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Biomedical subjects

R Apelo

Publications and source records attributed to R Apelo.

12 recordsLinked to original sources
PubMed1991

Timing of postpartum tubal sterilization using the Filshie clips: an analysis of data from two developing-country centers.

Two-hundred-ninety-seven women at a Panamanian center and 148 women at a Philippine center had their tubal sterilization performed during their postpartum hospital stay after an uncomplicated vaginal delivery of a live birth. The sterilizations were all performed with the use of the Filshie clip via minilaparotomy. The timing of the sterilization varied from two hours to six days after delivery. At each of the two centers, women sterilized within 48 hours after delivery were compared with those sterilized at 49 or more hours with respect to surgical difficulties, tubal injuries, complications/complaints, technical failures and lengths of hospitalization after sterilization and before discharge. The one-year gross cumulative pregnancy rates were also compared. No significant differences were detected in any of the above outcome variables between the two timing groups at each center. While the data suggest that tubal sterilizations by the Filshie clip performed two to six days following childbirth are as safe and effective as those performed within 48 hours of delivery, further studies are urged.

Developing Countries↗
PubMed1990

Risk of ovulation during lactation.

60 breastfeeding mothers in Baltimore and 41 in Manila recorded their infant feeding patterns daily, and gave additional information at weekly interviews. Ovarian activity was monitored by assays for hormone metabolites in daily urine samples. On average, women in Baltimore breastfed less often but for longer at each feed than women in Manila, and the mean times until ovulation were 27 and 38 weeks post partum. 41% of first ovulations had luteal phase defects. Anovular first menses were common (45.1%) during the first 6 months post partum but the rate fell greatly thereafter. The risk of ovulation was reduced by a higher frequency of breastfeeds, longer duration of each feed, and less supplementary feeding. During the first 6 months post partum, amenorrhoeic women had low risks of ovulation (below 10%) with partial breastfeeding, and exclusive breastfeeding reduced the risk to 1-5% with either frequent short feeds or infrequent longer feeds. However, if the woman started menstruating before 6 months post partum, or if she continued breastfeeding beyond 6 months, the risk of ovulation rose, and contraception would be needed.

Amenorrhea↗
PubMed1989

A comparative analysis of three different dose combinations of oral contraceptives.

Three different low-dose formulations of oral contraceptives were compared to determine the most suitable preparation for Filipino women as reflected in the first year continuation rates, incidence of side effects and failure rates. A total of 1,800 subjects were enrolled in the study from 18 health centers in six provinces in two regions of the Philippines, covering a total of 18,282 women-months of use. Sociodemographic characteristics were comparable. The monophasic levonorgestrel group showed the best performance followed by the triphasic preparation. The norethindrone group consistently showed higher drop-out rates, which may be due to the relatively higher incidence of side effects. For all three preparations, bleeding irregularities were low. There were no major side effects and no pregnancy was reported in one year of use. Noted was a distinct regional and provincial difference in recruitment and follow-up performance, possibly due to clinic, client or program factors.

Adult↗
PubMed1978

Experience with minilaparotomy in the Philippines.

This paper presents the socio-demographic characteristics, medical histories, and clinical data on 651 women sterilized by interval minilaparotomy procedures in Manila, Philippines. About two thirds of the procedures were performed with local anesthesia; the Pomeroy technique was used for tubal ligation. In 2.8% of the patients, salpingectomy or fimbriectomy was performed on one side because of surgical difficulties and complications. Surgical difficulties were encountered in 19.8% of the procedures; adhesions (4.3%) and bowel interference (4.0%) were the most frequent causes of surgical difficulty. Complications occurred during surgery in 1.7% of the procedures. Early postoperative complications were noted in 9.1% of the cases. None of the patients required readmission to the hospital. While 612 women were followed up at 6 months, 299 were followed up at 12 months. One women (0.2%) became pregnant after sterilization; at repeat minilaparotomy, ligation of the left round ligament rather than the tube was observed. Pelvic surgery, other than pregnancy-related surgery, during the year following sterilization was reported for one patient who underwent exploratory laparotomy with appendectomy and oophorocystectomy. Menstrual pattern changes were minimal. The results of this study suggest that tubal ligation via minilaparotomy is practical, safe, and effective.

Adult↗
PubMed1976

The LEM device in an immediate postpartum contraception program.

Experience with the LEM intrauterine device in an immediate postpartum program at the Jose Fabella Memorial Hospital, Manila, Philippines, is reported. During a 6-month period, the LEM was inserted in 1359 women immediately after normal term deliveries. The early expulsion rate was high, but removals for bleeding or pain were minimal. Pregnancy rates during the second 6 months of use were higher than those reported previously for postpartum insertions of the LEM device.

Adult↗
PubMed1975

Clinical experience with ethinyl estradiol and d-norgestrel as an oral contraceptive.

One hundred eighty-one women received 30 mug of ethinyl estradiol plus 150 mug of d-norgestrel as an oral contraceptive for 21 days and then received no tablets for the next seven days for a total of 1,488 cycles. There were no pregnancies. Cycle control was good to excellent. Menstrual cycles lasted 25 to 32 days in 96.2% of treatment cycles. Menstruation lasted three to five days in 93.2% of the cycles, and it began three to five days after the last day of medication in 79.1%. The menstrual flow was moderate in 87%. Breakthrough bleeding occurred in 2.0% of treatment cycles, spotting in 0.1%, and amenorrhea in 0.8%. The incidence of adverse subjective symptoms was minimal and significant increases compared with the pretreatment cycle were noted only for nausea in the first two cycles and for nervousness in the second cycle of treatment. Overall incidence of nausea was 3.2% of treatment cycles.

Adolescent↗
PubMedDate not supplied

The reliability of menses to indicate the return of ovulation in breastfeeding women in Manila, The Philippines.

Demographic studies generally use menses to indicate the return of fertility during breastfeeding. In a prospective study of 40 breastfeeding women in Manila, the resumption of ovarian activity was monitored by urinary hormone assays, and menstrual status was determined by weekly interview. For the women who menstruated before six months postpartum, first menses was not a good indicator of ovulation because there was a high proportion of anovular menses (67 percent), and the lag between anovular first menses and subsequent ovulation was 15.7 (+/- 4.4) weeks. After six months postpartum the proportion of anovular first menses declined to 22 percent, and the lag between anovular first menses and ovulation was 7.3 (+/- 4.6) weeks. If all anovular and ovulatory menstrual episodes are considered, the mean interval between first observed menses and first ovulation was 8.4 weeks during the first six months postpartum and only 0.1 week after six months. Thus, in breastfeeding women, menses is an inaccurate proxy measure for the timing of fertility return before six months postpartum, but a good indicator of the resumption of ovulation after six months.

Amenorrhea↗