10mg米非司酮紧急避孕102例临床观察

目的:观察10mg米非司酮用于紧急避孕的效果、副反应及对月经的影响。方法:对无防护性生活5天以内的102例要求紧急避孕的妇女口服米非司酮10mg,并嘱其在服药后7~10天、月经来潮或延迟不来时随诊。结果:102例妇女中有2例妊娠,妊娠率(即避孕失败率)1.96%,其副反应及对月经影响均不明显。结论:10mg米非司酮用于紧急避孕是安全、有效的。     

小剂量米非司酮用于紧急避孕25例分析

目的探讨一次性小剂量米非司酮25mg用于紧急避孕的效果及可接受性。方法25例无保护性交或避孕措施失败后72小时内来院就诊的健康妇女，单次口服米非司酮25mg，服药后按时随访并观察药物副反应及下次月经情况，保证月经复潮前禁欲或采用避孕套避孕。结果25例中有2例避孕失败，避孕有效率达96％。结论小剂量米非司酮用于紧急避孕是非常简便、安全、有效的方法。     

低剂量米非司酮紧急避孕100例临床效果分析

目的 探讨一次性口服低剂量米非司酮10mg用于紧急避孕的效果。方法 选择自愿接受试验，无口服米非司酮禁忌证的健康妇女，在无保护性交72h以内口服米非司酮10mg，服药后定期随访，观察不良反应及下次月经复潮情况，并在月经复潮前严格避孕。结果 按Dixon方法计算，预期妊娠数为10．08，实际妊娠数为2例，避孕总有效率为80．15％，副反应发生率为8．00％（8／100），影响月经周期的占11．00％（11／100）。结论 低剂量米非司酮用于紧急避孕安全有效。     

低剂量米非司酮用于紧急避孕的临床观察

为探索米非司酮用于紧急避孕的临床效果、最低有效剂量及对月经的影响,将避孕失败或未保护性生活后120 h内要求紧急避孕的279例妇女随机分为2组,研究组149例,对照组130例,分别单次口服米非司酮10 mg或25 mg,以服药后月经来潮为成功标准.结果显示两组各妊娠2例,均明显低于预期妊娠数,其避孕有效率分别为84.12%和81.01%,组间无明显差异(P＞0.05).副反应发生率低;对月经周期、经期与经量影响较小;经间期出血的发生率对照组明显高于研究组(18.75%、0.68%),其发生与服药的时期有关,组间有极显著性差异(P＜0.01).对月经的影响,研究组更优于对照组.提示10 mg米非司酮用于紧急避孕亦是安全、有效的.     

米非司酮用于紧急避孕的临床观察

目的探索米非司酮用于紧急避孕的临床效果及副反应。方法采用无保护性生活后72h内自愿要求紧急避孕的216例妇女,单次口服米非司酮25mg,服药后按期随访,以月经来潮未孕为成功标准。结果根据Dixon发放计算,实际妊娠数1例,与预期妊娠数相比差异有显著性。结论米非司酮25mg是一种高效、安全、简便的紧避孕方法。     

三种不同剂量米非司酮用于紧急事后避孕随机对比临床观察

为探索米非司酮用于紧急事后避孕的最低有效剂量,接纳无保护房事后120小时内要求紧急服药避孕者共150例,随机分成三组,分别为600mg组49例;50mg组51例及10mg组50例,均为一次服药,比较避孕有效率,副反应发生率及对下次月经来潮的影响。结果仅10mg组有1例妊娠,按Dixon法计算出三组相应的避孕有效率:600mg组、50mg组均为100％,10mg组为75.8％。副反应轻微,月经延迟发生率在7天以上者,三组分别为12.3％、11.7％及8.2％。研究结果证明低剂量米非司酮10mg和50mg用作紧急事后避孕和高剂量600mg同样有效。     

小剂量米非司酮用于紧急避孕临床观察

目的:观察小剂量米非司酮用于紧急避孕的临床效果及对月经影响。方法:选择无保护性生活或避孕失败后来院就诊的健康妇女110例,在性交后72h内一次性口服米非司酮10mg,服药后定期随访,并观察避孕效果,药物副反应及对月经的影响。结果:110例采用小剂量米非司酮经观察随访后,避孕有效率为82.0%,失败率为0.91%。药物副反应小,对月经影响轻微。结论:小剂量米非司酮用于紧急避孕是一种简便、安全、有效的方法,是一种理想的避孕方法。     

