Women's health reports (New Rochelle, N.Y.)最新文献

{"title":"Investigation of Thyroid Disorders in Women with Diabetes in the United Arab Emirates: A Retrospective Cross-Sectional Study.","authors":"Bashair M Mussa, Narjes Saheb Sharif-Askari, Nabil Sulaiman, Salah Abusnana","doi":"10.1089/whr.2024.0136","DOIUrl":"10.1089/whr.2024.0136","url":null,"abstract":"<p><strong>Aim: </strong>The present study aims to investigate thyroid disorders (TDs) in women with diabetes mellitus (DM) and the correlation, if any, between TDs and development of hypertension in this group of patients.</p><p><strong>Methods: </strong>The present study is a retrospective cross-sectional study that was conducted in the United Arab Emirates. Women with DM were randomly selected from the electronic medical records database, and 429 patients were included in the study. The investigation included age, diabetes duration, body mass index, blood pressure, hemoglobin A1c, fasting and random glucose, lipid profile, thyroid function test, and levels of thyroid-stimulating hormone. In addition, the antidiabetic medications used by patients with DM were analyzed.</p><p><strong>Results: </strong>The majority of the studied population (90%, n = 386) had type 2 DM and 33% (n = 142) had TDs; 42% participants with thyroid dysfunction had hypertension compared with 57% participants with normal thyroid function (odds ratio 0.57; 95% confidence interval 0.33-0.97; <i>p</i> = 0.039). It was also found that a smaller number of patients with DM who use pioglitazone as a main antidiabetic medication had thyroid dysfunction (1.4%), whereas participants who used liraglutide were more vulnerable to develop TDs (16.9%).</p><p><strong>Conclusions: </strong>Two-thirds of women with DM and TDs had hypothyroidism; 42% of women with DM and TDs had hypertension. Liraglutide was seen more in patients with TDs compared with pioglitazone suggesting a potential correlation between TDs and the use of Glucagon-Like Peptide (GLP-1) analogues.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"161-168"},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and Integration of a Hospital-Wide Postpartum Hypertension Clinic.","authors":"Aida Roman, Erika Faircloth, Joseph Tortora, Elizabeth Deckers, Melissa Ferraro-Borgida, Stephanie Saucier","doi":"10.1089/whr.2024.0149","DOIUrl":"10.1089/whr.2024.0149","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity and mortality in the United States with an increased risk for hospital readmission and cardiovascular disease. The American College of Obstetricians and Gynecologists recommends that women with severe HDP follow-up within 72-hours post-discharge after childbirth. The purpose of this study is to evaluate if a postpartum hypertension (PPHTN) clinic improves follow-up and management.</p><p><strong>Methods: </strong>Retrospective chart review of a referred cohort in a single-center, tertiary care hospital in Hartford, Connecticut. This study included women with severe HDP who were referred to the PPHTN clinic between March 2022 to February 2023. Primary outcomes were the percentage of patients seen within 72-hours postdischarge of hospitalization, percentage of patients achieving goal blood pressure (BP) (<130/80) at first and last follow-up visits, and hospital readmission rate. Secondary outcomes included the percentage of patients receiving HDP education materials, automatic BP cuff upon discharge from hospitalization, and antihypertensive medications prescribed postpartum.</p><p><strong>Results: </strong>Our cohort had 157 women with a mean age of 32 years old (19-44), mean body mass index (BMI) 32 kg/m² (16-49), and were 39% White, 24% African American, and 33% Hispanic. Comorbidities included 41% nulliparity, 19% gestational diabetes, 23% HTN, 28% gestational HTN and 10% prior preeclampsia. Among the women seen in the clinic, 53% were observed within 72 hours, 28% achieved their goal BP at first visit, and 58% achieved their goal BP at subsequent visits. Hospital readmission occurred in 5% of women. Overall, 86% received HDP education and 89% had or were prescribed a BP cuff upon discharge. Lastly, 85% were discharged on antihypertensives and 60% required antihypertensive modification postpartum.