Obstetrics and Gynecology International最新文献

{"title":"How Menstruation Is Perceived by Adolescent School Girls in Gedeo Zone of Ethiopia?","authors":"Zelalem Belayneh,&nbsp;Moges Mareg,&nbsp;Birhanie Mekuriaw","doi":"10.1155/2020/3674243","DOIUrl":"https://doi.org/10.1155/2020/3674243","url":null,"abstract":"<p><strong>Introduction: </strong>Perception regarding menstruation is insufficiently acknowledged. Lack of adequate perception towards menstruation may make girls vulnerable to mental, emotional, and physical problems. This might also be a reason for the failure of menstrual hygiene practice which in turn can have multiple social and health consequences.</p><p><strong>Objective: </strong>To assess the perception and correlation regarding menstruation among adolescent high school girls in Gedeo zone, Southern Ethiopia.</p><p><strong>Methods: </strong>An institutional-based cross-sectional study was conducted among a randomly selected 791 adolescent high school girls at the Gedeo zone through the multistage sampling technique. Data were collected using an interviewer-administered questionnaire. The data were entered to EPi Info version 3.5 and exported to SPSS version 20.0 for analysis. Frequency tables were used to describe study variables. Odds ratio with 95% confidence interval was computed to determine the level of significance.</p><p><strong>Result: </strong>From a total of 806 adolescent girls that were invited to participate in the study, 791 (98.1%) participated. The mean (±SD) age of respondents was 16.3 (±4.7) years. Living alone in dormitories {OR = 1.75 CI = (1.07, 2.85)}, lower maternal educational status {OR = 4.03, CI = (2.41, 6.74)}, and age of menarche before 12 years {OR = 2.07, CI = (1.02, 4.24)} were factors statistically associated with unfavorable perception regarding menstruation.</p><p><strong>Conclusion: </strong>Most high school girls had an unfavorable perception regarding menstruation. Living alone, lower maternal educational status, and age of menarche before 12 years were factors with statistically significant association with unfavorable perception regarding menstruation. This demonstrates a need to design and implement advocacy programs.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"3674243"},"PeriodicalIF":1.9,"publicationDate":"2020-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3674243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38373889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Care Pathway Delays of Cervical Cancer Patient in Morocco.","authors":"Hind Mimouni,&nbsp;Khalid Hassouni,&nbsp;Boujemaa El Marnissi,&nbsp;Bouchra Haddou Rahou,&nbsp;Leila Alaoui,&nbsp;Rachid Ismaili,&nbsp;Abderraouf Hilali,&nbsp;Leila Loukili,&nbsp;Rachid Bekkali,&nbsp;Ahmed Nejmeddine","doi":"10.1155/2020/8796570","DOIUrl":"https://doi.org/10.1155/2020/8796570","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to document time intervals in cervical cancer care pathways, from symptom onset to disease detection and start of treatment, and evaluate how clinical, sociodemographic, and treatment factors influence delays throughout a patient's clinical pathway.</p><p><strong>Methods: </strong>A retrospective study was conducted at the FEZ Oncology Hospital of the Hassan II University Hospital Center in Morocco.</p><p><strong>Results: </strong>190 medical records of cervical cancer patients were collected. The dominant age group was 35-44, the median patient delay (PD) was 6 days, the median healthcare provider's delay (HCP) was 21 days, the median referral delay (RD) was 17 days, the median diagnostic delay (DD) was 9.5 days, the median total diagnostic delay (TDD) was 16 days, the median treatment delay (TD) was 67 days, and the median health system interval (HSI) was 92 days. Multivariate analysis revealed that age was associated with the patient delay, the healthcare provider's delay, the diagnosis delay, and the health system interval. The diagnosis year (the year in which the patient was diagnosed (either before 2012 or during 2012 as well as the other study years (from 2013 to 2017))), all investigations done prior to admission to the oncology hospital, and the age of first sexual activity were significantly associated with healthcare provider's delay.</p><p><strong>Conclusion: </strong>The integration of a model and standard care pathway into the Moroccan health system is essential in order to unify cervical cancer care in the country.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"8796570"},"PeriodicalIF":1.9,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8796570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38362007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Exclusive Breastfeeding Practice and Associated Factors among Mothers in West Shoa Zone, Oromia, Ethiopia.","authors":"Kassa Mamo, Tizita Dengia, Abuzumeran Abubeker, Eden Girmaye","doi":"10.1155/2020/3965873","DOIUrl":"10.1155/2020/3965873","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development, and health. Even though appropriate feeding practice is the most cost-effective intervention to reduce child morbidity and mortality, exclusive breastfeeding practices in developing countries are still low.