corrections, in order to build a sustainable model of conscientious objection.
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FARIAS, REJANE SANTOS. « CONCEPTIONS AND PERFORMANCES/ACTIONS THE INTERRUPTION OF PREGNANCY PROVIDED BY LAW FROM THE PERSPECTIVE OF SOCIAL WORKERS IN HEALTH UNITS OF THE MUNICIPALITY OF RIO DE JANEIRO ». PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2014. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=25154@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO
O presente estudo busca analisar as concepções e atuações dos assistentes sociais na atenção às mulheres com demanda por interrupção da gestação prevista em lei e nos serviços de saúde do município do Rio de Janeiro que são referência para o atendimento às mulheres em situação de violência sexual. Trata-se de uma pesquisa com abordagem qualitativa, cujos instrumentos utilizados para produção de dados foram a análise de documentação institucional e a entrevista do tipo semiestruturada, realizada com nove assistentes sociais, todas do sexo feminino, que trabalham em três maternidades que atendem mulheres em situação de violência sexual. As entrevistas foram gravadas em MP3 com o consentimento das entrevistadas, nos meses de fevereiro e março de 2014, e tiveram duração total de 206 minutos. Para discussão dos dados utilizou-se a análise de conteúdo em sua modalidade temática. Os resultados apontam para uma invisibilidade tanto pública quanto interna desse tipo de serviço no município estudado, limitando o acesso das mulheres a esse direito assegurado por lei. Prevalece, dentre os sujeitos da pesquisa, uma concepção da interrupção da gestação prevista em lei como um direito da mulher e de que o assistente social deve envidar todos os esforços para sua garantia, apesar de enfrentar dificuldades como a ausência de preparo e abordagem sobre a temática durante a graduação e o desconhecimento em relação à legislação vigente sobre o aborto legal e a forte influência dos valores ético-religiosos na postura dos profissionais de saúde que comprometem o acesso das mulheres a esse direito.
This study assesses the views and actions of social workers in the care of women with demand for termination of pregnancy provided for by law in the health services in the city of Rio de Janeiro that are reference to the assistance to women in situations of sexual violence. This is a research with qualitative approach, whose instruments used for the production of data was the institutional analysis and documentation of the semi-structured interview of the type held with nine social workers, all female, working in three hospitals that serve women in situation of sexual violence in the city of Rio de Janeiro. The interviews were recorded in MP3 with the consent of the interviewees in the months of February and March 2014 and had total duration of 206 minutes. For discussion the data use the content analyses the subject modality. The result shows a public and intern invisibility for this services in this municipality, with limitate the women access for a law right. The research subjects prevalence a conception the pregnancy interruption previous in law with a woman right and the social work obligation to guarantee this right, despite the social workers have some difficulties like no prepare or approach during the graduation about this subject and unknowing with current legislation about legal abortion and an ethical religious values influences the health professional attitude and implicate the women access a this right.
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Cia, Walkiria Cordenonssi. « Sonho desfeito : anencefalia e experiência emocional dos pais ». Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-10112014-161146/.
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O desenvolvimento tecnológico contemporâneo permite a detecção precoce de malformações fetais, tais como a anencefalia, que inviabilizam a sobrevivência do bebê. Tal constatação implica imediata revelação diagnóstica aos pais, que deverão decidir pela continuidade ou interrupção da gravidez. O presente trabalho tem como objetivo investigar a experiência emocional de casais que se deparam com o diagnóstico de anencefalia fetal, tendo em vista trazer subsídios para um melhor atendimento psicológico. A investigação organizou-se como pesquisa qualitativa, com método psicanalítico, estruturada ao redor de procedimentos investigativos de acesso, registro, interpretação e interlocuções reflexivas sobre atendimentos clínicos. A partir de sessões com casais parentais, realizadas ao longo de oito anos, foram elaboradas duas narrativas transferenciais ficcionais, que preservam elementos essenciais da dramática em pauta. Uma das narrativas aborda uma situação de opção por interrupção gestacional, enquanto a outra focaliza uma decisão de continuidade. Os procedimentos interpretativos permitiram a \"criação/encontro\" dos seguintes campos de sentido afetivo-emocional ou inconscientes relativos: É um pesadelo?, Quem ou o quê está aí?, É preciso decidir. O quadro geral aponta que grande parte do trabalho clínico tem lugar num campo bastante singular, É preciso decidir, que se define pela urgência de tomada de decisão relativa à eventual interrupção de processos vitais. O campo É um pesadelo? aponta para o fato deste tipo de revelação diagnóstica, derivada do uso de uma tecnologia, que detecta problemas que não estão sendo vivenciados como sinais ou sintomas físicos, gerar muito frequentemente reações dissociativas, cujo manejo torna-se, assim, clinicamente indispensável. O outro campo, Quem ou o quê está aí?, assume uma posição de centralidade, nesta clínica, na medida em que porta consigo uma interrogação radical acerca do estatuto ontológico do feto, vivido como um bebê ou como um não-bebê. Uma compreensão sensível e atenta acerca dos diferentes modos como cada casal habita este campo parece fundamental para a provisão de um cuidado psicoterapêuticoThe contemporary technological development allows the early detection of fetal malformations, such as anencephaly, which makes the babys survival unfeasible. This assumption leads to the immediate revelation of the diagnosis to the parents who will decide either to continue or interrupt the pregnancy. This paper focuses on the investigation of the emotional experience that couples have when facing a fetal anencephaly diagnosis, bringing instruments for a better psychological care. The investigation process was organized as a qualitative research, through psychoanalytic approach, based on the investigation procedures of access, register, interpretation and reflexive interlocution on clinical care sessions. From the sessions with couples, during eight years, two transferential fictional narratives, that preserve essential elements of drama at stake, were created. One of the narratives approaches a situation of choice for pregnancy interruption, while the other aims at the decision to keep it. The interpretative procedures allowed the \"creation / finding\" of the following fields of affective-emotional sense or relative unconscious: Is it a nightmare?, Who or what is there?, We have to make a decision. The big picture shows that great part of the clinical work takes place in a singular field, We have to make a decision, defined by the sense of urgency around the decision about the eventual interruption of vital processes. The field Is it a nightmare? leads to the fact that this kind of diagnosis revelation, derived from the technology which detects problems that were not being lived as physical signals or symptoms, frequently generates dissociative reactions, making the clinical care mandatory. The other field Who or what is there? has a central role, in this clinic, as soon as it contains an extreme question around the fetuss ontological statute, being a baby or a non-baby. A sensible and attentive comprehension of the different ways in which couples deal with this field is essential for a psychotherapeutic care
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Warnier, de Wailly Diane. « La grossesse suivant une interruption médicale de grossesse : quelles traces du deuil prénatal dans le lien à l'enfant suivant ? : de la préoccupation maternelle mélancolique à la préoccupation maternelle primaire ». Thesis, Sorbonne Paris Cité, 2015. http://www.theses.fr/2015PA05H107.
