Self-managed abortions are increasingly common globally, but little is known about young women’s experiences.
Methods
Secondary analysis of data from 1847 women accessing MA in urban Cambodia in 2018-2019 and in-depth interviews with seven women aged 15-19. Descriptive statistics compared young and adult women on self-reported abortion outcomes and experiences in clinics and pharmacies, and qualitative data contextualized quantitative findings.
Results
Young women were better represented among clinic clients (30.0%) compared to pharmacy clients (20.2%). Young women had comparable MA success rates and better MA experiences across settings, but young pharmacy clients were more likely to seek support from friends and family.
Discussion
Young women had comparable MA outcomes and experiences as adult women in both clinics and pharmacies, but young women self-managing their abortions may require information and support beyond the pharmacist.
{"title":"Comparing Medical Abortion Outcomes and Experiences Between Young and Adult Women: Evidence From Urban Cambodia","authors":"Erin Pearson PhD, MPH , Paige Logan MPH , Elisabeth Eckersberger PhD, MPA , Jamie Menzel MPH , Bunsoth Mao MD , Sovanthida Suy MAppStat, MSc , Vonthanak Saphonn MD, PhD, MSc , Nathalie Kapp MD, MPH","doi":"10.1016/j.jpag.2025.07.007","DOIUrl":"10.1016/j.jpag.2025.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-managed abortions are increasingly common globally, but little is known about young women’s experiences.</div></div><div><h3>Methods</h3><div>Secondary analysis of data from 1847 women accessing MA in urban Cambodia in 2018-2019 and in-depth interviews with seven women aged 15-19. Descriptive statistics compared young and adult women on self-reported abortion outcomes and experiences in clinics and pharmacies, and qualitative data contextualized quantitative findings.</div></div><div><h3>Results</h3><div>Young women were better represented among clinic clients (30.0%) compared to pharmacy clients (20.2%). Young women had comparable MA success rates and better MA experiences across settings, but young pharmacy clients were more likely to seek support from friends and family.</div></div><div><h3>Discussion</h3><div>Young women had comparable MA outcomes and experiences as adult women in both clinics and pharmacies, but young women self-managing their abortions may require information and support beyond the pharmacist.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 114-120"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.09.016
J.L. Feuerstein DO , S. Menon MD , B. Lockart DNP, APRN, NP , S. Zarnegar-Lumley MD , A.K. Johnson PhD
Study Objective
As survival rates improve for adolescents and young adults (AYAs) with cancer, understanding barriers to fertility preservation (FP) decision-making has become increasingly important. FP decisions involve both AYAs and caregivers, yet discordance in fertility goals is common and may hinder FP utilization. The factors contributing to discordance and its impact remain underexplored. This study used the Ottawa Decision Support Framework (ODSF), which identifies essential medical decision-making needs and categorizes barriers into 7 domains, to examine the experiences of discordance in FP decision-making.
Methods
Semi-structured qualitative interviews were conducted with AYA-caregiver dyads who experienced discordance during FP decision-making. Participants were aged 12-25, were ≥6 months post-cancer diagnosis, read and spoke English, and were at risk for infertility due to gonadotoxic therapy. Interviews were conducted via ZOOM between July 2024 and January 2025. Data analysis used a content analysis approach guided by existing theory and the ODSF.
Results
Caregivers emphasized accurate information, AYAs’ maturity, and seeking external advice, whereas AYAs had greater difficulty with internal confidence and decision-making uncertainty. Caregivers often assumed directive roles due to treatment urgency and perceived AYA immaturity. AYAs, despite valuing autonomy, deferred to caregivers due to emotional distress and limited knowledge.
Conclusion
The ODSF-guided analysis revealed several sources of discordance, though none led to FP refusal. Structured counseling mitigated decisional conflict, and all participants expressed decision satisfaction. The findings support structured counseling to align AYAs’ autonomy with caregiver support. Future studies should include more diverse sociodemographic, multi-institutional samples and the perspectives of those who declined FP.
