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Biomedical subjects

H L Coêlho

Publications and source records attributed to H L Coêlho.

6 recordsLinked to original sources
PubMed1994

Misoprostol: the experience of women in Fortaleza, Brazil.

Misoprostol is used by women in Brazil in case of unwanted pregnancy to attempt abortion. This paper reports the characteristics, pattern of misoprostol use and opinions of a group of 102 women (median age 25 years, range 16-49 years), from Fortaleza, capital of Ceará state, who had used misoprostol to attempt abortion. Seventy-five percent were women of lower social class, 58% had less than 8 years of education and 46% were never married. Misoprostol was used for the first induced abortion by 65 women. Modal dose was 4 tablets--200 micrograms of misoprostol each--most frequently 2 tablets by oral route and 2 tablets by intravaginal route. This pattern of use was associated with the highest rate of abortion, mainly at 9-12 weeks of amenorrhea. Fifty-five percent of women had no pregnancy test; 41% had 8 weeks or less of amenorrhea. Curettage was performed in 49 of 84 women who reported abortion and in 41 of 43 women who entered the hospital. Infection and uterine perforation were the complications described. Seventy-two percent of women were in favor of legalization of abortion, but 52% were also in favor of the prohibition of misoprostol sales; 66% would not repeat misoprostol use and 53% would not suggest it to a friend. The poorest women were less favorable to misoprostol ban. Despite the current lack of safer alternatives, misoprostol does not seem a satisfactory solution to illegal abortion in Brazil.

Abortion, Induced↗
PubMed1993

Misoprostol and illegal abortion in Fortaleza, Brazil.

Misoprostol, a prostaglandin E1 analogue indicated for ulcer treatment, has been widely used as an abortifacient by women in Brazil, where abortion is legal only in cases of rape or incest, or to save the woman's life. Because misoprostol is an inefficient abortifacient, many women who use it have incomplete abortions and need uterine evacuation. We reviewed the records of women admitted to the main obstetric hospital of Fortaleza, capital of Ceará state, Brazil, between January, 1990, and July, 1992, for uterine evacuation after induced abortion. The number of incomplete abortions induced by misoprostol increased substantially during the first half of 1990, and declined thereafter. Of the 593 cases in 1991, 75% were related to misoprostol, 10% to the use of other specified drugs, and 6% to unspecified drugs. For the remaining 9% the procedure used was not recorded; these included 3% in whom abortion had been induced by a clandestine abortionist. The number of uterine evacuations per month fell from 89 in August, 1990, to 62 in July, 1991, when sales of misoprostol in Ceará state were suspended. The fall continued after the sale of misoprostol ceased, to about 20 cases in December, 1991; numbers remained around this level until June, 1992, sustained by clandestine sales. The lack of access to contraception is the main reason for the large numbers of unplanned pregnancies and is a major public health issue for Brazilian women. The prohibition of abortion creates a void in which misuse of medicines is one extra complication, mainly because of the poor control of drug marketing.

Abortifacient Agents↗
PubMedDate not supplied

[Pharmacovigilance: a necessary tool].

This paper discusses the potential benefits of pharmacovigilance in promoting rational drug use and the implementation of drug policies, especially drug regulation, based on the WHO International Drug Monitoring Program. The initial development of pharmacovigilance in Brazil is presented and the need for a national pharmacovigilance system is stressed.

Brazil↗
PubMedDate not supplied

[Ceará State Pharmacovigilance System: a year of experience].

This paper summarizes the first year of activity of the Ceará State Pharmacovigilance System (SIFACE) as a strategy to discuss practical and methodological problems related to developing pharmacovigilance in Brazil. Siface is being structured by the Group for the Prevention of Improper Use of Pharmaceuticals (GPUIM), based on hospital pharmacies. A total of 63 reports (119 suspected adverse drug reactions, or ADRs) were processed, the majority among women (55.7%) and children (34.4%). Antibiotics were the drug group most frequently involved, and the most common reactions were dermatological. In 20% of the cases, patients had been re-exposed to drugs previously reported as producing adverse reactions, thus highlighting the importance of pharmacovigilance to prevent ADRs.

Adolescent↗