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PubMed2000

Reproduction in women reporting chronic musculoskeletal disorders.

UNLABELLED: The present population based study assessed aspects of female health as a part of a national cardiovascular screening program in 40-42 year old women in the Sor-Trondelag county. Fertility, events related to the menstrual cycle, reproduction, and the use of contraceptive methods in women reporting musculoskeletal diseases (MSD) were compared to women without these disorders (references). A higher proportion of women with MSD reported subfertility. No significant difference in mean age of menarche or menstrual cycling pattern was found, however women reporting MSD had significantly more often metrorrhagia than references. Mother's age at birth of the first and last child differed from references only in two of the patient groups, and interval between pregnancies was longer in women with MSD. Women with MSD more often chose sterilisation as a contraceptive method. CONCLUSION: Reproduction was altered in women with MSD. It remains to elucidate the interrelationship between rheumatic disorders and gynecological dysfunction.

Adult↗
PubMed2000

Adolescent pregnancies in Addis Ababa.

OBJECTIVE: To determine the pattern, obstetric outcome, knowledge and practice of modern family planning methods and factors that predispose to pregnancy among adolescent mothers. DESIGN: A descriptive study comparing findings in adolescent and mature mothers. SETTING: Two teaching Hospitals in Addis Ababa. SUBJECTS: Adolescent mothers under 20 years of age and mature mothers aged between 20 and 34 years. MAIN OUTCOME MEASURES: Age at pregnancy, demographic variables, gestational age, parity, antenatal care attendance, modes of deliveries, birthweight, Apgar scores, condition of babies at birth and knowledge and utilisation of modern contraceptive methods. RESULTS: Five hundred and sixty nine (74%) of the adolescents were single compared with 226 (29%) of mature mothers (p<0.001, OR 6.83, 95%; CI=5.47-8.45). There were 391 (51%) unemployed adolescents compared with 99 (13%) of mature mothers (p<0.001, OR 7.0, 95% CI 3.06-5.05). Five hundred and twelve (67%) of the adolescent pregnant mothers failed to attend antenatal clinic compared with 344 (45%) of the mature mothers (p<0.001, OR 0.41, 95% CI=0.33, 0.5). Two hundred (26%) of adolescent mothers underwent Caesarean section compared with 82 (11%) of mature mothers (p<0.001, OR 2.44, 95% CI=1.90, 4.56). Two hundred and fifty six (33%) of the adolescent mothers delivered low birthweight babies compared with 106 (14%) of mature mothers (p<0.001, OR 3.12, 95% CI=2.4, 3.99). The one and five minute Apgar scores were less than seven in 301 (39%) babies born to adolescent mothers compared with 20 (27%) babies born to mature mothers (p<0.001, OR 1.73, 95% CI=1.39, 2.14. Five hundred and twelve (67%) of adolescent mothers had no knowledge about modern contraceptive methods compared with 147 (19%) mature mothers (p<0.001, OR 0.12, 95% CI=0.45-0.49). CONCLUSION: Adolescent pregnancy is common in the city of Addis Ababa. Adolescent pregnancy study revealed low birthweight, high Caesarean section rate and foeto-pelvic disproportion as a consequence of incomplete development of the bony pelvis. Improved education and contraceptive services are needed to reduce the incidence of adolescent pregnancy.

Adolescent↗
PubMed1991

Reproductive failure and antisperm-antibody production among prostitutes.

Reproductive failure and anti-sperm antibody (ASA) production among prostitutes were investigated. A questionnaire including the subject's age, years of prostitution, date of most recent birth, number of children and contraceptive method used at the beginning of prostitution were asked of 109 prostitutes, but only 53 agreed to complete the questionnaire. ASA was detected by ELISA in the prostitutes (n = 109) and in the control group (n = 40) sera. The tests revealed a high ASA rate (43.1%) among the prostitutes. The difference in the incidence of ASA between controls (5%) and the prostitutes (43.1%) was highly significant (p less than 0.01). It was found that ASA positivity incidence in 27 prostitutes who had never use any contraception method and who became infertile within 9.3 years (average) was 61.3%. These results may be explained by repeatedly inoculations with multiple sperm antigens and/or microorganisms.

