S356 Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396

O922

Prevalence of gestational trophoblastic disease in ectopic

pregnancy in O-GUH

I. Tasha, V. Tavo, K. Dallaku. Albanian Assocation of Gynaecology and

Obstetrics

Study design: Medical records of 75 patients with EP (18 of them

GTD in EP) from 2007–2008. They underwent surgery with a

diagnosis of EP, and histological analysis revealed GTD. During last

two years our hospital admitted 75 cases with EP. 50 patients

with EP underwent surgery due to a diagnosis of EP with hem

peritoneum and in 13 of them the answer of the biopsy was GTD.

4 of 75 cases admitted in our hospital with diagnosis of EP,

(pregnancy test not estimation of the level of bhCG because our

hospital couldn’t offer estimation of bhCG during 24 hours) have

been not confirmed diagnosis of EP by biopsy, but ruptured ovary

cyst with hem peritoneum.

21 cases with EP (enraptured EP) underwent medical treatment

with methotroxate. In 4 cases last management was failed and

surgical intervention was institutionalized and histological analysis

revealed GTD (partial mole).

bhCG level was detected in 21 cases with enraptured fallopian

pregnancy; in all cases where treatment with methotroxate has

been failed and GTD was confirmed, the level of bhCG was

>10234mUI/ml.

17 cases with enraptured fallopian pregnancy were successfully

treated, and at this point we never learned the answer of biopsy.

We registered one case with cervical pregnancy and one cornual

(interstitial portion) pregnancy.

Conclusion: we found 17 cases of STG in EP/8000 deliveries,

prevalence of the GTD in EP was about 22%.

O923

Impact of home based skilled birth attendant service on

selected indicators of safe motherhood

S. Tasnim. Institute of CHild and Mother Health

In Bangladesh about 3.7 million births occur annually and 90%

of them take place at home by untrained personnel. Maternal and

neonatal mortality is still quite high. Government of Bangladesh has

implemented community based skilled birth attendant program

since 2003 to improve coverage of skilled care at childbirth and

reduce the deaths.

A quasi experimental study was conducted in four upazilla (sub

district) of Bangladesh to see the effect of community based skilled

birth attendant service on selected indicators. The intervention

areas were where CSBA program is functional for 3–4 years

and in control areas the program was non existent. Data was

collected during September-November 2007 through interview of

1002 mothers who had childbirth in the preceding twelve months

or less in those areas. The analysis was done using EPI Info and

SPSS software.

Antenatal care availed in last pregnancy was significantly more in

intervention area with weighing, measurement of blood pressure,

abdominal examinations and counseling on obstetric emergency

and birth planning. Community SBA treated 23.6% of pregnancy

complications and advised 51.94% to health centers.

Majority of the delivery took place at own home (73.3%

vs.65.2%), conducted by traditional birth attendant (65.9% vs. 55.3%)

in intervention and control area respectively. Community SBA

conducted 5.6% of the deliveries. The practices of hand wash, use

of germ free tools, not using injection for enhancing labour pain

were significantly more in CSBA area. The practices of hanging by

holding legs (38.6% vs. 81.4%), slap on back (32.3% vs. 73.6%) and

mouth to mouth breathing (42% and 65%) for delayed crying of

newborn was found in intervention and control area respectively.

Postnatal care was availed by (71.3% vs 39.8%), Colostrums’ was

first feed to (79.5% vs. 56%) newborn and birth weight measured

in 36.3% vs. 33% cases in intervention and control area respectively.

Community SBA provided 1.6% of postnatal care.

The impact of CSBA services can be assumed from some features

related with care of mother and newborn. However, their

contribution was only a limited proportion and that need to be

scaled up to visualize any change on safe motherhood indicators.

O924

Barriers facing adolescents accessing legal abortion services

in Mexico City

C. Tatum, M. Rueda, J. Clyde, D. Kohn, G. Carino, J. Friedman.

IPPF/WHR

Objectives: To understand the barriers facing young women ages

14–18 in accessing legal abortion services in Mexico City.

Materials and Methods: The study consisted of: 11 in-depth

interviews and four triad groups with young women ages 14 to

18 who had experienced an unwanted pregnancy; 16 simulated

user visits to NGO and public health centers to solicit counseling

for an abortion; and a survey with 125 service providers in public

sector health centers.

In-depth interviews, groups and simulated user visits were coded

and analyzed by key themes; the provider survey was analyzed

using SPSS and univariate and bivariate analyses were conducted.

Results: When attempting to access abortion services, adolescents

faced barriers related to required documents and inconsistent

regulations regarding the type of adult needed to give permission.

The structure and culture of public centers allowed for many

breaches of confidentiality. Participating adolescents had varying

experiences related to the quality of treatment throughout the

procedure, particularly by support staff. In general, adolescents who

opted to abort rather than continue with the pregnancy appeared

more empowered, had clearer life plans, and were less influenced

by partners’ opinions. Most of the adolescents who opted to abort

sought out the help of a trusted adult. Adolescents relied heavily

on these adults for information; both adolescents and their trusted

adults lacked accurate information about abortion procedures and

its legal status in Mexico City.

Conclusions: Efforts should be made to safeguard patients’

confidentiality when attending Mexico City public clinics. In

addition, advocates should promote mechanisms to reduce barriers

related to document requirements that are particularly difficult

for adolescents. It appears important for both adults as well as

adolescents to be better educated about unsafe abortion methods

and the availability of legal abortion in Mexico City.

O925

Future recruitment into obstetrics & gynaecology in the United

Kingdom: Factors affecting early career choice

J. Tay1, W. Atiomo2, T. Siddiq1. 1Queen’s Medical Centre, Nottingham,

United Kingdom, 2Division of Human Development, School of Clinical

Sciences, University of Nottingham

Objectives: In the last decade, the recruitment of medical students

into O&G has been falling. The aim of our study was to identify

positive and negative factors, which influenced career choice

amongst undergraduate medical students. Findings could be used

to design O&G clinical attachments that maximise early interest in

this speciality.

Materials and Methods: 72 medical students who attended a talk

on “Career in Obstetrics and Gynaecology” were approached to

take part in a cross-sectional survey. A 15-item questionnaire

with a 5-point Likert scale was developed. Using Excel spread

sheet, categorical variables were summarized as proportions and

statistical comparisons between groups performed using chi-

squared test.

Results: Students who had undertaken their O&G attachment

reported a strong interest in pursuing a career in O&G (39%

versus 10%, p = 0.0253), with hands-on experience being a positive