Haemostatic function changes in Singapore women using Norplant implants: a four year review.
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Asia↗
Biomedical subjects
O A Viegas
Publications and source records attributed to O A Viegas.
The 75 and 50g OGTT response in normal pregnant women.
The 75 and 50g OGTT (Oral Glucose Tolerance Test) responses were studied in 86 normal healthy pregnant women (mean age 28.7 +/- 0.4 (SEM) years) at 28 and 32 weeks respectively. Of these were 50 Chinese, 20 Malays and 16 Indians. Mean glucose responses at fasting, 1 and 2h post glucose load were 78.3 +/- 0.7, 132.2 +/- 2.8 and 116.2 +/- 2.1 mg/dl respectively for the 75g OGTT and 78.5 +/- 0.7, 130.5 +/- 2.5 and 106.7 +/- 1.8 mg/dl respectively for the 50g OGTT. Except for the 2h responses, corresponding responses between both OGTTs were not significantly different. All races showed a similar OGTT response. Using a set criteria for diagnosis of abnormals resulted in gross inconsistency in the number of abnormals diagnosed for both OGTTs. However, the use of 95th percentile shows a closer agreement in the diagnosis of abnormal cases for both OGTTs. Also, the 2h OGTT response for the 75g OGTT is higher than that of WHO's criteria for impaired glucose tolerance. This emphasizes the need to establish our own reference range.
Adult↗
A three-year clinical evaluation of Norplant-2 rods in Singapore.
A three-year clinical evaluation of Norplant-2 rods in Singapore shows that no pregnancy occurred during the three years of use. The continuation rate at the end of three years was 74%. Desire for planned pregnancy was the main reason for removal during the three years. The post-removal conception rate in women desiring planned pregnancy was 50.0% at the end of one year. This low rate could be attributed to the four women deciding against a pregnancy after removal. However, despite this apparent reason one needs to monitor the post-removal return of fertility closely in the years to come.
Adolescent↗
A three-year evaluation of metabolic changes in Singaporean Norplant-2 rod acceptors.
In this longitudinal study involving 100 Singaporean women, the effects of Norplant-2 rods on metabolic function were evaluated. With respect to liver function, the results indicate possible hepatocellular dysfunction as evidenced by a significant rise in serum bilirubin and a significant fall in total proteins and globulin during the three years of use. As regards lipid metabolism total triglycerides, cholesterol and LDL cholesterol were significantly decreased as compared to their preinsertion values at the end of three years. The HDL-cholesterol was also significantly decreased during the second and third year of use. Despite this, the HDL-cholesterol/total-cholesterol-HDL-cholesterol remained above 0.200. Thus, though speculative, it still appears to indicate that use of Norplant-2 rods is not directly contributory to cardiovascular risk. The use of Norplant-2 was not associated with any significant effect on carbohydrate metabolism after three years of use.
Bilirubin↗
A three-year evaluation of hemostatic function in Singaporean Norplant-2 rod acceptors.
A longitudinal study of hemostatic function was carried out on 100 Singaporean acceptors using Norplant-2 rods for contraception. The results at the end of three years indicate a possible increased predisposition to thrombosis, as evidenced by significant increases in platelet count and aggregability. The prothrombin time (PT) and activated partial thromboplastin time (APTT) continued to remain shortened at the end of three years of use. There was also a general fall in most of the vitamin K coagulation factors. There is thus still an indication of a possible enhanced potential for hypercoagulation at the end of three years of Norplant-2 rod use.
Contraceptive Agents, Female↗
A three-year clinical evaluation of Norplant in Singaporean acceptors.
A three-year clinical evaluation of Norplant implants in Singaporean acceptors shows that no pregnancy occurred during the first three years of use. The continuation rate at the end of three years was 69%. Desire for planned pregnancy and disruption of menstrual rhythm were the two main reasons for implant removal during the three years. The post-removal conception rate in women desiring pregnancy was 94.1% at the end of one year. It thus appears that Norplant offers a highly effective, safe, acceptable and reversible method of contraception.
Adolescent↗
A three-year evaluation of metabolic changes in Singaporean Norplant acceptors.
In a longitudinal study involving 100 Singaporean women, the effect of NorplantR on metabolic function was evaluated. With respect to liver function, the results indicate possible hepatocellular dysfunction as evidenced by a significant rise in serum bilirubin and a significant fall in total proteins and globulin during the period under review. As regards lipid metabolism, total triglycerides and total cholesterol still remained significantly decreased at the end of the three years. The LDL, which was significantly decreased in the first year, increased during the subsequent two years to its preinsertion value at the end of three years. The HDL-cholesterol levels continued to decrease in the second and third year after a significant increase in the first year. Despite this, the HDL cholesterol/total cholesterol-HDL cholesterol remained above 0.200. As we have not incorporated a simultaneous non-pill treated control group, the observed changes in lipoprotein lipids could be attributed to extraneous factors such as diet, exercise, or other environmental changes. Nevertheless, the findings at the end of three years, though speculative, still appear to indicate Norplant use to be not directly contributory to cardiovascular risk. The use of Norplant was not associated with any significant effects on carbohydrate metabolism after three years of use.
Contraceptive Agents, Female↗
A three-year evaluation of hemostatic function in Singaporean Norplant acceptors.
In a longitudinal study involving 100 Singaporean women, results indicate that the acceptors persist in having a possibly increased predisposition to thrombosis, as evidenced by a significant increase in platelet count and aggregability. Furthermore, the shortened prothrombin time and activated partial thromboplastin time, together with changes in vitamin K factors, still indicate the possible enhanced potential for hypercoagulation.
Blood Coagulation Factors↗
Attitudes towards contraceptive implants and injectables among present and former users in Singapore.
