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Biomedical subjects

I C Chi

Publications and source records attributed to I C Chi.

At least 73 records · Page 4Linked to original sources
PubMed1984

Post-cesarean section insertion of intrauterine devices.

Among 52 women who delivered by cesarean section in a medical center in Beijing, China and had either a Delta Loop or Delta T intrauterine device (IUD) inserted manually through the incision wound, the expulsion rates were significantly lower than among a comparable group of 147 women who both delivered and had the IUD inserted vaginally (4.1 versus 20.5 per 100 women at six months post-insertion). Since the cesarean delivery rate is increasing worldwide, we deem this preliminary finding important for postpartum contraception programs and urge further studies.

Adult↗
PubMed1984

IUD-associated hospitalization in less developed countries.

Data on 11,977 insertions of an intrauterine device (IUD) from 25 collaborating centers in 16 less developed countries (LDCs) were investigated for IUD-associated hospitalizations. These centers maintained regular follow-up and reported at least one hospitalization among their IUD cases. The Lippes Loop, Copper T, Delta Loop, and Delta T were the most commonly used devices, and three-fourths of all devices were inserted in postpartum women. Fifty-five of the 128 reported subsequent hospitalizations were associated with IUD use. Main indications for IUD-associated hospitalizations were pelvic infection, bleeding/pain, and method failure. Statistically significant differences were not detected in the three-month gross cumulative rates for hospitalizations due to IUD complications by age (less than 30 vs 30+), parity (0-1 vs 2+), or device type (Lippes Loop and Copper T vs Delta devices vs others). Three types of IUD-associated hospitalization rates were calculated, each involving a margin of error: 1) a Pearl rate of 8.0 per 1,000 woman-years of IUD use; 2) a one-year life table rate of 6.3 per 1,000 insertions; and 3) crude rates ranging from 3.2 to 4.6 per 1,000 cases.

Adult↗
PubMed1984

Ectopic pregnancies following female sterilization. A matched case-control analysis.

The present study compared 15 ectopic pregnancies occurring after female sterilization (EPs) with 30 non-pregnant control patients who had also undergone female sterilization (NPCs) for a history of induced abortion, any pelvic surgery, abdominal surgery, or pelvic infection. EP cases and controls were individually matched for clinic, surgeon, surgical approach, tubal occlusion technique, and date of operation, as well as patients age and parity. The only significant difference was the greater proportion of EP patients, reporting a history of induced abortion (matched triplet odds ratio = 9.0, 95% confidence limits = 1.39, 58.26). Women with EPs were further compared with 78 women with post-sterilization intra-uterine pregnancies (unmatched). Results again show a significantly greater risk of conceiving an EP following previous induced abortion (odds ratio 5.8, 95% confidence limits = 1.78, 18.60). Women with previous abdominal surgery also ran a significantly higher risk of post-sterilization EP (odds ratio 10.0 95% confidence limits = 2.45, 40.83). Limitations of the data and clinical implications of the results are discussed.

Abdomen↗
PubMed1983

Methodologic considerations in studies on female sterilization--a review for clinicians.

Despite the large number of female sterilization (FS) studies and their relatively straightforward nature (compared to oral contraceptive studies for instance), results are often conflicting and a number of unanswered questions remain. Methodologic shortcomings can explain at least a portion of this confusion. This paper provides guidelines so that clinicians may better conduct and evaluate studies of FS techniques. Some important study topics for the future are reviewed, and the authors briefly describe the three main study designs for FS studies--clinical trial, cohort and case-control.

Clinical Trials as Topic↗
PubMed1983

Deliveries after cesarean birth in two Asian university hospitals.

