Antimicrobial prophylaxis in abdominal hysterectomy: A prospective randomized study

40 from endocervix and endometrium were cultured searching for Chlamidya Trachomatis, Neisseria Gonorrheae, Mycoplasma Hominis, and aerobic and anaerobic agents. Some of these patients underwent either laparoscopy or laparotomy. Definitive diagnosis of PID was considered with histopatology (Kiviat criteria), positive Cervix culture for Neisseria Gonorrheae, positive endometrium culture for any STD cultured or macroscopic findings. Then, we compared the ultrasound with the definitive diagnosis. Results: The ultrasound shows a sensitivity of 36%, specificity of 48% and Likelihood Ratio of 1.33 diagnosing Pelvic Inflammatory Disease. Conclusions: We dont recommend the routinely use of Ultrasound in the study of patients with suspected PID.

FC2.11.02 ANTIMICROBIAL PROPHYLAXIS IN ABDOMINAL HYSTERECTOMY: A PROSPECTIVE RANDOMIZED STUDY G. G. Di Gem, F. Lorusso, F. Di Fazio, G. Loverro, L. Selvaggi, Dept OB/GYN, University of Bari. Policlinico. Bari, Italy Objectives: The aim of the study was to compare amoxicillin + ciavulanic acid with cefazoline as ultra-short term prophylaxis in abdominal hysterectomy. Study Methods: 260 patients submitted to total abdominal hysterectomy with or without salpingo-oophorectomy for a benign condition that were randomly allocated to receive amoxicillin. Results: The clinical characteristics (age, weight, concurrent disease, duration of surgery, blood loss, use of drains) were similar in the two groups of patients. Overall febrile morbidity occurred in 13 patients (5%), 6 in Group A and 7 in Group B. No statistical significant difference was observed in the two groups also concerning urinary tract infections and wound infiltrate according to the ASEPSIS scoring system. Conclusion: Ultra short-term prophylaxis is safe and effective in abdominal hysterectomy. Preliminary data would not suggest a statistically significant difference between the two regiments.

FC2.11.03 NEW APPROACHES TO THE TREATMENT OF SUBACUTE INFLAMMATORY DISEASES OF UTERINE APPENDAGES V.I. Grischenko, N.P. Subbota , V.A. Pitko, I.V. Manchenko Institute for Problems of Criobiology and Cryomedicine of the National Academy of Sciences of the Ukraine, Kharkov Kharkov State Medical University, Ukraine The search for new efficient methods of treating the patients with subaccute inflammatory diseases of uterine appendages is one of the actual tasks of modern gynaecology. The application of natural biogenic stimulators obtained from human chorion of early term of the development (lo-12 weeks) seems to be perspective as it was seen from our studies. Experimental study of biological properties of preparation testifies to their manifested biostimulating and antioxidative characteristics. The biomaterial harvesting and its application in clinic was performed in the accordance with the requirements to transplantational material. In every case legal and ethical norms were also met according to the EATB (European Association of Tissue Banks) requirements. The preparations were prepared as the cryoextractions, those were subcutaneously introduced with protein standartization. The application of developed by us treating methods of patients of given pathology with combining treatment by biostimulators from human chorion as cryoextractions allowed to obtain manifested therapeutic effect.

FC2.11.04 HEALTH SERVICE UTILIZATION OF WOMEN WITH REPRODUCTIVE TRACT INFECTIONS IN RURAL CHINA S.(l), R. Oratai (2) (1) Research and Training Center on MCH, Beijing Medical University, Beijing, China. (2) Mahidol University, Bangkok, Thailand. Objective: The objective of this study is to provide insight into psychosocial factors underlying utilization of government health services of women who perceived RTI symptoms and to describe health-

TUESDAY, SEPTEMBER 5 seeking behavior of women with RTIs. Study Method: A cross-sectional study, adopted Aday and Andersen’s Social Behavior Model, complemented by qualitative in-depth interviews, was conducted in 1998-1999 in China. In the context of a high-incidence of RTIs and low health service utilization rate of women with RTIs, Hebei province of China was purposively chosen as the research site. All eligible married women aged 21 to 60, 378 subjects, were interviewed face-to-face and 8 women and 3 village healers were interviewed in-depth. Results: The findings show that the percentage of self-reported symptoms of RTIs was 46.8 and the proportion of women with RTIs who utilized government health services was only 18.0%. Concerning the users of government health services, most women sought care only once at the suggestion of their husbands. Nearly half of the non-users of government health services used self-medication and nearly one-third of them did not seek any kind of care at all, whereas only a few of them sought care in village or private clinic. The results of logistic regression analysis show that knowledge about self-medication, duration of RTIs, perceived social stigma of getting RTIs, family income, perceived severity of RTIs and prior experience of RTIs are predictors of RTI women’s utilization of government health services. The qualitative study strongly supported the quantitative results. In addition, it was also found that the women’s beliefs about RTI etiology, workload and drug price are determinants of RTI women’s utilization of government health services. Conclusion: These findings show that there is a need for great emphasis on offering reproductive health education, alleviating women’s stigma related to RTIs, giving women social and moral support, empowering of women and improving the quality of health services.

FC2.11.05 CONSERVATIVE VS. RADICAL MANAGEMENT IN PELVIC ABSCESS M. T. Tamara, S. Habib, Dept. OB/GYN, Ain Shams University, Giza Cairo, Egypt. Objectives: The aim of the study was to find out which is more beneficial conservative or radical treatment in cases of pelvic abscess in terms of patient’s general condition, hospital stay & cost benefit. Study Methods: 37 patients with pelvic abscess were included in the study. They were divided into 4 groups. Group I (10 patients) had laparotomy and drainage. Group II (8 patients) had laparoscopy and drainage. Group III (11 patients) had TAHBSO. Group IV received medical treatment. Second look laparoscopy was done in Groups I, II & IV. Results: There was no mortality in Groups I, II & IV. The rate of mortality in Group III was 36.6%, the average hospital stay was 9, 4, 12, 7 days in Group I, II, III & IV respectively. Second look laparoscopy revealed filmy adhesion in 60% in Group I, 83.3% in Group II and 87.50% in Group III. Conclusion: It seems that medical treatment of cases of pelvic abscess when possible is better than surgical management in terms of fertility conservation, average hospital stay and cost benefit. However, if surgery is mandatory, conservative (better by laparoscopy) rather than radical surgery gives better results.

FC2.11.06 DIFFERENTIAL IMMUNODIAGNOSIS OF THE SPECIFIC AND NON-SPECIFIC INFLAMMATORY DISEASES OF THE FEMALE GENITAL ORGANS A.Bakradze, N. Gogebashvili, N. Mirabishvili, Tbilisi State Medical University, Georgia, Russia Objectives: The goal of the present paper was to develop the criteria of specific immunodiagnosis of inflammatory diseases of female genital organs. Study Methods: A total of 210 patients were studied. Of those, 124 had non-specific inflammation and 86 had TB. 50 practically healthy women constituted the control group. The women under study were subjected to tuberculin-provocation test. High doses of tuberculin (20TU) before and after provocation were used to study the tuberculin-specific response of the organism and specific reactivity to tuberculin, viz., the number of cells with CD3+, CD4+, CDE+and CD22+ markers and functional activity of lymphocytes basing on blasttransformation and lymphocytes migration inhibition reactions, definition of G, M, A classes of immunoglobulins and anti-TB antibodies titers. The provocation results were also estimated by the level of changes of blood serum a,antitrypsin, cc2 macroglobulin,