子宫内“V型”节育装置穿孔病例报告

计划生育是为了实现人口与经济、社会、资源、环境的协调发展而实施的生育调节。实行计划生育是以避孕为主,创造条件保障使用者知情选择,安全、有效、适宜的避孕措施。而宫内节育器(IVD)是一种安全、有效、简便、经济、可靠的节育方法,深受广大妇女的欢迎。     

子宫内“V型”节育装置穿孔病例报告

计划生育是为了实现人口与经济、社会、资源、环境的协调发展而实施的生育调节。实行计划生育是以避孕为主,创造条件保障使用者知情选择,安全、有效、适宜的避孕措施。而宫内节育器(IVD)是一种安全、有效、简便、经济、可靠的节育方法,深受广大妇女的欢迎。     

中国少数民族避孕现用率、效果及影响因素

本文应用国家计划生育委员会１９８８年组织的全国２‰生育节育抽样调查资料，分析中国少数民族避孕现用率、避孕效果及其影响因素。１９８８年全国少数民族避孕现用率为５９．４１％，低于汉族避孕现用率７３．１８％，在十五个主要少数民族中满族现用率最高，为７３．４５％，高于汉族现用率；维吾尔族的现用率最低，仅为１７．６％。少数民族中各种方法的现用率，宫内节育器为最高，在使用者中占４９％；而汉族以绝育为最高，在使用者中占４８．３８％。居住在城市的少数民族避孕现用率高于农村中的避孕现用率。年龄３０～４４岁已婚育龄少数民族妇女中，约有８５％避孕，其中３５～３９岁妇女的避孕现用率最高，为９１．８９％。文化程度高者避孕现用率高，文化程度低者避孕现用率较低。无论宫内节育器、绝育、口服避孕药或避孕套，意外妊娠、副反应和宫内节育器的脱落，为少数民族终止某种避孕方法的主要原因，其中意外妊娠占的比例较高。这说明避孕失败仍是终止使用的最重要的原因。经比例风险模型分析，发现宫内节育器失败妊娠受放器时年龄、居住地城市或农村、放器医院、有无副反应、孩子性别和成活孩子数等多种因素的影响。同样，绝育失败妊娠受妇女文化程度、医院手术水平和成活孩子数的影响?     

云南白族、贵州苗族已婚妇女的婚姻、生育观念及状况分析

云南白族、贵州苗族已婚妇女的婚姻、生育观念及状况分析钱汉竹，赵鹏飞，于虹（上海市计划生育科学研究所，上海，２０００３２）潘钦瑞，李永波，杨元（贵州省计划生育科学研究所，贵阳，５５０００４）彭林，叶汉风，吴亚萍，袁彦玲（云南省计划生育科学研究所，昆明，...     

节育措施与异位妊娠（附295例临床分析）

节育措施与异位妊娠（附２９５例临床分析）邹淑华，孙进莲（即墨市人民医院）宋秀芳（即墨市计划生育局）各种节育措施中，宫内节育器（ＩＵＤ）为一种安全有效、简便经济的可逆性避孕方法，绝育术则为一劳永逸的简便手术。但随时间推移，有发生异位妊娠的问题。我们统计...     

江苏农村育龄妇女避孕方法可接受性的研究

对1986年9月在中国江苏农村进行的“中国农村已婚育龄妇女使用避孕方法的变化”调查资料,应用单因素交叉表及多因素logistic回归分析江苏农村妇女的节育方法使用状况、副作用评价、满意程度及其原因。研究结果表明;江苏农村已婚妇女中,现用的节育方法主要是宫内节育器和女性绝育(分别占46.67%和36.39%)。妇女对各种节育方法的满意程度均较高,尤其对口服避孕药和宫内节育器更为满意。妇女对各种节育方法的评价不尽相同,宫内节育器、针剂、绝育和口服避孕药的优点较为突出,但副作用也较明显。避孕套虽然“使用简便”一项较差,但副作用小。不同特征妇女对各种节育方法的评价有所不同。     

