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女性实体器官移植受者的避孕与生育意识。

Contraception and fertility awareness among women with solid organ transplants.

机构信息

Olson Center for Women's Heath, Department of Obstetrics and Gynecology, and the College of Public Health, University of Nebraska Medical Center, and the Omaha VA Medical Center, Omaha, Nebraska; and the Department of Obstetrics and Gynecology, Good Samaritan Hospital Medical Center, West Islip, New York.

出版信息

Obstet Gynecol. 2013 Oct;122(4):809-814. doi: 10.1097/AOG.0b013e3182a5eda9.

Abstract

OBJECTIVE

To assess the contraception and fertility counseling provided to women with solid organ transplants.

METHODS

A telephone survey of 309 women aged 19-49 years who had received a solid organ transplant at the University of Nebraska Medical Center was performed. Of the 309 eligible women, 183 responded. Patients were asked 19 questions regarding pretransplant and posttransplant fertility awareness and contraception counseling. Data were summarized using descriptive statistics.

RESULTS

Patients had undergone a variety of solid organ transplantations: 40% kidney (n=73); 32% liver (n=59); 6% pancreas (n=11); 5% heart (n=9); 3% intestine (n=5); and 14% multiple organs (n=26). Before their transplantations, 79 women (44%) reported they were not aware that a woman could become pregnant after transplantation. Only 66 women aged 13 and older at the time of transplantation reported that a health care provider discussed contraception before transplantation. Approximately half of women surveyed were using a method of contraception. Oral contraceptive pills were the most commonly recommended method. Twenty-two of the 31 pregnancies after organ transplantation were planned, which is higher than that of the general population.

CONCLUSION

Few women with transplants are educated regarding the effect of organ transplantation on fertility and are not routinely counseled about contraception or the potential for posttransplant pregnancy. Health care providers should incorporate contraceptive and fertility counseling as part of routine care for women with solid organ transplants.

LEVEL OF EVIDENCE

: II.

摘要

目的

评估为实体器官移植女性提供的避孕和生育咨询。

方法

对在内布拉斯加大学医学中心接受实体器官移植的 19-49 岁的 309 名女性进行了电话调查。在 309 名符合条件的女性中,有 183 名做出了回应。患者被问及 19 个关于移植前和移植后生育意识和避孕咨询的问题。数据使用描述性统计进行总结。

结果

患者接受了各种实体器官移植:40%为肾脏(n=73);32%为肝脏(n=59);6%为胰腺(n=11);5%为心脏(n=9);3%为肠道(n=5);14%为多个器官(n=26)。在移植前,79 名女性(44%)表示她们不知道女性在移植后可以怀孕。只有 66 名在移植时年龄在 13 岁及以上的女性报告说,在移植前有医疗保健提供者讨论过避孕方法。接受调查的女性中约有一半人正在使用某种避孕方法。口服避孕药是最常推荐的方法。在 31 例器官移植后的妊娠中,有 22 例是计划内妊娠,这一比例高于普通人群。

结论

很少有接受移植的女性接受关于器官移植对生育能力影响的教育,也没有接受关于避孕或移植后怀孕可能性的常规咨询。医疗保健提供者应将避孕和生育咨询纳入实体器官移植女性的常规护理。

证据水平

II。

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