Search PubMed⌕ Search

Biomedical subjects

Patricia Aikins Murphy

Publications and source records attributed to Patricia Aikins Murphy.

13 recordsLinked to original sources
PubMed2003

Bleeding patterns after immediate vs. conventional oral contraceptive initiation: a randomized, controlled trial.

OBJECTIVE: To compare bleeding patterns after immediate vs. conventional oral contraceptive (OC) initiation. DESIGN: Randomized controlled trial. SETTING: University-based clinic. PATIENT(S): One hundred thirteen women initiating combination OCs. INTERVENTION(S): Participants received a 4-month supply of a monophasic 35-microg ethinyl E(2) (EE) OC and a bleeding diary, were randomized to immediate or conventional OC start, underwent monthly telephone follow-up, and after 90 days returned the diary and completed an exit interview. MAIN OUTCOME MEASURE(S): Total number of bleeding-spotting days, using the World Health Organization 90-day reference period method. Comparisons were made by trial assignment (immediate vs. conventional) and cycle day of OC initiation (day 8+ vs. days 1-7). RESULT(S): There was no significant difference in the number of bleeding-spotting days (mean difference: -0.5 days; 95% CI: -3.4 to 2.3) or any other bleeding parameter between the immediate and conventional starters, or days 1-7 and day 8+ starters. CONCLUSION(S): Immediate start of OCs does not induce bleeding patterns different from conventional starting regimens. Concern about adverse bleeding patterns should not be considered a justification for instructing women to wait until menses before starting OCs.

Adult↗
PubMed2003

New methods of hormonal contraception.

Several new hormonal contraceptive methods have recently been approved by the Food and Drug Administration. most new methods combine the high efficacy of oral contraceptives with the longer-term delivery methods that eliminate the need to take a pill each day. New methods also offer reversibility and resumption of fertility if desired. This article discusses these new methods and reviews the literature on efficacy and side effects.

Contraception↗
PubMed2002

Quick start: novel oral contraceptive initiation method.

Conventional oral contraceptive (OC) starting instructions require waiting until menses to begin the OC. The conventional approach requires detailed patient education about when to begin and also may require the use of less effective or less acceptable interim contraceptive protection until menses. At our urban family planning clinic, we routinely offer patients starting the OC the option of taking the first tablet sooner. We prospectively evaluated predictors of short-term OC continuation among 250 OC requestors who were offered several approaches to OC initiation. Telephone follow-up of 91% of participants showed that women who swallowed the first OC in the clinic were more likely to continue the OC until the second package than women who planned to start the OC later (adjusted OR 2.8, 95% C.I. 1.1-7.3). Other factors associated with short-term continuation were: partner's knowledge of planned OC use, older age, and participant's agreement that she would be very unhappy about becoming pregnant in the next 6 months.

Abortion, Induced↗
PubMedDate not supplied

A description of the management and outcomes of vaginal birth after cesarean birth in the homebirth setting.

Our objective was to describe the outcomes of intended home birth among 57 women with a previous cesarean birth. Data were drawn from a larger prospective study of intended homebirth in nurse-midwifery practice. Available data included demographics, perinatal risk information, and outcomes of prenatal, intrapartum, postpartum, and neonatal care. The hospital course was reviewed for those transferred to the hospital setting. Fifty-three of 57 women (93%) had a spontaneous vaginal birth, 1 had a vacuum-assisted birth, and 3 (5.3%) had a repeat cesarean birth. Thirty-one of 32 (97%) women who had a previous vaginal birth after cesarean birth (VBAC) had a successful VBAC; 22 of 25 (88%) women without a history of VBAC successfully delivered vaginally. Fifty (87.7%) of these women delivered in the home setting, whereas 7 (12.3%) delivered in the hospital setting. None of the women experienced uterine rupture or dehiscence. One infant was stillborn. This event was attributed to a postdates pregnancy with meconium. Certified nurse-midwives with homebirth practices must be knowledgeable about the risks for mother and baby, screen clientele appropriately, and be able to counsel patients with regard to potential adverse outcomes. Given what is presently known, VBAC is not recommended in the homebirth setting. It is imperative in the light of current evidence and practice climate to advocate for the availability of certified nurse-midwife services and woman-centered care in the hospital setting.

Adult↗
PubMedDate not supplied

St. John's wort and oral contraceptives: reasons for concern?

St. John's wort (Hypericum perforatum) is one of the best-selling herbal remedies in the United States. It has been implicated as an inducer of the P450 enzyme system, and as such, may cause increased metabolism of certain drugs, including oral contraceptives. Women using oral contraceptives have been warned against using St. John's wort. To date, there are some case reports but little clinical data demonstrating risk of contraceptive failure if they do. This article reviews available data and discusses theoretical reasons for concern about possible drug-herb interactions.

Contraceptives, Oral↗
PubMedDate not supplied

Development of the Optimality Index as a new approach to evaluating outcomes of maternity care.

Evaluating perinatal outcomes within a framework of normalcy is a new focus of measurement. As maternal and child health clinicians and researchers look to evaluate care practices that are both of high quality and cost-effective, it is important to have measurement tools that assess differences among all women giving birth. The Optimality Index-US shifts the focus from rare adverse events to evidence-based optimal events. This article describes the continuing development of the index and discusses clinical implications for obstetric nurse clinicians.

Cost-Benefit Analysis↗
PubMedDate not supplied

Partner influence on early discontinuation of the pill in a predominantly Hispanic population.

CONTEXT: Although studies have examined U.S. pill users' patterns of discontinuation, little is known about pill discontinuation, and the effects of partner influence, among Hispanics. METHODS: Follow-up data on pill use were collected from 213 predominantly Hispanic women who requested the pill in an urban family planning clinic in 2000. Logistic regression analyses were conducted to assess the association between a range of factors, including partner and relationship variables, and the odds of discontinuation within one month. RESULTS: The overall discontinuation rate within one month was 23%. Women who reported that their partner was unaware of their planned pill use had significantly elevated odds of discontinuing use (odds ratio, 3.4). Other variables that were independently associated with increased odds of early pill discontinuation were not taking the first pill during the clinic visit (3.0), feeling happy about the prospect of a pregnancy in the next six months (2.4) and intending to use the pill for one year or less (2.3). Age, which was assessed as a continuous variable, was negatively associated with the odds of early discontinuation (0.9). CONCLUSIONS: Male partners' awareness of planned pill use may be a marker for the level of communication and commitment in the relationship. Women may choose to disclose their planned pill use to supportive partners, and this may be beneficial to the relationship and the couple's contraceptive use. However, clinicians should take women's circumstances and needs into account before counseling them to tell a partner that they intend to use the pill.

Adolescent↗