Contraception最新文献

{"title":"Interest in Rh testing and Rh immunoglobulin treatment among patients obtaining telehealth medication abortion","authors":"Linda J. Shin ,&nbsp;Leah R. Koenig ,&nbsp;Jennifer Ko ,&nbsp;Karen Meckstroth ,&nbsp;Ushma D. Upadhyay","doi":"10.1016/j.contraception.2025.110856","DOIUrl":"10.1016/j.contraception.2025.110856","url":null,"abstract":"<div><h3>Objective</h3><div>Despite an absence of evidence that Rhesus (Rh) immunoglobulin is necessary before first-trimester medication abortion, many providers require routine Rh testing and Rh immunoglobulin. We sought to assess knowledge of blood type, receipt of Rh immunoglobulin, and interest in Rh testing and Rh immunoglobulin among patients seeking direct-to-patient telehealth medication abortion care and who may not otherwise need to travel to a clinic.</div></div><div><h3>Study design</h3><div>We used data from the California Home Abortion by Telehealth (CHAT) Study, which included patients who sought medication abortion through telehealth in 20 states and Washington, D.C., in 2021–2022. We analyzed data from two CHAT study samples: survey data from three virtual clinics and electronic medical records (EMRs) obtained from one of those clinics. Patients were counseled on low risk of Rh sensitization at early pregnancy durations and referred for testing or treatment as preferred.</div></div><div><h3>Results</h3><div>Among 1779 survey participants and 2803 patients with EMR records, 51% and 52% respectively knew their blood type, of which 21% and 18% were Rh-negative. Among 189 Rh-negative survey participants, six (0.4%) obtained Rh immunoglobulin. In the EMR sample, among 1341 patients with unknown blood type, 3% indicated interest in Rh testing, and 10% of the 263 Rh-negative patients indicated interest in receiving Rh immunoglobulin.</div></div><div><h3>Conclusions</h3><div>Most patients who choose telehealth services for medication abortion opt out of Rh testing and treatment. Guidelines that mandate Rh testing and Rh immunoglobulin for first-trimester abortions should consider low patient interest alongside the lack of demonstrated clinical necessity.</div></div><div><h3>Implications</h3><div>There is low patient interest in Rh testing and Rh immunoglobulin treatment for first-trimester medication abortion through telehealth. There is a need for clinical guidelines to incorporate patient preferences. Guidelines that do not require Rh testing and treatment following first-trimester abortion are consistent with evidence-based patient-centered abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110856"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception and nonalcoholic fatty liver disease in women with prior gestational diabetes mellitus","authors":"Supatsri Sethasine ,&nbsp;Sasiwan Suthasmalee ,&nbsp;Siriwan Tangjitgamol ,&nbsp;Chadakarn Phaloprakarn","doi":"10.1016/j.contraception.2025.110860","DOIUrl":"10.1016/j.contraception.2025.110860","url":null,"abstract":"<div><h3>Objectives</h3><div>Nonalcoholic fatty liver disease (NAFLD) is an increasing concern among women with a history of gestational diabetes mellitus (GDM). Hormonal contraceptives may affect liver metabolism, potentially increasing NAFLD risk. This study examined the association between different contraceptive methods and NAFLD risk approximately one year postpartum in women with prior GDM.</div></div><div><h3>Study design</h3><div>We conducted a prospective cohort study involving 130 women with prior GDM. We categorized these women into three groups based on their contraceptive use: no contraception or non-hormonal methods (<em>n</em> = 86); progestin-only contraceptives (POCs), including progestin-only pills (POPs), depot medroxyprogesterone acetate (DMPA), and implants (<em>n</em> = 29); and combined oral contraceptives (COCs) (<em>n</em> = 15). At 1 year postpartum, we measured the controlled attenuation parameter to assess hepatic steatosis and diagnose NAFLD. We used multivariable logistic regression analyses to evaluate the association between contraceptive methods and NAFLD risk.</div></div><div><h3>Results</h3><div>The POC group had the highest median controlled attenuation parameter (307<!--> <!-->dB/m) and NAFLD prevalence (55.2%), followed by the no contraception or non-hormonal group (237<!--> <!-->dB/m; 30.2%), with the lowest values in the COC group (213<!--> <!-->dB/m; 13.3%). POCs, particularly POPs and DMPA, significantly increased the risk of NAFLD compared to no contraception or non-hormonal methods (adjusted odds ratio 4.28, 95% confidence interval 1.55–11.85). In contrast, COCs did not show a significant association with NAFLD risk.</div></div><div><h3>Conclusions</h3><div>POCs, particularly POPs and DMPA, significantly increased NAFLD risk, whereas COCs showed no such association. These findings have important implications for contraceptive counseling in women with prior GDM.</div></div><div><h3>Implications</h3><div>Healthcare providers should be cautious about the increased nonalcoholic fatty liver disease risk associated with progestin-only contraceptives, especially progestin-only pills and depot medroxyprogesterone acetate. These findings could guide contraceptive options for women with a history of gestational diabetes mellitus.