Knowledge of Emergency Contraceptive Pills among Hungarian Women Presenting for Induced Abortion or Seeking Emergency Contraception.

Aim: To compare the differences in contraceptive characteristics and the knowledge of emergency contraception (ECP) among women who used ECP after unprotected intercourse and those who sought an abortion. Methods: A questionnaire survey was conducted in a Hungarian university hospital among women for whom ECP was prescribed after unprotected intercourse (n = 940) as well as women who presented for the termination of pregnancy (n = 1592) between January 1, 2005 and November 20, 2006. Their knowledge of ECP and their experience with and attitudes toward ECP use were targeted. Results: The availability of ECP was well known (87.9 %), but it was still greatly underutilized: applied by only 13 of the 1592 women who resorted to abortion. Primarily, the ECP group consisted of those who experienced a condom failure significantly more often (odds ratio [OR] = 4.1), followed by those cases where ECP applications was a consequence of not using any kind of contraception (OR = 3.8). Fewer than one third (32 %) of the abortion seekers had previously used ECP, and only one fifth knew how to obtain it. Appropriate awareness of ECP was influenced by information obtained from health-care providers (adjusted odds ratio [AOR] = 3.93) or school education (AOR = 1.82). Conclusions: More thorough education is needed to provide a deeper knowledge of ECP use during contraceptive counseling for women seeking abortion, including those contraceptive mishaps where unintended pregnancy can be prevented by ECP.

Placental three-dimensional power Doppler indices in mid-pregnancy and late pregnancy complicated by gestational diabetes mellitus.

OBJECTIVES: The aim of our study was to evaluate placental three-dimensional power Doppler indices in diabetic pregnancies in the second and third trimesters and to compare them with those of the normal controls. METHODS: Placental vascularization of pregnant women was determined by three-dimensional power Doppler ultrasound technique. The calculated indices included vascularization index (VI), flow index (FI), and vascularization flow index (VFI). Uncomplicated pregnancies (n = 113) were compared with pregnancies complicated by gestational diabetes mellitus (n = 56) and diabetes mellitus (n = 43). RESULTS: The three-dimensional power Doppler indices were not significantly different between the two diabetic subgroups. All the indices in diabetic patients were significantly reduced compared with those in non-diabetic individuals (p < 0.001). Placental three-dimensional power Doppler indices are slightly diminished throughout diabetic pregnancy [regression coefficients: -0.23 (FI), -0.06 (VI), and -0.04 (VFI)] and normal pregnancy [regression coefficients: -0.13 (FI), -0.20 (VI), and -0.11 (VFI)]. The uteroplacental circulation (umbilical and uterine artery) was not correlated significantly to the three-dimensional power Doppler indices. If all placental indices are low during late pregnancy, then the odds of the diabetes are significantly high (adjusted odds ratio: 1.10). CONCLUSIONS: A decreased placental vascularization could be an adjunct sonographic marker in the diagnosis of diabetic pregnancy in mid-gestation and late gestation.

Birth weight discordance in spontaneous versus induced twins: impact on perinatal outcome.

PURPOSE: To compare the rate of birth weight discordance and perinatal outcome of twin pregnancies after assisted reproduction with that of spontaneous twins. METHOD: A total of 12,920 deliveries were analyzed retrospectively. Seventy-five twin pregnancies after ART were compared to the 94 spontaneous counterparts. Birth weight discordance was defined as a difference of 20% or more. RESULTS: Discordance rate was elevated (25.3% vs. 17.0%) among ART twins. SGA was increased and NICU admission was more frequent in discordant group. Unlike-sexed twins were more prevalent (73.7% vs. 37.5%) among discordants after ART. CONCLUSIONS: ART can increase discordance rate which can elevate perinatal risk.

Dilemma of increased obstetric risk in pregnancies following IVF-ET.

