11 research outputs found

    Evaluation of physicians’ sensibility for the risk of unplanned pregnancy

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    Prémio em Contraceção 2012 da Sociedade Portuguesa de ContraceçãoABSTRACT: In Portugal, about 94% of sexually active women who don`t want to become pregnant, use a contraceptive method. From these, oral hormonal contraceptives are the most used. Despite this, unplanned pregnancies are a reality. The current study aimed to evaluate physicians’ sensibility to contraceptive counselling on the introduction of new therapies in women with underlying medical conditions and in polymedicated ones. It was a survey study with ten closed-ended questions. Physicians who care for women of reproductive age in a tertiary referral centre (n= 181). It was conducted an opinion survey among physicians who care for women of childbearing age. The differences in medical opinion considering age, sex, medical / surgical specialties and years of clinical practice were analyzed. In the introduction of new therapies, asked about the contraceptive method in use: always 16,6% (n=30) of respondents, nearly always 28,7% (n=52) and sometimes 44,8% (n=81). From these, 62% (n=101) neither provided complete information nor remitted to family planning appointments. When pregnancy was contraindicated 38,7% (n=70) informed about a safe method. About 89,5% (n=162) of the respondents didn't attended updates on contraception in the last year. Even though 64,6% (n= 117) considered it useful taking into account clinical practise. The respondents had poor knowledge about the resources in family planning, 79% (n=118). The female doctor showed a greater information about family planning topics (p=0,001). The younger physicians (<35 years old) and those with few years of clinical practise (<8 years) referred more constantly the importance of professional qualification on family planning (p=0,034; p=0,034). Despite the care of women in childbearing age the issues on drug interactions haven't been addressed constantly. There is evidence of a poor knowledge of the respondents of existing resources which limits an effective contraceptive counselling

    Instability of misoprostol tablets stored outside the blister: a potential serious concern for clinical outcome in medical abortion

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    Misoprostol (Cytotec) is recognised to be effective for many gynaecological indications including termination of pregnancy, management of miscarriage and postpartum haemorrhage. Although not licensed for such indications, it has been used for these purposes by millions of women throughout the world. Misoprostol tablets are most often packaged as multiple tablets within an aluminium strip, each within an individual alveolus. When an alveolus is opened, tablets will be exposed to atmospheric conditions

    Recurrent Pregnancy Loss

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    Management of pain associated with up-to-9-weeks medical termination of pregnancy (MToP) using mifepristone–misoprostol regimens: expert consensus based on a systematic literature review

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    Evidence-based guidelines on the management of pain associated with first-trimester medical abortion are lacking. Most published clinical trials have failed to report on this important aspect of the procedure. The aim of this comprehensive work was to provide clinical advice based on a comprehensive literature review, supplemented by the clinical experience of a group of European experts in case no evidence is available. Pain level ranged from 5 to 8 in 80% of studies where pain was measured on a 0–10 visual analogue scale; severe pain was reported by 20–80% of women. Pain assessment was rarely reported in studies. Pain treatment should be preventive and avoidance of unnecessary uterine contractions should be considered. Analgesic treatment should follow the WHO three-step ladder, starting with the use of NSAIDs and allowing for easily available back-up treatment with weak opioids
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