BMJ Sexual & Reproductive Health最新文献_第2页

Sexual and reproductive health clinical consultations: problematic bleeding with the implant. 性健康和生殖健康临床咨询：植入物出血问题。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202423

Eloise Mary Aikin Smellie, Jayne Kavanagh

引用次数: 0

Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study. COVID-19 大流行对瑞典南部出生和人工流产的影响：一项基于登记的研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2023-202162

Jesse D Thacher, Andreas Vilhelmsson, Annelise J Blomberg, Lars Rylander, Anna Jöud, Lone Schmidt, Charlotte Ørsted Hougaard, Eva Elmerstig, Ditte Vassard, Kristina Mattsson

{"title":"Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study.","authors":"Jesse D Thacher, Andreas Vilhelmsson, Annelise J Blomberg, Lars Rylander, Anna Jöud, Lone Schmidt, Charlotte Ørsted Hougaard, Eva Elmerstig, Ditte Vassard, Kristina Mattsson","doi":"10.1136/bmjsrh-2023-202162","DOIUrl":"10.1136/bmjsrh-2023-202162","url":null,"abstract":"Background: Pandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic and reproductive decisions, specifically to identify potential changes in the frequency of deliveries and induced abortions in Skåne, Sweden.Methods: Using the Skåne Healthcare Register, we identified women aged 15-45 years who had at least one pregnancy-related care visit registered between 1 January 2013 and 11 November 11 2021. Deliveries and induced abortions were identified, and changes in weekly delivery and abortion counts were assessed using an interrupted time series design. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated from a Poisson regression model.Results: During the study period we identified 129 131 deliveries and 38 591 abortions. Compared with the counterfactual (exposed interval assuming COVID-19 had not occurred), pandemic exposure was associated with fewer deliveries (RR 0.93; 95% CI 0.89 to 0.98). For abortions, pandemic exposure appeared to be associated with fewer abortions (RR 0.95; 95% CI 0.90 to 1.00); however, age-related differences were found. Among women aged 25 years and over, pandemic exposure was more strongly associated with fewer abortions. Contrastingly, among women aged under 25 years, abortions appeared to increase.Conclusions: The COVID-19 pandemic seemed to have contributed to a decline in births in Southern Sweden. During the same period, abortions declined in women in the older age range, but contrastingly increased among younger women.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"9-17"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006-2010 versus 2017-2019. 随着伴侣获得长效可逆避孕药具（LARC）机会的增加，男性永久避孕的变化：2006-2010 年与 2017-2019 年全国家庭增长调查的分析。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202372

Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw

{"title":"Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006-2010 versus 2017-2019.","authors":"Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw","doi":"10.1136/bmjsrh-2024-202372","DOIUrl":"10.1136/bmjsrh-2024-202372","url":null,"abstract":"Objective: Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.Study design: We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006-2010 (early) and 2017-2019 (recent) waves.Results: We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.Conclusion: Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"43-50"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Centring women's voices in contraceptive innovation: building the case for an on-demand, pericoital pill. 将妇女的声音集中到避孕创新中：为按需服用的围产期避孕药提供依据。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202510

GIlda Sedgh, Laura J Frye, Kristina Gemzell-Danielsson, Nathalie Kapp, Kayode Afolabi, Angela A Boateng, Mary Mulombe-Phiri, Sharon Cameron, Kanya Manoj, Kirti Iyengar, Abigail Grace Winskell, Kristen M Little, Susannah Gibbs, Eden Demise, Stephen Bell

引用次数: 0

Local anaesthesia for pain control in surgical abortion before 14 weeks of pregnancy: a systematic review. 妊娠 14 周前手术流产中局部麻醉止痛：系统综述。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202437

Regina Renner, Madeleine Ennis, Adrienne McKercher, Jillian T Henderson, Alison Edelman

