ABSTRACT
BACKGROUND: Telehealth holds the potential to expand access to sexual and reproductive health care services to meet the needs of teens. The COVID-19 pandemic represented the opportunity to expand services and reduce barriers through virtual care. METHOD(S): In the summer of 2020, Essential Access Health conducted a 22 question survey via SurveyMonkey that received 401 responses and analyzed young people's experience with and attitudes towards telehealth including interest in home STI testing kits. In the fall of 2021, Essential Access repeated the survey that received 202 responses. Surveys were promoted through social media and with community partners. RESULT(S): The percentage of respondents who had ever had a telehealth visit increased 92% (13.2 to 25.4 percent) between surveys. Over 80 percent of respondents in survey 1 rated their experience as excellent or good, and 67.3 percent rated their experience excellent or good in survey 2. The top reasons for being interested in telehealth remained the same, it is more private, easier, and less intimidating than going to a clinic. When asked if respondents would be more or less likely to get the care they need using telehealth, the percent of respondents who said unsure decreased 57% (29.4 to 12.6). The percentage of participants who responded that they would be somewhat more or much more likely to get the care they needed if they were able to use telehealth increased 51% (46.3 to 70.1). Interest in a home STI test kit decreased slightly from 55.42 to 48.1 percent of respondents noting interest in using a home STI test kit either now or once the pandemic had ended. CONCLUSION(S): The COVID-19 pandemic increased knowledge of and experience with telehealth. Opportunities remain to increase awareness about telehealth among teens, expand access to care, and improve teen satisfaction with remote visits.
ABSTRACT
The diagnosis of visceral perforation during pregnancy is often delayed and the management complex. A 32-year-old primigravid woman in her second trimester presented with abdominal pain and a pre-existing ileoanal pouch. Initial imaging was negative but later imaging was suggestive of serious pathology. At laparotomy, a caesarean section was performed. Peritonitis was encountered secondary to two discrete perforations in the small bowel separate from her pouch. Histology found an ischaemic perforation secondary to a pressure effect from the gravid uterus. In pregnancy, ileoanal pouches may make the interconnected bowel vulnerable to the pressure effect of the gravid uterus and perforation. Pregnant women with such a surgical history who develop symptoms suggestive of bowel perforation should have rapid imaging and their clinical team should consider early definitive surgical intervention.