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Biomedical subjects

A Faúndes

Publications and source records attributed to A Faúndes.

At least 55 records · Page 3Linked to original sources
PubMed1997

No relationship between the IUD position evaluated by ultrasound and complaints of bleeding and pain.

The objectives of this study were to define the "normal" position of the T-shaped intrauterine device (IUD) in the endometrial cavity, using transvaginal ultrasound, and to compare the IUD's position in women with and without complaints of bleeding and/or pain. Vaginal ultrasound was carried out in women who had used a T-Cu 200 or T-Cu 380 for at least 6 months. Of these women, 236 registered bleeding complaints and/or pain and 245 had no complaints. The distances, IUD-endometrium, IUD-myometrium, and IUD-fundus, were measured in each woman. Our results showed that women with and without complaints presented no significant differences in age, parity, type of IUD, duration of use, previous contraceptive method used, hysterometry, uterine position, or period of the cycle in which the ultrasound was performed. The values of the three distances in users without complaints were widely dispersed. The 90th percentile of the IUD-endometrium, IUD-myometrium, and IUD-fundus distances were 7, 11, and 27 mm, respectively. The curve of the values for the three distances among women with complaints was similar to that of the subjects without complaints. Using the generally accepted measurement of 20 or 25 mm as the limits of normality of the distance IUD-fundus, and the 90th percentile of the distance IUD-endometrium as the gold standard, 77% and 43% of the women were false positives for "incorrect IUD position." Similar results were obtained when the 90th percentile of the distance IUD-myometrium was used as a gold standard. We concluded that the 90th percentiles of the distance IUD-endometrium, IUD-myometrium, and IUD-fundus were 7, 11 and 27 mm, respectively, among users without complaints. The ultrasonographic diagnosis of the IUD position was unable to discriminate between women who did or did not have complaints of bleeding and/or pain. If ultrasound were to be performed in T-shaped IUD users, the IUD-myometrium distance is likely to be the most reliable measurement.

Adult↗
PubMed1997

Pregnancy-induced hypertension and hyaline membrane disease.

OBJECTIVES: (1) To determine whether the incidence of hyaline membrane disease (HMD) is different among premature babies of pre-eclamptic women and those of normotensive controls; (2) to determine the relative risk (RR) of HMD according to the severity of pre-eclampsia and gestational age. METHODS: A retrospective and prospective cohort of 271 pre-eclamptic women and 271 normotensive controls, with gestational age between 28 and 34 weeks was studied, including only singleton pregnancies, live fetuses and well-documented gestational age. Exclusion criteria were ruptured membranes > 24 h, other maternal diseases and previous use of corticosteroids. Statistical analysis included relative risk and multiple logistic regression model. RESULTS: The RR of HMD for babies of pre-eclamptic women was 0.96 (95% CI: 0.78-1.17), and remained unchanged after controlling for gestational age and multiple logistic regression analysis. CONCLUSION: Preterm babies of pre-eclamptic mothers had the same probability of having HMD as newborns of normotensive mothers.

Adult↗
PubMed1997

Illegal abortion: consequences for women's health and the health care system.

Illegal abortion is responsible for up to half of maternal deaths and consumes a large proportion of health resources in many developing countries, particularly in Africa and Latin America. The legal situation of abortion in a country does not influence the abortion rate, but illegality is associated with a much greater risk of complications and death. To make abortion legal is not enough. Access to safe abortion strongly depends on the capacity and willingness of physicians and the health system to provide safe services, which sometimes are made available in spite of restrictive laws. The abortion rate will drop and the safety of the procedure will improve, parallel to the position women occupy in a given society, and to the level of recognition of their sexual and reproductive rights. The medical profession, and FIGO in particular, has a great role to play in implementing initiatives that will reduce the consequences of illegal abortion for women and society.

Abortion, Induced↗
PubMed1996

Post-abortion complications after interruption of pregnancy with misoprostol.

The high incidence of abortion in Brazil and the increased use of misoprostol among women having clandestine/unsafe abortions has led to an interest in evaluating whether there is an association between the use of misoprostol and the incidence of septic complications post-abortion. To test this association, a retrospective cohort study was conducted with 1840 women treated post-abortion at the Instituto Materno-Infantil de Pernambuco (IMIP) between 1988 and 1992. Incidence of infection (4.2%) was lower in women stating they had used misoprostol than in those stating that the abortion was not induced (7.9%) and twelve times lower than in women stating that they had used other methods (49.4%). These results suggest that misoprostol is a safe, inexpensive method for inducing abortion, and leads to fewer complications and consequently shorter hospital stays. Misoprostol should be considered a viable option in situations where induction of abortion is legal or medically indicated.

