European Journal of Contraception and Reproductive Health Care最新文献

Depomedroxyprogesterone acetate impact on mifepristone action during medication abortion. 醋酸去甲羟孕酮对药物流产时米非司酮作用的影响。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-05-14 DOI: 10.1080/13625187.2025.2495601

Mitchell D Creinin, Christy M Boraas

{"title":"Depomedroxyprogesterone acetate impact on mifepristone action during medication abortion.","authors":"Mitchell D Creinin, Christy M Boraas","doi":"10.1080/13625187.2025.2495601","DOIUrl":"https://doi.org/10.1080/13625187.2025.2495601","url":null,"abstract":"Purpose: To evaluate outcomes by gestational duration in patients who did and did not receive depomedroxyprogesterone acetate (DMPA) concurrently with mifepristone for mifepristone-misoprostol medication abortion and estimate the impact of DMPA on mifepristone action.Materials and methods: In this secondary analysis of a retrospective study, we analysed treatment failure and continuing pregnancy as a reason for failure both overall and by gestational duration group. We assessed available literature to estimate that misoprostol alone would result in abortion in approximately 74% of pregnancies without mifepristone and calculated the impact of adding mifepristone to the treatment regimen and of DMPA on these outcomes.Results: More than half of the patients in each group had pregnancies ≤49 days gestation (no DMPA: 432/704 [61.4%]; DMPA 73/141 [51.8%], p = 0.04). Ongoing pregnancy rates increased with advancing gestational duration both with (p = 0.0005) and without (p = 0.04) concomitant DMPA administration. No individual gestational duration group demonstrated a significant difference in outcomes between patients that did and did not receive DMPA, likely because of small numbers in each group. Overall, concomitant DMPA with mifepristone increased the likelihood of an ongoing pregnancy by 25.3% of the expected rate if DMPA completely blocked all mifepristone action but only by 16.1% for patients with pregnancies ≤49 days gestation.Conclusion: Ongoing pregnancy as the reason for medication abortion failure occurs more frequently with advancing gestation in patients that do and do not receive DMPA concurrently with mifepristone. DMPA may impact mifepristone variably by gestational duration, but larger studies are needed.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081742","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}

引用次数: 0

Characteristics, determinants of decision-making process and experience of French men undergoing vasectomy: a cross-sectional multicentric study. 特点，决策过程的决定因素和经验的法国男性输精管切除术：一项横断面多中心研究。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-05-14 DOI: 10.1080/13625187.2025.2496384

S Loubersac, M Chaillot, T Loubersac, A Reignier, T Freour

{"title":"Characteristics, determinants of decision-making process and experience of French men undergoing vasectomy: a cross-sectional multicentric study.","authors":"S Loubersac, M Chaillot, T Loubersac, A Reignier, T Freour","doi":"10.1080/13625187.2025.2496384","DOIUrl":"https://doi.org/10.1080/13625187.2025.2496384","url":null,"abstract":"Purpose: The use of vasectomy varies hugely depending on the countries, even though it is one of the safest and simplest male contraceptive method. In France, its use recently increased. The purpose of this study was to report the characteristics, motivations, decision-making process and experience of French men undergoing vasectomy.Materials and methods: This cross-sectional multicentric study was conducted in 17 French andrology laboratories in 2021-2022. All patients referred for post vasectomy semen analysis were proposed to participate in an online anonymous survey about vasectomy.Results: A total of 541 men were included in the study (56% participation rate). Participants were 41 years old on average and were mostly engaged in a stable relationship. Most of respondents had at least one child and waited >5 years after last birth before vasectomy A total of 134 men (25%) reported a history of unintended pregnancy. Most heard about vasectomy from relatives or media, rarely from doctors or authorities. Although most participants reported concerns about side effects, 81% experienced no side effects in the end of the procedure. The strong support of a partner (76%) appears to be a significant factor in the acceptance of this contraceptive method. A minority of participants had undergone semen cryopreservation before vasectomy.Conclusion: This study contributes to the literature on male contraception, and highlights the history, motivations, experience, but also fears of men undergoing vasectomy.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081741","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}

