Success of medication abortion with mifepristone followed by two doses of misoprostol in very early pregnancy.

Objectives: To compare medication abortion (MAB) success in very early pregnancy (VEP) with mifepristone followed by either one or two doses of misoprostol.

Study Design: We performed a retrospective cohort analysis of VEP MABs from July 1, 2021 to May 31, 2022 treated with mifepristone 200 mg oral followed by a single dose of misoprostol 800 mcg buccal 24 to 48 hours later and MABs from June 21, 2022 to October 31, 2022 treated with mifepristone 200 mg oral followed by two doses of misoprostol 800 mcg buccal spaced 4 hours apart, with first dose taken 24 to 48 hours after mifepristone. Serum BhCG was collected at the time of mifepristone treatment with additional BhCG collected 48 to 72 hours after misoprostol treatment in both groups.

Medical management of ectopic pregnancy in a family planning clinic: A case series.

Objective: To evaluate safety of medical management of ectopic pregnancy in a free-standing family planning clinic setting.

Study Design: We retrospectively reviewed cases of ectopic pregnancy between January 2014 and December 2018 which were identified using a "Beta Board" tracking system. Planned Parenthood of Orange and San Bernardino Counties staff added patients the "Beta Board" if they had a positive urine pregnancy test without definitive ultrasound diagnosis of intrauterine pregnancy and/or symptoms suggestive of ectopic pregnancy, such as vaginal bleeding, and cramping.

A qualitative study of digoxin injection before dilation and evacuation.

Objective: We sought to qualitatively understand patients' experiences with digoxin as a step before dilation and evacuation (D&E).

Study Design: We recruited English-speaking women from one abortion health center where digoxin is routinely used before D&E. We interviewed participants one to three weeks after the D&E about physical and emotional experiences with digoxin and understanding of its purpose.

The Longest Wait: Examining the Impact of Utah's 72-Hour Waiting Period for Abortion.

Purpose: To assess the impact of Utah's 2012 law increasing the mandatory abortion waiting period from 24 to 72 hours.

Methods: This paper includes two assessments of this change: (1) Comparison of the proportion of women returning for an abortion after counseling before and after the introduction of the 72-hour law and (2) self-reported wait times between abortion and procedure, distance traveled, financial expenditures, and perceived impact of the law in a subset of women who were surveyed.

Main Findings: Aggregate counseling and procedural data were available at three Utah clinics; 2,793 of 3,618 women (77%) returned for abortion procedures under the 72-hour law, compared with 2,513 of 3,130 (80%) in the previous year (p < .

Evaluation of an intervention designed to improve the management of difficult IUD insertions by advanced practice clinicians.

Objectives: To assess whether clinical skills training in cervical dilation and paracervical anesthesia, as well as the introduction of a clinical protocol for difficult insertions, increased intrauterine device (IUD) insertion success rates among advanced practice clinicians (APCs) including women's health and family practice nurse practitioners, physician assistants and certified nurse midwives.

Study Design: This prospective study assessed an intervention to improve IUD insertions among APCs at six family planning clinics in Utah. We collected data on IUD insertions performed by participating clinicians during two observation phases: preintervention (Phase 1) and postintervention (Phase 2).

We should really keep in touch: predictors of the ability to maintain contact with contraception clinical trial participants over 12 months.

Objectives: This study assesses the ability to maintain contact with participants enrolled in an emergency contraception (EC) trial with 12 months of follow-up based on the modes of contact they provided at enrollment.

Study Design: Data came from a clinical trial offering women the copper intrauterine device or oral levonorgestrel for EC. A modified Poisson regression was used to assess predictors associated with the ability to contact study participants 12 months after enrollment.

Removal of the LNG IUD when strings are not visible: a case series.

Objectives: To report length of intrauterine device (IUD) and strings as well as technique for extraction when IUD removal occurs without visible strings.

Study Design: A prospective case series of 29 women who had IUDs removed in-office when strings were not visible at the external cervical os.

Results: One third (n=11) were found to have a total length of IUD and strings <7.

Vaginal microbiome changes with levonorgestrel intrauterine system placement.