Abortion, Induced↗
PubMed1996

Evaluation of the effectiveness of vaginal misoprostol to induce first trimester abortion.

Two doses, 200 and 400 micrograms, of misoprostol, administered vaginally every 12 hours, up to four times, were tested in 101 and 133 healthy women, respectively, for interruption of pregnancies with 35 through 77 days of amenorrhea. The proportion of women who aborted increased with longer duration of treatment and was significantly higher with 400 than with 200 micrograms (66 versus 46 percent at 48 hours). Significance was maintained after controlling by age, body weight, parity, previous abortion and gestational age. Abortions were classified as incomplete or complete, according to the presence or not of embryonic tissue in the uterine cavity, diagnosed by vaginal sonography. Vacuum aspiration was carried out in all cases not classified as complete abortion 48 hours after the initiation of treatment, or earlier in case of persistent bleeding or woman's request. The possibility of increasing effectiveness by using higher dose, shorter intervals or longer duration of treatment is discussed.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

Risk factors for tubal sterilization regret, detectable before surgery.

Brazil has one of the highest prevalence rates of female surgical sterilization in the world. At the same time there is an increased demand for sterilization reversal. In order to understand which women tend to later request reversal of the procedure, a case-control study was carried out comparing 216 women who requested reversal with sterilized women who did not, paired by year of surgery. The relative risk of requesting reversal for women sterilized before age 25 was 18 times that of women sterilized after age 29. The elevated risk remained even after controlling for a number of variables present at the time of surgery. Multiple regression analysis showed that request for reversal was associated with younger age, less information about the procedure, and fewer contraceptive methods known before sterilization. These results support the recommendation that women should be fully informed about the tubal ligation procedure and have access to other contraceptive options before being sterilized.

Adult↗
PubMed1996

[Difficulties encountered in gathering information on illegal abortion in the population of women].

Any attempt to study the practice of illegal abortion faces the problem of asking women about a delicate, sensitive issue that has many implications. This may make it difficult to obtain truthful information on the subject. Results related to methodological aspects are emphasized and their possible association with variables included in a cross-sectional study carried out among 1,955 women, of 15 to 49 years of age is analysed. The frequency and conditions under which induced abortion was performed in a region of S. Paulo State are investigated. The women were interviewed at home using a pre-tested, structured questionnaire. Most of the women interviewed declared they had never had an abortion nor had they thought of having one, and four percent referred to having had an induced abortion. However, another 16.7 percent said that they had taken tea or medicine at least once to bring on their menses. In this group, most of the women who thought they were pregnant at that time said they had had never an abortion, in spite of having bled after drinking tea or medicine. The results lead to the conclusion that women tend no omit information on the practice of abortion when questioned directly. This is especially true of those who use oral means to bring on their menses and who seemed not to consider this a way of inducing an abortion.

Abortion, Illegal↗
PubMed1995

Follow-up of women seeking sterilization reversal: a Brazilian experience.

OBJECTIVE: To analyze the follow-up of a cohort of women who requested reversal of surgical sterilization. METHODS: This retrospective study was carried out at the State University of Campinas, Brazil. A cohort of 394 women who requested sterilization reversal was followed up for one year after reversal surgery. The analysis includes the percentage of women who completed the steps between the initial consultation up to one year after reversal surgery. RESULTS: After an initial consultation, 55.1% of the patients decided not to continue with the procedures. Of the patients who did undergo laparoscopy (n = 177), 48.6% had no possibility of a successful surgical reversal because the Fallopian tubes were in very poor condition. Only 17.5% of the initial patients requesting reversal ultimately underwent surgery and 3.3% became pregnant. CONCLUSIONS: The analysis of regret about surgical sterilization should include not only women who undergo surgery but also women requesting surgery. Better patient selection and counseling prior to sterilization are necessary in order to prevent increasing rates of sterilization regret in Brazil.

Adult↗
PubMed1995

From birth control to reproductive health.

