Document Detail


Surgical management of early pregnancy failure: history, politics, and safe, cost-effective care.
MedLine Citation:
PMID:  17466695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early pregnancy failure and induced abortion are often managed differently, even though safe uterine evacuation is the goal in both. Early pregnancy failure is commonly treated by curettage in operating room settings in anesthetized patients. Induced abortion is most commonly managed by office vacuum aspiration in awake or sedated patients. Medical evidence does not support routine operating room management of early pregnancy failure. This commentary reviews historical origins of these different care standards, explores political factors responsible for their perpetuation, and uses experience at University of Michigan to dramatize the ways in which history, politics, and biomedicine intersect to produce patient care. The University of Michigan initiated office uterine evacuations for early pregnancy failure treatment. Patients previously went to the operating room. These changes required faculty, staff, and resident education. Our efforts blurred the lines between spontaneous and induced abortion management, improved patient care and better utilized hospital resources.
Authors:
Lisa H Harris; Vanessa K Dalton; Timothy R B Johnson
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Publication Detail:
Type:  Historical Article; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  196     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-30     Completed Date:  2007-05-17     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445.e1-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Division of Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents / therapeutic use
Abortion, Incomplete / drug therapy,  surgery*
Abortion, Induced / economics,  history,  legislation & jurisprudence,  methods*
Ambulatory Surgical Procedures
Attitude of Health Personnel
Cost-Benefit Analysis
Female
History, 20th Century
History, 21st Century
Humans
Politics*
Pregnancy
Pregnancy Trimester, First
United States
Vacuum Curettage / history,  legislation & jurisprudence
Grant Support
ID/Acronym/Agency:
1 K12 HDO1438-01//PHS HHS
Chemical
Reg. No./Substance:
0/Abortifacient Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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