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110860"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race-ethnicity and sex disparities in the use of pregnancy prevention methods among U.S. high school students","authors":"Jamille Nagtalon-Ramos ,&nbsp;Tyshaneka L. Saffold ,&nbsp;Nancy Pontes ,&nbsp;Manuel Pontes","doi":"10.1016/j.contraception.2025.110857","DOIUrl":"10.1016/j.contraception.2025.110857","url":null,"abstract":"<div><h3>Objective</h3><div>To examine race-ethnicity and sex differences in the reported use of pregnancy prevention methods at the last sexual encounter among sexually active high school students.</div></div><div><h3>Study design</h3><div>Three waves of cross-sectional data from the nationally representative Youth Risk Behavior Survey (2015–2019) were used to analyze sexually active students who exclusively had sex with opposite-sex partners. R, with its survey package, was used to estimate average marginal percentages, risk differences, and confidence intervals.</div></div><div><h3>Results</h3><div>Results showed significant sex differences in the use of contraceptives. Females (52.4%) were significantly less likely to report condom use than males (61.4%). Females were significantly more likely than males to report the use of oral contraceptive pills (23.2% vs 19.1%) or long-acting reversible contraception (11.8% vs 5.4%). Black (23.2%), Hispanic (21.0%), and Asian (23.0%) females were significantly less likely than White (45.6%) females to use oral contraceptive pills or long-acting reversible contraception. There were significant race-ethnicity differences in not using pregnancy prevention or a reliable pregnancy prevention method. About 37% of Asian female students did not use condoms or any reliable form of contraception.</div></div><div><h3>Conclusions</h3><div>Overall, the use of contraceptives among U.S. female high school students was low. Except for condom use, male high school students underreported the use of contraceptives. Black, Hispanic, and Asian female students are significantly less likely to use reliable contraception compared to White students.</div></div><div><h3>Implications</h3><div>Efforts are needed to close the race-ethnicity gap in contraceptive use and increase contraceptive use among all sexually active students.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110857"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving hemostasis with the JADA system after induced abortion at 12 weeks: A case report","authors":"Serena Ly ,&nbsp;Sheeva Yazdani ,&nbsp;Nicole Economou","doi":"10.1016/j.contraception.2025.110855","DOIUrl":"10.1016/j.contraception.2025.110855","url":null,"abstract":"<div><div>The JADA system is safe and effective for control of abnormal postpartum bleeding and hemorrhage at gestational ages (GA) greater than 34 weeks. This report describes successful use of the JADA to control significant uterine atony and hemorrhage in a patient undergoing procedural abortion at 12 weeks 3 days gestation.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110855"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Contraceptive Access Foundation’s model for improving access to the hormonal intrauterine device","authors":"Lorna Begg ,&nbsp;James Sailer ,&nbsp;Kai Risse ,&nbsp;Kendal Danna ,&nbsp;Joanna Holopainen ,&nbsp;Milly Kaggwa ,&nbsp;Anne Pfitzer ,&nbsp;Saumya Ramarao ,&nbsp;Juhani Syrjala ,&nbsp;Nahla Tawab ,&nbsp;Marcel Van Valen ,&nbsp;Maria Mercedes Vivas ,&nbsp;Carolyn Westhoff ,&nbsp;Frank Strelow","doi":"10.1016/j.contraception.2025.110854","DOIUrl":"10.1016/j.contraception.2025.110854","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110854"},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcervical foley balloon versus osmotic dilators for cervical preparation","authors":"Patrice Trowbridge,&nbsp;Mitchell D. Creinin","doi":"10.1016/j.contraception.2025.110841","DOIUrl":"10.1016/j.contraception.2025.110841","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110841"},"PeriodicalIF":2.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilation and evacuation in the setting of trachelectomy and abdominal cerclage: A case report and review of the literature","authors":"Megan Masten ,&nbsp;Cosette Kathawa ,&nbsp;Tsion Shiferaw ,&nbsp;Cara Clure ,&nbsp;Nancy Fang","doi":"10.1016/j.contraception.2025.110840","DOIUrl":"10.1016/j.contraception.2025.110840","url":null,"abstract":"<div><div>This is a patient with a history of radical trachelectomy and abdominal cerclage who underwent an uncomplicated dilation and evacuation at 15 weeks gestation with mifepristone preparation. Dilation and evacuation may be attempted and safely completed for patients in the early second trimester with this history.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110840"},"PeriodicalIF":2.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-acting reversible contraceptive preference and initiation among clinic-based and telemedicine medication abortion patients at one academic health system in California","authors":"Rebecca Woofter ,&nbsp;Rajita Patil ,&nbsp;May Sudhinaraset ,&nbsp;Jessica Gipson","doi":"10.1016/j.contraception.2025.110838","DOIUrl":"10.1016/j.contraception.2025.110838","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine possible differences in postabortion long-acting reversible contraception (LARC) preference and initiation among clinic-based medication abortion and telemedicine medication abortion patients.