• Congenital diaphragmatic hernia: improved surgical results should influence abortion decision making

      Gudbjartsson, T; Gunnarsdottir, A; Topan, C Z; Larssons, L T; Rosmundsson, Th; Dagbjartsson, A; Department of Cardiothoracic surgery, Landspitali University Hospital, Reykjavik, Iceland. tomasgud@landspitali.is (The Finnish Surgical Society, 2008-03-15)
      AIMS: To compare surgical results for congenital diaphragmatic hernia (CDH) in two Scandinavian university hospitals and to evaluate the effects of abortions on the clinical profile of CDH in Iceland. METHODS: A retrospective study including all CDH-cases in Iceland 1983-2002 and children referred to Lund University Hospital 1993-2002. Aborted fetuses with CDH from a nation-wide Icelandic abort-registry were also included. RESULTS: In Iceland, 19 out of 23 children with CDH were diagnosed < 24 hours from delivery, one with associated anomalies. Eight fetuses were diagnosed prenatally and seven of them aborted, three having isolated CDH at autopsy. In Iceland, 15 of 18 children operated on survived surgery (83% operative survival). In Lund 28 children were treated with surgery, 23 of them diagnosed early after birth or prenatally. Four children did not survive surgery (86% operative survival) and 9 (31%) had associated anomalies. All the discharged children treated in Iceland and Lund are alive, 3-22 years postoperatively. CONCLUSION: CDH is a serious anomaly where morbidity and mortality is directly related to other associated anomalies and pulmonary hypoplasia. However, majority of CDH patients do not have other associated anomalies. In spite of improved surgical results (operative mortality < 20%), a large proportion of pregnancies complicated with CDH are terminated. We conclude that the improved survival rate after corrective surgery must be emphasized when giving information to parents regarding abortion of fetuses with a prenatally diagnosed CDH.
    • Fóstureyðing með lyfjum : fyrstu 246 meðferðirnar á Íslandi

      Ágúst Ingi Ágústsson; Kristín Jónsdóttir; Jens A. Guðmundsson; Odense Universitetshospital, Odinsvéum, Danmörku, Odense C, Danmörku. agusagu@yahoo.com (Læknafélag Íslands, Læknafélag Reykjavíkur, 2010-05-01)
      OBJECTIVE: Medical abortion is a safe and effective treatment and is increasingly being used for termination of early pregnancy. In February 2006 medical abortion became available to women in Iceland. The purpose of this study is to assess the efficacy of medical abortion and evaluate whether it is a suitable alternative to surgical abortion in Iceland. MATERIAL AND METHODS: All eligible women (pregnancy <63 days, n=246) who chose medical abortion from February 2006 until July 2007 were included in the study. Data was collected on those who needed surgical evacuation and on other complications. RESULTS: The proportion of women who had medical abortion was 17.4% (n=246/1171). Curettage was needed in 8.9% of cases. Antibiotics were prescribed in 4.1% of cases and four women were admitted for complications without need for evacuation (urinary tract infection=2, bleeding=2), one woman was admitted to the intensive care unit for 24 hours because of unexplained fever and one woman needed blood transfusion. CONCLUSION: The success rate of more than 90% is comparable to what has been reported in other studies (92-99%) and this treatment option has proven to be safe in our settings. In total 17.4% of women opting for abortion had a medical abortion compared to 50% in Sweden and 46% in Denmark. With more experience and general awareness of the possibilities of medical abortion the ratio is likely to increase.
    • Lower genital tract infection with chlamydia trachomatis in women requesting induced abortion

      Kristín Jónsdóttir; Reynir Tómas Geirsson; Ólafur Steingrímsson; Jón Hjaltalín Ólafsson; Svava Stefánsdóttir (Læknafélag Íslands, Læknafélag Reykjavíkur, 1995-07-01)
      Postoperative pelvic infection is a serious complication of induced abortion, and may occur in 2-6% of cases. A study of the prevalence and distribution by age and marital status of cervical Chlamydia infection in 1991-93 in women seeking termination of pregnancy is in progress. The data for 1993 are presented and compared to results from a previous study. There were 686 women requesting termination of pregnancy in 1993. Of those 636 had induced abortion by suction evacuation, 11 aborted spontaneously, three were not pregnant, two were refused termination of pregnancy and 34 women withdrew their request. Of those who had the operation, 633 (92.3%) had samples taken and 48 were Chlamydia trachomatis positive (7.6%). The reduction from the previous study was significant where 13.5% of the women were Chlamydia positive. The Chlamydia positive women were also younger and more often single than those who were negative. It has been shown that if Chlamydia positive women are treated the incidence of later endometritis and salpingitis is not higher than among those that are negative. This emphasizes the importance of screening and treating Chlamydia positive women requesting termination of pregnancy.