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2019 | 1 | 23-29

Article title

The seven-year epidemiological study of legal abortion caused by heart disease, blood disorders, diabetes and hypertension as referred to forensic medicine centers in Fars Province


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common risk factors for high risk pregnancies and spontaneous or therapeutic abortions. Objectives. To investigate the legal abortion caused by heart disease, blood disorders, diabetes and hypertension as referred to forensic medicine centers in Fars Province from 2007 to 2013. Material and methods. In a retrospective, cross-sectional study, samples consisted of all documents of people referred to forensic medicine centers in Shiraz since 2007 to 2013, comprising of 1664 files. Data collection tools included a demographic forum and the checklist of abortion causes. SPSS.16.0 was applied to analyze the data through descriptive statistical analysis. Results. The most frequent age group was 25–29 years at 31.5% (n = 522) and the lowest was over 40 years old at 4.15% (n = 70). The statistical report of the reasons for legal abortion permission were 19% (n = 63), 24.4% (n = 81), 10.54% (n = 35), and 8.13% (n = 27) due to heart problems, blood disorders, hypertension, and diabetes mellitus, respectively. Most frequent legal abortion permits by forensic medicine due to maternal causes were between the years of 2011–2012 at 17.8–28% (n = 59–93). The relationship between legal abortion permission at The Forensic Medicine Center at different years and maternal ages was statistically significant (p < 0.00001). Conclusions. The most common prevalent reason of abortion was Blood Disorder – 81 patients (24.4%) and heart disease – 63 cases (19%). It is essential that family education and prevention of repeated pregnancies be done with high-risk women. Also, initiation of pregnancy care at lower gestational age in identifying risky pregnancies and timely control of complications must also be undertaken