</p><p><strong>Conclusion: </strong>Our initiative significantly improved the percentage of patients observed within 72 hours of discharge and facilitated longitudinal follow-up. Future analysis is needed to evaluate readmission rate reduction and the cost-effectiveness of the PPHTN clinic.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"169-177"},"PeriodicalIF":1.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis Among Surgical Specimens in Gabon: A 35-Year Retrospective Study.","authors":"Irène Pegha-Moukandja, Sydney Maghendji-Nzondo, Jean Engohang-Ndong, Sidonie Nguindzi-Ogoula, Euloge Ibinga, Gabrielle Atsame-Ebang, Géremy Abdoul Koumbadinga, Ophilia Makoyo, Ludjer Mpiga-Ekambo, Jean Bernard Lekana-Douki, Edgard Brice Ngoungou","doi":"10.1089/whr.2023.0154","DOIUrl":"10.1089/whr.2023.0154","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a chronic inflammatory gynecological disease affecting many women worldwide. In Gabon, data on this disease has never been published. Created in 1978, the laboratory of the Department of Pathological Anatomy at the University of Health Sciences was the only laboratory for histological analysis throughout all the country until 2009.</p><p><strong>Methods: </strong>A descriptive and analytical retrospective study was conducted using data from the medical records of women whose operation specimen samples were examined between 1987 and 2022.</p><p><strong>Results: </strong>A total of 6666 files were collected for the period between 1987 and 2022. The mean age of the patients was 38.0 ± 10.8 years. The proportion of endometriosis between 1987 and 2022 was 7.3% [6.7-7.9]. The year 2004 had the highest prevalence (23.2%). Endometriosis was significantly elevated in patients aged 36 to 50 years (10.8%), followed by those aged 51 years and over (9.6%) (<i>p</i> < 0.001). The uterus was the most resected surgical part (40.3%) and the most affected organ (72.6%). Malignant (23.9%) and benign (51.4% including 29.6% leiomyomas) tumors were the most common pathologies. In the final model, age, in particular the groups of [35-50 years] (OR = 11.4 (95% CI [2.8-46.5]) and [51-89 years] (OR = 11.2 (95% CI [2.7-46.1]), salpingitis (OR = 2.6 (95% CI [2.1-3.3]), and benign tumors (OR = 1.3 (95% CI [1.1-1.6]) were risk factors for the occurrence of endometriosis.</p><p><strong>Conclusion: </strong>This study is the first published study, which reveals that endometriosis is a health issue in Gabon. In order to better characterize this pathology in the country, it would be wise to conduct prospective studies, including Knowlege Attitude and Pratice's (KAP) studies.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"190-198"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race/Ethnicity, Human Papillomavirus Vaccination Status, and Papanicolaou Test Uptake Among 27-45-Year-Old Women: A Cross-Sectional Analysis of 2019-2022 Behavioral Risk Factor Surveillance System Data.","authors":"Elinita Pollard, Minjee Lee, Alice W Lee, Mary A Gerend, Meng-Han Tsai","doi":"10.1089/whr.2024.0170","DOIUrl":"10.1089/whr.2024.0170","url":null,"abstract":"<p><strong>Purpose: </strong>The human papillomavirus (HPV) vaccine was recently approved for 27-45-year-olds. We examined the association between HPV vaccination status and having an up-to-date Papanicolaou (Pap) test for 27-45-year-old women across racial/ethnic groups.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using 2019-2022 Behavioral Risk Factor Surveillance System data. We performed weighted multivariable logistic regressions to examine the association between being unvaccinated, initiating, and completing the HPV vaccine series and Pap test uptake.</p><p><strong>Results: </strong>Among 7,052 women, non-Hispanic White (NHW) women had the highest rate of HPV vaccine series completion (14.0%). Non-Hispanic Black (NHB) had the lowest rate of HPV vaccine series completion (9.2%) and the highest rate of up-to-date Pap tests (71.2%). Non-Hispanic Other (NHO) women had the lowest rate of up-to-date Pap tests (52.1%). Completing the HPV vaccine series was associated with increased odds of having an up-to-date Pap test (odds ratio [OR]: 1.66 95% confidence interval [CI]: 1.23-2.24). Among Hispanic and NHW women, HPV vaccine series completion was associated with increased odds of up-to-date Pap testing (Hispanic: OR: 2.16, 95% CI: 1.02-4.58; NHW: OR: 1.49, 95% CI: 1.01-2.21). HPV vaccine series initiation was associated with up-to-date Pap tests for NHB (OR: 2.75, 95% CI: 1.19-6.34) and NHO women (OR: 3.15, 95% CI: 1.56-6.37).