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Ailments and Diseases
Published in James Sherifi, General Practice Under the NHS, 2023
Intrauterine systems (IUS, formerly IUD/IUCD), such as the Mirena coil, which could be left in vivo for up to five years, were increasingly being used not just as a contraceptive device but also for the management of irregular menstrual bleeding, menorrhagia, and dysmenorrhoea. The NHS vigorously promoted long-acting reversible contraceptives (LARC) as both safer and more reliable than the combined contraceptive pill, and QOF rewarded their use. Female doctors and nurses found themselves taking on the bulk of any work relating to women’s health.
Case 40
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
The basic options available to any patient areIntrauterine contraceptives (long-acting reversible contraception)Copper-containing intrauterine contraceptive device (copper coil)Levonorgestrel releasing intrauterine system (e.g. Mirena® or Jaydess®)Progestogen-only contraceptionImplantDepot injectionProgestogen-only pillCombined hormonal contraceptionCombined oral pillTransdermal patchesVaginal rings
Common Tips on Communication
Published in Justin C Konje, Complete Revision Guide for MRCOG Part 3, 2020
When can pregnancy occur after a molar pregnancy? You can usually get pregnant after treatment if you wish, but you will be advised not to try for at least 6 months if your hormone levels are back to normal within 56 days (8 weeks), but if they are not back to normal within 8 weeks, you should avoid pregnancy for at least a year from when they are back to normal because there’s a chance (about 1 in 30) that PTD could come back during this time. You can have sex as soon as you feel physically and emotionally ready. If you have any bleeding after your treatment, you should avoid sex until it stops. Having a molar pregnancy does not affect your chances of getting pregnant again, and the risk of having another molar pregnancy is small (about 1 in 80). It is best not to try for a baby until after monitoring has finished, in case you need further treatment to remove any cells left in your womb/body. Apart from the intrauterine contraceptive device (the coil), most forms of contraception are acceptable. In the past, it used to be thought that the combined pill delays a return to normal of the hormones, but there is no evidence for this. Doctors say it’s safe to get pregnant again. You can however use the coil once your hCG level has returned to normal.
Intrahepatic cholestasis of pregnancy: from an obstetrician point of view
Published in Journal of Obstetrics and Gynaecology, 2022
Mohsen M. A. Abdelhafez, Karim A. M. Ahmed, Win Win Than, Dg Marshitah Pg Baharuddin, Fairrul Kadir, Saffree Jeffree, Mohammad Firdaus Hayati, Mohd Nazri Bin Mohd Daud, Aya M. Eldiastey, Kai Xin Tay
Interestingly, children born to women with ICP were found to have higher tendency to develop dyslipidemia and also, risk of increased body mass index at age of 16 (Papacleovoulou et al. 2013). Women with ICP should be counselled postnatally on the increased risk of recurrence of the condition in subsequent pregnancy and must be informed that the magnitude of this risk may be as high as 90% (Gonzalez et al. 1989), Of note, recurrence of pruritus and cholangitis may occur on combined oral contraceptive pills administration (14% risk) (Williamson et al. 2004), which should be avoided in those women and recommend alternative method of contraception. Hence, contraceptive counselling may include, progestogen-only pills, subdermal progestogen implants, levonorgestrel-intrauterine contraceptive device (LNG-IUS), intrauterine contraceptive device (IUCD) (Wood et al. 2018) as well as permanent methods of contraception (male and female).
Timely use of in-car dim blue light and blue blockers in the morning does not improve circadian adaptation of fast rotating shift workers
Published in Chronobiology International, 2021
Jeanne Sophie Martin, Luc Laberge, Alexandre Sasseville, Marilie Bérubé, Samuel Alain, Joëlle Lavoie, Jérôme Houle, Marc Hébert
The “winter study” was conducted between November 2011 and April 2012 (mean sunrise ± SD = 06:56 ± 00:25 h). A total of 25 police patrol officers (19 males, 6 females; mean age ± SD = 29.4 ± 3.7 y) were recruited with the same procedures and at the same police station as in the summer study. All subjects reported being in good mental and physical health, and not taking medication affecting sleep. One subject reported being an occasional cigarette smoker (˂5 cigarettes/week). No subject took a transmeridian flight in the 3 months prior to the study. Four women were using oral contraceptives and one woman an intrauterine contraceptive device. One woman reported having a 30-day natural menstrual cycle. This latter subject was evaluated during her follicular phase. None of the female subjects was pregnant or planning to become pregnant. Subjects filled the MEQ, and, as in the summer study, no participant was categorized as Morning type. Moreover, no subject was categorized as an extreme chronotype, and no subject presented indications of either a sleep disorder or seasonal affective disorder. All subjects had been working full time for 2 to 15 y (7.0 ± 3.4 y) on a 5-week cycle of rapidly rotating shift schedule.
Factors influencing utilization of intra-uterine device among postpartum mothers at Gombe Hospital, Butambala disrtict, Uganda
Published in Cogent Medicine, 2020
Kizito Omona, Winnifred Namuli
The most effective modern family planning method consists of long-acting reversible contraceptives (LARCs) which include intra-uterine contraceptive devices (IUCD). This method has multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long (Espey & Ogburn, 2011). Intra-uterine contraceptive has the following advantages; its contraceptive effect is quickly reversible following removal and has a longer duration of effectiveness of at least 12 years. It is completely good for breastfeeding post-partum women and safe for mothers where hormonal methods are contraindicated (ACCESS-FP J, 2008). The intra-uterine contraceptive device is a safe and highly effective contraceptive method (Getinet et al., 2014).