- Email: [email protected]
Experience of the first pelvic examination
MONDAY,
SEPTEMBER
4
45
Results: The patients in the misoprostol group aborted within a significantly shorter time (mean 13 hours and 10 minutes) than those in the dinoprost group (18 hours and 50 minutes, P
FC1.17 ADOLESCENT
GYNECOLOGY
2
FC1.17.01 ADOLESCENT GYNAECOLOGICAL PROBLEMS IN TRIBAL POPULATION OF BIHAR (INDIA) S. Chakraborty, Dept. OBIGYN, Rajendra Medical College Hospital; Bihar, India. Objectives: The study aimed to investigate into the problems of local adolescent tribal population. Important gynecological problems were documented. Study was targeted towards working out the modes of awareness creation, prevention & treatment of the maladies. Study Methods: 100 gynecological cases were studied, during the period January 1999.December 1999. History, followed by clinical exam was carried out. Lab investigations were done. Protocol was designed for every case group regarding its management. The findings were analyzed to formulate the treatment protocol and to go into the depths of it’s overall medical and social implications Results: Menstrual problem (40 cases) 16 pubertal menorrhagia. Oligomenorrhoea (10 cases), 14 cases of amernorrhoea (10 were primary & 4 secondary). Dysmenorrhoea - 20 (Spasmodic dysmenorrhoea, endometriosis & pelvic inflammation). Ulterine anomalies -10 (including mullarian agenesis as well as dysgenesis). Polycystic ovaries (16 cases). Tumors and Ulcers - lO( dysgerminonia (3), Epithelial tumor (l), Dermoid (3), Vulvar Ulcer (l), Uterine Sarcoma (1) & Sercoma Cx. (1)). Reproductive tract infections (4 cases). Conclusions: The findings stressed the need of developing an adolescent care sub-specialty. Lack of awareness and social motivation was a prime cause for late presentation in most of the cases. This further stresses the need of a core group approach to the problem, with gynecologist, medical social workers and various govt. & non-govt., bodies joining hands to work for this special age group.
FC1.17.02 ADOLESCENT REPRODUCTIVE HEALTH COURSE IN INDONESIA S. Adiie, Dept. OBIGYN, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Objective: To increase knowledge among adolescents about reproductive health. Design/Identification: Course and questionnaire, Descriptive study Setting: Dept. OB.GYN, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Subject: High school students in Jakarta who participate voluntarily in the course. There was a test prior to the course subjects of: * The anatomy of male and female reproductions * The function of female’s reproduction process, from menstruation to pregnancy and delivery. * The function of male’s reproduction * The cycle of healthy reproduction * The risk of underage/teenage pregnancy with all of its complications * The gynecology * The importance of reproduction’s responsibility * After course, there was a post-test. Intervention: Interactive course (with a pre- and post-test). Results: From 54 participants, 37 female and 17 male, on average have never been in a similar course before. The age of the participants ranged from 15 to 17 years. Before the course, average points were 5.83 with lowest point of 0 and the highest was 8. After course, average points were 9.33 with the lowest of 7 and the highest was 10. The knowledge of reproduction anatomy before course was 13.73%, after course,
90.19%. The knowledge about physiology of reproduction before course was 17.64%, after course, 88,24%. The knowledge about pathology of gynecology before course was 13.73% and after course, 78.43%. Conclusions: There was a significant increase in the participants’ knowledge about reproductive health.
