Screening for Bacterial Vaginosis at the Time of Intrauterine Contraceptive Device Insertion: Is There a Role?

ObjectiveTo estimate the prevalence of bacterial vaginosis (BV) among women attending outpatient gynaecology clinics for insertion of an intrauterine contraceptive device (IUD); and to describe any differences between BV-positive and BV-negative women at one month after insertion with respect to four primary clinical outcomes: expulsion of IUD, pain, fever > 38ºC, and heavy bleeding.MethodsWe carried out an observational prevalence study between March 2008 and March 2009. Seventy women were each followed for one month. Vaginal cultures for BV were obtained before and at one month after IUD insertion, and women were assessed for complications at one month after insertion. Thirty-eight women had a copper IUD (Cu-IUD) inserted and 32 had a levonorgestrelreleasing IUD (LNG-IUD) inserted. Bacterial vaginosis was diagnosed using Nugent’s scoring and Gram stain evaluation of the cultures. Frequency distributions, Student t test, and Fisher exact test of independence were used to analyze the data.ResultsThe prevalence of BV was 7.1%. Five women were found to be BV positive at the time of IUD insertion, and none experienced any clinical complications. One BV-negative patient developed a tubo-ovarian abscess three months after LNG-IUD insertion, and another BV-negative patient reported persistent, thick vaginal discharge after Cu-IUD insertion. Of 43 BV-negative patients who had repeat cultures performed at their one-month follow-up visit, four (9.3%) shifted from having normal flora to being BV positive. We found no significant relationship between a patient’s BV status and any clinical outcome.ConclusionThe incidence of BV in this study was lower than that described in other populations. No clinical complications occurred among the BV-positive women. Screening for BV prior to IUD insertion is neither currently recommended, nor supported by our study findings.     

Factors influencing women's satisfaction with birth control methods.

OBJECTIVES: To study the extent to which variation in satisfaction with a birth control method is explained by variation in perceived physical and psychological effects. METHODS: A population survey among 1466 German women was carried out. Within the overall sample, 1303 women had ever used oral contraceptives, 996 had relied on condoms, 342 had ever used intrauterine devices (IUD), 428 had used natural family planning and 139 women were sterilized. For each method a woman had ever used, she answered questions about satisfaction with the method, concerns about getting pregnant or suffering health risks during use, ease of use, changes in sexual relationship, relationship with the partner and mood. Past and current users of oral contraceptives and IUDs and sterilized women additionally reported changes in menstrual bleeding. RESULTS: Variation in satisfaction was, for a large part, explained by variation in health concerns among oral contraceptive users, by variation in perceived changes in the quality of the sexual relationship among condom users, by perceived ease of use among IUD users and sterilized women, and by variation in pregnancy concern among natural family planning users. CONCLUSION: Counselling about these perceived experiences is most likely to result in greater satisfaction and therefore improved compliance.     

Frequency of bacterial vaginosis among women attending for intrauterine device insertion at an inner-city family planning clinic.

The aim of this study was to investigate the rate of bacterial vaginosis in women attending an inner-city family planning clinic for intrauterine device (IUD) insertion. In a population of 86 women, eight (9.3%) and 20 (23.2%) were found to have bacterial vaginosis according to the criteria of Amsel and Nugent, respectively. Sensitivity, specificity, positive and negative predictive values were calculated in relation to bacterial vaginosis for Amsel's criteria. The detection of clue cells demonstrated excellent sensitivity (85%). Positive amine test and vaginal discharge demonstrated poor sensitivity (50% and 55%, respectively). Our results suggest that Gram staining of vaginal specimens may be of use to identify the presence of bacterial vaginosis prior to IUD insertion.     

Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception

OBJECTIVES: The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. STUDY DESIGN: To investigate ongoing condom behavior in teens using levonorgestrel (Norplant) contraceptive implants, oral contraceptives, and condoms alone, we examined data from a 2-year prospective cohort study of 399 urban teens. The study consisted of 3 clinic-based cohorts of adolescent female contraceptive users: Norplant contraceptive implants (n = 200), oral contraceptives (n = 100), and condoms alone (n = 99). Data were collected at an admission interview and at 1- and 2-year follow-up from method continuers. RESULTS: Norplant contraceptive implant users were less likely than oral contraceptive or condom users to report condom use at last sex or consistent condom use at 1- and 2-year follow-up. The implant group showed a significant decrease in condom use from admission to 2 years after method initiation. The proportion of implant users self-reporting new sexually transmitted infections at 2-year follow-up, however, was not significantly greater than that of oral contraceptive or condom users. CONCLUSIONS: Our findings indicate that teen users of Norplant contraceptive implants are less likely to use condoms than teens who choose oral contraceptives but, probably because of differences in sexual behavior, are no more likely to self-report sexually transmitted infections. Our findings also indicate that teens who choose oral contraceptives and condoms do not use them consistently enough to avoid pregnancies or sexually transmitted infections.     

