Journal of pediatric and adolescent gynecology最新文献

{"title":"10. Improving counseling on treatment options for heavy menstrual bleeding via an educational aid: a pilot study","authors":"Erin Isaacson,&nbsp;Rebecca Richardson,&nbsp;Kate McCracken,&nbsp;Melina Dendrinos,&nbsp;Monica Rosen","doi":"10.1016/j.jpag.2025.01.022","DOIUrl":"10.1016/j.jpag.2025.01.022","url":null,"abstract":"<div><h3>Background</h3><div>Heavy menstrual bleeding (HMB) affects a significant number of reproductive-aged adolescents assigned female at birth (AFAB). There is limited literature examining the use of educational aids (EDA) or videos for adolescent patients initiating hormonal treatment for HMB. EDA could help to eliminate bias and ensure patients receive high-quality information. We hypothesized that use of an EDA would be non-inferior to traditional counseling from a Pediatric and Adolescent Gynecology (PAG) physician on patient's knowledge of treatment options and confidence in method selection</div></div><div><h3>Methods</h3><div>This is a prospective, randomized controlled trial. IRB approval was obtained. An EDA was created by the PAG department within our institution. Patients AFAB ages 11-21 presenting with a complaint of HMB were recruited to the study. Participants completed a short demographic and knowledge survey and were randomized based on medical record number to traditional versus EDA counseling. Traditional counseling was performed by PAG attendings or fellows. After EDA or traditional counseling, participants completed an additional survey of questions assessing their counseling experience, knowledge of options, and their decision-making process</div></div><div><h3>Results</h3><div>17 patients were recruited, 8 in the EDA group and 9 in the traditional group. There were no differences between groups in patient ages, race or ethnicity (Table 1). Patients in both groups felt the amount of information they received was “perfect” (p=.76). Patients in the traditional group felt they received more new information compared to the EDA group (p=.02) (Table 1). Both groups felt they learned equally about all options (p=.28). The EDA group answered more post-survey knowledge questions correctly on average compared to the traditional group (p= .02) (Table 1). The traditional counseling group felt significantly more confident than the EDA group when choosing a method (p=.02), though both groups fell into the “confident” range</div></div><div><h3>Conclusions</h3><div>Patients learned equally about options in both the EDA and traditional counseling groups but felt more confident about choosing an option in the traditional group. EDAs may be a useful tool to eliminate potential bias, improve efficiency in clinic, and increase adolescents’ confidence in making health care choices</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 225"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"7. Fertility Attitudes and Turner Syndrome","authors":"Lauren Roth ,&nbsp;Madeline Ross ,&nbsp;Anne-Marie Priebe ,&nbsp;Jacqueline Maher ,&nbsp;Veronica Gomez-Lobo ,&nbsp;Tazim Dowlut-McElroy","doi":"10.1016/j.jpag.2025.01.019","DOIUrl":"10.1016/j.jpag.2025.01.019","url":null,"abstract":"<div><h3>Background</h3><div>Primary Ovarian Insufficiency is the main reproductive effect in individuals with Turner syndrome (TS). Guidelines recommend disclosure of reduced fertility in individuals with TS and counseling inclusive of options for fertility preservation and family planning. Although ovarian tissue cryopreservation (OTC) and oocyte cryopreservation (OC) are offered to individuals with TS, live births rates remain unknown. Also unknown are the attitudes of adolescents and young adults with TS (AYA-TS) and their parents regarding future fertility. The objective of this study was to compare differences in attitudes between AYA-TS and their parents regarding future fertility and fertility preservation.</div></div><div><h3>Methods</h3><div>After IRB approval, we conducted two studies in sequence of 12- to 25-year-olds with TS and their parents. First, to maximize acceptability/applicability of the Fertility ConcepTS questionnaire, a two-staged Delphi Procedure was implemented during 3 focus groups with AYA-TS and parents to develop/ refine survey questions. Second, a finalized cross-sectional survey was distributed via a social media platform of the Turner Syndrome Global Alliance and during a multidisciplinary TS clinic. Statistical analysis was performed using SPSS. Statistical significance was defined as P &lt;.05.