</p><p><strong>Objective: </strong>The objective of the study was to assess exclusive breastfeeding practice and associated factors among mothers in West Shoa zone.</p><p><strong>Methods: </strong>Community-based cross-sectional study design was conducted from May to December 2018 in the West Shoa zone, Ethiopia, among 710 mothers with 6-9-month-old infants. The multistage stage sampling technique was employed. A pretested structured interviewer-administered questionnaire was used to collect the data. Epi Info version 7.1.2.0 was used to enter the data, and we transferred to SPSS version 25 for analysis. The association between factors and the exclusive breastfeeding were analyzed with bivariate and multivariate logistic regression.</p><p><strong>Result: </strong>A total of 710 women were included with a response rate of 97.9%. The prevalence of unintended pregnancy was 38.7%, and only 65.35% of the respondents reported that they have exclusively breastfed for the first six months of their infant's life. Marital status (AOR 2.467 (1.333-4.564)), ANC visit (AOR 2.562 (1.250-5.252)), pregnancy intentionality (AOR 4.727 (3.217-6.945)), postnatal care clinic attendance (AOR 3.373 (2.293-4.963)), and counseling on exclusive breastfeeding AOR 2.544 (1.239-5.225) were the factors associated with exclusive breastfeeding. Exclusive breastfeeding practice is still low and actions need to be taken like educating the community about the importance of exclusive breastfeeding using every accessible media. Maternal health service centers should provide counseling and education for women about breastfeeding.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"3965873"},"PeriodicalIF":1.6,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38408770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Luteal Phase Support Effect Pregnancy Rates in Intrauterine Insemination Cycles? A Prospective Randomised Controlled Study in a Tertiary Center.","authors":"Müge Keskin,&nbsp;Ruşen Aytaç","doi":"10.1155/2020/6234070","DOIUrl":"https://doi.org/10.1155/2020/6234070","url":null,"abstract":"<p><p>Intrauterine insemination (IUI) is a common treatment for couples with subfertility. Clomiphene citrate, gonadotropins, and letrozole are used for ovulation induction in IUI cycles. It has been well documented that luteal support with exogenous progesterone after in vitro fertilization is associated with higher pregnancy and live birth rates. Yet, luteal phase support in IUI cycles has become a debatable issue. The aim of this prospective controlled study was to assess the effect of luteal phase vaginal progesterone supplementation on <i>β</i>-hCG positivity and clinical pregnancy rates in women undergoing IUI. This prospective controlled randomised study was conducted at a tertiary infertility center. 87 patients with unexplained infertility or male subfertility who were treated with IUI using gonadotropins were enrolled. Patients in the study group (<i>n</i> = 44) received luteal phase vaginal progesterone supplementation. Patients in the control group (<i>n</i> = 43) did not receive any luteal phase support. There was no statistical difference between two groups in terms of <i>β</i>-hCG positivity and clinical pregnancy rates. Our findings do not show any beneficial effect of luteal phase support in IUI cycles stimulated with gonadotropins. Although luteal phase support in IUI cycles stimulated with gonadotropins is widely adopted, there is a lack of robust evidence.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"6234070"},"PeriodicalIF":1.9,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6234070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38294935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Indications, and Community Perceptions of Caesarean Section Delivery in Ngora District, Eastern Uganda: Mixed Method Study.","authors":"Isaac Waniala,&nbsp;Sandra Nakiseka,&nbsp;Winnie Nambi,&nbsp;Isaac Naminya,&nbsp;Margret Osuban Ajeni,&nbsp;Jacob Iramiot,&nbsp;Rebecca Nekaka,&nbsp;Julius Nteziyaremye","doi":"10.1155/2020/5036260","DOIUrl":"https://doi.org/10.1155/2020/5036260","url":null,"abstract":"<p><strong>Background: </strong>Uganda has a high maternal mortality ratio (MMR) of 336/100,000 live births. Caesarean section is fundamental in achieving equity and equality in emergency obstetric care services. Despite it being a lifesaving intervention, it is associated with risks. There has been a surge in caesarean section rates in some areas, yet others remain underserved. Studies have shown that rates exceeding 15% do not improve maternal and neonatal morbidity and mortality. Our study aimed at determining the prevalence, indications, and community perceptions of caesarean section delivery in Eastern Uganda.