BMJ Sexual & Reproductive Health最新文献

{"title":"Early medical abortion before missed menses: outcomes of abortion at less than 30 days from last menstrual period.","authors":"Elizabeth April Wheate, John Joseph Reynolds-Wright, Sharon T Cameron","doi":"10.1136/bmjsrh-2024-202534","DOIUrl":"10.1136/bmjsrh-2024-202534","url":null,"abstract":"<p><strong>Introduction: </strong>High-sensitivity urine pregnancy tests can detect pregnancy before missed menses. The widespread availability of these tests, alongside improvements in abortion access in many settings, may mean more women present for abortion at a very early stage of pregnancy. We aimed to examine the outcome of early medical abortion (EMA) in pregnancies less than 30 days from last menstrual period (LMP).</p><p><strong>Methods: </strong>This study analysed prospectively collected data on patients at less than 30 days from LMP seeking abortion at a single service in Edinburgh, UK between March 2020 and December 2023. We determined the effectiveness, outcomes of the pregnancy (complete abortion, ongoing pregnancy, incomplete abortion) and serious complications among those seeking EMA at this gestation.</p><p><strong>Results: </strong>Of 13 565 patients seeking abortion, 78 (0.6%) presented with a self-reported positive home pregnancy test and less than 30 days from LMP. Some 63/78 patients (81%) proceeded to EMA with mifepristone followed by misoprostol. Of this group, 31/63 (49%) had a pre-abortion ultrasound. Complete abortion occurred in 58/63 (92%, 95% CI 82% to 97%), 4/63 (6%) had an ongoing pregnancy and 1 (1%) had a surgical evacuation for incomplete abortion. There were no serious complications.</p><p><strong>Conclusions: </strong>Only a very small percentage of patients present for abortion before a missed period. Nevertheless, EMA at this stage is safe and effective. There may be a higher rate of ongoing pregnancy, and so those patients wishing to proceed to EMA should be advised of the importance of confirming success in line with local protocols.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482228","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}

{"title":"Real world performance of an atraumatic cervical stabiliser for intrauterine device insertion: single centre observational study.","authors":"Sandra Molin, Caroline Rosvall Hansson, Maria Sjöstrand, Sofia Almén, Susanna Henriques","doi":"10.1136/bmjsrh-2025-202949","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202949","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069144","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}

{"title":"Correspondence on \"Sexual and reproductive health clinical consultations: recurrent vulvovaginal candidiasis\" by Horan and Benns.","authors":"Tulika Chouhan, P S Arunakumari","doi":"10.1136/bmjsrh-2025-203026","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-203026","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039070","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}

{"title":"Highlights from the literature.","authors":"","doi":"10.1136/bmjsrh-2024-202601","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202601","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032739","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}

{"title":"In reproductive health policy and access, Canada is not the 51st US state.","authors":"Laura Schummers, Wendy V Norman","doi":"10.1136/bmjsrh-2025-202912","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202912","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943555","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}

{"title":"'Problem representations' in post-abortion contraception: a critical review of UK literature.","authors":"Marie Larsson, Jeni Harden, John Joseph Reynolds-Wright, Sharon Cameron, Nicola Boydell","doi":"10.1136/bmjsrh-2025-202887","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202887","url":null,"abstract":"<p><strong>Objective: </strong>To critically review post-abortion contraception literature from the UK based on Bacchi's 'What's the Problem Represented to Be?' (WPR) approach.</p><p><strong>Methods: </strong>A systematic search of six electronic databases - complemented by a grey literature search encompassing reports, policy documents and government publications - identified a total of 31 publications: 19 peer-reviewed articles and 12 items of grey literature.</p><p><strong>Results: </strong>Multiple - and sometimes conflicting - 'problem representations' coexisted across the texts, operating at different levels of abstraction. Applying the WPR approach, six 'problems' were identified: existing abortion rates and repeat abortion; risky groups; meeting service users' needs; organisational capacity; knowledge of contraceptive methods; and abortion stigma.</p><p><strong>Conclusions: </strong>While some problem representations focused on service user needs, care satisfaction and organisational capacity, the dominant framing positioned abortion rates - particularly subsequent abortions - as the central 'problem'. It is implied that too many abortions are being had and that a key purpose of post-abortion contraception is to address this issue. Abortion was often framed as an individual's failure to use (effective) contraception (correctly). This places the burden on individuals, further exacerbates abortion stigma and obscures structural constraints. Several conceptual slippages were identified, including using 'unplanned', 'unintended' and 'unwanted' pregnancy synonymously. Such practices risk collapsing and misrepresenting different kinds of lived experiences, creating barriers to the provision of person-centred abortion and contraceptive care. We recommend greater critical reflection on the language and assumptions within post-abortion contraception discourse to ensure research, policy and practice remain person-centred, evidence-informed and committed to principles of reproductive justice.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943579","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}

