Hamdaoui N, Cardinale C, Agostini A
Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France.
Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France.
Gynecol Obstet Fertil Senol. 2018 Dec;46(12):799-805. doi: 10.1016/j.gofs.2018.10.006. Epub 2018 Oct 30.
Edit, by the French National College of Gynecologists and Obstetricians (CNGOF), recommendations based on the evidence available in the literature for the use in terms of effectiveness, safety and side effects of emergency contraception (EC).
A review of the literature was conducted by consulting Medline, Cochrane Library and international recommendations in French and English from January 1, 1979 to May 1, 2018.
It is recommended to inform patients that EC is not 100% effective. A pregnancy test is recommended if there is a delay after taking an EC. It is recommended to use EC as soon as possible after the unprotected intercourse. In the absence of long-term contraception, in the first 72hours after unprotected intercourse, ulipristal acetate (UPA) and levonorgestrel (LNG) may be offered with a superiority of UPA from 0 to 72h. Beyond 72hours, the data suggest a better efficiency of the UPA. However, taking into account practical elements (access to EC, cost, impact on the taking of hormonal contraception after UPA), it is difficult to recommend the UPA as a priority between 0 and 72h. Menstruation is more likely to happen early with LNG. The copper IUD is an effective method that can be used in EC until 120hours after unprotected intercourse or when there is a risk of contraceptive failure.
EC is not 100% effective. The closer the intake of EC with the unprotected intercourse, the more effective is the EC in terms of pregnancy rate.
由法国国家妇产科医生学院(CNGOF)编辑基于文献中现有证据的紧急避孕(EC)在有效性、安全性和副作用方面使用的建议。
通过查阅1979年1月1日至2018年5月1日期间的Medline、Cochrane图书馆以及法语和英语的国际建议进行文献综述。
建议告知患者紧急避孕并非100%有效。服用紧急避孕药后若月经推迟,建议进行妊娠试验。建议在无保护性交后尽快使用紧急避孕。在没有长期避孕措施的情况下,无保护性交后的前72小时内,可提供醋酸乌利司他(UPA)和左炔诺孕酮(LNG),0至72小时内UPA效果更佳。超过72小时后,数据表明UPA效率更高。然而,考虑到实际因素(紧急避孕的可及性、成本、对服用UPA后激素避孕的影响),很难在0至72小时内优先推荐UPA。使用LNG时月经更可能提前到来。铜宫内节育器是一种有效的方法,可在无保护性交后120小时内或存在避孕失败风险时用于紧急避孕。
紧急避孕并非100%有效。紧急避孕服用时间与无保护性交越接近,在妊娠率方面紧急避孕就越有效。