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At least 1,423 records · Page 79Linked to original sources
PubMed1989

Serum IgG and IgA antibodies to Chlamydia in ectopic pregnancies.

The possible association of Chlamydia trachomatis with ectopic pregnancies was evaluated in a case-control study, comprising 35 women with ectopic pregnancy and 294 apparently healthy women who served as controls. Chlamydia-specific IgG and IgA antibodies were determined by single serovar (L2) inclusion immunoperoxidase assay (IPA). Socio-demographic characteristics, gynecological history and contraceptive methods were also evaluated. An inverse relationship was found between the educational levels and the prevalence of IgG and IgA antibodies to chlamydia. The prevalence rate of elevated IPA IgG (titer greater than or equal to 128) and IPA IgA (titer greater than or equal to 16) specific to chlamydia was significantly higher in women with ectopic pregnancy versus controls (32% vs 8%, respectively, for IgG: odds ratio = 4.9; and 26% vs 4% for IgA: odds ratio = 7.5). Chlamydia trachomatis was not isolated in cell cultures in 10 specimens available from fallopian tubes of women with ectopic pregnancy. Only 9% of the women recall having pelvic inflammatory disease (PID) indicating that most of the infections were asymptomatic. Women who did not use IUD had a higher proportion of chlamydia-specific IgG and IgA seropositives, though not statistically significant, as compared to IUD users. This study further supports the hypothesis that subclinical infection of the tube with C. trachomatis may underlie ectopic pregnancies.

Adolescent↗
PubMed1990

Comparison of the lipoprotein and hemostatic changes after a triphasic and a monophasic low dose oral contraceptive in premenopausal middle-aged women.

Metabolic and hemostatic effects of 2 low dose oral contraceptives (OCs), a triphasic (ethinylestradiol + (-)-norgestrel) and a monophasic (ethinylestradiol + desogestrel) preparation, were compared in a cross-over trial in fertile women over 35 years of age. Both combinations moderately affected plasma lipids, with 17-24% increases of total triglyceridemia. Triglycerides accumulate in low density lipoproteins, thus suggesting the possible formation of an atherogenic lipoprotein particle. Only the monophasic preparation increased high density lipoprotein (HDL)-cholesterol levels significantly, with a rise in HDL3 mass and cholesterol. OC treatment led to slight changes in HDL2 and HDL3 structure, with a rise of the cholesteryl ester and triglyceride contents, indicative of a stimulated cholesterol esterification and reverse transport. Changes in the hemostatic indexes (fibrinogen, antithrombin III and protein C) were negligible. The new low dose OCs, even when prescribed to relatively older women, affect to a relatively small extent lipid/lipoprotein metabolism, with the exception of changes in the low density lipoprotein composition.

Adult↗
PubMed2000

Intrauterine device use and some issues related to sexually transmitted disease screening and occurrence.

The objective of this study was to compare sexually transmitted disease (STD) occurrence and STD complaints in women using intrauterine device (IUD) with women who are not using any modern contraceptive method in a family planning setting in Trabzon, Turkey. A great majority of all women in both groups were housewives and all indicated their husbands as the first and only lifetime sexual partner. The IUD user group (n = 211) did not differ significantly from the nonuser group (n = 155) in terms of mean age, years of schooling, first age at intercourse, frequency of sexual intercourse or practice of vaginal douching (p >0.05). STD signs and symptoms were not found to be significantly different among both groups, with the exception of vaginal discharge. IUD users complained more of abnormal vaginal discharge than nonusers (RR = 2.09, CI = 1.17-3.75, p = 0.007). Bacterial vaginosis was diagnosed with the Gram-staining of the vaginal smear and current IUD users were found to be 2.78 times more likely to be diagnosed with bacterial vaginosis as compared to nonusers (p <0.00). The diagnosis of trichomoniasis, N. gonorrhea, vulvovaginal candidiasis, and Chlamydia was not found to be associated with IUD use.

Adult↗
PubMed2007

Depo Now: preventing unintended pregnancies among adolescents and young adults.

PURPOSE: We compared the immediate administration of DMPA (Depo Now) to the immediate use of short-term hormonal methods that served as a "bridge method" until later DMPA initiation. We examined whether Depo Now, as compared to initiating with a bridge method (pills, transdermal patch, or vaginal ring), resulted in greater DMPA continuation at six months. METHODS: Young women aged 14 to 26 years seeking to use DMPA were randomized (nonblinded) after meeting eligibility criteria to either the Depo Now (n = 101) or bridge method (n = 232) group. Depo Now subjects received their first injection of DMPA at the conclusion of their first visit provided each was medically suitable and had a negative urine pregnancy test regardless of menstrual cycle day. Those assigned to the bridge method group were allowed to choose their starting contraceptive method and it was provided at the first visit. All subjects were told to return to the clinic in 21 days to repeat the urine pregnancy test, and among those who were assigned to use a bridge method, to receive their first injection of DMPA. All subjects were followed to their third injection, or about 6 months later. RESULTS: Those randomized to a bridge method were 1.8 (1.1, 2.9) times more likely than Depo Now subjects to return for their 21-day repeat pregnancy test, but only 55% (n = 125) of these young women actually received their first DMPA injection. Continuation rates at the third injection were 29.7% (n = 30) for those in the Depo Now group and 21.1% (n = 49) for those assigned to the bridge method (p = .09). Three factors were significantly associated with adherence to the third injection: randomized to Depo Now group, knowing more women who use DMPA, and returning to clinic for the 21-day repeat pregnancy test visit. Finally, 28 pregnancies were diagnosed during the study period, and those in the bridge method group were almost 4.0 (1.2, 13.4) times more likely to be diagnosed with a pregnancy than those in the Depo Now group. CONCLUSIONS: Immediate administration of DMPA is associated with improved adherence to DMPA continuation and fewer pregnancies.

