国产长效避孕皮下埋植剂避孕效果及副作用的临床观察

对国产长效避孕皮下埋植剂的避孕效果及副作用进行了临床观察。共观察210例,时间为1年。结果显示:国产长效避孕皮下埋植剂的避孕效果达100％,因副作用要求取出埋植剂者7例,其持续使用率为96.67％。副作用主要为月经紊乱(52.38％)、少数表现有头痛(2.38％),恶心呕吐(2.38％)、过敏反应(0.48％)和手臂麻木(0.95％)等。本法对不适宜放置宫内节育器、不能坚持口服避孕药的育龄妇女最为适用。     

国产皮下埋植剂多中心研究

目的:评价两种国产皮下埋植剂的避孕效果、副反应和继续使用率。方法:分两期进行。第一期为国产Ⅰ型、Ⅱ型皮下埋植剂与Norplant进行前瞻性临床对比研究,各100例,共300例。第二期为国产皮下埋植剂扩大临床应用,接受合格对象Ⅰ型999例,Ⅱ型998例,共1997例。随访5年。结果:5年随访率为99.5％。第一期国产Ⅰ型、Ⅱ型皮下埋植剂和Norplant的5年累计妊娠率分别为0/百妇女、1.0/百妇女、0/百妇女,5年继续使用率分别为77％、80％、80％,差异均无统计学意义(P>0.05)。主要副反应为月经紊乱,月经卡分析显示3种埋植剂的出血模型相似。第二期国产Ⅰ型、Ⅱ型皮下埋植剂5年累计妊娠率分别为0.20/百妇女,2.10/百妇女,5年继续使用分别为84.47％、82.28％。使用埋植剂6个月Ⅰ型和Ⅱ型月经问题主诉发生率分别为50.88％、57.16％,差异有显著意义(P<0.01),但随着使用时间延长,月经紊乱主诉发生率逐渐下降,两组间无差异。结论:5年研究表明两种国产皮下埋植剂的避孕效果、副反应发生率和继续使用率与Norplant相似,也是一种高效,长效的避孕制剂。国产皮下埋植剂Ⅱ型使用至第5年避孕失败率明显增加,建议国产Ⅱ型皮下埋植剂使用期限在3～4年为好。     

两种皮下埋植避孕剂使用效果比较

<正> 皮下埋植避孕剂是低剂量恒定释放孕激素的长效避孕剂。目前全世界已有180万余例育龄妇女使用皮下埋植避孕法。近年国产埋植剂已在临床试用。为了比较国产和进口埋植剂的效果,我所于     

国产Ⅱ型皮下埋植剂5年临床应用观察

本文对505例接受国产Ⅱ型皮下埋植避孕剂的妇女进行5年临床应用观察,随访率99.01％。仅1例妊娠,5年累积妊娠率0.27％。该皮下埋植剂的主要副反应仍是月经问题,也是终止使用的主要原因,占总终止数的88.53％。1～5年的累积续用率分别为88.87％、78.25％、67.62％、60.07％、56.75％接受者。本组对象埋植和取出术均无局部伤口感染,有2例仅取出一根埋植剂,可能与埋植技术有关。观察结果表明国产Ⅱ型皮下埋植避孕剂可以使用5年,是一种长效、高效、安全、可逆的避孕方法。     

国产Ⅱ型皮下埋植剂避孕6年临床效果观察

<正> 国产Ⅱ型皮下埋植剂避孕有效期为4年,因其长效、高效、安全、简便、可逆、副反应小而深受节育者欢迎。国内有关资料报道根据国产Ⅱ型埋植剂体内释放量研究,推算和预计实际避孕期可达5～6年的可能,我站临床应用国产Ⅱ型皮下埋植剂120例,现将6年避孕效果报告如下。     

皮下埋植避孕的不良反应与治疗

皮下埋植避孕通过缓慢释放孕激素达到避孕目的，其优点是高效、长效、简便、可逆。我国自1984年引进Norplant皮下埋植剂，曾进行多项临床可接受性研究。90年代初期，国产皮下埋植剂研制成功，并应用于临床。皮下埋植避孕不良反应的监测与治疗，对保护受术者的健康有着重要的意义。     