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L'objet de ce travail est d'analyser l'évolution du processus de deuil lors d'une grossesse suivant une interruption médicale de grossesse (IMG). 8461 enfants sont nés sans vie en France en 2012 et 59 à 86% des femmes démarre,t une nouvelle grossesse dans les 6 mois suivant la perte; le deuil périnatal constitue un problème de santé publique puisque 25% évoluent vers un deuil pathologique. Le statut de l'objet perdu et la représentation que s'en font les mères participent du destin de ce foetus perdu; l'évolution des pratiques favorisant l'humanisation du foetus et l'objectalisation de ce dernier est critiquée par certains auteurs. Nous relevons un maque de consensus dans la littérature sur l'impact de cette nouvelle grossesse sur le processus de deuil; selon certains, elle pourrait interrompre le travail de deuil, pour d'autres au contraire favoriser une reprise élaborative. Ces grossesses suivantes, teintées du deuil, semblent représenter un facteur de risque dans l'attachement prénatal avec des conséquences sur le lien à l'enfant puîné. Nous interrogeons donc la relation entre le processus de deuil périnatal et le processus d'investissement de l'enfant à venir lors d'une grossesse suivante. Méthodologie utilisée: suivi longitudinal de 7 femmes enceintes lors d'une grossesse suivant une IMG après 15 SA, aux 3 trimestres de la grossesse et aux 3 mois de l'enfant suivant, selon une analyse qualitative au moyen d'entretiens de recherche clinique et une analyse quantitative de la dépression (EPDS), anxiété (STAI), deuil périnatal (PGS) et attachement prénatal (PAI) au moyen d'autoquestionnaires. Les résultats qualitatifs, traités de façon singulière selon une analyse psychodynamique, sont regroupés ensuite en fonction de nos hypothèses. Les résultats quantitatifs sont intégrés dans un corpus plus large pour permettre une analyse statistique des données. Résultats: entre le normal et le pathologique, les affects, les émotions, les représentations oscillent sur ce continuum, au fil de la grossesse, des termes et dates anniversaires, des manifestations sensorielles éprouvées. La grossesse suivante permet de revisiter la grossesse précédente; elle donne l'opportunité aux mères endeuillées de mettre en mots les affects brutes consécutifs à la perte, de mettre du sens pour inscrire cet événement traumatique dans l'histoire individuelle, conjugale et familiale. Certaines patientes, pour qui le travail de deuil pouvait sembler figé, ont pu mettre la transparence psychique de cette nouvelle grossesse à profit pour ré-élaborer la perte précédente et donner une juste place à chacun des deux bébés. L'actualisation du processus de deuil lors de la grossesse suivante sera fonction de la structure psychique des patientes; la dépression et l'angoisse sont également des marqueurs de l'élaboration de la perte et de la place faite à l'enfant puîné. L'analyse quantitative des données statistiques montre la présence d'anxiété particulièrement au début de la grossesse suivanteThe objet of this work is to analyze the evolution of the process of mourning during a pregnancy following a termination of pregnancy (TOP). 8461 children were born dead in France in 2012 and 59 to 86% of women start a new pregnancy in the six months following the loss; the perinatal mourning constitutes a problem of public health because 25% lead to a pathological mourning. The status of the lost object and maternal representations participate in the fate this lost foetus. The evolution of the practices favoring the humanization of the foetus and the objectalisation of the latter is criticized by some authors. We find a lack of consensus in the literature on the impact of this new pregnancy on the process of mourning. According to certain authors, she could interrupt the work of mourning, for others on the contrary, favor a elaborative resumption. These following pregnancies, tinged with the mourning, seem to represent a risk factor in the prenatal attachment with consequences on the link to the puisne child. We thus question the relation between the process of perinatal mourning and the process of investment of the child coming during a following pregnancy. Used methodology: longitudinal follow-up of seven pregnant women during pregnancy following a TOP after 15 weeks, three times during the pregnancy and at three months after the birth of the subsequent child according to a qualitative analysis (interview of clinical research) and a quantitative analysis of depression (EPDS), anxiety (STAI), perinatal mourning (PGS) and prenatal attachment (PAI) by means of auto-questionnaires. The qualitative results, treated in a singular way according to a psychodynamic analysis, are then included according to our hypotheses. The quantitative results are integrated into a wier corpus to allow statistical analysis of the data. Results: between the normal and the pathological, affects, feelings and representations oscillate on this continuum, in the course of the pregnancy, the terms and anniversaries, the proven sensory demonstrations. The following pregnancy allows to revisit the previous pregnancy; she gives the opportunity to the mothers saddened to put into words the gross affects consecutive to the loss, to put of the sens to register this traumatic event in the individual, conjugal, and family history. Somme women,for whom the work of mourning could seem motionless, were able to put the psychic transparency of this new pregnancy in profit to redevelop the previous loss and to give a just place to each of both babies. The updating of the process of mourning during the following pregnancy will be function of the psychic structure of the woman. The depression and the anxiety are also markers of the elaboration of the loss and the place made for the puisne child. The quantitaive analysis of the statistical data shows the presence of anxiety, particularly at the begining of the following pregnancy
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Troude, Pénélope. « Devenir à long terme de couples traités par fécondation in vitro dans la cohorte DAIFI ». Phd thesis, Université Paris Sud - Paris XI, 2013. http://tel.archives-ouvertes.fr/tel-00933360.
Texte intégralRésumé :
Les études sur les couples traités par fécondation in vitro (FIV) ont jusqu'à présent porté essentiellement sur l'évaluation du succès en FIV. Très peu de données sont disponibles sur le devenir à long terme de couples traités par FIV. L'objectif de ce travail était d'estimer la fréquence de réalisation du projet parental à long terme, et d'étudier les facteurs associés aux interruptions précoces des traitements et aux naissances naturelles.L'enquête DAIFI-2009 a inclus 6 507 couples ayant débuté un programme de FIV en 2000-2002 dans l'un des 8 centres de FIV participant à l'étude. Les données médicales des couples et leur parcours dans le centre ont été obtenus à partir des dossiers médicaux des centres de FIV pour tous les couples. L'information sur le devenir des couples après le départ du centre a été obtenue par questionnaire postal auprès des couples en 2008-2009 (38% de participation 7 à 9 ans après l'initiation des FIV). L'étude des facteurs associés à la participation à l'enquête postale suggérait que la fréquence de réalisation du projet parental estimée sur les répondants seulement pourrait être biaisée. Les différentes méthodes mises en œuvre pour corriger la non réponse (pondération, imputation multiple) n'ont pas modifié l'estimation de la fréquence de réalisation du projet parental. Au total, 7 à 9 ans après l'initiation des FIV, 60% des couples ont réalisé leur projet parental de façon biologique, suite à un traitement ou suite à une conception naturelle. Lorsque les adoptions sont aussi prises en compte, 71% des couples ont réalisé leur projet parental. Après l'échec d'une première tentative de FIV, un couple sur 4 (26%) a interrompu les FIV dans le centre d'inclusion. Globalement, les couples avec de mauvais facteurs pronostiques ont un plus grand risque d'interrompre les FIV. Cependant, la proportion plus importante d'interruption parmi les couples avec une origine inexpliquée de l'infécondité pourrait s'expliquer par la survenue plus fréquente de naissance naturelle dans ce sous-groupe de couples. Parmi les couples n'ayant pas eu d'enfant suite aux traitements, 24% ont ensuite conçu naturellement en médiane 28 mois après l'initiation des FIV. Parmi les couples ayant eu un enfant suite aux traitements, 17% ont ensuite conçu naturellement en médiane 33 mois après la naissance de l'enfant conçu par AMP. Les facteurs associés aux naissances naturelles sont des indicateurs d'un meilleur pronostic de fertilité, particulièrement chez les couples sans enfant AMP.L'enquête DAIFI-2009 a permis d'apporter des informations sur le parcours à long terme des couples traités par FIV qui n'avait jusqu'à présent été que peu étudié, souvent sur de faibles effectifs et avec un suivi plus court. Ces résultats doivent apporter de l'espoir aux couples inféconds, puisque la majorité d'entre eux ont finalement réalisé leur projet parental, même si cela peut prendre de nombreuses années.
