Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care

396 Pages·2009·8.61 MB·English

by  Maureen Paul

BLBK137-Paul February26,2009 4:9
Management of
Unintended and
Abnormal Pregnancy
Comprehensive Abortion Care
Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care
Edited by M. Paul, E. S. Lichtenberg, L. Borgatta, D. A. Grimes, P. G. Stubblefield
and M. D. Creinin © 2009 Blackwell Publishing Ltd. ISBN: 978-1-405-17696-5
i
BLBK137-Paul February26,2009 4:9
This book is dedicated to family planning and abortion providers throughout the world whose expertise,
courage,andcommitmentmakesuchadifferenceinwomen’slives.
ii
BLBK137-Paul February26,2009 4:9
Management of
Unintended and
Abnormal Pregnancy
Comprehensive Abortion Care
Edited by
Maureen Paul,
MD, MPH
E. Steve Lichtenberg,
MD, MPH
Lynn Borgatta,
MD, MPH
David A. Grimes,
MD
Phillip G. Stubblefield,
MD
Mitchell D. Creinin,
MD
Illustrator: Lisa Pen˜alver,
BA, AMI
A John Wiley & Sons, Ltd., Publication
iii
BLBK137-Paul February26,2009 4:9
Thiseditionfirstpublished2009,(cid:1)C 2009byBlackwellPublishingLtd
BlackwellPublishingwasacquiredbyJohnWiley&SonsinFebruary2007.Blackwell’s
publishingprogramhasbeenmergedwithWiley’sglobalScientific,TechnicalandMedical
businesstoformWiley-Blackwell.
Registeredoffice:JohnWiley&SonsLtd,TheAtrium,SouthernGate,Chichester,West
Sussex,PO198SQ,UK
Editorialoffices:9600GarsingtonRoad,Oxford,OX42DQ,UK
TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK
111RiverStreet,Hoboken,NJ07030-5774,USA
Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabout
howtoapplyforpermissiontoreusethecopyrightmaterialinthisbook,pleaseseeour
websiteatwww.wiley.com/wiley-blackwell.
Therightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedin
accordancewiththeCopyright,DesignsandPatentsAct1988.
Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrieval
system,ortransmitted,inanyformorbyanymeans,electronic,mechanical,photocopying,
recordingorotherwise,exceptaspermittedbytheUKCopyright,DesignsandPatentsAct
1988,withoutthepriorpermissionofthepublisher.
Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappears
inprintmaynotbeavailableinelectronicbooks.
Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedas
trademarks.Allbrandnamesandproductnamesusedinthisbookaretradenames,service
marks,trademarksorregisteredtrademarksoftheirrespectiveowners.Thepublisherisnot
associatedwithanyproductorvendormentionedinthisbook.Thispublicationisdesigned
toprovideaccurateandauthoritativeinformationinregardtothesubjectmattercovered.It
issoldontheunderstandingthatthepublisherisnotengagedinrenderingprofessional
services.Ifprofessionaladviceorotherexpertassistanceisrequired,theservicesofa
competentprofessionalshouldbesought.
Thecontentsofthisworkareintendedtofurthergeneralscientificresearch,understanding,
anddiscussiononlyandarenotintendedandshouldnotberelieduponasrecommending
orpromotingaspecificmethod,diagnosis,ortreatmentbyphysiciansforanyparticular
patient.Thepublisherandtheauthormakenorepresentationsorwarrantieswithrespect
totheaccuracyorcompletenessofthecontentsofthisworkandspecificallydisclaimall
warranties,includingwithoutlimitationanyimpliedwarrantiesoffitnessforaparticular
purpose.Inviewofongoingresearch,equipmentmodifications,changesingovernmental
regulations,andtheconstantflowofinformationrelatingtotheuseofmedicines,
equipment,anddevices,thereaderisurgedtoreviewandevaluatetheinformation
providedinthepackageinsertorinstructionsforeachmedicine,equipment,ordevicefor,
amongotherthings,anychangesintheinstructionsorindicationofusageandforadded
warningsandprecautions.Readersshouldconsultwithaspecialistwhereappropriate.The
factthatanorganizationorWebsiteisreferredtointhisworkasacitationand/ora
potentialsourceoffurtherinformationdoesnotmeanthattheauthororthepublisher
endorsestheinformationtheorganizationorWebsitemayprovideorrecommendationsit
maymake.Further,readersshouldbeawarethatInternetWebsiteslistedinthisworkmay
havechangedordisappearedbetweenwhenthisworkwaswrittenandwhenitisread.No
warrantymaybecreatedorextendedbyanypromotionalstatementsforthiswork.Neither
thepublishernortheauthorshallbeliableforanydamagesarisingherefrom.
ISBN:978-1-4051-7696-5
AcataloguerecordforthisbookisavailablefromtheBritishLibrary.
