比林斯法在哺乳期应用的实验和临床研究

目的 :观察比林斯生育调节法 (BOM)在哺乳期避免妊娠的可行性和有效性 ,寻找监测哺乳期生育力恢复的指标。方法 :对比研究比林斯法和 IUD法在 1 2个月中的意外妊娠率、停用率和续用率。测定血生乳素、雌二醇用以估计月经恢复 ;检测尿雌激素和孕二醇 ,确定第 2次月经前是否排卵。结果 :哺乳期比林斯法和 IUD法两组妇女分别观察了 2 1 9例和 2 0 0例。妊娠率、停用率和续用率分别为 1 .43 %、1 .5 4 %,8.5 3 %、8.87%和 90 .1 7%、91 .3 5 %,两组间无统计学差异 (P>0 .0 5 )。同期进行的 90例和 2 75次血生乳素、雌二醇的测定发现 ,二者比例以 0 .3 5作为月经恢复的指标。6 1例尿雌激素和孕二醇测定表明 ,宫颈粘液类型与激素水平吻合外 ;混合喂养妇女第 2次月经前排卵发生率为 47.0 5 %。结论 :(1 ) BOM用于哺乳期避孕的效率如同 IUD法 ,也能被哺乳期妇女接受。 (2 )血生乳素和雌二醇测定可估计哺乳期妇女月经恢复 ,方法简单 ,可应用于临床。 (3 )混合喂养有延迟哺乳期生育的作用。

The Clinical and Experimental Research for Billings Ovulation Method during Breastfeeding

Objective: The effectiveness and acceptability of Billings ovulation method (BOM) during breastfeeding were studied. At the same time, the monitoring indexes of fertility return were determined. Methods: This is a comparative study of BOM and IUD containing Copper 200 mm 2. There were 219 women enrolled in the BOM group, 200 women in the IUD group. The annual rate of pregnancy, discontinuation and continuation in the two groups was calculated. The experimental research included1] the measuring of serum prolactin and estradiol in 90 breastfeeding mothers2]. the measuring of urine estrogen and pregnanediol in different-feeding mothers. Results: The pregnancy rate was 1.43% and 1.54% respectively. The rates of discontinuation and continuation in the BOM group were 8.53% and 90.17%. The rates of discontinuation and continuation in the IUD group were 8.87% and 91.35%. Neither result was significant statistically (P>0.05). About the experimental research, it showed that menses return was well-estimated by 0.35 ratio of serum prolactin and estrodiol. Sensitivity was 94.61% and specificity 84.61%. The levels of urine hormone were closely related to the patterns of cervical mucus. The incidence of ovulating before the second return of menses in partially breastfeeding mothers was much lower than that of bottle-feeding mothers (47.05% vs 94.20%). Conclusion: BOM is a simple and reliable contraceptive method is during breastfeeding. It is accepted by breastfeeding mothers since it is as effective as IUD. If it could be combined with the measurement of serum prolactin/estradiol, the date of menses return would be determined easily. Encouraging mothers to breast-fed their babies is a good idea because it would be beneficial to the health of both babies and mothers and to delay the fertility return of mothers.