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Ridaura, Pastor Isabel. « Estudio del duelo perinatal : interrupciones médicas del embarazo, muertes prenatales y muertes postnatales ». Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/295973.
Texte intégralRésumé :
El objetivo principal del estudio fue describir la evolución del proceso de duelo y la sintomatología depresiva a lo largo de un año después de haber sufrido una pérdida perinatal y estudiar qué factores se asocian a unos peores/mejores resultados a largo plazo.
Se contactó con 125 mujeres que habían sufrido una pérdida perinatal y fueron atendidas en el Hospital de la Vall d’Hebron. Se establecieron dos grupos según el tipo de pérdida: interrupción médica del embarazo (IME) y muerte prenatal/postnatal. Se realizaron tres evaluaciones tras la pérdida: al mes, a los 6 meses y al año. Setenta mujeres participaron en el primer seguimiento, 46 en el segundo y 41 en el tercero. Se utilizaron tres instrumentos: la versión reducida de la Perinatal Grief Scale (PGS), que evalúa aspectos específicos del duelo perinatal; el Beck Depression Inventory (BDI) que valora sintomatología depresiva; y la Dyadic Adjustment Scale (DAS) que mide aspectos relativos a la satisfacción marital.
Los principales resultados del estudio fueron la presencia de sintomatología propia del duelo (PGS) y depresiva (BDI), sobre todo en el primer tiempo tras la pérdida y la disminución progresiva de las puntuaciones en la escala de duelo a lo largo de los seguimientos.
Se observó una asociación positiva entre las puntuaciones de las subescalas Dificultades de afrontamiento al mes y Desesperanza del primer tiempo y las puntuaciones totales de duelo a más largo plazo.
No se observó una relación estadísticamente significativa entre los factores socioeconómicos, los antecedentes mentales previos, la satisfacción marital y las variables asistenciales respecto a las puntuaciones de la PGS y el BDI. Tampoco se encontró relación entre la historia obstétrica ni respecto a las semanas de gestación en que se produjo la pérdida y las respuestas estudiadas, a excepción de las semanas de gestación y las puntuaciones del BDI al mes. La asociación entre quedarse embarazada durante el estudio y la evolución en cuanto al duelo y la depresión no fue estadísticamente significativa, aunque el grupo de mujeres embarazadas mostró puntuaciones ligeramente más altas.
Respecto al tipo de pérdida, no se observaron diferencias estadísticamente significativas entre los dos grupos considerados y las puntuaciones de las escalas de duelo y depresión, aunque el grupo de muertes pre/postnatales tenía una media de puntuaciones mayor en la PGS al mes y a los 6 meses, mientras que al año las puntuaciones diferían poco e incluso eran ligeramente más altas para el grupo de mujeres que habían hecho una interrupción. En este mismo grupo, el pronóstico de la malformación tampoco se asoció significativamente con la evolución del duelo y la sintomatología depresiva.
La variable ver al hijo resultó ser un aspecto controvertido, pues en el grupo de mujeres que sufrieron una IME la media de puntuaciones en las escalas de duelo y depresión al año era mayor para las que habían decidido verlo.
Algunos resultados del estudio apoyan los resultados obtenidos en otras investigaciones, tales como que el duelo perinatal sigue el mismo curso que otros duelos; no se observan diferencias significativas en función del tipo de pérdida; la mayoría de mujeres están satisfechas con la asistencia médica recibida y que un pobre ajuste marital está relacionado con puntuaciones más altas de duelo y sintomatología depresiva. Aspectos como ver al hijo, son susceptibles de ser estudiados en un futuro debido al impacto que provocan en la mujer y a los hallazgos encontrados.
A modo de conclusión general se ha de destacar que el duelo perinatal es un constructo complejo, con múltiples variables implicadas, que comporta malestar significativo.The main objective of the study was to describe the evolution of the grieving process and the depressive symptomatology over one year, after having suffered a perinatal loss and to determine factors associated with the best/worst long-term results. We contacted 125 women who had undergone a perinatal loss and who had been treated at the Hospital in Vall d’Hebron. Two groups were formed according to the type of loss: medical termination of pregnancy (MTP) and prenatal/postnatal death. Three assessments were carried out after the loss: at one month, 6 months and one year. Seventy women participated in the first follow-up, 46 in the second and 41 in the third. Three instruments were used: the short version of the Perinatal Grief Scale (PGS) which assesses specific aspects of perinatal bereavement; the Beck Depression Inventory (BDI) which assesses depressive symptomatology, and the Dyadic Adjustment Scale (DAS) which measures aspects of marital satisfaction. The main results of the study were the presence of symptoms that are characteristic of grief (PGS) and depression (BDI), especially in the first period after the loss, as well as a progressive reduction in scores on the grief scale over all three periods. A positive association between the subscale scores of Difficulties of coping at one month and Hopelessness during the first period, and the total scores of grief at a longer term was observed. No statistically significant relationship between socioeconomic factors, previous mental history, marital satisfaction and assistance variables regarding PGS scores and BDI was observed. Neither was a relationship with the obstetric history observed, nor one regarding the pregnancy week in which the loss occurred and the responses studied, except for one between the weeks of pregnancy and BDI scores at one month. The association between becoming pregnant during the study and evolution of the grieving and depression was not statistically significant, although the group of pregnant women showed slightly higher scores. Regarding the type of loss, no statistically significant differences between the two groups and the scores of the scales of grief and depression were observed, although the pre/postnatal death group had higher mean scores for PGS at one month and at six months, whereas the scores at one year differed little and were even slightly higher for the group of women who had terminated. In this group, the prognosis of the malformation was not significantly associated with the evolution of grieving and depressive symptomatology. The variable 'seeing the child' proved to be a controversial issue: the average scores for the group of women who had suffered an MTP on the scales of grief and depression at one year was higher for those who had decided to see it. Some results of the study support the results of other investigations, such as the finding that perinatal grief follows the same course as other grief; there are no significant differences in the type of loss; most women are satisfied with the medical care received and that a poor marital relationship is associated with higher scores of grief and depressive symptomatology. Aspects such as 'seeing the child' are likely to be studied in the future because of the impact they have on women and the findings. As a general conclusion is worth noting that perinatal grief is a complex construct, that involves multiple variables and which entails significant distress.
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Mirlesse, Véronique. « Diagnostic prénatal et médecine fœtale : Du cadre des pratiques à l’anticipation du handicap. Comparaison France-Brésil ». Thesis, Paris 11, 2014. http://www.theses.fr/2014PA11T043/document.
