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法国宫内节育的最佳实践共识。

Consensus of best practice in intrauterine contraception in France.

作者信息

Serfaty David, Bénézech Jean-Paul, Heckel Sergine, De Reilhac Pia

机构信息

a Obstetrician Gynaecologist , Paris , France.

b Obstetrician Gynaecologist , Albi , France.

出版信息

Eur J Contracept Reprod Health Care. 2019 Aug;24(4):305-313. doi: 10.1080/13625187.2019.1625325. Epub 2019 Jun 17.

Abstract

Our aim was to provide a consensus of best practice in intrauterine contraception (IUC) for French practitioners. A meeting of 38 gynaecologists was held to establish a consensus of best practice in IUC, using the validated nominal group (NG) method to reach consensus. Seventy questions were posed covering insertion, monitoring and removal of IUC devices. Two working groups were formed and all proposals were voted on, discussed and approved by the NG. Of the 70 questions asked, answers to only four failed to reach NG consensus. While, in general, the IUC practices of French gynaecologists are in line with international guidelines, some notable differences were identified: for example, when to use the levonorgestrel-releasing intrauterine system versus the copper intrauterine device; practice recommendations in the event of upper genital tract infections; and immediate postpartum insertion. Clinicians are encouraged to inform women about IUC, irrespective of their age or parity. In general, the wishes and characteristics of the woman must be the main criteria informing the choice of IUC, once all potential contraindications have been excluded and information about IUC shared. This consensus paper is intended to update and standardise knowledge about IUC for health care professionals, to address any reticence about use of this contraceptive method.

摘要

我们的目标是为法国的从业者提供关于宫内节育器(IUC)最佳实践的共识。38名妇科医生召开了一次会议,采用经过验证的名义小组(NG)方法达成共识,以确立宫内节育器最佳实践。提出了70个问题,涵盖宫内节育器的插入、监测和取出。成立了两个工作组,所有提案都经过名义小组投票、讨论并获得批准。在提出的70个问题中,只有4个问题的答案未达成名义小组的共识。总体而言,法国妇科医生的宫内节育器使用实践符合国际指南,但也发现了一些显著差异:例如,何时使用左炔诺孕酮宫内节育系统与铜宫内节育器;上生殖道感染情况下的实践建议;以及产后立即插入。鼓励临床医生向女性介绍宫内节育器,无论其年龄或生育状况如何。一般来说,一旦排除所有潜在禁忌症并分享了有关宫内节育器的信息,女性的意愿和特征必须是指导宫内节育器选择的主要标准。本共识文件旨在更新和规范医疗保健专业人员关于宫内节育器的知识,以消除对使用这种避孕方法的任何顾虑。

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