Biomedical subjects

Edith Guilbert

Publications and source records attributed to Edith Guilbert.

10 recordsLinked to original sources

PubMed2005

[Social representation of pregnancy in adolescence: appraisal of dominant attitudes and others of negative impact].

This study was undertaken to gather information on the social representations of teenage pregnancy among adolescents, aged between 15 and 17. Eighteen focus groups were conducted among 150 boys and girls. The data were subjected to a qualitative content analysis. Results show that youths did not form homogeneous groups. The points of view expressed gave rise to 4 dimensions (emotive, reflexive, psychobiological, economic-social) and 4 positions (negative, positive, ambivalent and dynamic). From these dimensions and positions, 4 representations of teenage pregnancy were identified: pregnancy as a problem, pregnancy as a project, pregnancy as a source of tension, and pregnancy as a source of power. This study illustrates the importance of educative strategies such as going beyond alarmist preventive messages, opening dialogue with and between youngsters, and promoting social support and mutual aid.

Adolescent↗

PubMed2004

RETIRED: Canadian contraception consensus.

This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.

Canada↗

PubMed2004

RETIRED: Canadian contraception consensus.

Canada↗

PubMed2004

A fatal case of Clostridium sordellii septic shock syndrome associated with medical abortion.

BACKGROUND: Clostridia bacteria are infrequent human pathogens. In the obstetric and gynecologic literature, Clostridium sordellii infections have been very rarely reported. This is a case of infection following medical termination of early pregnancy with mifepristone and misoprostol. CASE: A 27-year-old woman presented for termination of pregnancy at 5.5 weeks from her last menstrual period. She received mifepristone 200 mg orally followed by 800 microg vaginal misoprostol. Three days after administration of misoprostol, she complained of dizziness, pelvic pain, and bleeding. The next day, she experienced worsening of symptoms and was hospitalized. She developed pulmonary edema, ascites, and heart failure. Despite supportive measures, antibiotics, and hysterectomy, she died 3 days later. The post mortem examinations indicated that death was caused by shock secondary to C sordellii infection. CONCLUSION: The frequency of infection following medical abortion is low. The rapid and fatal course of this infection is similar to other obstetric and gynecologic cases reported in the literature. Although providers should remain vigilant to the possibility of infection following medical abortion, the overall proven safety of medical abortion remains the same.

Abortion, Therapeutic↗

PubMed2004

SOGC clinical practice guidelines: Canadian contraception consensus.

OBJECTIVE: To provide guidelines for health-care providers on the use of contraceptive methods to prevent pregnancy and sexually transmitted diseases. OUTCOMES: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, risk of infection, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the cost and availability of cited contraceptive methods in Canada. EVIDENCE: Medline and the Cochrane Database were searched for articles in English on subjects related to contraception, sexuality, and sexual health from January 1988 to March 2003, in order to update the Report of the Consensus Committee on Contraception published in May-July 1998. Relevant Canadian Government publications and position papers from appropriate health and family planning organizations were also reviewed. VALUES: The quality of the evidence is rated using the criteria described in the Report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this Report.

Canada↗

PubMed2003

Sterilization failure, sterilization reversal, and pregnancy after sterilization reversal in Quebec.

OBJECTIVE: 1). To determine the likelihood of sterilization reversal and of subsequent sterilization after sterilization reversal among men and women and 2). to examine the likelihood of pregnancy after sterilization (contraceptive failure) and of pregnancy after sterilization reversal. METHODS: Payment data from the Quebec provincial health insurance system were obtained for each person undergoing vasectomy or female sterilization from January 1, 1980 to December 31, 1999 and linked through a unique identifying number for each person. Using standard techniques of survival analysis, we computed the cumulative probability of experiencing each of six events. RESULTS: Among women, 0.9% (of 311960) experienced a pregnancy after sterilization, 1.8% (of 321929) obtained a reversal after sterilization, 61% (of 4369) achieved a pregnancy after sterilization reversal and 48% achieved a delivery; 23% (of 4677) obtained a subsequent sterilization after reversal. Among men, 2.4% (of 310827) obtained a reversal after vasectomy and 18% (of 6694) obtained a subsequent vasectomy after reversal. All of these risks were much higher among those in the youngest age groups. CONCLUSION: Sterilization reversal and pregnancy after sterilization are not rare. Relatively high rates of reversal among the youngest age groups suggest a need for better counseling about alternative contraceptive strategies.

Adolescent↗

PubMed2003

"The state has no business in the bedrooms of the nation".

Explore the source record for details and available documents.

Canada↗

PubMed2003

Emergency contraception.

