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PubMed1988

Fertility after ectopic pregnancy in relation to background factors and surgical treatment.

To study the importance of certain background factors and surgical treatment, the obstetric outcome in 205 women consecutively treated for ectopic pregnancy was analyzed by means of questionnaires 4 to 5.5 years after surgery. The response rate was 83.4% and, among women desiring pregnancy (n = 112), the total pregnancy rate was 75.9% and the delivery rate 53.6%. The total incidence of repeat ectopics was 27.3%, and the proportion of women who had a repeat ectopic pregnancy but no delivery was 20.5%. Six of seven women having an ectopic pregnancy with a copper intrauterine contraceptive device in situ had a normal delivery during the follow-up period. The subsequent fertility among nonresponders appeared lower than among responding women. A number of background factors present at the time of surgery were correlated to subsequent infertility, e.g., history of infertility and previous abdominal surgery. Conversely, there was no correlation between the fertility outcome and the type of operative procedure.

Female↗
PubMed2000

Bacterial vaginosis and contraceptive methods.

UNLABELLED: OBJECTIVES The aim of this study was to investigate if bacterial vaginosis is associated with the use of specific contraceptives. METHODS: The study population consisted of 1314 women attending for periodical preventive examinations at our gynecology unit at the II Institute of Obstetrics and Gynecology of the University 'La Sapienza' in Rome. The patient's history and any current genital symptom were recorded on a structured protocol. Current users of contraceptives were compared with non-users. The chi(2) test and the t-test were used in the statistical analysis; a stepwise logistic regression analysis was performed to assess the simultaneous effect of more than one variable and to identify for possible confounding factors. RESULTS: Both oral contraceptive and condom use showed a significant protective effect against bacterial vaginosis. Our results also showed a significant increase of BV among IUD users, either before or after adjustments. CONCLUSIONS: This study showed a significant negative association between BV and OC and condom use, respectively, and a significant positive association between BV and IUD use. Therefore, we suggest that it is advisable to carry out a systematic microscopic evaluation in order to identify BV for IUD users.

Adult↗
PubMed1990

Contraception in the adolescent. Preparation for the 1990s.

An overview of current and future contraceptive methods available to the adolescent is presented. Emphasis is given to oral contraceptives, including low-dose monophasics and triphasics. Current research confirms the efficacy and safety or oral contraceptives for teenagers. Other methods are reviewed, such as the mini-pill, barrier contraceptives (including the cervical cap and female condom), injectable contraceptives, hormonal contraceptive implants, the vaginal ring, postcoital contraception, periodic abstinence, gossypol, and others. Though abstinence is the best contraceptive method for adolescents, contraceptive technology of the 1990s presents clinicians and sexually active youth with many additional options.

Adolescent↗
PubMed1999

Angiogenesis of the endometrium.

OBJECTIVE: To present current data pertaining to angiogenesis of the endometrium throughout the normal menstrual cycle and in benign and neoplastic diseases of the endometrium. SOURCES: We conducted a computerized search of MEDLINE, Current Contents, and Index Medicus for relevant studies in the English literature published between January 1966 and October 1998. STUDY SELECTION: We reviewed all studies that included human and animal models of angiogenesis of normal cyclic endometrium and benign and neoplastic endometrial diseases. TABULATION, INTEGRATION, AND RESULTS: Angiogenesis is important to cyclic, regenerating endometria and disease processes including dysfunctional uterine bleeding, response to exogenous hormonal treatment, bleeding associated with intrauterine contraceptive devices, uterine leiomyomata, endometriosis, complex endometrial hyperplasia, and endometrial carcinoma. CONCLUSION: In the future, knowledge of specific angiogenic patterns of various disease processes might improve application of antiangiogenic medications in therapies for benign and neoplastic diseases of the endometrium.

Carcinoma↗
PubMed2004

Youth risk behaviour in a Chinese population: a territory-wide youth risk behavioural surveillance in Hong Kong.

