Abortion problem: Early pregnancy loss, physiology, psychological, and economic costs (above)

Abortion is usually defined as an embryo/fetus loss before the survival ability.It is estimated that 23 million abortion incidents occur each year, equivalent to 44 abortion per minute.In all clinically confirmed pregnancy, the risk of miscarriage was 15.3% (95% CI 12.5-18.7%).The incidence of women’s abortion once is 10.8%(10.3-11.4%), the two abortion 2 times (1.8-2.1%), and the incidence of abortion 3 times or more is 0.7%(0.5-0.8%).

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The impact of miscarriage is both physiological, such as bleeding or infection, and psychological.Psychological influence includes anxiety, depression, post -trauma stress disorder (PTSD) and suicide risks.Abortion, especially recurrent abortion, is a risk early warning sign of obstetric complications (including premature birth, fetal growth, premature placental peeling and death). It is also a predictive factors for long -term health problems such as cardiovascular disease and venous thrombosis.The cost of abortion will affect individuals, health care systems and even society.

In the UK, the short -term national economic loss caused by miscarriage is expected to be 471 million pounds per year.Repeated abortion is a warning sign of various obstetric risks in future pregnancy, and women should receive care at obstetric clinics that are pre -pregnancy and special treatment for patients with high -risk patients.Because post -abortion psychological diseases are common, effective screening tools and treatment strategies are needed to cope with psychological effects caused by miscarriage.We recommend collecting and reporting abortion data to promote cases between countries to accelerate the research process and improve patient nursing and formulation policies.

Abortion is often misunderstood by many women, men and health care providers (nurses, midwifers, doctors, health care professionals, community health workers, other trained and healthy knowledge). These misunderstandings are widely known.For example, women may think that abortion is rare, which may be caused by weightlifting or previous use of contraceptive measures, or there is no effective treatment to prevent abortion.These misunderstandings may have serious impacts, making women and their partners blame themselves and give up treatment and help.Abortion also makes people lonely, because many women may not tell their family, friends, and even their partners after abortion.The couple expressed concern about the consent of concentric care for health care providers.

Women and their partners who have experienced abortion usually want to understand the cause of abortion. What can they do to prevent abortion from re -occurring, how much the probability of pregnancy and childbirth of healthy babies, and how to deal with the grief brought by miscarriage.Different health care professionals may provide couples with different opinions, which may exacerbate their pain.There are also disputes on the definition, causes, prognosis and cost of miscarriage.This article is the first article in the abortion series of articles. We introduce the need for knowledge, suggestions, and follow -up research, and call for action to take action priority.We discussed the epidemiology of natural abortion and recurrent abortion, and reviewed the risk factors and prognosis of future obstetrics, maternal psychology and long -term health.We also use the literature review to evaluate the economic cost of abortion.

The definitions of abortion of various countries and international organizations are different, which will affect the estimation of abortion risks and prevalence in different countries or organizations.Abortion is generally defined as an embryonic/fetus in intrauterine pregnancy before the survival ability; however, there are differences in the diagnosis of pregnancy and the ability to survive in the diagnosis of pregnancy.The boundaries of the survivability can be determined by the age of fetal age or fetal weight. The threshold root can be ranging from 20 to 28 weeks of pregnancy according to the geographical area.The WHO defines abortion as a fetus (embryo) with an excretion or removal of less than 500 grams, which is about 22 weeks of pregnancy.In the UK, the law stipulates that the survival of the fetus is 24 weeks +0 days of pregnancy.The American Reproductive Medicine defines abortion as a clinical pregnancy loss of less than 20 weeks of pregnancy.European human reproductive and embryo society defines abortion as abortion before 22 weeks of pregnancy.

In most countries, the threshold of survivability is stipulated by the law. As high -income countries have more and more effective in severe cases of newborns of premature babies, they often deviate from the limit of medical survival capabilities.Although the embryo scientists define the first week of pregnancy as the week after the bed, for clinical purpose, the pregnancy length of pregnancy after the first day of the last menstrual period is referred to.This series of documents use this definition.

According to the concentration of serum or urine β-human chorionic gonadotropin (HCG) concentration from serum or urine β-human chorion, or the visualization of ultrasonic examination in the uterine pregnancy, a series of dazzling dazzling trials lost the term before pregnancy.

The risk of abortion depends on the boundary value of the upper limit of the fetal or the fetal weight, and the pregnancy of the denominator is the pregnancy determined by the serum or urine β-HCG concentration or the pregnancy diagnosed by the ultrasonic examination.Including clinical pregnancy loss, defined as a pregnancy loss before ultrasound, it will increase the abortion rate.The development of high-sensitivity β-HCG detection can detect extremely early pregnancy (starting 22 days after the last menstrual period), so it can diagnose extremely early abortion that may have been missed, which will also lead to an increase in the abortion rate.Finally, the characteristics of population statistics will affect the risk of abortion, and the distribution of women’s age has a long -term impact on risks.

Our literature retrieval determined 9 large -scale queue research, reporting a total of 4,638,974 abortion risks of pregnancy.All research comes from Europe and North America.6 studies are the forward -looking queues of the pregnancy ending of self -reporting. 3 studies use medical records to determine the ending of abortion.Our review of existing evidence found that in all recognized pregnancy, the risk of miscarriage was 15.3% (95% CI 12.5-18.7%).

About 130 million newborns are born every year in the world. 15%of the abortion risk means about 23 million abortion events per year, that is, 44 cases per minute.In the UK, 40,000 to 45,000 patients were admitted to the hospital from 2012 to 2013 due to diagnosis and treatment of abortion. However, due to miscarriage and clinical pregnancy loss at home, the actual number of abortion is much higher than the number of reports.Unfortunately, since 2013, the data of abortion admission is no longer included in the statistical report of pregnant women in the UK.Only a few countries in Denmark report the annual abortion rate, which makes it more difficult for international internationals.According to the results of several existing queues, the abortion rate of the United States, China, and Sweden seems to be increasing, while in Finland is decreasing.

The reasons for these changes are unclear, but it may reflect that women’s pregnancy age is increasing (in the United States, China, and Sweden, but excluding Finland).Female age and abortion have a great impact on the risk of abortion.The lowest risk of women 20-29 years old is 12%, and the abortion risk of women 45 and above has risen sharply to 65%.The minimum abortion risk of women’s history of non -flow -free history (11%), and then the risk of miscarriage at each time of abortion increased by about 10%, and women’s abortion risk of three or more than 3 times in the past reached 42%.

The last part is over.

This article only selects part of the literature, this translation is not allowed to be reproduced without permission.

Literature source: quenby s, gallos id, dhillon-smith rk, podesek m, Stephenson MD, Fisher J, Brosens J, Brewin J, Ramhorsst R, luccoy RC, Anderson R, dags, regan l, a a, a, a L-MEMARM, Bourne T, Macyre Da, RAI R, Christiansen Ob, Sugiura-OGAWARA M, ODENDAAL J, Devall AJ, Bennett PR, PETROU S, Coomarasam A. Miscarriage Matters: The Epi Demiology, Physical, Psychology, and Economic Costs of Early PregnancyLoss. Lancet. 2021 May 1; 397 (10285): 1658-1667.

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