Causes of abortion and ways to treat its effects in women in Saudi

Arabia

King Abdulaziz Hospital, Kingdom of Saudi Arabia, 2017.

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Researchers:

Hanan Mohammed Ali Al-Ghamdi ,

Abrar Faisal Al-Johani,

Alaa Mohammed Baraheem,

Ahdab Faisal Nono,

Ahela faisal nono ,

Joud Ahmed Babaghi,

Doaa Mohammed Barnawi

Bayan Abbas Zaatari,

Tasnim Ali Al-Bati,

Neda Ali-Bati,

Sana Moghram Saeed Alahmari,

Amani Nasser Alsubaie

Manal Mahmood alsalmi,

Maram mudhhi Al abdali,

Data collectors:

Nada Abdo Abdulrab Nagi

Randa Abdulrahman Al Joubi,

Haya Mohammed Bin Hassan,

Ghadah Abdulrahman Albalawi,

Areej Abdulrahman Alotaibi,

Roaa Fahad Alshabanah,

Tahani Saeed Almohayya,

Abdullah Fahad Alharbi,

Supervisors of the study

Dr. Entessar Tyloni Consultant of Obstetrics and Gynecology at King Abdul Aziz Hospital Dr. Aisha Ibrahim Tarabay Consultant of Obstetrics and Gynecology

Dr. Bassem Al Byrouti Consultant of Hematology at King Abdul Aziz University Hospital

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ABSTRACT

In our research study we try to make an investigation about the reasons of abortion in

women in Jeddah and the Eastern Region of Saudi Arabia as there has been an increasing

number of abortion cases in this region, as well as, throughout the whole world. This study

also includes an attempt to determine possible methods to treat these effects. in addition, we

present an overview on different responses of women in that area of Saudi Arabia on abortion, To achieve the objectives of the research, the researchers used the descriptive method to

determine the causes of abortion and its effects in women in Jeddah and the Eastern Province

of Saudi Arabia, the important conclusions; Most of the causes of abortion among women in

the study sample were external factors, Most methods of treating the effects of abortion among

women in the study sample were preventive methods.

Introduction:

Birth and death represent the strongest indicators of the human being on Earth,

However, there is a previous stage represents the pregnancy, which represents the

composition of the human being, may succeed and end birth or fail and ends with abortion.

In general, approximately 205 million pregnancies occur each year worldwide[1][2]

.

Pregnancy is typically divided into three trimesters. The first trimester is from week one

through 12 and includes conception. Conception is when the sperm fertilizes the ovule.

The fertilized ovule then travels down the fallopian tube and attaches to the inside of

the uterus, where it begins to form the embryo and placenta. The second trimester is from

week 13 through 28. Around the middle of the second trimester, movement of the fetus may

be felt. At 28 weeks, more than 90% of babies can survive outside of the uterus if provided

with high-quality medical care. The third trimester is from 29 weeks through 40 weeks[3]

. As

for abortion, the first trimester carries represent the highest risk of miscarriage(natural death of

embryo or fetus) [4]

. Due to the importance of abortion and the importance of determining the

causes, types and effects, many studies have been concerned with the issuance of accurate

statistics and information.

Over a third are unintended and about a fifth end in induced abortion[1][2]

. Most

abortions result from unintended pregnancies[5][6]

. Only 30% to 50% of conceptions progress

past the first trimester[7]

. The vast majority of those that do not progress are lost before the

woman is aware of the conception.[8]

many pregnancies are lost before medical practitioners

can detect an embryo[9]

. Between 15% and 30% of known pregnancies end in clinically

apparent miscarriage, depending upon the age and health of the pregnant woman[10]

. 80% of

these spontaneous abortions happen in the first trimester[11]

.

Abortion, whatever its different types, methods and causes must be identified methods

of treatment effects, The effects vary from case to case depending on the severity of the impact

and the seriousness of the impact on women's health, the more serious the effect, the greater

the tendency for surgical intervention, the less the impact, the more therapeutic or preventive

intervention becomes the safest way to treat the effects of abortion.

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Background:

Because abortion is a humanitarian process, it is subject to the general rules governing

the individual's health and legal rights, which vary from country to country, around 56 million

abortions are performed each year in the world[14]

. with a little under half done unsafely,

Abortion rates changed little between 2003 and 2008[1]

. before which they decreased for at

least two decades as access to family planning and birth control increased[15]

.

As of 2008, 40% of the world's women had access to legal abortions without limits as to

reason[16]

. When allowed by law, abortion in the developed world is one of the safest

procedures in medicine[12][13]

. Legal abortions performed in the developed world are among

the safest procedures in medicine [17]

in the US, the risk of maternal death from abortion is 0.7

per 100,000 procedures[3]

. In the United States from 2000 to 2009, abortion had a lower

mortality rate than plastic surgery.[21]

making abortion about 13 times safer for women than

childbirth (8.8 maternal deaths per 100,000 live births) [18] [19]

. Considered Outpatient abortion

is as safe and effective from 64 to 70 days' gestation as it is from 57 to 63 days[20]

.

From an ethical point of view those who oppose abortion often maintain that an embryo

or fetus is a human with a right to life and may compare abortion to murder[22] [23]

. Those who

favor the legality of abortion often hold that a woman has a right to make decisions about her

own body[24]

.

Some purported risks of abortion are promoted primarily by anti-abortion groups[25] [26]

,

For example, the question of a link between induced abortion and breast cancer has been

investigated extensively. Major medical and scientific bodies (including the World Health

Organization, National Cancer Institute, American Cancer Society, Royal College of OBGYN

and American Congress of OBGYN) have concluded that abortion does not cause breast

cancer[27]

.

Problem of Research:

Women seeking to terminate their pregnancies sometimes resort to unsafe methods,

particularly when access to legal abortion is restricted. They may attempt to self-abort or rely

on another person who does not have proper medical training or access to proper facilities.

This has a tendency to lead to severe complications, such as incomplete abortion, sepsis,

hemorrhage, and damage to internal organs[39]

.

A major factor in whether abortions are performed safely or not is the legal standing of

abortion. Countries with restrictive abortion laws have higher rates of unsafe abortion and

similar overall abortion rates compared to those where abortion is legal and available[1][28]

.

When performed legally and safely, induced abortions do not increase the risk of long-term

mental or physical problems[29]

.

On the other hand, the World Health Organization recommends safe and legal abortions

be available to all women[30]

. Unsafe abortions are believed to result in millions of

injuries[12][31]

. Secondary infertility caused by an unsafe abortion affects an estimated 24

million women[37]

. Complications of unsafe abortion account for approximately an eighth of

maternal mortalities worldwide[111]

.

