University of California, Davis School of Medicine; Sacramento, CA, USA.
Department of Obstetrics and Gynecology; University of California, Davis; Sacramento, CA, USA.
Contraception. 2022 Mar;107:48-51. doi: 10.1016/j.contraception.2021.10.008. Epub 2021 Nov 5.
To describe changes in contraceptive method plans pre-appointment, after counseling, and post-procedure in patients having an abortion.
We reviewed electronic medical records of University of California, Davis Health patients who had an operating room abortion from January 2015 to December 2016. We excluded persons with procedures for fetal anomaly or demise. We extracted patient demographics and contraceptive plans reported at each encounter (telephone intake, pre-operative appointment, and day of abortion). We evaluated individual contraceptive plans across the encounters, identified patient characteristics that contributed to plan change, and created a multivariable logistic regression model for predictors of contraception method plan change from telephone intake to post-procedure.
The 747 patients had a mean gestational age of 16 4/7 ± 5 0/7 weeks with 244 (32.7%) <15 weeks and 235 (31.5%) ≥20 weeks. At telephone intake, 273 (36.4%) wanted a long-acting method (139 [50.9%] intrauterine device [IUD]; 99 [36.3%] implant; 35 [12.3%] unspecified), 11 (3.9%) permanent contraception, and 248 (33.2%) a less effective or no method; 215 (28.8%) stated they were undecided. Most (357/433 [82.4%]) patients who planned a reversible method based on the telephone intake obtained that or a similar method. Of the 273 patients planning a long-acting method, 258 (94.5%) received an IUD (158 [40.9%]) or implant (100 [36.6%]). Of the 215 undecided patients, 88 (40.9%) received an IUD and 55 (25.6%) an implant. No demographic factors predicted a change in method plan.
Most patients will receive the method they initially identified at the telephone intake after an abortion, especially those planning an IUD or implant. Undecided patients are commonly open to discussing options.
描述行人工流产术患者在预约前、咨询后和术后避孕方法计划的变化。
我们回顾了 2015 年 1 月至 2016 年 12 月在加利福尼亚大学戴维斯分校健康中心行手术室流产术患者的电子病历。我们排除了因胎儿异常或死亡而行手术的患者。我们提取了每个就诊时（电话就诊、术前预约和流产当天）报告的患者人口统计学和避孕计划。我们评估了就诊时避孕方法计划的变化，确定了导致计划变化的患者特征，并创建了多变量逻辑回归模型，以预测从电话就诊到术后避孕方法计划的变化。
747 名患者的平均妊娠龄为 16 4/7 ± 5 0/7 周，其中 244 名（32.7%）<15 周，235 名（31.5%）≥20 周。在电话就诊时，273 名（36.4%）患者希望使用长效方法（139 名[50.9%]宫内节育器[IUD]；99 名[36.3%]植入物；35 名[12.3%]未指定），11 名（3.9%）永久性避孕，248 名（33.2%）使用效果较差或不使用避孕方法；215 名（28.8%）表示他们尚未决定。大多数（357/433 [82.4%]）根据电话就诊时计划使用可逆方法的患者获得了该方法或类似方法。在 273 名计划使用长效方法的患者中，258 名（94.5%）患者接受了 IUD（158 名[40.9%]）或植入物（100 名[36.6%]）。在 215 名未决定的患者中，88 名（40.9%）患者接受了 IUD，55 名（25.6%）患者接受了植入物。没有人口统计学因素预测方法计划的变化。
大多数患者在行人工流产术后会接受他们在电话就诊时最初确定的方法，特别是那些计划使用 IUD 或植入物的患者。未决定的患者通常愿意讨论各种选择。
