Dilbaz Berna, Bülbül Mehmet, Dilbaz Serdar, Yılmaz Nafiye, Sanisoğlu Sema
Clinic of Reproductive Endocrinology and Family Planning, University of Health Sciences Turkey, Etlik Zübeyde Hanım Women’s Health Research and Training Hospital, Ankara, Turkey
Department of Obstetrics and Gynecology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
J Turk Ger Gynecol Assoc. 2022 Dec 8;23(4):255-262. doi: 10.4274/jtgga.galenos.2021.2021-0004. Epub 2021 Jun 8.
The aim of this study was to evaluate the efficacy, side-effects and continuation rate of the desogestrel-progestin-only-pill (POP) in postpartum and post-abortive Turkish women and its relation with breast-feeding.
In this prospective multicentric study women who delivered (or had surgical abortion) and wanted to receive POP for contraception were recruited to the study. The follow-up visits were scheduled at the third, sixth and ninth months.
Overall A total of 7,468 women (66.5% postpartum, 33.5% post-abortive) participated in the study. The number of women who attended follow-up visits in relation to the previous visit at the third, sixth and ninth months was 944/7,468 (12.6%), 406/944 (43%) and 121/406 (29.8%) respectively. The incidence of breastfeeding at all visits was between 54.8% and 68.4%. Out of the 7,468 women recruited only 6% continued with the method at the end of the ninth month. There was a statistically significant increase in hemoglobin level at the third month compared to initial values. Oligomenorrhea, spotting and headache were the three leading side-effects. There was no pregnancy among the patients who were followed up.
This study demonstrated that POP was an effective postpartum and post-abortive contraceptive method that had no negative impact on breast-feeding. A change in bleeding patterns was the most common side-effect. However, the possible causes of low contraceptive maintenance rates need to be investigated.
本研究旨在评估去氧孕烯单方孕激素避孕药（POP）在产后及流产后的土耳其女性中的疗效、副作用及持续使用率，以及其与母乳喂养的关系。
在这项前瞻性多中心研究中，招募了分娩（或接受手术流产）且希望使用POP进行避孕的女性。随访安排在第三个月、第六个月和第九个月。
共有7468名女性（66.5%为产后女性，33.5%为流产后女性）参与了该研究。在第三个月、第六个月和第九个月，与上次随访相比，参加随访的女性人数分别为944/7468（12.6%）、406/944（43%）和121/406（29.8%）。每次随访时母乳喂养的发生率在54.8%至68.4%之间。在招募的7468名女性中，只有6%在第九个月末继续使用该方法。与初始值相比，第三个月时血红蛋白水平有统计学显著升高。月经过少、点滴出血和头痛是三种主要的副作用。随访的患者中无妊娠情况。
本研究表明，POP是一种有效的产后及流产后避孕方法，对母乳喂养没有负面影响。出血模式改变是最常见的副作用。然而，避孕持续使用率低的可能原因需要进行调查。