{"title":"“I am so grateful you made me do this”: Navigating AYA-Caregiver Discordance on Shared Decision-making about Fertility Preservation","authors":"J.L. Feuerstein DO , S. Menon MD , B. Lockart DNP, APRN, NP , S. Zarnegar-Lumley MD , A.K. Johnson PhD","doi":"10.1016/j.jpag.2025.09.016","DOIUrl":"10.1016/j.jpag.2025.09.016","url":null,"abstract":"<div><h3>Study Objective</h3><div>As survival rates improve for adolescents and young adults (AYAs) with cancer, understanding barriers to fertility preservation (FP) decision-making has become increasingly important. FP decisions involve both AYAs and caregivers, yet discordance in fertility goals is common and may hinder FP utilization. The factors contributing to discordance and its impact remain underexplored. This study used the Ottawa Decision Support Framework (ODSF), which identifies essential medical decision-making needs and categorizes barriers into 7 domains, to examine the experiences of discordance in FP decision-making.</div></div><div><h3>Methods</h3><div>Semi-structured qualitative interviews were conducted with AYA-caregiver dyads who experienced discordance during FP decision-making. Participants were aged 12-25, were ≥6 months post-cancer diagnosis, read and spoke English, and were at risk for infertility due to gonadotoxic therapy. Interviews were conducted via ZOOM between July 2024 and January 2025. Data analysis used a content analysis approach guided by existing theory and the ODSF.</div></div><div><h3>Results</h3><div>Caregivers emphasized accurate information, AYAs’ maturity, and seeking external advice, whereas AYAs had greater difficulty with internal confidence and decision-making uncertainty. Caregivers often assumed directive roles due to treatment urgency and perceived AYA immaturity. AYAs, despite valuing autonomy, deferred to caregivers due to emotional distress and limited knowledge.</div></div><div><h3>Conclusion</h3><div>The ODSF-guided analysis revealed several sources of discordance, though none led to FP refusal. Structured counseling mitigated decisional conflict, and all participants expressed decision satisfaction. The findings support structured counseling to align AYAs’ autonomy with caregiver support. Future studies should include more diverse sociodemographic, multi-institutional samples and the perspectives of those who declined FP.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 43-49"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.09.003
Nicole R. Ferrigno-Layton DO , Carly E. Milliren MPH , Sarah Pitts MD , Amy D. DiVasta MD, MMSc , Michelle Escovedo MD , Sarah A. Golub MD, MPH , Susan M. Coupey MD , Sofya Maslyanskaya MD
Study Objective
Body image concerns may influence contraceptive choices of adolescents and young adults (AYAs) with eating disorders (EDOs). We aimed to compare long-acting reversible contraceptive (LARC) choices and continuation rates for AYAs with and without EDOs.
Methods
We used data on LARC insertions from 2017 to 2021 from four US adolescent medicine practices measuring demographics, menstrual history, reason for LARC device, follow-up, and continuation. Additional record search identified participants with EDOs. We examined associations of EDOs and choice of device using adjusted logistic regression and 1-year discontinuation using Cox proportional hazards survival analysis.
Results
The cohort included 2,346 AYAs; 80 (3%) with EDO; 32% White; 29% Hispanic, 15% Black. Mean age at LARC insertion 18.7 ± 2.4 years (range 12-25). Participants with EDO vs. without had higher odds of choosing intrauterine devices (IUD) over implants (OR = 2.18; 95% CI: 1.31, 3.61; p = .003). One-year LARC continuation rates were 77% overall and similar for those with and without EDOs. AYAs with EDOs vs without had similar likelihood of LARC device removal within 1 year. Participants identifying as Black non-Hispanic (OR = 0.34;95% CI: 0.26, 0.45, p < .001) and Hispanic (OR = 0.34; 95% CI: 0.26, 0.45, p < .001) vs White non-Hispanic had lower odds of choosing IUDs over implants. Black non-Hispanic AYAs had higher likelihood than White non-Hispanics for LARC removal within 1-year (HR = 1.58; 95% CI: 1.11, 2.25; p = .01).
