三种不同方法用于紧急避孕的临床观察

目的:观察三种方法用于紧急避孕的临床效果。方法:选择接收无保护性生活或避孕失败72小时内要求紧急避孕的健康育龄妇女354例。组Ⅰ(119例),单次口服米非司酮25mg(25mg/片);组Ⅱ(120例),左炔诺酮首次口服0.75mg(0.75mg/片),间隔12小时再服0.75mg;组Ⅲ(115例):放置含铜IUD。以服药或放置IUD后月经来潮为成功标准,以Dixon表格计算避孕有效率。结果:三组共有3例失败,均显著低于预期妊娠数(10.945,9.516,8.461)(P<0.05);避孕有效率分别为81.7%、89.5%、100%。对下次月经影响均较轻微(P>0.05),组Ⅰ副反应发生率明显低于组Ⅱ(P<0.01)。结论:三种方法用于紧急避孕安全、有效、简便。     

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。     

左炔诺酮紧急避孕失败后继续妊娠和胎儿发育不良的风险

最常见有效的紧急避孕制剂有:大剂量雌激素,达那唑,米非司酮,雌孕激素复合制剂(Yuzep法)和左炔诺酮(商品名:毓婷)。1998年因左炔诺酮耐受性和功效的改进,被WHO作为紧急避孕的金标准,从而导致Yuzpe法被替代。左炔诺酮有两种给药方法:①每12h0.75mg(片剂),口服2次。②单次给药1.5mg,有效率约85%。能推迟或阻止排卵,减少黄体生成或引起子宫内膜组织学、生物学改变,从而阻止着床。本组调查了紧急避孕失败与妊娠及围产期不利因素增加的关系。意大利畸形信息服务处(TIS)为公众提供生育风险的咨询。2000—2003年,所有因左炔诺酮紧急避孕失败后,…     

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.     

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     

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。     

米非司酮紧急避孕三种剂量比较

英国两项随机研究比较了无保护性性交后72h内给与米非司酮(mifepristone)600 mg单剂量口服与Yuzpe口服方法(炔雌醇100μg加左旋18甲基炔诺酮500 μg,12h后重复一次),结果显示,米非司酮组597例中3例妊娠,而Yuzpe法组589例中9例妊娠。然而服用米非司酮易延迟下次月经来潮。米非司酮对卵巢及子宫内膜作用的研究表明,600 mg以下剂量用于紧急避孕有效,而且减少剂量可降低费用,符合药物应使用最低有效剂量的原则。本研究旨在比较无保护性交后120 h(5 d)口服600 mg、50mg与10 mg三种剂量米非司酮的避孕效果与副反应发生率。     

两种低剂量米非司酮用于紧急避孕随机对比临床观察

为寻求米非司酮用于紧急避孕的最低有效剂量 ,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 112 4例紧急避孕临床效果。对避孕失败或无保护性生活后 72 h内就诊并符合条件的健康妇女随机分为两组 :组 1(n=5 79)为单次口服米非司酮 2 5 mg,组 2 (n=5 45 )单次口服米非司酮 10 mg。组 1失败 5例 ,组 2失败 12例 ,按Dixon法计算两组避孕有效率分别为 91.2 5 %和 77.99% ,经检验 P<0 .0 1,两组间有显著差异 ;两组受试者的月经周期无明显改变且未出现明显副作用。该试验结果与单次服用米非司酮 6 0 0 mg、15 0 mg、5 0 mg、10 mg、5 mg临床研究报告相比较 ,就其避孕效果、对月经周期的影响和药物副作用而言 ,米非司酮 2 5 mg单次口服用于紧急避孕最为理想。     

