Risks of venous thromboembolic complications in related to combined oral contraceptives

Hormonal contraception is the most popular and effective reversible method for preventing unwanted pregnancy exerting multiple prophylactic and therapeutic effect along with contraceptive activity. The main adverse coupled to combined oral contraceptives (COCs) is its impact on the hemostasis and increased risk of venous thromboembolic complications. A great evolutionary path has been travelled after beginning application of hormonal contraception to reduce dose of its estrogen component and improving quality of gestagen component. Nevertheless, thrombotic complications related to COCs use still remain a pressing issue not only due to disease severity and high mortality rate from pulmonary embolism (PE), but also due to the difficulties in its timely diagnostics. Here we describe a clinical case of a 19-year-old patient suffering from vena cava inferior thrombosis complicated by PE after using COCs.

The Sexual and Reproductive Health Context of an Internally Displaced Persons' Camp in Northeastern Nigeria: Narratives of Girls and Young Women

In humanitarian settings, ~35 million girls and young women of reproductive age (15–24) are in urgent need of sexual and reproductive health (SRH) information and services. Young women and girls in humanitarian contexts are particularly vulnerable to unwanted pregnancies, unsafe abortion, gender-based violence, and early and forced marriage. We sought to understand girls' and young women's experiences with unwanted pregnancy, abortion, contraception, sexually transmitted infections (STIs), gender-based violence (GBV), and forced marriage in an IDP camp in Northeastern Nigeria. We conducted 25 in-depth interviews with girls aged 15–19 (N = 13; 8 single and 5 married) and young women aged 20–24 (N = 12; 3 single and 9 married). All interviews were audiotaped, transcribed, translated, computer recorded and coded for analysis. The participants in our study fled from and witnessed violence to arrive in the IDP camp with little material support. Lack of necessities, especially food, has driven many to sex in exchange for goods or into forced marriages. This, in turn, leads to increased unwanted pregnancies and unsafe abortions. Participants had limited knowledge about contraception, and some information about SRH services available in the camp, but overall, knowledge and utilization of SRH services was low.

Postabortion Contraceptive Acceptance Rate and Its Determinants among Women Receiving Abortion Service before Discharge from the Health Facilities in Harar, Eastern Ethiopia

Background. Annually, around 121 million unintended pregnancies occur in the world and more than 73 million encountered abortion. Ethiopia is also losing 19.6% of mothers due to unsafe abortion. Despite that postabortion contraceptive service is a climactic entry point for the prevention of unwanted pregnancy and associated deaths, the service magnitude and determinants immediately before discharge are not characterized well in Ethiopia. Hence, this study aimed to assess the magnitude of postabortion contraceptive utilization and associated factors among women receiving abortion care service before being discharged from health facilities in Harar, Eastern Ethiopia. Methods. A facility-based cross-sectional study was conducted among 390 women receiving abortion care services. At discharge, data about contraceptive acceptance and related maternal characteristics were collected. A binary logistic regression model was used to assess the association between independent and dependent variables (postabortion contraceptive utilization). Analysis was done with SPSS 22. Statistical significance was considered at P < 0.05 . Result. The overall prevalence of postabortion contraceptive utilization was 81.5% (95% CI: 77.9, 85.4). Being unmarried (AOR, 0.05; 95% CI (0.02, 0.16)), having no history of previous abortion (AOR, 0.11; 95% CI (0.04, 0.34)), being multigravida (AOR 8.1; 95% CI (2.20, 13.40), lacking desire to have an additional child (AOR, 6.3; 95% CI (2.65, 15.34), and history of family planning use (AOR, 17.20; 95% CI (6.5, 38.60)) were determinants of postabortion contraceptive utilization before being discharged from the health facilities. Conclusion. Postabortion contraceptive utilization in Harar health facilities still needs improvement as per the WHO and national recommendations. Therefore, the family planning provision strategies should be convincing and friendly, especially for unmarried mothers, and those who had no history of abortion should be counseled in friendly and systematically convincing schemes for enabling them to take the service before discharge from the health facility.