{"title":"Collaboration between the independent sector and the National Health Service to improve patient access to surgical abortion.","authors":"Yvonne Neubauer","doi":"10.1136/bmjsrh-2025-202888","DOIUrl":"10.1136/bmjsrh-2025-202888","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882199","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}

{"title":"Pain management for medical abortion beyond 12 weeks of gestation: a cross-sectional study in Sweden.","authors":"Johanna Rydelius, Helena Kopp Kallner, Ove Karlsson, Helena Hognert, Kristina Gemzell-Danielsson","doi":"10.1136/bmjsrh-2024-202691","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202691","url":null,"abstract":"<p><strong>Background: </strong>Medical abortion beyond 12 weeks' gestation increases experienced pain. The effectiveness of pain management protocols remains to be evaluated.</p><p><strong>Methods: </strong>This was a secondary analysis of a randomised controlled trial, conducted in six Swedish hospitals from 2019 to 2022, investigating home administration of the first misoprostol dose. Paracetamol 1000 mg and a non-steroidal anti-inflammatory drug (NSAID) were provided with the first misoprostol dose and subsequent breakthrough pain medication as required. We recruited persons >18 years of age, with a viable singleton pregnancy between 12 weeks+1 day and 21 weeks+6 days of gestation. We collected data on patient-reported pain using a visual analogue scale (VAS, 0-100 mm) at fetal expulsion and maximum pain assessed retrospectively prior to discharge. We collected data on the use of breakthrough pain medication, satisfaction scores with pain relief, and VAS scores before/after administration of breakthrough analgesia.</p><p><strong>Results: </strong>We included 425 individuals. The participants reported a mean VAS of 39.1 (SD 34.4) at expulsion and 65.4 (SD 28.6) as maximum pain (assessed after abortion before discharge) and 352/425 (82.8%) received breakthrough pain medication, with 266/425 (62.6%) receiving an oral opioid, 163/425 (38.4%) a paracervical block (PCB) and 86/425 (20.2%) a parenteral opioid. A total of 357/392 (91.1%) participants were satisfied with the pain relief. Administration of a PCB alone or following an opioid resulted in the largest decrease in VAS.</p><p><strong>Conclusions: </strong>Many participants reported high VAS scores but most of them were satisfied with their analgesic treatment. A PCB was associated with the highest effectiveness in alleviating pain.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820641","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}

{"title":"Distinguishing between fertility awareness-based methods, digital contraception and period tracking apps: the importance of language in contraception research.","authors":"Eleonora Benhar, Danielle Perro, Raoul Scherwitzl, Alice Pelton, Melanie Davis-Hall, Michelle Griffin, Kerry Krauss, Elina Berglund-Scherwitzl","doi":"10.1136/bmjsrh-2025-202789","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202789","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820640","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}

{"title":"Sexual and reproductive health clinical consultations: Contraception and HIV antiretroviral therapy.","authors":"Sian Pearson, Nadi Gupta","doi":"10.1136/bmjsrh-2024-202602","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202602","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688970","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}