ABSTRACT
Among the most common reasons given for discontinued use of some contraceptive methods is a disturbance in the menstrual cycle, particularly changes in vaginal bleeding. Work to date suggests marked populational variation in menses duration, but few data have been collected from South America. This longitudinal study of non-contracepting Aymara women (n = 189 providing 837 non-truncated bleeding episodes) identified conceptions and fetal loss via urine tests for human chorionic gonadotropin and classified episodes accordingly to test the hypotheses that (a) vaginal bleeding patterns differ between lactating and non-lactating women, (b) duration of vaginal bleeding accompanying fetal loss differs from that of menstruation, (c) menses preceding a conception are longer than those not followed by a conception. Compared to published values, mean menses duration (3.5 days) in these women was relatively short. Menses duration was not significantly correlated with current age, age at menarche or first birth, parity, time postpartum, or menstrual segment length. Mean menses duration (not preceding a conception) was comparable for lactating and non-lactating women. Mean duration of fetal loss bleeding did not differ from that of menses. Pre-conception episodes were significantly longer than those not followed by conception. Thus, because the rate of conceptions was twice as great among lactating than non-lactating women, the mean duration of all menses (irrespective of conception) was significantly longer in lactating women. Bolivian, and perhaps other South American, women may be particularly disinclined to accept contraceptives (e.g., intrauterine devices) that modify an otherwise relatively brief menses duration. Therefore, a wide variety of contraceptive choices accompanied by population-specific informed counseling is essential. In addition, these findings suggest that studies of fecundability limited to non-lactating women may be biased toward those of relatively lower fecundity and that menses duration may be predictive of risk for some cancers.
Subject(s)
Fertility/physiology , Fetal Death/complications , Fetal Death/physiopathology , Lactation/physiology , Uterine Hemorrhage/etiology , Uterine Hemorrhage/physiopathology , Adult , Bolivia , Contraception Behavior , Female , Humans , Menstruation/physiologyABSTRACT
La mortalidad perinatal 1 (MP1) comprende defunciones ocurridas desde la semana 28 de gestación hasta la primera semana de vida extrauterina. El objetivo de nuestro estudio fue describir, a partir de expedientes clínicos, las características clínicoepidemiológicas de 19 casos y 36 controles de MP1 ocurridos en 1998 en nuestro Hospital General de Zona. Resultados. Las causas más frecuentes de MP1 fueron: interrupción de la circulación fetoplacentaria, cardiopatías y hemorragias ventriculares. Los casos y controles fueron similares en cuanto a edad materna 27.6 ñ 7 vs 28.8 ñ 5 años (p = 0.52), edad gestacional por amenorrea: 39.2 ñ 1.4 vs 39.0 ñ 1.4 semanas (p = 0.82) y peso al nacer: 2892 ñ 769 vs 3352 ñ 549 gramos (p = 0.03) respectivamente. En nuestro estudio, el riesgo de MP1 estuvo incrementado cuando hubo antecedentes de uno a cuatro partos previos (OR = 4.67, p = 0.03) y estuvo disminuido cuando hubo antecedente de nuliparidad (OR = 0.21, p = 0.03). De los 19 casos, 10 fueron mortinatos y nueve fueron casos de muerte hebdomadal. Sus características fueron similares: edad materna 26.1 ñ 5 vs 29.6 ñ 8 años (p = 0.34), edad gestacional 37.7 ñ 3 vs 34.1 ñ 3 semanas (p = 0.05) y peso 3025 ñ 699 vs 2780 ñ 853 gramos (p = 0.53) respectivamente. Los casos de muerte hebdomadal ocurrieron a las 44 ñ 5 horas de su nacimiento. Con lo anterior se concluye que es importante mejorar la atención prenatal sobre todo durante las últimas semanas de la gestación aun en embarazos considerados como normales.
Subject(s)
Humans , Male , Female , Infant, Newborn , Fetal Death/physiopathology , Perinatal Mortality , Prenatal Care , Infant Mortality/trends , Maternal Age , Risk FactorsABSTRACT
Apresentamos três casos de Osteogênese imperfeita tipo II (forma letal). A investigaçäo foi realizada pela descriçäo fenotípica, antropometria, estudo radiológico e necropsia. Foram selecionados de uma amostra de casos de osteocondrodisplasias letais. Dois dos casos apresentavam a forma IIA da osteogênese Imperfeita enquanto que o último caso, IIB. A sistematizaçäo diagnóstico é fundamental pois trata-se de patologia heterogênea do ponto de vista genético. Assim, o diagnóstico preciso dos subtipos é fundamental para o aconselhamento genético