Objective: To investigate changes in female genital tract bacterial ecology associated with levonorgestrel intrauterine system (LNG IUS) use.

Study Design: Study participants were regularly cycling Caucasian women without recent history of pregnancy or exogenous hormone use. Vaginal, cervical and uterine samples were obtained at nine time intervals, from 1 week before to 12 weeks after LNG IUS placement.

Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates.

Objective: We investigated the 1-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 intrauterine device (IUD) or oral levonorgestrel (LNG) for EC.

Study Design: This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC.

Same-day cervical preparation with misoprostol prior to second trimester D&E: a case series.

Background: Traditionally, overnight cervical preparation with osmotic dilators has been used for second trimester dilation and evacuation (D&E) procedures. Misoprostol offers an alternative treatment that could shorten cervical preparation time.

Study Design: This study reports on a case series of patients who received only buccal or vaginal misoprostol for cervical preparation on the same day as the D&E procedure.

Extended and continuous combined contraceptive regimens for menstrual suppression.

Many women have medical indications for menstrual suppression or a personal preference to reduce or eliminate monthly bleeding, which can be achieved with extended and continuous regimens of combined estrogen and progestin contraceptives. Combined contraceptives are traditionally administered in a 28-day cycle, with 21 days of a contraceptive pill, vaginal ring, or transdermal patch followed by a hormone-free interval that is usually 7 days. During the hormone-free interval, women either take a placebo pill or do not use their combined contraceptive method.

Criterion-based screening for sexually transmitted infection: sensitivity, specificity, and predictive values of commonly used questions.

Introduction: Practice protocols that mandate prescreening for sexually transmitted infection prior to insertion of an intrauterine device for contraception can pose obstacles for women seeking this highly effective method of birth control. Some practices screen for presumed risk factors for sexually transmitted infection in order to identify those who may be infected or those in whom laboratory testing should be obtained. The value of such criterion-based screening is unclear.

Failed IUD insertions in community practice: an under-recognized problem?

Background: The data analysis was conducted to describe the rate of unsuccessful copper T380A intrauterine device (IUD) insertions among women using the IUD for emergency contraception (EC) at community family planning clinics in Utah.

Methods: These data were obtained from a prospective observational trial of women choosing the copper T380A IUD for EC. Insertions were performed by nurse practitioners at two family planning clinics in order to generalize findings to the type of service setting most likely to employ this intervention.

Self-administered misoprostol or placebo before intrauterine device insertion in nulliparous women: a randomized controlled trial.

Objectives: To estimate the effects of self-administered misoprostol compared with placebo before intrauterine device (IUD) insertion in nulliparous women.

Method: Nulliparous women requesting either the copper T380A or levonorgestrel IUD were randomized to self-administer either 400 μg of misoprostol or placebo (vaginally or buccally) 3-4 hours before the IUD insertion appointment. The primary outcome was health care provider-perceived ease of insertion recorded on a visual analog scale (anchors: 0 extremely easy, 100 impossible).

A survey of provider experience with misoprostol to facilitate intrauterine device insertion in nulliparous women.

Background: There is a significant need for research on treatments that provide pain relief during intrauterine device (IUD) insertion. Misoprostol is frequently used before IUD insertion but is not always necessary and its use may increase pain and side effects. This survey evaluated how providers who perform IUD insertion in nulliparous women report using misoprostol to facilitate the procedure.

United States medical eligibility criteria for contraceptive use 2010: a review of changes.

In the late 1990s, the World Health Organization (WHO) created the Medical Eligibility Criteria for Contraceptive Use (MEC), which provide evidence-based recommendations for safe and effective contraception in women with medical problems. The WHO MEC incorporate the best available evidence, are periodically updated, and are designed to be modified for specific populations. The US Centers for Disease Control and Prevention published US MEC in 2010.

The methodology for developing a prospective meta-analysis in the family planning community.

Background: Prospective meta-analysis (PMA) is a collaborative research design in which individual sites perform randomized controlled trials (RCTs) and pool the data for meta-analysis. Members of the PMA collaboration agree upon specific research interventions and outcome measures, ideally before initiation but at least prior to any individual trial publishing results. This allows for uniform reporting of primary and secondary outcomes.