{"title":"Local anaesthesia for pain control in surgical abortion before 14 weeks of pregnancy: a systematic review.","authors":"Regina Renner, Madeleine Ennis, Adrienne McKercher, Jillian T Henderson, Alison Edelman","doi":"10.1136/bmjsrh-2024-202437","DOIUrl":"10.1136/bmjsrh-2024-202437","url":null,"abstract":"Background: Abortions are common and associated with procedural pain. We aimed to evaluate benefits and harms of local anaesthesia given for pain control during surgical abortion at less than 14 weeks' gestation.Methods: We searched a systematic review on local anaesthesia for pain control for surgical abortion at less than 14 weeks' gestation using uterine aspiration. We searched multiple databases through December 2022. We evaluated study quality using the Cochrane Risk of Bias 2 (RoB2) instrument and assessed the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Outcomes included intraoperative pain (with dilation, aspiration or procedure), patient satisfaction and adverse events.Results: Thirteen studies with 1992 participants met the inclusion criteria and the majority were judged as low risk of bias. Intervention protocols were heterogeneous, limiting meta-analysis. A 20 mL 1% lidocaine paracervical block (PCB) reduced pain with dilation compared with sham PCB (mean difference (MD) -37.00, 95% CI -45.64 to -28.36) and aspiration (MD -26.00, 95% CI -33.48 to -18.52; 1 randomised controlled trial (RCT), n=120; high-certainty evidence). A PCB with 14 mL 1% chloroprocaine was associated with a slight reduction in pain during aspiration compared with normal saline PCB injected at two or four sites (MD -1.50, 95% CI -2.45 to -0.55; 1 RCT, n=79; high-certainty evidence). Other RCTs compared a range of local anaesthetic types, PCB techniques and topical anaesthetics. Participants reported moderately high satisfaction with any type of pain control and studies reported few adverse events that were rarely medication-related.Conclusion: RCT evidence supports PCB efficacy but was inconsistent and of low certainty for topical anaesthesia.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"54-63"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 breast engorgement after second-trimester abortion or loss: a survey of current practice patterns. 二胎流产或流产后乳房胀痛的处理：当前实践模式调查。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202438

Andrea Henkel, Kate A Shaw

引用次数: 0

Self-performed Rh typing: a cross-sectional study. 自行进行的 Rh 分型：一项横断面研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202349

Divya Dethier, Mary Tschann, Meliza Roman, John J Chen, Reni Soon, Bliss Kaneshiro

{"title":"Self-performed Rh typing: a cross-sectional study.","authors":"Divya Dethier, Mary Tschann, Meliza Roman, John J Chen, Reni Soon, Bliss Kaneshiro","doi":"10.1136/bmjsrh-2024-202349","DOIUrl":"10.1136/bmjsrh-2024-202349","url":null,"abstract":"Objective: To evaluate whether patients are capable and willing to self-administer and interpret an EldonCard test to determine their Rh status.Methods: This was a cross-sectional study in Honolulu, HI, USA of pregnancy-capable people aged 14-50 years who did not know their blood type and had never used an EldonCard. Participants independently completed EldonCard testing, determined their Rh type and answered a survey on feasibility and acceptability. Separately, a blinded clinician recorded their interpretation of the participant's EldonCard. When available, we obtained blood type from the electronic health record (EHR). We measured Rh type agreement between participant, clinician and EHR, as well as participant comfort and acceptability of testing.Results: Of the 330 total participants, 288 (87.3%) completed testing. Patients and clinicians had 94.0% agreement in their interpretation of the EldonCard for Rh status. Patient interpretation had 83.5% agreement with EHR while clinician and EHR had 92.3% agreement. Sensitivity of EldonCard interpretation by patient and clinician was 100%. Specificity was 83.2% for patients and 92.2% for clinicians. Two patients (of 117) had Rh-negative blood type in the EHR. The vast majority of participants found the EldonCard testing easy (94.4%) and felt comfortable doing the testing (93.7%). Participants with lower education levels felt less confident (p=0.003) and less comfortable with testing (p=0.038); however, their ability to interpret results was similar to others (p=0.051).Conclusions: Patient-performed Rh typing via the EldonCard is an effective and acceptable option for patients, and could be used as a primary screening test for Rh status.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"36-42"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Foregrounding pain in self-managed early medication abortion: a qualitative study. 早期药物流产自我管理中的疼痛前景：一项定性研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2023-202198