Texte intégralRésumé :
Cette thèse analyse les pratiques du diagnostic prénatal (DPN) en France et au Brésil, entre mondialisation des savoirs et des techniques et régulations locales, à la recherche des modalités d’anticipation du handicap. Le DPN s’est développé dans les pays d’Europe et d’Amérique du Nord en lien direct avec les législations sur l’avortement. Il a pris ancrage dans le suivi des grossesses comme l’un des modes de prévention des handicaps à la naissance. Son expansion aux pays où l’accès à l’avortement est restreint oblige à des adaptations fonction des régulations locales. Les dispositifs réglementaires encadrent le travail professionnel (travail en réseau, pluridisciplinarité) et l’enregistrement des pratiques (omniprésent en France, absent au Brésil). Ils modulent, en France, l’expérience des femmes ayant vécu une interruption de grossesse pour pathologie fœtale, comme en témoigne l’analyse de questionnaires semi directifs soumis à deux groupes de femmes à deux époques différentes. En 1999 les femmes réclament plus d’autonomie dans la prise de décision d’interruption. En 2005, elles sollicitent plus volontiers une décision partagée avec les praticiens, mais considèrent que la décision leur revient plus spécifiquement lors des termes tardifs, dans les situations à risque de retard mental, de grande incertitude pronostique, ainsi que dans le cadre de situations spécifiquement recherchées lors du parcours anténatal (telle la trisomie 21). Ces dispositifs réglementaires conditionnent aussi l’usage des techniques et les informations délivrées aux couples. Au Brésil, dans un contexte d’accès restreint à l’avortement et de fortes inégalités sociales, l’échographie en situation de normalité foetale glorifie la « naissance sociale anticipée» de l’enfant et de sa famille. En cas d’anomalie fœtale, une rupture radicale se produit. A l’hôpital public, qui concerne la majorité des femmes, la poursuite obligée de la grossesse règle l’attitude des praticiens : l’étude ethnographique menée à Rio de Janeiro montre que les obstétriciens optent alors pour l’éducation des femmes (dans l’espoir d’un accès progressif à l’autonomie, chemin espéré vers une société plus juste). Les pédiatres provoquent pour leur part un glissement sémantique proposant une utilisation positive de l’incertitude médicale qui modifie le cadre de la réflexion préservant une approche dynamique de l’accueil de l’enfant. Dans le secteur privé au Brésil, les interruptions de grossesse possibles hors des cadres légaux, sont maintenues sous le sceau du secret et ne laissent que peu entrevoir la dynamique décisionnelle préalable. L’anticipation du handicap lors des consultations prénatales met partout en avant la crainte du retard mental et de la souffrance pour l’enfant, le couple ou la fratrie, mais le discours varie selon les contextes : l’analyse comparative des observations souligne qu’en France, les praticiens utilisent la médecine basée sur les preuves pour informer le couple et réduire risques et incertitude en vue d’un choix nécessaire et dans le respect de l’autonomie décisionnelle des couples. Au Brésil, à l’hôpital public, la hiérarchie des priorités diffère: devenir mère, avoir un enfant vivant passent au premier plan. Le risque est présenté comme faisant partie de la vie et l’incertitude dynamique préserve l’avenir de l’enfant malade au sein de sa famille. Ces approches différenciées du risque et du handicap amènent à évoquer les évolutions récentes du champs du handicap qui ont peu pénétré l’univers du DPN. Portées notamment par les « disability studies », études menées par les personnes elles mêmes concernées par le handicap, elles considèrent le handicap comme un processus dynamique résultant d’une interaction entre l’état de santé et une situation sociale donnés. La thèse suggère en conclusion un rapprochement des savoirs, des expériences et des pratiques entre l’univers du prénatal et celui du handicap par le biais d’un dialogue inter et transdisciplinaireIn search of modes of anticipating disability, this thesis examines and compares prenatal diagnosis (PND) practices in France and Brazil. In Europe and North America, PND has developed directly in line with legislation on abortion and is rooted in the monitoring of pregnancy, as one of the ways of preventing disability at birth. Its expansion into countries where access to abortion is restricted, is led by the globalization of knowledge and techniques, and has to be adapted to suit local regulations. Regulatory frameworks govern professional work (networking, multidisciplinarity) and the recording of PND practices (omnipresent in France, non-Existent in Brazil). As can be seen from our analysis of semi-Directive questionnaires given to two groups of women at two different periods of time, in France such mechanisms modulate the experiences of women who have undergone an abortion due to a foetal pathology. In 1999 women wanted greater autonomy when deciding whether or not to terminate a pregnancy. In 2005 they were more readily in favour of sharing decision-Making with doctors, but felt that the decision was theirs to make when it was a question of late-Term pregnancies, of situations with a risk of mental retardation, of major prognostic uncertainty, and of situations subject to specific tests during the prenatal period (such as Down’s Syndrome). These regulatory mechanisms also affect how technical tools are used and the information given to couples. In Brazil, in a context of restricted access to abortion and of very significant social inequality, an ultrasound in a situation of foetal normality glorifies the “anticipated social birth” of the child and its family. When a foetal anomaly is diagnosed, a radical rupture occurs. In public hospitals – used by the majority of women – obligatory continuation of pregnancy regulates doctors’ attitudes: the ethnographic study carried out in Rio de Janeiro shows that obstetricians have opted for the education of women (in the hope of gradual access to autonomy, hopefully the road towards a fairer society). Paediatricians produce a semantic shift, encouraging a positive use of medical uncertainty, which modifies the decision-Making framework and maintains a dynamic approach to welcoming the child-To-Be. In the private sector in Brazil, terminations of pregnancy which are possible outside of any legal framework are kept behind a wall of secrecy, revealing next to nothing about the prior decision-Making process. During prenatal consultations, the anticipation of a disability systematically brings out fears of mental retardation and of the suffering which will be caused to the child, the couple or siblings, but the discourse varies, depending on the context: a comparative analysis of our observations shows that, in France, doctors use evidence-Based medicine to inform couples and to reduce risks and uncertainties with a view to making a necessary choice, whilst at the same time respecting the couple’s decision-Making autonomy. In public hospitals in Brazil, there is a different hierarchy of priorities: the primary focus is that of becoming a mother and having a life-Born child. Risk is presented as being part of life and the dynamic aspects of medical uncertainty safeguard the future of the “sick” child within its family. These differentiated approaches to risk and disability lead us to consider recent evolutions in the field of disability which has so far had little impact on PND. Led in particular by “disability studies” – studies carried out by people who are themselves affected by disability – these evolutions consider disability to be a dynamic process resulting from an interaction between a given state of health and a given social situation. In its conclusion, the thesis suggests that the knowledge, experiences and practices of the prenatal world and that of disability be brought together through inter and transdisciplinary dialogue
