[Approach to teaching health care related material to physicians].

The article discusses an approach of high school professors to teaching physicians during raising the level of physicians skill.

Contraceptive practices and intentions of Ukrainian women.

OBJECTIVES: This study was undertaken to investigate contraceptive practices and factors behind contraceptive preferences among Ukrainian women attending for abortion or gynecological health check-up. METHODS: Women attending for abortion (n = 919) and healthy non-pregnant women (n = 297) were studied by an anonymous 192-item self-questionnaire in a hospital-based unmatched case-control design. RESULTS: The average number of abortions per woman rose with age to 4.6 in the abortion group and 2.4 abortions in the non-pregnant group. In the abortion and non-pregnant groups, no contraceptive use during the past year was reported by 27% and 20% and at the time of conception or during the previous month, by 61% and 51%, respectively. Nevertheless, no intention to use contraception in the future was reported by 15% and 8% of women, respectively. A history of previous childbirth (odds ratio (OR) = 1.8), at least two induced abortions (OR = 1.7) and sexual education obtained from literature (OR = 1.8) were associated with preference to use modern contraceptives. Intention to use no contraception in the future was associated with giving no answer about acceptance of abortion as a birth control method (OR = 5.4), uncertainty whether to use abortion or an intrauterine device in a situation of choice (OR = 1.8), low income (OR = 1.9) and no answer about housing situation (OR = 3.9). Lack of experience with contraception reduced the intention to use any method in the future. CONCLUSIONS: Better reproductive education/information and economic incentives could contribute to a change from abortion to use of contraception.

Ukrainian medical students' experiences, attitudes, and knowledge about reproductive health.

In a 1999 classroom survey of sexual behavior among 689 1st-year medical students at Donetsk State Medical University, Ukraine, 59% of the women and 83% of the men revealed they had "ever" had sexual intercourse. The mean age of first intercourse was 15.7 years for the men and 16.6 years for the women. Thirty-two percent of the students reported they did not use contraceptives at their first intercourse, and 19% said they used no contraceptives at their most recent coitus. Condoms were the most frequent means of contraception, followed by coitus interruptus. Less than 5% used oral contraceptives, and 73% of students reported being afraid to use them. About 6% of the students reported they had had sexually transmitted infections (STI) and 10% had had an abortion. Improving knowledge concerning unwanted pregnancies and STI among Ukraine's future health providers may contribute to improving reproductive health issues in general in Ukraine.

Factors associated with pregnancy termination in Ukrainian women.

OBJECTIVES: To study differences in social and demographic characteristics between women undergoing an induced abortion and antenatal care attendants in the Ukraine. DESIGN: Hospital-based unmatched case control study. METHODS: From a survey including 1,694 women of fertile age, who attended five women's clinics in the Donetsk region, Ukraine, we studied those who came for termination of pregnancy (n = 919) and for antenatal care (n = 478). The data were obtained through an anonymous self-questionnaire. From the 192-item questionnaire questions dealing with social and demographic characteristics, previous pregnancy experience, and attitude towards abortion were analyzed. Multiple logistic regression was used to analyze the risk of pregnancy termination. RESULTS: Termination of pregnancy was associated with being single (OR = 11.8). Both previous childbirth and previous induced abortion were other determinants as well as being younger than 19 years old (OR = 3.8), having a positive attitude towards abortion (OR = 2.7), and sharing apartment with parents (OR = 1.9). A higher risk for an induced abortion was found among women with a history of previous induced abortion(s). Neither income nor educational level was identified as a risk factor for pregnancy termination. CONCLUSION: This study demonstrated major social and demographic differences between women attending for abortion and antenatal care patients, and highlights some of the factors influencing the decision to terminate a pregnancy.

Sexually transmitted diseases and gynecologic symptoms and signs in women with a history of induced abortion.