</p><p><strong>Methods and materials: </strong>It was both health facility and commuity based cross-sectional descriptive study in Ngora district, Eastern Uganda. Mixed methods of data collection were employed in which quantitative data were collected by retrospectively reviewing all charts of all the mothers that had delivered at the two comprehensive emergency obstetric care service facilities between April 2018 and March 2019. Qualitative data were collected by focus group discussions till point of saturation. Data were entered into EpiData (version 3.1) and analyzed using SPSS software (version 24). Qualitative data analysis was done by transcribing and translating into English verbatim and then analyzed into themes and subthemes with the help of NVIVO 12.</p><p><strong>Results: </strong>Of the total 2573 deliveries, 14% (357/2573) were by CS. The major single indications were obstructed labour 17.9%, fetal distress 15.3%, big baby 11.6%, and cephalopelvic disproportion (CPD) 11%. Although appreciated as lifesaving for young mothers, those with diseases and recurrent intrauterine fetal demise, others considered CS a curse, marriage-breaker, misfortune, money-maker and a sign of incompetent health workers, and being for the lazy women and the rich civil servants. The rise was also attributed to intramuscular injections and contraceptive use. Overall, vaginal delivery was the preferred route.</p><p><strong>Conclusion: </strong>Several misconceptions that could hinder access to CS were found which calls for more counseling and male involvement. Although facility based, the rate is higher than the desired 5-15%. It is higher than the projected increase of 36% by 2021. It highlights the need for male involvement during counseling and consent for CS and concerted efforts to demystify community misconceptions about women that undergo CS. These misconceptions may be a hindrance to access to CS.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"5036260"},"PeriodicalIF":1.9,"publicationDate":"2020-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5036260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38238257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual Morbidities, Menstrual Hygiene, Cultural Practices during Menstruation, and WASH Practices at Schools in Adolescent Girls of North Karnataka, India: A Cross-Sectional Prospective Study.","authors":"Rajasri G Yaliwal, Aruna M Biradar, Shreedevi S Kori, Subhashchandra R Mudanur, Shivakumar U Pujeri, Mohd Shannawaz","doi":"10.1155/2020/6238193","DOIUrl":"10.1155/2020/6238193","url":null,"abstract":"<p><strong>Background: </strong>Issues of menstrual morbidities, menstrual hygiene, and cultural practices are rarely discussed by adolescents. The burden of menstruation and cultural practices which the adolescent girls have to face has been less quantified. This study aims to assess the issues related to menstruation in school girls.</p><p><strong>Method: </strong>A cross-sectional prospective study was conducted on 1016 school-going adolescent girls in January 2020. A questionnaire in English and in Kannada was distributed to girls of class 8-12 of ages between 10 and 19 years.</p><p><strong>Results: </strong>70.5% of the girls attained menarche by 12 to 14.9 years, 37.2% of the girls had their periods every 28-34 days, and 12.2% of the girls said they have heavy periods. 61.95% of the girls had dysmenorrheal, and 9.7% of the girls said that they required medications for the pain. 70.7% of the girls were using commercial sanitary napkins, 12.7% were using cloth, and 15.3% were using both. 55.5% of the girls who were using cloth as an absorbent were not drying the cloth in sunlight. 57.1% of the girls were washing their genitals more than 2 times a day. 93.8% were having bath during menses and 87.2% were using soap along with water. 37.7% of the girls disposed their pads by burning them, 50.8% of then disposed them in the dust bin, and 4.9% of them buried them. 8.6% of the girls said that they remained completely absent from school during periods. 17.85% said that they remained absent for a day. 53.4% of the respondents said that they have difficulty in concentrating at school. 76.1% said that they had adequate water and sanitation facilities at school. 22.3% said that there was adequate facility to change their pads at school. 73.2% said that they could get a spare pad at school. 43.3% of the girls said they avoided cultural functions during their periods, and 38.5% said that they avoided religious ceremonies and practices during their periods. 8.7% of the girls were made to sit outside the house during their periods. The girls from rural areas had poorer hygienic habits, in comparison to the urban girls. Cultural restrictions such as sitting outside the house during menstruation and restricting play were more in the rural girls than the urban girls.</p><p><strong>Conclusion: </strong>Menstrual morbidities, menstrual hygiene management, and cultural beliefs all play a role in school absenteeism in adolescent girls. Improvement of facilities at school and conducting awareness programs can help adolescent girls to attend schools.