Essa tese analisa as práticas de diagnóstico pré-natal (DPN) na França e no Brasil, entre a mundialização de saberes, técnicas e regulações locais, focando as modalidades de antecipação da deficiência. O DPN desenvolveu-se nos países da Europa e América do Norte de forma diretamente relacionada com as leis sobre o aborto. Enraizou-se no monitoramento da gravidez como um dos modos de prevenção das deficiências. Sua expansão em países onde o acesso ao aborto é restrito leva a adaptações de acordo com as regulamentações locais. Disposições regulamentares enquadram o trabalho profissional (em rede, pluridisciplinar) e o registro das práticas (onipresente na França e ausente no Brasil). Elas modulam, na França, a experiência de mulheres que se submeteram ao aborto devido a uma patologia fetal, conforme evidenciado pela análise de questionários semi-estruturados aplicados em dois grupos de mulheres em duas épocas diferentes. Em 1999, as mulheres exigiam mais autonomia na tomada de decisões de interrupção. Em 2005, elas procuravam mais frequentemente uma decisão compartilhada com os médicos, porém consideravam que a decisão cabia a elas, especificamente em gestações mais adiantadas, em situações com risco de retardo mental, com elevada incerteza prognóstica, e no contexto de situações específicas rasteadas ao longo do percurso pré-natal (tal como a síndrome de Down).Estes mecanismos reguladores também condicionam o modo de utilização das técnicas e as informações fornecidas para os casais. No Brasil, em um contexto de acesso restrito ao aborto e de fortes desigualdades sociais, a ultrassonografia em situações de normalidade fetal glorifica o "nascimento social antecipado" da criança e a « ampliação » da família. Em caso de anomalia fetal, uma ruptura radical se produz.No hospital público, para onde vai a maioria das mulheres, a impossibilidade de interromper a gestação define a atitude dos profissionais: o estudo etnográfico realizado no Rio de Janeiro mostra que os obstetras optam então pela educação das mulheres (na esperança de um ganho progressivo de autonomia, em direção a uma sociedade mais justa). Os pediatras realizam, por sua vez, uma mudança semântica, proporcionando um uso positivo da incerteza médica que muda o contexto do debate, preservando uma abordagem dinâmica sobre a chegada da criança. No setor privado no Brasil, a interrupção da gravidez, possível fora dos quadros jurídicos, é mantida sob o selo do segredo e dá pequeno vislumbre da dinâmica anterior da decisão.A antecipação da deficiência durante o pré-natal dissemina o medo do retardo mental, do sofrimento para a criança, para o casal ou irmãos, mas o discurso varia de acordo com o contexto: a análise comparativa de observações destaca que na França, os médicos utilizam a medicina baseada em evidências para informar o casal e reduzir o risco e a incerteza, tendo em vista uma escolha necessária e o respeito à autonomia das decisões dos casais. No Brasil, no hospital público, a hierarquia de prioridades é diferente: tornar-se mãe, ter um filho vivo vêm em primeiro plano. O risco é apresentado como parte da vida e a dinâmica da incerteza salvaguarda o futuro do filho doente no seio de sua família. Estas abordagens diferenciadas de risco e deficiência nos remetem ainda mais aos recentes achados nas áreas da deficiência, que pouco penetraram no universo do DPN. Impulsionados principalmente pela área dos « disability studies », pesquisas conduzidas pelas próprias pessoas afetadas pela deficiência, esses estudos consideram a deficiência como um processo dinâmico, resultante de uma interação entre um estado de saúde e uma situação social determinada. A tese apresenta como conclusao a necessidade da aproximaçao entre o universo do pré-natal e o da deficiência, por meio de um diálogo inter e transdisciplinar, compartilhando conhecimentos, experiências e práticas
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Tararbit, Karim. « Assistance médicale à la procréation et cardiopathies congénitales : études en population ». Thesis, Paris 11, 2014. http://www.theses.fr/2014PA11T024/document.
Texte intégralRésumé :
A partir de données en population, nous avons: 1) évalué le risque de cardiopathies congénitales (CC) chez les fœtus conçus par assistance médicale à la procréation (AMP); et 2) déterminé les effets de l’AMP sur la prise en charge prénatale et le devenir périnatal des fœtus porteurs de CC. Nous avons observé que l'AMP était associée à une augmentation de 40% du risque de CC sans anomalies chromosomiques associées (OR ajusté = 1,4 IC95% 1,1-1,7). Nous avons également retrouvé qu'il existait des associations variables selon la catégorie de CC et la méthode d'AMP considérées. Nous avons observé que l'AMP était associée à une multiplication par 2,4 du risque de tétralogie de Fallot (OR ajusté = 2,4 IC95% 1,5-3,7), alors que nous n’avons pas retrouvé d’association statistiquement significative pour les trois autres CC spécifiques étudiées. Dans notre population, l'exposition à l'AMP ne semblait pas modifier le recours au diagnostic prénatal et à l'interruption médicale de grossesse chez les fœtus porteurs de CC comparés aux fœtus porteurs de CC conçus spontanément. Nous avons par ailleurs observé que le risque de prématurité des fœtus porteurs de CC conçus par AMP était environ 5 fois plus élevé que celui des fœtus porteurs de CC conçus spontanément (OR ajusté = 5,0 IC95% 2,9-8,6). En nous basant sur une méthodologie d'analyses de cheminement, nous avons retrouvé que les grossesses multiples contribuaient pour environ 20% au risque plus élevé de tétralogie de Fallot associé à l'AMP que nous avons observé. Enfin, les grossesses multiples contribuaient pour environ 2/3 du risque de prématurité associé à l'AMP chez les fœtus porteurs de CCUsing population-Based data, we: 1) assessed the risk of congenital heart defects (CHD) in assisted reproductive techniques (ART) conceived fetuses; and 2) evaluated the effects of ART on prenatal management and perinatal outcomes of fetuses with CHD. We observed that ART were associated with a 40% increased risk of CHD without associated chromosomal anomalies (adjusted OR = 1.4 95%CI 1.1-1.7). We also found varying associations between the different methods of ART and categories of CHD. We observed that ART were associated with 2.4-Higher odds of tetralogy of Fallot (adjusted OR = 2.4 95%CI 1.5-3.7), whereas no statistically significant association was found for the three other specific CHD included. In our population, ART exposure did not seem to modify prenatal diagnosis and termination of pregnancy for fetal anomaly in fetuses with CHD compared to fetuses with CHD conceived spontaneously. The risk for premature birth in fetuses with CHD conceived following ART was 5-Fold higher as compared to fetuses with CHD conceived spontaneously (adjusted OR = 5.0 95%CI 2.9-8.6). Using a path-Analysis method, we found that multiple pregnancies contributed for about 20% to the higher risk of tetralogy of Fallot associated with ART that we had found. Finally, multiple pregnancies contributed for the 2/3 of the risk of premature birth associated with ART in fetuses with CHD
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Vincent, Anne-Violette. « L'intérêt de l'enfant à naître ». Thesis, Normandie, 2018. http://www.theses.fr/2018NORMR157.
