Contraception and reproductive medicine最新文献

{"title":"Pregnancy-related complications in patients with endometriosis in different stages.","authors":"Khadijeh Shadjoo, Atefeh Gorgin, Narges Maleki, Arash Mohazzab, Maryam Armand, Atiyeh Hadavandkhani, Zahra Sehat, Aynaz Foroughi Eghbal","doi":"10.1186/s40834-024-00280-0","DOIUrl":"10.1186/s40834-024-00280-0","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is one of the most common and costly diseases among women. This study was carried out to investigate pregnancy outcomes in women with endometriosis because of the high prevalence of endometriosis in reproductive ages and its effect on pregnancy-related complications outcomes.</p><p><strong>Methods: </strong>This was a cross-sectional study performed on 379 pregnant women with endometriosis who were referred to the endometriosis clinic of the Avicenna Infertility Treatment Center from 2014 to 2020. Maternal and neonatal outcomes were assessed for the endometriosis group and healthy mothers. The group with endometriosis was further divided into two groups: those who underwent surgery and those who either received medication alone or were left untreated before becoming pregnant. The analysis of the data was done using SPSS 18.</p><p><strong>Results: </strong>The mean age of the patients was 33.65 ± 7.9 years. The frequency of endometriosis stage (P = 0.622) and surgery (P = 0.400) in different age groups were not statistically significant. The highest rates of RIF and infertility were in stages 3 (N = 46, 17.2%) (P = 0.067), and 4 (N = 129, 48.3%) (P = 0.073), respectively, but these differences were not statistically different, and the highest rate of pregnancy with ART/spontaneous pregnancy was observed in stage 4 without significant differences (P = 0.259). Besides, the frequency of clinical/ectopic pregnancy and cesarean section was not statistically different across stages (P > 0.05). There is no significant relationship between endometriosis surgery and infertility (P = 0.089) and RIF (P = 0.232). Most of the people who had endometriosis surgery with assisted reproductive methods got pregnant, and this relationship was statistically significant (P = 0.002) in which 77.1% (N = 138) of ART and 63% (N = 264) of spontaneous pregnancies were reported in patients with endometriosis surgery. The rate of live births (59.4%) was not statistically significant for different endometriosis stages (P = 0.638). There was no stillbirth or neonatal death in this study. All cases with preeclampsia (N = 5) were reported in stage 4. 66.7% (N = 8) of the preterm labor was in stage 4 and 33.3% (N = 4) was in stage 3 (P = 0.005). Antepartum bleeding, antepartum hospital admission, preterm labor, gestational diabetes, gestational hypertension, abortion, placental complications and NICU admission were higher in stage 4, but this difference had no statistical difference.</p><p><strong>Conclusion: </strong>Endometriosis is significantly correlated with infertility. The highest rates of RIF and infertility are observed in stages 3 and 4 of endometriosis. The rate of pregnancy with ART/spontaneous pregnancy, preterm labor, preeclampsia and pregnancy-related complications is higher in stage 4. Most of the people who had endometriosis surgery with assisted reproductive methods got significantly pregnant. Clinical/ectopic pregnan","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917507","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":"Determinants of implanon discontinuation among women in Gedeo Zone, South Ethiopia: a case-control study.","authors":"Tihtina Bezabih, Selamawit Dires Agidew, Selamawit Semagn Kebede, Moges Mareg Belay, Ever Siyoum, Eden Ashenafi, Mahlet Birhane","doi":"10.1186/s40834-024-00263-1","DOIUrl":"10.1186/s40834-024-00263-1","url":null,"abstract":"<p><strong>Background: </strong>The main public health problem that has a significant impact on the high fertility rate, unintended pregnancies, and induced abortion is Implanon cessation. In addition to Implanon being underutilized in Ethiopia, the rate of cessation is higher among women who started using it. Nevertheless, little is known about the factors that lead to Implanon cessation.</p><p><strong>Objectives: </strong>The study was aimed to determine the factors that led women to discontinue Implanon in Gedeo Zone, Southern Nation Nationalities and Peoples Region, southern Ethiopia, 2019.</p><p><strong>Method: </strong>A community-based unmatched case-control study design was carried out. Cases and controls were selected by a multi-stage sampling with a 1:2 case-to-control ratio. Data was entered into EPi-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20 for analysis. A bivariate and multivariable logistic regression was used to identify the factors affecting Implanon discontinuation. The adjusted odd ratio (AOR) with 95% Confidence Interval (CI) was used to determine the precision of estimates, and statistical significance was declared at a p-value of 0.05.