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"6238193"},"PeriodicalIF":1.6,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38555260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of Women regarding Respectful Maternity Care during Facility-Based Childbirth.","authors":"Pratima Pathak, Bijaya Ghimire","doi":"10.1155/2020/5142398","DOIUrl":"10.1155/2020/5142398","url":null,"abstract":"<p><strong>Background: </strong>Respectful care during childbirth has been described as \"a universal human right that encompasses the principles of ethics and respect for women's feelings, dignity, choices, and preferences.\" Many women experience a lack of respectful and abusive care during childbirth across the globe.</p><p><strong>Objective: </strong>This study aimed to determine women's perception of respectful maternity care (RMC) during facility-based childbirth.</p><p><strong>Method: </strong>A descriptive cross-sectional study was conducted among 150 mothers admitted to the maternity ward of Nepal Medical College and Teaching Hospital using a purposive sampling technique. Data were collected through an interview technique by using a validated tool containing 15 items each measured on a scale of 5. Statistical Package for Social Science (SPSS) version 16 was used for data analysis. Frequency, percentage, mean score, standard deviation, chi-square test, and binary logistic regression were used to analyze descriptive and inferential statistics.</p><p><strong>Results: </strong>In total, 84.7% of the women reported that they have experienced overall RMC services with a mean score ± SD (61.70 ± 12.12). Though the majority of the women reported that they have experienced RMC services, they also revealed that they have experienced disrespectful care in various forms such as being shouted upon (30.0%), being slapped (18.7%), delayed service provision (22.7%), and not talking positively about pain and relief during childbirth (28.0%). Likewise, length of stay, parity, and time of delivery were found as factors that influenced friendly care (COR = 0.383, 95% CI: 0.157-0.934), abuse-free care (COR = 3.663, 95% CI: 1.607-8.349), and timely care (COR = 2.050, 95% CI: 1.031-4.076) dimensions of RMC, respectively.</p><p><strong>Conclusion: </strong>Even though RMC emphasizes eliminating disrespectful and abusive environment from health facilities, 15.0% of participants perceived that they have not experienced overall RMC services. So, the health facility should focus on the interventions which ensure that every woman receives this basic human dignity during one of the most vulnerable times in their lives.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"5142398"},"PeriodicalIF":1.9,"publicationDate":"2020-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5142398","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38177868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Life-Threatening Pregnancy Complications, \"Near Miss\" and Maternal Mortality in a Tertiary Hospital in Southern Nigeria: A Retrospective Study.","authors":"Ubong Bassey Akpan,&nbsp;Udeme Asibong,&nbsp;Ezukwa Omoronyia,&nbsp;Kazeem Arogundade,&nbsp;Thomas Agan,&nbsp;Mabel Ekott","doi":"10.1155/2020/3697637","DOIUrl":"https://doi.org/10.1155/2020/3697637","url":null,"abstract":"<p><strong>Background: </strong>Investigating severe life-threatening pregnancy complications that women encounter and the maternal morbidities (near miss) may help to evaluate the quality of care in health facility and recommend ways to improve maternal and infant survival especially in low-income countries. The aim of this review was to identify, classify, and determine the frequency and nature of maternal near miss events and the maternal and perinatal outcomes.</p><p><strong>Methods: </strong>A retrospective facility-based review of cases of near miss and maternal mortality occurring between 1^st January 2012 and 31^st December 2016 at the University of Calabar Teaching Hospital was conducted. Near miss case definition was based on the WHO disease specific criteria. The main outcomes included the maternal mortality ratio (MMR), maternal near miss ratio (MNMR), mortality index, maternal morbidities, and perinatal outcome.</p><p><strong>Results: </strong>There were 10,111 pregnancy-related admissions, 790 life-threatening pregnancy complications that resulted in 99 maternal deaths, and 691 near miss cases. The maternal mortality ratio was 979 maternal deaths per 100,000 live births, and the maternal near miss ratio was 6,834 per 100,000 maternities. The MMR to MNMR ratio was 1 : 8. Sepsis and severe anaemia had high case-specific mortality indices of 0.4 and 0.53, respectively. The perinatal outcome was poor compared to that of uncomplicated pregnancies: perinatal mortality rate (PMR) 266 per 1000 live births (OR 7.74); neonatal intensive care (NIC) admissions 11.6 percent (OR 1.83); and low birth weight (LBW) (<2.5 kg) 12.19 percent (OR 1.89).</p><p><strong>Conclusion: </strong>Antenatal care and early recognition of danger signs in pregnancy as well as prompt referral and early institution of essential obstetrics care are important for maternal and infant survival.