In a comparison of present and past users of contraceptive implants (Norplant) or injectables (DMPA) and discontinuers of Norplant or DMPA, information concerning the women's knowledge and perception of, and attitude to, implants and injectable contraceptives, was studied. The long duration of action (5 years) of implants was perceived positively by all groups as compared to the shorter 3-month duration of injectables, though this was seen as an advantage over the pill. It appears that the Norplant system has potential for wider use in Singapore in the future.
Adult↗
Three decades of breast-feeding trends in Singapore.
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Asia↗
Norplant contraceptive implants--a comparison of capsules versus rods in Singapore.
The NORPLANT system is one of the most modern long acting steroidal fertility regulatory delivery systems to be introduced. It consists of six silicone capsules. The NORPLANT-2 rod system on the other hand consists of only 2 rods. The comparative study undertaken suggests that the NORPLANT-2 rod system is highly effective, safe and acceptable as the NORPLANT six capsule system in Singapore. It would thus appear that the NORPLANT-2 rod system as compared to the NORPLANT six capsule system has a great potential for acceptability in terms of ease of insertion and removal.
Adult↗
A comparison of the effects of NORPLANT capsules and NORPLANT-2 rods on clinical chemistry: metabolic changes.
A comparison of the effects of NORPLANT capsules and NORPLANT-2 rods on liver function, lipid and carbohydrate metabolism is presented. The results indicate that the effects of both these long acting progestogen-containing subdermal implant systems are similar and comparable. With respect to liver function, possible hepatocellular dysfunction is indicated as evidenced by a significant rise in serum bilirubin and a significant fall in total protein and globulin. As regards to lipid metabolism, there appears to be no cardiovascular risk in both groups. The effects of NORPLANT on carbohydrate metabolism is not of any clinical significance.
Capsules↗
Serum fructosamine concentrations in Singapore pregnant women.
Serum fructosamine levels in women at pregnancy (28 weeks' gestation) were determined. The women (n = 99) also participated in an oral glucose tolerance test (OGTT) with a 75g liquid glucose load, to determine their glucose tolerance. At 32 weeks' gestation, seventy-nine of them repeated the oral glucose tolerance test and fructosamine measurement. Results showed that fructosamine levels in pregnant women with normal glucose tolerance (2.20 +/- 0.19 mmol/l, n = 76), were not statistically different from those with glucose intolerance (gestational diabetes: 2.19 +/- 0.22 mmol/l, n = 23) at 28 weeks' and also 32 weeks' gestation. However, serum fructosamine levels in pregnant women were lower than those in non-pregnant subjects. Serum fructosamine measurement is not a sufficiently sensitive test for diagnosis of gestational diabetes.
Adult↗
Norplant-2 rods contraceptive subdermal implants: two-year experience in Singapore.
Norplant-2 contraceptive implants consist of two Silastic rods in which levonorgestrel has been incorporated with the polymer. This on-going study describes our two-year experience with 100 acceptors of Norplant-2 rods in Singapore. No pregnancies occurred during the first two years of use. Desire for planned pregnancy and menstrual irregularities accounted for 86.4% of the removals during this period. The continuation rate at the end of two years was 78%. The post-removal conception rate in women desiring planned pregnancy was 54.5% at the end of one year. Apart from this apparent slow return of fertility requiring future close surveillance, it appears that the Norplant-2 rod system offers a highly effective and convenient means of contraception.
Adolescent↗
Long-acting progestins--an update.
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Contraceptive Agents, Female↗
Norplant contraceptive subdermal implants: two-year experience in Singapore.
Norplant contraceptive implants are Silastic containing levonorgestrel implants. This study describes our two-year experience with 100 acceptors of Norplant implants in Singapore. No pregnancies occurred during the first two years of use. Desire for planned pregnancy and disruption of menstrual rhythm were the two main reasons for twenty implant removals during the two years. The continuation rate at the end of two years was 79%. The post-removal conception rate in women desiring pregnancy was 90% at the end of one year. It thus appears that the Norplant contraceptive system offers a highly effective, acceptable, reversible and safe method of contraception.
Adolescent↗
Ethnic and other factors affecting birthweight in Singapore.
Data on 1800 term babies, 600 from each of the Chinese, Malay and Indian racial groups, were used to identify the factors affecting birthweight in Singapore. After adjustment for gestation, maternal height and other variables, the mean Indian birthweight was 100 g less than for the Chinese (P less than 0.001), 0.001), while the Malays averaged 33 g less than the Chinese. The shortfall in Indian birthweight is thought to be due, at least partly, to environmental factors.
Asian People↗
Breastfeeding trends in Singapore.
About 60% of well-to-do mothers in Singapore initiate breastfeeding. This value compares favourably with the 36% recently recorded for poor mothers, but is still unacceptably low compared to the 85-95% of well-to-do mothers and 90% of poor mothers who breastfed in the 1950s and 1960s. There has been a general decline in the incidence of breastfeeding over the last 35 years. Differences between the well-to-do and poor groups were initially small. A pronounced decline in the incidence of breastfeeding among the well-to-do mothers followed; a reversal in this downward trend in well-to-do mothers over the past 10 years has narrowed, and indeed reversed, the difference between the two groups. Similar trends can be found for the duration of breastfeeding. Whilst the overall decline probably reflects increasing affluence and 'Westernization' of the population the variation between these two economic groups is probably a result of differences in education. Among the three major ethnic communities, Chinese favoured breastfeeding least and Malays favoured it most. The differences are believed to be related to cultural differences and the ability of traditional practices and beliefs among the ethnic groups to resist the modern trend towards bottlefeeding.
Breast Feeding↗