FC1.17.03 EXPERIENCE OF THE FIRST PELVIC EXAMINATION S. Guuta (l), R. Hogan (2), R. Kirkman (3) (1) Women’s Services, Forest Healthcare Trust, London, UK (2) Dept. of Family Planning, Mancunian Trust, Manchester, UK. (3) Dept. of Family Planning, University of Manchester, Manchester, UK. Objectives: To identify positive and negative components of the first pelvic examination and incorporate positive components in a model of good study clinical practice. Methods: 167 women under 25 years of age filled out an open crosssectional questionnaire within clinics in the Mancunian Community Trust, Manchester. 163 responses were analyzed with Mann Whitney and Chi Square tests. 2% of the questionnaires were incomplete and not included in the analysis. Results: There was a significant trend of positive experience compared to expectations if the examination was conducted by a female doctor (P=O.O2), if the doctor asked permission (P=O.OOl) and if the examination was in a Family Planning Clinic compared to a GP surgery (P=O.4) and if the average age of the girl being examined was 18 as opposed to 16 (P=O.O04). A large proportion of doctors did not seek permission before examination. There were no significant differences in experience and expectations with offer of a chaperone. The women considered a female doctor, a friendly doctor, ability to ask questions and an uninterrupted examination as important aspects of an internal examination. Conclusion: A friendly female doctor seeking permission before the examination which should be uninterrupted, were considered important aspects of an internal examination and should be incorporated as a model of good clinical practice.
FC1.17.04 PROBLEMS OF ADOLESCENT GIRLS -A POPULATION-BASED STUDY R.K. Sarin cl), S. Gael(2), A.R. Sarin (1) (1) Dept. OBIGYN, Aastha Medical Center, Patiala, Punjab, India. (2) Dept. OBIGYN, Medical College Hospital, Patiala, Punjab, India. Objectives: The aim of this study was to investigate the medical and social problems among adolescent girls. Study Methods: Two thousand adolescent girls belonging to rural and urban areas and slums of Patiala district were studied in this populationbased face-to-face survey using a specially designed questionnaire. The interviews were conducted in schools or in the homes if they were not going to school. Besides interviews, a physical examination and Hb estimation were done. Results: 17.2% of these girls were already married. The average age of menarche was found to be 14.1 years. Most of these girls were found to anemic (87.3%), malnourished (59.4%) and had menstrual problems (51.4%), mainly dysmenorrhea. SexuaVphysical abuse was admitted to by 2.7% of girls. Vaginal discharge was complained of in 3.2% cases. A significant number (32.8%) had no knowledge about STD and contraception although 47.5% of girls were aware of gender discrimination. Conclusions: Rampant malnutrition, anemia, gynecologic problems and physicaVsexua1 abuse found in this study may have devastating effects on the future adult female, demanding serious attention of the healthplanners.
SEPTEMBER
4
45
Results: The patients in the misoprostol group aborted within a significantly shorter time (mean 13 hours and 10 minutes) than those in the dinoprost group (18 hours and 50 minutes, P
FC1.17 ADOLESCENT
GYNECOLOGY
2
FC1.17.01 ADOLESCENT GYNAECOLOGICAL PROBLEMS IN TRIBAL POPULATION OF BIHAR (INDIA) S. Chakraborty, Dept. OBIGYN, Rajendra Medical College Hospital; Bihar, India. Objectives: The study aimed to investigate into the problems of local adolescent tribal population. Important gynecological problems were documented. Study was targeted towards working out the modes of awareness creation, prevention & treatment of the maladies. Study Methods: 100 gynecological cases were studied, during the period January 1999.December 1999. History, followed by clinical exam was carried out. Lab investigations were done. Protocol was designed for every case group regarding its management. The findings were analyzed to formulate the treatment protocol and to go into the depths of it’s overall medical and social implications Results: Menstrual problem (40 cases) 16 pubertal menorrhagia. Oligomenorrhoea (10 cases), 14 cases of amernorrhoea (10 were primary & 4 secondary). Dysmenorrhoea - 20 (Spasmodic dysmenorrhoea, endometriosis & pelvic inflammation). Ulterine anomalies -10 (including mullarian agenesis as well as dysgenesis). Polycystic ovaries (16 cases). Tumors and Ulcers - lO( dysgerminonia (3), Epithelial tumor (l), Dermoid (3), Vulvar Ulcer (l), Uterine Sarcoma (1) & Sercoma Cx. (1)). Reproductive tract infections (4 cases). Conclusions: The findings stressed the need of developing an adolescent care sub-specialty. Lack of awareness and social motivation was a prime cause for late presentation in most of the cases. This further stresses the need of a core group approach to the problem, with gynecologist, medical social workers and various govt. & non-govt., bodies joining hands to work for this special age group.