Conclusions
AYAs with EDOs compared to those without EDOs are more likely to choose IUDs over implants and they have similar high 1-year LARC continuation rates . AYAs of non-White race/ethnicities independent of EDO diagnosis are less likely to choose IUDs.
{"title":"Comparison of Long-Acting Reversible Contraceptive (LARC) Choices by Multiethnic U.S. Adolescents and Young Adults With and Without Eating Disorders: A Multicenter Cohort Study","authors":"Nicole R. Ferrigno-Layton DO , Carly E. Milliren MPH , Sarah Pitts MD , Amy D. DiVasta MD, MMSc , Michelle Escovedo MD , Sarah A. Golub MD, MPH , Susan M. Coupey MD , Sofya Maslyanskaya MD","doi":"10.1016/j.jpag.2025.09.003","DOIUrl":"10.1016/j.jpag.2025.09.003","url":null,"abstract":"<div><h3>Study Objective</h3><div>Body image concerns may influence contraceptive choices of adolescents and young adults (AYAs) with eating disorders (EDOs). We aimed to compare long-acting reversible contraceptive (LARC) choices and continuation rates for AYAs with and without EDOs.</div></div><div><h3>Methods</h3><div>We used data on LARC insertions from 2017 to 2021 from four US adolescent medicine practices measuring demographics, menstrual history, reason for LARC device, follow-up, and continuation. Additional record search identified participants with EDOs. We examined associations of EDOs and choice of device using adjusted logistic regression and 1-year discontinuation using Cox proportional hazards survival analysis.</div></div><div><h3>Results</h3><div>The cohort included 2,346 AYAs; 80 (3%) with EDO; 32% White; 29% Hispanic, 15% Black. Mean age at LARC insertion 18.7 ± 2.4 years (range 12-25<strong>).</strong> Participants with EDO vs. without had higher odds of choosing intrauterine devices (IUD) over implants (OR = 2.18; 95% CI: 1.31, 3.61; <em>p</em> = .003). One-year LARC continuation rates were 77% overall and similar for those with and without EDOs. AYAs with EDOs vs without had similar likelihood of LARC device removal within 1 year. Participants identifying as Black non-Hispanic (OR = 0.34;95% CI: 0.26, 0.45, <em>p</em> < .001) and Hispanic (OR = 0.34; 95% CI: 0.26, 0.45, <em>p</em> < .001) vs White non-Hispanic had lower odds of choosing IUDs over implants. Black non-Hispanic AYAs had higher likelihood than White non-Hispanics for LARC removal within 1-year (HR = 1.58; 95% CI: 1.11, 2.25; <em>p</em> = .01).</div></div><div><h3>Conclusions</h3><div>AYAs with EDOs compared to those without EDOs are more likely to choose IUDs over implants and they have similar high 1-year LARC continuation rates . AYAs of non-White race/ethnicities independent of EDO diagnosis are less likely to choose IUDs.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 69-75"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trisomy 18 (Edwards syndrome) is a rare chromosomal disorder characterized by multiple congenital anomalies and poor survival. While the clinical spectrum is well-documented, ambiguous genitalia is not commonly associated with this syndrome and is infrequently reported in the literature.
Case Presentation
We report the case of a 35-day-old female infant presenting with respiratory distress and ambiguous genitalia. Physical examination revealed multiple dysmorphic features including micrognathia, dysmorphic facial features, low-set ears, agenesis of the left auricle, and limb abnormalities such as rocker-bottom feet. Ambiguous genitalia were staged as Prader and Sinnecker stage 2. Echocardiography revealed complex congenital cardiac defects, and chromosomal analysis confirmed 47,XX,+18. Despite severe anomalies, the patient remained clinically stable with supportive care. A multidisciplinary follow-up was initiated.
Discussion
This case highlights the importance of considering chromosomal anomalies such as Edwards syndrome in neonates with ambiguous genitalia, even in the absence of typical phenotypic findings. The presence of ambiguous genitalia should not preclude the diagnosis of Trisomy 18. Early recognition and genetic confirmation allow for appropriate counseling and management.