</div></div><div><h3>Results</h3><div>A total of 28 participants were included in the analysis. Sixteen (57%) were AYA-TS and 12 (43%) were parents (Table 1). The median age of AYA-TS was 17.5 (IQR 10.5) years and of parents was 48.0 (IQR 9.3) years. AYA-TS and parents did not differ in their interest in understanding the effects of TS on fertility and pregnancy, their interest building a family, their desire for awareness of the possibility of biological children, and their awareness that feelings about building a family might change (Table 2). AYA-TS and their parents differed in their consideration for adoption (p=.005), use of donor egg (p&lt;.001), use of a gestational carrier (p&lt;.001) and raising a child as a single parent (p=.002). While 6.3%, 18.8%, 37.5% and 31.3% of AYA-TS disagreed/strongly disagreed with adoption, donor egg, gestational carrier, and single parenthood, respectively, all parents agreed/strongly agreed. AYA-TS and their parents differed in their consideration for OC (p=.042), OTC (p=.021), and awareness of change in opportunity for OC/OTC (p=.002). Although all parents agreed/strongly agreed, 18.8%, 43.8%, and 18.5% of AYA-TS, respectively, disagreed/strongly disagreed with OC, OTC, and awareness of change in opportunity for OC/OTC.</div></div><div><h3>Conclusions</h3><div>AYA-TS and their parents have differing attitudes about fertility and fertility preservation. Counselling should include consideration of the needs of AYA-TS alongside parent priorities.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 223"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"11. Addressing Cervical Cancer Disparities in Adolescents with Disabilities through HPV Vaccination","authors":"Theresa Rager,&nbsp;William Gillespie,&nbsp;Harlan Mccaffery,&nbsp;Melina Dendrinos,&nbsp;Kate McCracken,&nbsp;Monica Rosen","doi":"10.1016/j.jpag.2025.01.044","DOIUrl":"10.1016/j.jpag.2025.01.044","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with disabilities (AWD) are often viewed as nonsexual, posing challenges in receiving sexual healthcare. Yet, patients with disabilities have higher rates of sexual abuse and unprotected sex and lower rates of cervical cancer screening. It is critical that AWD receive the HPV vaccination due to their risk of HPV exposure and lower likelihood of receiving routine cervical cancer screening. This study aims to assess if there is a discrepancy in HPV vaccination between AWD and their non-disabled peers.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted of adolescent females ages 16-21 years attending any visit in an academic health system from July 2021 - September 2024. Data collected included demographics, disability status, and receiving at least one dose of the HPV vaccine. Disability status was defined by the Children with Disabilities Algorithm (Agency for Healthcare Research and Quality), which uses ICD-9 codes to classify physical, sensory, developmental/behavioral, psychological, and intellectual disabilities. The primary outcome was differences in HPV vaccination between adolescents with specific disabilities, any disability, and non-disabled peers. Analysis included Chi-square tests and logistic regression. This study was exempt by IRB.</div></div><div><h3>Results</h3><div>Of 7,801 total adolescents, 1,132 (14.5%) were identified as having any disability, 5,785 (74.2%) of all patients received at least one dose of the HPV vaccine, and 870 (76.9%) patients with disabilities received at least one dose. Any disability was associated with higher HPV vaccination rate (p=0.025). Psychological and sensory disabilities were significantly associated with higher HPV vaccination rates (p=0.011; p=0.039), whereas intellectual disability was nearly significantly associated with lower HPV vaccination rates (p=0.07). Physical and developmental disabilities were not associated with HPV vaccination. Compared to white race, non-Black racial minorities had a significantly higher HPV vaccination rate (p=0.031). There was no significant difference between HPV vaccination among disabilities according to race. Older age was significantly associated with HPV vaccination (p=0.006). See Table 1.</div></div><div><h3>Conclusions</h3><div>Adolescents with psychological and sensory disabilities had higher HPV vaccination rates, suggesting lower cervical cancer risk. However, adolescents with intellectual disabilities may experience lower rates, exposing a potential disparity in cervical cancer risk. Providing patients and parents with education on HPV exposure and cancer risk tailored to the adolescent's disability may decrease barriers to HPV vaccination.