</p><p><strong>Conclusions: </strong>Unvaccinated women had decreased odds of up-to-date Pap testing. Shared clinical decision-making should be utilized to help 27-45-year-old women decide if they want to receive the HPV vaccine; culturally tailored efforts should be made to improve utilization of Pap testing across racial/ethnic groups.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"178-189"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder.","authors":"Samantha Girasulo, Caro Maltz, Maggie Weichert, Joy S Kaufman, Amanda Mele, Karen Hunkele, Kimberly A Yonkers, Nancy Byatt, Ariadna Forray","doi":"10.1089/whr.2024.0142","DOIUrl":"10.1089/whr.2024.0142","url":null,"abstract":"<p><strong>Objective: </strong>To assess the specific barriers and facilitators for pregnant individuals who have an opioid use disorder (OUD) receiving perinatal care.</p><p><strong>Methods: </strong>We conducted key informant interviews with patients who received care from obstetric clinicians who had been trained to provide medication for opioid use disorder (<i>n</i> = 16). We asked patients about the care they received for their OUD, the quality of communication with their perinatal care team, and any recommendations for improving OUD care. Two staff independently coded transcripts, and we used content analysis to identify themes.</p><p><strong>Results: </strong>Our analysis resulted in three main facilitators that support participants receiving care from their obstetric clinician: (1) positive relationship with supportive and nonjudgmental clinician; (2) access to medication for opioid use disorder (MOUD); and (3) access to therapeutic and peer supports. Patients noted that nonjudgmental clinicians provided a care environment where they felt safe, did not experience stigma, and felt they could be active participants in their care. Patients also expressed that access to MOUD and clinical and supportive services were beneficial components of perinatal care. The main barriers identified included lack of access to transportation, long wait times for treatment programs, and difficulty accessing MOUD.</p><p><strong>Conclusions: </strong>The results of this study suggest that increased obstetric provider education about OUDs and providing trauma-informed care for pregnant individuals who have an OUD may help reduce barriers to accessing care and increase satisfaction with care for this population. Furthermore, the present study suggests obstetricians provide in-house access to MOUD, if possible, or assist patients with referrals to care, as these may reduce the structural barriers patients face.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"155-160"},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Analysis and Literature Review of 26 Patients with Hematological Malignancies During Pregnancy.","authors":"Jie Ma, Huimin Zhu, Ling Li, Hui Ma, Bo Zheng","doi":"10.1089/whr.2024.0164","DOIUrl":"10.1089/whr.2024.0164","url":null,"abstract":"<p><strong>Background: </strong>The hematological malignancies during pregnancy are rare and lethal.</p><p><strong>Objective: </strong>The aim of this study is to demonstrate the incidence, clinical characteristics, treatment, and outcome of hematological malignancies diagnosed during pregnancy.</p><p><strong>Methods: </strong>This is a retrospective study of women who were diagnosed with hematological malignancies during pregnancy at an academic hospital between 2001 and 2021.</p><p><strong>Results: </strong>The incidence rate of 26 pregnant women with hematological malignancies in the pregnant patients admitted to the hospital was about 0.07%. Except for one patient who was diagnosed before pregnancy, the incidence rates of the first, second, and third trimesters of pregnancy were 12% (3/25), 48% (12/25), and 40% (10/25), respectively. Eleven out 26 patients (42.3%) finally gave birth to fetuses. In a long-term follow-up, the survival time of patients with leukemia in pregnancy was shorter than lymphoma (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>This report provides a comprehensive description of maternal and infant outcomes and insights into the management of hematological malignancies during pregnancy.