Contraception最新文献

{"title":"Knowledge gaps and information needs and preferences regarding oral contraceptive pills and over-the-counter access: A focus group study with Black and Latinx young people assigned female at birth","authors":"Riley J. Steiner ,&nbsp;Sarah M. Axelson ,&nbsp;Claudia Nuñez-Eddy ,&nbsp;Kelsie Williams ,&nbsp;Robin Watkins ,&nbsp;Tiffany Lloyd ,&nbsp;Francisco Zamudio","doi":"10.1016/j.contraception.2025.110900","DOIUrl":"10.1016/j.contraception.2025.110900","url":null,"abstract":"<div><h3>Objective</h3><div>On July 13, 2023, the Food and Drug Administration (FDA) approved a progestin-only oral contraceptive pill (OCP) for over-the-counter (OTC) use without an age restriction. Prior to this approval, we launched a qualitative study with Black and Latinx young people to inform access to an OTC OCP. Here we present findings related to knowledge gaps and information needs and preferences.</div></div><div><h3>Study design</h3><div>From April 26 to July 27, 2023, we held eight in-person focus groups (prior to the FDA approval) and one virtual focus group (after the FDA approval) with 65 pregnancy-capable young people aged 15–24 years (median 18 years) who identified as Black and/or Latinx. Community partners in Los Angeles, CA, Syracuse, NY, and Jackson, MS recruited participants from youth-serving programs and via social media. Authors double-coded focus group transcripts and analyzed the data thematically.</div></div><div><h3>Results</h3><div>Participants largely did not know that an OTC OCP was possible. Many participants wanted to learn about an OTC OCP from health care providers and consult with a provider for follow-up as needed. Participants wanted to know about effectiveness and side effects, including at point-of-sale. Some participants had misconceptions about the safety of OCPs in general.</div></div><div><h3>Conclusions</h3><div>Findings suggest that Black and Latinx young people want information about an OTC OCP from providers. Providers can help support equitable access to an OTC OCP by educating young people about OTC availability and the safety and effectiveness of this option regardless of cost or location. Such education can address broader misconceptions about OCPs.</div></div><div><h3>Implications</h3><div>Results can inform efforts to increase awareness of an OTC OCP among Black and Latinx young people. Health care providers should provide information about effectiveness and side effects of this option.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110900"},"PeriodicalIF":2.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058355","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":"Psychosocial burden of seeking medication abortion when using no-test telehealth care compared to in-person care with ultrasound","authors":"M. Antonia Biggs ,&nbsp;C. Finley Baba ,&nbsp;Lauren J. Ralph ,&nbsp;Rosalyn Schroeder ,&nbsp;Colleen McNicholas ,&nbsp;Amy Hagstrom Miller ,&nbsp;Daniel Grossman","doi":"10.1016/j.contraception.2025.110894","DOIUrl":"10.1016/j.contraception.2025.110894","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the relationship between abortion care model and living in a state with an abortion ban with the psychosocial burden of care-seeking.</div></div><div><h3>Study design</h3><div>From May 2021 to March 2023, we surveyed patients obtaining medication abortion ≤70 days gestation, ages ≥15 years at four abortion clinic organizations in six U.S. states. We used negative binomial regression to assess three psychosocial burden dimensions: structural challenges (5 items, α = 0.80), lack of autonomy (3 items, α = 0.73), and others’ reactions to the pregnancy (2 items, α = 0.88) by abortion care model (no-test telehealth + mail, no-test + pickup, and in-person + ultrasound) and living in an abortion-ban state.</div></div><div><h3>Results</h3><div>400 people completed psychosocial burden items. In adjusted analyses, no-test telehealth + mail was associated with less overall psychosocial burden (incident rate ratio [IRR] 0.82, 95% confidence interval [CI] 0.70, 0.95), including fewer structural challenges (IRR 0.78, 95% CI 0.67, 0.91) and less lack of autonomy (IRR 0.65, 95% CI 0.47, 0.90) than in-person + ultrasound, mostly due to less difficulty traveling (24% vs 32%, <em>p</em> &lt; 0.05) and feeling less forced to wait after deciding (11% vs 22%, <em>p</em> &lt; 0.05). People in abortion-ban states reported more psychosocial burden (IRR 1.62, 95% CI 1.26, 2.08) including more structural challenges (IRR 1.95 0.36, 95% CI 1.53, 2.29) than people in states without bans.</div></div><div><h3>Conclusions</h3><div>No-test telehealth abortion care may reduce the psychosocial burden of care-seeking, especially the difficulties of travel and feeling forced to wait for care.