Preface

Fertility regulation is a problem that is essential for life itself. The history of contraception has a strong relation to growing public interest. Induced abortion was formerly the only option and the main method of family planning. The negative attitude of society and religion to artificial abortion has a dramatic impact on its rate of reduction. The invention of hormonal contraception was one of the main events of the last century. It is contrary to human biology but hormonal contraception is the method of choice in Europe. The improved demographical situation in China over the last few decades has surprisingly increased the total level of induced abortions, but the involvement of the population in family planning is twice as high. The short- and long-term consequences of abortion on maternal and offspring health are still an issue. The decrease in the artificial abortion rate was found to be associated with improved maternal and perinatal outcomes. Therefore, the continuing battle against artificial abortion is an effective measure for the protection of female reproductive health.

The book contains fundamental data on the physiology of early gestation. The authors summarize theories to explain the pathogenesis of spontaneous abortion. Fetal and newborn health is known to be critically dependent on the intrauterine period of life. The fetal programming concept is based on the speculation that abnormal uteroplacental hemodynamics spreads a negative effect on fetal development and further diseases during postnatal life. Therefore, this book emphasizes endometrial status during preconception and implantation. The relevant complication of disturbed trophoblastic invasion is miscarriage. Spontaneous abortions are possibly involved in human evolution. But habitual abortion is a reason for active management. This text, therefore, presents the total spectrum of preventive and therapeutical interventions. One of the novel methods is based on biotechnology—the use of frozen human blood cells. The management of uterine scar pregnancy enhances the clinically oriented expectations of a reader. The post-cesarean uterine scar is associated with an excessive trophoblastic invasion and severe uterine bleeding during a surgical abortion. Thus, practical recommendations for the management of uterine scar pregnancy that contribute to the reduction of life-threatening complications are also presented.

The complications of abortion are well known. But the modern system of management is critically dependent on the latest medical advances, which could provide a wanted, safe, and happy pregnancy. This impact captures the total spread and positive outcome of family planning services in the world. The final goal is female reproductive health protection. Our book is only a small step in the march towards further development of modern contraceptive technologies and medical methods of recurrent pregnancy loss prevention.

The growing interest from the medical community to the problem of artificial and spontaneous abortion has induced this book. It is aimed at the introduction of a modern system for the prevention of artificial abortion and early pregnancy loss.

This book includes a preface by the editor, followed by six chapters written by international experts, arranged in two parts. It will be of great interest to social workers, psychologists, general practitioners, and gynecologists.

> **Igor V. Lakhno MD, PhD, DSc** Professor of the Obstetrics and Gynecology Department, Kharkiv National VN Karazin University, Ukraine

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Section 1

Historical Review and

Modern Trends in the

Prevention of Unwanted

Pregnancy
