Abstract:
OBJECTIVES:To compare pain levels and medication needs after placement of laminaria vs Dilapan-S, and after dilation and evacuation (D&E). STUDY DESIGN:We conducted a single-blinded randomized control trial of patients undergoing D&E at 15 0/7 to 23 6/7 weeks gestation, randomizing to cervical preparation with laminaria or Dilapan-S. We compared pain levels and medication usage following dilator placement (5 minutes; 2, 4, and 8 hours; the following morning) and D&E (1, 4, 24, and 48 hours). Our primary outcome was median change from baseline pain, and secondary outcomes included maximum pain timing and overall narcotic use. We compared baseline characteristics, median pain increases and quantities of narcotics used. RESULTS:We analyzed 67 participants with laminaria (n = 34) and Dilapan-S (n = 33). More Dilapan-S users had a prior vaginal delivery (n = 20, 60.6%) than laminaria users (n = 11, 32.4%), p = 0.02. Maximum median pain was not statistically different (Laminaria: +3.5 (interquartile range [IQR] +0.5, +6.5); Dilapan-S: +3 (IQR +1, +5); p = 0.42. Thirty-seven (63.8%) participants reported higher levels of pain following dilator placement than D&E. Overall, 26 (42.6%) participants used narcotics during their abortion episode, with no difference in median number of tablets between laminaria (2, range 1-8) and Dilapan-S (4.5, range 1-15) participants (p = 0.34). CONCLUSIONS:Median pain increase did not differ in participants receiving laminaria or Dilapan-S for cervical preparation prior to D&E. The majority of patients will use a small amount of narcotics if available. IMPLICATIONS:The lack of difference in pain between laminaria and Dilapan-S enhances the applicability of pain intervention research across dilator types. With over half of participants using a small amount of narcotics during their D&E episode, pain management should be individualized to patient needs.
journal_name
Contraceptionjournal_title
Contraceptionauthors
Liu SM,Flink-Bochacki Rdoi
10.1016/j.contraception.2020.11.014subject
Has Abstractpub_date
2020-12-04 00:00:00eissn
0010-7824issn
1879-0518pii
S0010-7824(20)30437-6pub_type
杂志文章相关文献
CONTRACEPTION文献大全abstract::A large international multi-center IUD data set (N = 5520) coordinated by Family Health International was analysed to determine if the uterine position of a woman (anteverted, mid-positioned or retroverted) affects the ease of IUD insertion and if knowledge of uterine position would diminish insertion-related problems...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0010-7824(90)90059-5
更新日期:1990-05-01 00:00:00
abstract::In this open-label, randomized study we compared the influence of a new oral contraceptive containing 30 microg ethinylestradiol and 3 mg drospirenone (Yasmin) with a reference preparation containing 30 microg ethinylestradiol and 150 microg desogestrel (Marvelon) on variables of carbohydrate metabolism by means of or...
journal_title:Contraception
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0010-7824(02)00537-1
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Although widely used, the mechanisms of action of the levonorgestrel emergency contraceptive pill (LNG ECP) are still unclear. There are increasing data to indicate that LNG is particularly effective as an ECP by interrupting follicular development and ovulation. An important outstanding question is whether ...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.contraception.2006.08.015
更新日期:2007-02-01 00:00:00
abstract::A group of 120 women with gestations from 64 to 84 days received 800 micrograms of vaginal misoprostol every 24 h for a maximum of three doses without performing postexpulsion systematic preventive curettage. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(98)00037-7
更新日期:1998-05-01 00:00:00
abstract::Gossypol has been shown to inhibit steroidogenesis in leydig cells. This study examined the mechanism of this action by investigating the effect of gossypol on leydig cell hCG receptor binding, adenylate cyclase activity and cyclic AMP production in leydig cells. Gossypol had no effect on hCG binding to cell membranes...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(86)80019-1
更新日期:1986-12-01 00:00:00
abstract::A comparative study of the performance of multi-sizes of the Mahua Ring inserted following measurement of the uterine cavity and one size of the same ring assigned at random was carried out from November 1984 to September 1985 at two hospitals in Tianjin. The experiences of 800 acceptors were analysed by life-table te...