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Also, unsafe abortions (those performed by unskilled individuals, with hazardous

equipment, or in unsanitary facilities) cause 47,000 deaths and 5 million hospital admissions

each year.[29][28]

Although data are imprecise, it is estimated that approximately 20 million unsafe

abortions are performed annually, with97% taking place in developing countries[12]

. Estimates

of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in the past

decade.[12][28][32]

The World Health Organization believes that mortality has fallen since the 1990s[33]

.

Health education, access to family planning, and improvements in health care during and after

abortion have been proposed to address this phenomenon[38]

. However, the Dublin

Declaration on Maternal Health, signed in 2012, notes that "the prohibition of abortion does

not affect, in any way, the availability of optimal care to pregnant women"[34]

, and the rate of

unsafe abortions has increased from 44% to 49% between 1995 and 2008,[1]

though this

varies by region.[36]

Search Terms:

Abortion is the ending of pregnancy by removing a fetus or embryo before it can survive

outside the uterus[40]

, either naturally or via medical methods.

The Theoretical Side:

Introduction:

Since ancient times abortions have been done through a number of methods, including the

administration of abortifacient herbs, the use of sharpened implements, the application of

abdominal pressure, and other techniques. Induced abortion has long history, and can be traced

back to civilizations as varied as China under Shennong (c. 2700 BCE), Ancient Egypt with its

Ebers Papyrus (c. 1550 BCE), and the Roman Empire in the time of Juvenal (c. 200 CE).[41]

One of the earliest known artistic representations of abortion is in a bas relief at Angkor Wat

(c. 1150), found in a series of friezes that represent judgment after death in Hindu and

Buddhist culture, it depicts the technique of abdominal abortion[42]

.

Islamic tradition has traditionally permitted abortion until a point in time when Muslims

believe the soul enters the fetus[41]

. The soul entering or quickening is considered by various

theologians to be at conception, 40 days after conception, 120 days after conception[43]

.

However, abortion is largely heavily restricted or forbidden in areas of high Islamic faith such

as the Middle East and North Africa[44]

.

The Concept and Types of Abortion:

An abortion is the termination of an embryo or fetus, either naturally or via medical

methods. [45]

An abortion that occurs spontaneously is also known as a miscarriage. An

abortion may be caused purposely and is then called an induced abortion, or less frequently,

"induced miscarriage". The word abortion is often used to mean only induced abortions. A

similar procedure after the fetus could potentially survive outside the womb is known as a

"late termination of pregnancy"[46]

.Medical abortions are those induced by abortifacient

pharmaceuticals. Medical abortion became an alternative method of abortion with the

availability of prostaglandin analogs in the 1970s and the antiprogestogenmifepristone (also

known as RU-486) in the 1980s[47][48]

, But When done electively or by induced way, it is more

often done within the first trimester than the second, and rarely in the third. Lennart

Nilsson(2004) [49]

.

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Early medical abortions, within the first trimester, account for the majority of abortions

before 9 weeks gestation in Britain, France, Switzerland, and the Nordic countries. In the

United States, the percentage of early medical abortions is far lower[50][51]

. In places which

lacks the necessary medical skill for dilation and extraction, or where preferred by

practitioners, an abortion can be induced by first inducing labor and then inducing fetal

demise if necessary[52]

. This process is sometimes called "induced miscarriage". This may be

performed from 13 weeks gestation to the third trimester. Although it is very uncommon in

the United States, more than 80% of induced abortions throughout the second trimester are

labor induced abortions in Sweden and other nearby countries[53]

.

The main downside that there is only limited data are available comparing this method

with dilation and extraction[53]

. However, labor induced abortions after 18 weeks may be

complicated by the occurrence of brief fetal survival, which may be legally characterized as

live birth. For this reason, labor induced abortion is legally risky in the U.S. [53]

. Premature

births and stillbirths are generally not considered to be miscarriages although usage of these

terms can sometimes overlap[54]

. A pregnancy that ends before 37 weeks of gestation resulting

in a live-born infant is known as a "premature birth" or a "preterm birth"[55]

, but When a fetus

dies in uterus after viability, or during delivery, it is usually termed "stillborn"[56]

.

Spontaneous Abortion:

Spontaneous abortion known as miscarriage, is the unintentional expulsion of an embryo

or fetus before the 24th week of gestation.[57]

The most common cause of spontaneous

abortion during the first trimester is chromosomal abnormalities of the embryo or fetus,[8][73]

A accounting for at least 50% of sampled early pregnancy losses[71]

. spontaneous abortion

can also be caused by accidental trauma; intentional trauma or stress to cause miscarriage is

considered induced abortion or feticide[72]

. Other causes include vascular disease (such as

lupus), diabetes, other hormonal problems, infection, and abnormalities of the uterus[73]

. Or an

intended abortion is referred to as an elective or voluntary abortion when it is performed at the

request of the woman for non-medical reasons[8]

.

Moreover in many places there is much debate over the moral, ethical, and legal issues

of abortion[58][59]

. As we see, legal, cultural or religious views of abortions are different

around the world. In some areas abortion is legal only in specific cases such as rape, problems

with the fetus, poverty, risk to a woman's health, or incest[60]

. Some of the most common

reasons are to postpone childbearing to a more suitable time or to focus energies and

resources on existing children. Others include being unable to afford a child either in terms of

the direct costs of raising a child or the loss of income while caring for the child, lack of

support from the father, inability to afford additional children, desire to provide schooling for

existing children, disruption of one's own education, relationship problems with their partner,

a perception of being too young to have a child, unemployment, and not being willing to raise

a child conceived as a result of rape or incest, among others[63][64]

, However Countries that

permit abortions have different limits on how late in pregnancy abortion is allowed[16]

. A

pregnancy can be intentionally aborted in several way, and The manner selected often

depends upon the gestational age of the embryo or fetus, which increases in size as the

pregnancy progresses[61][62]

, and The unsafe abortion rate in developing countries is partly

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attributable to lack of access to contraceptives would result in about 14.5 million fewer unsafe

abortions and 38,000 fewer deaths from unsafe abortion annually worldwide[65]

.

Therapeutic Abortion:

There are other specific procedures may also be selected due to legality, regional

availability, and doctor or a women's personal preference. Reasons for procuring induced

abortions are typically characterized as either therapeutic or elective. An abortion is medically

referred to as a therapeutic abortion when it is performed to save the life of the pregnant

woman; prevent harm to the woman's physical or mental health; terminate a pregnancy where

indications are that the child will have a significantly increased chance of premature

morbidity or mortality or be otherwise disabled; or to selectively reduce the number of fetuses

to lessen health risks associated with multiple pregnancy[66]

. The risk to maternal or fetal

health, which was cited as the primary reason for abortion in over a third of cases in some

countries and as a significant factor in only a single-digit percentage of abortions in other

countries[69]

. the woman's age relevant to the well-being of the patient. All these factors may

relate to health[70]

, also advancing maternal age and a women's history of previous

spontaneous abortions are the two leading factors associated with a greater risk of

spontaneous abortion[71]

.

