Contraceptive Techniques Research Articles

Challenging PPIUCD Removal: A Case of Hysteroscopic Extraction from the Uterine Fundus

Intrauterine contraceptive devices offer reliable and reversible contraception. However, there are still challenges that persist in their management, particularly regarding deeply embedded PPIUCDs (Post-Partum Intrauterine Contraceptive Devices). We present a case study of a 30-year-old woman who had two caesarean deliveries and sought PPIUCD removal to plan a future pregnancy. On speculum evaluation, the threads of the device were undetectable with no abnormal health symptoms. Subsequent ultrasound analysis confirmed the presence of PPIUCD, positioned obliquely within the uterine cavity. The first removal attempt under aseptic precautions with an IUCD hook was unsuccessful. The second attempt was guided by ultrasound and hysteroscopy, which successfully eliminated the IUCD. The case highlights the intricate challenges in managing PPIUCDs and emphasizes the importance of proactive management strategies. By integrating advanced techniques like hysteroscopy, healthcare providers can navigate these challenges effectively, enhancing patient care and satisfaction. Intrauterine contraceptive devices have become a reliable and convenient method of birth control due to their high effectiveness and reversibility. Long-acting contraceptives provide reliable and lasting protection against unintended pregnancy, making them a popular choice for individuals looking for a hassle-free contraception method. The PPIUCD technique involves implanting an IUCD within 48 hours following either vaginal delivery or caesarean surgery to block sperm survival and prevent endometrial foreign body reactions.[1] The acceptability rate for PPIUCD implantation is 36.25%.[2] The placement of the PPIUCD is preferable since it does not interfere with breastfeeding.[3] The prevalence of modern contraceptives among married women who have reached reproductive age has gradually increased globally, rising from 55.0% in 2000 to 57.1% in 2019.[4] According to the recent India National Family Health Survey, the contraception prevalence rate among currently married women under 15 to 49 increased from 54% in 2015-16 to 67% in 2019-21. Intrauterine devices comprise only 2.1% of all contraceptive techniques used in family planning. However, all government facilities offer free IUCD services.[5] Complications like bleeding, pain, infection, perforation, and expulsion contribute to 20–40% discontinuation rates.[6] Younger women using IUDs are more likely to experience adverse effects than older women.[7] The limited progress was attributed to factors such as the low quality of services offered, restricted access, and misconceptions about techniques held by providers and users. Despite their effectiveness, IUDs can lead to potential complications. One such issue is the occurrence of lost or embedded IUDs, which are rarely observed, with approximately 1-2 cases per 1000 insertions.[8] This case report illustrates the difficulties encountered in removing embedded IUDs and underscores the significance of exploring alternative techniques to manage challenging cases safely and effectively.

Sex Education in the Prevention of Teenage Pregnancy in Lambayeque

Comprehensive sexual education (CSE) seeks to prepare adolescents for a safe and healthy life. This study evaluated the effectiveness of sexual education programs in preventing adolescent pregnancy in Lambayeque, with a focus on their impact on reducing the rate of adolescent pregnancy, barriers and opportunities to improve sexual education in the region, the methodology, a bibliographic review was carried out and public health statistics were analyzed, the results eighty-five percent of students said their understanding of STD prevention and contraceptive techniques had significantly increased. This result is in line with research that demonstrate how well-designed educational initiatives can greatly increase young people's awareness of and ability to abstain from harmful sexual conduct. Additionally, 70% of respondents showed more positive attitudes toward contraceptive use, compared to 50% before the program was implemented. This change in attitudes is consistent with research indicating that comprehensive sexuality education can change attitudes toward contraception and promote safer sexual behaviors, disparities in the implementation and reach of sexual education programs in Lambayeque explain the differences in students' knowledge and attitudes. Improving coverage, ensuring the quality and comprehensive content of programs, providing adequate training to educators, and obtaining greater institutional and cultural support are crucial steps to increase the effectiveness of sexuality education in the region.

A REVIEW STUDY ON ROLE OF CONTRACEPTIVES AND THEIR VARIOUS TYPES.