Adult↗
PubMed1989

Post-puerperal Cu-T insertion: a prospective study.

One hundred and sixty eight consecutive women accepting copper T (CuT) intrauterine contraceptive device in the post-puerperal period were studied. Out of them, 63 could be followed after 6 weeks of insertion and 65 after 6 months of insertion. The risk of heavy bleeding, pain in abdomen etc. were no greater than those usually found when interval CuT insertion is carried out. There was no case of uterine perforation leading to migration of CuT. But the expulsion rate was found to be high i.e. 16.4%. CuT is a very useful post-puerperal contraceptive method and should be given more importance in MCH programme.

Female↗
PubMed1999

Successful use of levonorgestrel intrauterine system in a HIV positive woman.

After trying other contraceptive methods a woman with HIV disease found use of the levonorgestrel intrauterine system (IUS) very satisfactory, and benefited from the amenorrhoea it induced. She continued to use condoms. Other advantages of using the IUS were freedom from regular clinic visits, no need for daily pill taking, and absence of drug interactions.

Adult↗
PubMedDate not supplied

Sterilization: past, present, future.

Globally, sterilization protects more couples from pregnancy than any other contraceptive method. However, use of sterilization has grown only gradually and annual rates of adoption remain low. The high prevalence of sterilization can be explained by its excellent continuation rate, its appeal to a broad age range at the time of adoption, and its long history of availability. International patterns show that sterilization users are concentrated in the two large countries of China and India, but numerous smaller countries also have high proportions of couples using the method. Four personal characteristics differentiate its use within each country: age, parity, residence, and sex. A new projection method indicates that approximately 159 million sterilization adoptions are expected between 1990 and 2000, half of them in China. Most future sterilization users will be found where they have been in the past, due to their concentration in China and India and to the large carry-over of current users in all countries. Projections for sterilization are more dependable than are those for other contraceptive methods, because most current users are young enough to remain in the pool of active users for 10 years. They constitute a large component of the expected total in the year 2000--about 269 million users, or 29 percent of all couples.

Adult↗
PubMed1990

[Natural conceptive probability in normal married women].

A total of 1,974 married couples were investigated for natural conception rate and the time required to become pregnant after cessation of contraceptive measure. Among them, 33 couples were infertile due to various causes and 52 couples employed contraceptive method continuously. Therefore, the time intervals of natural conception were available for analysis only in 1,889 couples. Fourteen hundred and sixty-seven women (77.6%) became pregnant within 3 months after exposure to the risk of conception, 1,683 (89.0%) within 6 months, 1,793 (94.8%) within one year and 1,855 (98.0%) within 2 years. The correlations among conceptive probability, history of using contraceptive methods, age of marriage, and menstrual status were discussed.

Adult↗
PubMedDate not supplied

Users of reproductive health clinic services in a school pregnancy prevention program.

Although the potential of school-based programs in the prevention of adolescent pregnancy is well recognized, few have been evaluated. This paper describes the use of a reproductive health care clinic associated with a school pregnancy prevention program which had demonstrated success. The program operated in one junior and one senior high school in a large city during the 3 school years from 1981 to 1984. Three facets of the 818 users of the program clinic are explored: who enrolled in the clinic, why they enrolled and what contraceptive methods they received, and their continuation with the clinic. Chi-square analysis and Student's t-tests were used to test for significant differences between the two school and sex groups. Life table and regression techniques were employed to examine clinic continuation. The main findings are teens of both sexes used the clinic, and junior high males used it in surprisingly large numbers; there were no major school or sex differences in the characteristics of those who enrolled; most students enrolled to obtain a contraceptive method; although many females served by the clinic had previously used another family planning clinic, the majority of them had unmet needs; the rate of clinic continuation was high; and certain factors contributed to clinic continuation. These findings suggest that a clinic in a school-linked setting can successfully attract students to use its services and it may offer certain advantages for reaching sexually active teens in search of contraceptive protection.

Adolescent↗
PubMedDate not supplied

Effects of lactation and contraceptive use on birth-spacing in Bolivia.