引用次数: 0

Amniotic fluid embolism in late second trimester abortion: a case report. 晚期妊娠中期流产羊水栓塞1例报告。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-22 DOI: 10.1080/13625187.2025.2486681

Melissa L Wong, Erica Holland, Katharine O White, Elisabeth Woodhams

{"title":"Amniotic fluid embolism in late second trimester abortion: a case report.","authors":"Melissa L Wong, Erica Holland, Katharine O White, Elisabeth Woodhams","doi":"10.1080/13625187.2025.2486681","DOIUrl":"https://doi.org/10.1080/13625187.2025.2486681","url":null,"abstract":"Purpose: Amniotic fluid embolism (AFE) is a rare and catastrophic complication of pregnancy characterised by hypoxia, cardiovascular collapse, and disseminated intravascular coagulation (DIC). Scant literature exists on the prevalence of second trimester AFE or AFE at the time of abortion. Management recommendations specific to these settings are lacking. We present a case of AFE at the time of second trimester abortion.Case: A 32-year-old woman, gravida 4, para 3, presented for induced abortion at 24 weeks and 2 days. Her history was significant for three prior caesarean sections and sleeve gastrectomy. During the dilation and evacuation, the patient developed persistent hypoxia and pulseless electrical activity. The procedure was completed during resuscitation and return of spontaneous circulation (ROSC) was achieved. The patient underwent uterine artery embolisation for persistent uterine bleeding without signs of active extravasation in the setting of DIC. She experienced transient short-term memory loss but was otherwise neurologically intact. AFE was diagnosed based on cardiovascular collapse and DIC out of proportion to haemorrhage.Conclusion: AFE is sparsely described in abortion care. Clinicians must maintain a broad differential and consider AFE at the time of acute collapse in pregnancies greater than 20 weeks gestation. This is especially crucial as abortion bans may increase the incidence of AFE as delayed abortion care may yield an increase in gestational age and maternal morbidity. AFE and thromboembolism are the most likely diagnoses consistent with our case. Future investigation is needed to explore the long-term effects of abortion restrictions on maternal mortality and morbidity.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056366","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}

引用次数: 0

Management of anti-D prophylaxis in RhD negative women undergoing early medical abortion - an international practice survey among practitioners. RhD阴性妇女早期药物流产的抗d预防管理——一项国际实践调查。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-22 DOI: 10.1080/13625187.2025.2486690

Teresa Bombas, Mirella Parachini, Marek Lubusky, Kristina Gemzell-Danielsson, Aubert Agostini, Shanon Cameron, Mary Favier, Sandra Kroeze, Myriam Chebbah, Solenn Le Clanche, Alice-Anaïs Varlet, Linda Verhagen, Christian Fiala

{"title":"Management of anti-D prophylaxis in RhD negative women undergoing early medical abortion - an international practice survey among practitioners.","authors":"Teresa Bombas, Mirella Parachini, Marek Lubusky, Kristina Gemzell-Danielsson, Aubert Agostini, Shanon Cameron, Mary Favier, Sandra Kroeze, Myriam Chebbah, Solenn Le Clanche, Alice-Anaïs Varlet, Linda Verhagen, Christian Fiala","doi":"10.1080/13625187.2025.2486690","DOIUrl":"https://doi.org/10.1080/13625187.2025.2486690","url":null,"abstract":"Aim: We evaluated the current practices of abortion providers giving anti-D prophylaxis to RhD negative women undergoing first trimester medical abortion and factors that influenced the decision. We also examined RhD management strategies that could be safely adopted.Methods: A Steering Committee of abortion providers drafted a questionnaire on anti-D prophylaxis practices and perceptions. The 28-question survey, hosted online from December 2022 to December 2023, targeted international abortion providers.Results: Almost 62% of respondents perform medical abortion during the first trimester (up to 12 weeks of amenorrhoea [WA]), while 32.8% provide it during the second trimester (13 to 26 WA). Among providers, 55.8% administer anti-D prophylaxis to all RhD negative women during first trimester medical abortions, 25.5% provide it selectively, and 18.6% do not administer it at all. Providers who do not administer IgG anti-D rely on national guidelines (51.2%), hospital protocols (16.3%), or both (7.0%), citing early gestational age (36.5%) and insufficient evidence (22.9%) as reasons. The primary reason for administering IgG anti-D was preventing risks in future pregnancies (52.7%). Yet, 59.1% expressed interest in changing their anti-D prophylaxis practices during early abortion.Conclusion: This study highlights the huge variations in anti-D prophylaxis practices during first trimester medical abortion. These discrepancies mirror differences in national and international guidelines and underscore the need for robust clinical evidence to determine the gestational age limits for alloimmunization risk and support protocol updates.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058914","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}