拉萨地区已婚育龄妇女避孕方法应用现况

目的 :了解拉萨地区已婚育龄妇女正在使用中的避孕方法概况。方法 :对拉萨市、区、局各单位已婚育龄妇女进行计划生育、生殖健康普查 ,将调查结果填表 ,并进行统计分析。结果 :该地区所应用的避孕法共 6类 ,其中绝育术、宫内节育器、药物 (口服、针剂、皮埋剂 )及阴道药具避孕法为主要避孕措施。不同年龄组妇女应用避孕方法的种类不同 ,35岁以上妇女绝育术的应用率呈升高趋势 ;30～ 35岁年龄组妇女的宫内节育器应用率高 ;而小于 35岁的妇女多选用药物和阴道药具避孕法。结论 :反映了该地区和国内其他地区一样 ,避孕方法的选用呈多种类、高质量的发展趋势     

哺乳期妇女放置缓释黄体酮阴道环和铜T380A宫内节育器避孕效果及其安全性研究

本文对产后４２～６０天的哺乳妇女放置每天释放１０ｍｇ天然黄体酮的阴道环（１６０例）与铜Ｔ３８０Ａ宫内节育器（１００例）进行避孕效果及其安全性比较研究。结果表明：通过宣教，产后４２～６０天落实节育方法是可行的，放置铜Ｔ３８０Ａ宫内节育器在哺乳期无妊娠发生，哺乳期避孕对母儿健康无不良影响。围产保健和计划生育并行对提高母乳喂养率，落实计划生育方法，降低人工流产率，保障母儿健康收效显著，值得推广。     

孕妇产后的避孕意愿及其影响因素

本文对上海市黄浦区、普陀区、青浦县、奉贤县 40 37名孕妇对产后避孕意愿及影响因素进行了分析。结果显示 :79.96 %的妇女考虑产后避孕。2 5～ 2 9岁的妇女较其它年龄段的妇女考虑产后避孕的比例要高。产后避孕意愿与本人文化程度及职业无关 ,而亲戚朋友的文化程度对产后避孕意愿有影响。工作单位要求在 1年内落实避孕措施、接受过有关避孕知识教育或为此进行咨询或查阅书籍的妇女考虑产后使用避孕方法的比例较高。单位或计划生育部门建议使用的避孕方法以宫内节育器最高 ,占 97.1 4% ,避孕套仅为 1 .0 2 % ;妇女自我选择的避孕方法中宫内节育器为多 ,占 82 .34% ;其次为避孕套 ,占 1 1 .2 1 %。 L ogistic回归分析表明 :年龄、文化程度、职业、家庭收入等对产后避孕意愿影响不大。产后愿意哺乳者、接受过避孕教育、咨询或查阅书籍者、了解避孕知识年龄较小者、知晓宫内节育器者对产后避孕意愿有正面作用。建议在计划生育服务中 ,今后需加强产后避孕教育 ,开展各种避孕方法知情选择的教育和咨询 ,指导妇女在产后选择最适合于自己的避孕方法 ,从而减少产后意外妊娠的发生     

哺乳期妇女放置缓释黄体酮阴道环和铜T380A宫内节育器避孕效果…

本文对产后４２￣６０天的哺乳妇女放置每天释放１０ｍｇ天然黄体酮的阴道环（１６０例）与铜Ｔ３８０Ａ宫内节育器（１００例）进行避孕效果及其安全性比较研究。结果表明：通过宣教，产后４２￣６０天落实节育方法是可行的，放置铜Ｔ３８０Ａ宫内节育器在哺乳期无妊娠发生，哺乳期避孕对母儿健康无不良影响，围产保健和计划生育并行对提高母乳喂养率，落实计划生育方法，降低人工流产率，保障母儿健康收效显著，值得推广。     

