Goldthwaite Lisa M, Shaw Kate A
Stanford University School of Medicine, Stanford, California, USA.
Curr Opin Obstet Gynecol. 2015 Dec;27(6):460-4. doi: 10.1097/GCO.0000000000000224.
The objective of this review is to describe current literature regarding the role and characteristics of long-acting reversible contraception (LARC) used immediately postpartum.
Copper and levonorgestrel intrauterine devices (IUDs) inserted immediately postpartum at the time of both vaginal and cesarean deliveries are associated with higher rates of continuation at 6-12 months when compared with IUDs placed at the postpartum visit (4-8 weeks after delivery), despite higher rates of expulsion. IUDs and contraceptive implants are cost-effective when used immediately postpartum, and they are associated with longer interpregnancy intervals. There is limited evidence regarding the effects of immediate postpartum LARC on breastfeeding.
Use of LARC methods in the immediate postpartum period is both effective and safe, and could reduce unmet need for contraception during this time. More research is needed to explore various immediate postpartum IUD insertion methods and the effects of immediate postpartum progestin-containing LARC on breastfeeding.
本综述的目的是描述当前关于产后立即使用长效可逆避孕法（LARC）的作用和特点的文献。
与产后访视时（分娩后4 - 8周）放置宫内节育器相比，无论是顺产还是剖宫产，产后立即放置铜离子和左炔诺孕酮宫内节育器（IUD）在6 - 12个月时的持续使用率更高，尽管排出率也更高。产后立即使用IUD和避孕植入物具有成本效益，并且与更长的妊娠间隔相关。关于产后立即使用LARC对母乳喂养的影响，证据有限。
产后立即使用LARC方法既有效又安全，并且可以减少这段时间内未满足的避孕需求。需要更多的研究来探索各种产后立即放置IUD的方法以及产后立即使用含孕激素的LARC对母乳喂养的影响。