Contraception is the process used to stop unwanted pregnancy and control birth rate. Contraceptives reduces the chances of pregnancy after sexual intercourse. Contraceptives prevent pregnancies by interfering with the procedure of fertilization. Contraceptives reduces the chances of abortion by preventing unintended pregnancies on their partners, in which 842 million (44%) are modern using modern methods of Contraceptives are accessible in huge varieties and types . Numerous contraceptives are available, 790 million (42%) are traditional method users according the statistical data of 2019. The most common contraceptive techniques that are use of contraceptives are increasing day by day, 922 million of women of reproductive age used worldwide are female sterilization and male condoms, female sterilization are used in 219 million users (24%), male condoms are used in 189 million users (21%) according the data of 2019. The use of traditional methods and IUDs has reduced worldwide since 1994. According to WHO, The only form of birth control is a condom,that can prevent both unintended pregnancies and sexually transmitted diseases. The need of family planning is increased globally up to 77% from 2015 to 2020.. Over the past 20 years, the number of women using family planning methods has grown, rising from 900 million in 2020 to 2000 million. Use of modern contraceptive methods is also increased from 663 million to 851 million with the prevalence rate of 47.7% to 49.0%. Numerous contraceptive methods exist, including hormonal methods like CHC vaginal ring, CHC transdermal patch, and combination hormonal contraceptives. Progestin-only techniques include hormonal male contraceptives, progestin-only pills, DMPA injections, implants, and progestin-only IUDs. The other approach is non-hormonal and consists of vaginal pH modulators, barrier techniques like condoms, and copper IUDs. Traditional methods, such as the LAM method, the fertile cycle method, and the withdrawal approach, comprise the third type of contraception. Herbal contraceptives, which use a variety of herbs and plant preparations, are the fourth technique of birth control.

Unmet Need for Family Planning Among Women Attending Primary Healthcare in Alahsa, Saudi Arabia.

Enhancing maternal health quality is a concern among researchers globally. According to the World Health Organization (WHO), one factor in women's health and empowerment is the rate of use of various contraceptive techniques. The WHO defines unmet contraceptive need as the discrepancy between a woman's desire to delay or cease childbearing and lack of contraception use to achieve this goal. Our study was designed to measure the unmet need for family planning and contraceptive use among married Saudi women attending primary healthcare centers in Alahsa, Saudi Arabia. A cross-sectional study was carried out using multistage cluster stratified sampling. The study included all married Saudi women aged 18-49 attending primary health centers. A structured questionnaire from the United States Agency for International Development Demographic and Health Surveys Methodology was used. Data analysis was performed using the statistical software IBM SPSS version 29(IBM Corp., Armonk, NY). In all, 430 individuals were included.The participants' ages ranged from 19 to 49 years (33.4 ± 7 years). Among them, 50 (11.6%) were pregnant. Among those who were not pregnant, 268 (62.3%) were using a method of contraception. Based on the definitions adopted in this study, 90 (20.9%) had unmet needs for family planning, and 340 (79.1%) had their needs met. The total demand for family planning was estimated to be 83.2%. The percentage of demand for family planning satisfied by a modern contraceptive method was 46.9%. Although Alahsa has a lower unmet need rate (20%) than other cities in Saudi Arabia, it remains notably higher than the average rate in Northern African and Western Asian countries, which is 10.9%. A number of factors, including nulliparity and having more than two children, were associated with unmet contraceptive needs. The majority of women who did not use contraceptives had concerns about the side effects and inconvenience of use.

Assessing the impact of contraceptive use on mental health among women of reproductive age – a systematic review

