114 TUESDAY, SEPTEMBER 5

P2.04.02 ULTRASONOGRAPHIC ASSESSMENT AND EVALUATION OF SERUM CONCENTRATIONS OF ESTRADIOL AND PROGESTERONE AMONG NORPLANT@ USERS WITH IRREGULAR BLEEDING K. Srinaree (l), T. Surasak (2) (1) Dept. OB/GYN, Khon Kaen University, Khon Kaen, Thailand (2) Dept. OB/GYN, Chulalongkom University, Thailand

Objectives: T o determine the changes in the thickness and pattern of endometrium among Norplant” -users who have irregular bleeding, and to correlate these changes with estradiol and progesterone concentrations. Study Methods: Ultrasonographic evaluation (assessed by vaginal ultrasound) and serum sampling were performed among Norplant@ users who presented with complaints of bleeding, at their first visit at the Family Planning Clinic, Department of Obstetrics and Gynecology, Chulalongkong Hospital, Bangkok, Thailand, between October 1, 1998 and March 31, 1999. Results: A total of 85% (44/52 cases) of the subjects had estradiol concentrations below 50 pg/mL and none had any luteal activity (progesterone concentrations <3 ng/mL). The endometrial thickness remained thin to very thin (3 to 6 mm = 50%, <3mm = 48%). A hyperechoic pattern of the endometrium was found in 90% of subjects. There was a weak, negative correlation between the estradiol concentrations and endometrial thickness (p< 0.05, r= 0.337). Conclusions: Norplant” -users with irregular bleeding are usually characterized by low estradiol concentrations, absence of luteal activity and a thin, hyperechoic pattern of the endometrium.

P2.04.03 OB-GYNS OPINIONS TOWARDS CONTRACEPTION IN ARGENTINA M. Petracci. CEDES, B. Aires, Argentina, T. Durand, CEDES, B. Aires, Argentina, M. Gogna, CEDES/CONICET, B. Aires, Argentina, S. Ramos, CEDES, B. Aires, Argentina, M. Romero, CEDES/CONICET, B. Aires, Argentina, D. Szulik, CEDES, B. Aires, Argentina

Argentina is in a transition regarding the promotion of reproductive and sexual health and rights. Still, there is no national family planning program and abortion and surgical contraception are penalized. An inquiry on physician’s opinions on these matters has become relevant due to the undergoing public debate and the policy innovations. Objectives: The study focused on Ob-Gym’ opinions about: 1. hospital role in the provision of family planning services; 2. prescription criteria; 3. quality of the available family planning services. Study methods: The study was carried out in public hospitals that serve low-income population in Buenos Aires Metropolitan Area. A self- administered anonymous questionnaire was applied. The response rate reached 84% (n=467). A bivariate analysis was performed to explore age and sex differences. Results: 65.5% of subjects considered contraception as relevant or very relevant public health issue. 45.4% considered that public hospitals should inform and provide contraceptive methods to all women at no cost, while 34.3% considered that hospitals should do it only for women with bio-social risks. 90% considered that pills, IUDs and condoms should be provided. Even though tubal ligation and vasectomy are penalized, nearly 40% thought that hospitals should provide them. Over 75% indicated that pills and condoms were the most suitable methods for nuliparous adolescents and adults women while 73% considered the IUD as the best for multiparous women. 36% evaluated that family planning services at public hospitals were good, 31.3% indicated that they were neither good nor bad, while 30.7% referred to them as being of poor quality. Conclusions: Despite the absence of a national public policy towards family planning, Ob-Gym at public hospitals in Buenos Aires Metropolitan Area consider that hospitals should inform and provide contraceptive methods. They also evaluated that the available services are not of desirable quality. No differences were found regarding age and sex in anv of these matters.

P2.04.04 THE TRUE “MILLENEUM BUG”: PREVENTING UNWANTED MILLENNIAL BIRTHS D. Raiasekar, C. Lennox, Women & Children Directorate, Law Hospital, Carluke, Scotland.

Prevention of unintended teenage pregnancy is a universal public health issue, but little is known about the most effective strategies. The arrival of the new millennium occurred on a Saturday. In Britain, five continuous days were without routine health services. Access to community primary care contraceptive services was limited and secondary care required to fill the gap. The knowledge and attitude of secondary are staff to emergency contraceptive seekers is addressed in this study. Objectives: To study the hospital staff’s attitude towards teenage sexual accident clients. To ascertain the post-coital contraception knowledge among the secondary care hospital staff. Study Methods: One hundred and fifty one Lana&hire Acute care hospital doctors, nurses and midwives in obstetrics unit, gynecology wards, A & E departments and pediatrics wards were interviewed over the phone during the festive period. Results: Only 68% of the hospital staff are in a position to give post-coital contraception information. 98% of the hospital staff are aware of the Yuzpe regimen. Progesterone only pill and intra-uterine contraceptive device knowledge is deficient. None of the staff were aware of the local festive period family planning clinic location and opening hours. Conclusion: Regular primary care contraceptive services are difficult to access during the festive period. Secondary care staff lack knowledge in emergency contraception. New Millennium and similar festivals are joyous occasions but sadly will be remembered by some.

P2.04.05 A SURVEY OF AMERICAN WOMEN REGARDING THE USE OF ORAL CONTRACEPTIVES AND WEIGHT GAIN S. National Association of Nurse Practitioners in Women’s Health, Washington, DC, USA.

Objective: To determine the attitudes of women between the ages of 18 and 45 regarding the use of oral contraceptive (OCs) and weight gain. Study Methods: Telephone interviews were conducted in the U.S. in June 1999 with 704 women aged 18-45. In addition to demographic questions, the women were asked 5 questions pertaining to their use of OCs, their perception and fear of weight gain with OCs, the non-contraceptive health benefits of OCs and the decrease in side effects with lower-dose OC formulations. Results: The majority of women (69.8%) were currently taking an OC or had in the past, while 27.0% had never taken an OC. Half (50.6%) of the women believed that OCs cause weight gain. Regardless of whether or not they had ever taken an OC, 20.1% claimed that the fear of gaining weight was a reason they would not start or discontinue taking OCs. Of those who were currently taking or had taken OCs in the past, 17.3% replied that fear of weight gain was a reason they would consider discontinuing OCs. Of those who had never taken OCs, 26.6% said that they do not take OCs because of a fear of weight gain, among other reasons. Women were asked to choose from a list what was one important reason for taking OCs, besides protection from pregnancy. The following responses were given: more regular menstrual periods (24.5%), protection from ovarian cancer (24.4%), less bleeding or pain during menstrual cycles (19.8%), none of the reasons listed (6.9%), protection against endometrial cancer (6.5%), clearer skin (6.2%) and mood improvement (3.2%). Additionally, more than half the women (55.2%) had not heard that lower doses of hormones caused fewer side effects such as moodiness, breast tenderness and nausea. Conclusion: This survey indicates that many women may not be adequately counseled on the facts regarding OCs and weight gain. In addition, it demonstrates that it is essential to continually educate women about the lack of weight gain with OCs, as well as on the non-contraceptive health benefits of OCs.