</p><p><strong>Result: </strong>From 516 women included in to the study, 495 (cases = 166 and controls = 329) women have responded to the questionnaires making a response rate of 96%. Monthly income 500-1000 birr [AOR: 0.3; 95% CI (0.2-0.5)], above 1000 birr [AOR: 0.2; 95% CI (0.1-0.4)], history of abortion [AOR: 2.0; 95% CI (1.0-4.1)], birth spacing [AOR: 0.6; 95% CI (0.3-0.9)], partner objection [AOR: 2.4; 95% CI (1.4-4.2)] were significantly associated factors.</p><p><strong>Conclusion: </strong>This study identified that monthly income, having abortion history, birth spacing, partner objection were the factors that affect Implanon discontinuation. To reduce implanon discontinuation, reducing abortion, involving partner and increasing the birth spacing, appropriate counseling before the insertion and appropriate follow-up by a health care practitioner are highly recommended.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917505","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":"Determinants of postpartum long-acting reversible contraceptives in the extended postpartum period in Shashago district, Central Ethiopia: a cross-sectional study conducted in the community.","authors":"Tesfaye Eristu, Abera Mekis, Ritbano Ahmed Abdo","doi":"10.1186/s40834-024-00284-w","DOIUrl":"10.1186/s40834-024-00284-w","url":null,"abstract":"<p><strong>Background: </strong>Women who fail to initiate contraceptive use within the first year after childbirth face an increased likelihood of experiencing unintended pregnancies in close succession. In regions with limited resources, the use of postpartum contraceptives, particularly long-acting reversible contraceptives, remains notably low. Consequently, this study sought to assess the prevalence and determinants of postpartum long acting reversible contraceptives in the extended postpartum period in the Shashago district, Central Ethiopia.</p><p><strong>Methods: </strong>This study employed a community-based cross-sectional design, conducted between March 1, 2021, and April 15, 2021, involving a total of 617 women of reproductive age. The selection of study participants was performed using a multistage stratified sampling technique. Data collection was carried out through the use of a structured interviewer-administered questionnaire. Subsequently, the collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for further analysis. Bivariate and multivariable logistic regression analyses were conducted, and statistical significance was determined using a P value of 0.05, along with adjusted odds ratios (AORs) and their corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 224(36.3%) women used long-acting contraceptives after giving birth. Among these women, 31.1% used Implanon, while 5.2% used an intrauterine device (IUD). Factors significantly associated with the use of long-acting contraceptives after childbirth included age 25-29 years (AOR: 1.8, 95% CI: 1.1-3.0), age ≥ 35 years (AOR = 8.7, 95% CI: 3.6-21.5), primary education (AOR = 3.3, 95% CI: 1.6-6.7), secondary education and above (AOR = 3.5, 95% CI: 1.5-8.3), and history of abortion (AOR = 2.7, 95% CI: 1.3-5.4). Additionally, having good knowledge of long-acting contraceptives after childbirth (AOR: 2.4, 95% CI: 1.5-3.9) was significantly associated with their use.</p><p><strong>Conclusion: </strong>This study revealed that a small number of women opt for long-acting contraceptives after childbirth, with Implanon being more popular than IUDs. Factors such as age, education level, abortion history, pregnancy counseling, and knowledge about long-acting contraceptives were linked to their usage. Integrating contraceptive counseling into routine antenatal and postnatal care is essential for ensuring access to postpartum contraception. Tailored interventions based on age and education level could also help promote long-acting contraceptive use. More research and targeted interventions are needed to overcome these barriers and improve access to these methods for postpartum women.