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 234-235"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"29. Early growth in first trimester scan in adolescent pregnancies: Results from a comparative cohort study.","authors":"Anastasia Vatopoulou ,&nbsp;Athina Samara ,&nbsp;Hara Skentou ,&nbsp;Katerina Dadouli ,&nbsp;Fani Gkrozou ,&nbsp;Antonios Garas ,&nbsp;Sotirios Sotiriou","doi":"10.1016/j.jpag.2025.01.062","DOIUrl":"10.1016/j.jpag.2025.01.062","url":null,"abstract":"<div><h3>Background</h3><div>In the present study we aim to assess the Crown-rump length (CRL) values measured in first trimester scan in adolescent pregnancies compared with the respective CRL values in adult pregnancies.</div></div><div><h3>Methods</h3><div>All consecutive pregnancies that underwent a first trimester ultrasound scan in two fetomaternal units in Greece during a twelve-year period were included in the present study. Ultrasound findings, demographic characteristics and medical records were retrospectively reviewed and recorded in an anonymous database. Cases with a maternal age&lt; 20 years were characterized as adolescent pregnancies, and all other cases were grouped as adult pregnancies (control group). All statistical analyses were performed using R (version 4.2.2) software packages. The Kolmogorov-Smirnov test was used to test the normality of the variables. Multivariate linear regression model and linear regression model were used to assess the association between the weighted for gestational age CRL and the independent variables. The results are represented as the effect size of the CRL. Statistical significance was set at P&lt; 0.05 (two tailed).</div></div><div><h3>Results</h3><div>In total, 3234 pregnancies were included in the present study; 325 were identified as adolescent pregnancies and 2909 were adult pregnancies. In multivariate analysis, CRL values were statistically significant lower (52.6 mm and 58.8 mm respectively) in adolescent pregnancies (p&lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Based on our results, pregnancy in adolescents has been associated, with statistically significant lower CRL measures compared with adult pregnancies. More prospective studies with larger cohort series are needed.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 244"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3. A novel approach for controlled drainage of giant ovarian cysts through mini-laparotomy","authors":"Victoria Huynh ,&nbsp;Megan Sumida ,&nbsp;Kathleen McDowell Takahashi ,&nbsp;Ana Cisneros-Camacho ,&nbsp;Amitha Ganti ,&nbsp;Jennifer Bercaw-Pratt ,&nbsp;Sanjeev Vasudevan ,&nbsp;Olivia Winfrey","doi":"10.1016/j.jpag.2025.01.036","DOIUrl":"10.1016/j.jpag.2025.01.036","url":null,"abstract":"<div><h3>Background</h3><div>Large ovarian cysts in adolescents often present with low malignancy risk, prompting discussions about optimal surgical strategies. Minimally invasive methods aim to reduce complications, pain, hospitalization length, and scar appearance. As such, there is a desire to utilize less invasive approaches for the removal of large to giant masses. However, the advantages of minimally invasive surgery must be balanced with the risks of spillage, including malignant seeding and upstaging, chemical peritonitis, and recurrence. A few minimally invasive techniques have been proposed, including adherence of surgical gloves or bandages, controlled drainage with catheters, or use of the Alexis laparoscopic system. These techniques are poorly standardized and can fail to remain adherent during the case. We aim to describe a unique approach for the safe drainage of giant ovarian cysts.</div></div><div><h3>Case</h3><div>We present four adolescents with giant ovarian cysts (10-30 cm) and low pre-operative concern for malignancy, who proceeded to surgery for definitive treatment of the mass and associated symptoms. In all cases, a 4-6 cm midline infraumbilical incision was used. After obtaining adequate exposure of the mass, we adhered the rigid ring of a sterile 3 cm silo bag designed for ventral wall defects (Image 1) to a dried surface of the mass using sterile surgical glue. After ensuring the glue was dry, we trimmed off the closed distal end of the bag to allow access to the cyst surface. Through the constructed opening of the bag, the cyst was then entered sharply and contents were drained. In three cases, no spillage of contents was noted (Image 2) after multiple (1.9-5) liters were drained. In one case, there was minimal spillage noted due to malfunction of the suction device. In all but one case, the ovarian cortex was spared after cystectomy. In all cases, the bags remained firmly adherent to the ovarian cortex until the ovary and cyst could be exteriorized. There were no postoperative complications, and patients were discharged on postoperative days 0-2.