During the 1960s birth control was seen as the only means of curbing the very rapid population growth that resulted from decreased mortality without a parallel decrease in fertility. Birth control was considered such a priority that the means used to achieve it were not always respectful of human rights, and, for the same reason, it did not work as expected. During the 1970s and 1980s, birth control policy was re-evaluated. Concepts such as the need to balance birth control with socioeconomic development, to avoid target-oriented programs that imposed particular contraceptive methods on people, to integrate contraceptive services within a comprehensive women's health care program, and to emphasize the importance of quality of care became accepted. This led to the understanding that a reproductive health care approach was a more efficient way to achieve people's wellbeing and, at the same time, to reduce fertility. The need for greater dialog between women/clients and men/providers is emphasized.

Brazil↗
PubMed1995

Low-dose vaginal misoprostol for induction of labor with a live fetus.

OBJECTIVE: To test the effectiveness and safety of low-dose vaginal misoprostol for induction of labor with a live fetus. METHODS: Labor was induced in 666 pregnant women with a live fetus in the cephalic position, who had no medical complications and no history of uterine surgery. One-fourth of a 200-micrograms tablet of misoprostol (50 micrograms) was placed in the posterior vaginal fornix every 12 h for a maximum of four doses or until active labor commenced. Time from induction to delivery, side effects and neonatal outcome were evaluated. RESULTS: Labor was successfully induced in all cases. The mean time from induction to delivery was 10.4 h. The cesarean section rate was 7.8%. There were eight perinatal deaths, six of which occurred in low birth weight fetuses. There was one case of abruptio placenta, which was less than that expected in the study population. CONCLUSION: Vaginal misoprostol, in very low doses, was a remarkably efficient and safe method for induction of labor with a live fetus.

Administration, Intravaginal↗
PubMed1994

Users' awareness of factors associated with complications during pill use.

This study compared the frequency of factors and diseases that contribute to the risks of oral contraceptive use among current users and non-users of oral contraception in order to evaluate the users' awareness of factors associated with complications during oral contraceptive use. Data from 5317 current users and 8863 non-users in the state of São Paulo, Brazil, were collected using questionnaires requesting information on the following variables: use of oral contraceptives, age, weight, smoking status, and the presence or history of hypertension, diabetes, cardiopathies, painful varicose veins, and epilepsy. Half of the users had some risk factors, and 17.4% were at high risk of complications from oral contraceptive use. Risk factors and diseases which appeared to be poorly known by the population as increasing the risk of oral contraceptive use were smoking, hypertension and painful varicose veins. Only a small percentage of the population appeared to know that these diseases and factors could increase the risk of health problems during oral contraceptive use. The results suggest a lack of information among users and providers on factors which are associated with an increased risk of health problems during use of oral contraceptives.

Adult↗
PubMed1994

Score prognosis for the infertile couple based on historical factors and sperm analysis.

OBJECTIVE: To identify variables, obtained from historical factors and sperm analysis, associated with greater chances of pregnancy in infertile couples. METHODS: The study was carried out in Córdoba, Argentina. The characteristics of 247 couples consulting for infertility who achieved pregnancy within 3 years of their first visit were compared with those of 312 couples who did not become pregnant. We evaluated the relationship between the age of the woman and her partner, the type and duration of infertility, length of the last three menstrual cycles, history of pelvic surgery in the woman, and testicular volume, sperm density, motility and morphology in her partner, and the achievement of pregnancy. For the analysis, logistic regression was used. RESULTS: Six variables had a predictive value: sperm morphology, the woman's age, type and duration of infertility, her history of pelvic surgery, and duration of menstrual cycles. CONCLUSIONS: The best prognosis for future fertility in infertile couples is correlated with a higher percentage of normal sperm morphology, younger woman's age, secondary infertility, fewer years of infertility, negative history of pelvic surgery, and abnormal menstrual cycles.

Adolescent↗
PubMed1994

Spermicides and barrier contraception.

The contraceptive failure rate of condoms varies from 2 to 13%, depending on the study population, yet it is the contraceptive method with the greatest capacity to protect against sexually transmitted diseases (STDs) and AIDS. Breakage and slippage during intercourse are important causes of failure, and individual behavior leading to consistent and correct use is the most important factor in condom effectiveness. Female-controlled barrier methods may actually prevent more STDs than condoms, because of their more consistent use. Using the diaphragm continuously and without spermicide was well accepted and effective in preventing pregnancy in one study. The female condom appears to have a contraceptive effectiveness close to that of other vaginal methods. It is likely that it also protects against STDs and AIDS. Nonoxynol-9 appears to have a protective effect against some STDs and the data concerning the protective effect of spermicides containing nonoxynol-9 against HIV is conflicting, yet suggests some protection, especially if products are used with relatively low frequency that avoids dose-dependent vaginal irritation. New spermicides which could also protect against viral infection without affecting epithelial cells are currently being studied.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Effectiveness of the diaphragm, used continuously, without spermicide.