FC1.17.02 ADOLESCENT REPRODUCTIVE HEALTH COURSE IN INDONESIA S. Adiie, Dept. OBIGYN, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Objective: To increase knowledge among adolescents about reproductive health. Design/Identification: Course and questionnaire, Descriptive study Setting: Dept. OB.GYN, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Subject: High school students in Jakarta who participate voluntarily in the course. There was a test prior to the course subjects of: * The anatomy of male and female reproductions * The function of female’s reproduction process, from menstruation to pregnancy and delivery. * The function of male’s reproduction * The cycle of healthy reproduction * The risk of underage/teenage pregnancy with all of its complications * The gynecology * The importance of reproduction’s responsibility * After course, there was a post-test. Intervention: Interactive course (with a pre- and post-test). Results: From 54 participants, 37 female and 17 male, on average have never been in a similar course before. The age of the participants ranged from 15 to 17 years. Before the course, average points were 5.83 with lowest point of 0 and the highest was 8. After course, average points were 9.33 with the lowest of 7 and the highest was 10. The knowledge of reproduction anatomy before course was 13.73%, after course,
90.19%. The knowledge about physiology of reproduction before course was 17.64%, after course, 88,24%. The knowledge about pathology of gynecology before course was 13.73% and after course, 78.43%. Conclusions: There was a significant increase in the participants’ knowledge about reproductive health.
FC1.17.03 EXPERIENCE OF THE FIRST PELVIC EXAMINATION S. Guuta (l), R. Hogan (2), R. Kirkman (3) (1) Women’s Services, Forest Healthcare Trust, London, UK (2) Dept. of Family Planning, Mancunian Trust, Manchester, UK. (3) Dept. of Family Planning, University of Manchester, Manchester, UK. Objectives: To identify positive and negative components of the first pelvic examination and incorporate positive components in a model of good study clinical practice. Methods: 167 women under 25 years of age filled out an open crosssectional questionnaire within clinics in the Mancunian Community Trust, Manchester. 163 responses were analyzed with Mann Whitney and Chi Square tests. 2% of the questionnaires were incomplete and not included in the analysis. Results: There was a significant trend of positive experience compared to expectations if the examination was conducted by a female doctor (P=O.O2), if the doctor asked permission (P=O.OOl) and if the examination was in a Family Planning Clinic compared to a GP surgery (P=O.4) and if the average age of the girl being examined was 18 as opposed to 16 (P=O.O04). A large proportion of doctors did not seek permission before examination. There were no significant differences in experience and expectations with offer of a chaperone. The women considered a female doctor, a friendly doctor, ability to ask questions and an uninterrupted examination as important aspects of an internal examination. Conclusion: A friendly female doctor seeking permission before the examination which should be uninterrupted, were considered important aspects of an internal examination and should be incorporated as a model of good clinical practice.
FC1.17.04 PROBLEMS OF ADOLESCENT GIRLS -A POPULATION-BASED STUDY R.K. Sarin cl), S. Gael(2), A.R. Sarin (1) (1) Dept. OBIGYN, Aastha Medical Center, Patiala, Punjab, India. (2) Dept. OBIGYN, Medical College Hospital, Patiala, Punjab, India. Objectives: The aim of this study was to investigate the medical and social problems among adolescent girls. Study Methods: Two thousand adolescent girls belonging to rural and urban areas and slums of Patiala district were studied in this populationbased face-to-face survey using a specially designed questionnaire. The interviews were conducted in schools or in the homes if they were not going to school. Besides interviews, a physical examination and Hb estimation were done. Results: 17.2% of these girls were already married. The average age of menarche was found to be 14.1 years. Most of these girls were found to anemic (87.3%), malnourished (59.4%) and had menstrual problems (51.4%), mainly dysmenorrhea. SexuaVphysical abuse was admitted to by 2.7% of girls. Vaginal discharge was complained of in 3.2% cases. A significant number (32.8%) had no knowledge about STD and contraception although 47.5% of girls were aware of gender discrimination. Conclusions: Rampant malnutrition, anemia, gynecologic problems and physicaVsexua1 abuse found in this study may have devastating effects on the future adult female, demanding serious attention of the healthplanners.