低剂量米非司酮用于紧急避孕的临床观察

为探索米非司酮用于紧急避孕的临床效果、最低有效剂量及对月经的影响 ,将避孕失败或未保护性生活后 12 0 h内要求紧急避孕的 2 79例妇女随机分为 2组 ,研究组 14 9例 ,对照组 13 0例 ,分别单次口服米非司酮 10 mg或 2 5mg,以服药后月经来潮为成功标准。结果显示 :两组各妊娠 2例 ,均明显低于预期妊娠数 ,其避孕有效率分别为 84.12 %和 81.0 1% ,组间无明显差异 (P>0 .0 5)。副反应发生率低 ;对月经周期、经期与经量影响较小 ;经间期出血的发生率对照组明显高于研究组 (18.75%、0 .68% ) ,其发生与服药的时期有关 ,组间有极显著性差异 (P<0 .0 1)。对月经的影响 ,研究组更优于对照组。提示 10 mg米非司酮用于紧急避孕亦是安全、有效的     

含铜宫形节育器与米非司酮用于紧急避孕的临床观察

目的:评价含铜宫形节育器(IUD)与米非司酮在紧急避孕中的临床效果、副反应及对月经的影响。方法:将445例无保护性交后5 d内,要求采用紧急避孕措施的妇女,根据个人意愿分为两组,IUD组放置含铜IUD;米非司酮组,服用米非司酮50 mg连服2次,间隔12 h。采取随诊方式,判断避孕效果。避孕效果以Dixon's预期妊娠概率计算,记录副反应和月经改变。结果:放置含铜宫形IUD和口服米非司酮用于紧急避孕,有效率分别为100.0％、77.0％,两者比较有显著性差异(P<0.05),两组实际妊娠数与预期妊娠数均有显著性差异(P<0.01)。副反应轻,无需特殊处理。结论:放置含铜宫形IUD和口服米非司酮用于紧急避孕,均能够安全有效地防止妊娠。     

三种不同剂量米非司酮用于紧急避孕的临床观察

为探索小剂量米非司酮用于紧急避孕的效果,观察291例健康、月经规律妇女,在避孕失败或无保护的性生活后72小时内服药,并随机分为3组,组1(n=99)单次口服25mg米非司酮;组Ⅱ(n=92)单次服用10mg米非司酮;组Ⅲ(n=100)单次服用5mg米非司酮。3组共4例失败。避孕有效率分别为83.8％、84.92％和70.5％,三组间无明显差异。服低剂量米非司酮后副反应发生率低,对月经影响小。观察5例服用5mg米非司酮妇女子宫内膜形态,3例出现子宫内膜发育不同步,2例变化不明显。结果表明,5mg米非司酮用于紧急避孕,临床上虽有一定成功率,但对子宫内膜影响不肯定,尚需进一步研究,故应谨慎用于临床。     

低剂量米非司酮用于紧急避孕临床观察

目的:进一步确认米非司酮25mg用于紧急避孕的有效性。在全国11个省市的计划生育技术指导站及综合医院妇产科观察了622例紧急避孕的临床效果,均为避孕失败或无保护性生活后72小时内就诊并符合条件的健康妇女,单次口服米非司酮25mg。结果:失败5例,按Dixon法计算,避孕有效率为91.25％。受试者的月经周期无明显改变且未出现明显副作用。此研究进一步证实米非司酮25mg单次口服可作为理想的紧急避孕药物。     

10mg米非司酮与左炔诺酮用于紧急避孕的效果对比研究

通过米非司酮与左炔诺酮的临床效果对比,探讨米非司酮用于紧急避孕的最低有效剂量。选择接收无保护同房或避孕失败后72h内要求紧急避孕的健康育龄妇女400例,年龄29±6岁。米非司酮组200例,单次口服10mg(10mg/片);左炔诺酮组200例,首次口服0.75mg(0.75mg/片),间隔12h后再服0.75mg。以服药后月经来潮为成功标准,以Dixon表格计算避孕有效率。两组各妊娠2例,均明显低于预期妊娠数(15.46与10.84),有非常显著意义(P<0.01)。米非司酮组避孕有效率87.06％,与左炔诺酮组的81.55％相比无显著差异(P>0.05)。米非司酮组用药后副反应及对下次月经的影响均较轻微,且单次口服易于被接受,说明10mg米非司酮用于紧急避孕安全、有效、简便。     

Combined estimates of effectiveness of mifepristone 10 mg in emergency contraception