BackgroundContraceptive use is the principal method by which women avoid unintended pregnancy. An unintended pregnancy can induce long-term distress related to the medical, emotional, and social consequences of carrying that pregnancy to term.ObjectivesThis review investigates the effects of modern contraception techniques such as birth control pills, long-acting reversible contraceptives (e.g., intrauterine devices, implants), and condoms on mental health status.MethodsWe searched multiple databases from inception until February 2022, with no geographical boundaries. RCTs underwent a quality assessment using the GRADE approach while the quality of observational studies was assessed using the Downs and Black scoring system. Data were analyzed through meta-analysis and relative risk and mean difference were calculated and forest plots were created for each outcome when two or more data points were eligible for analysis.Main resultsThe total number of included studies was 43. In women without previous mental disorders, both RCTs (3 studies, SMD 0.18, 95% CI [0.02, 0.34], high quality of evidence) and cohort studies (RR 1.04 95% CI [1.03, 1.04]) detected a slight increase in the risk of depression development. In women with previous mental disorders, both RCTs (9 studies, SMD − 0.15, 95% CI [-0.30, -0.00], high quality of evidence) and cohort studies (SMD − 0.26, 95% CI [-0.37, -0.15]) detected slight protective effects of depression development. It was also noticed that HC demonstrated protective effects for anxiety in both groups (SMD − 0.20, 95% CI [-0.40, -0.01]).ConclusionsAmong women with pre-existing mental disorders who use hormonal contraceptives, we reported protective association with decreased depressive symptoms. However, the study also draws attention to some potential negative effects, including an increase in the risk of depression and antidepressant use among contraceptive users, a risk that is higher among women who use the hormonal IUD, implant, or patch/ring methods. Providers should select contraceptive methods taking individual aspects into account to maximize benefits and minimize risks.

Migrated Intrauterine Contraceptive Device: A Case Report

The use of long-term and reversible family planning methods such as intrauterine contraceptive devices is common in Nigeria likely due to the large population, fertility as well as less economic burden of placement, and maintenance of this device. Uterine embedment, perforation, and extrauterine migration of the device is becoming more frequent with the increased number of patients benefitting from the contraceptive technique. Distant abdominal migrations and intrathoracic migrations have been reported. Transabdominal ultrasound is an initial imaging modality used in assessment of such patients; in some cases, however, plain abdominal radiograph also needs to be used. This paper will discuss a 30-year-old female who had intrauterine contraceptive device inserted at a primary healthcare facility about 7 months before presentation that got misplaced and was referred to our facility for radiologic investigations and localization of the device.

Contraceptive Utilization and Its Associated Factors Among Married Women in West African Countries: A Population-Based Survey Using Multinomial Logistic Regression.

The international development agenda emphasizes universal access to family planning, as seen in Sustainable Development Goal 3.7. However, the use of modern contraceptive methods remains low in developing countries, specifically in West Africa. This study aimed to assess the current status of contraceptive use in the region, focusing on different methods. We analyzed Demographic and Health Survey data from 13 West African nations (2012-2022) involving 117,165 married women. Using binary and multiple multinomial logistic regression, we identified key factors associated with contraceptive use. Adjusted odds ratios with 95% confidence intervals were utilized, and significance was determined at p ≤ 0.2 for binary regression and p < 0.05 for multiple multinomial regression. About 80.86% of women did not use any method, while 16.56% of women used modern methods. Maternal age of 35-49 years (RRR=0.77, 95% CI, 0.72,0.82), had given first birth after 20 years (RRR=0.80,95% CI, 0.77,0.83), cohabitation after 20 years old (RRR=1.24,95% CI, 1.18,1.29), being employed (RRR=1.38,95% CI, 1.33,1.43), women who have from 3-5, and more than five living children (RRR=2.06,95% CI,1.97,2.16, and (RRR=2.57, 95% CI, 2.42,2.74), primary(RRR=1.59, 95% CI, 1.52,1.66), secondary/higher education (RRR=2.08, 95% CI, 1.99,2.18), antenatal visit (RRR= 1.38, 95% CI 1.28,1.49), institutional delivery(AOR=1.42, 95% CI, 1.35,1.49), husband working status (RRR=1.39, 95% CI, 1.28,1.51), media exposure(RRR=1.23, 95% CI, 1.19,1.28), visited health facility more than once (RRR=1.09, 95% CI, 1.05,1.13), rural women (RRR=0.89,95% CI,0.85,0.93), female households (RRR=0.79, 95% CI,0.76,0.83), richer (RRR=1.42, 95% CI,1.33,1.51), and richest wealth indexes (RRR=1.69,95% CI,1.58,1.82) were associated. This study revealed a low level of contraceptive use among women in West Africa. Strengthening maternal reproductive health services, such as antenatal care, institutional delivery, and health visits, while also targeting mass media and disadvantaged women, has the potential to significantly increase the adoption of modern contraception techniques.