This cross-sectional study investigated the prevalence rates of different categories of youth risk behaviour by age, sex and parental education. The study population consisted of 26,111 Hong Kong students, aged 10-19 years, recruited from 48 primary (primary grades 4-6) and secondary schools (secondary grades 1-7). Less than one-third of subjects participated in vigorous exercise regularly, about one-third consumed an unhealthy diet frequently, 18% had tried smoking, and 14.5% had seriously considered attempting suicide. Although only 3.4% of students reported experience of sexual intercourse, less than half used a contraceptive device. Older students had higher prevalence rates of health-compromising behaviours than younger students. Female students were more likely to report suicide-related behaviour, attempting weight loss, and non-participation in vigorous physical activities. Students with parents of a lower educational background were more likely to report rarely or never wearing seat belts and bicycle helmets, suicide-related behaviour, smoking, sexual intercourse before 13 years of age, and attempting weight loss. The availability of data on youth health risk behaviours would enable health educators, public health practitioners and clinicians to plan appropriate screening and counselling for risk behaviours in early adolescents.

Adolescent↗
PubMed1982

Pseudoactinomycotic radiate granules in the lower female genital tract: relationship to the Splendore-Hoeppli phenomenon.

Splendore-Hoeppli phenomenon, the in vivo formation of eosinophilic radiate structures around microorganisms and biologically inert substances, may simulate actinomycotic sulfur granules and has been recognized in extragenital sites. In the lower female genital tract, the authors have noted these pseudoactinomycotic radiate granules (PAMRAGs) in both the presence and the absence of intrauterine contraceptive devices. To elucidate the nature and morphogenesis of PAMRAGs, the light microscopic morphologic features of PAMRAGs were studied by means of a battery of special stains. The absence of central branching filaments or diptheroid forms in PAMRAGs serves to distinguish them from true actinomycotic sulfur granules. Using the immunoperoxidase technique, the authors examined PAMRAGs for the presence of immunoglobulin, complement, and fibrin. Their studies showed that PAMRAGs contain neutral glycoproteins, lipid, and calcium with no demonstrable microorganisms, immunoglobulin, complement, or fibrin. The authors do not support the assertions of others that Splendore-Hoeppli radiate bodies are immune complexes derived from host serum proteins. They speculate that PAMRAGs of the genital tract are derived from host leukocytes that aggregate in response to the commonly present bacteria, parasites, or inert foreign bodies that initiate the Splendore-Hoeppli phenomenon and the morphogenesis of PAMRAGs.

Actinomycosis↗
PubMed1976

Reduction of menstrual blood-loss by prostaglandin-synthetase inhibitors.

Six patients with menorrhagia due to dysfunctional uterine bleeding and one patient with an intrauterine contraceptive device were treated with prostaglandin-synthetase inhibitors in an attempt to reduce their excessive menstrual blood-loss. Mefenamic acid (six patients) or flufenamic acid (one patient) taken during menstruation for 2-3 cycles reduced menstrual loss in each patient. These preliminary observations suggest a new treatment for a common gynaecological problem and could imply that prostaglandins are involved in the aetiology of excessive menstrual blood-loss in such patients.

Adult↗
PubMed1976

Fertility patterns after discontinuation of use of oral contraceptives.

Investigation of the fertility-rate after discontinuation of use of oral contraceptives shows that the monthly rate consistently follows an oscillatory pattern. This pattern appears to be unique to women who have discontinued the use of oral contraceptives. It may result from synchronisation of a previously unrecognised natural cycle, rebound changes in the reproductive system following steroidal contraception, or an infertile period associated with early intrauterine mortality.

Adult↗
PubMed1978

Very early abortion by prostaglandins.

309 women whose menstruation was delayed by 3-35 days were treated with intrauterine or vaginal prostaglandins. Of 275 confirmed pregnancies, 229 were successfully terminated without further abortifacient therapy. A successful outcome was often associated with episodes of vomiting, diarrhoea, and uterine cramps in the 24 hours after prostaglandin administration, but the incidence was related to prostaglandin dosage and gastrointestinal side-effects were more common after vaginal administration. The best results were achieved by the analogue 16:16 dimethyl P.G.E2 as a vaginal pessary. 14 patients (6.1%) required uterine curettage for escessive or prolonged bleeding, while 2 patients required blood transfusion. One patient, who had an intrauterine contraceptive device left in situ during treatment, developed acute pelvic sepsis. No deleterious side-effects occurred in 34 patients who were subsequently proven not to be pregnant at the time of treatment. Treatment by intrauterine or vaginal prostaglandins offers promise as a method of pregnancy termination which avoids much of the physical and emotional trauma associated with surgical termination, and has the advantage of not requiring hospital admission in the majority of cases. The present study shows the safety of the method, and its potential as a self-administration technique.