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。     

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。     

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     

紧急避孕药系统评估

目的:评估两种(0.75mg双剂、1.5mg单剂)左炔诺孕酮(LNG)及两种低剂量(10mg、25mg)米非司酮(MFP)紧急避孕方案的有效性和副作用。方法:通过电子及手工检索方式检索相关文献,筛选出其中的随机对照临床试验,提取信息并进行Meta分析。结果:共检索到63篇相关文献,其中28篇纳入本评估。结果显示,两种剂量LNG方案有效性及副反应的发生率均相似。在服用紧急避孕药后无性生活的对象中,25mgMFP与10mgMFP(方法失败率)相似,然而25mgMFP总失败率(在所有对象中计算出的失败率)略低于10mgMFP,但差别没有统计学意义。25mgMFP方案恶心发生率比10mgMFP方案略高。10mgMFP方案与单剂1.5mgLNG方案总失败率相似,而前者方法失败率略低。25mgMFP方案方法失败率与总失败率均略低于单剂及双剂LNG方案,但差别无统计学意义。MFP紧急避孕方案月经延迟的发生率比LNG方案高,而后者点滴出血的发生率比前者高。无保护性生活后越早接受紧急避孕,失败率越低。结论:两种LNG方案和两种MFP方案有效性和副反应发生基本相似,由于LNG为传统避孕药物,其安全性已被证实,并为非处方药,故优先推荐使用LNG方案,单剂1.5mgLNG方案更为方便。     

Comparative evaluation of the effectiveness and safety of two regimens of levonorgestrel for emergency contraception in Nigerians

Emergency contraception was introduced in Nigeria over two decades ago, but few women have used this method even in emergency situations because of the side effects. To find an acceptable levonorgestrel regimen for emergency contraception in our community, the two-dose regimen 0.75-mg levonorgestrel 12 h apart (group A) and the single dose 1.5-mg levonorgestrel (group B) were studied in 1118 volunteers. Mild side effects such as nausea, vomiting, lower abdominal pains, menorrhagia, dizziness, headache, and breast tenderness were reported. Significantly more women in the high-dose group reported headache, breast tenderness, and heavy menstrual flow. Eleven pregnancies (1.0%) were reported (7 in group A and 4 in group B). The crude relative risk of pregnancies was similar in the two groups (RR = 0.71, 95% CI = 0.32-1.55; p > 0.05) [corrected]. On the other hand, the estimated effectiveness rate of 86.80% in group A was significantly lower than the 92.99% for group B (p < 0.05). The pregnancy rates increased with delay in starting treatment and if further acts of unprotected sexual intercourse took place after treatment. It was concluded that both regimens were effective and safe.     

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。     

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。     

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.     

Emergency contraception

Emergency contraception is used after unprotected intercourse or a contraceptive accident to prevent unwanted pregnancy. It is thought to work by stopping or delaying ovulation or preventing implantation if fertilization has already taken place. Hormonal methods, mifepristone, and intrauterine device insertion are among the methods used worldwide. Combination estrogen-progestin birth control pills are the most commonly used form of emergency contraception in the United States. According to the Yuzpe method, combination pills are taken within 72 hours after intercourse, followed by a second identical dose 12 hours later. With this method, the number of unintended pregnancies is reduced by about 75%. Nausea and vomiting are the most troublesome adverse effects, but these can be controlled with antiemetic medication taken prior to the first dose. The Food and Drug Administration, Washington, DC, has approved an emergency contraception kit consisting of 4 combination pills, a urine pregnancy test, and a patient information book. Most recently, the Food and Drug Administration has approved a progestin-only formulation, which has fewer adverse effects and equal or improved efficacy compared with the combination formula. An intrauterine device can be inserted up to 5 days after unprotected intercourse and is a cost-effective option if it is used as ongoing contraceptive protection. The most readily available form of emergency contraception consists of 2 doses of estrogen-progestin combination birth control pills or 2 levonorgestrel pills taken 12 hours apart. Emergency contraception should not be considered as an alternative to ongoing contraceptive methods, but can prevent unwanted pregnancy.     

单次服用25mg米非司酮用于紧急避孕的临床效果观察

对300例月经规律,未采取避孕措施或避孕失败72小时以内的妇女,单次口服米非司酮25mg,观察避孕效果、副反应及对经期和经量的影响。300例妇女中6例妊娠,按Dixon方法推算,预期妊娠数为22.983,避孕有效率73.89％。米非司酮25mg的副反应较少,仅11.7％。有不适主诉,主要为恶心,无呕吐发生。于月经前半周期服药的妇女月经推迟明显多于后半周期服药妇女(P<0.05)。低剂量米非司酮是安全有效的紧急避孕方法。     

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。