引用次数: 0

Barriers and facilitators for providing pain control during intrauterine device insertion: a multi-center physician survey. 宫内节育器插入过程中疼痛控制的障碍和促进因素：一项多中心医师调查。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-22 DOI: 10.1080/13625187.2025.2460015

Abirami Kirubarajan, Seoyeon Han, Anna Gryn, Priyanka Patel, Zuhal Mohmand, Natalie Morson, Mara Sobel

{"title":"Barriers and facilitators for providing pain control during intrauterine device insertion: a multi-center physician survey.","authors":"Abirami Kirubarajan, Seoyeon Han, Anna Gryn, Priyanka Patel, Zuhal Mohmand, Natalie Morson, Mara Sobel","doi":"10.1080/13625187.2025.2460015","DOIUrl":"https://doi.org/10.1080/13625187.2025.2460015","url":null,"abstract":"Purpose: To evaluate physicians' barriers and facilitators, as well as knowledge, practices, attitudes, and beliefs, regarding analgesia for IUD insertion.Methodology: A multi-center online survey was conducted from January to July 2023 in Ontario, Canada. Data was analysed using descriptive statistics, chi-square tests, ANOVA, and thematic analysis.Results: Among 85 providers who responded to the survey, there was a lack of consensus regarding provision of analgesia for IUD insertion, as only 52.9% routinely provided pain control. The remaining 40 providers (47.1%) stated that they do not routinely provide pain control for IUD insertion, although 87.5% of participants stated that they would provide pain control if the patient specifically requested analgesia. No differences were found between academic and community staff (p = 0.94) or less experienced providers in provision of pain control (p = 0.24). Reasons for provision of pain control included patient comfort, care, and procedure safety. Conversely, other physicians believed the pain was minimal or short-lived, or faced logistical barriers in providing analgesia.Conclusions: Patients and providers should engage in shared decision-making regarding pain control for IUD insertion.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052103","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}

引用次数: 0

Hormonal prolonged-release in oral contraception: how far are we from vaginal pharmacokinetics? 口服避孕药中的激素缓释：我们离阴道药代动力学还有多远？

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-16 DOI: 10.1080/13625187.2025.2485217

Giovanni Grandi

引用次数: 0

Combined oral contraceptive prescription patterns for therapeutic purposes: results from a subanalysis of the multinational PRO-E2 study. 用于治疗目的的联合口服避孕药处方模式：来自多国PRO-E2研究的亚分析结果。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-16 DOI: 10.1080/13625187.2025.2486686

