European Journal of Contraception and Reproductive Health Care最新文献_第3页

Safety and accuracy of dating unwanted pregnancies and detecting ectopic pregnancy with the RCOG decision aid without routine ultrasound - a retrospective analysis form a large abortion service. 无常规超声的RCOG决策辅助诊断意外妊娠和异位妊娠的安全性和准确性——一项大型流产服务的回顾性分析。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-01 Epub Date: 2025-02-06 DOI: 10.1080/13625187.2025.2452175

Janina Kaislasuo, Oskari Heikinheimo

{"title":"Safety and accuracy of dating unwanted pregnancies and detecting ectopic pregnancy with the RCOG decision aid without routine ultrasound - a retrospective analysis form a large abortion service.","authors":"Janina Kaislasuo, Oskari Heikinheimo","doi":"10.1080/13625187.2025.2452175","DOIUrl":"10.1080/13625187.2025.2452175","url":null,"abstract":"Background: Evidence suggests routine pre-abortion ultrasound is unnecessary for women with regular menstrual cycles and without symptoms or risk factors for ectopic pregnancy in early gestation.Objectives: We evaluated the safety and accuracy of using the decision aid for early medical abortion without ultrasound developed by the RCOG Abortion Care group in a Finnish setting.Method: Using gestational age (GA) expected by last menstrual period (LMP), cycle irregularities, use of hormonal contraceptives, breastfeeding and self-reported symptoms indicative of possible ectopic pregnancy, women were classified into 'no ultrasound needed' and 'ultrasound needed' with a cut-off of 10 + 0 weeks or 70 days. Findings on US were then evaluated to assess classification accuracy.Results: Between September and December 2023, 494 women attending the abortion clinic at the Helsinki University Hospital were assessed. Correct classification of the necessity of an ultrasound was made in 491/494 (99.4%) cases before the women had a scan. The remaining three cases were one woman with an unexpected GA just above 10 + 0, one asymptomatic ectopic pregnancy and one asymptomatic pregnancy of unknown location with high plasma hCG, diagnosed as a partial molar pregnancy on pathology after diagnostic vacuum aspiration.Conclusions: Use of the structured flowchart developed by the RCOG highly accurately identifies women needing an ultrasound examination. The few cases that would have been undetected highlight the importance of informing women and health care providers about symptoms of ectopic or abnormal pregnancy similar to practices in wanted pregnancies not routinely examined and dated before late first trimester.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"93-96"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257163","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

Mandatory spousal authorisation for abortion: characteristics of countries in which it exists and the potential for modernisation of the law. 配偶对堕胎的强制授权：存在这种授权的国家的特点和法律现代化的潜力。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-01 Epub Date: 2024-12-11 DOI: 10.1080/13625187.2024.2434844

Sam Rowlands

{"title":"Mandatory spousal authorisation for abortion: characteristics of countries in which it exists and the potential for modernisation of the law.","authors":"Sam Rowlands","doi":"10.1080/13625187.2024.2434844","DOIUrl":"10.1080/13625187.2024.2434844","url":null,"abstract":"Purpose: Spousal authorisation for abortion (SA) is in direct conflict with the right to bodily autonomy. The World Health Organisation guideline on abortion specifically recommends that abortion should be available on request without third-party authorisation. The objectives of this study were to: a) determine which countries insist by law on SA, b) describe shared characteristics of these countries, c) assess the impact of such legislation on access to abortion and d) evaluate the chances of repeal of such laws.Methods: Interrogation of known databases on global abortion laws. Grouping of countries with SA laws according to their characteristics. A literature review of material on how mandatory SA relates to reproductive rights.Results: Fifteen countries were found to require SA. Nine of these countries have low freedom and democracy scores. Three South Eastern Asian countries, Japan, South Korea and Taiwan, have high freedom and democracy scores and no dominant religion. Broader studies on third-party authorisation for abortion show delayed access to abortion and emphasise the general principle that it is the healthcare seeker alone whose consent should be required for a health intervention. A qualitative study from Türkiye showed specifically how SA requirements could impair access to abortion.Conclusions: Twelve of the countries do not appear to have the necessary government or societal conditions necessary for abortion law modernisation in the near future. In contrast, Japan, South Korea and Taiwan are prime candidates for immediate liberalisation of their abortion laws.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"104-106"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808474","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

Family planning and contraception in people with multiple sclerosis: perspectives for obstetricians, gynaecologists, and other health care professionals involved in reproductive planning. 多发性硬化症患者的计划生育和避孕：产科医生、妇科医生和其他参与生殖计划的医护人员的观点。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-01 Epub Date: 2024-12-16 DOI: 10.1080/13625187.2024.2434843

