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P739 Relative frequency of knowledge of women about oral contraceptive pills after attending family planning classes just before marriage in Iran
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
concentrate on increasing the availability of all methods, in many cases by means of lowering the cost. P737 Oral contraception: Optimization of patient information project – Step 1 of CORALIE study 1
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P. De Reilhac , B. Letombe , D. Serfaty , M. Micheletti , F. Fncgm. 1 3 Place Ladmirault, 44000 Nantes, 2 CHRU Hˆ opital Jeanne De Flandre, Avenue Eug`ene Avin´ee, 59037 Lille Cedex, 3 9, rue Villersexel, 75007 Paris, 4 Laboratoire Th´eramex, 6 avenue Albert II, BP 59, 98007 Monaco Cedex, 5 Contraception raises the problem of patient information. This problem often causes discontinuation or at least misuse and noncompliance. What information is sufficient for the doctor to provide the woman at the first prescription of a combined oral contraceptive (COC) to ensure proper use? Objectives: To develop and evaluate the best information to provide the woman at the first prescription of a COC in order to facilitate understanding of key messages and good use. The 1st step of this study is to develop this information by consensus of doctors. Material and Methods: DELPHI method (method for finding consensus) has been used. 100 gynecologists throughout France are asked to fill in a 1stquestionnaire. It included 39 items: how the COC works, how to take it, what to do if you forget it, benefits, risks, side effects, warning signs of potential adverse events. Information of this 1st questionnaire has been retained if there was a consensus of at least 70% of gynecologists. Each item fulfilling this selection criterion was in the 2nd questionnaire filled by the same gynecologists. Item has been then retained if there was a consensus of at least 99% of gynecologists. Informations finally fulfilling this criterion would be the “best informations” to deliver to women at the first prescription of a COC. This “best information” will be evaluated by women in the 2 nd step of CORALIE study. Results: Results will be presented at the Congress. P738 Comparison of two regimens of a new monophasic oral contraceptive combining 17beta-estradiol and nomegestrol acetate D. Serfaty1 , S. Christin Maitre2 , E. Ochsenbein3 , J. Thomas3 . 1 Paris, 2 Hˆ opital Saint Antoine, Saint Antoine, Paris, 3 Theramex, Monaco Objectives: To compare the effects on ovarian activity and vaginal bleeding of 2 regimens of a new monophasic combined oral contraceptive containing 17 beta-estradiol 1.5 mg and nomegestrol acetate 2.5 mg given for 3 consecutive 28-day (d) cycles. Materials and Methods: Double-blind study, 77 healthy women, aged 19–38 years were randomized to receive this oral contraceptive given either as 21d (n = 37) or 24d regimen (n = 40). Primary efficacy endpoints were follicle size assessed by transvaginal ultrasound and E2, progesterone, LH and FSH blood levels. Bleeding pattern was assessed using the data collected in diary cards. Secondary endpoint was the return of fertility in the post-treatment cycle. Results: All women had ovulation in the pre-treatment cycle. During treatment, mean diameter of the largest follicle was significantly larger in the 21d compared with the 24d regimen (13.0±7.5 vs 9.9±3.4 mm, p = 0.024). In both groups no ovulation or luteinised unruptured follicle syndrome occurred and the mean progesterone blood level remained <0.15 ng/mL. Both regimens suppressed ovulatory LH peak. 24d regimen delayed increase in FSH resulting in statistically lower mean levels on day 24 of each cycle. E2 was slightly lower during the 3rd cycle in the 24d regimen group. Mean duration of withdrawal bleeding was shorter and lighter in 24d compared with 21d regimen (3.7±1.4 vs 4.9±2.2d, p < 0.001) as well as mean duration of breakthrough bleeding/spotting (2.3±2.2 vs 5.7±5.0d, p = 0.021). Ovulation occurred in 72% of women during the post-treatment cycle.