</div></div><div><h3>Comments</h3><div>We introduce a safe, ovarian-sparing approach for extracorporeal drainage of giant adnexal cysts using a silo bag for spillage prevention through a mini-laparotomy incision. We believe this technique would be readily reproducible at many hospitals.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 230-231"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"37. Examining contraceptive knowledge, use and preferences of adolescents hospitalized with psychiatric disorders","authors":"Abigail Underwood ,&nbsp;Alicia Bunger ,&nbsp;Brittny Manos ,&nbsp;Elise Berlan","doi":"10.1016/j.jpag.2025.01.070","DOIUrl":"10.1016/j.jpag.2025.01.070","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with psychiatric symptoms have unique sexual health needs. These adolescents can have younger age at first sex, less frequent and/or inconsistent contraception use, and higher risk sexual behaviors than their peers without psychiatric symptoms. We examined contraception knowledge, use, and preferences among adolescents assigned female at birth (AFAB) hospitalized for psychiatric care, in addition to patient factors associated with contraceptive use.</div></div><div><h3>Methods</h3><div>Between November 2021 and March 2023, we recruited 451 adolescents AFAB ages 14-17 from 4 inpatient psychiatric units at a large children's hospital. As part of a larger study examining integration of contraception care in inpatient psychiatric settings, participants answered a survey about reproductive health, mental health, contraception knowledge, use, and preferences. The survey was administered via an electronic tablet using REDCap. Participants received a gift card incentive. Descriptive statistics included mean and standard deviation (SD) for continuous variables and frequencies and percentages for categorical variables. We used logistic regression to examine characteristics associated with contraception use. This study was approved by the institutional review board.</div></div><div><h3>Results</h3><div>Mean age was 16.1 (95% CI: 14.1-18.1); 65.4% identified as white and 9.3% identified as Hispanic. Most respondents reported knowledge about the contraceptive pill (98.9%), implant (76.1%), intrauterine device (IUD; 75.2%), and injectable (51.4%). Among the 44.6% of respondents that reported ever having intercourse, condoms (49.3%), withdrawal (29.4%) and contraceptive pills (23.4%) were the most common methods of contraception. Some (37.3%) reported using multiple methods and few (13.4%) reported using no method to prevent pregnancy. When asked to select their preferred method, participants chose contraceptive pills (38.6%) most, followed by the implant (16.0%) and IUD (11.3%). Age was significantly associated with contraceptive use (OR: 1.6; 95% confidence interval 1.3, 1.9; p&lt; 0.001) with older adolescents reporting higher odds of contraceptive use. Patient race, experience with sexual education, and insurance status were not significantly associated with contraceptive use.</div></div><div><h3>Conclusions</h3><div>Many adolescents hospitalized with psychiatric disorders are sexually active. Despite knowledge of contraceptives and preferences for more effective methods, their use of condoms and withdrawal may indicate their contraceptive needs are not being met. As adolescents face increasing rates of psychiatric symptoms, effort is recommended to ensure they have accessible sexual health services.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 247"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urethral prolapse in the course of cystic fibrosis: A case report.","authors":"Anna Mordarska, Karolina Kowalczyk, Grzegorz Kudela, Agnieszka Drosdzol-Cop","doi":"10.1016/j.jpag.