Cáncer de ovario y gestación / Ovarian cancer and pregnancy

El cáncer de ovario constituye una complicación poco frecuente durante la gestación, aunque cuando se produce representa un problema complejo y controvertido desde el punto de vista terapéutico. Su manejo deberá ser individualizado, teniendo en cuenta la edad gestacional, el estadio, el tipo histológico y los deseos genésicos de la paciente, tratando de minimizar los riesgos, tanto para la madre como para el feto. Resumen Presentamos un caso clínico de cáncer de ovario que complica la gestación y procedemos a revisar la bibliografía médica actual sobre esta rara asociación (AU)

Ovarian cancer is an uncommon complication during pregnancy and its therapeutic management is complex and controversial. Management should be individually tailored, bearing in mind gestational age, tumoral stage, histological type and the patient's wishes, with the aim of reducing the risks to both mother and child. We report a case of ovarian cancer during pregnancy and review the current literature on this infrequent association (AU)

Efectos beneficiosos no anticonceptivos de la píldora anticonceptiva / No disponible

El primer objetivo del uso de un anticonceptivo oral combinado (AOC) es el de evitar un embarazo. En ocasiones el AOC se asocia a efectos secundarios, pero cada día se conocen mejor los efectos beneficiosos no anticonceptivos del mismo. Existe evidencia de una buena calidad que asocia el uso de AOC con la mejoría de la dismenorrea, la disminución del sangrado menstrual y la mejoría del síndrome premenstrual. También se sabe que el uso de AOC protege frente a la enfermedad inflamatoria pélvica (EIP) y el embarazo ectópico, reduce la pérdida mineral ósea y es eficaz en el tratamiento del acné leve y moderado. Además, la AOC disminuye la incidencia de cáncer de ovario y cáncer de endometrio. Conocer estos efectos beneficiosos resulta de interés tanto para los profesionales sanitarios como para las mujeres (AU)

The first objective of using a combined oral contraceptive(COC) is that of avoiding pregnancy. COC is sometimes associated to side effects, but its non-contraceptive beneficial effects are becoming known day by day. There is evidence of the good quality associated to the use of COC with the improvement of dysmenorrhea, decrease of menstrual bleeding and improvement of premenstrual syndrome. It is also known that the use of COC protects against pelvic inflammatory disease (PID), and ectopic pregnancy, reduces bone mineral loss and is effective in the treatment of mild and moderate acne. Furthermore, COC decreases the incidence of ovarian cancer and endometrial cancer. Knowing these beneficial effects is of interest, both for the health care professionals and for women (AU)

Contraceptive practices and trends in Spain: 1997-2003.

OBJECTIVE: To know the contraceptive use and trends in the Spanish female population. STUDY DESIGN: Since 1997, we have conducted a survey every 2 years on the use of contraceptive methods among a representative sample of Spanish women of childbearing potential (15-49 years). RESULTS: In the period 1997-2003, the percentage of use of contraceptive methods in Spain rose from 55.6% to 71.2%. The most commonly used method was the condom (21% in 1997, 21.9% in 1999, 29.5% in 2001 and 35.7% in 2003), followed by the contraceptive pill (14.2%, 16.5%, 19.2% and 18.3%, respectively). Male or female sterilization remained stable with percentages of use of 5-7%. IUDs are used by about 5% of women. CONCLUSIONS: The use of contraceptive methods among Spanish women of childbearing potential generally fits quite well the patterns found in other developed countries, and we observed a trend towards increased use of effective methods.

Use of contraceptive methods and risk of unwanted pregnancy in Spanish women aged 40-50 years: results of a survey conducted in Spain.

A survey intended to ascertain the rate of use and type of contraceptive methods applied by Spanish women aged 40 to 50 years, and to determine the proportion of women in this group at risk of an unwanted pregnancy, was designed and validated. To achieve representative national results for the study population, it was estimated that a sample size of 2000 women was required. Women were selected using probabilistic, stratified random sampling. The survey questionnaire was prepared by the research group with the collaboration of experts in the conduct of population studies of this type. Participants were interviewed face to face by qualified and trained staff from a specialised company external to the research group. Overall, 1039 women (52%) resorted to some contraceptive method, of which (male or female) sterilisation was the most common. We estimate that in Spain there are 840,000 women (31.8%) aged 40 to 50 years at risk of unwanted pregnancy.

