Psychological problems sequalae in adolescents after artificial abortion.

UNLABELLED: STUDY AND OBJECTIVES: Controversy exists over psychological risks associated with unwanted pregnancy and consecutive abortion. The aim of this study was to assess the psychological health of female adolescents following artificial abortion up to 12(th) week of pregnancy. DESIGN: The control case study. SETTING: The study was carried out in the Department of Gynecology and Obstetrics, University Clinical Center Tuzla, in Bosnia-Herzegovina. PARTICIPANTS: We assessed 120 female adolescents. The mean (SD) age of the patients was 17.7 (1.5) years experiencing sexual intercourse in the age of 14-19 years for trauma experiences, presence of posttraumatic stress symptoms, depression and anxiety as state, and anxiety as trait. Sixty adolescents had intentional artificial abortion and 60 had sexual intercourse but did not become pregnant. MAIN OUTCOME MEASURES: We used the PTSD Questionnaire, the Beck Depression Inventory, and the Spielberger State Trait Anxiety Inventory (Form Y) for assessment of anxiety in adolescents. Basic socio-demographic data were also collected. RESULTS: PTSD presented significantly more often in adolescents who aborted pregnancy (30%), than in adolescents who did not abort (13.3%) (odds ratio = 4.91 (95%CI 0.142-0.907) P = 0.03). Anxiety as state and as trait were significantly higher in the abortion group, as the mean (SD) anxiety score of patients was 59.8 (8.9), 57.9 (9.7) respectively, than in non-abortion group 49.5 (8.8), 47.3 (9.9) respectively (t = 6.392, P < 0.001; t = 5.914, P < 0.001, respectively). Adolescents who aborted pregnancy had significantly higher depression symptoms severity 29.2 (5.6) than controls 15.2 (3.3) (t = 8.322, P < 0.001), and they presented significantly more often depression (75%), than adolescents who did not abort (10%) (χ(2) = 53.279, P < 0.001). Logistic regression showed that only experience of life threatening(s) and injury of other person(s) reliably predicted PTSD, whereas abortion and experience of life threatening(s) reliably predicted depression. CONCLUSION: Adolescents who aborted pregnancy presented significantly greater prevalence of PTSD and depression, and significantly greater depression severity and anxiety as state and trait than those who did not abort. Abortion predicted depression only, and did not predict PTSD.

Surveillance of intrahospital infections at the clinic for gynaecology and obstetrics.

Intrahospital infections (IHI) and antibiotics resistance are the problems which exist in virtually all hospitals in the world. The main aim of the present research is establishing of epidemiological surveillance over occurrence of IHI at the Clinic for Gynaecology and Obstetrics at the University Clinical Center Tuzla and thus identifies: types of bacteria which cause IHI, types of infection according to anatomical localization and research resistance organisms causing of IHI on antimicrobial drugs. A study was implemented on all patients admitted to Clinic for Gynaecology and Obstetrics during the period of one year and who subsequently developed infection. Determination of intrahospital infections was done according to criteria defined by the Centres for Disease Control and Prevention from the United States. The results of our work have shown that both urinary tract infections and surgical site infections are the most frequent. As IHI causers the most found are gram-negative organisms (73,7%), such as Escherichia coli (29,8%), right after that Klebsiella pneumoniae (24,6%), Pseudomonas aeruginosa (14%) and Proteus mirabilis (5,3%) (p<0,05). Gram-positive organisms as causers of IHI are registered in 26,3% cases. Out of that Streptococcus species are isolated in 10,5% cases, Staphylococcus aureus (8,8%) and coagulasa negative staphylococci (7%) (p>0,05). High percent resistance of bacteria was evident to beta-lactams, aminoglycosids and cephalosporin's of third generation. Gram-positive organisms were 100% sensitive to vancomycin, while gram-negative organisms manifested the high percent of sensibility to imipenem and cefepime.