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11084074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904992","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":"The effectiveness of cervical mucus electrical impedance compared to basal body temperature to determine fertility window.","authors":"Suzanne Tabbaa, Sealy Hambright, Katie J Sikes, Gary Levy, Jan Rydfors","doi":"10.1186/s40834-024-00276-w","DOIUrl":"10.1186/s40834-024-00276-w","url":null,"abstract":"<p><strong>Background: </strong>Serial serum hormone measurements and transvaginal ultrasound are reliable measures to predict ovulation. These measures are inconvenient and expensive therefore, basal body temperature charting (BBT) and urine ovulation predictor kits (OPK) for luteinizing hormone are often used to determine the 6-day fertile window. However, BBT does not clearly change until 1-2 days after ovulation. Additionally, while OPK can indicate positivity prior to ovulation, false readings are common. A novel alternative approach involves measuring electrolyte trends in cervical mucus using electrical impedance spectroscopy. Cervical mucus electrolyte measurements are associated with hormone level changes during the menstrual cycle. The purpose of this study was to compare the effectiveness of cervical mucus electrical impedance and basal body temperature. We sought to determine if cervical mucus electrolyte measurements provided improved detection of the ovulation day and therefore, improve fertility timing for women.</p><p><strong>Methods: </strong>14 healthy women between 18 and 44 years of age with normal menstrual cycles were enrolled in the Observational Study. Participants measured BBT and cervical mucus electrical impedance daily for 3 menstrual cycles using Kegg (Lady Technologies Inc. San Francisco, California, USA). Ovulation date for each cycle was confirmed by measuring hormone levels in urine and serum, and by vaginal ultrasound.</p><p><strong>Results: </strong>Electrical impedance was significantly different between the follicular phase versus ovulatory date (p = 0.007) and between the luteal phase versus the ovulatory date (p = 0.007). A significant difference in the rate of change of cervical impedance measurements in the pre-ovulatory follicular phase was found compared to BBT (p = 0.0225). The sensitivity (+ 7.14%), specificity (+ 20.35%), and accuracy (+ 17.59) to determine the 1-day fertility window was significantly higher using cervical mucus impedance compared to BBT.</p><p><strong>Conclusions: </strong>BBT is considered unreliable for evaluating ovulatory function. Cervical mucus electrical impedance offers a novel measure of electrolyte changes associated with hormone levels. We report that pre-ovulatory electrical impedance patterns demonstrated higher sensitivity, specificity, and accuracy for determining the fertility window when compared to BBT. These findings suggest that changes in electrical impedance may provide an accurate method for predicting ovulation and for measuring ovulatory function.</p>","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867932","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":"Predictors of contraceptive discontinuation in Rwanda: evidence from demographic and health survey 2019–2020","authors":"Harerimana Jean de Dieu, Mugabo Lambert","doi":"10.1186/s40834-024-00282-y","DOIUrl":"https://doi.org/10.1186/s40834-024-00282-y","url":null,"abstract":"","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140656476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia: an unmatched case-control study","authors":"Keraj Seboka, A. Gurara, Nardos Tilahun Bekele, Yohanes Abera Belachwe, Mihiret Shawel Getahun, Y. Negussie","doi":"10.1186/s40834-024-00283-x","DOIUrl":"https://doi.org/10.1186/s40834-024-00283-x","url":null,"abstract":"","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda","authors":"Janet Abiyo, Rose Chalo Nabirye, Brendah Nambozo, D. Mukunya, Ritah Nantale, Faith Oguttu, Solomon Wani, Milton W. Musaba, Josephine Tumuhamye, Joshua Epuitai","doi":"10.1186/s40834-024-00279-7","DOIUrl":"https://doi.org/10.1186/s40834-024-00279-7","url":null,"abstract":"","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wrong rulings come from wrong science","authors":"Anita Nelson, Margaret English","doi":"10.1186/s40834-024-00281-z","DOIUrl":"https://doi.org/10.1186/s40834-024-00281-z","url":null,"abstract":"","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to quality contraceptive counselling among adolescent girls and young women in sub-Saharan Africa","authors":"Aliu Mohammed, I. E. Donkoh, R. Aboagye, B. Ahinkorah, A. Seidu","doi":"10.1186/s40834-024-00267-x","DOIUrl":"https://doi.org/10.1186/s40834-024-00267-x","url":null,"abstract":"","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive use and method mix dynamics in Sub-saharan Africa: time trends and the influence of the HIV pandemic.","authors":"A. Bawah, Pearl S. Kyei, Charles Agyei-Asabere","doi":"10.1186/s40834-024-00273-z","DOIUrl":"https://doi.org/10.1186/s40834-024-00273-z","url":null,"abstract":"","PeriodicalId":93956,"journal":{"name":"Contraception and reproductive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140727155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}