宫内节育器失败原因浅析

避孕是计划生育中的主要措施,宫内避孕器是我国目前用于避孕的主要手段,在推行计划生育中起到了重要作用。然而还存在着一定数量的宫内避孕器的失败,受术者发生宫内避孕器脱落、带器妊娠、因症取器,均属宫内避孕器放置失败。宫内避孕器效果可因类型不同,使用期限长短而各异,因此宫内避孕器放置失败原因也比较复杂。下面就宫内避孕器放置失败原因浅析一二:1、宫内避孕器类型:各种类型的宫内避孕器各有其优缺点。带铜“V”形及“T”形宫内避孕器的模臂两端容易因宫缩而损伤子宫内膜,引起阴道点滴出血或腹痛;还可能因铜离子作用,使少数人月经…     

宫内节育器知识点滴

什么时间和什么情况下放置宫内节育器最合适?放置宫内节育器要在适宜的时间内,如果时间不合适会影响放环效果,导致出血过多,给妇女带来不必要的麻烦。通常情况下,以下时间放置宫内节育器较为合适:1.月经干净后的3～7天内为最佳时间。因为此期间正值子宫内膜早期增生期,子宫内膜较薄,此时放环可减少手术后出血。2.产后3个月的时候。3.施行人工流产术的同时放置避孕环。4.自然流产又来了月经后、中期引产3个月后可放环。5.剖宫产半年后,如果健康情况正常可以放环。6.月经延期或因喂奶闭经的妇女,应先检查证实没有怀孕再放环。宫内节育器能在宫…     

阴道避孕环的特点和使用方法

阴道避孕环是近几年研制出来的一种新型阴道避孕工具 ,避孕有效率在９７ %左右。它是由医用硅橡胶管制成的圆形环 ,环内放入甲地孕酮、炔诺酮或１８甲基炔诺酮等孕激素制做而成的。阴道避孕环放入阴道后 ,不断缓慢地释放环中的避孕药 ,然后由阴道粘膜吸收后而发挥避孕作用。根据阴道避孕环内含药种类、释放量及环在阴道内的留置时间 ,可分为间断使用的阴道避孕环和连续使用的阴道避孕环。前一种每个月经周期中放入阴道内的时间为２１～２８天 ,后一种可连续放置３～１２个月 ,月经期不取出。阴道避孕环的主要作用是通过改变宫颈粘液性质 ,使…     

谈谈农村妇女结扎后的家庭护理

<正> 输卵管结扎,是深受农村有再生育能力妇女欢迎的既安全又有效的节育措施。从每一个村来说,年年都有10几名村妇自觉实行计划生育——自愿采取这种一劳永逸的避孕措施。受术者通常在手术后1—5天,甚至在术后观察几小时就回家休息,这样,就使护理工作自动进入了家庭阶段。所以,如何科学地进行家庭护理,意义重大而深远。怎样才能做好农村妇女扎后的家庭护理?我想从衣、食、住、行、心(理),环(境)、卫(生)、护(理)等8个方     

扩乡并镇计划生育不放松

邢台县是一个有45万人口、33个乡(镇)的山区大县。在扩乡并镇中,县委县政府对计划生育单位采取了“设置机构、稳定队伍、提供方便、完善制度、强化工作”举措,使计生队伍适应新环境、建立新管理机制,保证了计划生育工作健康有序地开展。 一、扩乡并镇计生队伍不减 扩乡并镇使该县由33个乡(镇)并成19个乡(镇)。为适应这一形势,使计划生育不受损失,县委、县政府下发文件,要求在扩乡并镇中加强对计划生育工作的领导,计划生育机构不能削弱。目前,全县19个乡(镇)全部设置乡(镇)计划生育委员会,委员会下设计划生     

实行信得过医生聘任制 增强受术者的安全感

在1988年冬的“双服务”活动中,我们认真总结以往的经验教训,针对在落实节育手术中出现的新情况、新问题,大胆改革,在全区范围内,狠抓了技术服务队伍的整顿,实行了“信得过医生”聘任制,增强了医生的光荣感和责任感,增强了受术者的安全感和信任感。全区先后聘任了240名信得过医生,共作结扎手术32233例,无一例事故和并发症发生,取得了良好的社会效益和经济效益。     