Conclusion
This case contributes to the limited body of literature documenting ambiguous genitalia in Trisomy 18. Recognizing rare phenotypic presentations expands our understanding of the clinical heterogeneity of Edwards syndrome and supports early cytogenetic evaluation in neonates with multisystem anomalies.
{"title":"Trisomy 18 and Ambiguous Genitalia: A Case Report","authors":"Demet Tosun MD , İlyas Bingöl MD , Nihal Akçay MD , Çiğdem Özlem Sarıcalı MD , Merve Şakar Mehmet MD","doi":"10.1016/j.jpag.2025.10.004","DOIUrl":"10.1016/j.jpag.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Trisomy 18 (Edwards syndrome) is a rare chromosomal disorder characterized by multiple congenital anomalies and poor survival. While the clinical spectrum is well-documented, ambiguous genitalia is not commonly associated with this syndrome and is infrequently reported in the literature.</div></div><div><h3>Case Presentation</h3><div>We report the case of a 35-day-old female infant presenting with respiratory distress and ambiguous genitalia. Physical examination revealed multiple dysmorphic features including micrognathia, dysmorphic facial features, low-set ears, agenesis of the left auricle, and limb abnormalities such as rocker-bottom feet. Ambiguous genitalia were staged as Prader and Sinnecker stage 2. Echocardiography revealed complex congenital cardiac defects, and chromosomal analysis confirmed 47,XX,+18. Despite severe anomalies, the patient remained clinically stable with supportive care. A multidisciplinary follow-up was initiated.</div></div><div><h3>Discussion</h3><div>This case highlights the importance of considering chromosomal anomalies such as Edwards syndrome in neonates with ambiguous genitalia, even in the absence of typical phenotypic findings. The presence of ambiguous genitalia should not preclude the diagnosis of Trisomy 18. Early recognition and genetic confirmation allow for appropriate counseling and management.</div></div><div><h3>Conclusion</h3><div>This case contributes to the limited body of literature documenting ambiguous genitalia in Trisomy 18. Recognizing rare phenotypic presentations expands our understanding of the clinical heterogeneity of Edwards syndrome and supports early cytogenetic evaluation in neonates with multisystem anomalies.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 121-123"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.09.002
Tazim Dowlut-McElroy MD MS , Victoria O. Hyunh MD , Lauren Roth MD , Madeline Ross MD , Anne-Marie Priebe DO , Jacqueline C. Yano Maher MD , Veronica Gomez-Lobo MD
Study Objective
To compare differences in attitudes between adolescents and young adults with Turner syndrome (AYA with TS) and their parents regarding future fertility and fertility preservation.
Design
(1) FertilityConcepTS survey development with a 2-staged Delphi procedure. (2) Cross-sectional survey study.
Setting
(1) Web-based focus groups. (2) Survey dissemination during the multidisciplinary Turner syndrome clinic at a tertiary care children’s hospital and via the social media platform of the Turner Syndrome Global Alliance.
Participants
Members of the Turner syndrome community.
Main outcome Measures
Attitudes about (1) Interest in understanding the effects of TS on fertility and pregnancy, (2) Opinions of having children that are genetically similar, (3) Alternative methods of building a family, and (4) Medical/surgical fertility preservation procedures with unknown outcomes.
Results
Twenty-eight participants were included in the analysis. The median age of AYA with TS was 17.5 (IQR: 10.5) years, and of parents was 48.0 (IQR: 9.3) years. AYA with TS and their parents differed in their consideration for adoption (p = .005), use of donor egg (p < .001), use of a gestational carrier (p < .001) and raising a child as a single parent (p = .002). Although all parents agreed/strongly agreed with oocyte cryopreservation (OC) and ovarian tissue cryopreservation (OTC), 18.8% and 43.8%, of AYA with TS, respectively, disagreed/strongly disagreed with OC (p = .042) and OTC (p = .021).
Conclusions
In this pilot study, AYA with TS and their parents have differing attitudes about fertility and fertility preservation. Counselling should include consideration of the needs of AYA with TS alongside parent priorities.