Abortifacient Agents, Nonsteroidal↗
PubMed1998

Fetal Candida sepsis at midgestation: a case report.

A patient presented with intrauterine fetal death at 21 weeks. A Candida vaginitis was treated at 18 weeks of gestation. Fatal fetal Candida sepsis caused by Candida albicans can occur in the absence of known risk factors such as prolonged rupture of membranes, the presence of an intrauterine contraceptive device or cervical cerclage.

Administration, Intravaginal↗
PubMed2002

Diagnosis of pelvic actinomycosis by 16S ribosomal RNA gene sequencing and its clinical significance.

Traditional ways of identification of anaerobic Gram-positive non-sporulating bacilli by isolation of the organism and studying it phenotypically by elucidation of its morphologic and biochemical characteristics and metabolic end products are associated with a need for special equipment and expertise, and strains that are "unidentified" because of ambiguous biochemical profiles. In this study, an anaerobic Gram-positive non-sporulating bacterium was isolated from the intrauterine contraceptive device of a 36-year old woman with pyosalpinx. The Vitek system (ANI) showed that it was 99% Propionibacterium granulosum; whereas the API system (20A) showed that it was 78% Actinomyces meyeri/odontolyticus. The 16S ribosomal RNA gene of the strain was amplified and sequenced. There was 0 base difference between the isolate and A. odontolyticus (GenBank Accession no. AJ234047), indicating the isolate most closely resembled a strain of A. odontolyticus. Identification of the organism in this study was important because the duration of antibiotic therapy would be entirely different. In the present case, identification of the bacterium as A. odontolyticus inferred that the patient suffered from an intermediate form of pelvic actinomycosis. A prolonged course of antibiotics would be more desirable, as the relapse rate of actinomycosis after a short course of antibiotics is high.

Actinomyces↗
PubMed1991

Contraception for women with diabetes: an update.

Today several effective contraceptive methods are available for women with IDDM. Contraceptive guidance as part of the pre-pregnancy counselling needs to be more widely implemented by general practitioners and in non-specialized obstetrical and gynaecological departments. Women with diabetes are generally well motivated, and thus the barrier methods may prove both acceptable and reliable contraceptive agents for some of these women. When, however, a high risk of user failure can be predicted, the IUD or hormonal contraception may be the only reversible alternative. According to our findings, IUDs can be recommended without reservation to women with IDDM. In women with previous GDM it seems that low dose oral contraceptive compounds may be administered without running the risk of inducing glucose intolerance, but long-term results are still unavailable. Natural oestrogens may be administered in combination with a progestogen for a limited period as an efficient and acceptable mode of contraception in women with IDDM without any concomitant adverse effects on diabetic control. From our investigations it also appears that short-term administration of combined low dose OCs containing the traditional progestogens (e.g. norethisterone or levonorgestrel) or the new gonane progestogens (e.g. gestodene) does not alter glycaemic control in women with IDDM. Similarly, these compounds do not cause any significant changes in lipid/lipoprotein levels during short-term treatment, although the intake of monophasic ethinyloestradiol/norethisterone preparations may result in higher triglyceride levels and tends to increase lipid levels more than triphasic ethinyloestradiol/levonorgestrel compounds. The results from our clinic have shown that OCs can be safely recommended at pre-conception counselling so that women with diabetes can obtain both optimal glycaemic control and efficient spacing of their pregnancies.

Contraception↗
PubMed2001

Retained fetal bones in the uterine cavity.

A 33-year-old woman was referred for infertility of 5 years' duration. Her history included pregnancy terminations at 6 weeks' gestation in 1992 and at 16 weeks' gestation in 1993. Both abortions were performed by curettage in West Africa. Her menses were every 28 days with normal flow. Due to a suggestion of a filling defect in the uterus on hysterosalpingography, hysteroscopic examination was performed. At hysteroscopy, several fragments of fetal bones were present in the uterus. These appeared as white structures, some with trabeculated pattern. They were removed until the entire uterine cavity was devoid of bony fragments. Histopathology examination confirmed the diagnosis. It is very likely that the findings were related to the woman's abortion in 1993. Similar to intrauterine contraceptive devices, fetal bones in the uterine cavity prevent conception.

Adult↗