A Comparison Study of Oral RU486／Cytotec and Vacuum Aspiration for Termination of Early Preganacy

Objective : This study is to compare the personal acceptability and effect of Oral RU486/PG versus surgical vacuum aspiration on termination of early pregnancy. Method: Subjects were recruited by their voluntary choice of methods. One hundred women aged 20～34 with amenorrhea of 35～42 days chose the medical method (RU486 600 mg on the lst day and cytotec 0. 4 mg on the 3rd day). One hundred women aged 20～34 with amenorrbea ＜ 56 days chose vacuum aspiration. Subjects were asked to return on the 17th day in the medical group and 14th day in the surgical group for follow-up. Results: Complete abortion rates in the medical and surgical groups were 89% and 100% respectively. The main reason for choosing medicalabortion was “less painful“ (94%) while that for choosing surgical abortion was “quick and saving time (55 % ), with removing or insering IUD (45 % ) following surgical abortion“, Conclusion : For pregnancy termination RU486/Cytotec (PGE1) and vacuum aspiration are both highly acceptable, Each method has its own advantages and disadvantages and they can not replace each other. Selective use can provide advantages of either method. The earlier the termination, the safer the event.     

Female sterilization by tubal ligation: a re-appraisal of factors influencing decision making in a tropical setting

Background Female sterilization by tubal ligation is the most commonly used method of fertility regulation. However, in some lesser-developed country like Nigeria, it has not been accepted as a popular method of contraception. Objective To assess the pattern of female sterilization and determine factors that may influence its acceptability. Method A retrospective study of 102 cases of tubal ligation (TL) performed between January 1999 and December 2004. Result Of the 102 patients/clients, 60 (58.8%) had TL at caesarean section, 28 (27.5%) had TL with repair of ruptured uterus and 14 (13.7%) clients had TL alone on request. In the reproductive age group, the rate of TL increased with age. In the group that had TL at caesarean section, the highest incidence of TL (65%) was recorded against parity 4. However, in the groups that had TL with repair of ruptured uterus and TL alone, the highest proportion of TL was recorded against parity 6, with rates of 46.3 and 57.1%, respectively. The rates of TL increased with the level of literacy. In the group that had TL alone, 92.9% of the clients were in a monogamous union. On the contrary, 89.3% of patients that had TL with repair of uterine rupture were in a polygamous union. There was relative distribution of patients/clients amongst the two religions and five ethnic grouping. In 55 of the 102 patients/clients, the indication for TL was completion of family size, though 41 of the 55 patients had TL at caesarean section. Conclusion Demand for TL alone was low. A greater percentage of the patients had TL in conjunction with another surgical procedure.     

2006年攀枝花市女用安全套在女性性工作者中的可接受性调查

[目的]了解女用安全套在女性性工作者(FSW)中的可接受性及其影响因素。[方法]2006年,在攀枝花市抽取部分FSW,免费发放女用安全套(女套)试用,于试用前后进行调查。[结果]向458名FSW发放女套,拒绝接收率为1.75%;1个月后(后期)调查85名使用女套者,不能接受女套外观的占55.29%,认为女套使用不方便的占57.65%,认为客人不喜欢使用女套的占56.47%,使用中出现噪音、下腹涨痛的各占17.65%、36.47%。83.53%的FSW更喜欢男用安全套。[结论]目前推广女套尚存在较多困难。     

Acceptability and clinical performance of a copper-containing frameless IUCD in Hong Kong

This is the first study conducted in Hong Kong to evaluate the acceptability and clinical performance of a copper-containing frameless intrauterine contraceptive device (IUCD; GyneFix/Ji Ni). Sixty-two women chose to use the frameless IUCD for contraception. A learning curve was demonstrated in the insertion technique of this new device. Pain associated with insertion was acceptable. No pregnancy was reported during the 1-year trial period. Objectively, the amount of menstrual loss did not change and dysmenorrhea improved, but the duration of menstrual flow was slightly prolonged during the use of this device. However, there was a 10.7% request rate for removal of the device because of its side effects. The expulsion rate during the first year was 5.3%, and the continuation rate at the end of the first year was 76.7%. It was found that 85% of the 40 subjects interviewed upon the completion of the 1-year trial period wished to replace the same device after the product expiration date and that 92.5% would recommend this device to their friends. In summary, the clinical performance of the frameless IUCD was comparable to its framed counterparts. The device was considered acceptable to a majority of the women.     

