Sexual dysfunction among women of low-income status in an urban setting.
Int J Gynaecol Obstet. 2010 Aug 26;
Authors: Worly B, Gopal M, Arya L
OBJECTIVE: To determine demographic and clinical conditions associated with sexual dysfunction among women of low-income status living in an urban setting. METHODS: Cross-sectional study of 102 consecutive women attending an urban gynecology clinic. Women were given validated questionnaires to measure sexual function, depression, urinary incontinence, and erectile dysfunction in the partner. The association of sexual dysfunction with demographic variables, depression, urinary incontinence, and sexual function in the partner was assessed by the respondent. RESULTS: The prevalence of sexual dysfunction was 37.3% (n=38). Women with sexual dysfunction reported significantly lower scores on all subscales of sexual function compared with women without sexual dysfunction. Women with sexual dysfunction were more likely to be older (33+/-11.2 vs 28.7+/-8.6; P<0.04), unemployed (68% vs 47%; P<0.03), and report depression (OR 4.4; 95% CI, 1.7-11.3), urinary urge incontinence (OR 2.7; 95% CI, 1.2-7.3), and intake of multiple medications (OR 5.4; 95% CI, 1.6-20.1). On multivariate analysis, depression and urge urinary incontinence were independently associated with sexual dysfunction. CONCLUSION: Female sexual dysfunction is associated with the presence of depression and urge urinary incontinence in women of low-income status living in an urban setting.
PMID: 20800836 [PubMed - as supplied by publisher]
Adolescent pregnancy outcomes and risk factors in Malaysia.
Int J Gynaecol Obstet. 2010 Aug 26;
Authors: Omar K, Hasim S, Muhammad NA, Jaffar A, Hashim SM, Siraj HH
OBJECTIVE: To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia. METHODS: We conducted a case-control study of pregnant girls aged 10 through 19years. The controls were women aged 20 through 35years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals’ medical records. RESULTS: The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (P<0.05 for all); being anemic, being unsure of the expected delivery date, and having few antenatal visits and a late delivery booking; and low Apgar scores and perinatal complications. CONCLUSION: Adolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications.
PMID: 20800837 [PubMed - as supplied by publisher]
Effect of married women’s beliefs about gender equity on their use of prenatal and delivery care in rural China.
Int J Gynaecol Obstet. 2010 Aug 26;
Authors: Cui Y, Zhang Q, Yang L, Ye J, Lv M
OBJECTIVE: To investigate the effect of married women’s beliefs regarding gender equity on their use of prenatal and delivery care in China’s rural Xinjiang and Anhui provinces. METHODS: In this survey, 1029 women aged from 15 to 69years, living in rural Xinjiang and Anhui provinces, and married, answered a questionnaire designed to collect information on their demographic characteristics, reproductive history (number of pregnancies, level of prenatal care, and mode and place of delivery), and beliefs regarding gender equity. We quantified “belief in gender equity” based on responses to 7 specific statements and graded the responses according to a system scoring the strength of the overall belief (a total score >/=19, strong; 15-18, moderate; and </=14, weak). RESULTS: Only 34.3% of the women demonstrated strong convictions about gender equity. Even after adjusting for education and ethnicity, the percentage of women who received consistent prenatal care and were delivered at a maternity facility was highest among those scoring 19 or higher, and the reverse was true for women scoring 14 or less. CONCLUSION: Overall, women in China’s rural Xinjiang and Anhui provinces do not hold strong convictions about gender equity. There was a positive correlation between belief in gender equity and use of prenatal and delivery care.
PMID: 20800839 [PubMed - as supplied by publisher]
A randomized controlled trial of 400-mug sublingual misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two Egyptian hospitals.
