CDC Article-US Medical Eligibility Criteria for Contraceptive Use, 2010

More documents

Recommendations

Info

68 MMWR June 18, 2010 TABLE. (Continued) Classifications for barrier methods,* † including condoms, spermicides, and diaphragms/caps Category Condition Condom Spermicide Diaphragm/ cap Clarifications/Evidence/Comments Gestational trophoblastic disease a. Decreasing or undetectable β–hCG levels 1 1 1 b. Persistently elevated β-hCG levels or malignant disease § 1 1 1 Cervical ectropion 1 1 1 Cervical intraepithelial neoplasia 1 1 1 Clarification: The cap should not be used. Diaphragm use has no restrictions. Cervical cancer (awaiting treatment) 1 2 1 Clarification: The cap should not be used. Diaphragm use has no restrictions. Comment: Repeated and high-dose use of nonoxynol-9 can cause vaginal and cervical irritation or abrasions. Breast disease a. Undiagnosed mass 1 1 1 b. Benign breast disease 1 1 1 c. Family history of cancer 1 1 1 d. Breast cancer § i. Current 1 1 1 ii. Past and no evidence of current disease for 5 yrs 1 1 1 Endometrial hyperplasia 1 1 1 Endometrial cancer § 1 1 1 Ovarian cancer § 1 1 1 Uterine fibroids 1 1 1 Anatomical abnormalities 1 1 Not applicable Pelvic inflammatory disease (PID) a. Past PID (assuming no current risk factors of STIs) i. With subsequent pregnancy 1 1 1 ii. Without subsequent pregnancy 1 1 1 b. Current PID 1 1 1 STIs a. Current purulent cervicitis or chlamydial infection 1 1 1 or gonorrhea b. Other STIs (excluding HIV and hepatitis) 1 1 1 c. Vaginitis (including Trichomonas vaginalis and 1 1 1 bacterial vaginosis) d. Increased risk for STIs 1 1 1 Clarification: The diaphragm cannot be used in certain cases of prolapse. Cap use is not appropriate for a woman with markedly distorted cervical anatomy. HIV/AIDS High risk for HIV 1 4 4 Evidence: Repeated and high-dose use of the spermicide nonoxynol-9 was associated with increased risk for genital lesions, which might increase the risk for HIV infection (2). Comment: Diaphragm use is assigned Category 4 because of concerns about the spermicide, not the diaphragm. HIV infection § 1 3 3 Comment: Use of spermicides and/or diaphragms (with spermicide) can disrupt the cervical mucosa, which may increase viral shedding and HIV transmission to uninfected sex partners. AIDS § 1 3 3 Comment: Use of spermicides and/or diaphragms (with spermicide) can disrupt the cervical mucosa, which may increase viral shedding and HIV transmission to uninfected sex partners Other Infections Schistosomiasis a. Uncomplicated 1 1 1 b. Fibrosis of liver § 1 1 1 Tuberculosis § a. Nonpelvic 1 1 1 b. Pelvic 1 1 1
Vol. 59 / RR-4 Recommendations and Reports 69 TABLE. (Continued) Classifications for barrier methods,* † including condoms, spermicides, and diaphragms/caps Category Condition Condom Spermicide Diaphragm/ cap Clarifications/Evidence/Comments Malaria 1 1 1 History of toxic shock syndrome 1 1 3 Comment: Toxic shock syndrome has been reported in association with contraceptive sponge and diaphragm use. Urinary tract infection 1 1 2 Comment: Use of diaphragms and spermicides might increase risk for urinary tract infection. Endocrine Conditions Diabetes a. History of gestational disease 1 1 1 b. Nonvascular disease i. Noninsulin-dependent 1 1 1 ii. Insulin-dependent § 1 1 1 c. Nephropathy/retinopathy/neuropathy § 1 1 1 d. Other vascular disease or diabetes of >20 yrs’ duration § 1 1 1 Thyroid disorders a. Simple goiter 1 1 1 b. Hyperthyroid 1 1 1 c. Hypothyroid 1 1 1 Gastrointestinal Conditions Inflammatory bowel disease (ulcerative colitis, Crohn disease) 1 1 1 Gallbladder disease a. Symptomatic i. Treated by cholecystectomy 1 1 1 ii. Medically treated 1 1 1 iii. Current 1 1 1 b. Asymptomatic 1 1 1 History of cholestasis a. Pregnancy-related 1 1 1 b. Past COC-related 1 1 1 Viral hepatitis a. Acute or flare 1 1 1 b. Carrier 1 1 1 c. Chronic 1 1 1 Cirrhosis a. Mild (compensated) 1 1 1 b. Severe § (decompensated) 1 1 1 Liver tumors a. Benign i. Focal nodular hyperplasia 1 1 1 ii. Hepatocellular adenoma § 1 1 1 b. Malignant § (hepatoma) 1 1 1 Anemias Thalassemia 1 1 1 Sickle cell disease § 1 1 1 Iron deficiency anemia 1 1 1 Solid Organ Transplantation Solid organ transplantation § a. Complicated: graft failure (acute or chronic), 1 1 1 rejection, cardiac allograft vasculopathy b. Uncomplicated 1 1 1
Page 1 and 2:
Morbidity and Mortality Weekly Repo
Page 3 and 4:
Vol. 59 / RR-4 Recommendations and
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20: Vol. 59 / RR-4 Recommendations and
Page 69: Vol. 59 / RR-4 Recommendations and
show all

CDC Article-US Medical Eligibility Criteria for Contraceptive Use, 2010

Create successful ePaper yourself

Delete template?

Save as template?