Contraception in the Spanish press: an analysis of the 1997-2002 period.

OBJECTIVE: Based on the hypothesis that the media represent an important source of information about contraceptive methods and sexuality, this paper reviews the news items about contraception published by four important Spanish newspapers and four women's magazines. MATERIALS AND METHODS: All news items appearing from January 1, 1997 to December 31, 2002 in the following publications: El País, El Mundo, ABC, La Vanguardia, Mía, Clara, Ragazza, and Epoca were collected during the first 6 months of 2003. Results Seven hundred and ten news items about contraception were identified during the period analysed, of which 117 (16.5%) had a negative character. CONCLUSIONS: Over 80% of news items appearing in the Spanish press in the 1997-2002 period give a positive information about contraceptive methods.

La práctica de ''escansos'' en el uso de anticoncepción hormonal oral en España. Resultados de cuatro encuestas de ámbito nacional / Pill-free intervals in the use of oral hormonal contraception in Spain. Results of four national surveys

Objetivo: Investigar si las usuarias españolas de anticonceptivos hormonales orales realizan "descansos". Sujetos y método: Se han realizado 4 encuestas nacionales, en intervalos de 2 años, entre 1997 y 2003. El número de mujeres encuestadas, de edades comprendidas entre los 15 y los 49 años, osciló entre 2.076 en el año 1997 y 2.218 en 2001. La información se obtuvo mediante entrevistas personales. Resultados: En 1997, el 42% de las usuarias de la píldora realizaba "descansos", frente al 37% en el año 2003. En más del 60% de los casos fueron recomendados por un médico. Conclusiones: Hay que elaborar una estrategia para la formación, tanto de los profesionales de la salud como de las usuarias, que permita erradicar esta práctica inadecuada

Objective: To investigate whether Spanish women taking oral contraceptives have pill-free intervals. Subjects and method: Four national surveys were performed at 2-yearly intervals between 1997 and 2003. The number of women aged between 15 and 49 years who were surveyed ranged from 2,076 in 1997 to 2,218 in 2001. Information was obtained from personal interviews. Results: In 1997, 42% of pill users reported pill-free intervals compared with 37% in 2003. More than 60% of these women reported that these intervals were recommended by a doctor. Conclusions: A training strategy should be devised, aimed at both health professionals and users of hormonal contraceptives, that would eradicate this incorrect practice

Spanish population at risk of unwanted pregnancy: results of a national survey.

OBJECTIVE: We performed a personal survey in 2218 Spanish women aged from 15 to 49 years to establish the contraceptive methods used by this population and to determine the number of Spanish women of childbearing age exposed to unwanted pregnancy. METHODS: Stratified random sampling was performed to select the women to be interviewed; this sampling design ensured adequate representation of the sample in Spain. RESULTS: At the time of the survey, 69.1% of the women were using some contraceptive method, but 5% of them used poorly effective contraceptive methods, and their exposure to the risk of an unwanted pregnancy was therefore high. Moreover, among the 30.9% not using any contraceptive method, 21.1% were at risk because they were having sexual intercourse, did not want to become pregnant and did not use a contraceptive method. CONCLUSIONS: A little over one million Spanish women are exposed to the risk of having an unwanted pregnancy. Compiling the data on this significant problem is the first step in designing appropriate solutions.

Use of contraceptive methods in Spain: results of a national survey.

We conducted a personal interview of 2136 Spanish women aged 15 to 49 years with the aim of determining the contraceptive attitudes of this population. A stratified random sampling was performed to select the women who were to be interviewed, and this sampling design ensured adequate representation of the sample in Spain. At the time of the survey, only 1296 of the 2136 women used some type of contraceptive method (60.6%); the most commonly used method was the condom. The major reason given by the 840 women not using contraceptive methods was the absence of sexual intercourse. Nearly 25% of the Spanish women aged 15-49 years reported that they have no sexual relations.

[Sexuality and pregnancy]. / Sexualidad y embarazo.

