Commentary
Feticidal digoxin injection before dilation and evacuation abortion: Evidence and ethics
David A. Grimes, Gretchen S. Stuart, Elizabeth G. Raymond
pages 140-143
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Review Article
Pregnancy outcomes with an IUD in situ: a systematic review
Dalia Brahmi, Maria W. Steenland, Regina-Maria Renner, Mary E. Gaffield
pages 131-139
Pregnancies complicated by a remaining IUD in situ were at greater risk of adverse pregnancy outcomes. Early IUD removal appeared to improve outcomes but did not entirely eliminate risks.
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Original research articles
Safety of digoxin for fetal demise before second-trimester abortion by dilation and evacuation
Gillian Dean, Lisa Colarossi, Britt Lunde, Adam R. Jacobs
pages 144-149
Background: Digoxin is used to induce fetal demise before dilation and evacuation (D&E) abortion. Published data on the safety of digoxin in abortion care are limited.
Conclusions: Patients who received digoxin before D&E were more likely to experience spontaneous abortion, infection and hospital admission than controls who underwent D&E without digoxin.
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Infection and extramural delivery with use of digoxin as a feticidal agent
Rachel Steward, Alexander Melamed, Renita Kim, Deborah Nucatola
pages 150-154
Background: Many abortion providers use digoxin to induce fetal demise prior to dilation and evacuation (D&E). Our primary objective was to examine the frequency of infection and extramural delivery following digoxin use.
Conclusion: Rates of extramural delivery and infection are acceptably low following digoxin use prior to scheduled D&E.
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Revival of the intrauterine device: increased insertions among US women with employer-sponsored insurance, 2002–2008
Xin Xu, Maurizio Macaluso, Lijing Ouyang, Andrzej Kulczycki
pages 155-159
Background: Use of the intrauterine device (IUD) in the United States has recently increased. New evidence for women with employer-sponsored health insurance permits analysis of variation and trends in such use.
Conclusions: The sixfold increase in IUD insertion rates between 2002 and 2008 was accompanied by an increase in the share IUD use with the LNG-IUS from 40% to 85%. Substantial geographic and age variations existed.
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Does the provision of free intrauterine contraception reduce pregnancy rates among uninsured low-income women? A cohort study a two North Carolina clinics
Nicole Fanarjian, Christina Drostin, Joanne Garrett, Arlin Montalvo
pages 160-165
Background: Low-income women are disproportionately affected by unintended pregnancy. The Access to Resources in Contraceptive Health Foundation was established to provide free levonorgestrel intrauterine contraceptive systems to uninsured women who meet specific socioeconomic eligibility criteria. The aim of this study was to evaluate the effectiveness of this program at reducing pregnancies among uninsured women attending two North Carolina clinics.
Conclusion: Provision of a levonorgestrel-releasing device was associated with significantly lower risk of pregnancy than was use of alternative or no contraception. If these data from North Carolina are representative of experience nationwide, then the public health benefit of the Foundation's philanthropy may be large.
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Access to contraception after health care reform in Massachusetts: a mixed-methods study investigating benefits and barriers
Amanda Dennis, Jill Clark, Denisse Córdova, Jennifer McIntosh
pages 166-172
Background: In 2006, Massachusetts passed sweeping health care reform legislation aimed at improving access to health care for residents. This study investigates how this landmark legislation affected contraceptive access for low-income women.
Conclusions: Though health care reform legislation has benefited many women, barriers remain to ensuring consistent access to contraception for low-income women.
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Impact of etonogestrel-releasing implant and copper intrauterine device on carbohydrate metabolism: a comparative study
Hartmut Blode, Christine Klipping, Frank Richard, Dietmar Trummer
pages 177-184
Background: A new tablet formulation containing 0.02 mg ethinylestradiol/3 mg drospirenone/0.451 mg levomefolate calcium (calcium salt containing 0.416 mg L-5-methyltetrahydrofolate) was assessed for bioequivalence compared to the approved oral contraceptive (OC) tablet containing identical amounts of ethinylestradiol and drospirenone and to a tablet containing 0.451 mg levomefolate calcium.
Conclusion: The rate and extent of absorption of ethinylestradiol and drospirenone were not affected by the concomitant administration of levomefolate calcium and vice versa.