Wearable Devices and Intelligent Application in Women’s Postpartum Repair for Smart Healthcare

Wearable devices are more and more widely used in the field of smart healthcare. The purpose of this study was to explore the effect of contraceptive counseling and education on contraceptive behavior of women after induced abortion. The investigators will explain the situation of this topic to the respondents and select the respondents in strict accordance with the framework requirements of sampling design. All the data are from the induced abortion women in the first-, second-, and third-level hospitals, which reduces the selection bias of the respondents. It is found that the proportion of induced abortion among college students is the highest, reaching 66.03%. This study is helpful to reduce the incidence of unwanted pregnancy, induced abortion, and repeated abortion and improve the reproductive health of women.

Community acceptability of contraception after induced versus spontaneous miscarriage.

Objective: To study the relationship between history of miscarriage (induced or spontaneous) and current use of modern contraceptive method among women in Pakistan. Study Design: Cross Sectional study. Setting: OPD of MCH, PIMS. Period: July 2019 to December 2019. Material & Methods: A total of 80 married women were enrolled, 40 women who had induced miscarriage (group A) and 40 from spontaneous miscarriage (group B). Data is obtained on predesigned questionnaire. Primary outcome was acceptance of contraception (LARC) after induced versus spontaneous miscarriage. Results: About 51% of women were in the age group of 30–35 years and out of total 80 women, 67 (83%) women had parity of three or above (27 % had parity of three). Out of 66 women who used contraception, 35 (53%) had induced miscarriage (group A) and 31 (46%) had spontaneous miscarriage (group B). Women who belonged to induced miscarriage (group A) faced menstrual irregularity, as the reason of leaving contraception, followed by chronic PID and husband opposition. While in the group B, fertility desire was main reason of discontinuation of contraception. In Group A, 20 (50%) women were willing to use LARC (long acting reversible contraception) after induced abortion to reduce the chances of unwanted pregnancy while in other group B, 15 (37.5%) women were wanted to use LARC and 18 (45%) women were not ready to use contraception due to fertility. Conclusion: High rate of induced abortion due to failed contraception and dis-continuation of contraceptives needs to be addressed by encouraging women to manage the side effects to ensure continuity of contraceptives.

Reproductive health and reproductive culture of university students: tactics of preventive activities

BACKGROUND: Statistics shows a decrease in the birth rate in Russia. This is alarming fact that obliges to take some measures, including preventive ones. Since the reproductive health of students will determine demographic indicators for many years to come, it is very important to choose methods of prevention in one direction or another, taking into account modern technical trends and hobbies of young people. AIM: To explore the knowledge of students of different specialties in matters of reproductive health, reproductive culture. To suggest the way of preventive measures based on the data obtained. MATERIALS AND METHODS: The study involved students from the Ural, Moscow and St. Petersburg universities. 537 questionnaires were processed. The questionnaire indicated the social status of the participants (gender, age, university profile). According to the latter criterion, the sample was divided into four groups: natural sciences, medical sciences, technical sciences, and humanities. An anonymous survey was conducted in the “Google form”. The respondents answered questions about the most pressing problems of reproductive health and reproductive culture. RESULTS: 64% of the respondents assess their reproductive health as good; the most popular source of information on contraception for university youth is the Internet. According to the analysis of the data obtained, in the event of an unwanted pregnancy, only 24% of the women surveyed would have the pregnancy kept, which may indicate a low reproductive culture of students. CONCLUSION: To take attention to reproductive health and prevention issues among students in accessible terms, blogging on social networks by specialists in the field of obstetrics and gynecology, urology and andrology, senior medical students or clinical residents can be proposed.

