Contraceptive Intervention
Sujoy K. Guba in Bioengineering in Reproductive Medicine, 2020
Chemical methods either on oral administration or local vaginal application have long dominated the field of reversible contraception in the female. More recently, the intrauterine devices have gained popularity. In the sterilization area, the most widely practiced approach is tubal ligation by laparotomy and minilaparotomy. Very few contraceptive modes that may be considered as based upon physical sciences and bioengineering have been formulated. Some years ago, research offered the hope that improved means of temperature measurement and vaginal plethsymography, which is discussed in Chapter 2, would make ovulation detection reliable and convenient, and thereby make the rhythm method more acceptable. But the outcome of the research has not supported earlier expectations. Bioengineering, therefore, figures to some extent only in modifications of the routine surgical procedure for tubal ligation.
Why I am pro-life 1
Bertha Alvarez Manninen, Jack Mulder Jr. in Civil Dialogue on Abortion, 2018
To bring this long section to a close, we need to discuss a bit about the difference between abortion and contraception. While even Pope John Paul II, whose opposition to both is well known, knew there was a difference in that he saw abortion as a variety of killing, and contraception as a failure to respect the “full truth of the sexual act,” he nevertheless saw a connection between the two in various ways.74 An interesting case for discussion might be the case of a woman who undergoes tubal ligation as an elective procedure. While tubal ligation is meant to be a permanent form of sterilization, pregnancy can occur, and, when it does, the woman is at an increased risk of ectopic pregnancy, as even Planned Parenthood recognizes.75 I offer it as a question how “pro-life” one could be while embracing a form of sterilization that significantly enhances the likelihood that any possible embryo would neither implant in the uterus nor make it to term because of the danger it would cause to mother and embryo alike.76
Gynecologic Microsurgery
Waldemar L. Olszewski in CRC Handbook of Microsurgery, 2019
Yes. As a consequence of changing social mores and contraceptive technology, more women have developed tubal obstruction. The rising incidence and prevalence of sexually transmitted diseases and iatrogenic sterility resulting from sterilization cause blocked tubes. Voluntary sterilizaton by tubal ligation has become an increasingly popular form of contraception, and in recent years more nulliparous women are requesting this procedure. Age may be an important factor in regret and request for reversals. Although the wish to remain childless is the most frequent motivating factor leading women to seek sterilization, the patient’s inability to tolerate other contraceptive methods is also important. The changing lifestyles, increased divorce rate, and remarriage have caused many women to seek microsurgery for reversal of a sterilization. Besides the vast increase in the number of women being sterilized, a good deal of publicity has been given in the scientific and lay press about the prospects for reversibility. The liberalization of abortion has reduced the number of infants available for adoption. Left with few alternatives, and despite the limited chances for success with certain types of tubal repair, patients nevertheless are willing to undergo tubal reconstruction.
Sjogren’s with distal renal tubular acidosis complicating pregnancy
Published in Journal of Obstetrics and Gynaecology, 2018
Anand Yuvaraj, Sudakshina Ghosh, Lakshmi Shanmugasundaram, Georgi Abraham
As she experienced spontaneous labour pains, emergency caesarean was performed at 36 weeks. The cardiotocograph for 60 minutes prior to delivery was non-reassuring with reduced variability and sporadic decelerations. Preoperative serum HCO3 and K + levels were 16 mmol/L(mEq/L) and 3.5 mmol/L(mEq/L), respectively. Infusions of NaHCO3 and KCl were administered during the caesarean and maintained for the first 24 hours postoperatively. At delivery, the cord blood venous and arterial analysis were normal with no evidence of acute or chronic hypoxia and all intra-operative findings were unremarkable. The placenta separated spontaneously with oxytocin 10 units bolus dose at delivery and blood loss was minimal. Bilateral Tubal ligation was performed with prior informed consent.
Adapting and Expanding Home-Based Life-Saving Skills to Include Family Planning to Promote Maternal Health in South Sudanese Refugees
Published in Women's Reproductive Health, 2020
Kelly Ackerson, Ruth Zielinski
Following DMPA, the implant is the second most commonly used contraceptive method in SSA (Tsui et al., 2017). For example, the implant story developed in Phase 4 focuses on a newly married couple who want to delay childbirth until they finish college. If women have some education beyond secondary school, they are less likely to have multiple births, are more empowered, and are healthier (WHO, 2012). Although permanent contraception use is very low, many women in SSA have little understanding of what it is (Olakunde et al., 2019). For those women who do not want any more children, tubal ligation is a viable option. Common side effects of modern contraceptive methods (e.g., unscheduled bleeding, menses cessation, breast tenderness, mild headache, upset stomach) are prevalent reasons for discontinuation (Villavicencio & Allen, 2016). These side effects encountered with hormonal contraceptives can be managed if a woman understands that they are neither abnormal nor dangerous. Finally, there are misperceptions that using hormonal contraception can cause infertility and sometimes death (Ackerson & Zielinski, 2018; Adedze & Osei-Yeboah, 2019). Addressing these misperceptions is important, especially in a culture where a woman’s social status is connected to reproductive capability. However, it is not enough only to address modern contraception; women must have functional knowledge of basic reproductive physiology (menarche/puberty, menstrual cycle, fertility) to aid in understanding how contraception works and to prevent an unplanned/mistimed pregnancy.
Effect of Surgical Adhesive on the Uterus of Rabbits Following Occlusion
Published in Journal of Investigative Surgery, 2019
Anran Xu, Tianyu Hao, Xiaoqing Wei, Chuanfen Li, Lihua Niu, Xiaohui Deng
A duplex uterus is observed in rabbits, with similarities to the human fallopian tube in terms of lumen size and structure, thus making rabbits ideal experimental animals for the purpose of the present study. Previously, it has been demonstrated that patients undergoing pretreatment of abnormal fallopian tube exhibited evidently higher IVF-ET pregnancy rate as compared to those without any surgical intervention.5 Therefore, pretreatment of the abnormal fallopian tube is generally considered to be necessary. To date, the main treatments include laparotomy or laparoscopic salpingectomy, proximal tubal ligation, distal tubal expansion, and transvaginal ultrasound-guided fallopian tube fluid aspiration. However, researchers have demonstrated that all these methods had certain side effects.9,10,11 Therefore, it is urgent to search for novel and effective therapies for the treatment of abnormal fallopian tube in clinical practice prior to performing IVF-ET.