白衣战士贡献大 节育手术效果好

建国以来,我县共做各项计划生育手术上万例,没有发生死亡事故,既确保了受术者的安全,又有效地控制了人口增长,受到省地领导表彰。 解放后,党和国家重视医疗卫生事业的发展,在县委、县政府的领导下,建立了县医院、保健站和各乡、镇卫生院,并先后配备了妇产科医生和妇幼保健人员,以他们为骨干,组成了一支计划生育技术队伍。从1973年起,在全县开展了避孕节育活动。     

安徽歙县“四到位”确保计生奖扶“提标扩面”落到实处

安徽省歙县本着客观、公正、公开、透明的原则,精心组织,稳步推进,。坚持＂四个到位＂,努力确保计划生育奖励扶助政策及＂提标扩面＂工作落到实处。宣传教育到位。利用县政府网站、村务公开栏,宣传橱窗等载体宣传计生奖扶政策及提标扩面相关政策,进村人户与广大群众面对面进行政策讲解,提高群众的政策知晓率。资格审查到位。严格按照省市有关计生奖扶提标扩面的要求及办理程序,按照不错不漏的原则,     

抓住关键环节 推进人口计生工作综合改革

河北省鹿泉市在推进综合改革进程中,结合当地实际,抓住＂扩职、转型、关爱、创新＂等方面,进行改革尝试,初步建立起适应群众需求的服务管理新机制,全市人口计生工作正在由＂管理型＂到＂服务与福利型＂的变轨,有效促进了人口均衡发展。一是＂抓扩职＂,建立大人口工作机制。随着经济社会的发展,人口增长的态势与群众生育愿望发生了很大变化,     

将“惠民工程”打造成“幸福工程”

安徽省绩溪县被列入国家免费孕前优生健康检查项目试点县以来,积极探索、实践,不断增加地方投入,扩大受益群体,提升服务质量,构筑起出生缺陷一级预防的坚实屏障。提标扩面全覆盖绩溪县不断加强规范化管理,积极培树工作创新点,在保质保量完成＂规定动作＂的同时,探索、实践提标扩面的＂自选动作＂。增加投入保提标。     

微波治疗慢性宫颈炎306例州临床疗效观察

目的为了了解微波治疗慢性宫颈炎的疗效.方法采用微波对306例慢性宫颈炎进行治疗,并观察疗效.结果宫颈糜烂程度与痊愈时间有关,宫颈糜烂合并肥大者,治疗的有效率为100%.结论微波治疗慢性宫颈炎,操作简单、副反应少、治愈率高.     

微波治疗慢性宫颈炎306例临床疗效观察

目的:为了了解微波治疗慢性宫颈炎的疗效。方法:采用微波对306例慢性宫颈炎进行治疗,并观察疗效。结果:宫颈糜烂程度与痊愈时间有关,宫颈糜烂合并肥大者,治疗的有效率为100%。结论:微波治疗慢性宫颈炎,操作简单、副反应少、治愈率高。     

The Waterbirth Project: São Bernardo Hospital experience

Introduction

The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital.

Anopheles subpictus Grassi: Observations on survivorship and population size using mark-release-recapture and dissection methods

Summary A mark-release-recapture experiment to estimate population survivorship and absolute size was performed with wild-caughtAn. subpictus adults at the village of Khano-Harni, Lahore District, Punjab Province, Pakistan during September 1978, the end of the monsoon rainy season, when temporal population abundance was maximized. Daily survival rate estimated from the recapture sequence of marked adults was low, males=0.192 and females=0.343. Survivorship for females estimated by several vertical age-grading procedures ranged from 0.347 to 0.628. Both stage- and age-specific life tables were calculated from vertical age-grading data determined by the dilatation method. Female and male population size was estimated byBailey’s modification of theLincoln Index and was found to average 4478.4 and 6106.8, respectively. The bionomics, survivorship and population size ofAn. subpictus in the Lahore are indicated that this species was probably not important in the transmission of human malaria.     