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.02.009","url":null,"abstract":"<p><p>This case report highlights a rare occurrence of urethral prolapse (UP) in a 7-year-old girl diagnosed with cystic fibrosis (CF). The patient displayed a protruding, swollen, and bleeding mass at the urinary orifice, accompanied by chronic constipation and a recent respiratory syncytial virus (RSV) infection. Cystovaginoscopy and circumferential excision were performed, leading to a successful outcome. Since the operation, the patient has been pain-free. The association between CF and UP underscores the need for heightened awareness among clinicians. The report focuses on recognizing and managing UP in pediatric CF patients to provide the best possible care.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"57. Intralesional Cidofovir: A Promising Treatment for Refractory Genital Warts in Pediatric Patients","authors":"Mónica Muñoz ,&nbsp;Carolina Pastene ,&nbsp;Jorge Morales ,&nbsp;Patricio Garcia ,&nbsp;eugenio Ramirez ,&nbsp;Nicole Bruneau ,&nbsp;monserrat Balanda ,&nbsp;Paula Muñoz ,&nbsp;Magdalena Castro ,&nbsp;Patricia Romero","doi":"10.1016/j.jpag.2025.01.090","DOIUrl":"10.1016/j.jpag.2025.01.090","url":null,"abstract":"<div><h3>Background</h3><div>Human Papillomavirus (HPV) infections can lead to genital warts (GW) in pediatric patients, posing significant treatment challenges. Currently, no FDA-approved therapies for GW exist for children under 12, and conventional treatments often result in high recurrence rates. Emerging evidence suggests that intralesional Cidofovir, a broad-spectrum antiviral, may be effective for refractory GW, as demonstrated in related conditions like recurrent laryngeal papillomatosis.</div></div><div><h3>Case</h3><div>We present a case of a 2-year-and-8-month-old girl with persistent GW, unresponsive to multiple treatment regimens, including podophyllotoxin, liquid nitrogen, imiquimod, and trichloroacetic acid. After 2 years of failed therapies and a persistent HPV genotype 11 infection, she underwent surgical excision with intralesional Cidofovir instillation. Two years post-treatment, the patient remained asymptomatic, with no recurrence of vulvar lesions, and a negative HPV PCR molecular test. Ethics Approval: This case was reviewed and approved by the Ethics Committee of Hospital Dr. Luis Calvo Mackenna, in accordance with institutional guidelines.</div></div><div><h3>Comments</h3><div>This case underscores the potential of intralesional Cidofovir as a promising treatment for refractory GW in pediatric patients. Given the lack of approved therapies for children and the high recurrence rates associated with conventional treatments, Cidofovir may offer a new therapeutic option. Further studies are necessary to explore its efficacy as a first-line treatment for this vulnerable population. Financial Disclosure: The authors have no financial relationships relevant to this case to disclose.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 255-256"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"58. Is Reproductive Health Knowledge Protective Against Adolescent Pregnancy?","authors":"Wendy Jackson,&nbsp;Stephanie Stockburger,&nbsp;Mary Nunn,&nbsp;Madison Tackett,&nbsp;Rachel Cooper","doi":"10.1016/j.jpag.2025.01.091","DOIUrl":"10.1016/j.jpag.2025.01.091","url":null,"abstract":"<div><h3>Background</h3><div>Though teen pregnancy rates are declining, it remains a pressing issue. Data is limited on prevention of teen pregnancy but contraception and engagement with family and community have been identified as protective. A more universal intervention may have more equitable results. This study aims to identify if knowledge of female genitourinary (GU) structures is associated with nulliparity in adolescents, assessed by identification of anatomical structures on a digital image. Nulliparous adolescents will identify more female GU structures correctly than parous adolescents.</div></div><div><h3>Methods</h3><div>Subjects were adolescents (12-21 years old) and patients of University of Kentucky's Adolescent Medicine Clinic (AMC) or Young Parent Program Clinic (YPP). Participant's received a $20 check through the mail after completing a survey on an iPad with questions about demographics, educational background, and identification of GU structures. The survey was offered in English and Spanish. This was a cross-sectional study with purposive sampling. Sample size was 103, 55 from the AMC and 48 from YPP. Fisher's exact, χ2, and Shapiro-Wilk normality tests were used to compare answers between the two groups. Statistical significance was set at p≤0.05, all tests were two-sided. Respective clinic attendance was the predictive variable. The primary outcome was the number and percent of GU structures identified correctly. University of Kentucky Institutional Review Board approved this study (#81195).