Hubungan Dukungan Orang Tua dan Sekolah terhadap Sexual Abstinence pada Remaja

Background: Reproductive health problems such as STI and HIV/AIDS, and Unwanted Pregnancy are vulnerable to be experienced by adolescents if they do not have the ability and confidence to perform sexual abstinence. Parents and schools are considered appropriate parties to provide support to adolescents to perform sexual abstinence. Objective: This study was to analyze the relationship between parental and school support for sexual abstinence in high school adolescents in Pugung District, Lampung Province. Methods: this type of research is analytic observational with a cross sectional approach. Sampling using Proportional Random Sampling technique, with a total sample of 130 respondents. The statistical test of this study used the Fisher exact test. Results: there is no relationship between parental support (p-value 0.672 > 0.05) and school (p-value 1,000 > 0.05) with sexual abstinence in high school adolescents in Pugung District. Conclusion: It is necessary to explore other appropriate sources of support for adolescents and to expand the scope of research for further research, both in urban and rural areas.

A unique vaccine for birth control and treatment of advanced stage cancers secreting ectopically human chorionic gonadotropin

This article is a tribute and homage to Gerard Chaouat who invited me to contribute this article. My years in France have remained very memorable to me. Reviewed briefly is the vaccine that was made against human chorionic gonadotropin (hCG) to prevent unwanted pregnancy in sexually active women. It has now been developed as a genetically engineered recombinant vaccine and passed onto industry for its production under good manufacturing practices (GMP) conditions for confirmatory trials. The trials have received the approval of the Drugs Controller General of India. The trials have started but have been interrupted by the coronavirus disease 2019 (COVID-19) pandemic. This vaccine is likely to have another highly beneficial application in the treatment of cancers expressing ectopically hCG.

Under-Utilization of Maternal-Child Healthcare Services and Adverse Outcomes of Unwanted Pregnancies in Urban and Rural Areas of Indonesia

The study examines the association of unwanted pregnancy and the utilization of maternal-child health services, and the adverse health outcomes in urban and rural settings. The study employed data from the 2017 Indonesia Demographic Health Survey that included 13,806 live births; the mothers were not pregnant at the interview and were married participants. The multiple logistic regression analysis concerning residential areas was conducted separately to compare outcomes related to unwanted pregnancy. Non-standard antenatal care visits (adjusted odds ratio [AOR]=1.7; 95% confidence interval [CI]=1.2–2.4), prolonged labor (AOR=1.6; 95% CI=1.2–2.1), the absence of child’s birth documentation (AOR=1.3; 95% CI=1.0–1.6), and smaller baby size (AOR=1.2; 95% CI=1.0–1.4) are associated with unwanted pregnancy in urban areas. In rural settings, on the other hand, unwanted pregnancy is associated with non-standard antenatal care (AOR=1.6; 95% CI=1.2–2.2). Therefore, in Indonesia, urban areas lack maternal-child healthcare services utilization and higher adverse events due to unwanted pregnancy than rural areas. An adjustment approach is required in maternal-child health-related programs in both areas, particularly for women living in urban.

IMPLEMENTATION OF SYSTEM THEORY IN EDUCATIONAL MEDIA FOR EARLY MARRIAGE CASES IN YOGYAKARTA

Early marriage is an issue that is widely discussed around the world. Because the discourse of early marriage is often motivated by several factors that deviate from a child's justice rights. Even the issue of early marriage is also referred to as part of child abuse. The factors that cause early marriage are parents, economy, social and customary pressures, perpetuating relationships, social media and influencers, unwanted pregnancy, lack of reproductive health education for children and parents. PKBI is one of the institutions whose concentration focuses on the study of sexual and reproductive health for all parties providing several means to voice the importance of suppressing the increase in the rate of early marriage, especially in Yogyakarta. One of the efforts made by PKBI is to hold several discussion forums. The holding of discussions is one of the comprehensive efforts to educate adolescents and parents about the importance of sexual and reproductive health, which in turn can hamper the process of early marriage. Keywords: Early Marriage, Reproductive Health Education, Early Marriage Factors, Communication