Rural Egyptian women bear heavy disease burden

In 1998, a multidisciplinary group of researchers investigated women's reproductive health in two rural villages in Giza, Egypt using data from clinical examinations and laboratory tests. In addition, a questionnaire supplemented with in-depth interviews illuminated women's perceptions of illness and the sociocultural context of the community. Examining a random sample of 509 married, nonpregnant women, the researchers found that the vast majority of these women suffer from a spectrum of gynecological and related conditions. Beyond reproductive tract infections, which affect roughly half of the women, genital prolapse afflicts 56% and anemia 63%. Suspicious cervical cell changes (11%) and cervical erosion (22%) in women were noted. Moreover, related conditions were also highly prevalent: women suffered from urinary tract infections (14%), obesity (43%), and hypertension (18%). The team also discovered that two-thirds of women with symptoms had not sought care. Factors other than the physical accessibility, inadequacy in the quality and nature of available health services, and low priority that women place on their health have all contributed to women's lack of seeking treatment. This study suggests that a multidisciplinary approach to medical provision, taking women's perceptions into account is the most effective way to address reproductive health and ill health in communities of the developing world.     

A second look at natural family planning

There is renewed interest in natural family planning (NFP) as the Philippine Population Program enters the 1980s. Much of this interest is due to the realization that, properly practiced, NFP can be a highly effective means of birth spacing. In 1978 the Special Committee to Review the Philippine Population Program recommended that more efforts be made to promote NFP. The different methods of NFP are reviewed. Sex without intercourse, coitus interruptus, and prolonged nursing are not officially recognized as NFP methods by the Program. The rhythm method was first described independently by Drs. Hermann Knaus of Austria and Kyusaku Ogino of Japan in the 1930s. Ogino's method of calculating a woman's fertile period is based on the lengths of the last 12 menstrual cycles which she recorded on a calendar. The advantages of rhythm are that it is inexpensive, it requires only the cost of charts which may be homemade, there are no physical side effects, control is in the woman's hands, and it is acceptable to people who consider it their duty to follow religious teachings. Disadvantages include: keeping constant, accurate records of cycles for long periods of time; the need for perseverance and correct interpretation of the chart; the possible need for medical advice and help; and the fear that something might upset a woman's cycle and change the time of ovulation. The continuation rates of rhythm acceptors in the Philippines are unimpressive. A study of 142 women revealed a high pregnancy/failure rate--25% for a 12-month period compared to 0 with oral contraception (OC) and the IUD's 2%. The basal body temperature method helps determine the unsafe period with some accuracy. Its premise is that there are slight but detectable changes in a woman's body temperature during her cycle. These changes herald ovulation. A special thermometer must record temperature changes of 0.1 degree Farenheit. This instrument and the charts are the only expenses involved. The reviewers of the Philippine Population Program noted that since the end of the unsafe period can be indicated only by the temperature, the total period of abstinence becomes long, although the basal body temperature method gives more or less 10 successive days for intercourse. The cervical mucus method, also known as the Billings method, takes into account the cervical secretions during the menstrual cycle. Appearance of this mucus is an indication of fertility. All that is required of a practitioner is to learn to distinguish the different sensations of wetness and dryness. The disadvantage is that the method becomes ineffective in areas where there is cervicitis or infection of the cervix. The symptom thermal method is the basal body temperature method combined with other NFP techniques and is widely used. With this method an accurate record of the 6 immediately preceding menstrual cycles is established. The start of the fertile period is set by substracting 20 days plus 1. The woman watches for symptoms like pelvic heaviness, breast softness, and mucus discharge.     

Selling family planning to the farmer

Dr. Juan M. Flavier of the International Institute of Rural Reconstr uction (IIRR) found medical terms used by family planning teams had little meaning for rural audiences. In addition, the family planners lectured too much and did not truly reach their farm audiences. The Institute developed a series of materials based on agricultural parallels with captions in verse, capitalizing on the rural Filipino's love of balagtasan (debate in verse) and duplo (couplets). The IUD is likened to a stone which prevents a seed from germinating. The ill-effect of frequent childbirth is likened to a citrus tree laden with too many fruit. The program talks about birth control or limitation in number, spacing, and infertility. Dr. Flavier believes it is important to include infertility if only to show that family planning is an aid to all couples. Many times the farm illustration will spark discussion, which allows the group to bring up questions about birth control which otherwise they would not. A 3-year grant to study the IIRR approach found that this adaptive technique, though slower in the beginning, led to greater continuation rates and more confidence in family planning. It could be used in urban poor areas as well because many slum and working-class families have rural backgrounds. Also, the household illustrations (comparing a cervical cap to the lid of a pot which keeps unwanted items out) would be understandable to most women.     

