Organ or System Failure

Thomas W. Strahan Memorial Library
Index
Standard of Care for Abortion
Abortion Decision-Making
Psychological Effects of Abortion
Social Effects and Implications
Physical Effects of Abortion
Abortion and Maternal Mortality
Adolescents and Abortion
Definition of Terms
Women's Health After Abortion
Material Yet to be Cataloged
Strahan Summary Articles

Sub-Index
Physical Effects
Abortion Technique Risks
Short Term Complications
Immediate Complications
Pain in Women
Organ or System Failure
Infections Related Complications
Impact on Later Pregnancies
Cancer Risks

Organ or system failure as a result of induced abortion is very infrequent but nevertheless potentially extremely serious and, in many instances, fatal.

Negative Impact on General Health and Physical Well Being

'The Effects of Pregnancy Loss on Women’s HealthNey PG, Fung T, Wickett AR, Beaman-Dodd C. (1994) Soc Sci Med 38 (9): 1193-1200.'

Abstract

A survey of women patients in the practices of family physicians in Victoria, B.C. was undertaken to determine the factors associated with pregnancy losses and their effect on women's health. Questionnaires returned by 1428 women with 2961 pregnancies showed that a higher number of losses, particularly abortions, correlates both with poor health and the need to obtain professional help in dealing with the loss(es). Partner support appears to be one of the most important factors in maintaining a pregnancy.

The validity of these self-assessments were checked against ratings by their physicians and an independent physician’s review of patients’ medical records. The investigators found that women with a history of pregnancy loss, especially abortion, had significantly lower general health ratings than other women. The more pregnancy losses a woman had suffered, the more negative her general health score. Loss of a woman’s most recent pregnancy was more strongly associated with lower health than were losses followed by successful deliveries. While the researchers found that miscarriage was also associated with a lower health score, induced abortion was more strongly associated with a lower health assessment and more frequently identified by women as the cause of their reduced level of health. More than twenty percent of the women participating in the study expressed a moderate to strong need for professional help to resolve their loss. From these data, the psychiatrist who led the research team concluded that pathological grief after the loss of an unborn child, whether by miscarriage or abortion, has a detrimental effect on the psychological and physical health of women.

'How Partner Support of an Adolescent Affects Her Pregnancy Outcome. Ney P, Peeters-ney MA, Fung T, Sheils C. WebmedCentral PUBLIC HEALTH 2013;4(2):WMC004076'

'Association between history of abortion and metabolic syndrome in middle-aged and elderly Chinese women. Xu B, Zhang J, Xu Y, Lu J, Xu M, Chen Y, Bi Y, Ning G. Front Med. 2013 Mar;7(1):132-7. doi: 10.1007/s11684-013-0250-x. Epub 2013 Feb 6.'

Abstract

Epidemiologic studies have suggested that abortion may cause long term health consequences such as cardiovascular disease. Until recently, studies focusing on the association between history of abortion and metabolic diseases were limited. In the present study, we aimed to investigate the association between history of abortion and metabolic syndrome (MetS) in middle-aged and elderly Chinese women. A cross-sectional survey was performed in 6302 women (age [Symbol: see text] 40 years) in Shanghai. Standardized questionnaire was used to obtain the information about reproductive histories. Overall, we observed a positive association between history of induced abortion and the prevalence of MetS, independent of potential confounding factors. A multivariable-adjusted logistic regression analysis revealed that compared to those without a history of induced abortion, women with a history of induced abortion remained at 1.25 times more likely to have MetS (OR = 1.25, 95% CI = 1.06-1.47, P < 0.05), and the association was number-dependent. However, no significant association between history of spontaneous abortion and the prevalence of MetS was observed. Compared to those without a history of spontaneous abortion, the multivariate-adjusted odds ratio associated with a history of spontaneous abortion for MetS was 0.88 (95% CI = 0.65-1.19, P > 0.05).

'Demands Made on General Practice by Women Before and After an Abortion, D. Berkeley et al., 34 J. ROYAL COLLEGE GEN. PRACTITIONERS 310, 313 (1984).'

In a review of the records of a group general practice in northwest London treating about 10,000 patients, researchers discovered that on average there was as much as an eighty percent increase in requests for health care services in the year following an abortion compared to the year prior to an abortion.

'Utilization After Induced Abortions In Ontario: A Comparison Between Community Clinics and Hospitals, Truls Ostbye et al., Health Services. 16 AM. J. MED. QUALITY 99 (2001).'

This study examined treatment rates three months before and after abortion and found a thirty-six percent increased rate of hospital admissions following abortion. The elevated hospitalization rates were statistically significant.