Contraception problems in the practice of a family doctor

Unplanned pregnancy can end with artificial or spontaneous termination, as well as it is also associated with the risk of complications that jeopardize safe motherhood in the future. One of the main trends in modern reproductology is the improvement and wider application of methods for planned and emergency contraception. The frequency of abortions in Russia is one of the highest worldwide; the reason of which is the poor awareness of the population about contraception devices and techniques. The significance of the problem is undeniable and important in preserving a women’s health. To solve this problem, it is necessary to increase the level of health education for both women and men in contraception and birth control. The paper presents the main known contraception types with their methods of application, advantages and disadvantages.

The Role of Digital Health Tools in Improving Contraceptive Use Among Reproductive Age Women

This article offers a thorough examination of the connection between contraceptive techniques and digital health technologies, clarifying their crucial roles in family planning and reproductive health. The introductory portion explores various contraceptive techniques, highlighting the significance of personalised decisions that take into account individual circumstances. The article explores a wide range of contraceptive alternatives, including barrier methods like condoms and modern Long-Acting Reversible Contraception (LARC) therapies. It acknowledges the impact of these options on making educated decisions about contraception. The article then transitions to the realm of "Digital Health," exploring the progression of telemedicine and its incorporation of artificial intelligence. The investigation spans several avenues via which digital health technologies are transforming the provision of healthcare, namely in the domain of sexual and reproductive health and rights (SRHR). The next sections analyse Digital Health Tools (DHTs) and its many manifestations, such as mobile apps, wearable devices, and internet platforms. These instruments are portrayed as catalysts for empowerment, offering knowledge, resources, and assistance pertaining to contraception. The article examines the advantages of digital health technology in improving understanding and compliance with contraceptives, while also analysing possible disadvantages such as difficulties in connecting different systems, fairness issues, and hazards to the privacy of data.

Investigating Determinants Affecting the Adoption of Contemporary Contraceptive Methods: A Cross-Sectional Analysis of Adolescent Utilization in the Nabdan District, Upper East Region, Ghana

Introduction: Promoting the use of contraception among adolescents is essential to improving their sexual and reproductive health. Teenage pregnancies are becoming more common, and the Nabdam area continues to have low rates of use of contemporary contraceptive methods. These facts highlight the urgent need to address the needs of adolescents concerning their sexual and reproductive health. This study aims to investigate the factors impacting the Upper East Region of Ghana's Nabdam District's adoption of contemporary contraceptive methods.&#x0D; Methods: 261 older teenage girls from the Nabdam district, ages 15 to 19, were included in the study, which used a quantitative technique and a descriptive cross-sectional design. Respondents were chosen using a multiphase sample technique, and data were collected over the course of 10 working days using a standardized survey form. STATA Version 14 was utilized for data analysis. A significance criterion of p &lt; 0.05 was applied to bivariate and logistic regression models to investigate any correlations between independent factors and outcome variables.&#x0D; Results: 52.1% of respondents said they have had their first sexual experience before turning 20. The oldest stated age at first sex was 19 years old, while the youngest was 10 years old. Additionally, 97.8% of respondents reported learning about contemporary contraception via a variety of sources, such as peers, instructors, health professionals, and radio media. Even with this knowledge, 48.7% of respondents thought using a contraceptive technique would provide 100% protection against getting pregnant, while 73.6% of respondents had never used any kind of birth control. Age (p&lt; 0.001), educational attainment (p&lt; 0.001), marital status (p&lt; 0.001), peer influence (p&lt; 0.001), place of residence (p&lt; 0.001), religious affiliation (p&lt; 0.018), consent from a sexual partner (p&lt; 0.001), positive attitudes from healthcare providers (p &lt; 0.001), and the availability of contraceptives (p &lt; 0.001) were discovered to be linked to the usage of modern contraceptives.&#x0D; Conclusion: Although a sizable percentage of respondents showed awareness of contemporary contraceptive methods, low modern contraceptive usage was significantly correlated with several factors, including age, marital status, educational attainment, peer influence, partner consent, and the unfavorable attitudes of healthcare professionals. To tackle this problem, a community-based strategy emphasizing the advancement of enabling elements and the removal of obstacles is required. The Ghana Health Service could enhance its School Health Education Program (SHEP) by increasing informational sessions, organizing theatrical productions and debates, and recruiting peer educators as invaluable resources to share experiences and instruct their peers on sexuality, reproductive health issues, and the use of modern contraceptives