</div></div><div><h3>Study design</h3><div>We examined electronic medical records among 576 medication abortion patients at one health system in California between 2020 and 2022.</div></div><div><h3>Results</h3><div>Overall, 25% of patients preferred LARC and 21% initiated LARC. Among those who preferred LARC, 77% initiated LARC. No statistically significant differences were found in LARC preference or initiation across medication abortion modalities.</div></div><div><h3>Conclusions</h3><div>In this health system, clinic-based medication abortion and telemedicine medication abortion patients did not differ in postabortion LARC preference or initiation.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110838"},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical development of a novel injectable hydrogel for vas-occlusion","authors":"Nicholas M. Matsumoto,&nbsp;Tyler G. Chiartas,&nbsp;Benjamin R. Paysour,&nbsp;Timothy J. Barry,&nbsp;Lindsey E. Ott,&nbsp;Yelena Tropsha,&nbsp;Kevin S. Eisenfrats","doi":"10.1016/j.contraception.2025.110839","DOIUrl":"10.1016/j.contraception.2025.110839","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this work is to outline the preclinical development of ADAM, an injectable, two-component polyethylene glycol hydrogel designed for long-lasting and nonpermanent vas-occlusive contraception.</div></div><div><h3>Study design</h3><div>A newly developed hydrogel was comprehensively characterized to evaluate its potential as a male contraceptive device. The material was optimized for porosity to ensure sperm occlusion, rheological properties, injectability, and mechanical durability within the dynamic vessel. Biocompatibility of the hydrogel was assessed using a suite of ISO 10993 tests, which are critical for clinical translation and supporting a future regulatory submission. The canine model was utilized to assess the chronic tissue response of the vas deferens post implantation, providing insights into long-term safety and functionality.</div></div><div><h3>Results</h3><div>The vas-occlusive hydrogel demonstrates selective permeability with a pore size of 10 to 20 nm, effectively preventing sperm passage while allowing diffusion of small molecules. Its mechanical properties facilitated injection into the vas deferens with minimal force (3.1 N), forming a viscoelastic material within 30 seconds, with the ability to resist ejaculatory pressures. The implant and its degradation products were found to be noncytotoxic, nonirritating, nonsensitizing, and nongenotoxic. Moreover, a 2-year in vivo study in a canine model showed minimal tissue reaction following implantation, with no adverse effects reported.</div></div><div><h3>Conclusions</h3><div>These findings indicate that the hydrogel’s chemical and mechanical properties align with the requirements for a safe, effective, and nonpermanent vas-occlusive contraceptive.</div></div><div><h3>Implications</h3><div>Currently, men lack options for effective, long-lasting, and reversible contraception. The development and evaluation of the study hydrogel described here suggest it would make a safe and effective vas-occlusive contraceptive and should be researched further in a clinical setting.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110839"},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do Australian contraceptive users say about their experience of having an intrauterine device inserted? Findings from an online, qualitative survey","authors":"Claire Felix-Faure ,&nbsp;Jacqueline Coombe ,&nbsp;Henrietta Williams ,&nbsp;Cassandra Caddy","doi":"10.1016/j.contraception.2025.110836","DOIUrl":"10.1016/j.contraception.2025.110836","url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to explore contraceptive users’ experiences of the intrauterine device (IUD) insertion in Australia.</div></div><div><h3>Study design</h3><div>We conducted an online qualitative survey with people in Australia, aged 18–45, who had undergone IUD insertion in the last 2 years. We recruited participants using online advertisements on social media and via researcher networks and inductively analysed the data.</div></div><div><h3>Results</h3><div>Of a total 294 recorded responses to our online survey, we included 175 based on completion of selected questions for analysis. Participants’ responses to questions regarding their overall feelings toward their experience of IUD insertion varied greatly. Here, we report on three key themes: <em>preparedness for the procedure, the role of staff and providers, and the role of the non-clinical support person.</em> Those who described being poorly prepared for the pain often reported feeling ‘shocked’ by the experience. Participants reported that support people fostered a sense of safety and served as advocates. Those reporting positive experiences with insertion typically described care that aligned with patient-centered principles.</div></div><div><h3>Conclusions</h3><div>Healthcare providers who insert IUDs should follow clinical guidelines that include guidance on preventing pain and preparing patients for potential pain. Providers can use patient-centered practice to improve patients' experiences of IUD insertion.</div></div><div><h3>Implications</h3><div>These results can be used to improve patient experience of IUD insertion. This work highlights important areas in clinical guidelines requiring review.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110836"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}