BMJ Sexual & Reproductive Health最新文献_第6页

Early medical abortion before missed menses: a prospective observational study of outcomes of abortion at less than 30 days from last menstrual period. 未经期前早期药物流产：一项距最后一次月经不到30天流产结局的前瞻性观察研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-02-23 DOI: 10.1136/bmjsrh-2024-202534

Elizabeth April Wheate, John Joseph Reynolds-Wright, Sharon T Cameron

{"title":"Early medical abortion before missed menses: a prospective observational study of 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":"https://doi.org/10.1136/bmjsrh-2024-202534","url":null,"abstract":"Introduction: 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).Methods: 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.Results: 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.Conclusions: 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.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-23","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}

引用次数: 0

Reusable menstrual hygiene products may lead to underdiagnosis of heavy menstrual bleeding: a randomised trial. 可重复使用的月经卫生用品可能导致严重月经出血的诊断不足：一项随机试验。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-02-04 DOI: 10.1136/bmjsrh-2024-202541

Bethany Samuelson Bannow, Katrina Ramsey, Katherine Courchaine, Alison Edelman, Alyssa C Colwill

{"title":"Reusable menstrual hygiene products may lead to underdiagnosis of heavy menstrual bleeding: a randomised trial.","authors":"Bethany Samuelson Bannow, Katrina Ramsey, Katherine Courchaine, Alison Edelman, Alyssa C Colwill","doi":"10.1136/bmjsrh-2024-202541","DOIUrl":"10.1136/bmjsrh-2024-202541","url":null,"abstract":"Background: Clinical diagnosis of heavy menstrual bleeding (HMB) is dependent on patient report of menstrual product usage of pads and tampons, but it is unknown if newer reusable menstrual products (cup and underwear) are similarly diagnostic.Methods: We enrolled 20 regularly menstruating individuals with HMB for two menstrual cycles. Participants completed a retrospective baseline Pictorial Blood loss Assessment Chart (PBAC) at the time of enrolment (eligibility PBAC score ≥100) as well as several different measures with each study cycle. In cycle 1, participants used study-provided disposable pads and tampons. For cycle 2, participants were randomised to menstrual cup or underwear and collected their menstrual fluid on their heaviest 2 days. We compared the two cycles with respect to the weight of menstrual fluid collected and the frequency of product changes and leaks during the heaviest days in cycles 1 and 2, as well as questionnaire responses.Results: Overall, the mean rate of product changes per heaviest day were 5.5 disposable product changes (range 1.5-11), 3.6 cup changes (range 1.3-6.2), and 3.5 underwear changes (range 2.7-6.9). Both groups (cup users and underwear users) reported a median 3.5 leaks (range 1-5) per heaviest day in cycle 2, while using the menstrual cup or underwear.Discussion: Participants reported fewer daily changes of reusable products compared with disposable ones, but more leaks, suggesting that 'rate of product change' with reusable products may result in missed diagnoses of HMB.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944886","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

Response to the letter: 'Sexual and reproductive health clinical consultations: preconception care' by Chingara et al. 对信的回应：Chingara等人的“性与生殖健康临床咨询：孕前护理”。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-30 DOI: 10.1136/bmjsrh-2025-202733

Amy Hough, Jayne Kavanagh, Neha Pathak

引用次数: 0

Abortion skills and workforce 50 years on: an ageing workforce in need of rejuvenation. 50年过去了，堕胎技术和劳动力：老龄化的劳动力需要振兴。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-25 DOI: 10.1136/bmjsrh-2024-202559

Edgar Kennedy Dorman

引用次数: 0

Acceptability of digital health intervention during pregnancy to inform women about postpartum contraception (DIGICAP): a pilot randomised controlled study. 怀孕期间数字健康干预的可接受性，以告知妇女产后避孕（DIGICAP）：一项试点随机对照研究

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-16 DOI: 10.1136/bmjsrh-2024-202479

Michelle Cooper, Caroline J Free, Kevin Ka-Wing Kuan, Karen McCabe, Emmanuela Osei-Asemani, Charles Opondo, Sharon Cameron

{"title":"Acceptability of digital health intervention during pregnancy to inform women about postpartum contraception (DIGICAP): a pilot randomised controlled study.","authors":"Michelle Cooper, Caroline J Free, Kevin Ka-Wing Kuan, Karen McCabe, Emmanuela Osei-Asemani, Charles Opondo, Sharon Cameron","doi":"10.1136/bmjsrh-2024-202479","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202479","url":null,"abstract":"Background: Pregnancy within a year of childbirth has negative impacts on women and their children's health. We developed a digital health intervention (DHI) to empower women in contraceptive choices postpartum. Our pilot randomised controlled trial (RCT) aimed to establish the feasibility of a main RCT of the effects of the DHI compared with standard care on long-acting contraception use.Methods: Our pilot RCT recruited 52, 20-24 weeks pregnant women in NHS Lothian, UK between October 2022 and April 2023. Participants were randomised 7:3 to receive either the DHI (n=37) in addition to standard care, or standard care alone (n=15). Telephone survey follow-up was at 24 weeks' gestation and 6 weeks postpartum. Semi-structured qualitative interviews (n=10) were conducted with participants receiving the DHI.Results: All eligible women joined the study and completed follow-up. All intervention participants found the animation highly acceptable; one participant requested text message discontinuation. We completed followed up on 37/37 (100%) of participants. DHI participants reported they valued access to credible contraceptive information that supported decision making in a non-pressurised way.Conclusions: Our DHI is highly acceptable and a trial is feasible. A larger trial is needed to establish if the DHI increases uptake of long-acting reversible contraception postpartum and reduces unintended pregnancies within 12 months of childbirth.Trial registration number: (Trial registration ISRCTN48521918).","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000470","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

