A. Templeton

Menstrual symptoms in women with pelvic endometriosis

Objective— To investigate menstrual symptoms in relation to pelvic pathology.

Medical abortion or vacuum aspiration? Two year follow up of a patient preference trial

Objective To describe and compare health outcomes two years after medical abortion or vacuum aspiration in women recruited into a patient preference trial during 1990 to 1991.

The epidemiology of infertility in the North East of Scotland

BACKGROUNDnThere is a perception that the prevalence of infertility is on the rise. This study aimed to determine the current prevalence of infertility in a defined geographical population, ascertain changes in self-reported infertility over time and identify risk factors associated with infertility.nnnMETHODSnA postal questionnaire survey of a random population-based sample of women aged 31-50 years was performed in the Grampian region of Scotland. Questions addressed the following areas: pregnancy history, length of time taken to become pregnant each time, whether medical advice had been sought and self-reported exposure to factors associated with infertility.nnnRESULTSnAmong 4466 women who responded, 400 (9.0%) [95% CI 8.1, 9.8] had chosen not to have children. Of the remaining 4066 women, 3283 (80.7%) [95% CI 79.5, 82.0] reported no difficulties in having children and the remaining 783 (19.3%) [95% CI 18.1, 20.5] had experienced infertility, defined as having difficulty in becoming pregnant for more than 12 months and/or seeking medical advice. In total 398 (9.8%) [95% CI 8.9, 10.7] women had primary infertility, 285 (7.0%) [95% CI 6.2, 7.8] had secondary infertility, 100 (2.5%) [95% CI 2.0, 2.9] had primary as well as secondary infertility. A total of 342 (68.7%) and 208 (73.0%) women with primary and secondary infertility, respectively, sought medical advice and 202 (59.1%) and 118 (56.7%) women in each group subsequently conceived. History of pelvic surgery, Chlamydial infection, endometriosis, chemotherapy, long-term health problems and obesity were associated with infertility. In comparison with a similar survey of women aged 46-50 from the same geographical area, the prevalence of both primary infertility (>24 months) [70/1081, (6.5%) versus 68/710 (9.6%) P = 0.02] and secondary infertility [29/1081 (2.7%) versus 40/710 (5.6%) P = 0.002] were significantly lower.nnnCONCLUSIONSnNearly one in five women attempting conception sampled in this study experienced infertility, although over half of them eventually conceived. Fertility problems were associated with endometriosis, Chlamydia trachomatis infection and pelvic surgery, as well as obesity, chemotherapy and some long-term chronic medical conditions. There is no evidence of an increase in the prevalence of infertility in this population over the past 20 years.

Maternal complications of twin pregnancy

It has been reported that women undergoing IVF treatment face a 20-fold increased risk of twins w1,2x. The purpose of this study was to review the nature and size of the obstetric risks in mothers who had twin pregnancies. From Aberdeen Maternity and Neonatal Databank, all twin pregnancies born to women resident in the Grampian region of Scotland from 1976–1999 were identified. This total population of twin pregnancies was compared with singleton pregnancies over the same time period. Relative risks have been calculated with 95% confidence intervals using the SPSS statistical package. Zygosity and placentation in twin pregnancy was determined throughout the study period. Between 1976 and 1999, 1694 twin pregnancies and 71 851 singleton pregnancies were available for review. Antenatal complications are listed in Table 1, including both minor and major complications. Placental abruption was twice as likely to occur in twin pregnancy although the overall incidence was low. However, there was no difference in the rates of placenta previa between twin and singleton pregnancies. Hyperemesis, anemia,

Pre‐operative cervical preparation before first trimester vacuum aspiration: a randomized controlled comparison between gemeprost and mifepristone (RU 486)

Objective— To compare the effectiveness of 200 mg mifepristone with 1 mg gcmeprost vaginal pessary in achieving cervical dilatation and softening (‘priming’) before late first trimester pregnancy vacuum aspiration.

Women's perceptions of decision-making about hysterectomy

Objectiveu2003 To explore womens views of decision‐making relating to hysterectomy.

Role of prostaglandin in the management of prelabour rupture of the membranes at term

Objective To compare conservative versus prostaglandin management of prelabour rupture of the membranes (PROM) in healthy primigravid women at term.

Active management of term prelabour rupture of membranes with oral misoprostol

Objective To compare the active management of term prelabour rupture of membranes with oral misoprostol with conservative management for 24 hours followed by induction with oxytocin or prostaglandin E2 (PGE2) gel.

The treatment of incomplete miscarriage with oral misoprostol

In a retrospective study of 112 women, the effectiveness of three sequential oral doses of misoprostol was evaluated for the treatment of incomplete miscarriage. We report our experience with this regimen, which achieved a complete miscarriage rate of 85%. Surgical intervention was required in 17 women (15%). The regimen appears to be effective in terms of a high rate of complete miscarriage, and it is safe.

A randomised comparison of oral misoprostol and vaginal prostaglandin E2 tablets in labour induction at term

Objectiveu2003 To compare the efficacy of 100 μg of oral misoprostol with 3 mg prostaglandin E2 vaginal tablets in term labour induction.