S623
Conclusion: Both regimens suppressed ovarian activity but 24d regimen was associated with stronger follicular suppression and shorter, lighter periods and breakthrough bleeding/spotting events. P739 Relative frequency of knowledge of women about oral contraceptive pills after attending family planning classes just before marriage in Iran F. Mirblook, M. Asgharnia, K. Forghanparast, M. Hajiaghaie. Guilan University of Medical Sciences Introduction: Taking oral contraceptives is one of the reliable and common methods to prevent pregnancy. These centers (family planning classes) can play an important role in increasing the women’s knowledge. Objectives: The aim of this study determine the knowledge of women about oral contraceptive pills after attending family planning classes just before marriage. Methods: During three months, a hundred women, were asked to fill a 21-item questionnaire at the end of family planning classes. The relative frequency of true answers for each question and aspect has been calculated separately. Result: The average relative frequencies of true answers for the questions were 57.5% for how to take the pills; 47.5% for their usages; 19.2% for the effects and problems related to the use of pills mentioned in the Health Center pamphlet and 51.3% for the effects and problems not mentioned in the Health Center pamphlet. In all aspects, those who were academically educated answered more correctly than others. Comparison of different items of questionnaire showed that the women’s knowledge of correct way of usage of pills was not satisfactory which may lead to quit of taking the pills. Conclusion: The less knowledge of the women in our region could be an indication of imperfect or inefficient education or lack of people’s attention to education due to the stresses arising from marriageTherefore, revising the related education is necessary. P740 Psycho-social support in labour, as a catalyst for contraceptive uptake in Nigeria: Preliminary analysis of a randomised controlled trial O. Ojengbede1 , I. Morhason-Bello1 , B. Adedokun2 , S. Becker3 , G. Oni3 , A. Tsui4 . 1 Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria, 2 Department of Epidemiology, Medical Statistics, and Environmental, 3 Gates institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA., 4 3. Gates institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA Objective: To determine the effect of the Presence of husbands during childbirth on the contraceptive use. Methodology: An ongoing randomised trial commenced April 2008. The experimental group had companionship in addition to routine care throughout labour till 2 hours after delivery, while the controls had only routine care. The primary outcome is contraceptive uptake. Analysis was by intention to treat, and statistical significance was at 5%. Results: Of 245 recruited thus far, 177 (84 in experimental and 93 in control group) have delivered. The randomisation was balanced in terms of biosocial and obstetric variables. A significantly higher proportion of women in the experimental (81%) compared to 57.5% of controls were using a modern contraceptive at 6 weeks post partum (p = 0.001). Joint decision for use was significantly higher among the experimental group (66.2 vs. 0) (p < 0.001). Moreover, significantly higher proportion of women alone (82.9% vs. 19.5%), and husband alone (17.1% vs. 14.7%), initiated use among the control compared to the experimental. Conclusion: It shows that support offered by Nigerian men during childbirth may provide a paradigm shift to the appalling
concentrate on increasing the availability of all methods, in many cases by means of lowering the cost. P737 Oral contraception: Optimization of patient information project – Step 1 of CORALIE study 1
2
3
4
P. De Reilhac , B. Letombe , D. Serfaty , M. Micheletti , F. Fncgm. 1 3 Place Ladmirault, 44000 Nantes, 2 CHRU Hˆ opital Jeanne De Flandre, Avenue Eug`ene Avin´ee, 59037 Lille Cedex, 3 9, rue Villersexel, 75007 Paris, 4 Laboratoire Th´eramex, 6 avenue Albert II, BP 59, 98007 Monaco Cedex, 5 Contraception raises the problem of patient information. This problem often causes discontinuation or at least misuse and noncompliance. What information is sufficient for the doctor to provide the woman at the first prescription of a combined oral contraceptive (COC) to ensure proper use? Objectives: To develop and evaluate the best information to provide the woman at the first prescription of a COC in order to facilitate understanding of key messages and good use. The 1st step of this study is to develop this information by consensus of doctors. Material and Methods: DELPHI method (method for finding consensus) has been used. 100 gynecologists throughout France are asked to fill in a 1stquestionnaire. It included 39 items: how the COC works, how to take it, what to do if you forget it, benefits, risks, side effects, warning signs of potential adverse events. Information of this 1st questionnaire has been retained if there was a consensus of at least 70% of gynecologists. Each item fulfilling this selection criterion was in the 2nd questionnaire filled by the same gynecologists. Item has been then retained if there was a consensus of at least 99% of gynecologists. Informations finally fulfilling this criterion would be the “best informations” to deliver to women at the first prescription of a COC. This “best information” will be evaluated by women in the 2 nd step of CORALIE study. Results: Results will be presented at the Congress. P738 Comparison of two regimens of a new monophasic oral contraceptive combining 17beta-estradiol and nomegestrol acetate D. Serfaty1 , S. Christin Maitre2 , E. Ochsenbein3 , J. Thomas3 . 