Table Of ContentVoluntary Termination of 
Pregnancy
Advances in Reproductive Health Care 
(1984/85) 
E. S. E. Hafez: Series Editor 
LHRH and Its Analogs: Contraception and Therapeutic 
Applications 
H. Vickery, J. J. Nestor, Jr. and E. S. E. Hafez (editors) 
Spontaneous Abortion 
E. S. E. Hafez (editor) 
Voluntary Termination of Pregnancy 
E. S. E. Hafez (editor) 
Biomedical Aspects of IUDs 
H. Hasson, W. A. A. van Os and E. S. E. Hafez (editors) 
Prostaglandins and Fertility Regulation 
M. Toppozada, M. Bygdeman and E. S. E. Hafez (editors) 
Male Fertility and Its Regulation 
T. Lobi and E. S. E. Hafez (editors)
Advances in 
Reproductive Health Care 
Voluntary 
Termination 
of  Pregnancy 
Editor 
E.  S.  E.  Hafez 
Reproductive Health Center and 
IVF jAndrology International 
MTP PRESS LIMITED  l1li... 
~  a member of the KLUWER ACADEMIC PUBLISHERS GROUP  •• 
LANCASTER I BOSTON I THE HAGUE I DORDRECHT  .~
Published in the UK and Europe by 
MTP Press Limited 
Falcon House 
Lancaster, England 
British Library Cataloguing in Publication Data 
Voluntary termination of pregnancy. 
(Advances in reproductive health care; 
1. Abortion 
I.  Hafez, E. S. E.  II. Series 
618.8'8  RG734 
Published in the USA by 
MTP Press 
A division of Kluwer Boston Inc 
190 Old Derby Street 
Hingham, MA 02043, USA 
Library of Congress Cataloging in Publication Data 
Main entry under title: 
Voluntary termination of pregnancy. 
(Advances in reproductive health care) 
Bibliography: p. 
Includes index. 
1. Abortion.  I.  Hafez, E. S. E., 1922-
II. Series.  (DNLM: 1. Abortion, Induced-Congresses. 
WQ 440 V943 1982) 
RG734.V64  1984  618.8'8  84-9691 
ISBN-13: 978-94-011-6680-5  e-ISBN-13: 978-94-011-6678-2 
DO I: 10.1007/978-94-011-6678-2 
Copyright © 1984 MTP Press Limited 
Softcover reprint of the hardcover 1s t edition 1984 
All rights reserved. No part of this publication 
may be reproduced,stored in a retrieval 
system, or transmitted in any form or by any 
means, electronic, mechanical, photocopying, 
recording or otherwise, without prior permission 
from the publishers.
Contents 
List of Contributors  vii 
I.  EPIDEMIOLOGY 
Epidemiology of Induced Abortion in Japan 
K. Shiota and H. Nishimura  3 
2 Epidemiology of Induced Abortion in the Middle East 
M.  M. Ahmad  11 
II.  METHODOLOGY  25 
3 Mid-trimester Abortion using Extraovular Normal Saline 
H. Abramovici, A. Rofe, J. Atad and J. H. Faktor  27 
4 Stretch-induced Abortion at Mid-trimester 
Y. Manabe, A. Nakajima and Y.  Yoshida  31 
5 Treatment of Intrauterine Fetal Death by Intracervical and 
Extra-amniotic PGF ./PGE
2 2 
W. Rath, W. Kuhn and H. Kuhnle  49 
6 Extra-amniotic Prostaglandins for Second Trimester 
Abortion 
M. P. Embrey and I. Z. MacKenzie  57 
7 New Prostaglandin Delivery Systems 
M. P. Embrey  67 
8 lamina ria Treatment prior to late Mid-trimester Abortion 
by Uterine Evacuation 
P. G. Stubblefield, A. M. Altman and S. P. Goldstein  75 
