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Yasal tahliye istemiyle başvuran olgularda bakteriyel vajinozis prevalansı ve çeşitli faktörlerle ilişkisi

Prevalence of bacterial vaginosis and relationship of various factors in women seeking legal abortions

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DOI: 
doi:10.2399/tahd.11.167
Abstract (2. Language): 
Objective: In this study, we aimed to investigate the prevalence of bacterial vaginosis (BV) in a group of women requesting termination of pregnancy in the Family Planning Department of Haydarpaşa Numune Training and Research Hospital and to evaluate their socio-demographic features, contraceptive methods and personal hygienic attitudes with regard to the presence of BV. Methods: Out of a total of 178 women who presented to the out patient family planning clinic with a request of termination of pregnancy during a six month period, a hundred women who met the criteria and accepted to be a part of the study group consti¬tuted the material of this study. A face to face structured ques¬tionnaire with 19 open ended questions was used to collect the data. Bacterial vaginosis was diagnosed using the Amsel and Nugent criteria. Statistical evaluations were made using mean val¬ues, standard deviations, Pearson's x2 test, Fisher's exact x2 test and student t test using the SPSS 10.0 for Windows programme. Results: The prevalence of BV was 27%. A statistically significant relationship was found between BV and vaginal discharge, foul odoured discharge, polygamy, sexual intercourse more frequently than twice a week and anogenital wiping from back to front (p<0.05). Bacterial vaginosis was more common with homemade, reusable sanitary towels used instead of commercial pads, frequent vaginal douching and intense use of soap in vulvar cleansing, but the difference was not statistically significant (p>0.05). We found that 80% of the women used traditional methods of contraception or none before conception and that half of the women who used a modern contraceptive method had an unwanted pregnancy because of faulty usage of the method. The educational status was low and a negative correlation was present between parity and education; 27% did not have social security and health insurance. Conclusions: We conclude that as the prevalence of BV was 27%, all women should be screened and treated before intrauter-ine manipulation, in order to prevent ascendant genital tract infections and minimize the risk of PID. Family physicians should counsel women for personal hygiene.
Abstract (Original Language): 
Amaç: Bu çalışma Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Aile Planlaması Ünitesine yasal tahliye istemiyle gelen hastalarda bakteriyel vajinozis (BV) prevalansının saptanması ve olguların sosyo-demografik verileri, varsa kullandıkları doğum kontrol yöntemleri ve kişisel temizlik alışkanlıkları ile BV'in ilişkisini araştırmak amacıyla planlandı. Yöntem: Aile planlaması polikliniğine 6 ayda yasal tahliye istemi ile başvuran 178 olgudan çalışmaya alınma kriterlerine uygun olan ve çalışmaya katılmak isteyen 100 olgu çalışma grubunu oluşturdu. Olgulara yasal tahliye işlemi öncesinde yüz yüze anket yönte¬miyle toplam 19 açık uçlu soru soruldu. Bakteriyel vajinozis tanısı Amsel ve Nugent kriterleri baz alınarak konuldu. istatistiksel değerlendirmeler Windows için SPSS 10.0 programında aritmetik ortalama, standart sapma, Pearson'un x2 testi, Fisher'in kesin x2 tes¬ti ve student t testi kullanılarak yapıldı. Bulgular: Bakteriyel vajinozis prevalansı %27 olarak saptandı. Bak-teriyel vajinozis ile vajinal akıntı, kokulu vajinal akıntı, multipartneri-te, haftada 2 kereden daha sık cinsel ilişkide bulunulması ve anüsten vulvaya doğru yapılan perine temizliği arasında istatistiksel olarak an¬lamlı ilişki saptandı (p<0.05). Bakteriyel vajinozisin menstrüasyonda bez kullananlar, sık vajen duşu alanlar ve vulva temizliğinde yoğun sabun kullananlarda daha sık görülmesine rağmen aradaki fark ista¬tistiksel olarak anlamlı bulunmadı (p>0.05). Olguların %80'inin ge¬leneksel yöntemlerle ya da yöntem kullanmadan gebe kaldığı, mo¬dern yöntem kullananların da yarıdan fazlasının yöntemi hatalı kul¬landığı için gebe kaldığı görüldü. Olguların eğitim düzeyinin olduk¬ça düşük olduğu, eğitim düzeyi ile parite arasında istatistiksel olarak anlamlı negatif korelasyon bulunduğu, olguların %27'sinin herhan¬gi bir sosyal sağlık güvencesinin olmadığı tespit edildi. Sonuç: Bakteriyel vajinozis prevalansının %27 gibi yüksek bir oranda olması nedeniyle asendan enfeksiyon ve pelvik enflamatuvar hastalık riskini en aza indirmek için intrauterin işlem öncesi tüm olgular taranmalı, gerekli olgular tedavi edilmelidir. Aile hekimleri hastalara mutlaka kişisel hijyen konusunda danışmanlık sunmalıdır.
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