Level of knowledge, attitude, and practice on modern contraceptive method and its associated factors among housemaids living in Debre Tabor town, northwest Ethiopia: a community-based cross-sectional study

BackgroundContraception is widely recognized as an effective technique for avoiding unplanned pregnancies and sexually transmitted diseases. Promoting contemporary contraceptive methods would minimize the number of unplanned pregnancies and the high number of maternal fatalities connected with unsafe abortions.ObjectiveThis study aims to assess the level of knowledge, attitude, and practice of modern contraceptive methods and its associated factors among housemaid residents of Debre Tabor Town, northwest Ethiopia:MethodsA structured questionnaire supplemented with face-to-face interviews was used to conduct a community-based cross-sectional study with 423 housemaids’ women of reproductive age in Debre Tabor City. The data were analyzed using descriptive analysis, binary analysis, and multivariable logistic regression.ResultsA 12.8% of respondents in this study used modern contraceptive methods. A 44.68% of study participants had good knowledge of modern contraceptive methods, and 36.40% had a positive attitude towards them. Housemaids’ older age, urban location, educational status, work experience, and family situation were found to be positive predictors of a good understanding of current contraceptive techniques. Housemaids’ older age, urban residence, educational level, work experience, family situation, and first sex before now are all positive predictors of a positive attitude and good practices.ConclusionsHousemaids’ knowledge, attitude, and practice of modern contraceptive methods were influenced by a variety of socio-demographic factors. As a result, housemaids should be educated about modern contraceptive methods by the health sector and other stakeholders to improve their knowledge, attitude, and practices.

Contraceptive awareness and its determinants for use among women of reproductive age: A cross sectional study

Introduction: According to the WHO, family planning is an approach to thinking and living that people and couples freely adopt in order to enhance their health and welfare based on their knowledge, attitude, and responsible choices. Each year, incorrect use of contraceptives or their failure to work as intended results in around one-third of unwanted births. The obstacles that exist in poorer nations include a lack of awareness about contraceptive techniques, the availability of supplies, their cost, or their inadequate accessibility. Method: This was a cross sectional study; conducted to asses o contraception awareness, acceptance, and adoption among women of reproductive age. Women who attended/delivered at the Saidham Hospital affiliated to Dr. Mane Medical Foundation and Research Centre (DMMFARC) Maharashtra, India were included. Face-to-face interviews were conducted while data were collected using a structured questionnaire. Result: Out of total 359 total women the majority 115 (32.02%) belonged to the 21–25 age group, while 197 (54.87%) were housewives, 112 (31.19%) had higher secondary education, 201 (54.98%) belonged to the lower socioeconomic class and were BPL cardholders, 191 (52.20%) belonged to rural areas, and Hindu populations contributed 182 (50.69%). Furthermore,165 (45.96%) study participants had one child, and 21 (5.84%) had a history of one abortion. occupation, level of education, socioeconomic class, area of residence, and religion showed statistically significant relationships with contraception usage. Conclusion: The present study concludes that the majority of women of reproductive age still do not use contraceptives and their opinion is not taken into account. More similar studies are needed to ascertain the determinants of contraceptive use and such knowledge can be used to formulate specific health education needed for adoption of family planning methods.

Nanomaterials Solutions for Contraception: Concerns, Advances, and Prospects.

Preventing unintentional pregnancy is one of the goals of a global public health policy to minimize effects on individuals, families, and society. Various contraceptive formulations with high effectiveness and acceptance, including intrauterine devices, hormonal patches for females, and condoms and vasectomy for males, have been developed and adopted over the last decades. However, distinct breakthroughs of contraceptive techniques have not yet been achieved, while the associated long-term adverse effects are insurmountable, such as endocrine system disorder along with hormone administration, invasive ligation, and slowly restored fertility after removal of intrauterine devices. Spurred by developments of nanomaterials and bionanotechnologies, advanced contraceptives could be fulfilled via nanomaterial solutions with much safer and more controllable and effective approaches to meet various and specific needs for women and men at different reproductive stages. Nanomedicine techniques have been extended to develop contraceptive methods, such as the targeted drug delivery and controlled release of hormone using nanocarriers for females and physical stimulation assisted vasectomy using functional nanomaterials via photothermal treatment or magnetic hyperthermia for males. Nanomaterial solutions for advanced contraceptives offer significantly improved biosafety, noninvasive administration, and controllable reversibility. This review summarizes the nanomaterial solutions to female and male contraceptives including the working mechanisms, clinical concerns, and their merits and demerits. This work also reviewed the nanomaterials that have been adopted in contraceptive applications. In addition, we further discuss safety considerations and future perspectives of nanomaterials in nanostrategy development for next-generation contraceptives. We expect that nanomaterials would potentially replace conventional materials for contraception in the near future.

