National Academies Press: OpenBook

The Safety and Quality of Abortion Care in the United States (2018)

Chapter:Appendix B: Acronyms and Glossary

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Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
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Appendix B

Acronyms and Glossary

ACRONYMS

AAAASF

American Association for Accreditation of Ambulatory Surgery Facilities

AAAHC

Accreditation Association for Ambulatory Heath Care

AAPA

American Academy of Physician Assistants

ACGME

Accreditation Council for Graduate Medical Education

ACME

Accreditation Commission for Midwifery Education

ACNM

American College of Nurse-Midwives

ACOG

American College of Obstetricians and Gynecologists

AHRQ

Agency for Healthcare Research and Quality

AMCB

American Midwifery Certification Board

ANSIRH

Advancing New Standards in Reproductive Health

APA

American Psychological Association

APAOG

Association of Physician Assistants in Obstetrics & Gynecology

APC

advanced practice clinician

APHA

American Public Health Association

ARC-PA

Accreditation Review Commission on Education for the Physician Assistant

ASA

American Society of Anesthesiologists

ASC

ambulatory surgery center

CAPS

Consortium of Abortion Providers

CDC

U.S. Centers for Disease Control and Prevention

CI

confidence interval

Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×

CMS

Centers for Medicare & Medicaid Services

CNM

certified nurse-midwife

CRNA

certified registered nurse anesthetist

D&C

dilation and sharp curettage

D&E

dilation and evacuation

EVA

electric vacuum aspiration

FAERS

FDA Adverse Event Reporting System

FDA

U.S. Food and Drug Administration

FPL

federal poverty level

HWPP

Health Workforce Pilot Project

IOM

Institute of Medicine

IUD

intrauterine device

LMP

last menstrual period

MAC

monitored anesthesia care

MAP

Midwest Access Project

MVA

manual vacuum aspiration

NAF

National Abortion Federation

NCCPA

National Commission on Certification of Physician Assistants

NCI

National Cancer Institute

NONPF

National Organization of Nurse Practitioner Faculties

NP

nurse practitioner

OB/GYN

obstetrician/gynecologist

OSHPD

Office of Statewide Health Planning and Development

PA

physician assistant

PTSD

posttraumatic stress disorder

RCOG

Royal College of Obstetricians and Gynaecologists

RCT

randomized controlled trial

REMS

Risk Evaluation and Mitigation Strategy

RHAP

Reproductive Health Access Project

RHEDI

Reproductive Health Education in Family Medicine

Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×

SFP

Society of Family Planning

STFM

Society of Teachers of Family Medicine

STI

sexually transmitted infection

UCSF

University of California, San Francisco

WHO

World Health Organization

GLOSSARY

abortion rate The annual number of abortions per 1,000 women aged 15–44 or other specific group within a given population.
abortion ratio The annual number of abortions per 1,000 live births within a given population.
abortion-related death A death resulting from a direct complication of an abortion (legal or illegal), from an indirect complication caused by a chain of events initiated by an abortion, or from an aggravation of a preexisting condition by the physiological or psychological effects of abortion.
advanced practice clinicians (APCs) Include physician assistants (PAs), certified nurse-midwives (CNMs), and nurse practitioners (NPs).
aspiration abortion Also referred to as surgical abortion or suction curettage, this procedure is used up to 14 to 16 weeks’ gestation. A hollow curette (tube) is inserted into the uterus. At the other end of the curette, a handheld syringe or an electric device is applied to create suction and empty the uterus.
buccal administration Administering a drug by placing in between the gums and cheek.
case control study An observational study that analyzes one group of persons with a certain disease, chronic condition, or type of injury (case patients) and another group of persons without the health problem (control subjects) and compares differences in their exposures, behaviors, and other characteristics to identify and quantify associations, test hypotheses, and identify causes.
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
case series Analyses of a series of people with a disease or health condition (there is no comparison group in case series).
certified nurse-midwife (CNM) An advanced practice registered nurse who has advanced education (master’s or doctorate) and training in both midwifery and nursing and is certified by the American Midwifery Certification Board.
cohort studies Observational studies in which groups of exposed individuals (e.g., women with an abortion in their first pregnancy or women whose early-gestation pregnancy was terminated by aspiration) are compared with groups of unexposed individuals (e.g., women whose first pregnancy was a delivery or women whose early-gestation pregnancy was terminated by medication) and monitored over time to observe an outcome of interest (e.g., future fertility). Cohort studies can be either prospective or retrospective.
comorbidity A condition that exists at the same time as the primary condition in the same patient (e.g., hypertension is a comorbidity of many conditions, such as diabetes, ischemic heart disease, and end-stage renal disease).
contraception An agent that prevents ovulation, fertilization of an egg, or implantation of a fertilized egg, thereby preventing a pregnancy from taking place.
deep sedation A drug-induced depression of consciousness during which patients cannot easily be aroused but respond purposefully following repeated or painful stimulation. The ability to maintain ventilatory function independently may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained but may be impaired.
dilation and sharp curettage (D&C) A surgical procedure in which the cervix is dilated so that the uterine lining can be scraped with a curette to remove products of conception.
dilation and evacuation (D&E) An abortion procedure that can be performed starting at 14 weeks’ gestation. The procedure involves cervical preparation with osmotic dilators and/or medications, followed by suction and/or forceps extraction to empty the uterus. Ultrasound guidance is often used.
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
