[New opportunities for preventing ovarian carcinoma].

A large majority of patients with ovarian carcinoma does not carry a BRCA1/2 mutation, nor another known mutation that increases the risk of ovarian carcinoma. Screening for early ovarian carcinoma in this low-risk group is not efficient. It is, however, a known fact the risk for ovarian carcinoma decreases slightly, but to a statistically significant extent, following sterilisation via tubal occlusion.

Recent developments have made female permanent contraception an increasingly attractive option, and pregnant women in particular ought to be counselled about it.

Background: Despite the increased prevalence of reversible contraception, global unintended pregnancy rates are stable. Mistakes, method failures, side effects, alcohol, stock-outs, fears, costs, delays, myths, religious interference, doctors with other priorities, traditions and lack of health professionals may all factor in. Yet these unintended pregnancies - nearly a hundred million annually - cause much individual suffering, and in the long run, can aggravate conflicts, poverty, forced emigration and climate change.

Symphysiotomy in Zimbabwe; postoperative outcome, width of the symphysis joint, and knowledge, attitudes and practice among doctors and midwives.

Background: Obstructed labour remains one of the leading causes of maternal and foetal death and morbidity in poorly resourced areas of the world, where the 24 hours availability of a caesarean section (CS) cannot be guaranteed, and the CS related mortality rate is still high. In these settings, reinstatement of symphysiotomy has been advocated. The objectives were, in1994; to study perioperative and long-term complications of symphysiotomy and compare them to those related to CS for similar indications, in 1996; to measure the symphyseal width after symphysiotomy and compare it to that after normal vaginal delivery, and, in 1998; to assess knowledge, attitudes and practice related to symphysiotomy among doctors and midwives in Zimbabwe.

Think globally act locally: the case for symphysiotomy.

When expatriate doctors from developed countries working in sub-Saharan Africa suggest to the local doctors and midwives that symphysiotomies should sometimes be done, they are silenced neither with quotations from the medical literature nor with tales of patients seen, but with: "If symphysiotomies are such good operations why don't you perform them at home?" Here is why.