Items in AFP with MESH term: Pregnancy, Unwanted
Management of Female Sexual Assault - Article
ABSTRACT: A sexual assault occurs once every 6.4 minutes in the United States. One in every six women will be raped during her lifetime. Although a woman is four times more likely to be assaulted by someone she knows than by someone she does not know, the majority of these crimes go unreported even though rape is a felony. The purpose of the medical examination after a sexual assault is to assess the patient for physical injuries and to collect evidence for forensic evaluation and possible legal proceedings. Laboratory samples should be obtained at the initial visit and should include testing for pregnancy, syphilis, hepatitis B and human immunodeficiency virus infection. Treatment should address physical injuries, pregnancy prophylaxis, sexually transmitted diseases and psychosocial sequelae. Appropriate referral services should be initiated during the initial visit. Victims of sexual assault require appropriate care, follow-up and information regarding their legal rights. Family physicians should be familiar with the state laws governing collection of evidence and should be prepared to advise the patient to report the crime. The history should be confined to medically relevant facts and should be conducted in a safe and quiet environment.
ABSTRACT: Unintended pregnancy can occur when women stop one birth control method before starting another. To prevent gaps in contraception, physicians should ask women regularly about adverse effects, cost, difficulty remembering the next dose, and other issues that affect adherence. Women who want to change contraceptive methods need accurate advice about how to do so. Some contraception transitions require an overlap between the old method and the new method. To switch safely from one contraceptive to another without overlap, women may go directly from the old method to the new method, abstaining from sexual intercourse or using a barrier method, such as condoms or spermicide, for the first seven days.
ACOG Addresses Psychosocial Screening in Pregnant Women - Practice Guidelines
ABSTRACT: Serious health problems, risky behavior, and poor health habits persist among adolescents despite access to medical care. Most adolescents do not seek advice about preventing leading causes of morbidity and mortality in their age group, and physicians often do not find ways to provide it. Although helping adolescents prevent unintended pregnancy, sexually transmitted infections, unintentional injuries, depression, suicide, and other problems is a community-wide effort, primary care physicians are well situated to discuss risks and offer interventions. Evidence supports routinely screening for obesity and depression, offering testing for human immunodeficiency virus infection, and screening for other sexually transmitted infections in some adolescents. Evidence validating the effectiveness of physician counseling about unintended pregnancy, gang violence, and substance abuse is scant. However, physicians should use empathic, personal messages to communicate with adolescents about these issues until studies prove the benefits of more specific methods. Effective communication with adolescents requires seeing the patient alone, tailoring the discussion to the individual patient, and understanding the role of the parents and of confidentiality.