The task force of the consensus conference on cesarean birth of the National Institutes of Health, USA, has recommended substituting a trial of labor and vaginal delivery for elective repeat cesarean section in selected women. This paper assesses the benefits and risks associated with that recommendation using data from two Asian teaching hospitals, one in Jakarta, Indonesia and the other in Colombo, Sri Lanka. Data recorded on the Maternity Record Form designed by the International Fertility Research Program and the International Federation of Gynecology and Obstetrics were used for analysis. Consistent findings were derived from the two hospitals, in spite of the different medical care delivery systems in their countries. No significant increase in maternal and infant mortality and morbidity were associated with women having vaginal delivery subsequent to cesarean birth as compared to those with repeat cesarean section. Savings in medical cost were considerable in the former group.

Adult↗
PubMed1983

Failure to insert an intrauterine device.

Numerous studies have reported IUD-related events in evaluating the rates of pregnancy, expulsion, and removal for bleeding and pain, but the inability to successfully insert an IUD has been overlooked. This study analyzed data on 51 unsuccessful insertions from 22 international centers collected on standard forms. The incidence of insertion failures was estimated to be between 2.3 and 8.3/1000 attempted insertions. No statistically significant risk factors in patient characteristics were delineated through a case-control analysis. The incidence of insertion failures among postpartum cases was highest for the Delta Loop (16.8/1000 insertions). Data suggest that failure to successfully insert an IUD may not be directly attributable to any specific host characteristic but rather is contingent on agent (IUD type) and provider (inserter) factors.

Cervix Uteri↗
PubMed1981

Maternal mortality at twelve teaching hospitals in Indonesia-an epidemiologic analysis.

Records on 36,062 maternity cases admitted to 12 teaching hospitals throughout Indonesia between 1977 and 1980 were analyzed. A hospital maternal mortality rate of 37.4/10,000 cases (39.0/10,000 live births) was derived that was about ten times higher than rates reported from developed countries in the early seventies. Hemorrhage, infection and toxemia accounted for 91.2% of deaths resulting from direct obstetric causes and for 86,1% of total deaths. It is postulated that if all pregnant women received adequate antenatal care, and if all women wanting no additional children were sterilized, maternal mortality would be cut in half. It is recommended that maternal health services in Indonesia be integrated into its successful family planning program.

Adolescent↗
PubMed1981

Pregnancy risk following laparoscopic sterilization in nongravid and gravid women.

A multicenter data set was analyzed to compare incidences of poststerilization pregnancies between women who were not pregnant and those who were pregnant at admission of laparoscopic sterilization. The 12-month life-table poststerilization pregnancy rate was 6.0 per 1,000 procedures for the 7,696 nongravid and 32.8 for the 1,703 gravid women, for a fivefold difference. The crude pregnancy rates were consistently higher for the gravid women when data were classified by tubal occlusion technique and by patients' sociodemographic characteristics. The difference in pregnancy rates between the two groups was reduced to 2.4-fold when analysis was limited to data sets from centers that admitted both groups of women and that performed sterilization by the same technique. Results of this analysis support previous studies suggesting that gravid women, especially postpartum patients, carry a higher pregnancy risk following sterilization.

Female↗
PubMed1980

Laparoscopic and minilaparotomy female sterilisation compared in 15 167 cases.

Three methods of female sterilisation were compared in data from 23 countries: laparoscopy with occlusion by the tubal ring (7053 cases), minilaparotomy with occlusion by the tubal ring (3033 cases), and minilaparotomy with occlusion by the modified Pomeroy technique (5081 cases). The 12-month failure rate was 0.60 per 100 women for laparoscopy/ring and 0.30 per 100 women for minilaparotomy/Pomeroy. The surgical complication rate for laparoscopy/ring (2.04%) was more than twice that for minilaparotomy/Pomeroy (0.79%). The technical failure rate of minilaparotomy/Pomeroy was twice that of laparoscopy/ring, but the complication and method-failure rates were much lower. Failure and complication rates with minilaparotomy/ring were intermediate. For many women seeking sterilisation, a minilaparotomy procedure will be preferable to a laparoscopy procedure.