{"title":"Fertility Attitudes of Adolescents and Young Adults With Turner Syndrome and Their Parents/Guardians: A Pilot Cross-Sectional Survey Study","authors":"Tazim Dowlut-McElroy MD MS , Victoria O. Hyunh MD , Lauren Roth MD , Madeline Ross MD , Anne-Marie Priebe DO , Jacqueline C. Yano Maher MD , Veronica Gomez-Lobo MD","doi":"10.1016/j.jpag.2025.09.002","DOIUrl":"10.1016/j.jpag.2025.09.002","url":null,"abstract":"<div><h3>Study Objective</h3><div>To compare differences in attitudes between adolescents and young adults with Turner syndrome (AYA with TS) and their parents regarding future fertility and fertility preservation.</div></div><div><h3>Design</h3><div>(1) <em>FertilityConcepTS</em> survey development with a 2-staged Delphi procedure. (2) Cross-sectional survey study.</div></div><div><h3>Setting</h3><div>(1) Web-based focus groups. (2) Survey dissemination during the multidisciplinary Turner syndrome clinic at a tertiary care children’s hospital and via the social media platform of the Turner Syndrome Global Alliance.</div></div><div><h3>Participants</h3><div>Members of the Turner syndrome community.</div></div><div><h3>Main outcome Measures</h3><div>Attitudes about (1) Interest in understanding the effects of TS on fertility and pregnancy, (2) Opinions of having children that are genetically similar, (3) Alternative methods of building a family, and (4) Medical/surgical fertility preservation procedures with unknown outcomes.</div></div><div><h3>Results</h3><div>Twenty-eight participants were included in the analysis. The median age of AYA with TS was 17.5 (IQR: 10.5) years, and of parents was 48.0 (IQR: 9.3) years. AYA with TS and their parents differed in their consideration for adoption (<em>p</em> = .005), use of donor egg (<em>p</em> < .001), use of a gestational carrier (<em>p</em> < .001) and raising a child as a single parent (<em>p</em> = .002). Although all parents agreed/strongly agreed with oocyte cryopreservation (OC) and ovarian tissue cryopreservation (OTC), 18.8% and 43.8%, of AYA with TS, respectively, disagreed/strongly disagreed with OC (<em>p</em> = .042) and OTC (<em>p</em> = .021).</div></div><div><h3>Conclusions</h3><div>In this pilot study, AYA with TS and their parents have differing attitudes about fertility and fertility preservation. Counselling should include consideration of the needs of AYA with TS alongside parent priorities.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 35-42"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.09.010
Yijing Wang PhD , Nuomin Sun MPH , Binglin Chen MS , Mengfei Liu , Ruming Bu MPH , Gang Liu MMS
Study Objective
In China, HPV vaccination coverage among young girls is relatively low, with parental knowledge, attitude, and practice (KAP) significantly influencing their daughters' vaccination decisions. To enhance vaccination rates, Guangdong Province has implemented a free vaccination policy for the bivalent HPV vaccine for eligible girls. This study aimed to assess the KAP levels of parents in Guangdong with daughters aged 9-15 regarding HPV vaccine and HPV vaccination and identify associated factors.
Methods
A cross-sectional online survey was conducted from April 21 to 29, 2022, recruiting 4976 parents in Guangdong Province. Socio-demographic characteristics and KAP levels were analyzed using frequencies and percentages. The Chi-square test compared KAP differences across various socio-demographic groups, while multivariable logistic regression identified factors associated with KAP.
Results
The sample included 1837 fathers (36.98%) and 3130 mothers (63.02%). The overall correct response rate of knowledge, attitude and practice questions was 80.91%, 79.05% and 66.26% respectively. 71.41% of parents demonstrated “good” knowledge, 40.69% exhibited “positive” attitude toward vaccination, and 56.79% reported “favorable” practice. Mothers, those aged 35 or older, and individuals with university/college -level education or above were more likely to show “good” knowledge and “positive” attitude, though they also exhibited “unfavorable” practice. Additionally, parents employed in public institutions and being married tended to have better KAP.
