Awareness, perceptions, and acceptance of human papillomavirus vaccination among parents in Hong Kong.

INTRODUCTION: This study investigated the awareness, perceptions, and acceptance of human papillomavirus (HPV) vaccination for children among parents in Hong Kong. It also explored factors associated with, and differences in, vaccine acceptance and hesitancy between parents of girls and boys. METHODS: Parents of boys or girls in Primary 5 to 6 were invited to participate in an online survey through an established health and lifestyle e-platform. RESULTS: Overall, 851 parents completed the survey: 419 (49.2%) had daughters, 348 (40.9%) had sons, and 84 (9.9%) had children of both genders. Parents who enrolled their children into the Childhood Immunisation Programme were more likely to accept HPV vaccination (79.7% vs 33.7%, odds ratio [OR]=7.70; 95% confidence interval [CI]=5.39-11.01; P<0.001); parents of girls were more likely to accept than parents of boys (86.0% vs 71.8%, OR=2.40; 95% CI=1.67-3.46; P<0.001). Among parents of girls and boys, the main reasons for HPV vaccination acceptance were prevention of cancers (girls: 68.8% and boys: 68.7%), prevention of sexually transmitted diseases (girls: 67.3% and boys: 68.3%), and optimal timing before initiation of sexual activity (girls: 62.8% and boys: 59.8%). Vaccine hesitancy was mainly associated with concerns about serious side-effects (girls: 66.7% and boys: 68.0%) and the belief that their children were too young (girls: 60.0% and boys: 54.0%). CONCLUSION: Parents in Hong Kong are hesitant about HPV vaccination for their sons. This barrier could be removed by providing information to correct vaccine safety misconceptions and offering a gender-neutral vaccination programme through the school-based Childhood Immunisation Programme.

Arterial embolisation in intractable primary post-partum haemorrhage: case series.

OBJECTIVE: To evaluate the efficacy and safety of arterial embolisation in the management of intractable primary post-partum haemorrhage. DESIGN. Retrospective case series. SETTING: Regional hospital, Hong Kong. PATIENTS: Nine patients aged 28 to 39 years who were treated for severe primary post-partum haemorrhage between October 2000 and January 2003. INTERVENTION: Emergency transcatheter arterial embolisation. MAIN OUTCOME MEASURES: Clinical outcome and complications. RESULTS: All nine arterial embolisations successfully arrested the haemorrhage. The main cause of primary post-partum haemorrhage was uterine atony. No serious complication arose, although one patient experienced slight numbness of the right leg. Normal menstruation resumed in all patients, except for the one who had had a hysterectomy as initial treatment. One patient became pregnant 1 year after embolisation. Patients were followed up for 10 months. CONCLUSION: In our experience, arterial embolisation is safe and efficacious, and is the treatment of choice for patients with intractable primary post-partum haemorrhage.

Laparoscopic management of large ovarian cysts: more than cosmetic considerations.

Laparoscopic management of three cases, each with a large ovarian cyst, is reported. Appropriate preoperative assessment, patient counselling, and good laparoscopic skills are the cornerstones of successful laparoscopic management in such patients.

Abdominal pregnancy presenting as a missed abortion at 16 weeks' gestation.

We report on an abdominal pregnancy that presented as a missed abortion at 16 weeks' gestation and review the literature on the management of abdominal pregnancy. The clinical presentation of abdominal pregnancy varies, and the diagnosis depends on a high index of suspicion. Ultrasonography is useful for early diagnosis of the condition. The management depends on the gestation at presentation; for advanced abdominal pregnancy, surgical intervention is recommended. The treatment of the placenta is a matter of controversy. In general, expectant management is suggested. When the placenta is left behind, the use of prophylactic methrotrexate is not advocated. An awareness of abdominal pregnancy is very important for reducing associated morbidity and mortality.

A prospective randomized study comparing hysteroscopy and curettage (H & C) under local anaesthesia (LA) and general anaesthesia (GA) in Chinese population.

OBJECTIVE: To compare the difference in patient's acceptance of local anaesthesia (LA) and general anaesthesia (GA) hysteroscopy and curettage in Chinese population. DESIGN: A prospective randomized study. SUBJECTS AND METHODS: In the period September 1994 to August 1995, all Chinese women with abnormal uterine bleeding or suspected uterine anomaly who warranted hysteroscopy and uterine curettage were invited to participate in this study with informed consent. They were randomly allocated to the control (i.e. GA) and study (i.e. LA) group. RESULTS: Overall 90% of the controls and 91% of the study group were satisfied with the procedure. The hysteroscopic diagnostic accuracy was 83%. Significantly higher percentage of patients in the study group opted for the same form of admission arrangement if given the choice. CONCLUSION: Hysteroscopy and curettage under LA and GA are equally acceptable in the Chinese population in Hong Kong. The patient satisfaction rate is high in both groups. Hysteroscopic diagnosis is highly accurate in malignant condition (100% sensitivity and 83% specificity).

Emergency obstetric hysterectomies for postpartum haemorrhage.

OBJECTIVE: To review emergency obstetric hysterectomy in our unit, including the indications for and morbidity associated with the procedure. DESIGN: A retrospective cases analysis. SUBJECTS AND METHODS: Records of obstetric patients who had undergone emergency hysterectomies in between 15 October 1993 and 31 December 1997 were reviewed retrospectively. RESULTS: There were 15,474 deliveries and 7 emergency obstetric hysterectomies. All cases had total abdominal hysterectomy. The indications for hysterectomy were uterine atony and placental disorders. There were one case of urinary bladder injury and 2 cases of disseminated intravascular coagulopathy. There was no maternal mortality. CONCLUSION: Emergency obstetric hysterectomy remains a potentially life-saving procedure in unavoidable catastrophe. The 7 patients with life threatening postpartum haemorrhage underwent hysterectomy after failure of conservative measures. The morbidity is low and there was no mortality in this series.