  • Faúndes A, Shah IH. Evidence supporting broader access to safe legal abortion. Int J Gynaecol Obstet 2015; 131(Suppl. 1): S56–S59,doi: 10.1016/j.ijgo.2015.03.018.
  • United Nations General Assembly. United Nations Millennium Declaration. New York: United Nations General Assembly; 2000. Available from URL: http://www .un.org/millennium /declaration/ares552e.htm.
  • Bustreo F, Say L, Koblinsky M, et al. Ending preventable maternal deaths: the time is now. Lancet Glob Health 2013; 1(4): E176–E177.
  • Emamiafshar N, Jalilvand P, Delavar B, et al. National maternal surveillance system. Tehran: Tandis Publication; 2006.
  • Veisi F, Zanganeh M. The causes of illegal abortions and their methods in outpatient Clinics of Kermanshah University of Medical Sciences.IJFM 2012; 18 (1): 47–52 (in Persian).
  • Kunins H, Rosenfield A. Abortion: a legal and public health persective. Annu Rev Public Health 1991; 12: 361–382.
  • Gülmezoglu AM, Lawrie TA, Hezelgrave N, et al. Interventions to reduce maternal and newborn morbidity and mortality. In: Black RE,Laxminarayan R, Temmerman M, et al., eds. Source reproductive, maternal, newborn, and child health: disease control priorities. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development/The World Bank; 2016.
  • Godrati F, Saadatmand N, Dinpazhoh M, et al. Epidemiological study of legal abortion due to fetal defects in the files referred to fars Province Forensic Medicine Centers from 2007 to 2013. Shiraz E-Med J 2016; 17(11): e40023, doi: 10.17795/semj40023.
  • Saadatmand N, Ghodrati F, Zarenezhad M, et al. Legal abortion with maternal causes referred to medico-legal centers in Fars: a seven years review of epidemiological evidence in 2007–2013. Health Science Journal 2016: 10(3): 1–6.
  • Abbasi M, Shamsi Gooshki E, Allahbedashti N. Abortion in Iranian legal system: a review. Iran J Allergy Asthma Immunol 2014; 13(1):71–84
  • Taylor M. Women’s right to health and Ireland’s abortion laws. Int J Gynaecol Obstet 2015; 130(1): 93–97.
  • Zúñiga-Fajuri A. Human rights and the right to abortion in Latin America. Cien Saude Colet 2014; 19(3): 841–846.
  • Shah I, Ahman E. Unsafe abortion in 2008: global and regional levels and trends. Reprod Health Matters 2010; 18(36): 90–101.
  • Rustamnezhad M, Asadzadeh F, Mustafazadeh F, et al. Study on abortion cases referred to the Forensic Medicine Center of Ardebil city.Health and Care Journal 2011; 11(4): 38–42.
  • Shaikh Z, Abbassi RM, Abbasi S. Morbidity and mortality due to unsafe abortion in Pakistan. Int J Gynecol Obstet 2010; 110(1): 47–49.
  • James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: management options. 4th ed. St. Louis (MO): Elsevier Saunders; 2011: 76–91.
  • Bharti M, Kumar V, Kaure A, et al. Prevalence and correlates of high risk pregnancy in Rural Haryana: a community based study. Int J Basic Applied Med Sci 2013; 3(2): 212–217.
  • Bouafia N, Mahjoub M, Nouira A, et al. Epidemiology of high risk pregnancy in Sousse, Tunisia. EMHJ 2013; 19(5): 465–473.
  • Pasdar Y, Heidari N, Safari Y, et al. Prevalence of some risk factors in pregnant women. Ir J Obstet Gynecol Infertility 2012; 15(21): 14–23.
  • Matteson PS. Women’s health during the childbearing years. New York: Mosby; 2001: 700–703.
  • Peyman N, Oakley D. Married Iranian women’s knowledge, attitude and sense of self-efficacy about oral contraceptives: focus group discussion. J Reprod Infertil 2011; 12(4): 281–288.
  • Monteiro AV, Rebelo J, Patricio L, et al. Ten years’ experience of pregnancy outcomes in women with cardiac valvulopathies: are valve prostheses worst? J Heart Valve Dis 2015; 24(3): 368–375.
  • Lupton M, Oteng-Ntim E, Ayida G, et al. Cardiac disease in pregnancy Curr Opin Obstet Gynecol 2002; 14(2): 137–143.
  • Bowater SE, Thorne SA. Management of pregnancy in women with acquired and congenital heart disease. Postgrad Med J 2010;86(1012): 100–105.
  • Bonakdaran S, Taghavi M. Cardiovascular risk factors in type 2 diabetic patients in Mashhad City. Iran J Endocrinol Metab 2010; 12(1):1–6.
  • Aksu H, Pala K, Aksu H. Prevalence and associated risk factors of type 2 diabetes mellitus in Nilufer District, Bursa, Turkey. Int J Diabetes Metabolism 2006; 14: 98–102.
  • Janus ED, Bunker SJ, Kilkkinen A, et al. Prevalence, detection and drug treatment of hypertension in a rural Australian population: the Greater Green Triangle risk factor study 2004–2006. Intern Med J 2008; 38(12): 879–886.
  • Khoshnniat Nikoo M, Abbaszadeh Ahranjani S, Larijani B. A review on the prevalence of gestational diabetes mellitus (GDM) in different regions of Iran. Iran J Diabetes Lipid Dis 2009; 8(7): 47–56.
  • Ferrara A, Kahn HS, Quesenberry CP, et al. An increase in the incidence of gestational diabetes mellitus: Northern California, 1991––2000. Obstet Gynecol 2004; 103(3): 526–533.
  • Kim JH, Shin HS, Park BK, et al. Impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy: a case-control study. J Korean Acad Nurs 2012; 42(4):517–524 (in Korean).
  • Khan KS, Wojdyla D, Say L, et al. WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367(9516): 1066–1074.
  • Seyom E, Abera M, Tesfaye M, et al. Maternal and fetal outcome of pregnancy related hypertension in Mettu Karl Referral Hospital,Ethiopia. J Ovarian Res 2015; 8: 10, doi: 10.1186/s13048-015-0135-5.