Bacterial flora of the cervix in women using different methods of contraception

Bacteriologic culture samples were taken from the cervix in three groups of 10 healthy, sexually active women using barrier contraception, oral contraceptives, or a levonorgestrel-releasing intrauterine contraceptive device. Culture samples for Candida albicans and Trichomonas vaginalis were taken, a cytologic vaginal smear was obtained, and an amine sniff test was performed; these were in addition to a routine gynecologic examination. Multiple bacteria were isolated from the cervix in women using oral contraceptives or an intrauterine contraceptive device, whereas lactobacilli alone dominated the flora of women using barrier contraception. Significantly more anaerobic bacteria were isolated from the cervix in oral contraceptive and intrauterine contraceptive device users when compared with the barrier method users. Symptoms and findings evident of anaerobic vaginosis were associated with the occurrence of anaerobic bacteria in the cervix of three patients using the intrauterine contraceptive device. The results showed that the cervical bacterial flora in sexually active healthy women is rich in anaerobes that can be regarded as a normal finding in women using oral contraceptives or intrauterine contraceptive devices. Barrier contraception with a condom prevents this anaerobic shift and maintains a lactobacilli-dominated flora in the cervix.     

Epidemiological data, cytology and colposcopy in IUD (intrauterine device), E-P (estro-progestogens) and diaphragm users. Study of cytological changes of endometrium IUD related

The author compares the epidemiological, cytological and colposcopical data found in IUD users, with a control population of estro-progestogens and condom users. The age, parity and clinical symptomatology, mainly leukorrhea, was higher in IUD users. At the colposcopic examination a normal pattern was found in condom users more frequently, but the suspect colposcopic signs were frequently associated with the use of the IUD. The oncologic evaluation of smears showed a slight dysplasia in 17.65% and 10.53% in IUD users and estro-progestogen users respectively. The only case of carcinoma in situ was found in the IUD users group. The bacteriological diagnosis on the smears did not reveal a quantitative difference in the three groups, while a qualitative difference was found, particularly with a high frequency of Trichomonas vaginalis and Corynebacterium vaginalis, and one case of Actinomyces in IUD users. The cytological study of the endometrium obtained by mono-use devices, revealed an aspect of aspecific non plasmacellular endometritis in 75% of the cases; a dysfunctional hormonal cytological aspect in 32.50%, and the oncological evaluation in 60% of the cases revealed atypical endometrial cells IUD related. No neoplastic lesion was found. The author concludes that the use of IUD must be prudent and accurate follow up must be carried out.     

妊娠合并细菌性阴道病的研究

目的：确定妊娠合并细菌性阴道病（ＢＶ）的发病情况，探讨妊娠合并ＢＶ与不良妊娠结局的关系。方法：根据临床表现和阴道革兰染色涂片镜检，对不同孕期的３８０名健康孕妇进行ＢＶ发病情况调查，并对其妊娠结局进行随诊。结果：妊娠合并ＢＶ的检出率为６．８％（２６／３８０）。妊娠合并ＢＶ孕妇的产褥感染、新生儿感染及新生儿黄疸的发生率，依次为１４．３％（３／２１）、９．５％（２／２１）及２３．８％（５／２１），高于无合并ＢＶ者（分别为２．２％、１．３％及５．４％，Ｐ＜０．０５，Ｐ＜０．０５，Ｐ＜０．００５）。结论：妊娠合并ＢＶ与母儿感染有关，有必要对妊娠合并ＢＶ孕妇进行治疗。     

Hormonal contraception and risk of sexually transmitted disease acquisition: results from a prospective study