For Example, in many cases, cancer of the mother leads to consideration of abortion to

protect the life of the mother, or in response to the potential damage that may occur to the

fetus during treatment[67]

. The process of birth itself may also put the mother at risk. "Vaginal

delivery may result in dissemination of neoplastic cells into lymphovascular channels,

haemorrhage, cervical laceration and implantation of malignant cells in the episiotomy site,

while abdominal delivery may delay the initiation of non-surgical treatment."[68]

Each year, ill

health as a result of pregnancy is experienced (sometimes permanently) by more than 20

million women around the world[74]

. In 2013 complications of pregnancy resulted in 293,000

deaths down from 377,000 deaths in 1990. Common causes include maternal

bleeding (44,000), complications of abortion (44,000), and high blood pressure of pregnancy

(29,000), maternal sepsis (24,000), and obstructed labor (19,000)[75]

.

AS we have seen earlier abortion is sometimes attempted by causing trauma to the

abdomen. The degree of force, if severe, can cause serious internal injuries without

necessarily succeeding in inducing miscarriage[76]

. In Southeast Asia, there is an ancient

tradition of attempting abortion through forceful abdominal massage[42]

. One of the bas

reliefs decorating the temple of Angkor Wat in Cambodia depicts a demon performing such

an abortion upon a woman who has been sent to the underworld[42]

.

On the other hand modern methods use medication or surgery for abortions[47]

. The

drug mifepristone in combination with prostaglandin appears to be as safe and effective as

surgery during the first and second trimester of pregnancy [47] [48]

. The most common early

first-trimester medical abortion regimens use mifepristone in combination with a

prostaglandin analog (misoprostol or gemeprost) up to 9 weeks gestational age, methotrexate

in combination with a prostaglandin analog up to 7 weeks gestation, or a prostaglandin

analog alone[77]

. As we know Mifepristone–misoprostol combination regimens work faster

and are more effective at later gestational ages than methotrexate– misoprostol combination

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regimens, and combination regimens are more effective than misoprostol alone[46]

. Morever

This regime is effective in the second trimester[78]

. Also Medical abortion regiments

involving mifepristone followed by misoprostol in the cheek between 24 and 48 hours later

are effective when performed before 63 days' gestation[79]

. But the most common methods

used for second-trimester abortions in Canada, most of Europe, China and India are Medical

abortion regimens using mifepristone in combination with a prostaglandin analog, [80]

.

vaginal misoprostol are 98% effective up to 9 weeks gestational age[90]

.

In contrast to the United States where 96% of second-trimester abortions are performed

surgically by dilation and evacuation. [81]

. Vacuum aspiration in the first trimester is the safest

method of surgical abortion, and can be performed in a primary care office, abortion clinic, or

hospital. Complications are rare and can include uterine perforation, pelvic infection, and

retained products of conception requiring a second procedure to evacuate. [82]

. These vaccum

aspiration or suction-aspiration are the most common surgical methods of induced abortion

Up to 15 weeks' gestation. [83]

. Manual vacuum aspiration (MVA) consists of removing the

fetus or embryo, placenta, and membranes by suction using a manual syringe, while electric

vacuum aspiration (EVA) uses an electric pump. These techniques differ in the mechanism

used to apply suction, in how early in pregnancy they can be used, and in whether cervical

dilation is necessary. MVA, also known as "mini-suction" and "menstrual extraction", can be

used in very early pregnancy, and does not require cervical dilation. Dilation and curettage

(D&C), the second most common method of surgical abortion, is a standard gynecological

procedure performed for a variety of reasons, including examination of the uterine lining for

possible malignancy, investigation of abnormal bleeding, and abortion. Curettage refers to

cleaning the walls of the uterus with a curette. The World Health Organization recommends

this procedure, also called sharp curettage, only when MVA is unavailable. [92]

There is little difference in terms of safety and efficacy between medical abortion using a

combined regimen of mifepristone and misoprostol and surgical abortion (vacuum aspiration)

in early first trimester abortions up to 9 weeks gestation. [84]

Medical abortion using the prostaglandin analog misoprostol alone is less effective and

more painful than medical abortion using a combined regimen of mifepristone and

misoprostol or surgical abortion. [85][86]

But the health risks of abortion depend principally upon whether the procedure is

performed safely or unsafely. The World Health Organization defines unsafe abortions as

those performed by unskilled individuals, with hazardous equipment, or in unsanitary

facilities[87]

. So Preventive antibiotics (such as doxycycline or metronidazole) are typically

given before elective abortion[88]

, as they are believed to substantially reduce the risk of

postoperative uterine infection. [51][89]

.

First-trimester procedures can generally be performed using local anesthesia, while

second-trimester methods may require deep sedation or general anesthesia[51]

.

From the 15th week of gestation until approximately the 26th, other techniques must be

used. Dilation and evacuation (D&E) consists of opening the cervix of the uterus and

emptying it using surgical instruments and suction. After the 16th week of gestation,

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abortions can also be induced by intact dilation and extraction (IDX) (also called intrauterine

cranial decompression), which requires surgical decompression of the fetus's head before

evacuation. IDX is sometimes called "partial-birth abortion", which has been federally banned

in the United States. BUT In the third trimester of pregnancy, induced abortion may be

performed surgically by intact dilation and extraction or by hysterotomy. Hysterotomy

abortion is a procedure similar to a caesarean section and is performed under general

anesthesia. It requires a smaller incision than a caesarean section and is used during later

stages of pregnancy. [92]

The following are some examples of pregnancy complications:

Pregnancy induced hypertension

Anemia [93]

Postpartum depression

Postpartum psychosis Thromboembolic disorders. These are the leading cause of death in pregnant women in

the US. [94] [95]

PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy), a skin disease that

develops around the 32nd week. Signs are red plaques, papules, and itchiness around the

belly button that then spreads all over the body except for the inside of hands and face.

Ectopic pregnancy, implantation of the embryo outside the uterus.

Hyperemesis gravidarum, excessive nausea and vomiting that is more severe than normal

morning Disease.

Pulmonary embolism, blood clots that form in the legs that can migrate to the lungs. [96]

There is also an increased susceptibility and severity of certain infections in pregnancy.

A pregnant woman may have intercurrent diseases, defined as disease not directly caused

by the pregnancy, but that may become worse or be a potential risk to the pregnancy.

Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not

restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage,

growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios (too

much amniotic fluid), and birth defects.