journal_title:Contraception
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0010-7824(90)90048-z
更新日期:1990-10-01 00:00:00
abstract::To assess how Flemish general practitioners (GPs) are handling the first contraception consultation, we used standardized patients (SPs) as the best method to assess the performance of GPs in daily practice. Thirty GPs got a visit from one of the three SPs. Based on a validated checklist, the SPs scored the performanc...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2004.12.007
更新日期:2005-06-01 00:00:00
abstract::The effect of 2 long-acting injectables on the plasma protein-bound carbohydrate components and serumucoid when taken for different periods, was illustrated in 100 women of childbearing age. 40 acted as controls, 30 took depot-medroxyprogesterone acetate (DMPA), and 30 took norethisterone enanthate (NET-EN). DMPA wa...
journal_title:Contraception
pub_type: 临床试验,杂志文章
doi:10.1016/0010-7824(77)90051-8
更新日期:1977-10-01 00:00:00
abstract::The study of a modified minilaparotomy technique of interval female sterilization is reported. The modified minilaparotomy technique of interval female sterilization is performed under local anesthesia using the Ramathibodi uterine manipulator, bivalve speculum, and a low midline incision. Sixty cases were treated wit...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(97)00043-7
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:Healthy People 2020 establishes objectives for reducing the proportion of pregnancies in the United States that are unintended and for improving contraceptive use. This analysis describes ways to more closely align measurement of contraceptive use with periods of risk for unintended pregnancy using the Natio...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2020.04.009
更新日期:2020-08-01 00:00:00
abstract::This study examined the effect of epostane, a new antifertility drug, on normal and hCG-stimulated progesterone production during the luteal phase of the menstrual cycle in rhesus monkeys. When administered once each day for five days, epostane inhibited normal luteal phase progesterone levels in a dose-related fashio...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(85)90083-6
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:This study was conducted to assess the potential impact of an unintended pregnancy on women's quality of life. STUDY DESIGN:We asked 192 nonpregnant women to report how they would feel if they learned that they were pregnant using a visual analog scale (VAS), a time trade-off (TTO) metric, a standard gamble...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2008.04.120
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Postplacental intrauterine device (IUD) insertion is a safe, convenient and effective option for postpartum contraception. Few studies involve ultrasound-guided insertion, and none involve the levonorgestrel IUD or take place in the United States. STUDY DESIGN:The study was conducted to assess the safety an...
journal_title:Contraception
pub_type: 临床试验,杂志文章
doi:10.1016/j.contraception.2007.06.003
更新日期:2007-10-01 00:00:00
abstract::On September 23, 2016, California became the sixth state to pass legislation requiring health plans and insurers to cover a 12-month supply of FDA-approved self-administered hormonal contraceptives such as contraceptive pills, patches and vaginal rings. This legislation is estimated to result in 38% of current contrac...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2016.12.008
更新日期:2017-05-01 00:00:00
abstract::A morphometric study was undertaken to quantitate vessel numbers in uterine biopsies from a control group of patients, patients with dysfunctional uterine bleeding and patients taking low dose norethisterone or levonorgestrel. Vessels were counted at the endometrial/myometrial junction and in the functional endometriu...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(86)80016-6
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Hypertension is recognized as a major risk factor for coronary, cerebral and renal vascular disease. Hormonal methods of contraception may increase the risk for cardiovascular events. We evaluated whether the combined hormonal contraceptive vaginal ring that releases 15-mcg ethinylestradiol and 120 mcg of et...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2013.04.003
更新日期:2013-10-01 00:00:00
abstract::A number of case-control studies published in recent years have shown an apparent increase in the risk of venous thromboembolism (VTE) associated with the use of third-generation oral contraceptives (OCs) compared with second-generation OCs. However, it is thought that these studies were subject to a number of biases ...
journal_title:Contraception
pub_type: 杂志文章,评审
doi:10.1016/s0010-7824(00)00146-3
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:New strategies are needed for preventing HIV infection in women. One potential approach is female-initiated use of an effective topical microbicidal gel in combination with a cervical barrier such as the diaphragm. STUDY DESIGN:Randomized, placebo-controlled safety and feasibility trial of diaphragm with va...
journal_title:Contraception
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.contraception.2009.10.011
更新日期:2010-03-01 00:00:00
abstract::Numerous non-comparative clinical trials of the Dalkon Shield appear to provide ample evidence that the Dalkon Shield was an effective IUD; they seem to yield little evidence that it was a dangerous device, nor markedly different from its contemporaries. Equating the performance of the Dalkon Shield IUD to that of the...
