Knowledge and attitudes of female university students on menstrual cycle and contraception.

Socioeconomic changes, as well as the development of new contraceptive modalities may influence women's preferences in the selection of a method of contraception. The aim of this study was to evaluate the knowledge, opinions and attitudes of female university students regarding the menstrual cycle, sexual health and contraception. A questionnaire-based survey was conducted among 2572 female university students in Hungary, Romania and Serbia, between November 2009 and January 2011. A higher proportion of students of health sciences than students of other faculties had appropriate knowledge of the fertile period within a menstrual cycle: 86.0%, 71.5% (p = .02) and 61.1% vs. 71.9% (p < .001), 59.8% and 43.2% (p < .001) in Hungary, Romania and Serbia, respectively. Overall, more than 69% of the female university students believed in the need for monthly menstruation in order to be healthy; however, merely 30 to 40% of them wished to have monthly bleeding. In general, the respondents were aware of the importance of menstruation in relation to sexual health; however, they wished to suppress the menstruation-related symptoms. Differences in the knowledge and attitudes of female university students of the three assessed countries may be explained in part by cultural differences, and in part by the nature of their studies.

Female Romanian university students' attitudes and perceptions about contraception and motherhood.

OBJECTIVES: The aim of our study was to investigate the knowledge, perceptions and attitudes of female Romanian university students, as possible future opinion leaders, about contraception and motherhood, by assessing their level of contraceptive use, opinions and knowledge with regard to combined oral contraceptives (COCs). METHODS: A knowledge, attitudes and practice questionnaire was conducted among 1105 female university students aged 19 to 30 years. The participants were recruited from six faculties at universities in Iasi and Arad, Romania. The study protocol was approved by the university ethics committees. Statistical analyses included percentages, χ(2) tests and Fisher's exact test. RESULTS: Two-thirds of respondents were in a relationship or married. Average age at first sexual intercourse was 18.6 years. Two out of three (69%) students identified themselves as sexually active. The same percentage showed a positive attitude towards contraception and stated that they used it. The most commonly used contraceptive methods were condoms, COCs and withdrawal. The students' perceptions of the benefits and adverse effects of COCs were analysed. Half of the students had heard about extended COC regimens, but only 24% showed interest in using them regularly. A large proportion of pharmacy and non-medical students appeared to have poor knowledge about contraception and reproductive health, which generated misperceptions and negative attitudes. Two-thirds of the participants considered 25 to 29 years to be the optimal age for starting a family, and 85.5% intended to have children in the future. CONCLUSIONS: Medical students, but not pharmacy students, showed higher levels of knowledge. Improvement of students' knowledge, perceptions and attitudes towards general contraceptive use, COCs and childbearing is needed. Evidence-based information is required to address poor knowledge about the physiology of reproduction, misconceptions relating to COCs, and the possibility of menstrual suppression using hormonal contraceptive methods. Compulsory reproductive health education for students is desirable.

Intrauterine foreign bodies, other than contraceptive devices and systems, may affect fertility - report of two very different cases.

OBJECTIVES: To present two cases in which foreign bodies in the uterine cavity had a contraceptive effect for the duration of their presence in utero. CASE: One case of endometrial osseous metaplasia and another case with unabsorbed suture material after a caesarean section resulted in foreign bodies acting like an intrauterine contraceptive. Ultrasound was used to diagnose the conditions, and hysteroscopy to remove the foreign bodies. CONCLUSION: Foreign intrauterine bodies should be considered in cases of infertility.

Levonorgestrel releasing-intrauterine system for the treatment of menorrhagia and/or frequent irregular uterine bleeding associated with uterine leiomyoma.

OBJECTIVE: To evaluate the effectiveness of the levonorgestrel releasing-intrauterine system (LNG-IUS) in the treatment of menorrhagia and/or frequent irregular uterine bleeding in women with uterine myomas. STUDY DESIGN: Prospective study whereby 102 women with intramural myomas (in a few cases associated with submucous or subserous myomas), suffering from menorrhagia and/or frequent irregular uterine bleeding, were evaluated by means of the Pictorial Blood Assessment Chart (PBAC; Higham score) and ultrasound, three, six and 12 months after insertion of a LNG-IUS. RESULTS: The PBAC score dropped (from a mean value of 231.7 to 17.6 at 12 months). The duration of menstrual bleeding diminished significantly (p<0.001). Uterine volume decreased from a mean of 145 cm3 to 129 cm3 at 12 months (p=0.01). Changes in the volume of the myomas were not statistically significant (p=0.23). Satisfaction rate was good in 91 cases (89%), fair in four cases (4%), and poor in seven cases (7%). During the one-year period of follow-up, 11 cases of expulsion or removal of the LNG-IUS were recorded. CONCLUSION: The LNG-IUS is effective in controlling heavy menorrhagia and/or frequent irregular uterine bleeding related to the presence of myomas, but has no significant effect on the size of the tumours.

Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007-2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe.

Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20-24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08-1.35]), foetal growth restriction (1.34 [1.21-1.48]), episiotomy (1.27 [1.21-1.34]), uterine revision (1.15 [1.06-1.25]), APGAR <7 at 1 min (2.42 [1.21-1.67]), cephalopelvic disproportion (1.26 [1.07-1.48]), and postpartum haemorrhage (1.42 [1.25-1.62]); however, caesarean delivery occurs less frequently in teenagers than in adults (0.75 [0.70-0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10-1.17]), low urinary tract infection (1.10 [1.03-1.18]), pediculosis (2.42 [1.90-3.00]), anogenital condyloma (1.50 [1.04-2.17]), and trichomoniasis (1.74 [1.12-2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26-0.71), 0.90 (0.85-0.96), and 0.29 (0.20-0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.

[Maternal immunophenotypic profile in normal pregnancy and preterm birth]. / Profilul imunofenotipic matern în sarcina normala si nasterea prematura.

UNLABELLED: During normal pregnancy, the maternal immune response achieves a split tolerance state towards the fetal allograft, expressed by immunophenotypic profile. This may be impaired in the preterm birth. Our study aimed to analyze the immunophenotypic profiles of the peripheral and retroplacental blood in women with normal pregnancy and preterm birth. Blood leukocyte populations were assessed by flowcytometry in nine normal at term pregnancies, five preterm births and eight nonpregnant controls. Our results showed in normal pregnant women as compared to controls, a significant decreased number of lymphocytes, monocytes and B cells, while granulocytes, T-lymphocytes and the T CD8+ subsets were elevated. The CD4/CD8 ratio was significantly decreased, especially in the retroplacental blood. The preterm birth group demonstrated a significantly elevated number of lymphocytes and B cells, lower T CD8+ cells and an increased CD4/CD8 ratio, in comparison with normal pregnancies group. CONCLUSION: Normal pregnancy determines a suppressive immunophenotypic profile that is impaired in the preterm birth suggesting its immunological involvement.

[HELLP syndrome--a severe form of pregnancy-induced hypertension. A case report]. / Sindromul HELLP--forma grava a hipertensiunii induse de sarcina.

HELLP syndrome consists in serious liver alterations during pregnancy induced hypertension, that causes hemolysis, elevated liver enzymes and low platelet count. It is frequently accompanied by evidence of severe kidney and brain involvement. Our paper aims to stress the importance of an early accurate diagnosis and an adequate management by presenting an illustrative case.