</div></div><div><h3>Results</h3><div>The participants in AMC scored significantly higher than YPP participants having a higher median overall correct responses (17 vs 13). The median percent correct was 89.5% in the AMC group and 68.4% in the YPP group (Table 2). Therefore, the hypothesis was accepted as true. Grade of reproductive education differed significantly between groups. In the AMC group 41.1% reported education in grades 6-9, 39% beyond high school, and 20.5% received no education compared to 58.5%, 29% and 12% in the YPP group, respectively (Table 1).</div></div><div><h3>Conclusions</h3><div>These results suggest reproductive health knowledge may serve as a protective variable against teen pregnancy. Though a majority of nulliparous teens reported receiving education after high school or no education at all. Interestingly, students are taught reproductive anatomy, but these concepts are not revisited at later grade levels (10-12) when adolescents may be more likely to engage in sexual activity. Despite health education being implemented in schools, the delivery and delivery timing may be ineffective. These conclusions are limited by the cross-sectional design of the study but strengthened by a racially and ethnically diverse sample population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 256"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"53. Implementation of an Enhanced Recovery After Surgery Pathway in Adolescent Patients Undergoing Laparoscopic Evaluation of Endometriosis","authors":"Lauren Roth ,&nbsp;Madeline Ross ,&nbsp;Ashli Lawson ,&nbsp;Todd Glenski ,&nbsp;Emily Weisberg","doi":"10.1016/j.jpag.2025.01.086","DOIUrl":"10.1016/j.jpag.2025.01.086","url":null,"abstract":"<div><h3>Background</h3><div>In July 2023, a multi-disciplinary team from a tertiary children's hospital implemented an enhanced recovery after surgery (ERAS) pathway to standardize care and improve the perioperative experience for adolescents undergoing diagnostic laparoscopy for endometriosis. Pathway components include pre-operative gynecologic and anesthesia visits, intraoperative multimodal analgesia, and postoperative management (Fig 1 &amp; 2). This study aimed to (1) assess perioperative compliance to the Endometriosis ERAS pathway, and (2) evaluate patient metrics as indicators for pathway efficacy pre- and post- pathway implementation.</div></div><div><h3>Methods</h3><div>This was an IRB approved, single-site study of patients aged 12-20 undergoing laparoscopy for endometriosis. Data was collected from 6/2022-6/2023 (pre-ERAS) and 8/2023- 8/2024 (post-ERAS). To assess pathway compliance (aim 1) the rates of preoperative prescription, referral placement, day of surgery preoperative medication, preoperative carbohydrate loading, intraoperative anesthesia bundle, and postoperative prescriptions were measured. Post Anesthesia Care Unit (PACU) length of stay, discharge pain score, and patient concerns (ER visit, phone call/message, or readmissions) were interpreted as surrogate metrics for pathway efficacy (aim 2) and were analyzed pre and post intervention using independent t-tests and Chi squared/Fisher's exact tests. All data analysis was performed using SPSS.</div></div><div><h3>Results</h3><div>53 patients were included (20 pre and 33 post-ERAS). Mean age was 16.6 years (SD 1.7). Compliance was as follows: 81% preoperative prescriptions, 45% pain management referrals, 33% physical/occupational therapy, 76% day of surgery preoperative medications, 39% preoperative carbohydrate load, 87% intraoperative bundle compliance, and 61% postoperative prescriptions. PACU length of stay, discharge pain scores, and patient concerns were not significantly different pre vs post ERAS.</div></div><div><h3>Conclusions</h3><div>The Endometriosis ERAS pathway was a multidisciplinary team effort and has overall high compliance but leaves room for improvement in some facets (particularly specialty referrals and preoperative carbohydrate loading). While our data does not show improved patient metrics in the pre vs post pathway group, this is likely reflective of our efforts to emulate this pathway in the year leading up to implementation. Future directions include: analyzing a pre-ERAS group more remote from the pathway start date, revisiting the multidisciplinary team to see what barriers exist to improve compliance, and eliciting qualitative feedback from patients about their perspective.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 254-255"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}