9 Ethacridine  (Rivanol R )-catheter  Technique  in  Second 
Trimester Abortion 
C. A. Ingemanson  83 
v
CONTENTS 
III. CLINICAL ASPECTS  91 
10 Hemostasis in Abortion 
R. C. Briel  93 
11  Complications of Induce8 Abortion 
V. M. Sadauskas and V. J. Czigreiene  99 
12 Effects  of  Spontaneous  and  Induced  Abortions  on 
Subsequent Pregnancies and Fetal Outcome 
N. Klearchou, J. Bontis and S. Mantalenakis  107 
13 Prophylactic Antibiotics in Induced Abortion 
L. Heisterberg, S. Sonne-Holm and J. T. Andersen  113 
IV.  PSYCHOSOCIAL ASPECTS  127 
14 Legal  Aspects of Scientific Research  on  Fetuses  in The 
Netherlands 
E. M. Derks-Hammelburg, W. A. A. van Os and 
P. E. R. Rhemrev  129 
15 Psychosocial Aspects of VIP in Historical Perspective: A 
case study of North-East Scotland 
B. Thompson R. IIIsley and R. Halliwell  137 
16 Legal Aspects of Abortion 
M. M. Baylson  147 
17 Law and Abortion in Italy 
M. Filicori, C. Flamigni and E. Saviotti  155 
18 Epilogue 
E.SE.~~  1~ 
vi
List of Contri butors 
H. ABRAMOVICI  University of Tuebingen, 
Department of Obstetrics and Gynecology,  D-7400 Tuebingen, FRG 
Carmel Medical Center, 
Haifa 34362, Israel  V. J. CZIGREIENE 
Department of Obstetrics and Gynecology, 
M. M. AHMAD  Kaunas Medical Institute, 
Department of Obstetrics and Gynecology,  Kaunas-233007 Eivieniu 2, 
The University of Texas Health Science  Lithuanian SSR. USSR 
Center at San Antonio, 
7703 Floyd Curl Drive, San Antonio,  E. M. DERKS-HAMMELBURG 
Texas 78284, USA  Elisabeth Gasthius, Boerhaavelaan 22, 
Haariem, The Netherlands 
A. M. ALTMAN 
Department of Obstetrics and Gynecology,  M. P. EMBREY 
Harvard Medical School and Brigham and  Nuffield Department of 
Women's Hospital (formerly the Boston  ObstetricsjGynaecology, 
Hospital for Women).  John Radcliffe Hospital, 
Boston, Massachusetts, USA  Headington, 
Oxford OX3 9DU, UK 
J. T. ANDERSEN 
Department of Gynecology and Obstetrics,  J. H. FAKTOR 
Gentofte and Herlev Hospitals,  Department of Obstetrics and Gynecology, 
University of Copenhagen, Denmark  Carmel Medical Center, 
Haifa 34362, Israel 
J. ATAD 
Department of Obstetrics and Gynecology,  M. FILICORI 
Carmel Medical Center,  Vincent Research Laboratories, 
Haifa 34362, Israel  Department of Gynecology, 
Massachusetts General Hospital, 
M. M. BAYLSON  Boston, Massachusetts 02114, USA 
Duane, Morris and Heckscher, 
One Franklin Plaza,  C. FLAMIGNI 
Philadelphia 19102, USA  Department of Reproductive Medicine, 
University of Bologna, 
J. BONTIS  Via Massarenti 13, 
First Department of Obstetrics and  40138 Bologna, Italy 
Gynecology, 
Aristotelian University of Thessaloniki  S. P. GOLDSTEIN 
Medical School,  Department of Obstetrics and Gynecology, 
Thessaloniki, Greece  Harvard Medical School and the Brigham 
and Women's Hospital (formerly the 
R. C. BRIEL  Boston Hospital for Women), 
Department of Obstetrics and Gynecology,  Boston, Massachusetts, USA 
vii
LIST OF CONTRIBUTORS 
E. S. E. HAFEZ  S. MANTALENAKIS 