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"3697637"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3697637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38152378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormone Replacement Therapy: Lebanese Women's Awareness, Perception, and Acceptance.","authors":"A Anastasia Salame,&nbsp;Mohammad J Jaffal,&nbsp;Fatin Khalifeh,&nbsp;Dalia Khalife,&nbsp;Ghina Ghazeeri","doi":"10.1155/2020/5240932","DOIUrl":"https://doi.org/10.1155/2020/5240932","url":null,"abstract":"<p><strong>Objectives: </strong>Hormone replacement therapy (HRT) had been the gold standard for the treatment of menopausal symptoms until the publication of the World Health Initiative (WHI) study. After the WHI study, the use of HRT changed among the physicians and patients all over the world despite newer more reassuring data. This study aimed to investigate the knowledge and attitudes of women towards HRT and the factors affecting it for better counseling. <i>Study design</i>. A clinic-based cross-sectional study using a survey was offered to women aged 40 years and above coming to the women's health center at the American University of Beirut Medical Center (AUBMC) from October 1^st, 2017, till March 31^st, 2018. The questionnaire included questions about demographics and menopausal symptoms in addition to knowledge and attitudes towards menopause and HRT. <i>Main outcome measures</i>. Our main hypothesis was that women would be aware of HRT as a treatment modality; however, the majority would have a negative attitude towards its usage.</p><p><strong>Results: </strong>The response rate was 87.8%. Seventy-three percent of the respondents had already heard about HRT with 57.9% supporting the use of HRT; however, 47.9% did not know when to use it. The significant predictor for having heard about HRT and a positive attitude towards HRT were having HRT prescribed as a part of treatment and employment status, respectively.</p><p><strong>Conclusions: </strong>Lebanese women are aware of HRT as a treatment option; however, a lack of both proper information and positive attitude towards HRT use was noted.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"5240932"},"PeriodicalIF":1.9,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5240932","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38103535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconception Care Uptake and Immediate Outcomes among Discordant Couples Accessing Routine HIV Care in Kenya.","authors":"Nyawira Gitahi,&nbsp;Sheila Juliet Eshiwani,&nbsp;Kenneth Mutai,&nbsp;Jared Ongechi Mecha,&nbsp;James Njogu Kiarie","doi":"10.1155/2020/1675987","DOIUrl":"https://doi.org/10.1155/2020/1675987","url":null,"abstract":"<p><strong>Introduction: </strong>A large proportion of new HIV infections occur within discordant partnerships making discordance a significant contributor to new HIV infections in Africa. Despite the role of preconception care for HIV discordant couples, there is little data on fertility desire and preconception care uptake. This study aimed at documenting fertility desire (desire to conceive), determining the uptake of preconception care, identifying HIV prevention strategies used during preconception care, and determining immediate conception outcomes among HIV discordant couples in Kenya.</p><p><strong>Methods: </strong>We retrospectively extracted electronic medical record data on discordant couples at an HIV care discordant couples' clinic. We included data on couples who expressed a desire to conceive and were offered preconception care and followed up for 29 months. We collected data on sociodemographic characteristics, preconception prevention methods, and associated outcomes.</p><p><strong>Results: </strong>Among couples, with male HIV-positive partners, there was a twofold likelihood of accepting preconception services (OR = 2.3, CI 95% (1, 1, 5.0)). A shorter discordant union was independently associated with the uptake of preconception services (OR = 0.92, CI 95% (0.86, 0.98)). The most used prevention intervention (38.5%) among discordant couples was a combination of pre-exposure prophylaxis (PrEP) by the uninfected partner, alongside HAART by the partner living with HIV. Pregnancy rates did not significantly (<i>p</i>  =  0.06) differ among those who took up preconception care versus those who did not. HIV-negative partners of couples who declined preconception care had a significantly (<i>p</i>  =  0.04) higher attrition from clinic follow-up. One confirmed seroconversion occurred; an HIV incidence rate of 0.19 per 100 person-years.</p><p><strong>Conclusion: </strong>The study demonstrates the feasibility of implementing safe and effective preconception servicesas part of routine HIV care for discordant couples living in low resource settings. The provision and the utilisation of safer conception services may be hindered by the poor retention to follow-up and care of HIV-negative partners. This challenge may impede the expected benefits of preconception care as an HIV prevention intervention.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"1675987"},"PeriodicalIF":1.9,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1675987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38068199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}