OBJECTIVE: To identify the risk factors for ectopic pregnancy (EP) in women using an intrauterine device (IUD). DESIGN: Case-control study.Setting: Auvergne region (France). PATIENT(S): Women using an IUD and suffering EP (243 cases) or having an intrauterine pregnancy (140 controls). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Sociodemographic characteristics, smoking, medical history, ...

Abstract: Pregnancy following rape is a continuing and significant public health issue. We estimate that the 333,000 sexual assaults and rapes reported in 1998, along with many more unreported, were responsible for 25,000 pregnancies. Potentially, as many as 22,000 such pregnancies could be prevented if all women who were raped ...

Emergency contraceptive pill prescription following rape is common. We report a case of ectopic gestation after emergency contraceptive pill failure and review the literature on this rare complication. A 26-year-old woman with a normal menstrual period 2 weeks before was administered an emergency contraceptive pill 8 hours after a single ...

Several progestin-only long acting contraceptives are currently available in the form of implants or injectables. Vaginal rings are another contraceptive option in the final stages of development. These steroid-containing polymer rings are placed in the vagina, providing relatively constant drug release, thus allowing for lower effective doses. Vaginal rings have ...

About 190,000 therapeutic terminations of pregnancy occur in the UK each year. Many of these could be prevented by the use of emergency contraception. We have previously discussed the use of combined hormonal emergency contraception. Now, a progestogen-only emergency contraceptive, levonorgestrel in the form of [symbol: see text]Levonelle-2 (Schering Health), ...

A 12 months longitudinal study was carried out in 214 consecutive Nigerian women using Nomegestrol acetate subdermal contraceptive implant (Uniplant) for the first time to establish the rates of different vaginal bleeding patterns according to WHO bleeding/spotting classification, and to assess their relationship with Uniplant discontinuation. The results showed an ...

OBJECTIVES: National and state data on the health, social, and economic consequences of unintended pregnancy prompted Washington policy makers to identify strategies to reduce such pregnancies. Though not well known, emergency contraceptive pills (ECPs) are a safe and effective contraceptive method that can prevent pregnancy if taken within 72 hr ...

BACKGROUND: For the past 30 years many effective methods of contraception have been available, yet unintended pregnancy rates still range from 30% to 50% in many populations. We examined patterns of women's contraceptive use throughout their lives and relate them to unintended pregnancy. METHODS: A total of 396 women aged ...

BACKGROUND: Unsafe abortion remains one of the major reproductive and public health challenges globally, but more so in developing countries. Lack of or poor contraception has been shown to be one of predisposing factors. OBJECTIVE: To determine contraceptive acceptance amongst post-abortion patients in Blantyre, Malawi. DESIGN: A cross-sectional pilot study. ...

OBJECTIVE: This study investigates the methods of contraception used by women attending for pregnancy counselling at the time of an unintended pregnancy. METHOD: Women attending three pregnancy counselling clinics in Birmingham were asked to fill in a questionnaire which was designed to obtain demographic data and history of women's methods ...

Hormonal fluctuations affect more than a woman's reproductive system. They have a surprisingly strong influence on the oral cavity. Puberty, menses, pregnancy, and menopause all influence women's oral health and the way in which a dentist should approach their treatment. This paper will review aspects of a woman's life when ...

Abnormal uterine bleeding accounts for the unacceptably high discontinuation rate of progestin-only contraceptives. Previously, we found that in-vivo and in-vitro decidualization of human endometrial stromal cells was associated with elevated concentrations of tissue factor (TF), the primary initiator of haemostasis. Moreover, enhanced TF expression required progesterone receptor (PR) and epidermal ...

Access to reliable contraception is often unavailable. Unsafe abortion yearly causes death for thousands and disabling illness for millions worldwide. Insufficient information, negligence, inappropriate contraception, poverty and poor education contribute to these serious sequelae of unintended pregnancy. Identification of those at risk, the provision of appropriate information and access to ...

The aim of this study was to develop an objective test for superficial endometrial vascular fragility at hysteroscopy, and to apply this test to women using Norplant((R)) for contraception and to women with ovulatory dysfunctional uterine bleeding (DUB). A prospective observational study was carried out in 34 Norplant users and ...

Doctors working in general practice and at family planning clinics throughout the UK who collaborate in the UK Family Planning and Reproductive Health Research Network were responsible for the fitting of 572 Nova-T380 intra-uterine contraceptive devices (IUDs). The Nova-T (and formerly the identical Novagard) IUDs have copper with a surface ...

Emergency contraception is used after unprotected intercourse or a contraceptive accident to prevent unwanted pregnancy. It is thought to work by stopping or delaying ovulation or preventing implantation if fertilization has already taken place. Hormonal methods, mifepristone, and intrauterine device insertion are among the methods used worldwide. Combination estrogen-progestin birth ...