Prevalence, Trends in and Determinants of Teenage Pregnancies in Rwanda: Analysis of Rwanda Demographic and Health Survey (2010 to 2020)

Background: According to the World Health Organization, roughly 16 million teen mothers aged 15 to 19 give birth annually resulting a 44,000 births per day worldwide. Moreover, the vicious cycle of poverty in sub-Saharan Africa is exacerbated by adolescent pregnancy, this also increases maternal, perinatal, and infant mortality hindering SDG goal 5 and target 3 of ending the child marriage of 2030 to be achieved. This study aimed to identify the prevalence, trends, and determinants of teenage pregnancies in Rwanda between 2010 and 2020. Methods: This study used Rwanda's demographic and health survey data from 2010, 2015, and 2020, and a cross-sectional study design. All data were cleaned and appended to get the final data set for analysis, all analyses were performed using R software package 4.3.1. Moreover, statistical significance was determined at a 5% p-value and 95% Confidence Interval (CI) while not crossing one. Results: The total number of teenagers between 2010 and 2020 was 9,050 and among them, the prevalence of teenage pregnancy was 6.11% (n = 553/9050). By trend, teenage pregnancy in 2010 was 6.22%, in 2015, 7.30%, and in 2015 5.41% in prevalence. After adjusting the variables in a multivariate logistic regression model, the following were found to be potential predictors of teenage pregnancy in Rwanda: Region by Eastern province (AOR: 1.55:95% CI: 1.078,2.24), lack of education and primary school teens (AOR: 2.9:95% CI: 1.22,6.89) and AOR: 1.67:95% CI: 1.25,2.24)respectively, Poorest households AOR: 2.02:95% CI: 1.27,3.12), those with knowledge of contraceptive methods (AOR: 8.70:95% CI: 3.34,23.01), sexually active unmarried women (AOR: 3.50:95% CI: 1.58,7.78), teens who did not access social media (AOR: 2.03:95% CI: 1.41,2.91), and it was protective against family size. Conclusion: These results imply that a combination of social, sociodemographic, and knowledge-related factors, as well as awareness of contraceptive techniques, may impact teenage pregnancy in Rwanda. The provision of contraception education and awareness should be the primary goal of efforts to minimize adolescent pregnancies in Rwanda, particularly in areas where the prevalence is higher. In addition, encouraging family planning and tackling economic inequalities can be effective tactics to lower adolescent pregnancy rates.

Spatial patterns and predictors of unintended pregnancy among reproductive age women in Ethiopia.

Unintended pregnancy is amajor sexual and reproductive health problem that imposes substantial health, economical and psychosocial costs to individuals and society as well as significant emotional distress to women, families, and society. The main aim of this study was to investigate the spatial distribution and predictors of unintended pregnancy in Ethiopian regions and administrative zones. This study was conducted based on data from 2016 Ethiopian Demographic and Health Survey. The prevalence of unintended pregnancy across regions and or zones was assessed using spatial analysis, and the effect of different factors on unintended pregnancy in Ethiopia was investigated using a generalized linear mixed model with a multistage clustered sampling strategy. The crude and best linear unbiased predictor estimations of zones were integrated with the shape file data to demonstrate the performance of each zone on maps. The prevalence of unintended pregnancy for reproductive women in Ethiopia was29.49%. The highest rates of unintended pregnancy were recorded in the North Gondar zone of the Amhara region and the Jima zone in the Oromiya region. The mixed effects model revealed that age [AOR = 0.78, 95% CI, 0.62-0.97], residence [AOR = 2.62, 95%CI, 1.94, 7.27], marital status [AOR = 0.05, 95%CI, 0.01-0.38], women education [AOR = 1.34, 95%CI, 0.75-2.39], smoking cigarettes [AOR = 3.67, 95CI, 1.17-11.56], and poorer wealth index [AOR = 1.89, 95% CI, 1.51-2.31] were significantly associated with unintended pregnancy. In Ethiopia, unintended pregnancy is a public health issue, and prevention stratagem for unintended pregnancy among reproductive women need to be focused based on the identified predictors. The spatial distribution of unintended pregnancy varied greatly at zonal and regional levels in Ethiopia. Hence, we recommended that, creating awareness of sexual and reproductive health with special priority to the identified hotspot areas (Amhara, Oromiya and SNN regions) to reduce unintended pregnancy. Emphasis on fertility and contraceptive techniques should be given to couples by health professionals.