OBJECTIVES: To examine the relationship between use of oral contraceptive pills or depot medroxyprogesterone acetate and sexually transmitted disease acquisition. STUDY DESIGN: Prospective cohort included 948 Kenyan prostitutes. Multivariate Andersen-Gill proportional hazards models were constructed, adjusting for sexual behavioral and demographic variables. RESULTS: When compared with women who were using no contraception, users of oral contraceptive pills were at increased risk for acquisition of chlamydia (hazard ratio, 1.8; 95% confidence interval, 1.1-2.9) and vaginal candidiasis (hazard ratio, 1.5; 95% confidence interval, 1.2-1.9) and at decreased risk for bacterial vaginosis (hazard ratio, 0.8; 95% confidence interval, 0.7-1.0). Women using depot medroxyprogesterone acetate had significantly increased risk of chlamydia infection (hazard ratio, 1.6; 95% confidence interval, 1.1-2.4) and significantly decreased risk of bacterial vaginosis (hazard ratio, 0.7; 95% confidence interval, 0.5-0.8), trichomoniasis (hazard ratio, 0.6; 95% confidence interval, 0.4-1.0), and pelvic inflammatory disease (hazard ratio, 0.4; 95% confidence interval, 0.2-0.7). Consistent condom use was associated with significantly decreased risk of gonorrhea, chlamydia, genital ulcer disease, bacterial vaginosis, and pelvic inflammatory disease. CONCLUSIONS: The use of oral or injectable hormonal contraception altered susceptibility to sexually transmitted diseases, which may in turn influence transmission of human immunodeficiency virus type 1. Consistent condom use was protective with regards to sexually transmitted disease and should be encouraged for the prevention of sexually transmitted disease and human immunodeficiency virus type 1 among women who use hormonal contraception.     

Risk score for antenatal bacterial vaginosis: BV PIN points.

OBJECTIVE: Develop a clinical risk score to screen for antenatal bacterial vaginosis (BV), irrespective of symptoms. STUDY DESIGN: Cohort study of 913 pregnant women with last menstrual periods between January 30, 1995 and February 22, 1997. BV was evaluated by Nugent-scored vaginal smears (scores of 7 to 10 considered positive) between 24 and 29 weeks' gestation. Forty-four potential risk factors were assessed. RESULTS: 17.8% of women had BV, of whom 22% were screened for BV by the usual care provider. Logistic regression-adjusted analyses found six predictors: vaginal pH>4.5 (OR=11.6, 95% confidence interval [CI] [7.8, 17.2]); black race (OR=1.9, 95% CI [1.3, 2.8]); condom use during pregnancy (OR=1.6, 95% CI [1.0, 2.5]); antenatal BV (OR=1.7, 95% CI [1.0, 2.8]); absence of sperm on smear (OR=1.7, 95% CI [1.0, 2.9]); and no history of sexually transmitted diseases (OR=1.6, 95% CI [1.0, 2.5]). Risk score weights were 5 for an elevated vaginal pH and 1 otherwise. The sensitivity and specificity of screening women with scores > or =4 were both 77%; this would involve screening 33% of patients. CONCLUSION: Approximately 80% of our BV cases were asymptomatic, emphasizing the need for objective risk assessment. Using six factors, clinicians can identify pregnant women at risk for BV.     

Anal sphincter disruption at vaginal delivery: is recurrence predictable?

Objectives: To evaluate the efficacy of clindamycin vaginal cream 2% once daily for 7 days in prolonging pregnancy. Study design: Randomised clinical trial of 112 women between 14 and 25 weeks of gestation with diagnosis of asymptomatic bacterial vaginosis were enrolled in a multicenter randomised trial and assigned to active or no treatment. A total of 55 women were assigned to clindamycin and 57 to no treatment. Main outcome measure: frequency of pre-term delivery. Results: The rates of pre-term delivery was 12.2% in the clindamycin group and 15.7% in the no treatment group (P=0.78). Birth weight was <2500 g in three and seven babies, respectively, in the two groups (P=0.32). Mean gestational ages at birth were 38.9 and 39.2 (P=0.52), respectively, in the clindamycin and no treatment groups. Conclusions: The results of this study suggest that treating asymptomatic bacterial vaginosis does neither markedly prolong pregnancy nor increase birthweight.     

Does the presence of vaginitis on a Pap smear correlate with clinical symptoms in the patient?