云南省县、乡计划生育服务机构IUD放置服务的管理现状研究

目的:了解云南省县、乡计划生育服务机构IUD放置服务管理现状。方法:采用多阶段分层整群随机抽样的方法,抽取云南3个县进行横断面调查。采用情景分析法收集与IUD放置服务及其管理的相关数据及资料并进行深入分析。结果:3个县的县、乡计划生育服务机构作为农村育龄妇女最易获得服务的机构,承担了大量IUD放取工作。其管理系统运行基本正常,但3个县计划生育服务站/所IUD放置服务的管理总体尚比较粗糙,且基层计划生育服务机构间管理水平差异显著。结论:情景分析法可以对生殖健康服务及其管理提供全面、丰富和细致的信息。开展试点和研究,提高西部农村IUD放置服务的管理水平现实可行。     

The dynamics of contraceptive use in developing countries. Pt. 1

The dynamics of contraceptive use in developing countries are described in an abbreviated discussion and are based on a prospective study of the determinants of contraceptive use in India. It is acknowledged use varies among different populations. Contraceptive use behavior is complex and affected by more than just desired family size. The pattern of usage may vary throughout the childbearing years. There is a complex interplay of various sociocultural and behavioral factors associated with the process of choice, continuation or cessation of use of a method, or switching to another method. Not only behavioral factors that operate at the individual level, but national factors such as the national family planning and health services are involved. Information on the social, cultural, and service related determinants of choice and use of different methods is important for policy makers. It affords them the information to plant what methods to offer, the supply of methods, and significance of offering new methods. Policy makers concerned with family planning to reduce fertility need to know to what extent the desire to become pregnant is a reason for discontinuation vs. method failure, opposition by spouse, or health concerns about side effects. Those desiring 2 children were twice as likely to have used other methods prior to sterilization than those desiring 4. Fertility intention was related to choice of method. The distance to the health clinic from home was also related to the prior use of methods before sterilization. Those 1 km from a clinic had a 1.8 times greater chance of having used another method prior to sterilization. IUD and pill users had high discontinuation rates. IUD users shifted to sterilization (34%) or natural methods (20%). while pill users changed to the IUD (49%), sterilization (29%), and the condom (23%). Fertility intentions, the nature and extent of health services, and woman's education affected the pattern. The number of living sons, the inaccessibility of services, and poor knowledge of spacing methods lead to more women accepting sterilization. Overall fertility rates have not had the desired impact from the current contraceptive use patterns (sterilization and little birth spacing). Lack of education affects the use of the pill and IUD knowledge of methods other than sterilization. Mothers desiring 4 or more children are less likely to space and exceed the desired size. Women's education and the quality and extent of health services are the 2 most important intervention efforts.     

Bangladesh: modern methods are well known but not widely used

A follow-up to the 1985 Contraceptive Prevalence Survey, this 1988 study of contraceptive use in Bangladesh revealed that although modern methods are well-know, contraceptive prevalence is low. This study reinterviewed 2586 women living in rural Bangladesh who had participated in the earlier survey. The study found a high level of knowledge about modern contraception, with nearly 95% of the women able to identify at least on modern method (94% mentioned oral contraceptives, 65% IUDs, 76% condoms, 64% injectables, 89% female sterilization, and 74% male sterilization). Concerning traditional family planning methods, only 40% could identify at least one. Despite knowing about modern methods, most women did not identify the advantages or disadvantages of the methods known, making informed choice problematic. Additionally, only 21% of the women interviewed were actually using method at the time of the survey. Contraceptive prevalence among women under 25 years of age and among women with only one child were 2% and 10%, respectively. The study also found that the level of the woman's education had a significant impact on her contraceptive behavior, with 65% of women with 10 or more years of schooling using a method, compared to 18% among women with no schooling. Among the women using contraception, younger women opted for birth spacing methods, while older women generally preferred sterilization. Over 90% of the women using contraception expressed satisfaction with the method they were using. The report regards the high level of contraceptive knowledge as a positive sign, adding that contraceptive prevalence could be increased by bringing services closer to the user, having each women of reproductive age visited by a family planning worker, and through careful follow-up.     