'Virginia DMAS analysis of health claims following abortion and childbirth. Nelson J. Department of Medical Assistance Services. Richmond, VA. March 21, 1997. Reply to request by Delegate Bob Marshall.

This was an exploratory investigation by the Virginia Department of Medical Assistance Services (DMAS) to compare health claims of women who aborted and women who had normal births. The study examined medicaid claims paid by DMAS over a three year period for 122 women who had a first live birth and 122 women with a first abortion.

In this study population, women who had abortions had 73% more subsequent health claims for reproductive health problems compared to women who carried to term, at a cost which was double the health benefits paid to women who carried to term. Aborting women had statistically significant 62% percent increase in subsequent mental health claims (43% higher costs), and a 12% increase in claims (53% higher costs) for treatments resulting from accidents.

'Report of the Committee on the Abortion Law, Supply and Services. Badgley, et.al. Ottawa, 1977:313-319.'

This Saskatchewan review examined the use of public funded health services 1 year before and 1 year after a pregnancy related event, including induced abortion, spontaneous abortions, and delivery of the pregnancy. In reviewing these records health officials found that postabortion women were treated for "mental disorders" 41 percent more often than postpartum women and 25 percent more often for accidents or conditions resulting from violence.

Cerebrovascular Diseases (Stroke)

Pregnancy, pregnancy loss, and the risk of cardiovascular disease in Chinese women: findings from the China Kadoorie Biobank, Peters SAE, Yang L, Guo Y, Chen Y, Bian Z, Tian X, Chang L, Zhang S, Liu J, Wang T, Chen J, Li L, Woodward M, Chen Z; China Kadoorie Biobank collaboration group. BMC Med. 2017 Aug 8;15(1):148. doi: 10.1186/s12916-017-0912-7. PMID: 28784170; PMCID: PMC5547470.

Background: Pregnancy and pregnancy loss may be linked to cardiovascular disease (CVD). However, the evidence is still inconsistent, especially in East Asians, whose reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy, miscarriage, induced abortion, and stillbirth with CVD incidence among Chinese women.

Methods: In 2004-2008, the nationwide China Kadoorie Biobank recruited 302,669 women aged 30-79 years from ten diverse localities. During 7 years of follow-up, 43,968 incident cases of circulatory disease, 14,440 of coronary heart disease, and 19,925 of stroke (including 11,430 ischaemic and 2170 haemorrhagic strokes), were recorded among 289,573 women without prior CVD at baseline. Cox regression yielded multiple adjusted hazard ratios (HRs) for CVD risks associated with pregnancy outcomes.

Results: Overall, 99% of women had been pregnant, and among them 10%, 53%, and 7% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Each additional pregnancy was associated with an adjusted HR of 1.03 (95% confidence interval, CI: 1.02; 1.04) for circulatory disease. A history of miscarriage, induced abortion, and stillbirth, respectively, were associated with adjusted HRs of 1.04 (1.01; 1.07), 1.04 (1.02; 1.07), and 1.07 (1.03; 1.11) for circulatory disease. The relationship was stronger with recurrent pregnancy loss; adjusted HRs for each additional loss being 1.04 (1.00; 1.09) for miscarriage, 1.02 (1.01; 1.04) for induced abortion, and 1.04 (1.00; 1.08) for stillbirth.

Conclusions: Among Chinese women, increases in pregnancy, and a history and recurrence of miscarriage, induced abortion, and stillbirth are each associated with a higher risk of CVD.

Deaths associated with pregnancy outcome: a record linkage study of low income women. Reardon DC1, Ney PG, Scheuren F, Cougle J, Coleman PK, Strahan TW. South Med J. 2002 Aug;95(8):834-41.

RESULTS: Compared with women who delivered, those who aborted had a significantly higher age-adjusted risk of death from all causes (1.62), from suicide (2.54), and from accidents (1.82), as well as a higher relative risk of death from natural causes (1.44), including the acquired immunodeficiency syndrome (AIDS) (2.18), circulatory diseases (2.87), and cerebrovascular disease (5.46).

Pregnancy-associated mortality after birth, spontaneous abortion, or induced abortion in Finland, 1987-2000. Gissler M, Berg C, Bouvier-Colle M-H, Buekens P. Am J Obstet Gynecol [Internet]. 2004 Feb

The study revealed a significant increase in the risk of death from cerebrovascular diseases after delivery among women aged 15 to 24 years (RR 4.08, 95% CI 1.58-10.55).

Circulatory & Heart Diseases

Deaths associated with pregnancy outcome: a record linkage study of low income women. Reardon DC1, Ney PG, Scheuren F, Cougle J, Coleman PK, Strahan TW. South Med J. 2002 Aug;95(8):834-41.