  • Ahmadi A. Basics of medical abortion and examine it from the perspective of criminal law. J Med Law 2012; 6(20): 115–140.
  • Shahabuddin S. Indications for abortion in diseases where risk of maternal death and fetal abnormalities and diseases that baby to still birth or death shortly after birth leads: Department of Legal Medicine. Circular 2006; 10: 31–43 (in Persian).
  • Astaraki P, Mahmoudi GA, Anbari K, et al. Evaluation of approved and non-approved requests for therapeutic abortion in cases referred to legal medicine organization of Lorestan province in 2013. Yafteh 2015; 17(2): 5–13.
  • Ghadipasha M, Aminian Z. Abortion, therapeutic abortion, criminal abortion: legal medicine. Journal of Kerman University of Medical Sciences 2007: 14(2): 147–152 (in Persian).
  • Tofighi H. Choice of forensic medicine, forensic medicine organization. 4th ed. Tehran: Mehr; 2005: 63–159 (in Persian).
  • Child JS. Fallot’s tetralogy and pregnancy prognostication and prophesy. J Am Coll Cardiol 2004; 44(1): 181–183.
  • Shaw JE, Sicree RA, Zimment PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010; 87:4–14.
  • Health Quality Ontario. Behavioural interventions for type 2 diabetes: an evidence-based analysis. Ont Health Technol Assess Ser 2009;9(21): 1–45.
  • Bell R, Bailey K, Cresswell T, et al. Trends in prevalence and outcomes of pregnancy in women with pre-existing type I and type II diabetes.BJOG 2008; 115(4): 445–452.
  • Nielsen GL, Møller M, Sørensen HT. HbA1c in early diabetic pregnancy and pregnancy outcomes: a Danish population-based cohort study of 573 pregnancies in women with type 1 diabetes. Diabetes Care 2006; 29(12): 2612–2616.
  • Wender-Ozegowska E, Wróblewska K, Zawiejska A, et al. Threshold values of maternal blood glucose in early diabetic pregnancy – prediction of fetal malformations. Acta Obstet Gynecol Scand 2005; 84(1): 17–25.
  • Talebian A, Soltani B, Sehat M, et al. Incidence and risk factors of neural tube defects in Kashan, Central Iran. Iran J Child Neurol 2015;9(3): 50–56.
  • McGrogan A, Snowball J, de Vries CS. Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records. Diabet Med 2014; 31(3): 357–365, doi: 10.1111/dme.12332.
  • Restrepo-Moreno M, Ramírez-Rincón A, Hincapié-García J, et al. Maternal and perinatal outcomes in pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring in two specialized centers in Medellin, Colombia. J Matern Fetal Neonatal Med 2017: 1–5, doi: 10.1080/14767058.2017.1295952
  • Rahimi-Madiseh M, Rahimi-Madiseh S, Gorji M. Continuing education in nursing and midwifery personnel to develop the human resources strategy. J Med Educ Dev 2010; 1(4): 11–20.
  • Gholamzadeh S, Godrati F, Saadatmand N, et al. The obstetrics and gynecology and genetic counseling of mother with legal abortion had been referred to in Fars Province center since 2007–2013. Shiraz E-Med J 2016; 17(2): e35271, doi: 10.17795/semj35271.
  • Abalos E, Cuesta C, Grosso AL, et al. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol 2013; 170(1): 1–7, doi: 10.1016/j.ejogrb.2013.05.005.
  • Safizadeh M, Damadi B, Safizadeh H. An epidemiologic study of maternal deaths in the population. Covered by Kerman University of Medical Sciences 2010–2012. 2015; 4(2): 114–120 (in Persian).
  • Sepidarkish M, Almasi-Hashiani A, Maroufizadeh S, et al. Association between previous spontaneous abortion and pre-eclampsia during a subsequent pregnancy. Int J Gynaecol Obstet 2017; 136(1): 83–86.
  • Poorolajal J, Cheraghi P, Cheraghi Z, et al. Predictors of miscarriage: a matched case-control study. Epidemiol Health 2014; 36: e2014031,doi: 10.4178/epih/e2014031.
  • Ranji A. Induced abortion in Iran: prevalence, reasons, and consequences. J Midwifery Womens Health 2012; 57(5): 482–488, doi:10.1111/j.1542-2011.2012.00159.x.
  • Ghodrati F, Akbarzadeh M. Mother’s rights and the therapeutic abortion according to Islam. Biomed Rev: J Basic Appl Med Sci 2016;3(1): 6–12.
  • Akbarzadeh M, Dokuhaki A, Joker A, et al. Teaching attachment behaviors to pregnant women: a randomized controlled trial of effects on infant mental health from birth to the age of three months. Ann Saudi Med 2016; 36(3): 175–183, doi: 10.5144/0256-4947.2016.175
  • Dokuhaki A, Akbarzadeh M, Pishva N, et al. A study of the effect of training pregnant women about attachment skills on infants motor development indices at birth to four months. Fam Med Prim Care Rev 2017; 19(2): 114–122, doi: https://doi.org/10.5114/ fmpcr.2017.67864.
  • Setodeh S, Zare N, Akbarzadeh M. A study of the efficacy of fathers’ attachment training on paternal-fetal attachment and parental anxiety. Fam Med Prim Care Rev 2017; 19(4): 393–398.
  • Akbarzadeh M, Rafiee B, Asadi N, et al. Comparative effect of attachment and relaxation training on perception of fetal movement and mother’s anxiety in Primiparous women: a randomized controlled study. Trends Med Res 2016; 11(2): 62–68.
  • Mokhtaryan T, Yazdanpanahi Z, Akbarzadeh M, et al. The impact of Islamic religious education on anxiety level in primipara mothers.J Family Med Prim Care 2016; 5: 331–337.

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