Cameron Sharon T, Berugoda Nayani, Johnstone Anne, Glasier Anna
Chalmers Sexual and Reproductive Health Service, NHS Lothian, Edinburgh, UK.
J Fam Plann Reprod Health Care. 2012 Jul;38(3):175-8. doi: 10.1136/jfprhc-2011-100166. Epub 2012 Jan 31.
A 'fast-track' referral system for intrauterine contraception was established in 2007 between the medical abortion service at the Royal Infirmary of Edinburgh and the principal family planning clinic (FPC) in Edinburgh.
Case note review of women fast-tracked for intrauterine contraception after medical abortion between January 2007 and June 2009. Main outcome measures were numbers of women referred, attendance rates, interval to insertion, devices chosen and known complication rates.
Of the 237 women referred, 126 (53%) attended for intrauterine contraception insertion. Attenders were slightly but significantly older than non-attenders (mean ages of 30 and 27 years, respectively; p=0.003), less likely to live in an area of deprivation (p=0.045) and were significantly more likely to have attended the FPC in the past (p<0.0001). Most attenders (90%; n=113) proceeded to have an intrauterine method inserted; 57% (n=64) chose the levonorgestrel intrauterine system and 43% (n=49) chose a copper intrauterine device. The median interval to insertion was 21 (range 0-54) days. Of those women (n=55) who attended for routine follow-up 6 weeks later (49%), there were four (7.2%) cases of expulsion, two (3.6%) requests for removal and four (7.2%) cases of suspected infection.
Only half the women fast-tracked for intrauterine contraception actually attended and these tended to be women who were pre-existing clients of the FPC. Consideration should therefore be given to provision of immediate insertion where possible.
2007年，爱丁堡皇家医院的药物流产服务部门与爱丁堡主要的计划生育诊所（FPC）之间建立了宫内避孕“快速通道”转诊系统。
对2007年1月至2009年6月间药物流产后被快速转诊至宫内避孕的女性病例记录进行回顾。主要观察指标包括转诊女性数量、就诊率、放置间隔时间、选择的避孕装置及已知并发症发生率。
在237名被转诊的女性中，126名（53%）前来接受宫内避孕装置放置。前来就诊者比未就诊者年龄稍大且具有显著差异（平均年龄分别为30岁和27岁；p = 0.003），居住在贫困地区的可能性较小（p = 0.045），且过去到FPC就诊的可能性显著更高（p < 0.0001）。大多数前来就诊者（90%；n = 113）进行了宫内避孕方法放置；57%（n = 64）选择了左炔诺孕酮宫内节育系统，43%（n = 49）选择了铜宫内节育器。放置的中位间隔时间为21天（范围0 - 54天）。在6周后前来进行常规随访的女性（n = 55，占49%）中，有4例（7.2%）发生了节育器脱落，2例（3.6%）要求取出，4例（7.2%）疑似感染。
被快速转诊至宫内避孕的女性中只有一半实际前来就诊，且这些女性往往是FPC的原有客户。因此，应考虑在可能的情况下提供即时放置服务。