Quasi Experimental Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Temporary Contraceptive Techniques among the Eligible Couples

Quasi Experimental Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Temporary Contraceptive Techniques among the Eligible Couples

Laser ablation of the equine oviductal papilla as a novel contraceptive technique

Reproductive control of wild horses has frustrated land management groups for decades. GnRH and Zona Pellucida vaccines have a limited duration of efficacy, intrauterine devices are unpredictably retained, and attempts to ovariectomize mares in the western United States were met with public outcry in 2018. The development of a non-surgical permanent sterilization technique has the potential to revolutionize management of wild equids on public lands. The objectives of this study were to develop a safe and effective sterilization technique for reproductively healthy mares. We hypothesized that laser ablation of the oviductal papillae would be an effective method of permanent sterilization. Seven light-breed reproductively healthy mares (5-21yrs) were enrolled in the study. On enrollment, mares were sedated for hysteroscopy, and the endometrium and oviductal papillae were examined using a 103cm flexible endoscope (Olympus GIF-160 Gastroscope, Center Valley, PA) attached to an Olympus EVIS EXERA CV-160 video processor. In five mares, a 600 μm laser fiber was advanced through the biopsy channel and a diode laser (Dornier Medilas D, Dornier MedTech America, Inc., Kenneasaw, GA) was used to deliver direct contact pulses of 3 to 5 seconds in duration to the oviductal papilla. The endoscope was then guided up the contralateral horn and the process repeated. In two control mares, the oviductalpapillae were visualized, but no laser ablation was performed. All mares received 5 mg dinoprost IM and a uterine lavage within 4 hours post-procedure. Transrectal ultrasound was performed every 2-3 days until a 35mm follicle was detected, and then mares were bred using semen from a fertile stallion. Pregnancy status was determined by transrectal ultrasound 14 days post-ovulation, luteolysis was induced, and mares were rebred on 2-4 consecutive cycles. Control mares conceived on 6 out of 9 cycles (67% pregnancy rate). Pregnancy rate was significantly lower in the treatment group (5%, 1 out of 20 cycles, p=0.003). The first mare that was laser ablated conceived on the 4th cycle, and repeat hysteroscopy determined that the left oviduct was not effectively ablated. The third mare was diagnosed with peritonitis via abdominocentesis 6 hours post hysteroscopy. The mare was treated with broad spectrum antibiotics and recovered uneventfully. Three mares were re-bred two years after the procedure and did not conceive. In conclusion, when laser ablation of the oviductal papillae was appropriately performed, scar tissue formation effectively prevented pregnancy for a minimum of four months post-procedure. Laser ablation of the oviductal papillae is a promising technique for permanent sterilization of the mare and a follow-up long-term fertility study is warranted in a larger group of mares is warranted.