Upholding the freedom of couples to use a method of their choice

A recent review of the Philippine Population Program's 5-year plan, ended in December 1982, showed that in 1980, natural family planning (NFP) users were only about 12.5% of couples practicing family planning. This figure doubled by 1982. Based on these responses the decision was made to intensify the NFP program as early as 1982. The 1st step was to put more money into the NFP program. The program includes the modern scientific techniques such as cervical mucus, basal body temperature, and sympto-thermal. The program also will fund the training of doctors and other clinic personnel and the production and distribution of appropriate training and information material. Other family planning methods, such as sterilization, oral contraception (OC) and the condom, also will be promoted. Promotion of NFP will depend on the choice of the family planning practitioners themselves. The program's community based services are being intensified. NFP, together with the other family planning methods such as sterilization and OC, will always be made available to couples in the community based services. All agencies in the population and family planning program will be promoting NFP. Knights of Columbus doctors have been invited to assist the program and share their own training modules for the training of trainers. An agreement has been entered into with the Gabriel M. Reyes Memorial Foundation based in Aklan. The goal is for trainers who need further knowledge and skills in NFP to learn from the foundation's wealth of organized orientation and training techniques in NFP. NFP is emphasized at this time because it is acceptable to a great number of couples.     

Medicalization and Teen Girls' Bodies in the Gardasil Cervical Cancer Vaccine Campaign

To explore the impacts of health advertising campaigns on media consumers' perceptions of their health and bodies, I applied the concept of medicalization to a current health media campaign about a cervical cancer vaccine, Gardasil. Literature about medicalization, women's reception of body images, and girl-centered communication studies framed the study. Thirty-nine teens from various backgrounds, aged between fourteen and seventeen years old, were interviewed in six states. Individual and dyad interviews and focus groups helped obtain thick, rich details. A grounded theory approach allowed previously unexplored themes to emerge. Findings suggest that girls believe that media messages about their sexual health—such as the Gardasil TV commercial—instruct them as to health topics they should be concerned about, the social rules that girls should follow—particularly in how, when, and with whom they can discuss sexual health—and how the practice of sex intersects with morality in personal and peer identity formation. Among other implications, this study suggests how campaign designers can re-situate health communication with teen girls. The study also suggests the importance of seeing medicalization effects within an intersectional framework of race, class, and parenthood status.     

The effectiveness of medical interventions aimed at preventing preterm birth: a literature review

Background

Preterm birth is a significant global health problem with serious short and long term consequences. This paper reviews the research literature to answer the question how effective are the medical interventions that aim to reduce the rates of preterm birth?

Methods

A systematic search was carried out in CINAHL, Cochrane, Medline and Embase in relation to following medical treatments aimed at preventing preterm births: anti-infective medications, tocolytics, progesterone and cervical cerclage. The research underpinning each type of intervention is critically analysed in order to establish the validity of knowledge claims that are made for each type of intervention.

Findings

In relation to reducing the rates of preterm births, anti-infectives are only effective in the presence of known infection. Screening for infections during pregnancy is ineffective. Tocolytic agents are not effective in decreasing the preterm birth rates. Progesterone seems to be effective in a select group of pregnant women at higher risk of preterm birth. Cervical cerclage plays a small and an occasional role in preventing some preterm births.

Conclusions

This literature review demonstrates that medical interventions aimed at preventing, not just delaying, preterm birth, are not effective at a population level. Providing holistic, antenatal midwifery care for women living in socio-economic disadvantage and/or with an increased risk of preterm birth seems to be a promising strategy to address the negative effects of the social determinants of disease and thus to reduce the rate of preterm births at an individual and a population level.