Gabriele S Merki-Feld, Riley Bove, Lisa B Haddad, Kerstin Hellwig, Jan Hillert, Maria Houtchens, Melinda Magyari, Scott Montgomery, Manuela Simoni, Egon Stenager, Heidi Thompson, Zeliha Tulek, Kurt Marhardt, Rossella E Nappi

{"title":"Family planning and contraception in people with multiple sclerosis: perspectives for obstetricians, gynaecologists, and other health care professionals involved in reproductive planning.","authors":"Gabriele S Merki-Feld, Riley Bove, Lisa B Haddad, Kerstin Hellwig, Jan Hillert, Maria Houtchens, Melinda Magyari, Scott Montgomery, Manuela Simoni, Egon Stenager, Heidi Thompson, Zeliha Tulek, Kurt Marhardt, Rossella E Nappi","doi":"10.1080/13625187.2024.2434843","DOIUrl":"10.1080/13625187.2024.2434843","url":null,"abstract":"Purpose: Multiple sclerosis (MS) is often diagnosed in people of reproductive age. However, family planning counselling is not always integrated within MS care. Decisions on family planning can be further complicated by potential side effects associated with several disease-modifying therapies. While neurologists may lack training in contraceptive use and family planning counselling, obstetricians and gynaecologists (OB-GYNs) and other health care professionals involved in reproductive life planning (RHCPs) may lack detailed knowledge and experience around the use of contemporary MS treatments.Material and methods: Through a modified Delphi consensus programme, a multidisciplinary steering committee of 13 international experts developed practical clinical recommendations on contraceptive use and family planning for people with MS (PwMS). This article offers insights to help OB-GYNs and RHCPs implement these recommendations, focusing on contraceptive decision-making and MS medications.Results: The perspectives discussed emphasise providing education on MS to OB-GYNs and other RHCPs, enabling informed counselling for PwMS and their partners regarding contraception and family planning. Close collaboration among the multidisciplinary team, including neurologists, is crucial in providing reproductive care for PwMS.Conclusions: The detailed perspectives provided aim to enable OB-GYNs and other RHCPs to provide informed counselling for PwMS and their partners regarding contraception and family planning.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"59-73"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830656","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

Would it be feasible for European Union countries to implement Safe Access Zones for premises providing abortion services? 欧洲联盟国家在提供堕胎服务的场所实施安全进入区是否可行？

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-01 Epub Date: 2025-02-28 DOI: 10.1080/13625187.2025.2463431

Emily Ottley, Sam Rowlands

{"title":"Would it be feasible for European Union countries to implement Safe Access Zones for premises providing abortion services?","authors":"Emily Ottley, Sam Rowlands","doi":"10.1080/13625187.2025.2463431","DOIUrl":"10.1080/13625187.2025.2463431","url":null,"abstract":"Anti-abortion protestors situated near premises providing abortion services create barriers and hurdles to accessing abortion services, which violates the right of pregnant people to seek sexual and reproductive health services. There has been shown to be a need for Safe Access Zones (SAZs) to guarantee physical access to abortion services without obstruction. SAZs usually operate within a prescribed radius around premises providing abortion services and set out what behaviour is prohibited. The objective of this paper is to present a summary of the international experience of introducing and implementing SAZ laws, and to explain the lessons to be learned from this experience. SAZ legislation has been successfully enacted internationally in 22 jurisdictions (USA excluded). Countries with SAZ laws include Australia, New Zealand, the UK, and parts of Canada. Despite the Parliamentary Assembly of the Council of Europe calling for the introduction of SAZs in 2022, only two European Union (EU) countries have implemented this recommendation so far. On the basis of the medical and legal insights gained from the functioning of SAZs to date, it is the authors' opinion that it would be feasible for the 25 EU countries that do not yet have such zones to legislate for SAZs.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"107-112"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525045","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

Tips and tricks for the management of contraceptive etonogestrel implant in clinical practice: an Expert Opinion. 在临床实践中管理避孕依诺孕酮植入物的提示和技巧：专家意见。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-01 Epub Date: 2024-12-05 DOI: 10.1080/13625187.2024.2434846

Giovanni Grandi, Lia Feliciello, Alice Sgandurra, Valeria Pedrini, Gloria Guariglia, Valentina Ferrari, Nicoletta Del Duca, Antonio La Marca

引用次数: 0

Association of intrauterine device use and risk of abnormal cervical cytology. 宫内节育器使用与宫颈细胞学异常风险的关系。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-04-01 Epub Date: 2025-03-04 DOI: 10.1080/13625187.2025.2453869