Franca Fruzzetti, Costantino Di Carlo, Vincenzina Bruni, Angelo Cagnacci

{"title":"Combined oral contraceptive prescription patterns for therapeutic purposes: results from a subanalysis of the multinational PRO-E2 study.","authors":"Franca Fruzzetti, Costantino Di Carlo, Vincenzina Bruni, Angelo Cagnacci","doi":"10.1080/13625187.2025.2486686","DOIUrl":"https://doi.org/10.1080/13625187.2025.2486686","url":null,"abstract":"Purpose: To investigate prescription for therapeutic purposes of combined oral contraceptives (COCs) in countries of the PRO-E2 study, with a special focus on Italy.Methods: Therapeutic reasons for prescription of COCs currently approved with no therapeutic the sole contraceptive indication, such as associations of nomegestrol acetate plus oestradiol and levonorgestrel plus ethynylestradiol, were investigated in the overall population (Italy excluded) (n = 71,630) and, separately, the Italian subpopulation (n = 19,683) of PRO-E2 study.Results: COC prescription for contraception only was 38.8% in Italy and 60.8% in the overall population (mainly European countries) (OR = 0.409; 95%CI:0.396-0.423; p < 0.0001). COCs were prescribed for therapeutic purposes and contraception in 44.2% of the Italian subpopulation and 30.2% of the overall population (OR = 1.809; 95%CI:1.752-1.869; p < 0.0001). More women in Italy than the overall population received COCs only for therapeutic purposes (16.7% vs. 6.9%, respectively; OR = 2.694; 95%CI:2.570-2.824; p < 0.0001). Problems related to menstruation, particularly in women aged below 20 or above 40 years, were the most important driver for COC therapeutic use.Conclusion: COCs are extensively used for therapeutic purposes, mostly to manage menstruation-related disorders. This is particularly evident among Italian prescriptions. The widespread therapeutic use of COCs that are licenced only for contraception indirectly proves their efficacy and the need of a formal recognition of their properties.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056368","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}

引用次数: 0

Access to abortion in a cross-border region in the Eastern Pyrenees: the case of Hospital de Cerdanya, between Spanish and French legislation. 东比利牛斯州跨界地区的堕胎情况：西班牙和法国立法之间关于Cerdanya医院的案例。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-11 DOI: 10.1080/13625187.2025.2481966

Aina Delgado-Morell, Maria Paniello Castaño, Laia Graña Llopis, Carla Domínguez Gallardo, Elisa Llurba Olivé

{"title":"Access to abortion in a cross-border region in the Eastern Pyrenees: the case of Hospital de Cerdanya, between Spanish and French legislation.","authors":"Aina Delgado-Morell, Maria Paniello Castaño, Laia Graña Llopis, Carla Domínguez Gallardo, Elisa Llurba Olivé","doi":"10.1080/13625187.2025.2481966","DOIUrl":"https://doi.org/10.1080/13625187.2025.2481966","url":null,"abstract":"In the present debate paper, authors seek to bring attention to the situation regarding abortion access in La Cerdanya - El Capcir, a cross-border region in the Pyrenees between Spain and France. Hospital de Cerdanya (HC) is the first cross-border health centre in Europe. It is placed in a high-altitude isolated mountain region, and the few physicians in town are conscientious objectors. An agreement with a tertiary hospital from Barcelona allows a gynaecologist to commute to the region weekly to guarantee the right of women to access abortion. In 2023, 67 abortions have been performed in HC: 58 pharmacological terminations and 9 surgical abortions. The Hospital protocol is described and data on the performed procedures are reviewed. Since requested until provided, mean time to pregnancy termination has been of 6.79 days. Difficulties in accessing health centres and professionals that women living in isolated areas experiment explain the major disparities among abortion rates in different regions, which are notable in Spain. Abortion rate in La Cerdanya is 13.7‰, showing no statistical difference compared to the global Catalan rate. Experiences such as the one at HC may be of interest in developing new protocols to address territorial inequities related to access to abortion.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057444","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}

引用次数: 0

Real-world use of antispasmodic drugs during IUD insertion - insights from the large observational study EURAS-LCS12. 放置宫内节育器时解痉药物的实际使用情况--大型观察性研究 EURAS-LCS12 的启示。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-04 DOI: 10.1080/13625187.2025.2480086

Lisa Eggebrecht, Manuel Rizzo, Moritz Klinghardt, Tanja Böhnke, Clare Barnett, Klaas Heinemann

引用次数: 0

How to discourage belief-based denial of abortion care. 如何阻止基于信仰的拒绝堕胎护理。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-03 DOI: 10.1080/13625187.2025.2482828

Christian Fiala, Joyce Arthur

引用次数: 0