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"147-154"},"PeriodicalIF":1.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Disparities in COVID-19 Survivors with Impaired Quality of Life, Effort Intolerance, and Cardiopulmonary Symptoms: A Prospective Cohort Study.","authors":"Krista Zachariah, Dustin Wessells, Prianca Tawde, Mahniz Reza, Caitlin Chiu, Pablo Villar Calle, Alexander Volodarskiy, Evelyn M Horn, Parag Goyal, Jonathan Weinsaft, Jiwon Kim","doi":"10.1089/whr.2024.0131","DOIUrl":"10.1089/whr.2024.0131","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have suggested gender differences in COVID-related outcomes that have the potential to impact cardiovascular risk. We aimed to investigate gender differences on short- and long-term effects of COVID-19 infection.</p><p><strong>Methods: </strong>Patients hospitalized with COVID-19 infection were enrolled in an ongoing prospective registry across NY-Presbyterian networks, which encompassed same-day echocardiogram, cardiac magnetic resonance (CMR), 6-minute walk test, and quality of life assessment 1 year following acute COVID hospitalization.</p><p><strong>Results: </strong>In this prospective cohort of 213 hospitalized patients with COVID-19 infection, males were more likely to require intensive care unit (ICU) stay (13.6 vs. 3.6%; <i>p</i> = 0.009) and oxygen supplementation (40.8 vs. 26.4%; <i>p</i> = 0.026), paralleling higher rates of elevated troponin, C-reactive protein, ferritin, and D-dimer (<i>p</i> < 0.05 for all). In contrast, 1 year following COVID hospitalization, females reported worse physical function and fatigue on Patient-Reported Outcomes Measurement Information System (PROMIS) scale (<i>p</i> < 0.05 for all). Additionally, 6-minute walk distance was less in females than males (383.0 ± 98.0 vs. 428.6 ± 78.6 m; <i>p</i> = 0.006), and Borg dyspnea score was nearly twofold higher in females vs. males (2.0 ± 2.3 vs. 1.0 ± 1.5; <i>p</i> < 0.001). With respect to imaging parameters, females had higher left ventricle and right ventricle ejection fraction (<i>p</i> < 0.05 for all) with smaller infarct size (<i>p</i> = 0.042) on CMR.</p><p><strong>Conclusion: </strong>Whereas males have greater morbidity during acute COVID hospitalization, females are disproportionately impacted by post-COVID impaired functional status despite higher biventricular ejection fraction and smaller infarct size.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"129-135"},"PeriodicalIF":1.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Gestational Diabetes Mellitus, Postpartum Depression, and Hypertension Affecting Pregnancies in Rural Ohio.","authors":"Amber M Healy, Mallory Faherty, Jordan Ackerman, Blake Leeds, Mandy Morell, Rachel Kim, Andrew Ackerman, Jody M Gerome","doi":"10.1089/whr.2024.0137","DOIUrl":"10.1089/whr.2024.0137","url":null,"abstract":"<p><strong>Objective: </strong>Determine if diagnosis of gestational diabetes mellitus (GDM) increases the incidence of postpartum depression (PPD) in rural Appalachian Ohio.</p><p><strong>Methods: </strong>A retrospective chart review was conducted to review pregnancies between February 2020 and March 2023 to look for diagnoses of gestational diabetes and PPD.</p><p><strong>Results: </strong>The population studied showed that 5.41% of pregnancies were affected by gestational diabetes, 7.76% of pregnancies had associated PPD, and 1.26% had both. Hypertension incidence that was a secondary data point in this study showed that 20.4% of pregnancies were affected by a form of hypertension.</p><p><strong>Conclusions: </strong>Incidence of gestational diabetes and PPD were similar in this population to the rest of the United States and occurred together at low rates. Hypertension was a more common condition that affected pregnancies in this population.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"122-128"},"PeriodicalIF":1.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How and What Do Women Learn About Contraception? A Latent Class Analysis of Adolescents and Adult Women in Delaware.","authors":"Mónica L Caudillo, Fatima Zahra, Michael S Rendall","doi":"10.1089/whr.2024.0064","DOIUrl":"10.1089/whr.2024.0064","url":null,"abstract":"<p><strong>Background: </strong>Across the reproductive life course, women receive information about contraception that may influence their contraceptive behaviors. This study examines the information sources that adolescents and older women combine to acquire information about contraception.