Christine M Corrêa, Luiz C Zeferino, Luis Bahamondes

{"title":"Association of intrauterine device use and risk of abnormal cervical cytology.","authors":"Christine M Corrêa, Luiz C Zeferino, Luis Bahamondes","doi":"10.1080/13625187.2025.2453869","DOIUrl":"10.1080/13625187.2025.2453869","url":null,"abstract":"Objective: To determine whether intrauterine device (IUD) use is associated with a significantly increased risk of abnormal cervical cytology.Methods: A retrospective cohort study was carried out at the University of Campinas, Campinas, SP, Brazil. Data came from medical records of 2,963 women from a family planning clinic who had undergone at least one cervical cytology for screening between 1990 and 2017. Women were split into three groups: users of either copper (Cu)- or the levonorgestrel 52 mg-IUD (2,305) and users of other contraceptive methods (658). The dependent variable was the cytological results as normal and abnormal, based on the Bethesda System. The most severe cytological result of each participant was considered and when all her results were normal, the last one was considered.Results: IUD use was associated with a lower risk of abnormal cervical cytology after adjusting for the number of cytology assessments per participant (RR 0.74; 95% CI 0.55;0.99; p = 0.049). Abnormal cervical cytology was more common in women with multiple cytology assessments and a longer duration since sexual debut. For each additional cytology test, the risk increased by 33.8% (p < 0.001), and for every additional year since sexual debut, the risk increased by 6.2% (p < 0.001). A lower incidence of abnormal cervical cytology was observed among women with a history of caesarean delivery, with a 24.9% reduction in risk per additional caesarean (p < 0.001). IUD users underwent more cervical cytology assessments than non-IUD users.Conclusion: We identified low risk of abnormal cervical cytology among IUD users.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"87-92"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544092","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

The SARS-CoV-2 (COVID-19) pandemic and diagnosis and treatment of women with abnormal uterine bleeding: findings from Brazil. SARS-CoV-2 （COVID-19）大流行与子宫异常出血妇女的诊断和治疗：来自巴西的调查结果。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-02-01 Epub Date: 2024-12-11 DOI: 10.1080/13625187.2024.2430285

Ilza Monteiro, Luis Bahamondes, Agnaldo Lopes Silva-Filho, Malcolm G Munro

{"title":"The SARS-CoV-2 (COVID-19) pandemic and diagnosis and treatment of women with abnormal uterine bleeding: findings from Brazil.","authors":"Ilza Monteiro, Luis Bahamondes, Agnaldo Lopes Silva-Filho, Malcolm G Munro","doi":"10.1080/13625187.2024.2430285","DOIUrl":"10.1080/13625187.2024.2430285","url":null,"abstract":"Objective: To determine practice patterns in the diagnosis and management of nongestational abnormal uterine bleeding (AUB) in women in reproductive years during the SARS-CoV-2 (COVID-19) pandemic in Brazil.Materials and methods: A web-based survey was conducted to determine the impact of the COVID-19 pandemic on the diagnosis and management of women with AUB. Survey elements included treatment location, the use of ultrasonography, laboratory evaluation for iron deficiency and some hormone determinations, and endometrial evaluation by histopathology, as well as the practice of hysteroscopy, hysterectomy and medical therapy including the placement of the 52 mg levonorgestrel-intrauterine system (LNG-IUS52). The survey was completed electronically at scientific meetings or sent by e-mail to Brazil-based OBGYNs between April and September 2021 during the COVID-19 quarantine.Results: Fully completed questionnaires were received from 541 physicians aged (mean ± SD) 46.6 ± 12.5 years. Whereas the overall number of AUB-related visits decreased (p < 0.001) compared to the pre-pandemic period, the reduction was in office-based encounters; AUB-related visits at emergency facilities did not change. Telehealth-based AUB consultations increased from 1.3% at pre-pandemic to 34.3% (p < 0.001) during the pandemic. There were significant reductions in the use of diagnostic hysteroscopy (p < 0.001), endometrial biopsy (p < 0.001), therapies with the LNG-IUS52, combined oral contraceptives and hysterectomies (p = 0.002, p = 0.006 and p < 0.001, respectively).Conclusions: In Brazil, during the COVID-19 pandemic, there was a decrease in AUB-related consultations, a slight increase in telehealth visits and a reduction in the use of procedures and treatments.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"49-53"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808477","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

Simultaneous removal of impalpable implants in both the left and the right arm - a case report and implications for their use in low-resource settings. 同时移除左臂和右臂的植入物--病例报告及其在资源匮乏地区使用的意义。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-02-01 Epub Date: 2024-10-16 DOI: 10.1080/13625187.2024.2413615