OBJECTIVE: We intend to describe the sexual behaviour of pregnancies women. LOCATION: Family Planning Center Nóvoa Santos, of Galician Health Service (SERGAS), of Ourense (SPAIN). POPULATION: 206 pregnancies women that are attended in a obstetric psychoprophylaxis's programme, during two years (January/93-January/95). MEASUREMENT: We analysed the social economic, of reproduction, of medical attention and psycho-sexual variables. We use the PRESTA and SPSS statistics programmes. RESULTS: The average age is 28 years old, is married, has elementary studies and this is the first pregnancy. Her pregnancy is desire and normally developed. Her sexual desire and intercourse frequency is the same (1-2 per week); the intercourse is pleasant and the more habitual position is she over. Some times, the couple has relations without coitus and she practises the masturbation, and she enjoy of this practice. CONCLUSION: The pregnancies women have different sexual behaviours. They are satisfied with all them. The health' professional should favour the complete enjoy of the sexuality during the pregnancy.

PIP: 206 randomly selected women in the 6th or 7th month of pregnancy participating in childbirth preparation classes at a center in Ourense, Spain, between January 1993 and January 1995, responded to anonymous questionnaires regarding their sexual behavior during pregnancy. The women were 28 years old on average, married, with secondary education, and employed in skilled jobs or as housewives. 88% were urban. 78% were childless. 93% stated the pregnancy was desired and 91% that it was normal. 73% of the pregnancies were attended by a gynecologist, 23% by a family doctor, and the rest by both. 63% of the women did not ask their physician about sexual activity during pregnancy. 26% did ask questions; 47% about sexual relations during pregnancy, 21% about whether the fetus would be harmed, and 13% about when relations should be discontinued. In an average week, 13% did not have coitus, 24% did so once, 28% twice, and 15% 3 times. 11% did not respond. 38% of the women responding reported always and 7% never reaching orgasm. 28% reported their sexual activity always included coitus and 29% that it almost always did so. 14% reported masturbating, 74% reported not masturbating, and 13% did not respond.

[The use and effects of postcoital contraception]. / Uso y efectos de la anticoncepción poscoital.

OBJECTIVES: To find those people seeking post-coital contraception (PCC), its efficacy and effects. DESIGN: A crossover study using a structured questionnaire, filled in both at the moment of demand and after using PCC. SETTING: The "Nóvoa Santos" Family Planning Centre in Ourense. PARTICIPANTS: All those requesting PCC between January 1995 and June 1996 (220 in all). INTERVENTIONS: The PCC norm was 8 pills, two taken every 12 hours, of 0.05 mg of Ethinyloestradiol (EE) plus 0.5 mg of Norgestrel. MEASURES AND MAIN RESULTS: We analysed social and demographic variables, sexual behaviour and PCC use with the SPSS programme for Windows. 96.4% attending were women, average age 21.98. They began coitus at 18.58 years old. 191 (86.8%) had a stable partner and 0 to 3 coitus per week. The condom was the commonest method (90.6%). CONCLUSIONS: Young women requesting PCC immediately after the risk coitus are students and residents in the city. It is a method used when there are problems with the condom and the frequency of failure is low. Sexually active people should be informed of the existence and use of PCC, as should the health professionals who could be asked for it.

Efeitos sobre o recem-nascido da alcalose respiratoria materna. / Effects on the newborn infant of maternal respiratory alkalosis

Os efeitos da intensa hiperventilacao materna sobre o equilibrio acido-basico e a condicao clinica do recem-nascido foram estudados em pacientes submetidos a cesareana com anestesia geral inalatoria e ventilacao controlada. Em um grupo de controle de 10 pacientes normoventiladas, foram analisados o pH, PaCO2,PaO2 excesso de bases e saturacao da hemoglobina no sangue arterial materno e de arteria e veia umbilicais. Estes valores foram comparados com os obtidos em grupo de 10 pacientes submetidas a hiperventilacao intensa. Com a hiperventilacao materna intensa houve queda na PaO2, saturacao da hemoglobina e PaCO2, acompanhado de aumento no pH, no sangue de arteria e veia umbilicais e nascimento de fetos clinicamente mais deprimidos avaliados segundo o indice de Apgar