OBJECTIVE: To investigate the association of the finding of trichomoniasis, candidiasis or bacterial vaginosis (BV) on Pap smear with possible symptoms, findings on the clinical examination or treatment that the patient received shortly before or shortly after the results of the Pap smear. STUDY DESIGN: Cases were selected from the Department of Pathology, UMDNJ-University Hospital, Newark. Retrospective chart review of patients who had a diagnosis of Trichomonas or Candida infection or bacterial vaginosis on Pap smear was performed. Controls were patients with none of these organisms on Pap smear. RESULTS: We reviewed 761 charts. Of the patients represented, 78 were menopausal, 258 were pregnant and 425 were neither menopausal nor pregnant; 533 (70%) of the patients had an organism associated with vaginitis on their Pap smear. There was a significant association (p <0.001) between a positive Pap smear finding and signs, symptoms or treatment for vaginitis overall. By individual organism, there was a significant association between a positive Pap smear and clinical indicators of Candida and Trichomonas, but not of BV. CONCLUSION: Finding Candida or Trichomonas organisms on a Pap smear is a reliable indicator of vaginitis associated with these organisms. Finding organisms consistent with a shift in vaginal flora (BV) on Pap smear did not correlate with clinical indicators of vaginitis.     

Prevalence and risk factors for bacterial vaginosis and cervicitis among 511 female workers attending gynecological examination in Changchun,China

ObjectiveThis study aims to identify the prevalence of bacterial vaginosis (BV) and cervicitis among 511 female workers attending gynecological examination and determine the risk factors for bacterial vaginosis and cervicitis.Materials and methodsThis study enrolled 511 female workers attending gynecological examination in Changchun Obstetrics-Gynaecology Hospital in Changchun city from January 1,2015 to December 31, 2015. A structured questionnaire was designed to survey the general demographic characteristics, living habits and health status of the participants. Gynecological examinations were performed to assess the presence of bacterial vaginosis and cervicitis. Univariate and multivariate logistic regression analysis were used to identify risk factors associated with bacterial vaginosis and cervicitis.ResultsOf 511 female workers (median age, 40 years) were enrolled in our study, the prevalence of BV was 5.3%, and the prevalence of cervicitis was 22.1%. In multivariable analysis, women of specific ethnic groups had a higher odds ratio of BV (OR = 3.332, 95%CI 1.014–10.955) and premenopausal women had a reduced odds ratio of BV(OR = 0.162, 95%CI 0.061–0.425). Higher levels of education were associated with a reduced odds ratio of cervicitis (OR = 0.248, 95%CI 0.080–0.772).ConclusionsBV and cervicitis were both common among female workers. Improving women's educational level should be concerned so as to reduce the prevalence of cervicitis.     

基于门诊患者阴道微生态与HPV感染的相关性研究

目的: 分析以外阴阴道瘙痒、干涩、疼痛和（或）分泌物异常为主诉就诊患者的阴道微生态及宫颈人乳头瘤病毒（human papilloma virus,HPV）分布特点,探讨阴道微生态失调与HPV感染的关系。方法: 选取2019年2月1日—2019年12月31日,因外阴阴道瘙痒、干涩、疼痛和（或）分泌物异常就诊于天津中医药大学第二附属医院妇科门诊的483例患者为研究对象,同时进行阴道微生态检测和宫颈HPV检测,对检测结果进行分析。结果: 483例患者中,阴道微生态正常者仅有4例,占0.8%,微生态失调者479例,占99.2%,其中有明确致病菌的微生态失调（即阴道感染）者350例（73.1%）,无明确致病菌的微生态失调者129例（26.9%）;在350例阴道感染患者中,单一感染287例（82.0%）,混合感染63例（18.0%）。外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）单一感染（38.7%,111/287）及含VVC的混合感染（79.4%,50/63）发生率最高。阴道感染者中乳杆菌减少者、H₂O₂含量减少者占比高于无明确致病菌的阴道微生态失调者,差异有统计学意义（P<0.05）。在483例患者中,HPV感染162例,感染率为33.5%,而阴道感染患者的HPV感染率（37.1%,130/350）明显高于无明确致病菌的阴道微生态失调患者（24.0%,31/129）,其中滴虫性阴道炎（trichomonal vaginitis,TV）、细菌性阴道病（bacterial vaginosis,BV）、需氧菌性阴道炎（aerobic vaginitis,AV）、VVC、BV中间型患者HPV感染率分别为73.3%（11/15）、52.9%（72/136）、34.5%（10/29）、29.2%（47/161）和 27.4%（20/73）。多因素回归分析结果显示,TV、BV与HPV感染正相关（OR分别为5.325和3.298,均P<0.05）。结论: 外阴阴道瘙痒、干涩、疼痛和（或）分泌物异常的患者常存在阴道微生态失调,而且容易合并HPV感染,当发生阴道感染时（特别是TV及BV）,HPV感染的风险显著增加。     

