BackgroundEctopic pregnancy is a potentially life-threatening condition occurring in 1-2 % of all pregnancies. The most common ectopic implantation site is the fallopian tube, though 10 % of ectopic pregnancies implant in the cervix, ovary, myometrium, interstitial portion of the fallopian tube, abdominal cavity or within a cesarean section scar.FindingsDiagnosis involves a combination of clinical symptoms, serology, and ultrasound. Medical management is a safe and effective option in most clinically stable patients. Patients who have failed medical management, are ineligible, or present with ruptured ectopic pregnancy or heterotopic pregnancy are most often managed with excision by laparoscopy or, less commonly, laparotomy. Management of nontubal ectopic pregnancies may involve medical or surgical treatment, or a combination, as dictated by ectopic pregnancy location and the patient's clinical stability. Following tubal ectopic pregnancy, the rate of subsequent intrauterine pregnancy is high and independent of treatment modality.ConclusionThis review describes the incidence, risk factors, diagnosis, and management of tubal and non-tubal ectopic and heterotopic pregnancies, and reviews the existing data regarding recurrence and future fertility.

Purpose-To explore contraceptive counseling and utilization among breast cancer survivors. Methods-This is a cross-sectional study. We enrolled reproductive-aged women with a history of breast cancer for a cross-sectional study. Participants were recruited via the Athena Breast Health Network and via the Young Survival Coalition's social media postings. Descriptive statistics were calculated to understand utilization of and feelings about contraceptive methods before, during, and after breast cancer treatment. Results-Data presented here are from an online survey of 150 breast cancer survivors who completed the survey. Seventy-one percent (n=105) of respondents reported being sexually active and not pregnant during their primary cancer treatment (surgery, chemotherapy, and/or radiation). Of these, 90% (n=94) reported using any form of contraceptive, and the most common method was condoms (n=55, 52%). Respondents reported that safety concerns had the biggest influence on their contraception method choice. Sixty-one percent (n=92) reported receiving contraceptive Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. http://www.springer.com/gb/openaccess/authors-rights/aam-terms-v1

IntroductionReproductive-aged women who have had breast cancer face unique challenges when it comes to making decisions about contraception. Clinical guidelines indicate that patients should avoid pregnancy during cancer treatment, however the extent of contraception counseling and utilization after diagnosis has not been well studied.MethodsWe conducted three focus groups and one semi-structured interview with women between the ages of 18 and 50 years old diagnosed with breast cancer within the last 5 years. We used clinic- and population-based recruitment methods to identify participants. Participants were asked a series of open-ended questions regarding their contraception decision-making and concerns at the time of their diagnosis, during treatment and afterward. We analyzed data to identify themes among participant responses.ResultsA total of 10 women participated. We identified the following themes: 1) doctors treating cancer do not focus on reproductive health issues; 2) there is misinformation and lack of information on contraceptive options and risks; 3) women fear unintended pregnancy but have limited guidance on prevention; 4) peers are a trusted source of contraception information; and 5) information about contraception should be provided soon after diagnosis.ConclusionReproductive-aged breast cancer survivors have unique contraceptive concerns and may not be adequately informed about their contraceptive options. The results of this study may help guide and improve contraceptive counseling services for breast cancer survivors.

No abstract