ectopic pregnancy An abnormal pregnancy that occurs when a fertilized egg grows outside of the uterus, most commonly in a fallopian tube. As the pregnancy progresses, it can cause the tube to rupture (burst), which can cause major internal bleeding. This can be life-threatening and needs to be treated with surgery.
effective Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse, respectively).
efficient Avoiding waste, including waste of equipment, supplies, ideas, and energy.
equitable Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
general anesthesia A drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to maintain ventilatory function independently is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
hemorrhage Bleeding in excess of 500 mL and/or excessive bleeding that requires a clinical response, such as transfusion or hospital admission.
incomplete abortion Occurs when parts of the products of conception are retained in the uterus.
induction abortion Also referred to as “medical” abortion; involves the use of medications to induce labor and delivery of the fetus. The most effective regimens use a combination of mifepristone and misoprostol.
laminaria A type of osmotic dilator (see definition below). Laminaria tents are made of dried, compressed Japanese seaweed derived from japonica or digitate plants. Laminaria comes in diameters ranging from 2 to 10 mm, and in the standard 60 mm length as well as an extra-long 85 mm model.
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
local anesthesia Elimination or reduction of sensation, especially pain, in one part of the body by topical application or local injection of a drug. In the context of abortion practice, local anesthesia almost always involves a paracervical block.
medication abortion Also referred to as “medical” abortion; involves the use of medications to induce uterine contractions that expel the products of conception. The regimen, approved by the FDA up to 70 days’ gestation, uses 200 mg of mifepristone followed by 800 mcg of misoprostol 24 to 48 hours later.
meta-analysis A systematic review that uses statistical methods to combine the results of similar studies quantitatively in an attempt to allow inferences to be drawn from the sample of studies and applied to the population of interest.
Mifeprex (mifepristone) The brand name for mifepristone, a progesterone receptor antagonist that competitively binds to the progesterone receptor, thereby inhibiting the physiological action of progesterone, a hormone needed for a pregnancy to continue. When used together with another medicine called misoprostol (defined below), Mifeprex is used to end a pregnancy.
minimal sedation (anxiolysis) A drug-induced state during which patients respond normally to verbal commands. Although cognitive function and physical coordination may be impaired, airway reflexes and ventilatory and cardiovascular functions are unaffected.
miscarriage Also termed spontaneous abortion (see below); the spontaneous loss of a fetus before 20 weeks’ gestation. Spontaneous abortion is a naturally occurring event.
misoprostol A synthetic prostaglandin E1 analogue that is used off-label for a variety of indications in the practice of obstetrics and gynecology, including medication abortion, medical management of miscarriage, induction of labor, cervical ripening before surgical procedures, and the treatment of postpartum hemorrhage. Misoprostol’s effects are dose dependent and include cervical softening and dilation, uterine contractions, nausea, vomiting, diarrhea, fever, and chills.
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
moderate sedation Also referred to as conscious sedation; a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
nurse practitioner (NP) An advanced practice registered nurse who has advanced education (typically a master’s degree) and extensive clinical training in both the NP role (e.g., acute or primary care) and one or more population practice areas (e.g., family, women’s health) and specialty practice areas (e.g., high-risk perinatal, infertility, abortion care). NPs diagnose and manage patient care for many acute and chronic illnesses, and they also provide preventive care.
osmotic dilator A device that absorbs moisture from the tissues surrounding the cervix and swells, slowly opening the cervix. There are two common types of osmotic dilators: laminaria, a small tube made of dried seaweed (see above), and synthetic dilators, tubes with varying rigidity and size made of polymer.
patient-centered Defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.”
physician assistant (PA) An individual certified to practice medicine with physician supervision (indirect). They provide health care services that range from primary care to very specialized surgical services.
safety Avoiding injuries to patients from the care that is intended to help them.
spontaneous abortion The spontaneous loss of a fetus before 20 weeks’ gestation. Spontaneous abortion is a naturally occurring event.
surgical abortion A term used to describe aspiration and dilation and evacuation (D&E) procedures. This report uses the specific procedure terms to avoid confusion as to what procedure is being described.
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
systematic review A scientific investigation that focuses on a specific question and that uses explicit, planned scientific methods to identify, select, assess, and summarize the findings of similar but separate studies. It may or may not include a quantitative synthesis of the results from separate studies (meta-analysis, defined above).
timely Reducing waits and sometimes harmful delays for both those who receive and those who give care.
unsafe abortion A procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both.
uterine perforation A rupture in the uterus caused by traumatic or pathologic processes.
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page177
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page178
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page179
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page180
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page181
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page182
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page183
Suggested Citation:"Appendix B: Acronyms and Glossary." National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. doi: 10.17226/24950.
×
Page184
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Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed.

The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.

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