Thyroid disease in pregnancy can, if uncorrected, cause adverse effects on fetal and

maternal well-being. The deleterious effects of thyroid dysfunction can also extend

beyond pregnancy and delivery to affect neurointellectual development in the early life of

the child. Demand for thyroid hormones is increased during pregnancy which may cause a

previously unnoticed thyroid disorder to worsen.

Untreated celiac disease can cause spontaneous abortion (miscarriage), intrauterine

growth restriction, small for gestational age, low birthweight and preterm birth.

Often reproductive disorders are the only manifestation of undiagnosed celiac disease and

most cases are not recognized. Complications or failures of pregnancy cannot be explained

simply by malabsorption, but by the autoimmune response elicited by the exposure to gluten,

which causes damage to the placenta. The gluten-free diet avoids or reduces the risk of

developing reproductive disorders in pregnant women with celiac disease. [97][98]

Also, pregnancy can be a trigger for the development of celiac disease in genetically

susceptible women who are consuming gluten. [99]

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Systemic lupus erythematosus in pregnancy confers an increased rate of fetal death in

uterus, spontaneous abortion, and of neonatal lupus.

Hypercoagulability in pregnancy is the propensity of pregnant women to

develop thrombosis (blood clots).Pregnancy itself is a factor

of hypercoagulability (pregnancy-induced hypercoagulability), as a physiologically

adaptive mechanism to prevent post-partum bleeding.[100]

However, in combination with an underlying hypercoagulable states, the risk of thrombosis

or embolism may become substantial. [100]

deaths from unsafe abortion account for around13% of all maternal deaths.[101]

To reduce the number of unsafe abortions, public health organizations have generally

advocated emphasizing the legalization of abortion, training of medical personnel, and

ensuring access to reproductive-health services.[102]

Historically, a number of herbs reputed to possess abortifacient properties have been used

in folk medicine: tansy, pennyroyal, black cohosh, and the now-extinct silphium.[103]

The use of herbs in such a manner can cause serious even lethal side effects, such as multiple

organ failure, and is not recommended by physicians.[104]

Reported methods of unsafe, self-induced abortion include misuse of misoprostol, and

insertion of non-surgical implements such as knitting needles and clothes hangers into the

uterus. These methods are rarely seen in developed countries where surgical abortion is legal

and available.[105]

All of these, and any other method terminate pregnancy may be called

"induced miscarriage".

Method and Procedures of Research:

Objective:

The objective of the current research was to determine the causes of abortion and ways to

treat its effects in jeddah and the Eastern Region of Saudi Arabia. Differences were significant

among the responses of women in Jeddah and the Eastern Province of Saudi Arabia on

abortion, its causes, and treatment of its effects due to (Age, level of education, number of

abortions).

In this part of the research we describe the field research procedures undertaken by the

researchers to achieve the research objectives. These include defining the methodology used

in the research, the community and the sample of the research, the research tool, verifying its

validity and stability, and the statistical analysis used in analyzing the results.

Research Methodology:

To achieve the objectives of the research, the researchers used the descriptive method

to determine the causes of abortion and its effects in women in Jeddah and the Eastern

Province of Saudi Arabia. The descriptive research describes what is being and is interpreted

and is concerned with determining the conditions and relationships that exist between the

phenomena and goes further and explains, The survey is done by taking the entire research

community in case of small size.

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Research Community:

The current research community is comprised of women who attend the follow-up

clinics in the department of gynecology at the branches of King Abdul Aziz Hospital,

numbering 200 women. The following table shows their distribution according to the

residential area.

Table(1)

Frequency of members of the research community by residential area

P F E S

%6 12 Al-Qatif 1

% 4 8 Al-Jubail 2

% 4 8 Al-Dhahran 3

%8.5 17 Dammam 4

% 17 34 Al-Khobar 5

% 3.5 7 Hafr Al-Batin 6

% 7 14 Ahsa 7

50% 100 Jeddah 8

100% 200 Total

It is clear from (Table 1) that most of the members of the research community are

women who live in jeddah (50%), women who live in Al-Khobar city (17%), women who

live in Dammam (8.5%), the women who live in the city of Ahsa by (7%),Then the women

who live in the city of Qatif by (6%),The women who live in the city of Jubail and Dhahran,

where the proportion of the percentage (4%), while the lowest percentage was found in the

city of Hafr Al-Batin (3.5%) of the total population of the research community.

Research Sample:

Because the research community is small and has easy access to all its members, all

women have been taken to the research community in a comprehensive manner.

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Characteristics of the members of the research sample:

The frequencies and percentages of the individuals of the research sample were

calculated according to demographic variables, age, level of education, number of abortions,

as follows:

Distribution of the research sample according to age:

The frequencies and percentages of the individuals of the research sample were

calculated according to the age variable as shown in the results in (Table 2) :

Frequency and percentages of the members of the research sample according to the

age variable

P F age S

%5 10 less than (25) 1

% 52 104 from (25 to 35) 2

% 43 86 (35) years and over 3

100% 200 Total

It is clear from the previous (Table 2) that the majority of the research sample with

ages from(25 to 35) years (52%), while in the second order the members of the research group

with ages(35) years and over (43%), The lowest percentage of individuals in the research

sample with ages of less than (25) years (5%) were members of the research sample.

Distribution of the research sample according to the level of education:

The frequency and percentages of the members of the research sample were calculated

according to the variable of the level of education as shown in the results in (Table 3):

Frequency and percentages of the members of the research sample according to the

variable level of education.

P F E S

%5 10 do not have a qualification 1

% 52 104 an average qualification 2

% 43 86 Bachelor's degree 3

%0.00 0 graduates 4

100% 200 Total

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It is clear from (Table 3) that most of the members of the research sample have an

average qualification (52%), followed by members of the research sample with a Bachelor's

degree (43%), followed by members of the research sample who do not have a qualification

(5%), while the share of graduates did not represent any proportion of the total members of

the research sample, so they are excluded from the sample segments in the statistical analysis.

Distribution of the research sample according to the number of abortions:

The frequencies and percentages of the individuals of the research sample were

calculated according to the number of miscarriages as shown in (Table 4):

Table (4)

Frequency and percentage of individuals of the research sample according to the

variable number of abortions

P N Frequencies S

%39 78 Once 1

%29 58 Twice 2

%17 34 three times 3

%7 14 four times 4

%4 8 five times 5

%4 8 Six times 6

100% 200 Total

It is clear from (Table 4) that the majority of the sample of women who are abortions

(once) by (39%), Followed by members of the study sample of women abortions (twice) by

(29%),Followed by members of the research sample of women abortions (three times) by

(17%) Followed by members of the study sample of women abortions (four times) by (7%),

The lowest percentage was followed by members of the study sample of abortive women (five

and six times), with a percentage of 4% of the total sample.

