a Department of Morphology Surgery and Experimental Medicine , University of Ferrara , Ferrara , Italy.
Gynecol Endocrinol. 2019 May;35(5):427-433. doi: 10.1080/09513590.2018.1538343. Epub 2019 Jan 2.
Long-acting reversible contraceptives (LARC) represent an especially effective kind of post-abortion contraception. We aimed at assessing satisfaction, discontinuation, efficacy, and tolerability associated with either levonorgestrel intrauterine device (L-IUCD), the copper intrauterine device (C-IUCD) and implant (IMP) after termination of pregnancy (TOP). We recorded baseline data about the patients and performed phone surveys at 3, 6 and 12 months after insertion to assess the bleeding profile. Furthermore, women were inquired about possible adverse events, satisfaction, and discontinuation at 12 months after insertion. LARC continuers (>12 months after TOP) were divided into three groups: L-IUCD (n = 47), C-IUCD (n = 6) and IMP (n = 36). Satisfaction rates among L-IUCD users were higher than among IMP users (100% vs. 72.2%, p < .05). A higher, yet not significant, share of patients decided to withdraw contraception in IMP group (3.6% in IUCD group and 12.2% in IMP group). The bleeding profile was significantly more favorable among L-IUCD users than among IMP users. Finally, the reported rate of treatment-associated adverse events did not differ significantly among the groups. L-IUCD insertion after TOP is associated with higher satisfaction and lower discontinuation rates than IMP. Such pattern could be attributed to a more favorable bleeding profile.
长效可逆避孕措施(LARC)是一种特别有效的流产后避孕方法。我们旨在评估终止妊娠(TOP)后使用左炔诺孕酮宫内节育器(L-IUCD)、铜宫内节育器(C-IUCD)和植入物(IMP)的满意度、停药率、效果和耐受性。我们记录了患者的基线数据,并在放置后 3、6 和 12 个月进行电话调查,以评估出血情况。此外,在放置后 12 个月询问妇女可能发生的不良事件、满意度和停药情况。LARC 持续使用者(TOP 后>12 个月)分为三组:L-IUCD(n=47)、C-IUCD(n=6)和 IMP(n=36)。L-IUCD 用户的满意度高于 IMP 用户(100%比 72.2%,p<.05)。IMP 组中有更高但不显著的患者决定停止避孕(IUCD 组为 3.6%,IMP 组为 12.2%)。L-IUCD 用户的出血情况明显优于 IMP 用户。最后,报告的与治疗相关的不良事件发生率在各组之间无显著差异。TOP 后放置 L-IUCD 与更高的满意度和更低的停药率相关,这可能归因于更有利的出血情况。