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Bioequivalence study of an oral contraceptive containing ethinylestradiol/drospirenone/levomefolate calcium relative to ethinylestradiol/drospirenone and to levomefolate calcium alone
Jennifer L. Kerns, Megan Swanson, Sherri Pena, Danny Wu
pages 63-68
Background: Most women diagnosed with a fetal anomaly terminate the pregnancy. Little is known about utilization of two procedures: dilation and evacuation (D&E) and induction termination.
Conclusions: The D&E procedure was more commonly utilized for terminating an anomalous pregnancy at UCSF than medical induction. Further inquiry is needed to explore how provider counseling influences the choice of D&E vs. induction.
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Induced abortion in Canada 1974–2005: trends over the first generation with legal access
Wendy V. Norman
pages 185-191
Background: The primary purpose of this study was to evaluate whether women undergoing medical abortion can accurately assess abortion outcome based on symptoms alone. Our secondary aim was to identify predictors of medical abortion failure.
Conclusions: Patient symptomatology and self-assessment of complete abortion alone are moderately useful in identifying medical abortion failure. An objective measure of complete abortion, such as a pregnancy test, is still required.
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Can women accurately assess the outcome of medical abortion based on symptoms alone?
Andrea V. Jackson, Ila Dayananda, Jennifer M. Fortin, Garrett Fitzmaurice
pages 192-197
Background: The primary purpose of this study was to evaluate whether women undergoing medical abortion can accurately assess abortion outcome based on symptoms alone. Our secondary aim was to identify predictors of medical abortion failure.
Conclusions: Patient symptomatology and self-assessment of complete abortion alone are moderately useful in identifying medical abortion failure. An objective measure of complete abortion, such as a pregnancy test, is still required.
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Effect of shared contraceptive experiences on IUD use at an urban abortion clinic
Lyndsey S. Benson, Alissa Perrucci, Eleanor A. Drey, Jody E. Steinauer
pages 198-203
Background: We studied the effect of contraceptive social networking on postabortion intrauterine device (IUD) uptake. This study explores whether women who have heard personal stories of IUD use are more likely to use an IUD for postabortion contraception.
Conclusions: Women undergoing abortion in an urban clinic have knowledge and high acceptance of IUDs, and sharing of contraceptive experiences is common among women of all demographics. Controlling for demographics and prior knowledge of IUDs, sharing of personal IUD experiences by providers is significantly associated with IUD use.
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Analyzing the impacts of abortion clinic structures and processes: a qualitative analysis of women's negative experience of abortion clinics
Katrina Kimport, Kate Cockrill, Tracy A. Weitz
pages 204-210
Background: In the United States, the social myth that abortion clinics are unsafe, lonely places is pervasive. Little research has investigated the extent to which women's negative experiences of clinic interactions and processes confirm or contest this myth.
Conclusions: Clinic workers and administrators should be aware that safety structures and processes may create negative experiences for some women. Policymakers should be aware of the extent to which public policies and conflict over abortion render the social myth of the clinic a reality. was concluded that 10−3 M PU pretreatment is a promising strategy able to reduce the “burst release” of copper and to ensure contraceptive action.
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Mifepristone may shorten the induction-to-abortion time for termination of second-trimester pregnancies by ethacridine lactate
YaLing Zhuang, XiuYing Chen, LiLi Huang
pages 211-214
Background: We reviewed our experience with adding mifepristone to the protocol for the termination of pregnancy up to 24 weeks of gestation by intra-amniotic ethacridine lactate.
Conclusions: The addition of mifepristone to ethacridine lactate may shorten the induction-to-abortion time compared with the use of ethacridine lactate alone without increasing the number of complications.
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Case Report
A life-threatening ectopic pregnancy with etonogestrel implant
Julie Bouquier, Virginie Fulda, Anne-Sophie Bats, Fabrice Lécuru
pages 215-217
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Letters to the Editor
Update on and correction to the cost effectiveness of contraceptives in the United States
James Trussell 218
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Mifepristone+misoprostol vs. misoprostol alone Thoai D. Ngo, Min Hae Park
Debra Bingham, Nan Strauss, Francine Coeytaux
pages 219
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Response to Letter to the Editor
Jennifer Blum, Nguyen Thi Nhu Ngoc, Sheila Ragjavem, Nguyen Thi Bach Nga
pages 219-200
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