Texte intégralRésumé :
En droit positif, la qualification de l’enfant à naître est incertaine et celui-ci ne bénéficie d’aucun statut. Pour autant, son intérêt est pris en considération depuis le droit romain à travers l’adage « infans conceptus pro nato habetur quoties de commodis ejus agitur » selon lequel l'enfant conçu est réputé né chaque fois qu’il en va de son intérêt. À l’origine, cet adage était exclusivement tourné vers la matière patrimoniale. Aujourd’hui, la préservation de l'intérêt de l’enfant à naître a connu des évolutions majeures dépassant largement cette maxime latine. Plusieurs facteurs ont été à l’origine de l’extension de la prise en considération de cet intérêt : la légalisation de l’interruption de grossesse, les techniques d’assistance médicale à la procréation, le développement de la recherche scientifique, l’évolution de la médecine prénatale et fœtale. La question de la préservation de l’intérêt de l’enfant à naître est aujourd’hui sans cesse renouvelée en raison du développement constant des pratiques médicales et scientifiques, et sous l’impulsion de la notion d’intérêt de l’enfant né.L'intérêt de l’enfant à naître entre en conflit avec d’autres droits et intérêts concurrents peu conciliables. Ces droits et intérêts font l’objet de revendications fortes dans la société et entraînent de vifs débats quant aux solutions de conciliation. L’antagonisme de ces droits et intérêts aboutit à d’importantes contradictions et incohérences difficilement surmontables. Aussi, appréhender l'intérêt de l’enfant à naître en droit positif consiste à analyser ses manifestations à l’aune de la conciliation avec les droits et intérêts concurrents. Notre étude vise à déterminer le contenu de l’intérêt de l’enfant à naître en droit français, afin de mettre en exergue les cohérences et les incohérences existantes, et ce dans une perspective de rationalisationIn positive law, the qualification of the unborn child is unclear and he has no status. However, his interest is taken into consideration since Roman law through the adage « infans conceptus pro nato habetur quoties de commodis ejus agitur » according to which the conceived child is deemed to be born whenever it is in his interest. Originally, this adage was exclusively focused on the patrimonial rights. Today, the preservation of the interest of the unborn child has undergone major changes far beyond this Latin maxim. Several factors explain this fact : the legalization of the termination of pregnancy, techniques of assisted procreation, the development of scientific research, evolution prenatal and fetal medicine. The question of preserving the unborn child’s interest is today constantly renewed because of the constant development of medical ans scientific practices, and under the impetus of the concept of the born child’s interest. The unborn child’s interest conflicts with other competing rights and competing interests. These rights and interests are the subject of strong demands in society and lead to intense debates over conciliation solutions. The antagonism of these rights and interests leads to important contradictions and inconsistencies that are difficult to resolve. Therefore, to apprehend the interest of the unborn child in positive law is to analyze its manifestations in termes of conciliation with competing rights and interests. Our study aims to determine the content of the interest of the unborn child in French law, in order to highlight the existing coherences and inconsistencies, and this in a perspective of rationalization
Livres sur le sujet "Interruption of pregnancy"
1
Glos, George Ernest. Interruption of pregnancy and abortion in European countries : A comparative survey. Washingotn, DC : Law Library of Congress, 1989.
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McMillan, Terry. The interruption of everything. Waterville, Me : Thorndike Press, 2005.
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The interruption of everything. New York : Viking, 2005.
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Our heartbreaking choices : Forty-Six Women Share Their Stories of Interrupting a Much-Wanted Pregnancy. New York, USA : iUniverse, 2008.
Trouver le texte intégralChapitres de livres sur le sujet "Interruption of pregnancy"
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Otaño, Lucas, César H. Meller et Horacio A. Aiello. « Medical Reasons for Pregnancy Interruption : Structural Abnormalities ». Dans Prenatal and Preimplantation Diagnosis, 67–96. Cham : Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18911-6_4.
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Evans, Mark I., Stephanie Andriole, Shara M. Evans et David W. Britt. « Medical Reasons for Pregnancy Interruption : Fetal Reduction ». Dans Prenatal and Preimplantation Diagnosis, 97–117. Cham : Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18911-6_5.
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Beller, F. K. « Interruption of Pregnancy After the 24th Week of Gestation ». Dans Gynecology and Obstetrics, 257–59. Berlin, Heidelberg : Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70559-5_84.
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Dungan, Jeffrey S. « Medical Reasons for Pregnancy Interruption : Chromosomal and Genetic Abnormalities ». Dans Prenatal and Preimplantation Diagnosis, 49–66. Cham : Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18911-6_3.
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W. Hoskin, D., R. A. Murgita, S. Hamel et K.-O. Gronvik. « PREGNANCY INTERRUPTION BY A MONOCLONAL ANTIBODY THAT RECOGNIZES NON-T SUPPRESSOR CELLS IN MATERNAL LYMPHOID TISSUE ». Dans Pregnancy Proteins in Animals, sous la direction de Jann Hau, 351–60. Berlin, Boston : De Gruyter, 1986. http://dx.doi.org/10.1515/9783110858167-035.
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Haspels, A. A. « Interruption of Early Pregnancy by the Antiprogestational Compound RU 486 ». Dans The Antiprogestin Steroid RU 486 and Human Fertility Control, 199–209. Boston, MA : Springer US, 1985. http://dx.doi.org/10.1007/978-1-4684-1242-0_16.
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Cinti, Saverio. « The Nutritional System ». Dans Perspectives in Nursing Management and Care for Older Adults, 215–24. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63892-4_17.
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AbstractThe white and brown adipose tissues are organized to form a true organ. They have a different anatomy and perform different functions, but they collaborate thanks to their ability to convert mutually and reversibly following physiological stimuli. This implies a new fundamental property for mature cells, which would be able to reversibly reprogram their genome under physiological conditions. The subcutaneous mammary gland provides another example of their plasticity. Here fat cells are reversibly transformed into glands during pregnancy and breastfeeding. The obese adipose organ is inflamed because hypertrophic fat cells, typical of this condition, die and their cellular residues must be reabsorbed by macrophages. The molecules produced by these cells during their reabsorption work interfere with the insulin receptor, and this induces insulin resistance, which ultimately causes type 2 diabetes. The adipose organ collaborates with those of digestion. Both produce hormones that can influence the nutritional behavior of individuals. They produce molecules that mutually influence functional activities including thermogenesis, which contributes to the interruption of the meal. The nutrients are absorbed by the intestine, stored in the adipose organ, and distributed by them to the whole body between meals. Distribution includes offspring during breastfeeding. The system as a whole is therefore called the nutritional system.
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« Interruption of Pregnancy : ». Dans The Ethics of Sex, 226–47. The Lutterworth Press, 2016. http://dx.doi.org/10.2307/j.ctt1p5f26t.17.
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Dikke, Galina, et Vladimir Ostromenskiy. « Interruption of Pregnancy in Women with the Uterine Scar : Potential Risks ». Dans Induced Abortion and Spontaneous Early Pregnancy Loss - Focus on Management. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.86282.
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Brandão, Andreia, et Filipe Portela. « Step towards Improving the Voluntary Interruption of Pregnancy by Means of Business Intelligence ». Dans Applying Business Intelligence to Clinical and Healthcare Organizations, 43–63. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-4666-9882-6.ch003.
Texte intégralRésumé :
With the implementation of Information and Communication Technologies in the health sector, it became possible the existence of an electronic record of information for patients, enabling the storage and the availability of their information in databases. However, without the implementation of a Business Intelligence (BI) system, this information has no value. Thus, the major motivation of this paper is to create a decision support system that allows the transformation of information into knowledge, giving usability to the stored data. The particular case addressed in this chapter is the Centro Materno Infantil do Norte (CMIN), in particular the Voluntary Interruption of Pregnancy (VIP) unit. With the creation of a BI system for this module, it is possible to design an interoperable, pervasive and real-time platform to support the decision-making process of health professionals, based on cases that occurred. Furthermore, this platform enables the automation of the process for obtaining key performance indicators that are presented annually by this health institution. In this chapter, the BI system implemented in the VIP unity in CMIN, some of the indicators (KPIs) evaluated as well as the benefits of this implementation are presented.