journal_title:Contraception
pub_type: 临床试验,杂志文章,meta分析,随机对照试验
doi:10.1016/0010-7824(93)90060-k
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:This study is designed to evaluate the popularity of vasectomy in Iran. The study was conducted to calculate the frequency of vasectomy over time, to compare vasectomy users' characteristics with the general population and whether these characteristics have changed over time. STUDY DESIGN:A cross-sectional ...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2015.07.010
更新日期:2015-11-01 00:00:00
abstract::A structured literature review was undertaken to determine, in the context of early medical abortion, the proportion of women who require analgesia, the predictors of analgesia requirement and the most appropriate analgesia regimen. Studies from different centers show wide variations in analgesia use, but, overall, ar...
journal_title:Contraception
pub_type: 杂志文章,评审
doi:10.1016/j.contraception.2006.03.002
更新日期:2006-07-01 00:00:00
abstract::The pharmacokinetics and pharmacodynamic effects of two doses of norethisterone (5mg and 3mg) used as a 'visiting pill' were investigated. There were no significant differences in the pharmacokinetics of the two doses except for the peak concentration achieved and the bioavailability as assessed by the area under the ...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(86)90008-9
更新日期:1986-09-01 00:00:00
abstract::The potential use of tamoxifen, a nonsteroidal antiestrogen, as an antifertility agent was studied in the long-tailed macaque (Macaca fascicularis). Twenty-six cycling females were bred, then treated with a single oral dose of tamoxifen (5 mg/kg) (N = 13) or vehicle (N = 13) on day 4 post-ovulation. Serum progesterone...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(93)90047-b
更新日期:1993-03-01 00:00:00
abstract::This systematic review examined whether women who use combined hormonal contraception experience changes in risk of fracture or bone mineral density (BMD) that differ from nonusers. We identified 86 articles from PubMed and EMBASE (published 1966 to August 2005) that reported on fracture or BMD outcomes by use of comb...
journal_title:Contraception
pub_type: 杂志文章,评审
doi:10.1016/j.contraception.2006.01.003
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Cyclofem is a combined injectable contraceptive, containing medroxyprogesterone acetate (MPA) and estradiol cypionate. The objective was to characterize the steady-state pharmacokinetics (PK) using tandem liquid chromatography/mass spectrometry and compare these data to a previous PK study of this formulatio...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2012.11.010
更新日期:2013-06-01 00:00:00
abstract::In order to determine whether inhibition of the endometrial estradiol-17 beta-dehydrogenase activity by Cu++ could be one of the factors accounting for the enhanced contraceptive efficacy of copper intrauterine devices (Cu-IUD), the activity of the enzyme was measured in endometrial biopsies from women wearing this de...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(79)90019-2
更新日期:1979-03-01 00:00:00
abstract:OBJECTIVE:To assess unintended pregnancy risk and associated factors among female urban Baltimore emergency department (ED) attendees. METHODS:A cross-sectional anonymous questionnaire study was completed by 790 women, sufficient to detect a 5% difference of unintended pregnancy risk in the national population and a 1...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2004.08.005
更新日期:2005-01-01 00:00:00
abstract::Patients taking anticonvulsants such as phenobarbitone, phenytoin and carbamazepine together with their oral contraceptive steroid may suffer contraceptive failure because of the enzyme-inducing properties of these anticonvulsants. We have examined, in six women, the effect of sodium valproate, an effective broad spec...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(86)90028-4
更新日期:1986-01-01 00:00:00
abstract::The efficacy and acceptability of a levonorgestrel-releasing intravaginal ring (IVR) for contraception was assessed in a British cohort studied as part of a multicentre, multinational clinical trial performed under the auspices of the World Health Organisation. One-hundred-and-fifty women took part in the study in two...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0010-7824(91)90040-m
更新日期:1991-02-01 00:00:00
abstract::The contraceptive efficacy of breastfeeding was assessed in 236 healthy urban women who were followed at monthly intervals during the first postpartum year. Proportional hazard models were used to evaluate the influence of time postpartum, menstrual status and breastfeeding pattern upon the risk of pregnancy. Time and...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(91)90072-n
更新日期:1991-04-01 00:00:00