The present paper combines the estimates of efficacy and side effects of 10 mg mifepristone for emergency contraception obtained from randomized trials. A total of 6083 women participating in 12 randomized trials and receiving 10 mg mifepristone for emergency contraception up to 120 h after intercourse, were analyzed for efficacy. Between 4188 and 5833 women were analyzed for side effects and 3601 for delay of menses of more than 7 days. Prevented fractions, the effect of delay and of further acts of intercourse after treatment administration were analyzed in 3440 women, using individual data. The combined pregnancy rate from all the 12 trials was 1.7% [101/6083, 95% confidence interval (CI): 1.3–2.2]. From the three trials providing individual data, the combined pregnancy rate was 1.3% (45/3440, 95% CI: 0.9–1.7) and the estimate of pregnancies prevented was 83.4% (95% CI: 77.4–87.8). There was a sharp decline in efficacy when treatment was administered during the 5th day after intercourse compared to administration during the 1st day, the odds of pregnancy increasing by a factor of 5.3 (95% CI: 1.9–14.9). The relative risk of pregnancy was about 28 times higher among women with unprotected acts of coitus between treatment administration and the onset of next menses, compared with women reporting none [odds ratio (OR) = 27.6, 95% CI: 12.7–60.2]. The increase in risk for women reporting protected acts of intercourse during this interval was not statistically significant (OR = 1.8, 95% CI: 0.9–3.8). There was a large heterogeneity among trials in all side effects and delay of menses of more than 7 days (all had p < 0.0001 for the test of homogeneity). The percentage of women with nausea ranged from 0.0–19.4% (highest upper 95% confidence limit: 23.0%), that of vomiting from 0.0–4.3% (highest upper 95% confidence limit: 6.1%), that of lower abdominal pain from 4.3–19.1% (highest upper 95% confidence limit: 22.7%). The percentage of women with delay of menses of more than 7 days ranged from 4.3–25.8% (highest upper 95% confidence limit: 34.1%). We conclude that 10 mg mifepristone is an effective emergency contraception regimen, with an acceptable side-effects profile. Postponing treatment until the 5th day seriously decreases efficacy. The risk of pregnancy is dramatically increased among women having unprotected acts of intercourse between treatment administration and the onset of next menses. This risk may be enhanced for women whose ovulation is postponed by treatment.     

Meta-analyses of randomized trials comparing different doses of mifepristone in emergency contraception

There is some evidence from randomized trials that different doses of mifepristone for emergency contraception do not differ in efficacy in the range from 10 mg to 600 mg. Lower doses have a better side effect profile and are cheaper and therefore they would be preferable in the absence of a dose effect. However, the lack of significance is not evidence of absence of an effect. More evidence can be obtained by combining results of trials. We present meta-analyses of randomized trials comparing doses of mifepristone for emergency contraception from 5 mg to 600 mg, with regard to the efficacy to prevent unwanted pregnancies. We use two approaches for analysis, one using only within-trial information and another one combining within-trial with between-trial information. We discuss the results in terms of equivalence. There is some evidence of a small dose effect on efficacy in the lower range of doses (<50 mg). The pregnancy rate increases by a factor of 1.6 when the dose of 10 mg is used instead of 25 mg (95% confidence interval: 1.1–2.4). In terms of the number of women needed to treat, however, using 10 mg in the place of 25 mg implies having one extra pregnancy every 146 women requesting emergency contraception, which might be a low cost compared to the benefit of more women having access to treatment.     

左旋18-甲基炔诺酮用于紧急避孕的效果与不良反应评价

目的和方法:对100例月经规律,未避孕或避孕措施失败性交后72小时内的妇女,口服左旋18-甲基炔诺酮(LNG),观察避孕效果与不良反应,并以50例妇女应用紧急避孕的经典方法Yuzpe法作对照。结果:LNG组2例妊娠,Yuzpe组1例妊娠,按Wilcox方法推算,避孕有效率分别为83％和82％,但LNG组的不良反应明显降低,P<0.001,优于经典的Yuzpe法。结论:推广使用LNG法将有利于减少非意愿妊娠,保障妇女身心健康。     

含铜IUD,小剂量米非司酮与单方左炔诺孕酮用于紧急避孕的临床？…

为观察米非司酮（Ｒｕ４８６）、左炔诺孕酮以及活性ＩＵＤ用于紧急避孕（ＥＣ）的临床效果、副反应、对月经的影响和活性ＩＵＤ的长期避孕效果，对１５０例身体健康、月经规律、未避孕或避孕失败１２０ｈ以内的妇女按自愿的方式分为放置ＩＵＤ组或服药组，服药组，服药组按随机方法给予口服Ｒｕ４８６或左炔诺孕酮。结果发现Ｒｕ４８６组和活性ＩＵＤ组有效率为１００％，左炔诺孕酮组为７６．８％（均按Ｄｉｘｏｎ方法计算），对月     