</div></div><div><h3>Implications</h3><div>Findings add to the body of evidence in support of expanding telehealth abortion care by reducing travel burden and potentially increasing autonomous decision-making when seeking abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110894"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743910","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":"Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 2 – Breast, ovarian, uterine, and cervical cancer: Joint with the Society of Gynecologic Oncology","authors":"Pelin Batur ,&nbsp;Ashley Brant ,&nbsp;Carolyn McCourt ,&nbsp;Eleanor Bimla Schwarz ,&nbsp;with the assistance of Anitra Beasley; Jessica Atrio; and Danielle Gershon,&nbsp;on behalf of the Clinical Affairs Committee, and Neil A. Nero","doi":"10.1016/j.contraception.2025.110867","DOIUrl":"10.1016/j.contraception.2025.110867","url":null,"abstract":"<div><div>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven recommendations to facilitate the management of and access to contraceptive care for individuals who are diagnosed with, being actively treated for, or who have previously been treated for breast, ovarian, uterine, or cervical cancer. For individuals with a history of breast cancer, we recommend nonhormonal contraceptives as the first-line option (GRADE 1B); additional guidance is provided for hormonal contraception depending on breast cancer hormone receptor status. For individuals with a history of or active ovarian cancer, we recommend clinicians provide access to all available contraceptive methods utilizing a person-centered approach (GRADE 1B); in individuals diagnosed with hormonally-sensitive ovarian malignancies, such as adult granulosa cell tumors, low-grade serous, and endometrioid adenocarcinomas, who are considering hormonal contraception, we suggest shared decision-making with the individual and their oncologist (GRADE 2C). Estrogen-containing contraceptives should be avoided by individuals treated with estrogen-blocking therapy (Best Practice). For individuals with a history of endometrial cancer, we recommend clinicians provide access to all available contraceptive methods utilizing a person-centered approach (GRADE 1B); in individuals with active endometrial cancer requesting an intrauterine device (IUD), we suggest shared decision-making with the individual and their oncologist (GRADE 1B). Recommendations for individuals with gestational trophoblastic disease are provided based on factors such as evidence of persistent intrauterine disease, human chorionic gonadotropin (hCG) levels, and the individual’s preferred contraceptive method. For individuals with cervical dysplasia or a history of cervical cancer, we suggest clinicians provide access to all available contraceptive methods (GRADE 2B); we suggest against IUD placement in individuals with active cervical malignancy (GRADE 2C). This document is part 2 of a three-part series that updates the Society of Family Planning’s 2012 <em>Cancer and contraception</em> clinical guidance. It builds upon the considerations outlined in the <em>Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 – Key considerations for clinical care</em> and parallels recommendations outlined in the <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 – Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers</em>. Readers are encouraged to review parts 1 and 3 for this additional context.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110867"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797294","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":"Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 – Key considerations for clinical care Joint with the Society of Gynecologic Oncology","authors":"Pelin Batur ,&nbsp;Ashley Brant ,&nbsp;Carolyn McCourt ,&nbsp;Eleanor Bimla Schwarz ,&nbsp;with the assistance of Anitra Beasley; Jessica Atrio; and Danielle Gershon, on behalf of the Clinical Affairs Committee, and Neil A. Nero","doi":"10.1016/j.contraception.2025.110870","DOIUrl":"10.1016/j.contraception.2025.110870","url":null,"abstract":"<div><div>With increasing trends in both cancer diagnosis and survivorship, a growing number of individuals impacted by cancer need high-quality contraceptive counseling. Individuals with cancer and cancer survivors have individualized needs with respect to sexual activity, fertility desires, and contraceptive preferences. Clinicians should provide person-centered contraceptive care that supports individual autonomy in decision-making, is tailored to the individual’s expressed preferences and values, and includes cancer-specific considerations<em>.</em> While pregnancy prevention is generally recommended during cancer treatment, pregnancy may occur before or during treatment and require person-centered counseling<em>.