Female↗
PubMed1980

An epidemiologic study of risk factors associated with pregnancy following female sterilization.

Data on 14,700 female sterilization patients were collected by the International Fertility Research Program (IFRP) from 1972 to 1978 and analyzed to determine risk factors associated with the incidence of pregnancy following sterilization. With a case-control approach, it was found that younger patients (less than or equal to 34 years old) and those who did not lactate after sterilization had a higher risk of becoming pregnant. Patients who were sterilized in the early phases of a service program had a higher risk of pregnancy than those sterilized later. In the laparoscopic series, the relative risk of pregnancy was four times greater in patients who had the prototype spring clip than in patients who had the Falope ring. The relative risk increased to 7.0 when patients who had the prototype spring clip were compared to those who had the Falope ring, electrocoagulation, or the Rocket clip. Patients sterilized by electrocoagulation had a low pregnancy risk, but the risk of an ectopic pregnancy was significantly higher than for those sterilized with mechanical devices. In the culdoscopic series, the tantalum clip had an unacceptable pregnancy risk.

Adult↗
PubMed1980

Timing of laparoscopic sterilization in abortion patients.

A total of 1604 laparoscopic sterilization procedures with variable time intervals after first trimester therapeutic abortion were performed at the Severance Hospital of the Yonsei University College of Medicine, Seoul, Korea, from May 1973 to October 1975. Two hundred fourteen women were sterilized immediately at the time of abortion; 359 were sterilized between 1 and 42 days later; and the remaining 1031 women were sterilized 43 or more days after abortion. Electrocoagulation and tubal ring application were the tubal occlusion techniques used. The findings indicate that patients who underwent the combined abortion-sterilization procedure did not encounter higher rates of technical problems and/or complications than the other 2 groups. Only a few of these 1604 women studied had potentially serious complications that necessitated subsequent laparotomy, hospitalization after sterilization, and/or hospital readmission.

Abortion, Therapeutic↗
PubMed1979

Incidence of pain among women undergoing laparoscopic sterilization by electrocoagulation, the spring-loaded clip, and the tubal ring.

Data analyzed from five comparative studies show a relationship between the technique of tubal occlusion and pain experienced by patients both at the time of the procedure and during the recovery period. During the procedure, the spring-loaded clip is the technique least likely and the tubal ring the technique most likely to be associated with pain. During the recovery period, both the spring-loaded clip and the tubal ring are associated with higher rates of abdominal or pelvic pain than is electrocoagulation. Differences in pain that occurred during the recovery period did not persist to the early follow-up visit.

Electrocoagulation↗
PubMed1977

A study of abortion in countries where abortions are legally restricted.

In countries where induced abortion is permitted, national family planning programs are able to combine pre- and postconceptive fertility control methods to maximize success in achieving personally desired fertility levels and nationally desired growth levels. The proscription against induced abortion tends to produce criminal abortions and consequent morbidity and mortality which, in some countries, are often recognized as a national health problem. The International Fertility Research Program has undertaken this study of incomplete, inevitable, threatened and septic abortion cases, using a standard data collection instrument, to facilitate comparisons across institutions and countries. The data gather since 1971 in nine Asian, African and Middle Eastern hospitals includes 7,331 cases. Policies of the participating institutions with respect to what constitutes a therapeutic abortion affected the proportions of spontaneous abortions and of abortions induced outside the hospital and inside the hospital. Women treated for induced abortion tended to be of higher parity and more likely to have attained their desired family size than patients treated for spontaneous abortions. Morbidity rates were quite low for patients treated in centers where vacuum aspiration was mainly used, particularly in contrast to the morbidity rates for patients treated in centers where dilatation and curettage was used exclusively. High mortality rates in patients admitted with sepsis confirm the need not only for improvement of clinical procedures but also for reconsideration of the legal issues since many patients admitted with sepsis can be assumed to have had abortions induced.

Abortion, Illegal↗