Update in contraception:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Obstetrics and gynecology clinics of North America
27,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 683 - 963 Ill., graph. Darst. |
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Datensatz im Suchindex
| _version_ | 1804128265637462016 |
|---|---|
| adam_text | UPDATE IN CONTRACEPTION
CONTENTS
Preface xi
Ronald T. Burkman
Evidence Based Medicine and Contraception 683
J. Kell Williams
The concept of evidence based medicine involves formalizing the
scientific approach to the practice of medicine to identify the
evidence supporting clinical decisions. To understand the con¬
cept, clinicians must have knowledge of critical appraisal and the
basic epidemiologic principles of study design, relative risk, odds
ratios, point estimates, confidence intervals, bias, and confound¬
ing. Using this information, clinicians can categorize evidence,
assess causality, and make evidence based recommendations. Evi¬
dence based medicine allows clinicians to analyze complicated
material so that the best possible clinical decisions can be made
for the population served.
Oral Contraceptives: Risks 695
Lee P. Shulman
The modern combination oral contraceptive (OC) has become a
mainstay in the effort to provide safe, reliable, and effective
contraception. Safety concerns with OC use have largely been
laid to rest as a result of multiple and extensive studies. Even so,
misperceptions about the risks of OC use and a relative lack of
recognition concerning the numerous and important noncontra
ceptive benefits limit their use, thus putting women in needless
danger for unintended pregnancy. Indeed, even fears concerning
breast cancer risk and OC use have been unsubstantiated by an
abundance of data. Clinicians should be aware of the safety of
low dose OCs so that they can provide accurate and individual
OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA
VOLUME 27 • NUMBER 4 • DECEMBER 2000 V
ized counseling concerning the applicability of OCs and other
contraceptive methods.
Health Benefits of Oral Contraceptives 705
Jeffrey T. Jensen and Leon Speroff
Oral contraceptives provide women with reliable, convenient,
and safe protection against pregnancy. The numerous noncontra
ceptive benefits associated with use of oral contraceptives, docu¬
mented by over 30 years of research, are not well known. The
evidence supports reduction in morbidity and mortality caused
by pelvic infection, gynecologic cancers, and problems related to
the menstrual cycle. Use of oral contraceptives to increase bone
density and treat acne represent emerging indications. Getting
the good news out about health benefits will enable more women
to take advantage of the positive health effects of oral contracep¬
tives.
The Intrauterine Contraceptive Device 723
Anita L. Nelson
Modern intrauterine devices provide safe, effective, convenient,
and cost effective reversible contraception. The key to success is
careful patient selection and counseling. This article provides
information about the efficacy, mechanisms of action, and man¬
agement of side effects for each of the devices currently available.
The potential role of newer intrauterine devices is also discussed.
Injectable Contraception: New and Existing Options 741
Andrew M. Kaunitz
The 3 month injectable depomedroxyprogesterone acetate
(DMPA) and the monthly injectable Lunelle (MPA/E2C) offer
women safe, effective, and convenient reversible birth control
choices. Patients using DMPA usually experience amenorrhea and
a delayed return of fertility, whereas patients using MPA/E2C
generally have regular cycles and a rapid return of fertility. Lactat
ing women and others in whom contraceptive doses of estrogen
are contraindicated can use progestin only DMPA. For women
who dislike daily pill taking, prefer regular cycles to amenorrhea,
find monthly injections acceptable, and prefer a short acting con¬
traceptive, MPA/E2C is appealing. The more innovations clini¬
cians, family planning agencies, and insurers can make to facili¬
tate access to care (including rcinjections), the more women will
choose to use these reversible methods of contraception.
Implantable Contraception 781
Karen R. Meckstroth and Philip D. Darney
Levonorgestrel implants have been available for over 15 years.
The experiences of over 6 million users of Norplant worldwide
Vi CONTENTS
have brought about improvements and several new implants.
Implants have many advantages. They are extremely effective
and immediately reversible with removal. They deliver the lowest
dose of progestin that can provide effective contraception. They
are not coitus dependent. In addition, they have the potential to
decrease menstrual blood loss, pain associated with endometrio
sis, and the risk of upper genital tract infection. Implants are an
important option for women who have problems with other types
of birth control. New implants decrease the difficulty and time of
removal by using one or two capsules. Menstrual irregularity is
the most common side effect of all types of progestin implants.