Adolescent↗
PubMed2002

Unsafe abortion: an avoidable tragedy.

An estimated 60 000-70 000 women die annually from complications of unsafe abortion and hundreds of thousands more suffer long-term consequences which include chronic pelvic pain and infertility. The reasons for the continuing high incidence of unwanted pregnancy leading to unsafe abortion include lack of access to, or misuse of and misinformation about, effective contraceptive methods, coerced sex which prohibits women from protecting themselves, and contraceptive failure. Unsafe abortion is closely associated with restrictive legal environments and administrative and policy barriers hampering access to existing services. Vacuum aspiration and medical methods combining mifepristone and a prostaglandin for early abortion are simple and safe. For second trimester abortion, the main choices are repeat doses of prostaglandin with or without prior mifepristone, and dilatation and evacuation by experienced providers. Strategies for preventing unsafe abortion include: upgrading providers' skills; further development of medical methods for pregnancy termination and their introduction into national programmes; improving the quality of contraceptive and abortion services; and improving partner communication.

Abortifacient Agents↗
PubMed1989

Oral contraceptives: a reassessment.

Cardiovascular risks attributable to oral contraceptive use may now be subdivided into those that appear to be secondary to the estrogen component, i.e., venous thrombosis, pulmonary embolism, and those linked to the progestin component, i.e., small vessel disease including myocardial infarction and cerebrovascular accident. It appears that venous risk is attributable to subtle changes in clotting factors, while arterial risk may be secondary to changes in glucose and lipid metabolism. In order to determine which women are at greatest risk from oral contraceptive use, Spellacy et al. has developed a risk scoring form that aids in the screening process. After excluding women with an absolute contraindication to pill use, women at greatest risk for cardiovascular disease related to oral contraceptive use are those with a family history of hyperlipidemia, gestational or overt diabetics, hypertensives, and smokers over the age of 35. The gradual reduction by manufacturers of the steroid content of oral contraceptives appears to have lessened the incidence of adverse effects. Our current knowledge of risk factors permits the clinician to reduce exposure to oral contraceptive-related mortality by as much as 86 per cent. As we continue to search for ways to reduce risk among oral contraceptive users, it is important to note that more than 25 per cent of women are still taking formulations containing 50 micrograms of estrogen. It becomes the responsibility of the practicing physician to "step-down" these patients to lower-dose preparations such as the multiphasics. Such preparations also represent optimal therapy for first-time pill users.

Contraceptives, Oral↗
PubMed1995

Rates of testosterone-induced suppression to severe oligozoospermia or azoospermia in two multinational clinical studies. World Health Organization Task force on Methods for The Regulations of Male Fertility.

Two multicentre studies of the contraceptive efficacy of azoospermia and severe oligozoospermia were conducted in 16 centres in 10 countries. They used a common protocol of weekly testosterone injections for sperm suppression, the patterns and degrees of which were compared among men from different population groups. Six hundred and seventy normal, health volunteers, of whom 205 were Asian (mostly Chinese) and 465 of non-Asian origin, were given weekly injections of testosterone enanthate, 200 mg IM, during the suppression (6-month) and efficacy (12-month) phases. Patterns of sperm suppression were assessed by semen analysis at monthly or 2-weekly intervals. Sperm counts suppressed more slowly in the Asian than in the non-Asian men in the first 2 months of injections but subsequently suppressed to lower sperm concentrations below 5 million/ml, 3 million/ml or azoospermia at 6 months were 97.1% 95.6%, and 66.7%, respectively for non-Asian men, compared to 99.4%, 98.4% and 89.2%, respectively for Asian men. In conclusion, a hormonal contraceptive method based on regular testosterone injections can suppress spermatogenesis to azoospermia or severe oligozoospermia in 97% of men, regardless of their ethnic origin.

Adult↗
PubMed1980

Comparative multicentre trial of three IUDs inserted immediately following delivery of the placenta.

A multinational comparative trial of three IUDs (Copper 7, Lippes loop size D and the Postpartum T) randomly inserted immediately following delivery of the placenta was conducted in six centres. A total of 841 women entered the study. As the predetermined termination indices for expulsions were exceeded at six months the trial was prematurely closed. An excess of expulsions during the first 48 hours following insertion was observed for the Lippes loop compared to the other devices. At six months the expulsion rate for the Lippes loop was significantly higher than that for the Copper 7. In addition, the discontinuation rate for the Lippes loop at 12 months was significantly higher than that for the Copper 7. There were no significant differences in either the expulsion rates or the discontinuation rate at six or twelve months between the postpartum T and the other devices. At 12 months the pregnancy rates with all three devices was high; there were no ectopic pregnancies. Considerable between-centre differences were observed, particularly for expulsion rates. Possible reasons for this are discussed and future research lines are suggested.

Adolescent↗