上海闵行区人工流产女性避孕知识的调查与分析

目的:了解人工流产女性的避孕状况,为进一步实施干预、提高育龄妇女生殖健康水平提供依据。方法:面对面问卷访谈,收集和了解要求人工流产女性术前避孕知识、避孕情况等信息进行分析,提出应对措施。结果:726例人工流产访谈女性多数为已婚(75.48%);一次以上的重复流产达57.99%,未婚人工流产占24.52%。未采取避孕措施(51.38%)或避孕失败(48.62%)是导致意外妊娠的主要原因。访谈对象对避孕套、口服避孕药、宫内节育器有所知晓,但对其他避孕方法知之甚少。访谈对象中知道免费提供避孕药具专门机构者仅35.54%。结论:降低重复流产和未婚人工流产是当务之急。对此,需要广泛、持久、深入开展计划生育健康教育,提高育龄人群避孕意识、避孕知识水平。同时,需要加强人工流产后生殖保健服务。     

上海市已婚妇女初产后避孕方法的选择和转换

本文对上海市3701名已婚妇女初产后15个月内避孕方法的选择和转换进行了分析,分析结果表明：产后15个月内,95．46％的妇女采取过避孕方法。产后首次采取的避孕方法城市以避孕套（50．72％）和IUD（29．09％）为主,农村以IUD（56．65％）和避孕套（30．60％）为主,其它方法较少。首次避孕选择避孕套者,终止向IUD的转换率较高;而选用IUD者终止向其它方法的转换率较低。15个月随访时,94．54％的妇女正在使用某种避孕方法,其中60．76％的城市妇女71．07％的农村妇女正在使用IUD。多项分类Logistic回归分析结果表明不同特征的妇女对避孕方法的选择存在很大差异,城市、文化程度高的妇女倾向于选用避孕套和安全期,较少选用口服药;年龄大的妇女使用避孕套和安全期的人要多些;正在哺乳的妇女不愿用口服药;单位或计划生育部门对产后选用何种避孕方法有推荐意向的妇女使用IUD的比例较高。提示计划生育管理部门应根据妇女的不同特征耐心、细致、客观地向她们说明各种避孕方法的优点和缺点,需纠正社会上对一些避孕方法的偏见。应充分尊重妇女的避孕选择,使妇女自觉满意地实行计划生育。     

Use-effectiveness of oral and intrauterine contraception

The use-effectiveness of oral contraception and intrauterine contraception was studied in 3 family planning centers in the United States: Grady Memorial Hospital in Atlanta, Georgia; State University of New York, Downstate Medical Center, in Brooklyn; and the Planned Parenthood Center in Buffalo, New York. In each locality 1000 women were selected for the study. 2900 women accepted intrauterine devices (IUDs) or oral contraceptives (OCs) as their first method of contraception. In Brooklyn 3 out of 4 women chose OCs; in Atlanta and Buffalo roughly equal numbers selected each method. The mean age of admission was 25.7 years in Buffalo, 24 years in Brooklyn, and 23.8 years in Atlanta. IUD acceptors were older than those choosing OCs. The difference was greatest in Buffalo (3.3 years) and smallest in Atlanta (.8 years). A special one-page, self-coding questionnaire was designed to collect the information required. In all 3 clinics contraceptive termination rates were markedly lower for the IUDs than for OCs. At 1 year of use for the first method only about one-fourth the women who chose the IUD had discontinued its use. Women on OCs terminated at rates from 10-20% higher. Termination rates for all contraception, both first-method and substitution, were lower than for first-method alone and lower for IUDs than for OCs. The highest continuation rate for all contraception was 92.5% for IUD users in Brooklyn while OC users in Atlanta were at the lowest level at 60.5%. Pregnancy rate studies demonstrated higher failure rates with OCs than with IUDs in all 3 clinics. Statistics by age showed that termination rates for both IUD and OC users declined with age. Women who selected IUDs as their method of contraception were more persistent users of contraception. Even after discontinuing IUD use, they were more likely to adopt another contraceptive method.     

