Family Planning Counseling and Practices in Kidney Transplant Recipients

IF 1.9 4区 医学 Q2 SURGERY
Swathi Rajagopal, Julia Ritchie, Dominika Seidman, Emily R. Perito, Deborah Adey, Monika Sarkar
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Abstract

Introduction

Half of all female kidney transplant (KT) recipients are reproductive-aged, though data on reproductive practices and counseling are limited.

Methods

This cross-sectional survey evaluated patient experiences, practices, and preferences surrounding contraception and pregnancy in female KT patients (listed or post-transplant) ages 14–45 years.

Results

A total of 152/682 eligible participants (22%; 50 pre- and 102 post-KT) completed the survey with 26% unaware at the time of KT that future pregnancy was possible. The majority (72%) of sexually active patients used contraception during the first year post-KT, though 24% exclusively used high failure-rate methods. Less than half (48%) felt their pre-KT reproductive counseling was adequate to guide decision-making, although 63% reported satisfaction with post-KT counseling. Discussions with transplant providers were the single most favored counseling modality at 74%. Misconceptions of intrauterine device safety and efficacy were identified.

Conclusion

Reproductive counseling commonly occurred, although information was inadequate for guiding pregnancy and contraceptive decisions in most pre-KT patients. Misconceptions about pregnancy potential and contraceptive efficacy and safety were common, as well as patient reliance on high-failure contraceptive methods. Improving patient knowledge and access to contraception and pregnancy planning is essential for honoring patients’ reproductive wishes while lowering obstetric, graft, and perinatal risks in post-KT pregnancies.

肾移植受者的计划生育咨询与实践
尽管关于生殖实践和咨询的数据有限,但所有女性肾移植(KT)接受者中有一半是育龄妇女。方法:本横断面调查评估14-45岁女性KT患者(已登记或移植后)在避孕和妊娠方面的经历、做法和偏好。结果共有152/682名符合条件的参与者(22%;50名KT前和102名KT后完成了调查,其中26%的人在KT时不知道未来可能怀孕。大多数(72%)性活跃的患者在kt后的第一年使用避孕措施,尽管24%的患者只使用高失败率的方法。不到一半(48%)的人认为他们在kt前的生殖咨询足以指导决策,尽管63%的人对kt后的咨询表示满意。与移植提供者讨论是最受欢迎的咨询方式,占74%。发现了对宫内节育器安全性和有效性的误解。结论生殖咨询是普遍存在的,但信息不足以指导大多数kt前患者的妊娠和避孕决策。对怀孕潜力和避孕有效性和安全性的误解是常见的,以及患者对高失败的避孕方法的依赖。提高患者对避孕和妊娠计划的了解和获取对于尊重患者的生育意愿,同时降低kt后妊娠的产科、移植物和围产期风险至关重要。
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来源期刊
Clinical Transplantation
Clinical Transplantation 医学-外科
CiteScore
3.70
自引率
4.80%
发文量
286
审稿时长
2 months
期刊介绍: Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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