A randomized comparative study on mifepristone alone and in combination with tamoxifen for emergency contraception

The purpose of the clinical study was to compare the efficacy and side effects of 10 mg of mifepristone alone (Group 1) and with 20 mg of tamoxifen (Group 2) for emergency contraception, especially as used within 72-120 h after coitus. Four-hundred female volunteers with one act of unprotected intercourse or contraception failure (200 cases in each group) were recruited and completed the study. There were 198 women treated < 72 h after coitus (100 in Group 1 and 98 in Group 2), whereas the remaining 202 patients were treated between 72-120 h (100 in Group 1 and 102 in Group 2). In total, four pregnancies occurred; one treated < 72 h in each group, two between 72-120 h in Group 1. Efficacy for prevention of unwanted pregnancy by Trussell method is 84% for Group 1, and 95% for Group 2, and which is not significantly different between the two groups and even subgroups. The side effects (15.5% for Group 1 and 14.5% for Group 2) and changes in menstruation were infrequent and mild in both groups. Further studies should be conducted to determine whether tamoxifen combined with mifepristone for emergency contraception is more effective as compared with mifepristone alone.     

New estimates of the effectiveness of the Yuzpe regimen of emergency contraception

The purpose of this study was to provide new estimates of the effectiveness of the Yuzpe method of emergency contraception and to offer correctly computed estimates of the confidence intervals for estimated effectiveness rates.

Through a literature search, seven studies that present the number of women treated and outcome of treatment by cycle day of unprotected intercourse relative to expected day of ovulation were identified. Probabilities of conception by cycle day of intercourse among women not using contraception and the associated variance-covariance matrix from five other datasets were estimated, and these external estimates were used to assess the effectiveness of the Yuzpe regimen.

The 40 estimates of effectiveness, based on seven separate studies and the seven studies combined and five different sets of conception probabilities by cycle day, ranged from a low of 44.2% to a high of 88.7%. The preferred point estimate is that emergency contraceptive pills reduce the risk of pregnancy by 75.4%, with a 95% confidence interval extending from 65.6% to 82.4%.

True effectiveness is likely to be at least 75% because treatment failures (observed pregnancies) include women who were already pregnant when treated and women who became pregnant after being treated.     

米非司酮用于排卵期房事后避孕的子宫内膜形态学观察

为了解米非司酮用于排卵期房事后避孕引起的子宫内膜形态学改变,选择21名健康育龄妇女做为受试者,于排卵后72小时内口服300mg米非司酮。排卵后7～8天取内膜做常规光镜下观察。结果发现所有内膜改变都与原周期时相不同步。说明排卵后服用米非司酮使内膜所发生的形态学改变足以防止胚胎种植,故可作为一月一次排卵期房事后有效的避孕药物。     

Young women requesting emergency contraception are, despite contraceptive counseling, a high risk group for new unintended pregnancies

Since its introduction in Sweden in 1994, emergency contraception has become a welcome addition to the campaign against unwanted pregnancy. In addition to an unplanned pregnancy, unprotected sexual intercourse may also involve the risk of contracting sexually transmitted diseases (STD). The aim of this study was to assess the short- and long-term risk of unintended pregnancy and to determine the frequency of chlamydia infections in women receiving emergency contraception.Between September 1998 and February 1999 young women aged 15-25 years had the opportunity to obtain emergency contraception (Yuzpe method) at a youth clinic in the city of Orebro where the opening hours were extended to include Saturdays and Sundays. A follow-up visit 3 weeks after treatment, which included contraceptive counseling, was offered to all participants. At both visits, a pregnancy test and a chlamydia test were performed, and the women completed a questionnaire. After the initial visit, the young women where monitored for new pregnancies during the following 12 months.One pregnancy occurred in the 134 young women who received emergency contraception during the study period. None of the women had a positive chlamydia test. Of those requesting emergency contraception, 54% did so because no contraception was used, 32% because of a ruptured condom, 11% because of missed oral contraceptives (OC), and 5% had mixed reasons. At long-term follow-up 1 year after the initial visit, 10 of the 134 young women had experienced an unplanned pregnancy that terminated in legal abortion in 9 women. All these women had either started and terminated OC or had never commenced the prescribed OC.Young women who request emergency contraception are, despite a planned follow-up with contraceptive counseling, a high risk group for new unintended pregnancies. In Sweden they do not seem to be a high risk group for STD.