1 Paris, 2 Hˆ opital Saint Antoine, Saint Antoine, Paris, 3 Theramex, Monaco Objectives: To compare the effects on ovarian activity and vaginal bleeding of 2 regimens of a new monophasic combined oral contraceptive containing 17 beta-estradiol 1.5 mg and nomegestrol acetate 2.5 mg given for 3 consecutive 28-day (d) cycles. Materials and Methods: Double-blind study, 77 healthy women, aged 19–38 years were randomized to receive this oral contraceptive given either as 21d (n = 37) or 24d regimen (n = 40). Primary efficacy endpoints were follicle size assessed by transvaginal ultrasound and E2, progesterone, LH and FSH blood levels. Bleeding pattern was assessed using the data collected in diary cards. Secondary endpoint was the return of fertility in the post-treatment cycle. Results: All women had ovulation in the pre-treatment cycle. During treatment, mean diameter of the largest follicle was significantly larger in the 21d compared with the 24d regimen (13.0±7.5 vs 9.9±3.4 mm, p = 0.024). In both groups no ovulation or luteinised unruptured follicle syndrome occurred and the mean progesterone blood level remained <0.15 ng/mL. Both regimens suppressed ovulatory LH peak. 24d regimen delayed increase in FSH resulting in statistically lower mean levels on day 24 of each cycle. E2 was slightly lower during the 3rd cycle in the 24d regimen group. Mean duration of withdrawal bleeding was shorter and lighter in 24d compared with 21d regimen (3.7±1.4 vs 4.9±2.2d, p < 0.001) as well as mean duration of breakthrough bleeding/spotting (2.3±2.2 vs 5.7±5.0d, p = 0.021). Ovulation occurred in 72% of women during the post-treatment cycle.
S623
Conclusion: Both regimens suppressed ovarian activity but 24d regimen was associated with stronger follicular suppression and shorter, lighter periods and breakthrough bleeding/spotting events. P739 Relative frequency of knowledge of women about oral contraceptive pills after attending family planning classes just before marriage in Iran F. Mirblook, M. Asgharnia, K. Forghanparast, M. Hajiaghaie. Guilan University of Medical Sciences Introduction: Taking oral contraceptives is one of the reliable and common methods to prevent pregnancy. These centers (family planning classes) can play an important role in increasing the women’s knowledge. Objectives: The aim of this study determine the knowledge of women about oral contraceptive pills after attending family planning classes just before marriage. Methods: During three months, a hundred women, were asked to fill a 21-item questionnaire at the end of family planning classes. The relative frequency of true answers for each question and aspect has been calculated separately. Result: The average relative frequencies of true answers for the questions were 57.5% for how to take the pills; 47.5% for their usages; 19.2% for the effects and problems related to the use of pills mentioned in the Health Center pamphlet and 51.3% for the effects and problems not mentioned in the Health Center pamphlet. In all aspects, those who were academically educated answered more correctly than others. Comparison of different items of questionnaire showed that the women’s knowledge of correct way of usage of pills was not satisfactory which may lead to quit of taking the pills. Conclusion: The less knowledge of the women in our region could be an indication of imperfect or inefficient education or lack of people’s attention to education due to the stresses arising from marriageTherefore, revising the related education is necessary. P740 Psycho-social support in labour, as a catalyst for contraceptive uptake in Nigeria: Preliminary analysis of a randomised controlled trial O. Ojengbede1 , I. Morhason-Bello1 , B. Adedokun2 , S. Becker3 , G. Oni3 , A. Tsui4 . 1 Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria, 2 Department of Epidemiology, Medical Statistics, and Environmental, 3 Gates institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA., 4 3. Gates institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA Objective: To determine the effect of the Presence of husbands during childbirth on the contraceptive use. Methodology: An ongoing randomised trial commenced April 2008. The experimental group had companionship in addition to routine care throughout labour till 2 hours after delivery, while the controls had only routine care. The primary outcome is contraceptive uptake. Analysis was by intention to treat, and statistical significance was at 5%. Results: Of 245 recruited thus far, 177 (84 in experimental and 93 in control group) have delivered. The randomisation was balanced in terms of biosocial and obstetric variables. A significantly higher proportion of women in the experimental (81%) compared to 57.5% of controls were using a modern contraceptive at 6 weeks post partum (p = 0.001). Joint decision for use was significantly higher among the experimental group (66.2 vs. 0) (p < 0.001). Moreover, significantly higher proportion of women alone (82.9% vs. 19.5%), and husband alone (17.1% vs. 14.7%), initiated use among the control compared to the experimental. Conclusion: It shows that support offered by Nigerian men during childbirth may provide a paradigm shift to the appalling