Optimizing Care for Reproductive-Age Women with Hepatitis C Virus.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Denise Monti, Emma Lantos, Nicola Lancki, William A Grobman, Ravi Jhaveri, Lynn M Yee
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Abstract

Background: Hepatitis C virus (HCV) infection affects between 1% and 2.5% of pregnant people in the United States and has maternal and fetal sequelae. Direct-acting antivirals are a highly effective curative strategy for HCV, yet data on their use in pregnancy are limited. Thus, family planning counseling of pregnancy-capable people seeking treatment for HCV is imperative. We aimed to examine whether and how pregnancy-capable people with HCV received family planning counseling from their clinicians during their treatment of HCV. Methods: This retrospective cohort study included all female patients between 18 and 50 years of age with HCV who sought care at a large, multihospital medical system between 2016 and 2020. Outcomes included whether patients who sought care for HCV received family planning or preconception counseling and the type of counseling they received. Analysis was conducted using descriptive statistics. Results: In this analysis of 194 people meeting inclusion criteria, 146 sought treatment for HCV, of whom 16 were currently pregnant. Of those seeking treatment, 24% discussed the uncertainty of treatment safety during pregnancy with their clinician, 23% received contraceptive counseling, 7% received preconception counseling, and 10% discussed family planning goals. Of the participants who were pregnant, 74% discussed the risks of treatment during pregnancy, and 67% had a postpartum treatment plan. Conclusions: In this cohort of pregnancy-capable people with HCV, patients infrequently received counseling about reproductive planning before or during their HCV treatment. Although most patients who were pregnant received counseling on treatment recommendations, few were referred to maternal-fetal medicine subspecialists.

优化对感染丙型肝炎病毒育龄妇女的护理。
背景:在美国,丙型肝炎病毒(HCV)感染影响1%至2.5%的孕妇,并有母体和胎儿后遗症。直接作用抗病毒药物是丙型肝炎病毒的一种非常有效的治疗策略,但有关其在妊娠期使用的数据有限。因此,对寻求丙型肝炎病毒治疗的有怀孕能力的人进行计划生育咨询是必要的。我们的目的是研究有妊娠能力的丙型肝炎患者在治疗丙型肝炎期间是否以及如何接受临床医生的计划生育咨询。方法:本回顾性队列研究纳入了2016年至2020年间在大型多医院医疗系统就诊的所有18至50岁的HCV女性患者。结果包括寻求HCV治疗的患者是否接受了计划生育或孕前咨询,以及他们接受的咨询类型。采用描述性统计进行分析。结果:在符合纳入标准的194例患者中,146例寻求HCV治疗,其中16例目前怀孕。在寻求治疗的人中,24%的人与临床医生讨论了怀孕期间治疗安全性的不确定性,23%的人接受了避孕咨询,7%的人接受了孕前咨询,10%的人讨论了计划生育目标。在怀孕的参与者中,74%的人讨论了怀孕期间治疗的风险,67%的人有产后治疗计划。结论:在这组有妊娠能力的丙型肝炎患者中,患者在丙型肝炎治疗前或治疗期间很少接受有关生育计划的咨询。虽然大多数孕妇接受了治疗建议的咨询,但很少有人被转介到母胎医学专科医生那里。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of women's health
Journal of women's health 医学-妇产科学
CiteScore
6.60
自引率
5.70%
发文量
197
审稿时长
2 months
期刊介绍: Journal of Women''s Health is the primary source of information for meeting the challenges of providing optimal health care for women throughout their lifespan. The Journal delivers cutting-edge advancements in diagnostic procedures, therapeutic protocols for the management of diseases, and innovative research in gender-based biology that impacts patient care and treatment. Journal of Women’s Health coverage includes: -Internal Medicine Endocrinology- Cardiology- Oncology- Obstetrics/Gynecology- Urogynecology- Psychiatry- Neurology- Nutrition- Sex-Based Biology- Complementary Medicine- Sports Medicine- Surgery- Medical Education- Public Policy.
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