Emergency Contraception 817
June LaValleur
The time has come for emergency contraception. It is highly
underused worldwide, and especially in the United States, where
patient and physician awareness remain low. There are several
highly effective, well tolerated methods that can be used to pre¬
vent undesired pregnancy after unprotected intercourse. This arti¬
cle discusses these methods, their method of action, effectiveness,
safety, and tolerability.
Barrier Methods of Contraception 841
Melissa L. Gilliam and Richard J. Derman
The use of barrier methods, with the exception of the male con¬
dom, has declined over the past decade. With a dual role of
preventing pregnancy and transmission of sexually transmitted
diseases, it can be argued that barrier methods are one of the
most important contraceptive methods available. This article re¬
views the various barrier methods of contraception and discusses
advantages, disadvantages, and future developments.
Female Sterilization: Evidence 859
Sangeeta Pati and Vanessa Cullins
Studies on female sterilization from 1996 through August 1999
are reviewed and classified according to level of evidence using
methodology developed by the Canadian Task force on the Peri¬
odic Health Examination. The resultant review focuses on evi¬
dence that has an impact on clinical standards for female steriliza¬
tion. Particular attention is paid to timing of the procedure,
operative approach, occlusion methods, immediate and long term
complications, and noncontraceptive health benefits.
New Contraceptive Methods 901
Daniel R. Grow and Shafeeq Ahmed
As the number of abortion procedures performed each year
reaches nearly 1 million, the incentive to decrease the incidence
CONTENTS Vii
of unwanted pregnancy in the United States is high. Better educa¬
tion regarding women s health issues and enhanced contraceptive
development are necessary to impact this long standing problem.
Several new contraceptive products are likely to become available
in years to come to increase the number of choices that women
and their health care providers have for pregnancy prevention.
These products include long acting implants, the levonorgestrel
intrauterine device, patches, and the vaginal ring. This article
surveys the near future of male and female contraception.
Health Economics of Contraception 917
Ronald T. Burkman and Frank A. Sonnenberg
Health economic analyses evaluate interventions from the stand¬
point of effectiveness and cost, important considerations in to¬
day s healthcare environment. Use of analytic cost effectiveness
approaches allows decision makers to evaluate interventions in a
more rational manner. With the use of sensitivity techniques,
various scenarios can be evaluated, particularly as they relate to
questions that have significant uncertainty. To date, there has been
limited application of these methods to the area of contraception.
Contraceptive Compliance 933
Kristin L. Dardano and Ronald T. Burkman
Contraceptives are very effective when used and taken properly.
Their effectiveness is limited by patient compliance with the
prescribed regimens and contributes to unintended pregnancies.
Multiple theories and models have been developed to address
the issue of contraceptive compliance. This article will examine
the consequences of noncompliance, potential reasons for non
compliance, and strategies for improving compliance in individ¬
ual patients.
Cumulative Index 943
Subscription Information inside back cover
viii CONTENTS
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| physical | XII S., S. 683 - 963 Ill., graph. Darst. |
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| series | Obstetrics and gynecology clinics of North America |
| series2 | Obstetrics and gynecology clinics of North America |
| spelling | Update in contraception Ronald T. Burkman guest ed. Philadelphia [u.a.] Saunders 2000 XII S., S. 683 - 963 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Obstetrics and gynecology clinics of North America 27,4 Empfängnisverhütung (DE-588)4070794-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Empfängnisverhütung (DE-588)4070794-5 s DE-604 Burkman, Ronald T. Sonstige oth Obstetrics and gynecology clinics of North America 27,4 (DE-604)BV000617486 27,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009196333&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Update in contraception Obstetrics and gynecology clinics of North America Empfängnisverhütung (DE-588)4070794-5 gnd |
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| title | Update in contraception |
| title_auth | Update in contraception |
| title_exact_search | Update in contraception |
| title_full | Update in contraception Ronald T. Burkman guest ed. |
| title_fullStr | Update in contraception Ronald T. Burkman guest ed. |
| title_full_unstemmed | Update in contraception Ronald T. Burkman guest ed. |
| title_short | Update in contraception |
| title_sort | update in contraception |
| topic | Empfängnisverhütung (DE-588)4070794-5 gnd |
| topic_facet | Empfängnisverhütung Aufsatzsammlung |
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