OBJECTIVES: The primary objective of this study was to investigate the profile of the Dutch Persona user and her opinion about this relatively new way of natural birth control. The results of the study were used to draw conclusions for the suitability for Persona as a contraceptive method. METHOD: Data ...

Background: Teen pregnancy is an important and costly issue for society and often commits the mother to a life of poverty. Physicians play an important role in preventing teen pregnancy by identifying teens at risk for pregnancy and prescribing contraception. This study examines for the first time, whether pharmacy data ...

CONTEXT: If the national health objective of reducing unintended pregnancy is to be met, a better understanding is needed of barriers to women's acquisition and use of contraceptives. METHODS: A sample of 311 Missouri women who were seeking pregnancy tests in public health department clinics in 1997 and who said ...

Fertility after ectopic pregnancy (EP) was investigated in a non-selected population taking into account intrauterine device (IUD) use at the time of the EP. Between January 1992 and June 1996, 647 women listed in the EP register of Auvergne (France) were followed up. The analysis included only the 328 women ...

This 2-year study compared Mesigyna(R) administered to 49 pre-menopausal women between 38 and 50 years, to 99 women fitted with an IUD (Nova-T). A complete lipoprotein assessment was carried out before treatment and at 6, 12, and 24 months of treatment. A bone densitometry was performed on half of the ...

OBJECTIVE: To compare the incidence of repeat pregnancy and method continuation rate at 12 months postpartum in young women who chose either depot medroxyprogesterone acetate or oral contraceptives (OCs) as contraception. METHODS: We conducted a prospective cohort study of 122 postpartum women younger than 18 years of age who delivered ...

This is a prospective study involving 120 women who requested abortion for an unplanned and unwanted pregnancy. We sought to determine their contraceptive intentions and use. The characteristics of these women revealed that the majority were young, single schoolgirls with 68.5% of them being nulliparous. Over 90% had had their ...

OBJECTIVE: To evaluate whether self-reported past migraine response to reproductive life events (menses, pregnancy, menopause) alters the likelihood of worsening of migraine with exogenous hormone use. METHODS: A retrospective study was conducted on 451 female patients at the University Headache Center who had a diagnosis of migraine with or without ...

OBJECTIVE: To evaluate the possible association between duration of sexual cohabitation and the risk of pregnancy-induced hypertension (PIH). STUDY DESIGN: A matched case-control design in which each case of PIH was compared with three controls. Information was obtained about use of barrier contraception, duration of intercourse prior to pregnancy and ...

We carried out a retrospective analysis of the continuation rates of 142 Norplant acceptors. Follow-up data was available on 110. We assessed the relative impact of side effects on discontinuation. No serious complications (immediate or late) were observed during the 3-year study period and no pregnancies occurred. The 3-year continuation ...

This study was conducted to evaluate a new and improved inserter (GyneFix) for the anchoring of the Frameless IUD in the uterine cavity. Previous studies conducted with a prototype inserter (Flexigard) did not show fully the advantages of the new anchoring concept because of the shortcomings of the Flexigard inserter ...

OBJECTIVE: To evaluate access to emergency contraception among women seeking help from clinicians who registered to be listed on the Emergency Contraception Hotline (1-888-NOT-2-LATE, ie, 1-888-668-2528) and the Emergency Contraception Website (not-2-late.com). METHODS: Two college-educated investigators posing as women who had a condom break the previous night called 200 providers ...

A 22-year-old primipara using intrauterine contraceptive device was diagnosed to be in haemorrhagic shock due to acute ruptured ectopic pregnancy. At laparotomy, both tubes and ovaries were normal and products of conception were found to be implanted on the posterior surface of uterus near the attachment of right uterosacral ligament ...

The primary mechanism of oral contraceptives is to inhibit ovulation, but this mechanism is not always operative. When breakthrough ovulation occurs, then secondary mechanisms operate to prevent clinically recognized pregnancy. These secondary mechanisms may occur either before or after fertilization. Postfertilization effects would be problematic for some patients, who may ...

Two hundred ten heterosexual undergraduates in dating relationships were surveyed about reasons for not using condoms every time for vaginal and anal sex and for increasing or decreasing condom use during their relationships. Half of the respondents reported consistent condom use in the first month of their relationships, while only ...

Knowledge and use of emergency contraception world-wide is extremely limited. Recent research has demonstrated that levonorgestrel alone is at least as effective as the Yuzpe regimen and is much better tolerated. Levonorgestrel is likely to become the method of choice in the early 21st century. Mifepristone is highly effective even ...

Four decades after introduction of the pill, more women than ever are using it. Today's low-dose oral contraceptives are safer and just as effective as earlier pills. Taken regularly, the pill prevents pregnancy almost without fail. Pill users benefit in other ways, too, such as less anemia and protection from ...