The acceptability of self-administration of subcutaneous Depo-Provera

Depo-Provera (depot medroxyprogesterone acetate, or DMPA) is an important contraceptive option for women worldwide. Currently, it is only available in intramuscular form requiring regular quarterly routine attendance at a health facility. A new subcutaneous preparation has been developed. This is self-administrable and could potentially reduce need for routine attendance to an annual visit. In a questionnaire survey of 176 women currently using DMPA, 67% would prefer to self-administer. Of the 33% who did not wish to self-administer, the most common reasons were a fear of needles (62%) and concern regarding incorrect administration (43%). In a second survey of 313 women not currently using DMPA, 64% of women said they would prefer to attend less often for contraceptive supplies. Twenty-six percent of women who had never used DMPA and 40% of ex-users would seriously consider DMPA if self-administration were possible. Our findings would suggest that the advent of subcutaneous self-administrable Depo-Provera with appropriate training and reminder system is likely to be beneficial and popular with many women.     

Women's perception of transvaginal sonography in the first trimester; in an early pregnancy assessment unit

The objective of this study was to gauge women views of transvaginal sonography in an emergency setting and to study any correlation between their perception of the procedure and their prior knowledge and experience of it. We surveyed women presenting with various complications of the first trimester. Only women who had transvaginal sonography and who gave informed consent were included. Four hundred and twenty-five women were recruited. Transvaginal sonography was considered not embarrassing, acceptable, not painful and not stressful by 378 (88.9%), 417 (98.1%), 419 (98.6%) and 385 (90.6%) of the women respectively. There were no statistically significant differences in the women's perception of the procedure whether they had prior knowledge and previous experience of the procedure or not. The majority of the women perceived transvaginal sonography favourably. Their perception of the procedure was favourable whether they had prior knowledge and previous experience of it or not.     

Similarities in women's perceptions and acceptability of manual vacuum aspiration and electric vacuum aspiration for first trimester abortion

This paper examines women's acceptability of and experiences with manual vacuum aspiration (MVA) as compared with electric vacuum aspiration (EVA) for first trimester abortion. Women requesting pregnancy terminations were randomly assigned to either MVA (n = 64) or EVA (n = 63). Participants completed questionnaires before and after their abortions and approximately 2-4 weeks later. We observed some differences by group in participants' ratings of the importance of method characteristics and in their perceptions of their abortion methods after their abortions. The two groups did not, however, differ in their reports of pain, anxiety or bleeding or in the acceptability of their method.     

Bleeding patterns and patient acceptability of standard or continuous dosing regimens of a low-dose oral contraceptive: a randomized trial

The purpose of this study is to compare bleeding patterns and acceptability of a contraceptive regimen of combined 20 microg ethinyl estradiol/100 microg levonorgestrel taken with and without a hormone-free interval. Thirty-two women desiring oral contraception were randomized to six 28-day cycles (standard group) or 168 days without a pill-free interval (continuous group). Participants kept a daily bleeding calendar documenting bleeding events (none, spotting or required sanitary protection) and side effects (headache, nausea, breast tenderness, depression, premenstrual syndrome and bloating). Primary outcome was number of bleeding days. Secondary outcomes included bleeding days requiring sanitary protection, amenorrhea, patient acceptability of bleeding patterns, method satisfaction and affective side effects. There were no differences in the baseline characteristics of the two groups. Although total bleeding days were fewer in the continuous group (mean = 25.9 vs. 34.9 days), this result did not reach statistical significance. However, women in the continuous group reported significantly fewer bleeding days that required protection (18.4 vs. 33.8 days, p < 0.01), and were more likely to have amenorrhea. Although both groups reported a high level of satisfaction with bleeding patterns and side effect profiles, women in the continuous group reported significantly fewer days of bloating (0.7 vs. 11.1 days, p = 0.04), and menstrual pain (1.9 vs. 13.3 days, p < 0.01). Continuous use of 20 microg ethinyl estradiol/100 microg levonorgestrel is associated with less bleeding requiring protection, and more amenorrhea than standard administration. Taken with or without a hormone-free interval, this oral contraceptive formulation is highly acceptable with regard to bleeding patterns and side effect profile. The continuous group had fewer light and moderate bleeding days, less bloating and menstrual pain. For patients who are seeking these results, this method may be more desirable.