Fourth: Research Tool:

After studying the theoretical literature and the previous studies related to the subject

of the research, the researchers constructed and developed a questionnaire to determine the

causes of the abortion and its effects in women in the Eastern Province of Saudi Arabia.

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The values of Pearson correlation coefficients ranged from (0.0637 to 0.846) at the

level of significance (0.01) indicating the true consistency of the expressions with their

dimensions. The results also showed that the values of the correlation coefficients The

stability coefficients of the tool ranged from (0.83 to 0.91) and the stability coefficient was

(0.96), indicating that the tool has a high degree of stability and is reliable in the current

research application.

Description of the search tool (resolution)The final version contained two main parts:

The first part is the personal data of the individuals in the research sample, which are

(age, level of education, number of miscarriages).

The second part: the axes of the questionnaire, and consists of two main axes:

The first axis: the causes of abortion in women, and consists of (25) words divided into

three dimensions as follows:

- The first dimension: external factors, and consists of (7) phrases.

- The second dimension: a Disease, and consists of (12) phrases.

- The third dimension: pregnancy complications, consisting of (6) phrases.

The distribution of the terms on the three dimensions included in the first axis as shown in the

following table:

Table(5)

Distribute the first axis statement numbers to its dimensions

Phrases

numbers statement numbers dimension S

7 From (1) to (7) external factors 1

12 From (8) to (19) Disease 2

6

From (20) to (25) pregnancy

complications 3

25 25 Total

Axis II: Treatment of side effects of abortion, consisting of (23) words divided into

three dimensions as follows:

- The first dimension: preventive, consisting of (3) phrases.

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- The second dimension: pharmaceutical, consisting of (12) phrases.

- The third dimension: surgical, consisting of (8) phrases.

The distribution of the terms on the three dimensions included in the second axis as

shown in the following table:

Table (6)

Distribute the numbers of the second axis statements to its dimensions

Phrases

numbers statement numbers dimension S

3 From (1) to (7) Preventive 1

12 From (8) to (19) Pharmaceutical 2

8 From (20) to (25) Surgical 3

23 25 Total

Believe The Search Tool:

In order to verify the veracity of the questionnaire, the researchers used the following

methods:

Virtual Honesty:

The first question consists of (25) words divided into three dimensions, and the

second axis consists of (23) words divided into three dimensions.

The researchers used the triangular Likert scale (disagree, do not know, I agree) to determine

the consent of the research sample members by agreeing to the terms specified in the

questionnaire.

Believe the internal consistency of the search tool:

a. The internal consistency of the first pillar (causes of abortion in women):

The validity of the internal consistency was calculated by calculating the Pearson

correlation coefficient between the scores of each statement and the total score of the

dimension to which the term belongs, as shown in the following table:

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Table(7) Pearson correlation coefficients between the scores of each statement

and the total score of the dimension of the first axis (causes of abortion in women)

D 3 D 2 D 1

C-C S C-C S C-C S

0.793 ** 20 0.775** 8 0.786** 1

0.777 ** 21 0.822** 9 0.776** 2

0.857 ** 22 0.776** 10 0.772** 3

0.800 ** 23 0.791** 11 0.811** 4

0.859 ** 24 0.864** 12 0.738** 5

0.863 ** 25 0.845** 13 0.780** 6

0.815** 14 0.756** 7

0.814** 15

0.785** 16

0.801** 17

0.821** 18

0.789** 19

** D statistically at the level of significance 0.01

It is clear from (Table 7) that the correlation coefficients of the expressions in the total

degree of the dimension to which the phrase belongs are all statistically significant at the level

of (0.01). All values of correlation coefficients were high values, ranging from (0.738)

(0.811). The second dimension (morbidity) was the correlation between 0.775 - 0.864 and the

third dimension (pregnancy complications) ranged between 0.779 - 0.863 indicating a high

degree of internal consistency of the first axis of the questionnaire Abortion in women.

The structural integrity of the first axis was verified by finding correlation coefficients

between the total degree of each dimension and the total sum of the axis.

Table (8) Correlation coefficients between the degrees of each dimension and the total

score of the first axis (causes of abortion in women).

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C-C Dimensions S

0.959** external factors 1

0.960** Disease 2

0.956** pregnancy complications 3

As shown in( Table 8), the correlation coefficients of the three dimensions, consisting

of the first axis and the total sum of the axis, were high (0.949 - 0.960), all of which are

statistically significant (0.01). Structural honesty for the first axis of the questionnaire (causes

of abortion in women).

.B. Internal consistency of the second axis(treatment of side effects of abortion):

The validity of the internal consistency was calculated by calculating the Pearson

correlation coefficient between the scores of each statement and the total score of the

dimension to which the term belongs, as shown in the following table:

Table (9)

Pearson correlation coefficients between the scores of each term and the total score of

the dimension of the second axis (treatment of the side effects of abortion)

D 3 D 2 D 1

C-C S C-C S C-C S

0.723** 16 0.715** 4 0.687** 1

0.766** 17 0.789** 5 0.756** 2

0.712** 18 0.844** 6 0.767** 3

0.739** 19 0.843** 7

0.709** 20 0.755** 8

0.609** 21 0.730** 9

0.655** 22 0.738** 10

0.762** 23 0.721** 11

0.813** 12

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0.825** 13

0.721** 14

0.727** 15

** D statistically at the level of significance 0.01

The correlation coefficients in the total score of the term are all statistically significant

at the level of (0.01). All values of the correlation coefficients were high, ranging from (0.687

- And the third dimension (surgical) ranged between (0.609 - 0.766), indicating a high degree

of consistency of internal consistency of the first axis of the questionnaire (treatment of

effects) Side effects of abortion).

The structural integrity of the second axis was also verified by finding correlation

coefficients between the total degree of each dimension and the total sum of the axis.

Table(10)

Correlation coefficients between the degrees of each dimension and the total score of the

second axis (treatment of the side effects of abortion)

C-C Dimension S

**0.856 Preventive 1

**0.891 Pharmaceutical 2

**0.839 Surgical 3

**D statistically at the level of significance 0.01

(Table 10) shows that the correlation coefficients of the three dimensions of the

second axis and the total sum of the axis were high (0.949 - 0.960), all of which are

statistically significant (0.01) indicating a high degree of structural honesty to the second axis

of the resolution (treatment of side effects of abortion).

Stability of the search tool:

The consistency of the questionnaire was determined by calculating the internal

consistency of the expressions using the Cronbach alpha factor. The results are shown in

(Table 11):

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Table (11) Coefficients of alpha-cronbach stability for axial dimensions

A-C N dimension S

0.89 7 external factors 1

0.91 12 Disease 2

0.92 6 pregnancy complications 3

0.90 25 Total for first axial

0.89 3 Preventive 1

0.95 12 Pharmaceutical 2

0.90 8 Surgical 3

0.91 23 Total for second axial

It is clear from (Table 11) that the values of stability coefficients for the dimensions

of the first axis (causes of abortions in women) were high. The values of stability coefficients

ranged from 0.89 to 0.92 and the values of the total stability coefficient of the first axis were

0.90.

