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印度客户使用醋酸甲羟孕酮(MPA)注射剂的经验洞察:来自实地的经验教训。

Insights from Client Experience with Injection Medroxyprogesterone Acetate (MPA) in India: Lessons from the Field.

作者信息

Agrawal Swati, Sood Shilpa, Chopra Kanika, Singh Anuradha, Gupta Aparajita, Singh Shalini, Puri Manju

机构信息

Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India.

Ex senior resident of Lady Hardinge medical college, Indirapuram, India.

出版信息

J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):262-266. doi: 10.1007/s13224-021-01538-2. Epub 2021 Aug 27.

Abstract

BACKGROUND

The injectable contraceptives have been recently added to the contraceptive basket of Government of India under the National Family Welfare program with the aim to reduce the unmet need of contraception in the country. The present study has been conducted to analyse the continuation rates and concerns among the acceptors of injection MPA.

MATERIALS AND METHODS

The present study was an ambispective observational study conducted in the out-patient department of family welfare division at a tertiary care hospital in New Delhi over a period of 6 months. The study enrolled 483 acceptors of injection MPA who were interviewed in person or telephonically, and a proforma was filled which included the demographic profile, obstetric history of the women, source of information about injection and its timing, number of doses received, side effects experienced and the compliance status. The data obtained was subjected to statistical analysis.

RESULTS

The mean age of the studied population was 28.44 ± 4.73 years and average parity was 2. It was found that injection MPA was initiated in the interval period in 304 women (63.3%), post-abortal in 124 (25.8%), and postnatal in 52 (10.8%). The source of information about the injection for most women was health workers (83.5%). Most women (74.3%) were pleased with the injection and showed their willingness to continue, and 67.7% were continuing with the injection at the time of interview. Menstrual irregularity was the most common side effect observed in 48.5% women.

CONCLUSION

The present study showed a good continuation rate of injection MPA for the Indian population. The coverage for this excellent contraceptive modality can be enhanced further if more efforts to disseminate awareness about this method are made. Menstrual irregularity is the most common side effect causing discontinuation which can be mitigated to a significant extent with an effective pre-administration counseling.

摘要

背景

在国家家庭福利计划下,注射用避孕药最近被纳入印度政府的避孕措施清单,目的是减少该国未满足的避孕需求。本研究旨在分析醋酸甲羟孕酮注射液使用者的持续使用率及相关问题。

材料与方法

本研究是一项在新德里一家三级护理医院家庭福利科门诊进行的双向观察性研究,为期6个月。该研究招募了483名醋酸甲羟孕酮注射液使用者,通过面对面或电话访谈的方式进行,并填写一份表格,内容包括人口统计学资料、女性的产科病史、注射信息来源及其时间、接受的注射剂量、经历的副作用和依从性状况。对获得的数据进行统计分析。

结果

研究人群的平均年龄为28.44±4.73岁,平均产次为2次。发现304名女性(63.3%)在间隔期开始使用醋酸甲羟孕酮注射液,124名(25.8%)在流产后使用,52名(10.8%)在产后使用。大多数女性(83.5%)的注射信息来源是卫生工作者。大多数女性(74.3%)对该注射剂满意并表示愿意继续使用,67.7%的女性在访谈时仍在继续使用。月经不规律是观察到的最常见副作用,48.5%的女性出现该症状。

结论

本研究表明,醋酸甲羟孕酮注射液在印度人群中的持续使用率良好。如果加大宣传该方法的力度,这种优秀避孕方式的覆盖率可以进一步提高。月经不规律是导致停药的最常见副作用,通过有效的用药前咨询可以在很大程度上缓解这一问题。

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