Actes de conférences sur le sujet "Interruption of pregnancy"
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Ellwanger, Juber Mateus, Caio Bertolini, Samuel Cavalcante Reis, Daniela Takito et Priscila Ribas. « RECURRENT INFILTRATING DUCTAL CARCINOMA IN LEFT MASTECTOMY PLASTRON DURING PREGNANCY : A CASE REPORT ». Dans Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1080.
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Introduction: Breast cancer has the highest incidence, prevalence, and mortality rate among malignant neoplasms in women worldwide (excluding non-melanoma skin cancer). Although there are well-defined treatments, they are still controversial during pregnancy: surgery seems safe and chemotherapy (CT) poses no harm to the fetus, especially if applied late in pregnancy. Hormone therapy (HT) and radiation therapy (RT) are prone to cause fetal damage. In patients diagnosed with pregnancy during treatment, there are no clear procedures about terminating the pregnancy or ceasing CT and RT. In these cases, it is necessary to monitor the patient and the fetus taking into account the woman’s will - especially if the tumor has estrogen and progesterone receptors, increasing the chance of relapsing or stop responding to CT. This study reports a case in which the hormones of pregnancy influenced a major recurrence of breast cancer, which diminished shortly after the birth. Case report: A 35-year-old woman, diagnosed with infiltrating ductal carcinoma in the left breast, underwent sectorectomy, axillary lymph nodes excision, and RT with an insufficient response. Subsequently, left tumor recurrence arose and mastectomy was performed. In the follow-up, she underwent CT and RT, with poor response. In the interim, it was discovered that the patient was pregnant, thus referred from oncology to gynecology for the interruption, since there was a considerable recurrence in the left breast plastron. Sixth -times pregnant, with five vaginal deliveries, the latest one six years before, all pregancies without complications. She was advised to terminate pregnancy but remained adamant in maintaining the pregnancy. She underwent an obstetric ultrasound showing a viable fetus of six weeks and six days of gestational age (GA). At 22 weeks of pregnancy, she was referred to the hospital by the oncologist for the interruption, as the plastron on the left breast was growing, with CT failure. The patient acknowledged that, with this GA, the fetus’s chance of survival was low. Yet, she opted for pregnancy continuation. Later she was sent by the prenatal care to the maternity hospital at 32 weeks of GA, aiming at delivery and a new CT protocol afterwards. She started corticosteroids for pulmonary development of the conceptus and endured cesarean delivery with bilateral adnexectomy. Female newborn, 1.830g, 8/9 APGAR score and 32 weeks and 5 days Capurro, transferred to the neonatal ICU (intensive care unit) due to prematurity. The patient was evaluated few months after delivery: great spontaneous resolution of the plastron in the left breast, with no effect of pregnancy hormones and responsive to CT. Follow-up in the oncology department.
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Meneghini, Angelita Kurle, Luiza Machado Kobe, Ana Paula Reginatto Tubiana, Alessandra Borba Anton de Souza et Felipe Pereira Zerwes. « BREAST CANCER DIAGNOSIS IN PREGNANCY DURING THE COVID-19 PANDEMIC : A CASE REPORT ». Dans Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1079.
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Introduction: Paget’s disease is a rare condition ocurring in the papillary-areolar complex, and it is associated with carcinoma, representing 0.5%–5% of all types of Breast Cancer (BC). The uniqueness of the case is related by the BC diagnosis during pregnancy, besides the COVID-19 pandemic context and its consequences. Case report: A 37-year-old woman identified a first-trimester pregnancy during preoperative exams of a nipple biopsy, which confirmed Paget’s disease. Due to the pregnancy and considering the COVID-19 pandemic, an expectant conduct follow-up was settled. After eight weeks, the patient at 26-week gestational age referred a breast lump, and a core biopsy confirmed invasive ductal carcinoma. She started treatment with neoadjuvant chemotherapy. After three cycles, the therapy was interrupted because she presented clinically local progression. The interruption of treatment and the pregnancy resolution was made at 36 gestational weeks. Posteriorly, the surgical approach involved mastectomy and axillary limph nodes dissection, followed by adjuvant chemotherapy.
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Dooper, Marten. « Endocrine interruption to pursue pregnancy does not impact short-term disease in breast cancer ». Dans SABCS 2022, sous la direction de Stefan Rauh. Baarn, the Netherlands : Medicom Medical Publishers, 2023. http://dx.doi.org/10.55788/2ce7ae0e.
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Souza, Alessandra Borba Anton de, Beatriz Fetzner, Ester da Rosa, Gustavo Roesler, Isabela Albuquerque Severo de Miranda, Marcelle Morais dos Santos, Felipe Pereira Zerwes et Antônio Luiz Frasson. « ENDOCRINE THERAPY INTAKE AND OVERALL SURVIVAL IN YOUNG WOMEN WITH BREAST CANCER ». Dans Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2073.
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Objective: Breast cancer (BC) in young women with positive hormone receptors (HR+) has a poor prognosis. There are possible clinical and biological explanations for these findings, being partially attributed to suboptimal adherence to endocrine therapy (ET). Fertility is one of the key factors for treatment discontinuation. This study aims to estimate the adherence of ET and the overall survival (OS) rate of BC/HR+ in young patients. Methods: We identified women from the public health system, diagnosed with stage I–III BC presenting at one single BC Center, between January 2006 and December 2015. Using the medical records of the hospital database, we constituted a cohort of 74 women aged ≤40 years. The discontinuation rate with associated factors and OS were summarized as percentages. Results: A total of 51 women were BC/HR+. The mean age at diagnosis was 35 years. The median follow-up was 89 months. Among them, 45% had BC recurrence (local and/or distance), and 21% died. A total of 15% of patients interrupted the ET. The reasons for interruption were pregnancy (three patients), menstrual disorders (two patients), and irregular adherence (three patients). Tamoxifen (TMX) was prescribed in 74% of cases. About 19% switched their treatment to aromatase inhibitors. The genetic risk assessment was recommended to 58% of patients, 13% performed genetic tests, and 2% of patients carried out the pathogenic mutation in the high-risk BC genes. Conclusion: This cohort showed 84% of ET intake should be improved. Pregnancy issues and irregular adherence were the main reasons for discontinuation. Considerations of 78% OS in 7 years are that TMX was the only ET for most of the cohort, and it is considered undertreatment according to the current recommendations, and the low rate of genetic tests performed leads unrecognized high risk of potential recurrence in women with hereditary BC. Research in medical records should be addressed as a limitation.
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Pagani, O., AH Partridge, F. Peccatori, HA Azim, M. Colleoni, C. Saura, JR Kroep et al. « Abstract OT1-01-06 : POSITIVE : A study evaluating Pregnancy, disease outcome and safety of interrupting endocrine therapy for premenopausal women with endocrine responsIVE breast cancer who desire pregnancy (IBCSG 48-14/BIG 8-13) ». Dans Abstracts : 2018 San Antonio Breast Cancer Symposium ; December 4-8, 2018 ; San Antonio, Texas. American Association for Cancer Research, 2019. http://dx.doi.org/10.1158/1538-7445.sabcs18-ot1-01-06.