The values of stability coefficients for the dimensions of the second axis (treatment of

the side effects of abortion) were high. The values of stability coefficients ranged from 0.80 to

0.85 and the total stability coefficient of the second axis was 0.91.

These values indicate stability coefficients and the reliability, reliability and reliability

of the application

Statistical Processing Methods:

Based on the nature of the research and the goals it sought to achieve, the data were

analyzed using the Statistical Package for Social Sciences (SPSS), and the results were

obtained according to the following statistical methods:

1. Duplicates and percentages: To identify the characteristics of the members of the

research sample according to personal data.

2. The arithmetical averages and the standard deviations: to calculate the mean of the

axial expressions as well as the total scores and the sub-grades of their dimensions

based on the responses of the members of the research sample.

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3. Pearson correlation coefficient: To calculate internal consistency, as well as to

determine the relationship between the degree of exercise causes of abortion in women

and treatment of side effects of abortion.

4. Alpha Kronbach: to calculate the stability of the terms of the questionnaire.

5. Range equation, so as to describe the arithmetic mean of responses on each and every

phrase.

Presenting and Interpreting The Results:

The current research sought to answer three main statistical questions:

1 . What causes abortion in women in Jeddah and the Eastern Province of Saudi Arabia?

2. What are the methods of treating the effects of abortion in women in Jeddah and the

Eastern Province of Saudi Arabia?

The results were analyzed to validate the hypothesis of the research. The results were as

follows:

Question 1: What causes abortion in women in Jeddah and the Eastern Province of Saudi Arabia?

The frequency and percentages of causes of abortion were calculated for women in the study sample. The results were shown in (Table 12):

Table(12)

Shows the calculation of the frequency and percentage of causes of abortion in the women of the research sample

P F causes S

%41.96 94 external factors 1

%32.14 72 Disease 2

%25.89 58 pregnancy complications 3

100% 224 Total

It is clear from (Table 12) that most of the causes of abortion in the female sample were external factors (41.96%). The lowest percentage of abortion reasons among women in the study sample was pregnancy complications (%25.89).

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The researchers point out that most of the causes of abortion in the women of the research sample were external factors that the external factors, although limited, but the level of possibility is higher than other causes because they are emergency factors interfere with the actions and reactions of people around, Quick-impact and often the payment or protection of those factors is difficult to achieve because they are unpredictable factors.

The researchers also point out that the lowest percentage of the causes of abortion in the women of the research sample was the complications of pregnancy until the periodic follow-up of pregnant women limit the occurrence of complications associated with pregnancy and make the likelihood of occurrence less, because of the similarity of such complications and the success of dealing with most of them.

External Factors:

The frequencies and percentages of external factors of abortion were calculated for the women in the study sample. The results were as shown in (Table 13):

Table(13)

Shows the calculation of the frequency and percentage of external factors of abortion in the women of the research sample

P F external factors S

%25.53 24 The uterus is exposed to shock 1

%0.00 0 Surgery 2

%0.00 0 Lack of oxygen in anesthesia 3

%8.51 8 Use of drugs that stimulated uterine

contraction 4

%2.13 2 Severe malnutrition 5

%0.00 0 Negative effect of smoking 6

%63.83 60 Without obvious reasons 7

100% 94 Total

It is clear from (Table 13) that most of the external factors of abortion among women in the study sample were (without clear reasons) which were (63.83%). The lowest external

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factors for abortion among the women in the study sample were Severe nutrition) which came at (2.13%), the word "surgical procedure" and "lack of oxygen in anesthesia" and "negative effect of smoking" were excluded because there were no responses to these terms.

The researchers attribute that most of the external factors of abortion in the women of the sample of the research was in the words (without obvious reasons) that the poor level of medical culture in the patients, which makes most of them can not identify the correct diagnosis information of the treating physician, and some are subjected to abortion from the impact of the attack from Before the husband or by their parents, which makes them keen to conceal the cause, and may resort to the use of some of the drugs without consulting the doctor lead to abortion and do not disclose it to escape responsibility.

The researchers also point out that the lowest external factors of abortion among women in the study sample were the term "severe malnutrition". Most women in the society know the need for good nutrition during pregnancy, which is common among women and most men know, this condition is rare and may result from the patient being traumatized by her or her inability to eat enough food or as a negative effect of another illness.

Disease:

The frequencies and percentages of the pathogenic injury of women in the study sample were calculated and the results were shown in (Table 14):

Table(14)

Shows the calculation of the frequency and percentages of the Diseases of women in the study sample:

P F Diseases S

11.11% 8 Genetic inheritance is abnormal. 1

5.56% 4 The patient's blood pressure rise. 2

5.56% 4 Deficiencies in kidney function. 3

13.89 % 10 Diabetes. 4

8.33% 6 Hypothyroidism. 5

13.89% 10 Infection of microbes or parasites. 6

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13.89% 10 Lack of uterine growth or birth defects. 7

0.00% 0 Weak muscle. 8

13.89% 10 The presence of uterine fibroids. 9

0.00% 0 Posterior tendency of the uterus. 10

13.89% 10 Immune causes prevent pregnancy from

continuing. 11

0.00% 0 The temperature of the patient. 12

100% 72 Total

It is clear from (Table 14) that most of the pathogenic causes of abortion among women in the study sample were (diabetes), (microbial or parasite), uterine growth or congenital malformations (fibroids) (Immunological reasons that prevent pregnancy), which came in equal proportions(%13.89),The lowest causes of abortion in the women in the study sample were the words (The patient’s blood pressure rise) and the phrase (Deficiencies in kidney function), which came in equal proportions(5.56%), While the term "weakness of the neck muscle" and the words "the back of the uterus" and "temperature of the patient" were excluded because there were no responses to these terms.

The researchers point out that most of the pathogenic causes of abortion in the women of the research sample were in the term (Diabetes) that the patients suffering from diabetes suffer from an imbalanced level of glucose in the blood at the beginning of pregnancy, and the period in which different devices develop in the fetus occur In addition, women with an unbalanced level of glucose in the blood are likely to develop problems and complications related to the equilibrium of the sugar level in the body of a woman such as hypoglycemia (low blood sugar level) and hyperglycemia (increase in the level of Z glucose) and fatty acids and exposure to the high level of pregnancy is one of the causes of abortion poisoning.