</em> No test reliably rules out pregnancy potential in cancer survivors; clinicians should offer to discuss contraception with individuals who are pregnancy-capable before cancer treatment. Clinicians should counsel individuals about common risks and complications that may impact contraceptive choice, as cancer and chemotherapy can cause (1) vascular injury, which can increase the risk of venous thromboembolism, (2) anemia, and (3) bone loss increasing the risk of fractures. Clinicians should counsel individuals with cancer that it is safe for them to use emergency contraception. Clinicians should be aware that individuals experiencing intimate partner violence and other marginalized populations, including adolescents and young adults and gender-diverse individuals, have unique needs requiring a person-centered approach to contraceptive care complicated by cancer. Access to the full spectrum of contraceptive methods should be prioritized for individuals with cancer and cancer survivors, accommodating individual preferences and health status. This document is part 1 of a three-part series that updates the Society of Family Planning’s 2012 <em>Cancer and contraception</em> clinical guidance. Its companion documents, <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 2 – Breast, ovarian, uterine, and cervical cancer</em> and <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 – Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers</em><strong>,</strong> build upon this document and focus on actionable, clinical recommendations.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110870"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015237","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":"Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 – Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers: Joint with the Society of Gynecologic Oncology","authors":"Pelin Batur ,&nbsp;Ashley Brant ,&nbsp;Carolyn McCourt ,&nbsp;Eleanor Bimla Schwarz ,&nbsp;with the assistance of Anitra Beasley; Jessica Atrio; and Danielle Gershon, on behalf of the Clinical Affairs Committee, and Neil A. Nero","doi":"10.1016/j.contraception.2025.110869","DOIUrl":"10.1016/j.contraception.2025.110869","url":null,"abstract":"<div><div>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven recommendations to facilitate the management of and access to contraception care for individuals who are diagnosed with, being actively treated for, or who have previously been treated for skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers. For individuals with a history of nonmelanoma skin cancers, we recommend clinicians provide access to all available contraceptive methods utilizing a person-centered approach (GRADE 1B). Based on expert opinion, for individuals with a history of melanoma who are considering hormonal contraception, we suggest shared decision-making with the individual and their oncologist (GRADE 2C). For individuals with a history of myeloproliferative neoplasms, lymphatic or hematopoietic cancer, and hematopoietic stem cell transplantation, we recommend clinicians provide access to all contraceptive methods (GRADE 1B); we suggest shared decision-making in those with follicular lymphoma subtype of non-Hodgkin lymphoma who are considering hormonal contraception (GRADE 2C). For individuals with a history of colorectal, pancreatic, esophageal, and gastric cancer, we recommend clinicians provide access to all available contraceptive methods (GRADE 1C). We recommend clinicians provide access to all available contraceptive methods in individuals with a history of primary hepatocellular carcinoma with normal liver function (GRADE 1C); with severely altered liver function, we recommend nonhormonal and progestin-only contraceptives as first-line contraceptive methods (GRADE 1B). For individuals with a history of glioma, we recommend clinicians provide access to all available contraceptives (GRADE 1B). For individuals with a history of meningioma who request hormonal contraception, we recommend shared decision-making with the individual and their oncologist (GRADE 2B). We recommend clinicians provide access to all available contraceptive options for individuals with a history of or active bladder, kidney, thyroid, head and neck squamous cell, and soft tissue sarcomas (GRADE 1B). This document is part 3 of a three-part series that updates the Society of Family Planning’s 2012 <em>Cancer and contraception</em> clinical guidance. It builds upon the considerations outlined in the <em>Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 – Key considerations for clinical care</em> and parallels recommendations outlined in the <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 2 – Breast, ovarian, uterine, and cervical cancer</em>. Readers are encouraged to review parts 1 and 2 for this additional context.