The experience of 670 diaphragm users from three Brazilian clinics was retrospectively reviewed. Most of the subjects (441) followed the traditional method (TM) of using the diaphragm, only at the time of sexual intercourse and with spermicide. One third (215) used the diaphragm continuously (CU), without spermicide, removing it only at the time of their daily shower to wash it, with immediate re-insertion. The total pregnancy rate was 7.0 per 100 women-years for the whole group. Patient and total failure rate were significantly lower in the CU (0.6 and 2.8), in comparison with the TM sub-group (6.5 and 9.8). The discontinuation rate for urinary infection or other medical reasons was not greater in the CU group. Logistic regression analysis, including age, parity, number of abortions and of living children, years of schooling, whether living with a partner, presence of mild cystocele or retroverted uterus, and form of use of diaphragm (TM or CU), showed that only the TM of diaphragm use was positively associated to patients' and total failure rate.

Adult↗
PubMed1993

Evaluation of the clinical performance of a levonorgestrel-releasing IUD, up to seven years of use, in Campinas, Brazil.

The clinical performance of a levonorgestrel IUD, releasing 20 mcg/day, used by 293 women at the Family Planning Clinic of the State University of Campinas, was evaluated up to the end of the seventh year of use. No pregnancies occurred in 899 women-years of observation. The cumulative removal rate for amenorrhea or severe hypomenorrhea was 15.7 per 100 women at seven years. The expulsion rate was within ranges observed with copper IUDs in the same clinic. The continuation rate was 49.5% at three years and 23.7 at seven years. The cumulative loss to follow-up rate was 13.7% at seven years. The effectiveness, good continuation rate, and reduction of the amount of blood loss make this device appropriate to be offered to Brazilian women, as an additional contraceptive option.

Adult↗
PubMed1993

[Factors associated with prenatal care among low income women in the State of São Paulo, Brazil].

This paper presents the results of a study carried out in 1988 in the State of S. Paulo, with the purpose of evaluating the Program for Women's Integral Health Care. A total of 3.703 low income women of 15-49 years of age were interviewed using a structured, pre-tested form. The data in this paper relate to 669 women who had been pregnant during 1987 or 1988 and who were asked about pre-natal, delivery and post-partum care. The association between some of their socio-demographic characteristics and the pre-natal care received, months pregnant at the time of first visit and total number of visits, were analysed. Results showed an association between socio-economic characteristics and pre-natal care received. The greatest percentage of pregnant women who had had pre-natal care was found among those with more than elementary education. The highest percentage of women who started prenatal care before the third month of pregnancy was found among those who had no living children (74%), were in union (70%), had at least some high school education (88%) and lived in the interior of the state (71%). The results show that it is necessary to increase the coverage and quality of pre-natal care so as to improve perinatal results.

Adolescent↗
PubMed1993

[Abortion among female students and employees of a Brazilian university].

In Brazil, the subject of induced abortion is controversial and considered by some to be a serious public health problem. On the other hand there are little data available as to its frequency and general characteristics. The difficulty encountered in obtaining reliable information is to be explained by the illegality of abortion that inhibits women from talking about their experience, and most studies are carried out in hospitals and thus succeed in identifying only those women who have complications. A study was carried out in 1990, involving all the female graduate students and employees of a Brazilian university. Data was obtained through a questionnaire that was returned by mail, anonymously. This paper presents some of the results relating to the frequency of miscarriage and abortion in this population. Significantly more students than employees were less than 25 years old (85% and 13.7% respectively); fewer students were married or in a common-law union (11% of students as against 56% of employees) and four times fewer students than employees had never been pregnant (15% and 65%). Nine percent of the students and 14% of the employees had had at least one abortion. When only sometime pregnant women were taken into consideration, over half the students (59%) and 20% of the employees had had an abortion. Differences between the two groups were maintained when considered by age, both for miscarriage and abortion. Students of less than 25 years of age presented the highest percentage of abortion.

Abortion, Induced↗