国产Ⅰ、Ⅱ型皮下埋植剂的临床应用研究

目的:评价两种国产皮下埋植剂的避孕效果、副反应和续用率。方法:在安徽省16个计划生育服务站对国产Ⅰ型和Ⅱ型皮下埋植剂进行临床研究,按统一筛选标准接收研究对象(Ⅰ型456例,Ⅱ型513例),并完成24个月的随访。结果:两种埋植剂24个月仅国产Ⅰ型发生1例妊娠,累积妊娠率0.22/百妇女年;24个月累积续用率Ⅰ型为83.98/百妇女年,Ⅱ型为94.33/百妇女年;24个月时副反应主诉发生率国产Ⅰ型为39.2％,Ⅱ型为35.1％,两组之间无显著性差异。结论:两种国产皮下埋植避孕剂均高效、可接受性较好。     

皮下埋植避孕剂超期20例临床观察

为观察育龄妇女使用释放左旋18一甲基炔诺酮的皮下埋植避孕剂国产Ⅱ型的避孕效果及安全性。本站于1995年开展皮下埋植避孕术,到2010年10月对20例放置皮埋剂7年以上的节育对象进行随访观察,现报告如下。     

国产长效皮下埋植避孕剂的研究与临床应用

<正> 皮下埋植长效避孕剂是一种新型节育技术,具有高效、长效、安全、简便和可逆的优点。90年代初期,国产皮下埋植剂研制成功,即国产Ⅰ型(6根胶棒)和国产Ⅱ型(2根胶棒)。两种国产埋植剂均定名为“左炔诺孕硅胶棒”。 埋植剂类型 一、国产Ⅰ型 每套6根,长3.4cm,直径2.4mm,内含LNG 36mg,共含216mg。有效期5年。由辽宁省计划生育科研所研制,丹东市     

国产皮下埋植剂对血糖及糖耐量的影响

<正> 左旋18甲基炔诺酮皮下埋植缓释避孕系统是一种长效、高效、可恢复性好的避孕方法。并已在国内外得到了较广泛的应用。国产埋植剂是利用国产原料仿制Norplant-Ⅰ型埋植剂,由辽宁省计划生育科研院研制,于1994年9月通过国家新药审评,得到试生产证书。本文观察使用国产埋植剂后对血糖及糖耐量的影响,评价其安全性。 资料和方法     

The Rise of Female Sterilization: A Closer Look at Colombia

Objective In the 1970s, OCPs and IUDs were the most popular contraceptive methods in Colombia. According to data from the most recent Demographic and Health Survey (DHS), sterilization has become the most common form of birth control in Colombia. This study aims to examine the characteristics of Colombian women desiring long-acting contraception. Methods This study uses the 2005 and 2010 Colombian DHS dataset. Women who choose long-acting contraception were divided into those using female sterilization and those using long-acting reversible contraception (LARC). A multivariate logistic regression model was used to compare demographic and social determinants of contraceptive choice among reproductive age women seeking long-acting contraception between the years 2005 and 2010. Results Among women using a long-acting contraceptive method in 2010, compared to 2005, women were significantly more likely to be sterilized (1.14 OR, 95% CI 1.09–1.18) and less likely to use LARC (0.88 OR, 95% CI 0.85–0.92). Of women seeking long-acting contraception, those exposed to a family planning provider were less likely to undergo sterilization (0.54 OR, 95% CI 0.51–0.58) and more likely to use LARC (1.84 OR, 95% CI 1.73–1.96). When compared to all contraceptive users, younger women and women with less than two children were more likely to use LARC than sterilization. Conclusion Between 2005 and 2010, an increase in the proportion of contracepting women being sterilized in Colombia occurred. Our findings suggest that exposure to a family planning provider and appropriate contraceptive counseling appears to be key determinants of long-acting contraceptive choice. To improve use of long-acting, effective contraception, efforts should be made to increase access to family planning providers.     

上海市中心城区产后妇女避孕需求及产后避孕服务利用调查

目的调查上海市中心城区产后妇女避孕节育现况及避孕相关生殖健康服务利用情况。方法2019年8月至12月期间,采用横断面调查的方法对在上海市4个区(长宁区、静安区、普陀区、杨浦区)产后42 d健康检查门诊就诊和前往儿童保健门诊的妇女进行问卷调查。数据分析采用频率和logistic回归分析等方法。结果调查的1170名产后妇女中有420名已恢复性生活,恢复时间为分娩后(3.6±1.5)个月。按照产后时间不同进行分组,已恢复性生活的调查对象在产后1~3个月、4~6个月、7~9个月和10~12个月坚持采用避孕措施的比例分别为69.4%(43/62)、77.2%(186/241)、79.2%(57/72)和71.1%(32/45)。是否计划妊娠、再生育意愿以及产后避孕指导是影响避孕行为的主要因素。产后不同时期的妇女采用的避孕方法均以避孕套为主,长效可逆避孕方法使用率低。在产后访视和产后42 d检查时分别有43.3%(395/913)和34.6%(369/1067)的调查对象获得了具体的避孕方法指导。37.6%(420/1117)的调查对象认为产后42 d检查是避孕最佳健康宣教时机,而30.5%(341/1117)的妇女认为孕期健康教育时就应该给予指导。结论约四分之一的上海市中心城区妇女在产后未坚持采用避孕措施;宫内节育器、皮下埋植剂等长效、可逆的避孕方法使用率低。应加强产后避孕指导,强化专业队伍培训,重视避孕药具的正确选择和使用,引导妇女正确认识长效避孕方法。同时,避孕指导服务可提前至孕期开展,做到关口前移。     

