Publications

Using a protected triple lumen device, Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were isolated from the endometriums of five out of 35 women with clinical postpartum endometritis compared with none of a control group of 30 puerperal women without endometritis (p less than 0.05) in Nairobi, Kenya. These sexually transmitted agents were also found in 12 cervical specimens from women with and three without postpartum endometritis (p = 0.04). Mycoplasma hominis and Ureaplasma urealyticum were equally isolated from the endometrium in both groups.

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We carried out a case-control study to investigate the role of sexually transmitted diseases (STDs), including infection with HIV, as risk factors for adverse outcome of pregnancy. Overall, 1507 women were enrolled within 24 h of delivery. Cases (n = 796) were mothers of low-birthweight infants (less than 2500 g) or of stillborns. Low-birthweight infants were divided into preterms (n = 373) and neonates small for gestational age (n = 234). Stillborns were separated into intrauterine fetal deaths (n = 120), and intrapartum fetal deaths (n = 69).

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During an ongoing study investigating the impact of maternal HIV infection on pregnancy outcome at a large maternity hospital in Nairobi, Kenya, asymptomatic HIV positive women who had recently delivered were informed of their HIV sero-status and counselled by a trained nurse regarding contraception and reproductive behaviour in a single session. Both HIV infected women and a comparison group of uninfected women matched for pregnancy outcome were followed up after an interval of one year. Contraceptive use, condom use and pregnancy rates were similar in both groups.

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