Conclusion
While parents in Guangdong display high knowledge and positive attitude towards HPV vaccine and HPV vaccination, inconsistencies exist between their knowledge, attitude, and practice. Future interventions should focus on well-designed educational campaigns with clear messaging and timely, transparent communication through trusted sources, in order to promote favorable practice alongside improving parental knowledge and attitude.
{"title":"Knowledge, Attitude, and Practice of Parents of Children Aged 9-15 Years for Human Papillomavirus Vaccine and Vaccination in Guangdong Province, China","authors":"Yijing Wang PhD , Nuomin Sun MPH , Binglin Chen MS , Mengfei Liu , Ruming Bu MPH , Gang Liu MMS","doi":"10.1016/j.jpag.2025.09.010","DOIUrl":"10.1016/j.jpag.2025.09.010","url":null,"abstract":"<div><h3>Study Objective</h3><div>In China, HPV vaccination coverage among young girls is relatively low, with parental knowledge, attitude, and practice (KAP) significantly influencing their daughters' vaccination decisions. To enhance vaccination rates, Guangdong Province has implemented a free vaccination policy for the bivalent HPV vaccine for eligible girls. This study aimed to assess the KAP levels of parents in Guangdong with daughters aged 9-15 regarding HPV vaccine and HPV vaccination and identify associated factors.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted from April 21 to 29, 2022, recruiting 4976 parents in Guangdong Province. Socio-demographic characteristics and KAP levels were analyzed using frequencies and percentages. The Chi-square test compared KAP differences across various socio-demographic groups, while multivariable logistic regression identified factors associated with KAP.</div></div><div><h3>Results</h3><div>The sample included 1837 fathers (36.98%) and 3130 mothers (63.02%). The overall correct response rate of knowledge, attitude and practice questions was 80.91%, 79.05% and 66.26% respectively. 71.41% of parents demonstrated “good” knowledge, 40.69% exhibited “positive” attitude toward vaccination, and 56.79% reported “favorable” practice. Mothers, those aged 35 or older, and individuals with university/college -level education or above were more likely to show “good” knowledge and “positive” attitude, though they also exhibited “unfavorable” practice. Additionally, parents employed in public institutions and being married tended to have better KAP.</div></div><div><h3>Conclusion</h3><div>While parents in Guangdong display high knowledge and positive attitude towards HPV vaccine and HPV vaccination, inconsistencies exist between their knowledge, attitude, and practice. Future interventions should focus on well-designed educational campaigns with clear messaging and timely, transparent communication through trusted sources, in order to promote favorable practice alongside improving parental knowledge and attitude.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 27-34"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.09.007
Natalie Hickerson MD , Hadar Lev-Tov MD, MAS , Sara Danker MD , Judith Simms-Cendan MD
Hidradenitis suppurativa (HS) is a complex disease that manifests with nodules, abscesses, and tunnels in the intertriginous regions of the body. Symptoms often begin after adrenarche and may progress to severe disease with draining tunnels and permanent scars, leading to a significant reduction in quality of life and mental health. Diagnostic delays are common, increasing the risk of disease progression. Timely diagnosis and effective management are essential to the prevention of complications in the pediatric and adolescent population. This review will cover the currently available information on pathophysiology, risk factors, presentation, diagnosis, and management of HS in this population.
{"title":"Hidradenitis Suppurativa in the Pediatric and Adolescent Population","authors":"Natalie Hickerson MD , Hadar Lev-Tov MD, MAS , Sara Danker MD , Judith Simms-Cendan MD","doi":"10.1016/j.jpag.2025.09.007","DOIUrl":"10.1016/j.jpag.2025.09.007","url":null,"abstract":"<div><div>Hidradenitis suppurativa (HS) is a complex disease that manifests with nodules, abscesses, and tunnels in the intertriginous regions of the body. Symptoms often begin after adrenarche and may progress to severe disease with draining tunnels and permanent scars, leading to a significant reduction in quality of life and mental health. Diagnostic delays are common, increasing the risk of disease progression. Timely diagnosis and effective management are essential to the prevention of complications in the pediatric and adolescent population. This review will cover the currently available information on pathophysiology, risk factors, presentation, diagnosis, and management of HS in this population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 17-24"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.07.010
Jacquelyn R. Evans DO , Katherine Bergus MD , Lindsey Asti PhD, MPH , Lesley L. Breech MD , Ruiqi Cen PhD, MPH , Yuan Yuan Gong MD , S. Paige Hertweck MD , Holly R. Hoefgen MD , Anne H. Horne MSN, RN, CPN , Ashli Lawson MD, MS , Seema Menon MD , Kathleen E. O’Brien MD , Shashwati Pradhan MD , Brenna Rachwal MPH , Yolanda R. Smith MD , Priya Suvarna , Sarah Van Son MD , Geri Hewitt MD
Study Objective
This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.