Setin9/12ptMeridienbyAptara(cid:1)R Inc.,NewDelhi,India
PrintedandboundintheUKbyTJInternational
1 2009
iv
BLBK137-Paul February26,2009 4:9
Contents
ListofContributors,vii
Foreword,x
AllanRosenfield,MD
Foreword,xiii
MalcolmPotts,MB,BChir,PhD,FRCOG
Preface,xv
SectionI Abortioninperspective
1 Abortionandmedicine:Asociopoliticalhistory,1
CaroleJoffePhD
2 Unsafeabortion:Theglobalpublichealthchallenge,10
IqbalH.ShahPhD,andElisabethA˚hmanMA
3 UnintendedpregnancyandabortionintheUSA:Epidemiologyandpublichealthimpact,24
StanleyK.HenshawPhD
4 AbortionlawandpolicyintheUSA,36
BonnieScottJonesJD,andJenniferDalvenJD
SectionII Pre-procedurecare
5 Informedconsent,patienteducation,andcounseling,48
AnneBakerMA,andTerryBeresfordBA
6 Clinicalassessmentandultrasoundinearlypregnancy,63
StevenR.GoldsteinMD,andMatthewF.ReevesMD,MPH
7 Medicalevaluationandmanagement,78
AnneDavisMD,MPH,andThomasEasterlingMD
8 Painmanagement,90
MarkNicholsMD,GlennaHalvorson-BoydPhD,RN,RobertGoldsteinMD,CliffordGevirtzMD,MPHand
DavidHealowMD
SectionIII Abortionmethodsandtechniques
9 Medicalabortioninearlypregnancy,111
MitchellD.CreininMD,andKristinaGemzellDanielssonMD,PhD
v
BLBK137-Paul February26,2009 4:9
vi Contents
10 First-trimesteraspirationabortion,135
KarenMeckstrothMD,MPH,andMaureenPaulMD,MPH
11 Dilationandevacuation,157
CassingHammondMD,andStephenChasenMD
12 Medicalmethodstoinduceabortioninthesecondtrimester,178
NathalieKappMD,MPH,andHelenavonHertzenMD,DDS
13 Thechallengingabortion,193
LynnBorgattaMD,MPH,andPhillipG.StubblefieldMD
SectionIV Post-procedurecare
14 Contraceptionandsurgicalabortionaftercare,208
EveEspeyMD,MPH,andLauraMacIsaacMD,MPH
15 Surgicalcomplications:Preventionandmanagement,224
E.SteveLichtenbergMD,MPH,andDavidA.GrimesMD
16 Answeringquestionsaboutlong-termoutcomes,252
CarolJ.RowlandHoguePhD,MPH,LoriA.BoardmanMD,ScM,andNadaStotlandMD,MPH
SectionV Managementofabnormalpregnancies
17 Pregnancyloss,264
AlisaB.GoldbergMD,MPH,DanielaCarusiMD,MSc,andCarolynWesthoffMD
18 Ectopicpregnancy,280
JenniferL.KulpMD,andKurtT.BarnhartMD,MSCE
19 Gestationaltrophoblasticdisease,293
NeilJ.SebireMD,andMichaelJ.SecklMD,PhD
20 Abortionforfetalabnormalitiesormaternalconditions,302
JeffreyS.DunganMD,andLeeP.ShulmanMD
21 Multifetalpregnancyreductionandselectivetermination,312
MarkI.EvansMD,andDavidW.BrittPhD
SectionVI Abortionservicedelivery
22 Providingabortioninlow-resourcesettings,319
LauraCastlemanMD,MPH,MBA,BeverlyWinikoffMD,MPH,andPaulBlumenthalMD,MPH
23 Ensuringqualitycareinabortionservices,335
BethKruseMS,CNM,ARNP,andCarlaEckhardtCPHQ
Appendix:Resourcesforabortionproviders,352
MelissaWernerMPH,MAT
Index,369
Colorplatesectionfollowsp.368
BLBK137-Paul February26,2009 4:9
List of contributors
ElisabethÅhman,MA DanielaCarusi,MD,MSc
DepartmentofReproductiveHealthandResearch InstructorinObstetrics,GynecologyandReproductiveBiology
WorldHealthOrganization HarvardMedicalSchool
Geneva,Switzerland BrighamandWomen’sHospital
Boston,MAUSA
AnneBaker,MA
DirectorofCounseling LauraCastleman,MD,MPH,MBA
TheHopeClinicforWomen,Ltd. MedicalDirector
GraniteCity,ILUSA Ipas
ChapelHill,NCUSA
AdjunctClinicalAssistantProfessor
KurtT.Barnhart,MD,MSCE
DepartmentofObstetrics&Gynecology
AssociateDirector
UniversityofMichiganSchoolofMedicine
PennFertilityCare
AnnArbor,MIUSA
DirectorofClinicalResearchfortheDepartmentof
ObstetricsandGynecology
AssociateProfessorofObstetricsandGynecology StephenT.Chasen,MD
UniversityofPennsylvaniaSchoolofMedicine AssociateProfessorofObstetricsandGynecology