India: sterilization is common; women know little about other methods

Results and policy recommendations are reported from a recent study of contraceptive use dynamics among 4000 women in 50 villages of Karnataka, India. The study also included a 4-village anthropological component and provider observation, and specifically sought determinant factors of contraceptive use, non-use, method choice, and use patterns. The most common reason for non-use of contraceptives was the desire to have more children, followed by fear of side-effects, lack of knowledge, and familial opposition. Among users, almost 90% chose sterilization. 86% of respondents interested in future contraceptive control also chosen sterilization. Of concern, however, was the finding that a very high percentage of already sterilized women had little or no knowledge of other contraceptive methods. Overall, a strong desire for future contraceptive practice methods. Overall, a strong desire for future contraceptive practice was observed among women in the study. Most all respondents knew about sterilization, while only 60%, 42%, and 18% knew of the IUD, pill, and condom, respectively. Moreover, only few women were able to correctly describe the workings of these methods. Doctors, health workers, neighbors, relatives, and radio and television were finally cited as important sources of family planning information. The paper, therefore, urges greater emphasis of alternative family planning program. Health services and the mass media should be engaged in promoting these alternative methods, with efforts also made to allay illfound fears of method use and side effects. On a more broad scale, greater education and economic advancement will help to change attitudes and norms of birth spacing and family size.     

已婚育龄妇女人工流产史及避孕知识态度和行为现况的相关研究

目的：了解育龄妇女的人工流产史及其原因和有关避孕的知识、态度和行为现状,探讨如何提高避孕知识知晓率和改善相关的态度和行为,以及降低非意愿妊娠率及人工流产率,提高育龄妇女的生殖健康水平。方法：对2012年1月至2013年5月在龙岗区龙城街道计生服务中心行人工流产术的510名已婚已育妇女进行有关人工流产和避孕知识、态度和行为的问卷调查,数据应用SPSS／PC10．0软件进行统计分析。结果：53．5％的妇女有人工流产史,其中人工流产3次及以上者达13．7％;未避孕者占32．6％,避孕失败者占46．8％,其中安全期避孕居首位,占避孕失败者的38．5％,其次放置IUD,占避孕失败者的48．2％。54．8％的人不知道任何一种避孕方法的避孕原理：有49．7％的妇女不知道人工流产手术对身体健康有不良影响;83．5％的人不知道有紧急避孕法。结论：迫切需要加强有关避孕知识的健康教育,并将其作为提供优质生殖健康服务的内容,促进合理有效避孕措施的安全使用,减少非意愿妊娠的发生,避免反复流产给育龄妇女身心带来的损害。     

Overview of modern contraception

The large-scale initiatives to address the global unmet needs for family planning (FP) have gathered and compelled scientists, providers, program managers, and other stakeholders (including users) to re-examine the various methods of modern contraception, focusing on those that are proven to be more effective (long-acting reversible contraceptives and permanent methods), historically more widely used (oral contraceptives, condoms), and in development (male hormonal contraception). Implementing FP programs requires an understanding of the human rights principles underpinning the delivery of contraceptive services, the various indicators related to demand, need, and use (demand satisfied, unmet need, and contraceptive prevalence), and its effectiveness (perfect or correct use and typical use), which will be presented in this article. Tools and guidance documents developed using the best available evidence have also been listed in this review article. This issue will also look at new initiatives about providing care (self-care), and key population groups (post-pregnancy and adolescence). The clinical use of the methods should go hand in hand with the programmatic initiatives to ensure that women, men, or couple take up the appropriate method of choice and continue using these based on their reproductive health goals.     

Interval and postabortal contraception with the frameless GyneFix

Intrauterine contraceptive devices (IUDs) have not suffered from the same negative influences in the developing world as in the first world. The method has too many basic advantages to be gainsaid including, most importantly, that it has the lowest lifetime cost of any effective method of contraception, and that user compliance is not an issue once the device is in place.

However, the global community is not immune from trends that are seen in selected industrialized countries. Today, better methods of contraception are requested and the discomforts associated with earlier models of IUD, which were once acceptable, are less so today. Faced with the side-effects of oral contraception and the high cost in developing countries, many women who have completed their families undergo surgical sterilization as the only long-term method available to them, notwithstanding severe cultural and economic reservations about doing so.

The development of the frameless device is a response to the growing need to develop high-performing, long-acting, reversible and acceptable contraceptives with a high continuation of use and to respond to the urgent need to reverse the legacy of neglect of immediate postabortal family planning.