The majority of the causes of abortion in the women of the research sample in the term (infection of microbes or parasites) that many women are infected with bacterial vagina, a disease that is difficult for women to detect easily and cause abortion of the fetus in the case of delayed treatment, Infection during pregnancy (toxoplasmosis) usually moves from

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the cats to the mother and then passes through the placenta from the mother to her fetus and causes miscarriage. The majority of the causes of abortion in the women of the research sample in the term (uterine growth or congenital malformations) that some women suffer from the presence of deficiency or abnormalities in the uterus is not discovered only after pregnancy, such as uterine uterus or uterus child, The two horns or the presence of cervical vertebrae, usually those distortions lead to abortions. Most of the causes of abortion in women in the research sample and in the presence of uterine fibroids are that most women are usually exposed to uterine fibroids in the case of a tumor in the uterus muscle or inside the uterus, which causes pressure on the fetus within the uterus, causing it not to grow, And may lead to abortion of the same pregnancy in its advanced stages, as well as chemical secretions that come out of fibroids that cause abortion as well. Most of the pathogenic causes of abortion in women in the study sample were also found in the term "immunological reasons to prevent pregnancy". Some patients suffer from hyperactivity of the immune system, which leads to the secretion of antibodies that attack the fetus, most commonly antibodies to phosphorus, Of the clotting factors associated with Lupus anticoagulant, all of which lead to abortion. The researchers also point out that the lowest pathogenic causes of abortion in the women in the study sample were (The patient’s blood pressure rise) and the term (lack of function of the kidney) to control hypertension is an uncomplicated medical process and usually succeed in pregnant women and not The loss of the fetus is rare, and kidney function is usually controlled by controlling the urine and creatinine ratios to maintain the mother's life, and the relative stability of the mother makes the fetus safe. Pregnancy Complications:

The frequency and percentage of abortion complications of women in the study sample were calculated and the results were as shown in (Table 15):

Table(15) Shows the calculation of the frequency and percentage of abortion complications in women in the study sample

P F complications S

3.45% 2 Extend the uterine wall as a result of twin

pregnancies 1

6.90% 4 The abundance of fluid surrounding the 2

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fetus.

62.07% 36 Incomplete fetus 3

13.79% 8 Ectopic pregnancy 4

10.34% 6 Placenta clots 5

3.45% 2 Wrap the umbilical cord around the

embryo 6

100% 200 Total

It is clear from (Table 15) that most of the complications of pregnancy causing abortions in the women of the sample of the sample was the word (incomplete fetal), which came (62.07%), and the lowest complications of pregnancy abortion in the women members of the research sample was in the phrase (A double extension of the uterus wall due to twin pregnancy) and also the term "cord wrap around the fetus" which came in equal proportions (3.45%).

The researchers attribute that most of the complications of pregnancy causing abortion in the women of the research sample was the term "incomplete fetal" to the fact that most cases of fetal death are interpreted by the patients as a state of incompletion regardless of the reasons leading to it, For the patient.

The authors report that the lowest complication of the abortion in the women in the study sample was the term "excessive extension of the uterus wall as a result of twin pregnancy" and the phrase "wrap the umbilical cord around the fetus." The extension of the uterine wall as a result of twin pregnancy is a rare case The pregnancy is in more than one fetus. It also requires a problem in the wall of the uterus. As for the umbilical cord wrapping around the fetus, the researcher attributed this to a medical error by the doctor in charge of the birth. Most doctors usually try to avoid such errors. Lack of medical expertise.

Question 2: Methods of treating the effects of abortion in women in Jeddah and the Eastern Province of Saudi Arabia?

The frequency and percentage of methods of treating the effects of abortion were calculated for the women in the study sample. The results were as shown in (Table 16):

C-C dimension S

**0.856 Preventive 1

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**0.891 Pharmaceutical 2

**0.839 Surgical 3

Table(17) Shows the calculation of frequencies and percentage of treatment methods for the effects of abortion in the women of the study sample

P F methods S

43.33% 156 Preventive 1

25.00% 90 Pharmaceutical 2

31.67% 114 Surgical 3

100% 360 Total

It is clear from (Table 17) that most methods of treatment of the effects of abortion in the women of the sample of the study were preventive methods, which came (43.33%), and the lowest proportion of ways to treat the effects of abortion in the women of the sample of the research sample was in the pharmaceutical methods by(25%).

The researchers point out that most methods of treatment of the effects of abortion in the women of the research sample were preventive methods that many doctors and patients are keen not to be exposed after the abortion to the side effects of drugs as well as surgery, so the concern of both sides to address the effects of abortion Preventive methods.

The researchers also point out that the lowest percentage of methods of treating the effects of abortion in women in the research sample was in the pharmacological methods that the patients usually prefer to keep away from the use of drugs to the limit, making their resort to take drugs to treat the effects of abortion less than other methods of treatment

Preventive Methods:

The frequency and percentages of methods of treating the effects of preventive abortion in the women of the study sample were calculated. The results were as shown in (Table 18):

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Table(18) The calculation of the frequency and percentages of the methods of treating the effects of preventive abortion in the women of the research sample

P F methods S

48.72% 76 complete rest 1

25.64% 40 Avoid sexual contact with the husband 2

25.64% 40 Avoid the vaginal shower 3

100% 156 Total

It is clear from (Table 18) that most of the methods of treating the effects of preventive abortion in the women in the sample of the sample were (complete rest) which came (43.33%), while the lowest proportion of ways to treat the effects of preventive abortion in the women of the research sample (Avoid sexual intercourse with the husband) and (avoid vaginal shower) equally(%25.64).

The researchers point out that most of the methods of treating the effects of preventive abortion in the women of the research sample were in the "complete rest" that the abortions adversely affect the public health of the patient, and make them more need to recuperate and restore physical strength and overcome the psychological state experienced as an expected impact of abortion.

The researchers also point out that the lowest percentage of ways to treat the effects of preventive abortion in women in the study sample (avoid sexual contact with the husband) and (avoid vaginal shower), that a few abortions may require avoiding sexual intercourse with the husband for the instability of the patient's condition and exposure For some complications in the case of the communication process, which are not prevalent, and may need to avoid some cases of dealing with any disinfectant chemicals other than "Betadine" to reduce interactions that may harm the uterus at that stage.

Pharmaceutical Methods:

The frequencies and percentages of treatment methods for the effects of pharmacological abortion in the women of the study sample were calculated. The results were as shown in (Table19):

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Table(19) The calculation of the frequencies and percentages of treatment methods for the effects of medical abortion in the women of the study sample

P F methods S

24.44% 22 Pain relievers 1

11.11% 10 Medications for inflammation such

as aspirin 2

8.89% 8 Antipyretic drugs such as hybrids 3

6.67% 6 Small doses of cortisone 4

4.44% 4 Antibiotics 5

8.89% 8 Progesterone 6

4.44% 4 Antimicrobial therapy 7

0.00% 0 Drugs for contractions 8

0.00% 0 Abortion pills 9

8.89% 8 Abortion Downloads 10

15.56% 14 Injection of abortion 11

6.67% 6 Oxytocin injection 12

100% 90 Total

It is clear from (Table 19) that most of the methods of treatment of the effects of medical abortion in the women in the study sample were (pain relievers), which came (24.44%), while the lowest proportion of ways to treat the effects of medical abortion in the women of the research sample (Antibiotic) and (antibody therapy) were equal(4.44%).

