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Side effects and acceptability measures for thermal ablation as a treatment for cervical precancer in low-income and middle-income countries:a systematic review and meta-synthesis

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Family Medicine and Community Health 2022年第2期10卷 40-51页

作者： Evelyne Marie Piret Beth A Payne Laurie W Smith Jessica Trawin Jackson Orem Gina Ogilvie carolyn nakisige British Columbia Women's Hospital and Health Centre Women’s Health Research InstituteVancouverBritish ColumbiaCanada Faculty of Medicine School of Population and Public HealthThe University of British ColumbiaVancouverBritish ColumbiaCanada Department of Reproductive Oncology Uganda Cancer InstituteKampalaUganda

Objective Understanding the side effects and acceptability of thermal ablation(TA)is necessary before large-scale application in screen-and treat programmes can be justified in low-income and middle-income countries(LMICs).Design Articles were selected for inclusion by two independent *** of bias was assessed using the Downs and Black’s *** data were extracted,and authors contacted for data when *** of interest and 95%CIs were estimated using a random effects *** analysis was performed based on place of treatment and timing of post-treatment *** was estimated using the I^(2).Eligibility criteria Studies that reported one or more side effects or patient acceptability measures after treatment of the cervix using TA in women living in LMICs who completed a cervical cancer screening *** articles were clinical trials or observational studies available in English and published before 18 December *** sources Ovid MEDLINE,EMBASE,CINAHL,CAB Global Health and WHO Global Index Medicus were searched for this systematic review and *** A total of 1590 abstracts were screened,84 full text papers reviewed and 15 papers selected for inclusion in the qualitative review,10 for meta-synthesis(N=2039).Significant heterogeneity was found in screening tests used to identify women eligible for TA and in methods to ascertain side *** most commonly reported side effect during treatment was pain(70%,95%CI 52%to 85%;I^(2)=98.01%)(8 studies;n=1454).No women discontinued treatment due to *** treatment follow-up,common side effects included vaginal discharge(72%,95%CI 18%to 100%;I^(2)=99.55%)(5 studies;n=771)and bleeding(38%,95%CI 15%to 64%;I^(2)=98.14%)(4 studies;n=856).Satisfaction with treatment was high in 99%(95%CI 98%to 100%;I^(2)=0.00%)of women(3 studies;n=679).Conclusions TA results in a number of common side effects,though acceptability remains high among women t

关键词： cervical treatment income

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Umbilical artery doppler flow patterns in high-risk pregnancy and foetal outcome in Mulago hospital

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Case Reports in Clinical Medicine 2013年第9期2卷 554-561页

作者： P. Komuhangi R. K. Byanyima E. Kiguli-Malwadde C. nakisige African Centre for Global Health and Social Transformation (ACHEST) Kampala Uganda Department of Obstetrics and Gynaecology Mulago Hospital Kampala Uganda ECUREI Mengo Hospital Kampala Uganda Radiology Department Mulago Hospital Kampala Uganda

Objective: To demonstrate the flow patterns and factors associated with adverse foetal outcome in high-risk pregnancy at Mulago Hospital using Doppler ultrasound of the foetal umbilical artery. Design: Cross-sectional descriptive study. Setting: Mulago National Referral Hospital, Kampala Uganda. Study Subjects: One hundred and ninety-two patients in a 4-month period (December 2008-April 2009). Results: Maternal age was 16 to 41 years. Twenty-one foetuses had abnormal flow patterns (12 had reduced end-diastolic flow, 8 had AEDF and 1 had RF). Prematurity was associated with abnormal flow patterns. 11 out of 12 foetuses with reduced end-diastolic flow survived. Of the foetuses with AEDF, 3 survived but were admitted to the neonatal special care unit while 5 died. One foetus had RF and was a stillbirth. Eighteen foetuses were delivered after an obstetric intervention. Conclusions: 1) The prevalence of abnormal flow patterns is 10.9%. 2) Abnormal flow patterns, low biophysical profile score, premature delivery, low birth weight and low Apgar score are related to adverse foetal outcome. 3) A low biophysical profile score is related to AEDF/RF. 4) Foetuses of low parity mothers are more likely to have abnormal flow patterns. Recommendation: Umbilical artery Doppler Biophysical profile scores should be done in high-risk pregnancy.

关键词： Doppler Umbilical Artery

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