Contraception
-
Some licensing authorities require fasting before abortions under intravenous sedation to avoid aspiration of gastric contents. This study was conducted to estimate the incidence of anesthesia-related complications in women undergoing abortions without preprocedure fasting. ⋯ This large retrospective cohort chart review identified no complications related to low-dose procedural sedation in over 47,000 consecutive nonfasting patients having abortions through 18 weeks' gestation. Eliminating the requirement to fast would decrease unnecessary stress and unpleasant symptoms without increase in the anesthesia-related complications for women having abortions.
-
Cervical preparation has been shown to reduce complications with dilatation and evacuation (D&E), but the optimal regimen is unknown. While most published reports are from North America and describe overnight cervical preparation, recent research suggests the safety of same-day cervical preparation up to a gestational age of 18 weeks. We investigated the safety and efficacy of a same-day preparation protocol using a combination of Dilapan-S and misoprostol for gestations of 18-22 weeks. ⋯ This study suggests that same-day cervical preparation with Dilapan-S and misoprostol is safe and feasible for second-trimester surgical abortion up to 22 weeks' gestation.
-
Randomized Controlled Trial
Pain control for intrauterine device insertion: a randomized trial of 1% lidocaine paracervical block.
This study was conducted to investigate the effects of a 1% lidocaine paracervical block on perceived patient pain during intrauterine device (IUD) insertion. ⋯ Compared with no anesthetic, a 1% lidocaine paracervical block did not result in a statistically significant decrease in perceived pain with IUD insertion.
-
Comparative Study
Hormonal contraception and HIV acquisition risk: implications for individual users and public policies.
A recent observational study among HIV-1 serodiscordant couples (uninfected women living with an infected partner) raised concerns about the safety of injectable contraceptives, especially depot medroxyprogesterone acetate (DMPA). The purpose of this paper is to assess the implications of potentially elevated risk of Human Immunodeficiency Virus (HIV) acquisition with the use of hormonal contraceptives for individual users and public policies. ⋯ Individual DMPA users may be advised to shift to sterilization, IUD or implant depending upon their reproductive needs and circumstances, but not to no method, OC or even condom alone. At the macro level, the decision to withdraw DMPA from family planning programs in sub-Saharan Africa is not warranted.
-
The study was conducted to compare the levonorgestrel intrauterine system (LNG-IUS) and Copper T380A intrauterine device (IUD) in women with and without adenomyosis and to investigate the effects on menstruation and dysmenorrhea. ⋯ The LNG-IUS results in significant improvements in adenomyosis-associated heavy menstrual bleeding and dysmenorrhea. Moreover, this study also shows that it is an effective contraceptive method with significantly lower side effects compared to CuT 380A IUD except for acne.