A study of the spousal role of Egyptian women in clerical jobs.

More women are seeking outside employment worldwide. However, the spousal role with all that it entails remains a significant core for women, particularly in developing countries. How women experience this role when they are also employed in low-income jobs has not been uncovered adequately. One hundred and ninety Egyptian women who are employed in clerical jobs were asked about the satisfaction and the stress they experience in their spousal role. The study's participants described the centrality of their spousal role in their life and discussed how fulfilling the needs and the expectations of their husbands were most significant for them. Their role in creating harmony in the family and the extent to which they were able to succeed in achieving this goal also were cited as the most significant aspects of their spousal relationship. Another satisfying part of their marital life was having children. On the other hand, their husbands' demanding behavior, the way the husbands express their demands, the husbands' abuse, and the participants' constant feeling of el masooliah, or their "sense of overload from responsibilities," were some of the stresses described by the participants. They also perceived a gap in the values that they and their husbands hold. This gap was most constraining to some of the participants. The participants coped by enduring the stress. This begs the question of what societal values keep women in less than satisfying relationships. The findings are discussed within a framework of societal norms and values expectations that reinforce women's commitment and endurance of spousal stress.

A review of 126 cases of ruptured gravid uterus.

Ruptured uterus is a grave obstetric complication, associated with high maternal mortality and morbidity, perinatal mortality and loss of future fertility as hysterectomy is inevitable in many cases. This study reviews the incidence, causes and other factors, to define problem areas and propose preventive measures. During 1979-1988, 126 cases of ruptured uterus occurred in 46,207 deliveries; these 126 cases were retrospectively analyzed in relation to causes, age, parity, maternal mortality and morbidity, perinatal mortality and management. Some of the results were compared with other authors. The incidence was 1/367 (2.7/1000 deliveries), traumatic rupture accounted for 42.86% while spontaneous rupture accounted for 57.14%. Maternal mortality was 21.43% and the perinatal mortality was 73.19%. Supravaginal hysterectomy, repair with sterilization and repair without sterilization were the selected lines of management. Proper quick diagnosis and prompt management will reduce maternal mortality and morbidity. Finally, recommendations to reduce the occurrence of this problem are proposed.

Efficacy and safety of repeated transcervical quinacrine pellet insertions for female sterilization.

OBJECTIVE: To investigate the rates of tubal occlusion, pregnancy, and side effects of repeated, monthly transcervical insertions of 252 mg quinacrine as pellets. DESIGN: Clinical trial among 159 reproductive age women receiving two monthly transcervical insertions of 252 mg of quinacrine followed by hysterosalpingograms (HSGs) 1 month after last insertion and an additional monthly insertion among women without evidence of bilateral tubal occlusion. Contraception of women's choice provided until bilateral tubal occlusion achieved, and surgical sterilization provided for women failing to achieve bilateral tubal occlusion after third quinacrine insertion. Women were followed for at least 24 months for evidence of pregnancy or side effects. RESULTS: Among the 159 women completing the protocol, 73% had evidence of bilateral tubal occlusion by HSGs after two insertions of quinacrine pellets and 94% after a third insertion. These 149 women were followed for 24 months without a pregnancy failure or serious side effect. CONCLUSION: Transcervical applications of quinacrine as pellets have potential for safe, effective, inexpensive, and easily deliverable female sterilization.

PIP: Between January 1988 and April 1988, physicians inserted at least 2 252 mg quinacrine pellets into the uterus via the cervix (1 month apart during days 5 to 18 of consecutive menstrual cycles) in 159 34-to-39-year-old women at the outpatient clinic at Boulak El-Dakrour Hospital in Giza, Egypt. 1 month after each insertion, they used hysterosalpingograms to determine tubal patency. They inserted a 3rd pellet if at least 1 tube remained patent. The women used additional contraceptives from first insertion to 1 month after the last insertion to prevent unwanted pregnancy. The physicians followed the women for 24 months. Quinacrine-induced menstrual changes, e.g., intermenstrual bleeding (13.2%) and amenorrhea (26.4%), basically disappeared by 6 months. Quinacrine abated heavy or prolonged menses in women who suffered from it beforehand. 84.3% did not experience any complications or had no complaints related to quinacrine insertion. Occlusion occurred in both tubes after 2 insertions in 73% of cases and after 3 insertions in 93.7%. Women who did not have any bleeding experienced tubal occlusion more readily than those who did (after 2 insertions, 80.8% vs. 69.2%). In fact, absence of blood in the uterus resulted in 100% efficacy after 3 insertions compared to only 90.7% in those who did bleed (p = .02). After 3 insertions, women whose uterus was longer than 8 cm were less likely to have occluded tubes than those whose uterus was at the most 8 cm long (87.2% vs. 95.8%; p = .09). In fact, they had the lowest tubal occlusion rate. None of the women with 2 occluded tubes at 24 months became pregnant. They did not use any contraception beginning 1 month after last insertion. These results indicate that quinacrine pellets are an effective and safe method of nonsurgical sterilization.

Histopathologic changes in the cornual portion of the fallopian tube following a single transcervical insertion of quinacrine hydrochloride pellets.

To study the sequence of histopathologic changes taking place in the cornual portion of the fallopian tube subsequent to exposure to quinacrine, 252 mg were inserted transcervically in 12 women awaiting hysterectomy for non-malignant conditions of the uterus. All patients who underwent surgery within ten days of insertion were found to have necrosis of the epithelial lining and an acute inflammatory reaction. Later on, the changes observed included progressive absorption of the inflammatory cellular exudate, progressive fibrosis, with partial or almost complete occlusion of the lumen, and failure of regeneration of the epithelial lining. Our results support other studies indicating that quinacrine can effectively produce tubal fibrosis and occlusion.