Amies Oelschlager Anne-Marie E, Micks Elizabeth A, Debiec Katherine E, Nizamic Tiana, Mantrala Malica D, Prager Sarah W
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA.
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA.
J Pediatr Adolesc Gynecol. 2014 Dec;27(6):353-5. doi: 10.1016/j.jpag.2014.01.102. Epub 2014 Sep 23.
The purpose of this case series was to evaluate the efficacy and complication rate with use of long-acting reversible contraceptive (LARC) methods in adolescents with cardiovascular conditions.
We performed a retrospective chart review of adolescents age 22 or younger with congenital cardiac anomalies or major cardiovascular conditions who had a LARC device placed at Seattle Children's Hospital or University of Washington Medical Center between January 1, 2007 and March 1, 2012.
Patient characteristics, medical conditions, indications, and complications including perforation, pregnancy, expulsion, and pelvic infection were collected and analyzed.
Thirty adolescents with congenital cardiac anomalies or other cardiovascular conditions had a LARC device inserted during the study period. Mean age at placement was 17.7 years (range 12-22). Twelve patients (40%) had reported a previous pregnancy and 12 (40%) had never been sexually active at time of placement. Common primary and secondary indications were desired contraception (22 patients, 73%), desired menstrual suppression (15 subjects, 50%) and treatment of heavy menstrual bleeding (8 subjects, 27%). Twenty-nine patients had a structural cardiac anomaly. There were 27 levonorgestrel-releasing intrauterine devices (IUD), 1 copper IUD, and 3 etonogestrel implants placed. There were 2 confirmed IUD expulsions and 1 removal due to persistent irregular bleeding and cramping. There were no cases of pelvic inflammatory disease or pregnancies with LARC methods in place. Twenty-seven (90%) patients were continuing LARC at last follow-up.
In this small case series of adolescents with cardiovascular conditions, LARC devices were effective at pregnancy prevention without serious complications.
本病例系列的目的是评估长效可逆避孕（LARC）方法在患有心血管疾病的青少年中的疗效和并发症发生率。
我们对2007年1月1日至2012年3月1日期间在西雅图儿童医院或华盛顿大学医学中心放置LARC装置的22岁及以下患有先天性心脏异常或主要心血管疾病的青少年进行了回顾性病历审查。
收集并分析患者特征、医疗状况、适应证以及包括穿孔、妊娠、排出和盆腔感染在内的并发症。
在研究期间，30名患有先天性心脏异常或其他心血管疾病的青少年植入了LARC装置。植入时的平均年龄为17.7岁（范围12 - 22岁）。12名患者（40%）报告曾有过妊娠，12名患者（40%）在植入时从未有过性行为。常见的主要和次要适应证是期望避孕（22例患者，73%）、期望抑制月经（15例患者，50%）以及治疗月经过多（8例患者，27%）。29名患者有结构性心脏异常。共放置了27个左炔诺孕酮宫内节育器（IUD）、1个铜IUD和3个依托孕烯植入剂。有2例IUD确认排出，1例因持续不规则出血和痉挛而取出。使用LARC方法期间没有盆腔炎或妊娠病例。27名（90%）患者在最后一次随访时仍在使用LARC。
在这个患有心血管疾病的青少年小病例系列中，LARC装置在预防妊娠方面有效且无严重并发症。