Methods
A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.
Results
There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common procedures performed concurrently included LNG-IUS placement (58.10%), ovarian cystectomy (11.27%), endoscopy (1.76%), and appendectomy (1.41%). Most patients (86.27%) experienced no postoperative complications within 30 days of the procedure. Significant postoperative pain was seen in 14 patients (4.93%) with 9 patients (3.17%) requiring additional narcotics and 5 patients (1.76%) requiring admission for pain control. One patient experienced a venous thromboembolism (0.35%). Reoperation rate was 12.32% with a median interval of 1.7 years (IQR: 0.93, 4) from initial surgery.
Conclusions
We demonstrate that laparoscopy for diagnosis and/or treatment of endometriosis has low complication and reoperation rates in adolescent and young adult patients. Performing concurrent indicated procedures, particularly LNG-IUS placement, is safe and should be considered to avoid additional anesthesia exposure and cost. Anticipatory guidance regarding postoperative pain may be beneficial in this patient population. This evidence-based data aids in shared medical decision-making.
{"title":"Intraoperative Care and Complications of Symptomatic Adolescent and Young Adult Patients Undergoing Laparoscopy to Diagnose and/or to Treat Endometrioses: A Multi-Institutional Review","authors":"Jacquelyn R. Evans DO , Katherine Bergus MD , Lindsey Asti PhD, MPH , Lesley L. Breech MD , Ruiqi Cen PhD, MPH , Yuan Yuan Gong MD , S. Paige Hertweck MD , Holly R. Hoefgen MD , Anne H. Horne MSN, RN, CPN , Ashli Lawson MD, MS , Seema Menon MD , Kathleen E. O’Brien MD , Shashwati Pradhan MD , Brenna Rachwal MPH , Yolanda R. Smith MD , Priya Suvarna , Sarah Van Son MD , Geri Hewitt MD","doi":"10.1016/j.jpag.2025.07.010","DOIUrl":"10.1016/j.jpag.2025.07.010","url":null,"abstract":"<div><h3>Study Objective</h3><div>This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.</div></div><div><h3>Methods</h3><div>A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.</div></div><div><h3>Results</h3><div>There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common procedures performed concurrently included LNG-IUS placement (58.10%), ovarian cystectomy (11.27%), endoscopy (1.76%), and appendectomy (1.41%). Most patients (86.27%) experienced no postoperative complications within 30 days of the procedure. Significant postoperative pain was seen in 14 patients (4.93%) with 9 patients (3.17%) requiring additional narcotics and 5 patients (1.76%) requiring admission for pain control. One patient experienced a venous thromboembolism (0.35%). Reoperation rate was 12.32% with a median interval of 1.7 years (IQR: 0.93, 4) from initial surgery.</div></div><div><h3>Conclusions</h3><div>We demonstrate that laparoscopy for diagnosis and/or treatment of endometriosis has low complication and reoperation rates in adolescent and young adult patients. Performing concurrent indicated procedures, particularly LNG-IUS placement, is safe and should be considered to avoid additional anesthesia exposure and cost. Anticipatory guidance regarding postoperative pain may be beneficial in this patient population. This evidence-based data aids in shared medical decision-making.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 94-100"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jpag.2025.10.013
Perihan Güner PhD, RN , Tuğba Ulukaya RN
Study Objective
To explore coping strategies among women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome following McIndoe vaginal reconstruction, focusing on how they adapt emotionally, cognitively, relationally, and spiritually.