Carrie Purcell, Victoria Louise Newton, Fiona Bloomer, Lesley Hoggart

{"title":"Foregrounding pain in self-managed early medication abortion: a qualitative study.","authors":"Carrie Purcell, Victoria Louise Newton, Fiona Bloomer, Lesley Hoggart","doi":"10.1136/bmjsrh-2023-202198","DOIUrl":"10.1136/bmjsrh-2023-202198","url":null,"abstract":"Objective: To explore experiences of pain in the context of early medical abortion (EMA) in the UK and to guide best practice around anticipatory guidance on pain.Methods: From late 2020 to early 2021, we recruited individuals from across the UK who had undergone abortion during the COVID-19 pandemic to participate in in-depth, semi-structured telephone interviews. A storytelling approach was used and data were analysed thematically using NVivo 12 software.Results: Focused coding and thematic analysis addressed accounts of pain, which were prominent in many interviews. We constructed the following subthemes: expected pain is manageable for some; the problem with unexpected pain; pain (co)produces fear; and problematising 'period-like pain'. The key issue which our analysis draws out is that while EMA pain experience might vary, for some it may be much worse than anticipated. Moreover, the common trope of likening it to 'period pain' can be misleading and a source of additional uncertainty at a potentially already challenging time.Conclusions: For some individuals, pain experienced in EMA will be severe and/or worse than expected. Insufficient preparation for pain can result in extremely negative experiences of EMA. Alongside development of improved analgesia, improvements should be made to anticipatory guidance on pain, particularly for those self-manging EMA at home. Framings of 'period-like pain' do not clarify expectations and should be avoided.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"3-8"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

A post-abortion contraception text-and-call service to support patients to access effective contraception after telemedicine abortion. 提供流产后避孕短信和呼叫服务，以支持患者在远程医疗流产后获得有效的避孕措施。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202391

John Joseph Reynolds-Wright, Sharon T Cameron

{"title":"A post-abortion contraception text-and-call service to support patients to access effective contraception after telemedicine abortion.","authors":"John Joseph Reynolds-Wright, Sharon T Cameron","doi":"10.1136/bmjsrh-2024-202391","DOIUrl":"10.1136/bmjsrh-2024-202391","url":null,"abstract":"Background: Most abortions in Scotland are conducted at home before 12 weeks' gestation using telemedicine. The volume of information given at a pre-abortion consultation may feel overwhelming and contraception may not be prioritised. Telemedicine limits immediate provision of some methods. Pathways to improve access to post-abortion contraception (PAC) are needed.Methods: We piloted a PAC 'text-and-call' service for patients having telemedicine abortion in Edinburgh. Those agreeing to contact were sent a text message 4-6 weeks later. The message offered a follow-up telephone call with a nurse to discuss contraception. An online decision aid was used to support method selection where needed. Rapid access to the chosen method was arranged.Results: During the period February-April 2022, 672 patients accessed abortion care, of whom 427 (64%) agreed to post-abortion text message contact. Most (354/427, 83%) did not respond or declined further contact, and 73/427 (17%) requested a follow-up call.Two participants did not respond to the follow-up call. Most (63/73, 86%) knew what method they wanted prior to the call. Just over half of these patients (34/73, 54%) changed to a higher-effectiveness method than they were currently using and the remainder obtained further supplies of their existing method. Eight participants had not selected a method prior to the call and received structured counselling; five chose long-acting reversible contraception (LARC) but only one subsequently initiated this.Conclusions: This PAC service was taken up by a small proportion of patients but supported a sizeable minority to connect to further contraceptive supplies, half of whom accessed more effective methods.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"51-53"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Acceptability of home-based medical abortion among Hong Kong women undergoing an abortion: a cross-sectional study. 香港人工流产妇女对在家进行药物流产的接受程度：一项横断面研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202360

Ingrid D Lui, Sue Seen Tsing Lo, Jianchao Quan

引用次数: 0