IVF/Andrology International,  First Department of Obstetrics and 
Reproductive Health Center  Gynecology, 
Medical University of  Aristotelian University of Thessaloniki 
South Carolina,  Medical School, 
171 Ashley, Charleston,  Thessaloniki, Greece 
SC 29425, USA 
A. NAKAJIMA 
R. HALLIWELL  Department of Obstetrics and Gynecology, 
MRC Medical Sociology Unit,  Ehime University School of Medicine, 
Institute of Medical Sociology,  Ehime 791, Japan 
Westburn Road, Aberdeen AB9 2ZE, 
Scotland, UK  H. NISHIMURA 
Central Institute for Experimental Animals, 
L. HEISTER BERG  Miyamae-Ku, Kawasaki 213, Japan 
Departments of Gynecology and 
Obstetrics,  W. RATH 
Gentofte and Herlev Hospitals,  Department of Gynecology and Obstetrics, 
University of Copenhagen, Denmark  University Gottingen, Humboldtalle 3, 
D-3400 Gottingen, FRG 
R.ILLSLEY 
MRC Medical Sociology Unit,  P. E. R. RHEMREV 
Institute of Medical Sociology,  Department of Gynecology and Obstetrics, 
Westburn Road, Aberdeen AB9 2ZE,  Elisabeth Gasthius, Boerhaavelaan 22, 
Scotland, UK  Haarlem, The Netherlands 
C. A. INGEMANSON  A. ROFE 
Department of Obstetrics and Gynecology, 
Obstetrics and Gynecology Department, 
Carmel Medical Center, 
Central Hospital, Eskilstuna, 
Haifa 34362, Israel 
Sweden 
N. KLEARCHOU  V. M. SADAUSKAS 
First Department of Obstetrics and  Department of Obstetrics and Gynecology, 
Gynecology,  Kaunas Medical Institute, 
Aristotelian University of Thessaloniki  Kaunas-233007 Eivieniu 2, 
Medical School,  Lithuanian SSR. USSR 
Thessaloniki, Greece 
E. SAVIOTII 
Department of Reproductive Medicine, 
W. KUHN 
University of Bologna, Via Massarenti 13, 
Department of Gynecology and Obstetrics, 
40138 Bologna, Italy 
University Gottingen, Humboldtalle 3, 
D-3400 Gottingen, FRG 
K. SHIOTA 
Congenital Anomaly Research Center, 
H. KOHNLE  Faculty of Medicine, Kyoto University, 
Department of Gynecology and Obstetrics,  Kyoto 606, Japan 
University Gottingen, Humboldtalle 3, 
D-3400 Gottingen, FRG  S. SONNE-HOLM 
Department of Gynecology and Obstetrics, 
I. Z. MACKENZIE  Gentofte and Herlev Hospitals, 
N uffield Department of  University of Copenhagen, Denmark 
Obstetrics/Gynaecology, 
John Radcliffe Hospital. Headington, 
Oxford OX3 9DU, UK  P. G. STUBBLEFIELD 
Department of Obstetrics and Gynecology, 
Y. MANABE  Harvard Medical School and the Brigham 
Department of Obstetrics and Gynecology,  . and Women's Hospital (formerly Boston 
Kyoto University School of Medicine,  Hospital for Women), 
Sakyo-Ku, Kyoto 606, Japan  Boston, Massachusetts, USA 
viii
LIST OF CONTRIBUTORS 
B. THOMPSON  Y. YOSHIDA 
MRC Medical Sociology Unit,  Department of Obstetrics and Gynecology, 
Institute of Medical Sociology,  Shiga University of Medical School, 
Westburn Road, Aberdeen AB9 2ZE,  Shiga 520, Japan 
Scotland, UK 
W. A. A. VAN OS 
Department of Gynecology and Obstetrics, 
Elisabeth Gasthuis, Boerhaavelaan 22, 
Haarlem, The Netherlands 
ix