Based on the 1989 Demographic and Health Survey of Bolivia, analysis of the joint effects of breastfeeding and contraceptive use on birth-spacing showed the IUD to be the most effective contraceptive method used to delay conception. Breastfeeding significantly lengthened the birth interval, but only following second and higher parity births. In addition, conditions of poverty appeared to further inhibit the return of fecundity and delay conception.

Adolescent↗
PubMed1989

Idiopathic thromboembolism associated with triphasic oral contraceptives.

Oral contraceptives are one of the most effective and widely used of the reversible contraceptive methods. Thromboembolic disease associated with the use of oral contraceptives has been widely reported. In recent years, attempts to understand the pathogenesis of oral contraceptive-induced thromboembolic disease have found a correlation between larger estrogen doses and increased risk for a thrombotic event. Because the newer triphasic oral contraceptives provide effective contraception with a method of administration that mimics normal hormonal fluctuations during the menstrual cycle, some prescribers may infer that these products are associated with a decreased incidence of adverse effects over alternative oral contraceptives. We present two cases of idiopathic thromboembolism associated with the use of a triphasic oral contraceptive with a discussion of the proposed pathogenic mechanisms for these events.

Adult↗
PubMedDate not supplied

Gynecologic and contraceptive services provided by certified nurse-midwives in North Carolina.

Gynecologic care by midwives has been little represented in the peer-reviewed literature despite the fact that the majority of midwives provide these services. Offering patients a variety of contraceptive options is important for informed choice and consent and for reducing the unintended pregnancy rate, which is nearly 50% in the United States. This study describes the volume of gynecologic care and the contraceptive methods provided by certified nurse-midwives (CNMs) in North Carolina. The study was conducted using a cross-sectional, confidential, self-administered mail questionnaire completed by 133 CNMs in clinical practice in North Carolina. The majority of the CNMs worked in private practice settings (67%), in urban areas (60%), and had 10 or fewer years of experience (62%). The median number of women seen weekly for gynecologic care was 15 (range 0-80), and 30% of CNMs provided gynecologic care to more than 25 women each week. The contraceptive methods discussed and provided by the CNMs were comprehensive. The high percentage of midwives providing gynecologic care merits further study of the content and quality of this care.

Adult↗
PubMed1996

Dihydroxyprogesterone acetophenide 150 mg + estradiol enantate 10 mg as monthly injectable contraceptives.

A survey among users and health personnel participating in the Salvadorian Social Security Institute (ISSS) Family Planning Program revealed interest in including a monthly preparation for injection as a contraceptive method offered by this Institution. The formulation containing dihydroxyprogesterone acetophenide (DHPA) 150 mg + estradiol enantate (E2EN) 10 mg was chosen for conducting an open and prospective study of efficacy and tolerability. Between January 1992 and March 1994, 7054 women were treated with this product for a total of 60010 months. A sample composed of 4505 women treated at this Institution confirmed that average users are young, have one or two children, do not show a particular geographical distribution and choose the monthly injection instead of oral contraceptives as the first contraceptive method or for the puerperium. The study formulation showed a high efficacy (Pearl Index: 0.018) and tolerability (general withdrawal rate throughout the study: 27.09%). The most frequent adverse events included bleeding disorders, headache and mastalgia; their incidence decreased spontaneously from the sixth month (3.9%), reaching 0% after two years. Treatment was discontinued due to adverse events in 3.47% of women. No significant bodyweight or systolic and diastolic blood pressure alterations were observed. Based on these results, the monthly injectable contraceptive was included in the basic product list at ISSS.

Adolescent↗
PubMed1990

Long-term contraception with the levonorgestrel 20 mcg/day (LNg 20) and the copper T 380Ag intrauterine devices: a five-year randomized study.