RESULTS: Compared with women who delivered, those who aborted had a significantly higher age-adjusted risk of death from all causes (1.62), from suicide (2.54), and from accidents (1.82), as well as a higher relative risk of death from natural causes (1.44), including the acquired immunodeficiency syndrome (AIDS) (2.18), circulatory diseases (2.87), and cerebrovascular disease (5.46).

Maternal and Fetal Outcomes of Subsequent Pregnancies in Women with Peripartum Cardiomyopathy U Elkayam et al, N Eng J Med 344(21):1567, May 24, 2001

This study found an elevated incidence of prior therapeutic abortion in women with left ventricular dysfunction which was sometimes fatal.

Association between history of abortion and metabolic syndrome in middle-aged and elderly Chinese women. Xu B, Zhang J, Xu Y, Lu J, Xu M, Chen Y, Bi Y, Ning G. Front Med. 2013 Mar;7(1):132-7.

The elevated risk from death from circulatory diseased and cerebrovascular disease may be partially explained by a finding that abortion is associated with elevated rates of metabolic syndrome which is a cause of increased cardiovascular disease.

Fatal Myocarditis Associated with Abortion in Early Pregnancy, DA Grimes and W Cates, Jr, Southern Medical Journal 73(2):236, 1980

Describes four cases of abortion-related deaths due to myocarditis.

Fatal Myocardial Infection Resulting From Cononary Embolism After Abortion: Unusual Cause and Complication of Endocarditis, Ann Emerg Med. 1997 Jan;29(1):175-7. 29:175, 1997

Disseminated Intravascular Coagulation (DIC)

DIC, or consumptive coagulophy, is caused by trauma or sepsis. It breaks down the various functions of the blood, resulting in defective coagulation with the risk of life- threatening hemorrhage and multiple organ failure.

"Coagulopathy and Induced Abortion Methods," ME Kafrissen et al, Am J Obstet Gynecol 147: 344, 1983.

The incidence of coagulopathy associated with first trimester abortion is 8 per 100,000 abortions; with D&E abortions it is 191 per 100,000 abortions; and with saline instillation abortions it is 658 per 100,000 abortions.

"Manmagement of Disseminated Intravascular Coagulophy," ME Richey et al, Clinical Obstetrics and Gynecology 38 (3): 514-520, 1995.

Induced Abortion is listed as one of the common causes of consumptive coagulophy.

Amniotic Fluid Embolism

Amniotic fluid embolism, an unusually catastrophic condition, is a sudden rush of amniotic fluid containing placental or fetal tissue fragments into maternal circulation. Frequently it is fatal. Although it can occur in a first trimester abortion, it is much more likely to occur in a second trimester abortion.

"Fatal pulmonary embolism during legal induced abortion in the United States from 1972 to 1985," HW Lawson et al, Am J Obstet Gynecol 162:986, 1990.

Includes deaths from amniotic fluid embolism as well as air embolism and pulmonary embolism.

"Amniotic Fluid Embolism," SL Clark, Critical Care Clinics 7(4):877-882, 1991.

" AFE has been reported under many conditions. These include first-trimester curettage abortion, second-trimester abortion with saline, prostaglandin, urea, and hysterotomy."

"Amniotic fluid embolism: Analysis of the national registry," SL Clark et al, Am J Obstet Gynecol 172:1158-1169, 1995.

Listing prior elective termination of pregnancy as one of the demographic data for patients with amniotic fluid embolism.

Pulmonary Embolism

Pulmonary embolism is an obstruction of pulmonary arteries, most frequently by detached fragments of clots from a leg or pelvic vein, especially following an operation or confinement to bed. Pulmonary embolism is known to occur in adolescents or adults following induced abortion. An incidence of 2.2 cases of pulmonary embolism per 10,000 induced abortions has been reported.

"Pulmonary Embolism in Adolescents," D Bernstein et al, Am J Diseases of Children 140:667, 1986

"Pulmonary Embolism in a 14 Year Old Following Elective Abortion," R Nudelman et al, Pediatrics 68:584, 1981

"Deaths Caused by Pulmonary Thromboembolism After Legally Induced Abortion," AM Kimball et al, Am J Obstet Gynecol 132:169, 1978.

Adult Respiratory Distress Syndrome

Manual of Obstetrics: Diagnosis and Therapy, 4 Edition, Kenneth R Niswander and Arthur T Evans (Boston: Little, Brown, 1991) 90

Adult respiratory distress syndrome (ARDS) is diffuse damage to the small cells of the lung accompanied by an excessive accumulation of water in the cells of the lung. It can occur from such etiologies as amniotic fluid embolism, sepsis, overdose or toxicity from various medications or chemicals, or in connection with DIC.