Int J Gynaecol Obstet. 2010 Aug 27;
Authors: Dabash R, Ramadan MC, Darwish E, Hassanein N, Blum J, Winikoff B
OBJECTIVE: To compare the safety, efficacy, and acceptability of 400-mug sublingual misoprostol with that of manual vacuum aspiration (MVA) in 2 Egyptian hospitals. METHODS: Participating women were randomized to either MVA or misoprostol treatment for incomplete abortion. The primary outcome, complete uterine evacuation, was determined 1week later, as were adverse effects, change in hemoglobin, acceptability, and satisfaction. RESULTS: Complete uterine evacuation was achieved in 98.3% of women who received misoprostol and 99.7% who underwent MVA (relative risk [RR] 0.99; 95% confidence interval [CI], 0.97-1.00). A decrease in hemoglobin of 2g/dL or more was comparably rare in the 2 groups (0.3% misoprostol vs 0.9% MVA; RR 0.34 [95% CI, 0.04-3.21]). Mean change in hemoglobin was also clinically similar (-0.5g/dL misoprostol vs -0.4g/dL MVA; P<0.01). Heavy bleeding was rare (2.4% misoprostol vs 1.6% MVA; RR 1.55 [95% CI, 0.51-4.68]) following treatment. Nearly all women (96.8% misoprostol vs 98.3% MVA) were satisfied with their treatment but those who received misoprostol were significantly more likely to prefer that method in the future (81.9% vs 62.8%; RR 1.30 [95% CI, 1.19-1.43]). CONCLUSION: The high efficacy, safety, and acceptability of 400-mug sublingual misoprostol indicate that it is analogous to surgery as a first-line treatment for incomplete abortion. Misoprostol might improve post-abortion care when resources are limited and surgical treatment is unavailable.
PMID: 20801444 [PubMed - as supplied by publisher]
Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 to prevent or cure bacterial vaginosis among women with HIV.
Int J Gynaecol Obstet. 2010 Aug 27;
Authors: Hummelen R, Changalucha J, Butamanya NL, Cook A, Habbema JD, Reid G
OBJECTIVE: To assess, among women with HIV, whether long-term oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 supplementation can prevent bacterial vaginosis (BV) and enhance the cure rate of metronidazole among those with BV. METHODS: A randomized, double-blind, placebo-controlled trial conducted among 65 HIV-infected women with an aberrant microbiota (Nugent score 4-10) who were randomized to receive daily probiotics or placebo for 6months. Those with BV (Nugent score 7-10) additionally received metronidazole for 10days (400mg twice daily). RESULTS: We did not find an enhanced cure rate of BV among women with HIV treated with adjuvant probiotics to metronidazole treatment. Among women with an intermediate vaginal flora, probiotics tended to increase the probability of a normal vaginal flora (odds ratio 2.4; P=0.1) and significantly increased the probability of a beneficial vaginal pH (odds ratio 3.8; P=0.02) at follow-up. CONCLUSION: Supplementation of probiotic L. rhamnosus GR-1 and L. reuteri RC-14 did not enhance the cure of BV among women living with HIV, but may prevent the condition among this population. Trial registration: NCT00536848.
PMID: 20801446 [PubMed - as supplied by publisher]
Cytology versus visual inspection with acetic acid among women treated previously with cryotherapy in a low-resource setting.
Int J Gynaecol Obstet. 2010 Aug 27;
Authors: Cremer M, Bullard K, Maza M, Peralta E, Moore E, Garcia L, Masch R, Lerner V, Alonzo TA, Felix J
OBJECTIVE: To compare visual inspection with acetic acid (VIA) with conventional cervical cytology as a follow-up cervical cancer screening method in women who had been treated previously with cryotherapy. METHODS: Salvadoran women screened with VIA and treated with cryotherapy within 3years were eligible to participate. Study participants were rescreened with VIA, Pap smear, colposcopy, 4-quandrant biopsy, and endocervical curettage. RESULTS: Of 147 women enrolled in the study, post-cryotherapy VIA was positive in 39 women (26.5%; 95% CI, 19.6%-34.4%). Of these 39, 1 woman had CIN 1 or higher on biopsy. Post-cryotherapy Pap smear was positive (ASCUS or higher) in 6 women (4.1%; 95% CI, 1.5%-8.7%). Of these 6, 2 women had CIN 1 or higher on biopsy. Post-cryotherapy specificity was significantly higher for Pap compared with VIA (95.8% [138/144]; 95% CI, 91.2%-98.5% vs 73.6% [106/144]; 95% CI, 65.6%-80.6%; P<0.001). CONCLUSION: As the single-visit approach for cervical cancer screening gains popularity, more women will have been treated with cryotherapy. Appropriate follow-up screening is therefore vital. Cytology may be a more suitable screening method than VIA in low-resource settings for women treated previously with cryotherapy.
PMID: 20801447 [PubMed - as supplied by publisher]