An intrauterine device, releasing approximately 20 micrograms/day of levonorgestrel (LNg 20), used by 1124 women, was studied in a randomized trial of five years duration in comparison with the Copper T, model TCu 380Agm in 1121 women. At five years, the gross cumulative pregnancy rate of 1.1 +/- 0.5 per 100 among users of the LNg 20 devices was not significantly different from the rate of 1.4 +/- 0.4 per 100 experienced by users of the Copper T 380Ag. The steroid-releasing IUD had significantly higher termination rates for expulsion and amenorrhea, a significantly lower termination rate for other menstrual problems and pain, and a lower continuation rate. The five-year continuation rate among women using the TCu 380Ag was 40.6 per 100 as compared with that of 33.0 per 100 among women randomized to the LNg 20 device (P less than .001). Terminations attributed to amenorrhea with the LNg device primarily account for differences in continuation. These two intrauterine devices are the most effective long-term, reversible IUDs yet reported in the literature. No other contraceptive methods have exhibited such low long-term pregnancy rates in randomized comparative trials.

Adolescent↗
PubMed1988

[A qualitative study on the reasons why the rural people in Nan province use contraceptive].

The purpose of this study is to investigate the reasons that rural people in Nan Province choose particular contraceptive methods, and places of services. The study utilizes the data from the study on the Impact and Efficiency of the Family Planning Program in Thailand: Phase II, which applied in-depth interview and small group discussion techniques. Findings indicate that wanting to limit the number of children to 2, wanting to space pregnancy, the limit of land, the conflict with working situation, and economic hardship are the reasons for using family planning. The major sources of contraception are health center, community health office, village health volunteer, village health practitioner, the border patrol police unit, and the military unit including other government agencies in the areas. As for the reasons for choosing a particular contraceptive method, convenience in practice and on obtaining services, desire for more children and concern over side effects are important.

Asia↗
PubMed2005

Fertility behavior and reproductive outcomes among young Guatemalan adults.

Fertility rates have declined in many developing countries and this has implications for health and development of subsequent generations. Guatemala has the highest fertility rates in Central America. Reproductive histories were obtained by interview in 2002-04, in a cohort of 779 women and 647 men who had participated as young children in a nutrition supplementation trial in Guatemala conducted between 1969 and 1977. Most women (77%) and men (79%) are currently married. Among the 700 women and 524 men reporting at least one birth, mean age at first birth was 20.7 +/- 3.8 years and 23.1 +/- 3.9 years respectively. Knowledge (> 80%) and use (approximately 70%) of modern contraceptive methods is fairly high; knowledge increases with parental socioeconomic status (SES) as measured in 1975. Younger respondents have experienced fewer pregnancies and live births compared with older respondents; age-specific fertility rates between 20 and 24 years were 294, 249, 236, and 261 births per 1,000 women, respectively, for women born from 1962-65, 1966-69, 1969-73, and 1974-77. Women in the top tertile of parental SES have had significantly fewer pregnancies (3.3) compared with those in the middle (3.7) and lower (3.8) tertiles. Migrants to Guatemala City reported greater knowledge of contraceptive methods, fewer pregnancies and living children, higher age at first birth, and more pregnancy and newborn complications as compared with cohort members who remained in the original villages (p < .05 for each comparison). Fertility rates, especially between 20 and 24 years, have declined over time. Differences in reproductive behaviors by parental SES and current residence suggest the role of social transitions in determining family formation in Guatemala.

Abortion, Induced↗
PubMed2003

[Norplant contraceptive implant].

OBJECTIVE: Norplant is a long lasting contraceptive method which protect again pregnancy for five years. We studied the side effects and the variations related to weight and blood pressure. MATERIAL AND METHODS: The study was carried out in three family planning clinics in Dakar with 450 women who have had their implants for at least six months. Data collection was based on patient interviews and review of medical files. RESULTS: The side effects reported were mainly menstrual problems with 54.7% of the women reporting menstrual spotting. The other non-menstruel side effects were headaches (64.2%) and dizziness (59.1%). The side effects at the insertion site were pruritus (16%) and pain (3.1%). Regarding weight and blood pressure, an increase in weight was observed up to three years of Norplant use and a decrease to the initial weight was seen during the fifth year of use. No variation was noted regarding blood pressure. CONCLUSION: Norplant is a contraceptive method widely used in Senegal. Most of the side effects involve menstrual problems. A slight increase of weight was observed in general with no variation in blood pressure.

Adult↗