PURPOSE: To determine the rates of pregnancy complications following in vitro fertilization in comparison with those in a matched control group. METHODS: A total of 13,543 deliveries at the Department of Obstetrics and Gynecology, University of Szeged, between January 1, 1995 and February 28, 2002 were subjected to retrospective analysis The 230 (1.7%) pregnancies following IVF-ET were evaluated and matched with spontaneous pregnancies concerning age, parity, gravidity, and previous obstetric outcome. Demographic and selected maternal characteristics, pregnancy and labor complications, and neonatal outcome were compared in the two groups RESULTS: The pregnancy complication rate was partly significantly higher among the singleton IVF-ET pregnancies. The obstetric risk was elevated, though not significantly concerning twin pregnancies. CONCLUSIONS: IVF-ET presents an additional obstetric risk. The neonatal outcome displays a significant difference only concerning an increased premature birth rate of singleton pregnancies. Triplet IVF-ET pregnancies involve a much higher risk of both pregnancy complications and neonatal outcome.

The incidence of major birth defects following in vitro fertilization.

PURPOSE: To evaluate the risk of congenital malformations in newborns delivered after IVF-ET in comparison with matched controls from spontaneous pregnancies. METHODS: A total of 12,920 deliveries were subjected to retrospective analysis. A total of 301 neonates were evaluated. The incidence of major birth defects was compared with controls matched with regard to age, gravidity, parity, and previous obstetric outcome after spontaneous pregnancies. RESULTS: The incidence of major congenital abnormalities was not significantly higher (p > 0.05) among the cases (1.90%) than among the controls (1.15%). CONCLUSION: The risk of major birth defects following IVF-ET is comparable with that of spontaneously conceived, matched pregnancies.

Perinatal outcome of induced and spontaneous pregnancies of primiparous women aged 35 or over.

OBJECTIVES: To compare the neonatal and maternal morbidity data associated with induced or naturally conceived pregnancies of primiparous women aged 35 years and older. METHODS: We recruited primiparous women aged 35 years and older, who delivered between January 1995 and December 2000. The outcomes of the induced (n=62) and naturally conceived (n=132) pregnancies were compared. The Fisher exact test was used for univariate analysis in order to compare the delivery and pregnancy characteristics in the two groups. RESULTS: Cesarean section featured with a 0.76 times lower prevalence among the induced pregnant women, than among the spontaneous ones, but the difference was not significant statistically. The induced pregnancies were not associated with a significantly higher rate of perinatal complications. CONCLUSIONS: Induced pregnancy does not involve a higher risk of maternal complications. The incidence of premature newborns and intrauterine growth retardation was high in both subgroups, but without a statistically significant difference.

Determinants of abortion among women undergoing artificial termination of pregnancy.

OBJECTIVES: In order to determine factors involved in the contraceptive practice of women undergoing artificial abortion, a prospective questionnaire survey was carried out. METHODS: Women (n = 800) requesting artificial abortion were compared with women (n = 1000) admitted to or visiting the department for reasons other than abortion. The SPSS program was used for statistical analysis between 1998 and 1999. Multiple logistic regression analysis was applied to evaluate the factors influencing the contraceptive practice of the aborters. RESULTS: Reliable contraceptive methods were used significantly less frequently by the aborters than by the control group (19.1% vs. 55%, p < 0.001, adjusted odds ratio (AOR), 0.46; 95% confidence interval (CI), 0.3-0.7). The contraceptive choice of the aborters depended significantly on their low income (AOR, 1.87; 95% CI, 1.5-2.4). The likelihood of abortion was significantly lower among those informed by a health-care provider (AOR, 0.56; 95% CI, 0.4-0.8) or the media (AOR, 0.51; 95% CI, 0.4-0.7). Awareness of reliable methods was also an important factor (AOR, 0.25; 95% CI, 0.1-0.5). CONCLUSIONS: It appears that a further decrease of the abortion ratio could be attained through an intensive media campaign and improved education.