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110869"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058817","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":"Society of Family Planning Clinical Recommendation: Prevention of infection after abortion and pregnancy loss","authors":"Terri Cheng ,&nbsp;Nimisha Kumar ,&nbsp;Laura Laursen ,&nbsp;Sharon L. Achilles ,&nbsp;Matthew F. Reeves ,&nbsp;with the assistance of Jessica Atrio, Sarita Sonalkar on behalf of the Clinical Affairs Committee","doi":"10.1016/j.contraception.2025.110895","DOIUrl":"10.1016/j.contraception.2025.110895","url":null,"abstract":"&lt;div&gt;&lt;div&gt;This Clinical Recommendation serves as a revision to the Society of Family Planning’s 2010 &lt;em&gt;Prevention of infection after induced abortion&lt;/em&gt; guidance. It examines infection risk, identifiable risk factors, and prophylactic measures for the prevention of infection associated with procedural and medication management of abortion and pregnancy loss to make evidence-based recommendations for the clinical care of patients. The following are the Society of Family Planning’s recommendations: We recommend clinicians (1) test and treat patients empirically for gonorrhea and chlamydia at the time of abortion if there is high clinical suspicion, (2) treat the patient if they have a known diagnosis of gonorrhea or chlamydia but have not received treatment, or (3) provide routine annual screening for gonorrhea and chlamydia for patients under 25 years and others at increased risk due for screening based on the US Preventive Services Task Force recommendations, and, if positive, treat according to the Centers for Disease Control and Prevention's guidelines; clinicians should not delay abortion while awaiting diagnosis or treatment (GRADE 1C). We recommend against screening for bacterial vaginosis before abortion (GRADE 1C). Since the rate of infection is low for nonprocedural abortion and the number needed to treat is high, coupled with inherent risks associated with antibiotic use, we recommend against the use of universal antibiotic prophylaxis in the setting of medication abortion, medication management of early pregnancy loss, or self-managed abortion (GRADE 1C). We recommend universal antibiotic prophylaxis for patients undergoing procedural abortion across all gestational durations (GRADE 1A). For procedural management of pregnancy loss, we recommend antibiotic prophylaxis (GRADE 1A). We recommend clinicians initiate antibiotic prophylaxis for procedural abortion and procedural management of pregnancy loss before instrumentation to maximize efficacy (GRADE 1B). Antibiotics should be given with adequate time for absorption, but data on the optimal timing for prophylaxis are lacking. In the setting of osmotic cervical dilator use, there is insufficient evidence to recommend for or against routine antibiotic prophylaxis before osmotic cervical dilator placement. We recommend discontinuing antibiotic prophylaxis after the procedure is completed (GRADE 1B). We recommend a single dose of doxycycline 200 mg orally or azithromycin 500 mg orally before a procedural abortion or procedural management of pregnancy loss (GRADE 1B). Metronidazole is a second-line option as it has evidence to suggest a prophylactic effect despite being less effective than doxycycline or azithromycin against aerobic bacteria. We recommend against the use of fluoroquinolones for prophylaxis in the setting of procedural abortion or procedural management of pregnancy loss due to the increased risk of side effects and complications (GRADE 1B). There is insufficient evidence ","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"148 ","pages":"Article 110895"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743913","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":"Effects of estetrol/drospirenone on self-reported physical and emotional premenstrual and menstrual symptoms: Data from the phase 3 clinical trial in the United States and Canada","authors":"Céline Bouchard ,&nbsp;Johannes Bitzer ,&nbsp;Melissa J. Chen ,&nbsp;Jeffrey T. Jensen ,&nbsp;Andrew M. Kaunitz ,&nbsp;Maud Jost ,&nbsp;Jean-Michel Foidart ,&nbsp;Mitchell D. Creinin","doi":"10.1016/j.contraception.2025.110889","DOIUrl":"10.1016/j.contraception.2025.110889","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the effects of estetrol 15<!--> <!-->mg/drospirenone 3 mg on physical and emotional premenstrual and menstrual symptoms in a North American population.</div></div><div><h3>Study design</h3><div>We used Menstrual Distress Questionnaire (MDQ) data from an open-label phase 3 trial conducted in the United States and Canada that enrolled participants 16–50 years to use estetrol/drospirenone for up to 13 cycles. Four most bothersome MDQ domains were evaluated: the physical domains of Pain and Water Retention and the emotional domains of Negative Affect and Impaired concentration. We assessed mean changes from baseline to end of treatment in premenstrual and menstrual scores in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain.</div></div><div><h3>Results</h3><div>Of 1864 treated participants, 1308 (70.2%) completed both MDQs of which 676 (51.7%) were starters and 1179 (90.1%) were US participants. Starters reported significant improvements (<em>p</em> &lt; 0.05) for menstrual Pain (−3.3), premenstrual (−1.5) and menstrual (−2.0) Water Retention and premenstrual Negative Affect (−1.2). Switchers reported no significant changes in any of the four domains. We observed a decrease in symptom intensity in &gt;40% of participants within the domain Pain for Headache, Cramps, Backache, Fatigue, and General Aches and Pain; within the domain Water Retention for Weight Gain, Skin Blemish, Painful or Tender Breast, and Swelling; and within the domain Negative Affect for Anxiety, Mood Swings, and Irritability.</div></div><div><h3>Conclusion</h3><div>Estetrol/drospirenone starters experienced the most significant improvements in the MDQ domains Pain, Water Retention, and Negative Affect. Domain scores for switchers remained stable.</div></div><div><h3>Implications</h3><div>In first time pill users, the estetrol/drospirenone containing oral contraceptive significantly reduces menstrual pain, premenstrual and menstrual water retention and premenstrual negative affect. In those switching from another pill, the menstrual-related distress symptoms remain stable.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110889"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694737","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":"Tribute to Prof. Eberhard Nieschlag","authors":"Regine Sitruk-Ware","doi":"10.1016/j.contraception.2025.110868","DOIUrl":"10.1016/j.contraception.2025.110868","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110868"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665750","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":"Multidisciplinary surgical planning for a patient with hyperthyroidism complicating a twin gestation of a complete hydatidiform mole and a coexisting fetus","authors":"Gillian Piltch ,&nbsp;Charit Taneja ,&nbsp;Justin Feit ,&nbsp;Elizabeth O. Schmidt","doi":"10.1016/j.contraception.2025.110866","DOIUrl":"10.1016/j.contraception.2025.110866","url":null,"abstract":"<div><div>This case report demonstrates hyperthyroidism complicating a twin gestation consisting of a complete hydatidiform mole and coexisting fetus. The patient underwent medical optimization of hyperthyroidism with a thionamide and beta blocker prior to undergoing uncomplicated dilation and evacuation under spinal anesthesia. She was cared for by a multidisciplinary team.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110866"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631127","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 impact of denying abortion access to patients with chronic kidney disease: A cost-effectiveness analysis","authors":"Sydney McCarthy,&nbsp;Julia Tasset,&nbsp;Olivia Curl,&nbsp;Sarah Dzubay,&nbsp;Aaron B. Caughey","doi":"10.1016/j.contraception.2025.110863","DOIUrl":"10.1016/j.contraception.2025.110863","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study focuses on how abortion access affects people who are pregnant, have chronic kidney disease (CKD), and desire an abortion. From the perspective of the pregnant patient, we will examine the outcomes and costs associated with providing or refusing in-state access to abortion for this population.</div></div><div><h3>Study design</h3><div>A decision-analytic model was built to compare the outcomes and costs associated with providing abortions in-state compared to those associated with a complete statewide abortion ban. The model includes outcomes of pregnancy with CKD and considers the progression of disease. The model also considers the likelihood and costs associated with traveling to another state for an abortion.</div></div><div><h3>Results</h3><div>In a cohort of 31,243 pregnant people with CKD desiring an abortion, providing abortions resulted in 1350 fewer cases of preeclampsia, 2703 fewer preterm births, 4837 fewer cases of CKD stage progression, 841 fewer cases of end-stage renal disease requiring dialysis, and nine fewer deaths per year. An absence of in-state abortion access was associated with an increased cost of $533,874,448 and a decrease of 6873 quality adjusted life years (QALYs) compared to states with abortion access.</div></div><div><h3>Conclusion</h3><div>Providing in-state abortion access to pregnant people with chronic kidney disease is a cost-effective strategy, due to the direct decrease in preeclampsia, preterm birth, mortality, and progression of kidney disease.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110863"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617905","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}