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Gynecologic Care and Contraception in the Medically Complex Adolescent

Abstract

When caring for adolescents and young women with chronic illnesses, it is important to address routine gynecologic care and your patient’s contraceptive needs to ensure her optimal health and avoid putting an unplanned pregnancy at risk for serious health effects to both the mother and/or the fetus. This chapter will review what special considerations need to be employed in routine gynecologic care for medically complex paients including Pap smear screening, STI screening, and HPV vaccination. In addition, this chapter will discuss special considerations to address your patient’s contraceptive needs. This will include how the chronic illness and the medications used to treat it interact with contraception and why it is important to consider the risk of pregnancy to your patient’s health and that of the fetus, in addition to issues of teratogenicity, thrombosis, contraceptive efficacy, continuation rates, and interactions with contraception and chronic illness medications.

Keywords

Routine gynecologic care Pap smear screening STI screening HPV vaccination 

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Suggested Educational Reading, References, and Policies

  1. The American Congress of Obstetricians and Gynecologists. Practice Bulletin Number 157: cervical cancer screening and prevention. Obstet Gynecol. 2016;127(1):e1–20.CrossRefGoogle Scholar
  2. Medical eligibility criteria for contraceptive use. 5th Edition. World Health Organization. http://www.who.int/reproductivehealth/publications/family_planning/MEC-5/en/.
  3. U.S. Medical Eligibility Criteria for contraceptive use. http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usmec.htm.
  4. 2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention. http://www.cdc.gov/std/tg2015/

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Division of Adolescent Medicine, Department of PediatricsChildren’s Hospital at Montefiore, Albert Einstein College of MedicineBronxUSA

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