Provision of contraceptive services to homeless women: results of a survey of health care for the homeless providers

Homeless women have both a higher rate of pregnancy and a higher proportion of unintended pregnancies than other American women. The authors sought to learn about contraception services offered by providers of health care to homeless women and barriers to provision of long-acting, reversible contraception in these settings. A survey of the 31 member organizations in the national Health Care for the Homeless Practice-Based Research Network was conducted, inquiring about services provided and barriers to service provision. Among the 20 responding organizations (65% response rate), 17 directly provided contraceptive services; two referred patients elsewhere, and one provided no contraceptive services. All 17 that provided such services provided condoms; 15 provided oral contraceptives; 14 provided injectable contraception; 6 provided intrauterine devices, and 2 provided contraceptive implants. Barriers to providing the last two methods included lack of provider training, lack of resources for placement, costs, and concerns about complications. The present survey results suggested very limited access for homeless women across the country to the two most effective means of long-acting, reversible contraception. Modest investments of resources could reduce a number of barriers to providing these services.     

Context of care and contraceptive method use.

OBJECTIVES: We assessed the relationship between context of care (incorporates insurance status with clinical setting) on contraceptive use among a national sample of reproductive-aged women. Our hypothesis is that compared to privately insured women who receive their health care in private doctors' offices, women who are publicly insured or self-pay and/or receive their health care in a clinic are more likely to use permanent or long-acting contraceptive methods. METHODS: The study population, consisting of 4,358 women surveyed as part of the 1995 National Survey of Family Growth (NSFG) who were both at risk of unintended pregnancy and currently sexually active, was analyzed using polytomous logistic regression. RESULTS: Following adjustment for age, race/ethnicity, marital status, education, income, parity and smoking, there was a trend toward long-acting contraceptive use among women with public insurance or who were self-pay, regardless of clinical setting compared to privately insured women seen in private clinics. Self-pay and publicly insured women of low parity tended to use long-acting contraception, as did privately insured women seen in clinics. CONCLUSIONS: Insurance information, as well as clinical setting, may guide clinicians' contraceptive decision-making.     

Contraceptive method and self-reported HIV status among women in Malawi

ObjectivesWe aimed to describe contraceptive methods used by women in Malawi and determine whether contraceptive use differed by self-reported HIV status. Effective contraception is a primary method of preventing mother-to-child transmission of HIV.Study designAnalysis is based on 12,658 nonpregnant, sexually debuted women ages 15–49 years in the 2010 Malawi Demographic and Health Survey. Analysis was restricted to respondents with contraceptive need (i.e., fecund and did not want a child in the next 12 months) who reported their last HIV test result. We accounted for the two-stage cluster sampling design by applying cluster, stratum and sample weights. We assessed differences in contraceptive method use by HIV status with χ² tests and multivariable logistic regression.ResultsA total of 893 (7.0%) of respondents reported being HIV positive. Use of long-acting reversible contraception (LARC) was low and did not differ between HIV-positive (1.4%) and HIV-negative (1.9%) women [adjusted odds ratio (aOR)=0.7, 95% confidence interval (CI), 0.4–1.4]. HIV-positive women (15.6%) were less likely than HIV-negative women (30.4%) to use progestin-only injectable contraception (aOR, 0.7; 95% CI, 0.5–0.8). Prevalence of female sterilization was higher among HIV-positive women (17.9%) compared to HIV-negative women (9.2%; aOR=1.7; 95% CI, 1.2–2.3).ConclusionsLARC use was low among adult women with contraceptive need in Malawi. HIV-positive women were less likely to report progestin-only injectable use but more likely to report having undergone female sterilization compared to their HIV-negative counterparts. Noncoercive interventions that provide highly effective methods of contraception to HIV-positive women with contraceptive need are valuable methods of vertical transmission prevention in Malawi.ImplicationsContraceptive use differed by self-reported HIV status among adult women with contraceptive need in Malawi. Female sterilization was significantly higher, and use of progestin-only injectables was significantly lower, among HIV-positive women compared to their HIV-negative counterparts. Use of long-acting reversible contraception was low among both HIV-positive and HIV-negative women.     