OBJECTIVE: To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting. OPTIONS: The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital copper intrauterine devices, are reviewed. OUTCOMES: Efficacy in terms of reduction in risk of pregnancy, safety, and side effects of methods for EC and the effect of the means of access to EC on its appropriate use and the use of consistent contraception. EVIDENCE: MEDLINE and the Cochrane Database were searched for English-language articles published from January 1998 through March 2003, to update the previous SOGC guidelines published in 2000. Clinical guidelines and position papers developed by health or family planning organizations were also reviewed. Key words used were: emergency contraception, post-coital contraception, emergency contraceptive pills, postcoital copper IUD. VALUES: The studies reviewed were classified according to criteria described by the Canadian Task Force on the Periodic Health Exam and the recommendations for practice were ranked based on this classification. BENEFITS, HARMS, AND COSTS: These guidelines are intended to help reduce unintended pregnancies by increasing awareness and appropriate use of EC. RECOMMENDATIONS: 1. Women who have had unprotected intercourse and wish to prevent pregnancy should be offered hormonal EC up to 5 days after intercourse. (II-2A) 2. A copper IUD can be used up to 7 days after intercourse in women who have no contraindications. (III-B) 3. Women should be advised that the levonorgestrel EC regimen is more effective and causes fewer side effects than the Yuzpe regimen. (I-A) 4. Either 1 double dose of the levonorgestrel EC regimen (1.5 mg) or the regular 2-dose levonorgestrel regimen (0.75 mg each dose) may be used, as they have similar efficacy with no difference in side effects. (I-A) 5. Hormonal EC should be started as soon as possible after unprotected sexual intercourse. (II-2B)6. Women of reproductive age should be provided with a prescription for hormonal EC in advance of need. (I-A) 7. The woman should be evaluated for pregnancy if menses have not begun within 21 days following EC treatment. (III-A) 8. A pelvic examination is not indicated for the provision of hormonal EC. (III-A) Validation: These guidelines have been reviewed by the Clinical Practice Gynaecology and Social and Sexual Issues Committees of the Society of Obstetricians and Gynaecologists of Canada. SPONSOR: The Society of Obstetricians and Gynaecologists of Canada.

Canada↗

PubMed2002

Comparison of abortions induced by methotrexate or mifepristone followed by misoprostol.

OBJECTIVE: To compare the effectiveness, side effects, and acceptability of medical abortions induced by methotrexate and misoprostol with abortions induced by mifepristone and misoprostol. METHODS: This was a multicenter, randomized, nonblinded, controlled trial comparing 50 mg/m(2) of methotrexate followed 4-6 days later by 800 microgram of vaginal misoprostol with 600 mg of oral mifepristone followed 36-48 hours by 400 microgram of oral misoprostol. RESULTS: There were 518 women in the methotrexate group and 524 women in the mifepristone group. In the methotrexate group, 21 women required suction curretage, two for continuing pregnancy, eight because of physician request (usually for excessive bleeding), and 11 because of patient request. In the mifepristone group, 22 women needed surgical termination, 17 because of physician request, and five because of patient request. By day 8, only 386 (74.5%) in the methotrexate group had completed the abortion compared with 474 (90.5%) in the mifepristone group, and the mean number of days from beginning to completion was 7.1 for methotrexate and 3.3 for mifepristone (P </=.001). There were no differences in complications, and side effects were similar. Acceptance was slightly higher with mifepristone (88.0%) than with methotrexate (83.2%). CONCLUSION: Abortions induced with mifepristone completed faster than those induced with methotrexate, but the overall success rates, side effects, and complications were similar. Acceptance rates were slightly higher with mifepristone than methotrexate (P =.03).

Abortifacient Agents, Nonsteroidal↗

PubMedDate not supplied

[The social representation of pregnancy in adolescence. A Quebec study. ].

OBJECTIVE: To gather information on the themes underlying social representations of teenage pregnancy among adolescent girls and boys and people working with them (health/social/school workers). METHOD: A qualitative approach was used. Adolescents and health/social/school workers were gathered separately in focus groups. A content analysis of their discourses was done. RESULTS: This study shows that adolescents and health/social/school workers were not homogeneous groups. Their representations on teenage pregnancy varied and were sometimes contradictory. Several points of view were expressed that gave rise to four distinct positions: negative, positive, ambivalent and dynamic. It is from these four positions that four social representations of teenage pregnancy were defined: pregnancy as a problem, pregnancy as a project, pregnancy as a tension, pregnancy as a gain of power. Within these four representations, the discourses were divided into four dimensions: emotional, introspective, psychobiological and socio-economic. DISCUSSION: The similarities and divergences between the discourses of adolescents and those of health/social/school workers reveal that the representations of teenage pregnancy are neither preconceived nor unalterable. They have functional properties of adaptation to changing realities, individual conditions, ongoing events, times of crisis and diverse social and cultural grounds. This study presents a new perspective on the topic of teenage pregnancy and questions people's attitude and relationship with teenagers with respect to this issue.

Adaptation, Psychological↗