Norman D Goldstuck, Pumza Mjuleka

引用次数: 0

Feasibility and acceptability of outpatient medical induction at 13-18 weeks' gestation in public sector hospitals in Nepal: a prospective cohort study. 尼泊尔公立医院妊娠 13-18 周门诊引产的可行性和可接受性：一项前瞻性队列研究。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-02-01 Epub Date: 2024-10-30 DOI: 10.1080/13625187.2024.2416054

Anand Tamang, Ilana G Dzuba, Heera Tuladhar, Bhakta Batsal Raut, Sajan Kc, Achala Shrestha, Hillary Bracken, Ingrida Platais, Beverly Winikoff

{"title":"Feasibility and acceptability of outpatient medical induction at 13-18 weeks' gestation in public sector hospitals in Nepal: a prospective cohort study.","authors":"Anand Tamang, Ilana G Dzuba, Heera Tuladhar, Bhakta Batsal Raut, Sajan Kc, Achala Shrestha, Hillary Bracken, Ingrida Platais, Beverly Winikoff","doi":"10.1080/13625187.2024.2416054","DOIUrl":"10.1080/13625187.2024.2416054","url":null,"abstract":"Purpose: To evaluate the feasibility and acceptability of outpatient medical induction at 13-18 weeks' gestation to limit overnight hospital stays.Methods: In this prospective cohort study, participants with 13-18-week pregnancies seeking abortions at two government hospitals swallowed mifepristone 200 mg and self-administered misoprostol 400 mcg buccally 24-48 h later, 1-2 h before returning to the outpatient clinic (OPD). Repeat misoprostol was dosed every 3 h until expulsion. Participants requiring care beyond OPD hours were admitted as inpatients. Acceptability was evaluated by exit interview before discharge. Participants were contacted two weeks later to assess any subsequent issues.Results: Ninety-eight (82%) of 120 participants had successful outpatient abortions using a median two (IQR 2, 3) misoprostol doses. The median induction-to-abortion time was five hours (IQR 4, 7.5). Eleven (9%) participants expelled before clinic arrival. Twenty-two (18%) participants were transferred as inpatients at OPD closing. Transferred participants remained inpatient for a median 18 h (IQR 18, 21.25). There were no serious adverse events and satisfaction with the abortion process was high.Conclusions: Although the outpatient model did not meet statistical expectations, it is clinically feasible, acceptable, and improves efficiency, expands access, and reduces burdens for women and providers. Operational adjustments may facilitate higher outpatient success.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"42-48"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548730","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

Reproductive performance and obstetric outcomes after hysteroscopic septum resection. 宫腔镜下中隔切除术后的生殖性能和产科结局。

IF 1.9 4区医学

European Journal of Contraception and Reproductive Health Care Pub Date : 2025-02-01 Epub Date: 2024-12-13 DOI: 10.1080/13625187.2024.2429381

Elif Aylin Taşkın, Kübra Dilbaz, Didem Demir, Berna Dilbaz, Yaprak Engin Üstün

{"title":"Reproductive performance and obstetric outcomes after hysteroscopic septum resection.","authors":"Elif Aylin Taşkın, Kübra Dilbaz, Didem Demir, Berna Dilbaz, Yaprak Engin Üstün","doi":"10.1080/13625187.2024.2429381","DOIUrl":"10.1080/13625187.2024.2429381","url":null,"abstract":"Purpose: The aim of this retrospective cohort study was to investigate the effects of hysteroscopic uterine septum resection on the clinical pregnancy rate (CPR), live birth rate (LBR) and miscarriage rate.Materials and method(s): Hospital records of consecutive patients who underwent hysteroscopic uterine septum resection between February 2021 and December 2022 were reviewed. They were telephoned and interviewed about their reproductive performance after surgery, and pregnancy outcomes, if achieved.Results and conclusions: Sixty-nine eligible patients were enrolled. Forty-one (59.4%) of these patients were referred to our clinic for otherwise unexplained infertility of at least 1 year and 28 (40.6%) for pregnancy loss. During the follow-up period, 32 patients conceived. The overall CPR was 46.4%, the LBR per woman was 36.2%, the LBR per pregnancy was 78.1% and the miscarriage rate was 12.5%. The LBRs per pregnancy were 83.3% and 71.4% in the infertility and miscarriage subgroups, respectively. The miscarriage rates per pregnancy were 0% and 28.6% in the infertility and miscarriage subgroups, respectively. Three of 6 patients whose uterine septum was incomplete but prominent became pregnant (CPR: 50.0%), and all pregnancies resulted in live birth (LBR per pregnancy:100%, LBR per woman:50%). Two patients with complete uterine septum didn't achieve pregnancy. Hysteroscopic uterine septum resection may improve the CPR, LBR and miscarriage rates in subfertile population with and without previous pregnancy loss.","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":" ","pages":"54-57"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819768","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