Methods
A descriptive phenomenological study was conducted at a tertiary university hospital in Türkiye. Ten women with MRKH syndrome who underwent McIndoe vaginoplasty were recruited. Data were collected through semi-structured, in-depth interviews and analyzed using Colaizzi’s seven-step framework. Reporting adhered to the COREQ checklist.
Results
Six overarching themes and twelve subthemes were identified:1 managing silence and avoidance,2 reframing and positive reappraisal,3 spiritual coping,4 relational dynamics of support and stigma,5 disclosure dilemmas, and6 pathways to empowerment. Coping strategies were dynamic, shifting from avoidance to eventual empowerment, and were shaped by family dynamics, cultural norms, spirituality, and relational contexts.
Conclusion
Coping following McIndoe reconstruction extends beyond surgical success to encompass psychological adjustment, relational support, and the creation of cultural and spiritual meaning. Holistic interventions-including psychoeducation, culturally sensitive counselling, family- and couple-based approaches, and structured peer networks-may strengthen resilience and promote well-being in this population.
研究目的：探讨McIndoe阴道重建术后MRKH （mayer - rokitansky - k ster- hauser）综合征女性的应对策略，重点关注她们在情感、认知、关系和精神方面的适应情况。方法：采用描述性现象学研究方法在浙江省某三级大学附属医院进行。10名患有MRKH综合征的女性接受了McIndoe阴道成形术。通过半结构化的深度访谈收集数据，并使用Colaizzi的七步框架进行分析。报告遵循COREQ检查表。结果：确定了6个总体主题和12个副主题：(1)管理沉默和回避，(2)重构和积极的重新评价，(3)精神应对，(4)支持和耻辱的关系动力学，(5)披露困境，(6)赋权途径。应对策略是动态的，从回避到最终的授权，并由家庭动态、文化规范、精神和关系背景形成。结论：McIndoe重建术后的应对不仅仅是手术成功，还包括心理调整、关系支持以及文化和精神意义的创造。整体干预措施——包括心理教育、文化敏感咨询、以家庭和夫妻为基础的方法，以及结构化的同伴网络——可能会增强这一人群的适应力，促进他们的福祉。
{"title":"From Avoidance to Empowerment: Coping Strategies in Women With Müllerian agenesis (MRKH) After McIndoe Reconstruction: A Descriptive Phenomenological Study","authors":"Perihan Güner PhD, RN , Tuğba Ulukaya RN","doi":"10.1016/j.jpag.2025.10.013","DOIUrl":"10.1016/j.jpag.2025.10.013","url":null,"abstract":"<div><h3>Study Objective</h3><div>To explore coping strategies among women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome following McIndoe vaginal reconstruction, focusing on how they adapt emotionally, cognitively, relationally, and spiritually.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological study was conducted at a tertiary university hospital in Türkiye. Ten women with MRKH syndrome who underwent McIndoe vaginoplasty were recruited. Data were collected through semi-structured, in-depth interviews and analyzed using Colaizzi’s seven-step framework. Reporting adhered to the COREQ checklist.</div></div><div><h3>Results</h3><div>Six overarching themes and twelve subthemes were identified:<span><span><sup>1</sup></span></span> managing silence and avoidance,<span><span><sup>2</sup></span></span> reframing and positive reappraisal,<span><span><sup>3</sup></span></span> spiritual coping,<span><span><sup>4</sup></span></span> relational dynamics of support and stigma,<span><span><sup>5</sup></span></span> disclosure dilemmas, and<span><span><sup>6</sup></span></span> pathways to empowerment. Coping strategies were dynamic, shifting from avoidance to eventual empowerment, and were shaped by family dynamics, cultural norms, spirituality, and relational contexts.</div></div><div><h3>Conclusion</h3><div>Coping following McIndoe reconstruction extends beyond surgical success to encompass psychological adjustment, relational support, and the creation of cultural and spiritual meaning. Holistic interventions-including psychoeducation, culturally sensitive counselling, family- and couple-based approaches, and structured peer networks-may strengthen resilience and promote well-being in this population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 101-108"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145390737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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