胎膜早破患者细菌性阴道病阴道唾液酸酶活性的检测

目的　探讨细菌性阴道病 (bacterial vaginosis,BV)与胎膜早破及早产的关系。　方法　我们采用阴道分泌物唾液酸酶比色检测法 ,检测了 10 4例胎膜早破孕妇和 80例足月正常妊娠妇女阴道分泌物中的细菌唾液酸酶水平。　结果　 10 4例胎膜早破孕妇中 38例 (36 .5 4 % ) BV呈阳性 ;80例足月正常妊娠孕妇中 9例 (11.2 5 % ) BV呈阳性 (P<0 .0 1)。胎膜早破孕妇中合并早产 4 6例 ,其中2 6例 (5 6 .5 2 % ) BV呈阳性 ,平均出生体重为 2 180 g;足月妊娠胎膜早破 5 8例 ,其中 12例 (2 0 .6 9% )BV呈阳性 (P<0 .0 1)。　结论　细菌性阴道病可使胎膜早破、早产和低体重出生儿的危险性增加。     

Bacterial vaginosis in early pregnancy and adverse pregnancy outcome.

OBJECTIVE: To assess the prevalence of bacterial vaginosis (BV) in asymptomatic pregnant women and its association with preterm birth (PTB) and premature rupture of membranes (PROM). METHODS: In a cohort study 1,006 pregnant women between 16-28 weeks' gestation were screened for BV (Nugent's criteria) and for lower genital tract infection. Women were followed to confirm pregnancy outcome. Data were analyzed using STATA software. Univariate and multivariate methods were used to investigate the association between bacterial vaginosis and adverse pregnancy outcome. RESULTS: Prevalence of BV was 11.53%. Baseline characteristics were similar for both groups, 6.8% women were lost to follow-up. Incidence of PTB was higher in BV positive women compared to BV negative women (p = 0.001). On multiple logistic regression (MLR), BV was associated with an increased risk of PTB (p = 0.001) and PROM (p = 0.001), other correlates being previous PTB (p = 0.003) and the presence of enteropharyangeal organisms in vagina (p = 0.03). BV accounted for 82.53% of the attributable risk for PTB. CONCLUSION: Presence of BV in early pregnancy is associated with an increased risk of PTB and PROM. Multicentric interventional study is recommended.     

Attitudes towards contraception and some reasons for discontinuation

3101 women aged 20-44 were surveyed in Flanders in 1982-83 concerning their perceptions of the contraceptive methods they used. The survey was part of a larger longitudinal study of changes in family formation in Belgium. Traditional and modern contraceptive methods were perceived very differently. Withdrawal/periodic abstinence and the condom were regarded as effective by 61% and 79% of respondents, while the IUD, pill, and female sterilization were believed by 99% of respondents to be effective. Traditional and intermediate contraceptive methods were believed to be less convenient to use, to be more frustrating sexually, but to be more natural. The IUD and pills were associated with higher risks of secondary effects, but oral contraceptive (OC) users believed their method to be much more harmful to their health than did IUD users. IUD users complained of physical secondary effects, while OC users complained of physical, psychic, and sexual secondary effects. Fewer IUD users than OC users believed their method to be highly effective. Considerable proportions of withdrawal, periodic abstinence, and condom users appeared to overestimate the efficacy of their method. Sterilization users believed the accessibility of their method to be significantly lower than did users of other methods, perhaps because sterilization has become accepted and widely available in Flanders only in the past few years. The most frequently cited advantages of withdrawal/periodic abstinence and the condom were naturalness, innocuity, and lack of secondary effects, while the most frequently cited advantage of OCs and sterilization was their efficacy. Ease of use and efficacy were both cited as advantages by IUD users. A large number of women, especially those using modern methods, stated their method had no major disadvantages. The principle disadvantages cited by withdrawal, abstinence, and condom users were low efficacy and inconvenience for sex life, while the principle disadvantages for the pill and IUD were health worries and secondary effects. Perception of the attributes of the contraceptive method used was influenced more by prior contraceptive use than by age, educational level, ideology or completeness of the family. As in other countries, users of modern methods seem to be more satisfied with their choice. Reasons for terminating use of different methods used in the past were directly related to their perceived disadvantages. Secondary effects and health worries were the major reasons for terminating OC and IUD use. A nonnegligible proportion who terminated IUD use cited its lack of efficacy.     