OBJECTIVE: To investigate associations between a history of induced abortion and current or previous sexually transmitted diseases and other gynecologic infections. METHODS: A cohort study was performed at two family planning clinics and one youth clinic. Of 996 women, 192 (19.3%) admitted a history of induced abortion, whereas the remaining 804 women served as a control group. A structured, personal interview which included details on previous genital infections and gynecologic symptoms and a gynecologic examination was performed. Genital chlamydial infection, gonorrhea, genital herpes, genital warts, cervical human papillomavirus infection, bacterial vaginosis, candidiasis, and bacteria associated with bacterial vaginosis were diagnosed. RESULTS: Both a history of genital infections, with the exception of vulvovaginal candidiasis, and current genital symptoms were more common in women with a history of induced abortion, compared with the control group. Age-adjusted odds ratios ranged from 1.5 (history of genital warts, 95% confidence interval (95% CI 0.9-2.5) to 5.0 (history of gonorrhea, 95% CI 2.6-9.7). Odds ratios for current bacterial vaginosis was 1.9 (95% CI 1.2-2.9) and for vulvovaginal candidiasis 1.8 (95% CI 1.1-2.7). CONCLUSION: Women attending a clinic for an induced abortion could be a target group for sexually transmitted disease information programs.

PIP: This study examines the relationship between a history of induced abortion and current or previous sexually transmitted diseases (STDs) and other gynecologic symptoms. Study participants consisted of a cohort of women attending 2 family planning and 1 youth clinic; 192 were admitted with history of induced abortion and 804 women served as controls. A structured interview to obtain data on previous genital infections and gynecologic symptoms was conducted and gynecologic examination was performed. Various types of STDs and gynecologic symptoms were diagnosed including chlamydial infection, gonorrhea, genital herpes, genital warts, cervical human papillomavirus infection, bacterial vaginosis, candidiasis, and bacterial vaginosis. The study found a high frequency of gynecologic symptoms in women with history of induced abortion such as abnormal vaginal discharges, pruritus, genital malodor, deep dyspareunia and urinary symptoms. Moreover, a history of gonorrhea, genital chlamydial infection, genital warts, and genital herpes were 1.5-5 times more common among women who experienced induced abortion. As a consequence of the 3-fold increase in the history of STDs, the study found a 4-fold increase of a history of pelvic inflammatory disease in women with induced abortion history. Considering these findings, women attending clinics for induced abortions could be a good target population for STD information programs and campaigns.

Induced abortions and childbirths: trends in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine during 1970 to 1994.

BACKGROUND: To analyse trends in childbirth, induced abortions and maternal morbidity from 1970 to 1994 in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine. METHODS: Official health statistics from the six countries were compiled and analysed. RESULTS: High abortion rates (up to 142 per 1000 women of fertile ages and years) were seen in all countries analysed, but since 1980 a continuing decrease is noted for Estonia, Latvia and Kalimingrad with a lowest rate of 50 abortions/1000 women/year in Latvia in 1994. Teenage abortions and childbirths are increasing. Maternal mortality, including complications of abortions, is still a reality in all the countries studied. CONCLUSION: The high abortion frequencies in all countries studied here indicate that national abortion prevention programs are needed. Such programs should focus on education, both of medical professionals, teenagers, fertile women and males. Concomitantly, the availability of cheap and modern contraceptives must increase, especially to defined risk groups.

PIP: The aim of this study was to analyze trends in childbirth, induced abortions, and maternal morbidity from 1970 to 1994 in Estonia, Latvia, Lithuania, Russia, Belarussia, and the Ukraine. Official health statistics from the six countries were compiled and analyzed. High abortion rates (up to 142/1000 women of fertile ages and years) were seen in all countries analyzed, but since 1980 a continuing decrease was noted for Estonia, Latvia, and Kalimingrad, with a lowest rate of 50 abortions/1000 women/year in Latvia in 1994. Teenage abortions and childbirths are increasing. Maternal mortality, including complications of abortions, is still a reality in all the countries studied. The high abortion frequencies in all countries studied here indicate that national abortion prevention programs are needed. Such programs should focus on education of medical professionals, teenagers, and fertile women and men. Concomitantly, the availability of cheap and modern contraceptives must increase, especially to defined risk groups.

[Transfusion of UV-irradiated autologous blood in the complex treatment of women with anemia after cesarean section]. / Primenenie transfuzii obluchennoi ul'trafioletom autokrovi v kompleksnoi terapii zhenshchin s anemiei, perenesshikh operatsiiu kesareva secheniia.

Transfusion of ultraviolet-irradiated autologous blood in women delivered by cesarean section and grade I and II anemia has improved their postoperative course, blood concentration, transcutaneous oxygen tension, hemostasis and fibrinolytic activation responses. The transfusion produced a more marked improvement as compared with iron drugs and packed erythrocyte transfusion.