Remember vasectomy: challenges and successes-one small snip for mankind. 记住输精管结扎术：挑战和成功——对人类来说是一小步。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-08 DOI: 10.1136/bmjsrh-2024-202431

Gareth James, Melanie Atkinson

引用次数: 0

Evaluating the effectiveness of a tailored online educational video on the contraceptive knowledge and decision making of young women from culturally and linguistically diverse backgrounds: findings from the EXTEND-PREFER study. 评估定制在线教育视频对来自不同文化和语言背景的年轻女性避孕知识和决策的影响：EXTEND-PREFER 研究的结果。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202236

Danielle Mazza, Jessica R Botfield, Jessie Zeng, Claudia Morando-Stokoe, Noushin Arefadib

{"title":"Evaluating the effectiveness of a tailored online educational video on the contraceptive knowledge and decision making of young women from culturally and linguistically diverse backgrounds: findings from the EXTEND-PREFER study.","authors":"Danielle Mazza, Jessica R Botfield, Jessie Zeng, Claudia Morando-Stokoe, Noushin Arefadib","doi":"10.1136/bmjsrh-2024-202236","DOIUrl":"10.1136/bmjsrh-2024-202236","url":null,"abstract":"Background: Young Australian women from culturally and linguistically diverse (CALD) backgrounds are vulnerable to unwanted pregnancy. We aimed to assess whether an online educational video, co-designed with young CALD women, can increase their contraceptive knowledge, preference for and uptake of long-acting reversible contraception (LARC).Methods: Online advertising was used to recruit young CALD women aged 16-25 years. Participants completed the pre-video survey (S1), watched the 13-min co-designed video, then completed a survey immediately afterwards (S2) and 6 months later (S3). Outcomes were analysed using McNemar tests and multivariate logistic regression.Results: A total of 160 participants watched the video, completed S1 and S2, and 57% of those completed S3. At S1 only 14% rated their knowledge about every contraceptive method as high. Knowledge improved at S2 for all methods (aOR 3.2, 95% CI 2.0 to 5.0) and LARC (aOR 4.7, 95% CI 2.9 to 7.5). Overall method preference for LARC increased from 2.5% (n=4) at S1 to 51% (n=82) at S2. Likelihood of using a LARC increased at S2 (aOR 3.8, 95% CI 2.6 to 5.6). The overall proportion of participants using a LARC increased from 8% at S1 to 11% at S3; however, this increase was not significant (p=0.7).Conclusions: The significant increase in knowledge, likelihood of use, and preference for LARC underscores the potential of online video-based contraceptive education to address contraceptive knowledge gaps and challenge misconceptions about LARC held by young women. Combining contraceptive education with supports to LARC access is crucial for empowering young CALD women to make informed contraceptive decisions.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"18-26"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316730","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

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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874269/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influences on ethnic minority women's experiences and access to contraception in the UK: a systematic qualitative evidence synthesis. 影响英国少数民族妇女避孕经历和机会的因素：系统性定性证据综述。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202488

Ryan James Cory, Rebecca Mawson, Emma Linton, Dalal Y Al-Bazz, Kate Fryer, Richard Ma, Caroline Anne Mitchell

{"title":"Influences on ethnic minority women's experiences and access to contraception in the UK: a systematic qualitative evidence synthesis.","authors":"Ryan James Cory, Rebecca Mawson, Emma Linton, Dalal Y Al-Bazz, Kate Fryer, Richard Ma, Caroline Anne Mitchell","doi":"10.1136/bmjsrh-2024-202488","DOIUrl":"10.1136/bmjsrh-2024-202488","url":null,"abstract":"Background: Accessible contraception is critical for promoting the health and well-being of women and their families. In the UK, contraception is free at the point of access, but only 55% of pregnancies are planned, with negative implications for maternal and infant outcomes. In general, women from ethnic minorities use contraceptives less than white women. Barriers to the uptake of contraceptives have been identified, including perceived poor information from healthcare professionals and concerns about side effects. However, most studies do not include representative proportions of women from ethnic minorities. Evidence suggests that ethnic minority (EM) women feel targeted and coerced by healthcare professionals regarding contraception.Methods: A systematic search of Medline, Embase, and PsycINFO via Ovid, CINAHL, and Web of Science was conducted to identify primary qualitative and mixed-methods studies exploring ethnic minority women's experience of contraception in the UK. The data were charted using thematic analysis, using both summary and synthesis.Results and conclusions: 16 studies met the inclusion criteria, including the perspectives of 717 participants from an ethnic minority. Four overarching themes were developed: contraceptive knowledge, beliefs, family, and services. Similar to women in general, ethnic minority women have concerns about side effects, especially infertility, value the perspectives of their peers and male partners, and express a preference for female healthcare professionals. Novel perspectives included conflicting ideas about the influence of religion and stereotyping of ethnic minority women. Culturally competent consultations and a better understanding of hormonal hesitancy are essential.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"64-73"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0