流产后关爱服务对流产后妇女口服避孕药使用状况的影响

目的：调查流产后关爱服务（PAC）对流产后妇女口服避孕药使用情况的影响，探讨如何促进流产后计划生育服务、降低重复流产率。方法调查2012年10月至2013年10月在我院计划生育科入院终止妊娠的妇女，流产后立即服用口服避孕药2个月。分别于出院1个月、3个月及半年后随访，了解其服药情况、后续避孕方法的选择以及有无重复流产，共随访850名妇女。结果服用2个周期者731例，占86.0%。随访妇女2个周期后避孕方法的使用情况，继续使用口服避孕药者115例（13.5%），使用其他方法者631例（74.2%）；未采取任何避孕方式者104例（12.2%）。49.8%的妇女因为担心不良反应而不愿意选择口服避孕药为后续避孕方式。服药期间出现不良反应者15例（1.8%），为恶心或头晕不适。6个月内意外妊娠者34例（4.0%），再次行人工流产26例，重复流产率为3.1%。结论口服避孕药作为一种高效、安全的避孕方法，尽管非常适合绝大多数的妇女在流产后立即开始使用，但是由于对其不良反应的担心使得目前坚持使用口服避孕药的妇女比例较低。对于流产后妇女，关于避孕方法的选择和使用的咨询内容还需要细化，需要更有针对性，同时咨询要有长期性，才有利于增加妇女长期采用口服避孕药避孕的信心。

Effect of PAC on the use of oral contraceptive service in women after abortion

Objective To investigate the effect of post abortion care （PAC） on taking oral contraceptives in women after abortion, and to promote the family planning services after abortion, reduce the repeated abortions. Methods From October 2012 to 2013 October, 850 women who performed induced abortion in our hospital and taken oral contraceptives immediately after abortion were involved. Patients were followed up for 1, 3, 6 months after abortion. Results Seven hun-dred and thirty-one cases taking 2 cycles of oral contraceptives （86.0%）. After 2 cycles, 115 cases （13.5%） continued the use of oral contraceptives, 631 cases （74.2%） continued to use other methods of contraceptives, 104 cases （12.2%） did not take any contraception measures. 49.8% of women were unwilling to choose oral contraceptives because of concerning about adverse reactions. During the period of drug taking, 15 cases （1.8%） had adverse reactions including nausea or dizzi-ness and discomfort. Within 6 months, unintended pregnancy happened in 34 cases （4.0%）, 26 cases （3.1%） had repeated abortion. Conclusion Oral contraceptive is a highly effective and safe method for contraception, which is very suitable for immediately use after abortion, but currently the use of oral contraceptives is low for fearing its adverse reactions. For women after abortion, contents of consultation need to be tailored and proloned. It is beneficial to enhance the confidence of long-term use of oral contraceptives in women.