Users' awareness of factors associated with complications during pill use.

This study compared the frequency of factors and diseases that contribute to the risks of oral contraceptive use among current users and non-users of oral contraception in order to evaluate the users' awareness of factors associated with complications during oral contraceptive use. Data from 5317 current users and 8863 non-users in the state of São Paulo, Brazil, were collected using questionnaires requesting information on the following variables: use of oral contraceptives, age, weight, smoking status, and the presence or history of hypertension, diabetes, cardiopathies, painful varicose veins, and epilepsy. Half of the users had some risk factors, and 17.4% were at high risk of complications from oral contraceptive use. Risk factors and diseases which appeared to be poorly known by the population as increasing the risk of oral contraceptive use were smoking, hypertension and painful varicose veins. Only a small percentage of the population appeared to know that these diseases and factors could increase the risk of health problems during oral contraceptive use. The results suggest a lack of information among users and providers on factors which are associated with an increased risk of health problems during use of oral contraceptives.

Randomized clinical study of the T-Cu 380A and the Lippes loop C, in Campinas, Brazil.

The copper IUD model T-Cu 380A has shown the best performance when compared with other copper and inert IUDs in studies carried out in the U.S.A., but it had not been tried out in developing countries yet. T-Cu 380A and Lippes loop C were inserted at random in 328 healthy parous women, in Campinas, SP, Brasil. Forty-five percent of the T-Cu 380A insertions and 40% of the Lippes loop insertions were performed by trained midwives. No pregnancies occurred in 1419 woman-months of use of T-Cu 380A, against 5 pregnancies in 1454 woman-months of use of Lippes loop. The difference was significant at the 5% level. No other significant differences were found. The continuation rate after one year of use was 82.5 for the T-Cu 380A and 75.1 for the Lippes loop. These results suggest that the performance of the T-Cu 380A in developing countries could be similar to the one observed in the United States, provided that the users are carefully selected and that an adequate insertion technique is followed.

Acceptability of the contraceptive vaginal ring by rural and urban population in two Latin American countries.

A study of the field acceptability of the Contraceptive Vaginal Ring (CVR) was carried out in rural, small town and urban slum clinics in four locations, two in Brazil and two in the Dominican Republic (D.R.) The CVR was offered as a new method in the clinics and described as similar to the pill but placed in the vagina for three weeks each month with a one-week rest interval. Follow-up surveys were carried out in the four locations at the end of the experimental period. Three, eight, nine and 12.5% of the total acceptors in each of the 4 locations chose the CVR. The acceptance rate fell after the first five months but recovered during the second year. The acceptance rate was much higher in three rual clinics where the nurses themselves used the ring. The follow-up surveys showed that the fact that the ring is placed and kept in the vagina without removal for a prolonged period was the most important attribute of the method and played a large role in women's reactions to it. Anticipated use-related problems were the most prominent reason given by pill users for not choosing the ring, however ease of use was named as the "most killed" characteristic by 55% of ring users. Women tended to remove the ring for intercours and washed it frequently, often with detergents, thus illustrating their concern with "cleanliness" of an object kept within a body cavity for long periods of time.

Programa de tocoginecologia preventiva.Plano piloto de medicina integral. / Program of preventive obstetrics and ginecology. Pilot plan of integral medicine

E importante conscientizar os estudantes de medicina e os medicos de que e mais adequado atender o paciente fazendo o que e necessario de forma simples e eficiente, sem perda de qualidade, de que atender de modo sofisticado a demanda manifestada sem olhar diversos aspectos organicos do paciente como um todos

IUD insertions by midwives: five years' experience in Santiago, Chile.

This report includes data on insertions of Lippes Loop D, Copper-7, and Copper-T intrauterine devices (IUDs) performed by certified nurse-midwives and physicians with comparable levels of training and experience in inserting IUDs. Net 1-year pregnancy, expulsion, and removal rates were used to compare the experiences of the 2 groups. There were no significant differences between the groups in most of the event rates or in the overall method discontinuation rates. The authors conclude that, with adequate training and experience, nurse-midwives can provide this family planning service with no additional risk to patients.