The role of bacterial vaginosis in infection after major gynecologic surgery.

PURPOSE: Previous studies have reported an association between bacterial vaginosis (BV) and postoperative fever and infection. This prospective study investigated whether the intermediate or definite stages of BV are risk factors for postoperative infection after major gynecologic surgery. METHODS: Vaginal cultures were obtained preoperatively from 175 women undergoing gynecologic surgery. The diagnostic criteria for BV were based on Nugent's standardized method of Gram stain interpretation. Postoperative fever was defined as at least one temperature equal to 101.0 degrees F or greater, or two or more temperatures more than 6 hours apart equal to 100.4 degrees F or greater. RESULTS: Thirty-six percent of the positive-BV group developed a postoperative fever, compared with 20% of the Lactobacillus-predominant group and 12% of the intermediate-BV group (P = 0.017). The differences between the positive-BV group and the Lactobacillus-predominant group, and between the positive-BV group and the intermediate-BV group, with respect to postoperative fever, were statistically significant (P = 0.045 and P = 0.007, respectively). The difference between the intermediate-BV group and the Lactobacillus-predominant group was not statistically significant (P = 0.28). CONCLUSIONS: Although the association between BV and postoperative febrile morbidity could be a spurious result of confounding with other variables, it may be prudent for the surgeon to identify patients with BV and treat them preoperatively.     

Periodontal disease and bacterial vaginosis increase the risk for adverse pregnancy outcome

OBJECTIVES: To determine whether periodontal disease or bacterial vaginosis (BV) diagnosed before pregnancy increase the risk for adverse pregnancy outcome. METHODS: We enrolled a total of 252 women who had discontinued contraception in order to become pregnant. The first 130 pregnant women were included in the analyses. RESULTS: Multivariate analysis showed a strong association between periodontal disease and adverse pregnancy outcome (OR 5.5, 95% confidence interval 1.4-21.2; p = 0.014), and a borderline association between BV and adverse pregnancy outcome (OR 3.2, 95% confidence interval 0.9-10.7; p = 0.061). CONCLUSION: Our study suggests that pre-pregnancy counseling should include both oral and vaginal examinations to rule out periodontal disease and BV. This may ultimately have an impact on antenatal healthcare, and decrease the risk for adverse pregnancy outcome.     

A follow-up study of methods of contraception, sexual activity, and rates of trichomoniasis, candidiasis, and bacterial vaginosis

A randomized, clinical trial was conducted to evaluate the spermicidal agent nonoxynol 9 as prophylaxis for sexually transmitted diseases. Eight hundred eighteen women using birth control who attended a sexually transmitted disease clinic were evaluated monthly for trichomoniasis, candidiasis, and bacterial vaginosis for 6 months. Women using the active spermicide experienced a somewhat lower incidence rate of trichomoniasis (relative rate 0.83; 95% confidence interval 0.61 to 1.12) and bacterial vaginosis (relative rate 0.86; 95% confidence interval 0.69 to 1.12) as compared with placebo users. The rate of candidiasis was nearly identical for spermicide and placebo users (relative rate 1.02; 95% confidence interval 0.77 to 1.35). The number of sexual partners during the preceding month was related directly to the occurrence of trichomoniasis (p = 0.047) and bacterial vaginosis (p = 0.009) but not candidiasis (p = 0.99). Subjects using oral contraceptives experienced a statistically significant lower rate of trichomoniasis than did women using an intrauterine contraceptive device or who had had a tubal ligation (relative rate 0.56; 95% confidence interval 0.39 to 0.81).     

异位妊娠与IUD关系的探讨(附107例分析)

本文根据我院1984～1990年间62,321妊娠妇女的资料分析,宫内妊娠与异位妊娠的发病率发生了高度显著的变化(P<0.01)。特别是带器异位妊娠与未带器异位妊娠、带器异位妊娠与带器宫内妊娠之间的比例,1990年与1984年相比,差别高度显著(P<0.01),说明带器异位妊娠发病率极显著地上升。进一步对107例带器异位妊娠进行分析,发现与环位异常有一定的关系,经B超测定环位异常者占53%(35/66);且大部分发生在带器1～4年期间(68%);输卵管病理未能证实与炎症有关。指出带器异位妊娠发病率逐年增高,应予重视,与IUD之间的关系仍需进一步探讨。