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Pagani, Olivia, Ann H. Partridge, Fedro A. Peccatori, Hatem A. Azim, Chikako Shimizu, Cristina Saura, Ellen Warner et al. « Abstract OT1-04-02 : POSITIVE : A study evaluating pregnancy, disease outcome and safety of interrupting endocrine therapy for premenopausal women with endocrine responsive breast cancer who desire pregnancy (IBCSG 48-14/big 8-13) ». Dans Abstracts : 2019 San Antonio Breast Cancer Symposium ; December 10-14, 2019 ; San Antonio, Texas. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.sabcs19-ot1-04-02.
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Pagani, O., AH Partridge, HA Azim, F. Peccatori, M. Ruggeri et Z. Sun. « Abstract OT3-02-01 : POSITIVE : A study evaluating pregnancy and disease outcome and safety of interrupting endocrine therapy for young women with endocrine-responsive breast cancer who desire pregnancy (IBCSG 48-14/BIG 8-13) ». Dans Abstracts : 2016 San Antonio Breast Cancer Symposium ; December 6-10, 2016 ; San Antonio, Texas. American Association for Cancer Research, 2017. http://dx.doi.org/10.1158/1538-7445.sabcs16-ot3-02-01.
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Pagani, O., A. Partridge, HA Azim, FA Peccatori, M. Ruggeri et Z. Sun. « Abstract OT2-01-08 : POSITIVE : A study evaluating pregnancy and disease outcome and safety of interrupting endocrine therapy for young women with endocrine responsive breast cancer who desire pregnancy (IBCSG 48-14/BIG 8-13) ». Dans Abstracts : Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium ; December 8-12, 2015 ; San Antonio, TX. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7445.sabcs15-ot2-01-08.
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Partridge, Ann H., Samuel M. Niman, Monica Ruggeri, Fedro A. Peccatori, Hatem A. Azim, Marco Colleoni, Cristina Saura et al. « Abstract PS12-17 : Baseline characteristics of women enrolled in the POSITIVE trial (pregnancy outcome and safety of interrupting therapy for women with endocrine responsIVE breast cancer) ». Dans Abstracts : 2020 San Antonio Breast Cancer Virtual Symposium ; December 8-11, 2020 ; San Antonio, Texas. American Association for Cancer Research, 2021. http://dx.doi.org/10.1158/1538-7445.sabcs20-ps12-17.
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Hull, Russell D., et Gary E. Raskob. « TREATMENT OF DEEP VENOUS THROMBOSIS AND ECONOMIC ASPECTS ». Dans XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642968.
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Initial therapy with intravenous heparin, followed by long-term anticoagulant therapy for three months or more, is the treatment of choice for most patients with acute venous thrombosis. Inferior vena caval interruption, using a transvenously inserted filter, is the management of choice for preventing pulmonary embolism in patients in whom anticoagulant therapy is contraindicated, and in the very rare patient in whom anticoagulant therapy is ineffective. The role of thrombolytic therapy has not been completely resolved. It was hoped that thrombolytic therapy would minimize or prevent the post-phlebitic syndrome; unfortunately, this may not be the case because the critical factor in the development of the post-phlebitic syndrome appears to be venous valve damage, which occurs early in the formation of venous thrombosis. Thrombolytic therapy should be considered in selected patients with acute massive venous thrombosis (eg. the patient with phlegmasia cerulea dolens).Intravenous heparin administered in doses which prolong the activated partial thromboplastin time (APTT) to 1.5 to 2 times control is highly effective and is associated with a low frequency (2%) of recurrent venous thromboembolism. A recent randomized trial (1) in patients with proximal-vein thrombosis indicates that failure to achieve an adequate anticoagulant response (APTT > 1.5 times control) is associated with a high risk (20%) of recurrent venous thromboembolism. Therefore, sufficient heparin should be administered to maintain the APTT above 1.5 times the control value.Intravenous heparin is continued for 7 to 10 days, overlapped with oral anticoagulant therapy for 4 to 5 days before heparin is stopped. Multiple randomized clinical trials in patients with proximal-vein thrombosis indicate that when heparin is administered for 7 to 10 days, followed by adequate long-term anticoagulant therapy, the frequency of recurrent venous thromboembolism is very low (2%). An alternative approach is to commence heparin and oral anticoagulants together at the time of diagnosis, and to discontinue heparin on the fourth or fifth day. If this latter approach is effective, it would avoid 4 to 5 days of unnecessary hospitalization in many patients, and would markedly reduce the cost of initial heparin therapy. A recent randomized trial (2) in patients with submassive venous thromboembolism suggests that 4 to 5 days of initial heparin therapy is effective and safe, but this approach must be evaluated by further randomized clinical trials before it is routinely recommended.Recent clinical trials indicate that inadequate long-term therapy in patients with proximal-vein thrombosis results in a high frequency (40-50%) of recurrent venous thromboembolism and is cost-ineffective because of the diagnostic and treatment costs of recurrent venous thromboembolism (3). The risk of recurrence is markedly reduced to 2% by adequate long-term anticoagulant therapy with warfarin sodium or adjusted subcutaneous heparin; both of these approaches are markedly more cost-effective than inadequate long-term therapy (3). Oral anticoagulant therapy with warfarin sodium for three months (or longer in selected patients), is less expensive than adjusted subcutaneous heparin and is preferred in most patients with acute proximal-vein thrombosis. The risk of bleeding associated with oral anticoagulant therapy can be reduced to less than 5%, without loss of effectiveness for preventing recurrent venous thromboembolism, by adjusting the dose of warfarin sodium to achieve a less intense anticoagulant effect (PT 1.25 to 1.5 times control using a rabbit brain thromboplastin such as Simplastin or Dade-C, corresponding to an INR of 2.0 to 3.0). Less intense warfarin sodium therapy is the most cost-effective of the alternative long-term anticoagulant regimens (3). Adjusted dose subcutaneous heparin is an effective and safe alternative to warfarin sodium; although slightly more expensive, it is the long-term regimen of choice in pregnant patients, and in patients returning to geographically remote areas lacking the facilities for anticoagulant monitoring (in whom the dose is adjusted during the first few days of long-term therapy and then fixed). REFERENCES: (1) Hull R, Raskob G, Hirsh J et al. N Engl J Med 1986;315:1109-1114. (2) Gallus A, Jackaman J, Tillett J et al.Lancet 1986;2:1293-1296. (3) Hull R, Raskob G, Hirsh J, Sackett DL. JAMA 1984;252:235-239.
Rapports d'organisations sur le sujet "Interruption of pregnancy"
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Epstein, Suzanne. The interruption of the developmental tasks through pregnancy in the female adolescent. Portland State University Library, janvier 2000. http://dx.doi.org/10.15760/etd.2777.
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Viswanathan, Meera, Jennifer Cook Middleton, Alison Stuebe, Nancy Berkman, Alison N. Goulding, Skyler McLaurin-Jiang, Andrea B. Dotson et al. Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women : A Systematic Review of Perinatal Pharmacologic Interventions. Agency for Healthcare Research and Quality (AHRQ), avril 2021. http://dx.doi.org/10.23970/ahrqepccer236.
Texte intégralRésumé :
Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.