Philadelphia,PAUSA WeillMedicalCollegeofCornellUniversity
NewYork,NYUSA
TerryBeresford,BA
Consultant MitchellD.Creinin,MD
Alexandria,VAUSA Professor
DepartmentofObstetrics,Gynecology&ReproductiveSciences
DivisionofGynecologicSpecialties
PaulD.Blumenthal,MD,MPH
UniversityofPittsburghSchoolofMedicine
Professor
ProfessorofEpidemiology
DepartmentofObstetrics&Gynecology
UniversityofPittsburghGraduateSchoolofPublicHealth
StanfordUniversitySchoolofMedicine
Pittsburgh,PAUSA
Stanford,CAUSA
JenniferDalven,JD
LoriA.Boardman,MD,ScM
DeputyDirector
ProfessorofObstetricsandGynecology
ReproductiveFreedomProject
CollegeofMedicine
AmericanCivilLibertiesUnionFoundation
UniversityofCentralFlorida
NewYork,NYUSA
Orlando,FLUSA
LynnBorgatta,MD,MPH AnneDavis,MD,MPH
AssociateProfessor AssistantClinicalProfessorofObstetricsandGynecology
DepartmentofObstetricsandGynecology ColumbiaUniversityCollegeofPhysiciansandSurgeons
BostonUniversitySchoolofMedicine ColumbiaPresbyterianMedicalCenter
Boston,MAUSA NewYork,NYUSA
DavidW.Britt,PhD JeffreyS.Dungan,MD
DepartmentChair,Professor AssociateProfessor
DepartmentofHealth&SportSciences DivisionofReproductiveGenetics
UniversityofLouisville DepartmentofObstetricsandGynecology
Louisville,KYUSA NorthwesternUniversityFeinbergSchoolofMedicine
vii
BLBK137-Paul February26,2009 4:9
viii ListofContributors
NMH/PrenticeWomen’sHospital StevenR.Goldstein,MD
Chicago,ILUSA Professor
DepartmentofObstetricsandGynecology
ThomasEasterling,MD NewYorkUniversitySchoolofMedicine
ProfessorMFM NewYork,NYUSA
DepartmentofObstetrics&Gynecology
UniversityofWashingtonSchoolofMedicine DavidA.Grimes,MD
Seattle,WAUSA ClinicalProfessor
DepartmentofObstetrics&Gynecology
CarlaEckhardt,CPHQ DivisionofWomen’sPrimaryHealthcare
Co-founder UniversityofNorthCarolinaSchoolofMedicine
bdiConsulting ChapelHill,NCUSA
ExecutiveDirector
AdvancingNewStandardsinReproductiveHealth(ANSIRH)
GlennaHalvorson-Boyd,PhD,RN
andProgramonReproductiveHealthandthe
Co-Director
Environment(PRHE)
FairmountCenter
UniversityofCalifornia,SanFrancisco
Dallas,TXUSA
SanFrancisco,CAUSA
CassingHammond,MD
EveEspey,MD,MPH
Director
AssociateProfessor
SectionandFellowshipinFamilyPlanning&Contraception
GeneralObstetrics&Gynecology
AssociateProfessorofObstetricsandGynecology
UniversityofNewMexicoSchoolofMedicine
NorthwesternUniversityFeinbergSchoolofMedicine
Albuquerque,NMUSA
Chicago,ILUSA
MarkI.Evans,MD
DavidHealow,MD
President
AssociateMedicalDirectorforSurgicalServices
FetalMedicineFoundationofAmerica
IntermountainPlannedParenthood
Director
Billings,MTUSA
ComprehensiveGenetics
ClinicalProfessor
StanleyK.Henshaw,PhD
Obstetrics,GynecologyandReproductiveScience
SeniorFellow
Mt.SinaiSchoolofMedicine
GuttmacherInstitute
NewYork,NYUSA
NewYork,NYUSA
KristinaGemzellDanielsson,MD,PhD
CarolJ.RowlandHogue,PhD,MPH
Professor
TerryProfessorofMaternalandChildHealth
DepartmentofObstetricsandGynecology
Director
KarolinskaUniversityHospital
Women’sandChildren’sCenter
KarolinskaInstitutet
ProfessorofEpidemiology
Stockholm,Sweden
RollinsSchoolofPublicHealth
RobertW.WoodruffHealthSciencesCenter
CliffordGevirtz,MD,MPH
EmoryUniversity
MedicalDirector
Atlanta,GAUSA
SomniaPainManagement
AdjunctAssociateProfessorofAnesthesiology
CaroleJoffe,PhD
LouisianaStateUniversity-NewOrleans
NewYork,NYUSA Professor
DepartmentofSociology
UniversityofCalifornia,Davis
AlisaB.Goldberg,MD,MPH
Davis,CAUSA
DirectorofClinicalResearchandTraining
PlannedParenthoodLeagueofMassachusetts,Inc.
