摘要：

The French abortion law of January 1975 permits therapeutic abortion if 2 doctors attest after examination and discussion that continuation of the pregnancy would pose a serious threat to the mothers health or if a high probability exists that the infant would be born with a serious and incurable defect. 120 medical abortions performed at a facility in Lille France between 1976-83 were analyzed to assess implementation of the new legislation. The number of abortions per year varied from 8 in 1978 to 29 in 1982 a year marked by a rubeola epidemic. 58 of the abortions were for maternal indications and 62 were for fetal indications. Maternal indications included 14 cases of cardiovascular disease including 10 of poorly tolerated valvulopathies 12 of pleuropulmonary disease including 10 of pulmonary tuberculosis 7 of endocrine disease 5 of cancer 5 of psychiatric disorders 4 of neurologic disease 3 each of renal and hematologic disorders 2 of inflammatory disease and 1 each of digestive and ophthalmologic disorders and rape. 37 of the fetal indications referred to exogenous factors including 23 of rubeola 10 of radiation 3 of exposure to toxic chemicals and 1 of listeriosis. Fetal indications also included genetic anomalies in 9 cases fetal malformation in 8 cases hereditary disorders in 6 cases and Rhesus isoimmunization in 2 cases. Among abortions for maternal and fetal indications respectively 51 and 22 were performed before 12 weeks of gestation 4 and 5 from 12-16 weeks and 3 and 35 after 16 weeks. The high proportion of abortions after 16 weeks for fetal indications is related to the lateness of the principal diagnostic methods amnioscentesis and sonography. 51 abortions before 12 weeks were done by vacuum aspiration 20 by dilatation and curettage (D and C) 1 by hysterotomy and 1 by oxytocin perfusion. 6 abortions between 12-16 weeks were by aspiration 1 by D and C and 2 by other procedures. 8 abortions after 16 weeks were by D and C 3 by oxytoxin perfusion 7 by hysterotomy 15 by intraamniotic prostaglandins and 5 by other means. 21 women underwent tubal sterilization after abortion 16 after abortions for maternal indications and 5 older women after abortions for fetal indications. The number of medical abortions has increased because the 1975 law gave greater discretion to the physician and legalized abortions for fetal indications. Analysis of the 120 cases indicates that a high proportion of medical abortions could be avoided with better information use of contraception among women for whom pregnancy is inadvisable and better understanding of fetal risks. In 39 of 58 cases the condition constituting the maternal indication for abortion was known before the pregnancy began and the abortion would have been avoided with effective contraception. 30 of the 62 abortions for fetal indications could have been avoided if 22 mothers had been vaccinated against rubeola and 8 others had avoided x-rays in early pregnancy.

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