(364) Abortion: Genesis of an Authoritan Shift in 2022

Abstract Introduction Access to abortion is questioned in the USA. The abortion debate crystallizes in the form of a confrontation between pro and anti clans. Is it possible to get away from this rhetoric and consider that the question of abortion is that of access to care? Abortion is a social fact described since Antiquity, for this reason, States have the duty to accompany applicants. Reducing the abortion debate to the dialectic of for or against is the linguistic maneuver generating emotional activation opposing human rights. Can scientific research be an explanatory factor for social constructions relating to abortion? Our study proposes to put into perspective the end of the decriminalization of abortion with gender asymmetry in scientific analysis in reproductive health, in particular concerning induced abortion. Objective to consider abortion as a social fact to put into perspective the abortion's right and the inequality of research according to gender Methods we conducted a literature review from 07/2021 to 06/2022 with the keywords men and abortion and women and abortion introduced on Pub Med: 86 articles are referenced for men, 10 of which are relevant. 1698 references for women of which 1310 are relevant. The criterion of relevance is the reference to induced abortion. Results this literature review shows scientific research in reproductiv health concerning abortion overwhelmingly in favor of women. The scientific literature studying the man whose ephemeral partner or not is confronted with abortion constitutes less than 1% of research on abortion. Remember in this regard that the man and the woman each participate equally in fertilization Conclusions Conclusions: this work questions the imperativ of an egalitarian scientific treatment for genders in reproductiv health and particularly on abortion. Gender iinequalities in scientific research could perform heteronormativ frameworks, generating power relations and discrimination in the construction of symbolic and social representations. This dynamic of socio-scientific inequalities crystallizes in the field of law, assigning the most vulnerable to situation that violates human rights The asymmetry of gender, namely the social domination of men versus the reproductiv power of women, has a strong impact on the developpement of frameworks for the scientific analysis of fertility and sexuality: the place of men, central to sexual health, with HIV, is on the contrary marginalized in reproductiv health, excluding the man from almost the entire reproductiv mechanism. Birth control has existed since ancient times, by this means, people match societies with the limited resources of the environment in order to create a sustainable world for all living species including the human species. The logic, the contraceptive techniques sometimes fail: forcing a person to have a pregnancy, which is physically, psychologically and socially constraining, which involves risks in particular for overall health, is a serious attack on the democratic principles guaranteeing people's freedom Disclosure No

To determine the burden of ectopic pregnancy in the tertiary care centre (TRIHMS) of Arunachal Pradesh and its implication on the type of surgical and anaesthetic management

The incidence of Ectopic Pregnancy (EP) is 1 – 2% in India, with mortality rate of none to 3.5%. It is considered to be emerging as one of the leading problem for woman’s fertility with major mortalities in reproductive age group.In this study we had intended to find out the incidence of EP in tertiary care centre of Arunachal Pradesh along with clinical presentation and mode of surgical and anaesthetic management. After clearance from Institutional ethics committee, patients’ with diagnosis of ectopic pregnancy, whether elective or emergency were included in this study. This study aimed to determine the incidence of EP, type of surgical intervention and mode of anaesthesia. 81 diagnosed cases of EP admitted in obstetrics ward were enrolled for this study. The incidence of EP was 22.9 per 1000 deliveries in tertiary care centre of state of Arunachal Pradesh. Emergency contraceptive pill intake was single most leading risk factor in this study, with history of intake in 28.4% of the cases. 85.2% cases had salphingectomy and 90.1% surgeries were conducted under spinal anaesthesia EP may be rising in recent trends due emerging use of contraceptive and other reproductive techniques. We conclude that the ectopic pregnancy is major cause of morbidity in reproductive female age group; however, with timely diagnosis and collaborative obstetrical and anaesthetic management, its mortality can be reduced significantly.

How to adapt message to adolescents about sexuality?

IntroductionA mature and fulfilling sexuality is based on appropriate sexual education. The message must be adapted to the level of knowledge and practices of young people. Old studies dating back more than 15 years have been published.ObjectivesThe objective of this study is to assess adolescents’ knowledge and attitudes about sexuality.MethodsThis is a descriptive cross-sectional study conducted among 80 adolescents using an anonymous online questionnaire.ResultsThe average age of the participants was 18 years old 45% had had at least one sexual intercourse, they are mostly male. Only 9% had used a method of contraception. Most of them had heard of contraceptive techniques. Young age, male gender, lack of dialogue with parents, low socio-economic status and lack of sex education were significantly associated with a low level of knowledge about sexuality.ConclusionsThe results show that adolescents had risky practices with a lack of information. More studies are needed to approve these results and improve sexual health of these teenagers thanks to targeted sensitization.Disclosure of InterestNone Declared