“It Makes You Rethink Your Choice of the Pill”: Theory-Based Formative Research to Design a Contraceptive Choice Campaign

Half of all pregnancies in the United States remain unplanned despite improved access to highly effective long-acting reversible contraception, including the intrauterine device and the implant. This study conducted theory-based formative research to develop a contraceptive choice campaign aimed at increasing long-acting reversible contraception uptake by women ages 18–44 years in Charleston, South Carolina, an urban area in the southeastern United States. Researchers developed and tested message concepts and designs. Six focus groups and 18 interviews were conducted among reproductive-age women (n = 79). Qualitative data analysis revealed messages and designs that resonated with these women. Emphasizing long-acting reversible contraception as the healthy option, highlighting long-acting reversible contraception effectiveness, including relatable and trustworthy characters, and using language of control emerged as themes. Women reported a preference for statistics illustrating effectiveness combined with empowering messages of control over contraceptive decision making. Findings from this study offer practical recommendations for developing contraceptive choice campaigns targeting long-acting reversible contraception use and further the goal of reducing unintended pregnancy among women.     

What contraception do women use after abortion? An analysis of 319,385 cases from eight countries

Contraception is an essential element of high-quality abortion care. However, women seeking abortion often leave health facilities without receiving contraceptive counselling or methods, increasing their risk of unintended pregnancy. This paper describes contraceptive uptake in 319,385 women seeking abortion in 2326 public-sector health facilities in eight African and Asian countries from 2011 to 2013. Ministries of Health integrated contraceptive and abortion services, with technical assistance from Ipas, an international non-governmental organisation. Interventions included updating national guidelines, upgrading facilities, supplying contraceptive methods, and training providers. We conducted unadjusted and adjusted associations between facility level, client age, and gestational age and receipt of contraception at the time of abortion. Overall, postabortion contraceptive uptake was 73%. Factors contributing to uptake included care at a primary-level facility, having an induced abortion, first-trimester gestation, age ≥25, and use of vacuum aspiration for uterine evacuation. Uptake of long-acting, reversible contraception was low in most countries. These findings demonstrate high contraceptive uptake when it is delivered at the time of the abortion, a wide range of contraceptive commodities is available, and ongoing monitoring of services occurs. Improving availability of long-acting contraception, strengthening services in hospitals, and increasing access for young women are areas for improvement.     

农村已婚育龄妇女节育措施落实状况调查

<正> 计划生育工作的重点在农村。为了解农村妇女节育措施落实情况,提高节育、避孕率及避孕效果,     

Why are rates of sterilization in decline? A pilot study designed to explore reasons for declining female sterilization in Scotland

BACKGROUND: In the last decade, female sterilization had been in decline throughout the UK. It is not clear whether fewer women are requesting sterilization or whether the universal enthusiasm for long-acting reversible methods is leading health professionals to discourage women from being sterilized. Since correct and consistent use of alternative, reversible contraceptive methods depends somewhat on their acceptability, it is important to determine whether women are being refused sterilization or whether they are freely choosing other methods. This study aims to explore whether female sterilization is being widely considered as a contraceptive method, the reasons for choosing or rejecting it, and whether women are being discouraged by health professionals from being sterilized. STUDY DESIGN: A self-completed questionnaire survey among 205 women aged 30 to 50 years who felt that their family was complete attending a family planning clinic in Scotland. RESULTS: Of the 203 women included in the study, 151 (74.4%) had heard of female sterilization, 90 had discussed it with someone (60%) and 87 (58%) had considered it as a contraceptive option. Of the 56 women who consulted their family doctor about sterilization, almost half (27; 48%) were not referred to a hospital and fewer than one (17, 30.4%) in three of them was eventually sterilized or had arrangements in place to get it done. Free-text comments from the women revealed a variety of reasons for not choosing female sterilization and suggested that some women are being deterred from sterilization. CONCLUSION: The study suggests that some women are being actively encouraged by health professionals to use long-acting reversible contraceptive methods and discouraged from choosing sterilization. However, other women recognize for themselves the wisdom of keeping their fertility options open.