</p><p><strong>Methods: </strong>A state-representative survey of women aged 18-44 residing in Delaware, US, in 2017 asked from what sources respondents recently learned about contraception and the type of information obtained. The 2017 Delaware Youth Risk Behavior Survey, representative of public high school students aged 14-18, included analogous questions. Latent class analysis was applied to classify respondents in both samples of adolescents (<i>n</i> = 1253) and adult women (<i>n</i> = 1008) according to the information sources they combined. We estimated multinomial logistic regressions to assess the demographic and reproductive history predictors of using each of the information source repertoires and binomial logistic regressions to analyze their relationship to the information acquired.</p><p><strong>Results: </strong>Adolescents are more likely than adults to report having recently acquired any information about contraception (76% vs. 64%), but they are more likely to rely primarily on a single source. In contrast, adult women are more likely to combine multiple sources. Age, education, and sexual activity emerged as important predictors of information source repertoires. Adults who combine information sources and adolescents who learn mainly from health care providers or school personnel report the greatest breadth in the contraception-related information acquired.</p><p><strong>Conclusion: </strong>Interventions to provide or improve contraceptive knowledge may be more effective if they account for how women use and combine information sources, particularly at different stages of their reproductive lives.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"136-146"},"PeriodicalIF":1.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Providing Gynecological Procedures in Primary Care: A Survey of Canadian Academic Family Physicians.","authors":"Parisa Rezaiefar, Douglas Archibald, Monisha Kabir, Susan Humphrey-Murto","doi":"10.1089/whr.2024.0098","DOIUrl":"10.1089/whr.2024.0098","url":null,"abstract":"<p><strong>Purpose: </strong>Globally, there is a lack of access to health care providers who offer gynecological procedures. Understanding the practice patterns of academic family physicians (AFPs) and whether additional training impacts the provision of care is critical. This study surveys the practice patterns of AFPs regarding gynecological procedures offered, identifies barriers, and explores the impact of additional training.</p><p><strong>Methods: </strong>We circulated an anonymous, cross-sectional survey to all 17 family medicine programs across Canada, receiving responses from 71 AFPs. We computed descriptive statistics and bivariate associations.</p><p><strong>Results: </strong>A total of 71 respondents from five universities participated. Most participants (97.2%) performed Papanicolaou (Pap) smears; 67.6% provided intrauterine device (IUD) insertion, and only 54.9% offered endometrial biopsy. Numbers decreased significantly for routine pessary care (29.5%), punch biopsy of the vulva (15.5%), and pessary fitting (5.6%). Eighteen participants (26.9%) had received enhanced skills training with a certificate of added competence (CAC), of which 55.6% were in women's health. CAC holders in women's health provided IUD insertions (100% vs. 67.3%; <i>p</i> = 0.049, V = 0.28) and endometrial biopsies (90.0% vs. 53.1%; <i>p</i> = 0.036, V = 0.28) at higher rates than general AFPs. Frequently cited barriers to offering gynecological procedures included lack of knowledge, procedural skills, and insufficient patient volumes to maintain competence. During the COVID-19 pandemic, 44% of respondents reported reducing or ceasing to provide Pap smears.</p><p><strong>Conclusions: </strong>Many AFPs in Canada do not provide essential gynecological procedures. This impacts patient access and the training of the next generation of family physicians and thus requires innovative strategies to address the persistent procedural skills educational gap for trainees.</p>","PeriodicalId":75329,"journal":{"name":"Women's health reports (New Rochelle, N.Y.)","volume":"6 1","pages":"102-112"},"PeriodicalIF":1.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}