While the term "drugs for contractions" and "abortion pills" were excluded because there were no responses to these terms.

The researchers point out that most methods of treating the effects of medical abortion in the women in the research sample were painkillers, that many women suffer after the abortion of pain that makes them more likely to take painkillers, so that they can endure until they are identical to the full recovery.

The researchers also point out that the lowest percentage of ways to treat the effects of drug abortion in women in the antibiotic and antibiotic treatment sample indicates that the

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high frequency of antibiotics may adversely affect the patient's overall health and make her less immune, Side effects. As for the lack of use of antibody therapy, it is suggested that these antibodies may increase the level of immune activity by a rate that harms the patient, and may cause the increase of hormonal activity than normal, which adversely affects the health of the patient.

Surgical Methods:

The frequency and percentage of methods of treating the effects of surgical abortion in the women of the study sample were calculated. The results were shown in (Table 20):

(Table 20) The Calculation of the Frequency and Percentages of the Methods of Treating the Effects of Surgical Abortion in the Women of the Research Sample

P F Methods S

%0.00 0 Cervical connective tissue 1

3.5% 4 Expansion and suppression 2

%0.00 0 Expansion and extraction 3

%0.00 0 Maternal extraction 4

%0.00 0 Suction suction 5

96.5% 110 Empty the uterus or clean the uterus 6

%0.00 0 Hysterectomy 7

%0.00 0 Artificial Vaccination 8

100% 114 Total

It is clear from (Table 20) that most of the methods of treatment of the surgical abortion of women in the sample of the sample were (emptying the uterus or cleaning the uterus), which came (96.50%), while the lowest proportion of ways to treat the effects of surgical abortion in women members Sample of research in (expansion and extinction) by )3.50 %).

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The term "cervical dislocation", "hysterectomy", "hysterectomy", "hysterectomy" and "artificial insemination" were excluded because there were no responses to these terms.

The researchers point out that most of the methods of treating the effects of surgical abortion in the female members of the research sample were (emptying the uterus or cleaning the uterus) that most abortions left behind.

Of abortive pregnancy should be eliminated to avoid severe bleeding and prevent any uterine infections.

The researchers also point out that the lowest percentage of methods of treating the effects of surgical abortion in the women of the study sample in the expansion and extinction, that the process of enlargement and abortion in the case of abortion is usually decided by the doctor of the patient in the case of early abortion in the first three months, The patient is under total anesthesia and presents it to many risks, and there are many alternatives that result in good results and less dangerous, and recommends that the World Health Organization not to resort to abortion in the treatment of abortions, except in the absence of alternative, abortion only in the absence of an alternative.

Conclusions and Recommendations:

The research concludes with the following results:

Results of the First Question: What causes abortion in women in Jeddah and the Eastern

Province of Saudi Arabia?

1. Most of the causes of abortion among women in the study sample were external factors

2. The lowest percentage of causes of abortion among women in the study sample were complications of pregnancy.

3. Most of the external factors of abortion in the women of the research sample were in the phrase (without obvious reasons).

4. The lowest external factors of abortion among the women in the study sample were (severe malnutrition).

5. Most of the pathogenic causes of abortion in the women of the study sample were in the term (lack of uterine growth or congenital malformations).

6. The lowest pathogenic causes of abortion among women in the study sample were in the term (lack of kidney function).

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7. Most complications of pregnancy causing abortion in women in the sample of the research was in the phrase (incomplete fetal).

8. The lowest complication of the abortion in the women of the sample of the research was the words (excessive extension of the uterine wall as a result of twin pregnancy) as well as the phrase (wrap the cord around the fetus).

Results of the Second Question: What are the methods of treating the effects of abortion in women in Jeddah and the Eastern Province of Saudi Arabia?

1. Most methods of treating the effects of abortion among women in the study sample were preventive methods.

2. The lowest percentage of methods of treatment of the effects of abortion among women in the study sample was in the pharmacological methods.

3. Most methods of treating the effects of preventive abortion in the women of the sample of the research were in (complete rest).

4. The lowest percentage of ways to treat the effects of preventive abortion in the women of the research sample (avoid sexual intercourse with the husband) and (avoid vaginal shower).

5. Most methods of treatment of the effects of medical abortion in the women of the sample of the research was in (pain relievers).

6. The lowest percentage of the methods of treatment of the effects of medical abortion in the female members of the research sample in (antibiotics) and (antibody therapy).

7. Most methods of treating the effects of surgical abortion in the women of the research sample were (emptying the uterus or cleaning the uterus).

8. The lowest percentage of methods of treating the effects of surgical abortion in the women of the study sample in (expansion and extinction).

Search Recommendations: In light of the current research results, the researcher recommends the following:

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Researchers: Hanan Mohammed Ali Al Ghamdi , Resident - in king abdul aziz hospital - Jeddah

Abrar Faisal Al Johani Resident – KAAH - Jeddah

Ahdab Faisal Nono, ibn sina college- Jeddah

Ahela faisal nono –ibn sina college- Jeddah

Joud Ahmed Babaghi, ibn sina college- Jeddah

Doaa Mohammed Barnawi , Resident - Makkah

Bayan Abbas Zaatri, Resident at ,King fahad university – Al Khobar

Tasnim Ali Al-Bati, Resident at PHC

Neda Ali-Bati, student at Immam Abdulrahman bin Faisal university- Dammam

Sana Moghram Saeed Alahmari, ibn sina national college

Amani Nasser Alsubaie- king Abdul Aziz University

Manal Mahmood alsalmi, student- ibn sina national college

Maram mudhhi Al abdali, student- ibn sina college

Alaa Mohammed Baraheem, Resident in king abdul aziz hospital - jeddah

Data collectors:

-41-

Nada Abdo Abdulrab Nagi

Randa Abdulrahman Al Joubi, Resident in Al Batarji collage – Jeddah

Haya Mohammed Bin Hassan,Student in Princess Nourah Bint Abdul Rahman university- Al Riyadh

Ghadah Abdulrahman Albalawi, Student in Hail university

Areej Abdulrahman Alotaibi, Student in Tabuk university

Roaa Fahad Alshabanah, Intern in king khalid university – Abha

Tahani Saeed Almohayya, Intern in king khalid university – Abha

Abdullah Fahad Alharbi, student in Ibn sina national college – Jeddah