AssistantProfessorofObstetrics,GynecologyandReproductiveBiology BonnieScottJones,JD
HarvardMedicalSchool DeputyDirector
Director U.S.LegalProgram
DivisionofFamilyPlanning CenterforReproductiveRights
BrighamandWomen’sHospital NewYork,NYUSA
Boston,MAUSA
NathalieKapp,MD,MPH
RobertC.Goldstein,MD MedicalOfficer
ChiefMedicalOfficer DepartmentofReproductiveHealthandResearch
Somnia,Inc. WorldHealthOrganization
NewRochelle,NYUSA Geneva,Switzerland
BLBK137-Paul February26,2009 4:9
ListofContributors ix
BethKruse,MS,CNM,ARNP ConsultantPathologisttotheTrophoblasticDiseaseUnit,
AssociateDirectorofClinicalServices CharingCrossHospital
NationalAbortionFederation London,UnitedKingdom
Washington,DCUSA
MichaelJ.Seckl,MD,PhD
JenniferL.Kulp,MD ProfessorofMolecularCancerMedicine
Women’sHealthClinicalResearchCenter ImperialCollegeSchoolofMedicine
UniversityofPennsylvaniaMedicalCenter Director
Philadelphia,PAUSA GestationalTrophoblasticDiseaseCentre
DepartmentofCancerMedicine
CharingCrossHospital
E.SteveLichtenberg,MD,MPH
London,UnitedKingdom
MedicalDirector
FamilyPlanningAssociatesMedicalGroup,Limited
AssistantProfessorinClinicalObstetricsandGynecology IqbalH.Shah,PhD
NorthwesternUniversityFeinbergSchoolofMedicine Coordinator
Chicago,ILUSA PreventingUnsafeAbortion
UNDP/UNFPA/WHO/WorldBankSpecialProgrammeinHuman
Reproduction
LauraMacIsaac,MD,MPH
DepartmentofReproductiveHealthandResearch
Director
WorldHealthOrganization
DivisionofFamilyPlanning
Geneva,Switzerland
BethIsraelMedicalCenter
AssistantProfessor
DepartmentofObstetrics&GynecologyandWomen’sHealth LeeP.Shulman,MD
AlbertEinsteinCollegeofMedicine AnnaRossLaphamProfessorinObstetricsandGynecology
NewYork,NYUSA Chief
DivisionofReproductiveGenetics
NorthwesternUniversityFeinbergSchoolofMedicine
KarenMeckstroth,MD,MPH
Chicago,ILUSA
AssociateClinicalProfessor
DepartmentofObstetrics,Gynecology&ReproductiveSciences
Director NadaStotland,MD,MPH
UCSFFamilyPlanningatMt.Zion Professor
UniversityofCalifornia,SanFrancisco DepartmentofPsychiatry
SanFrancisco,CAUSA RushMedicalCollegeofRushUniversity
Chicago,ILUSA
MarkNichols,MD
Professor PhillipG.Stubblefield,MD
DepartmentofObstetricsandGynecology Professor
OregonHealth&ScienceUniversitySchoolofMedicine DepartmentofObstetricsandGynecology
Portland,ORUSA BostonUniversitySchoolofMedicine
Boston,MAUSA
MaureenPaul,MD,MPH
ChiefMedicalOfficer HelenavonHertzen,MD,DDS
PlannedParenthoodofNewYorkCity MedicalOfficer
AssociateClinicalProfessor DepartmentofReproductiveHealthandResearch
DepartmentofObstetrics,Gynecology&ReproductiveScience WorldHealthOrganization
Mt.SinaiSchoolofMedicine Geneva,Switzerland
NewYork,NYUSA
MelissaWerner,MPH,MAT
MatthewF.Reeves,MD,MPH ReproductiveandWomen’sHealthConsultant
AssistantProfessor Washington,DCUSA
DepartmentofObstetrics,Gynecology&ReproductiveSciences
UniversityofPittsburghSchoolofMedicine
CarolynWesthoff,MD
Pittsburgh,PAUSA
ColumbiaUniversityMedicalCenter
NewYork,NYUSA
NeilJ.Sebire,MD
ConsultantinPediatricPathology
BeverlyWinikoff,MD,MPH
DepartmentofHistopathology
President
GreatOrmondStreetHospital
GynuityHealthProjects
NewYork,NYUSA