Despite the major strides made in birth control, which have produced a decline in unintended pregnancies over the past decade and the lowest rates of teen pregnancies seen since 1974 (1,2), significant problems still remain. Almost half (48%) of US pregnancies in 1995 were unintended (1) and many more that ...

Emergency contraceptive pills ("ECPs"), a form of contraception which has a 75% chance of preventing pregnancy when taken within 72 hours after unprotected intercourse, are currently available only by prescription. Increasing access to ECPs will help to reduce unintended pregnancies and abortions and will help to provide women with an ...

OBJECTIVES: To assess the safety and efficacy of IUD insertion immediately after spontaneous or induced abortion. SEARCH STRATEGY: We used Medline, Popline, and EMBASE computer searches, supplemented by review articles and contacts with investigators. SELECTION CRITERIA: We sought all randomized controlled trials that had at least one treatment arm that ...

High rates of adolescent pregnancy remain a challenge for health care providers. For most sexually active adolescents, pregnancy is unintended. Emergency contraception, also called the "morning-after-pill" or postcoital contraception, is a way to prevent pregnancy after unprotected intercourse. In the United States, three forms of emergency contraception currently are available: ...

To make an informed decision when choosing a contraceptive, women and couples need to know how effective different methods are when used perfectly, where perfect use is defined as following the directions for use. In this article, we show that unbiased estimates of pregnancy rates during perfect use can be ...

The antiprogestin mifepristone has shown potential to be used as a contraceptive. If 200 mg mifepristone is administered immediately after ovulation, the endometrium shows sufficient impairment of secretory development to prevent implantation. Low daily doses of mifepristone have been shown to reduce several of the local factors regarded as crucial ...

Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The ...

OBJECTIVE: The safety and contraceptive efficacy of a new 24-day regimen of an oral contraceptive combination containing gestodene (GTD) 60 microg and ethinylestradiol (EE) 15 microg was evaluated in an open-label, multicenter study. METHODS: Adult women received GTD 60 microg/EE 15 microg from day 1 to 24 and 4 days ...

A 22-year-old woman presented with bilateral thickening and hyperpigmentation of her nipples since the age of 17 years. There was no history of pregnancy or oral contraceptive pill use. Isotretinoin 0.025% gel was applied twice daily and the lesions disappeared in 4 weeks. After the drug was ceased, recurrence appeared ...

An open-label, nonrandomized, parallel, controlled study compared the efficacy, safety, and cycle control of a new monthly injectable contraceptive containing 25 mg of medroxyprogesterone acetate (MPA) and 5 mg of estradiol cypionate (E2C) (MPA/E2C) (Lunelle Monthly Contraceptive Injection) with that of a norethindrone 0.5, 0.75, 1.0 mg/0.035 mg ethinyl estradiol ...

CONTEXT: The incidence of unintended pregnancy has long been used as a primary indicator of the state of reproductive health. However, the definition--and therefore the measurement--of this indicator has been elusive. METHODS: Data from the 1995 National Survey of Family Growth (NSFG) were used to compare levels of unintended pregnancy ...

This case emphasizes that negative urine pregnancy testing and a written declaration of the patient are not sufficient to safely exclude an early pregnancy. Serum pregnancy testing inherently has a diagnostic gap of about 1 wk following conception. We recommend sufficient contraception at least 1 mo before radioiodine treatment in ...

The FemCap is a new silicone rubber barrier contraceptive shaped like a sailor's hat, with a dome that covers the cervix, a rim that fits into the fornices, and a brim that conforms to the vaginal walls around the cervix. It was designed to result in fewer dislodgments and less ...

OBJECTIVE: The aim of this survey was to assess the evaluation, management, and future recommendations of patients with the diagnosis of peripartum cardiomyopathy and to evaluate the interest in the creation of a prospective database regarding this rare disorder. STUDY DESIGN: A total of 116 surveys were sent to major ...

Although the 1990s have seen a reduction in unintended pregnancy rates and improved contraceptive-use rates, the negative consequences of unintended pregnancy and STD acquisition continue to plague our youth. Primary health care providers, including pediatricians, play an essential role in further reducing unintended teen pregnancy and STD acquisition rates through ...

A total of 265 women who had the Norplant system inserted were followed for 5 years. The present study is based on 11,435 women-months of use, describing the continuation rates and efficacy of Norplant among these women. The 5-year cumulative continuation rate was 45.7 per 100 continuing users. The continuation ...

Data from a large, international, multicenter, randomized trial were analyzed to compare the acceptability of two nonoxynol-9 spermicide preparations. Women who wished to use a spermicide for contraception were randomly assigned to use either a foaming tablet (n = 383) or a nonoxynol-9 film (n = 382) for 28 weeks ...