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醋酸甲羟孕酮注射剂作为产后早期避孕措施:对其可接受性、有效性及对泌乳影响的评估

Injection Depot Medroxyprogesterone Acetate as an Early Postpartum Contraceptive Measure: Evaluation of Its Acceptability, Efficacy, and Impact on Lactation.

作者信息

Srivastava Garg Sonal, Bhateja Bhavna, Grover Seema, Tapasvi Isha

机构信息

Obstetrics and Gynecology, Guru Gobind Singh Medical College and Hospital, Faridkot, IND.

出版信息

Cureus. 2024 Aug 8;16(8):e66454. doi: 10.7759/cureus.66454. eCollection 2024 Aug.

DOI:10.7759/cureus.66454
PMID:39246969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11380525/
Abstract

Introduction Through its National Family Planning Programme, India has been relentlessly working to decrease society's unmet contraception needs. The postpartum period is of paramount importance for addressing these contraceptive needs owing to alterations in fertility and coital behavior associated with childbirth. Depot medroxyprogesterone acetate (DMPA), a long-acting reversible contraceptive, is one of the safe options available in the early postpartum period. In this study, we aimed to evaluate its efficacy and acceptability among postpartum women delivering in Guru Gobind Singh Medical College and Hospital. Methodology We recruited 206 early postpartum women for the study. After thorough counseling and ensuring establishment of lactation, we administered DMPA 150mg by injection intramuscularly and repeated it at intervals of three months in willing patients. We then evaluated them for their symptoms, side effects, and lactation status using a predesigned proforma either during their follow-up visits or telephonically. Results We found DMPA to be 100% efficacious as an early postpartum contraceptive measure. The main reasons for acceptance were its ease of use, long-term effects of a single dose, and noninterference with lactation. However, the continuation rate for the second dose was only 18% in our study, highlighting the need for better counseling and improving awareness among our patients. Ninety-nine percent of our patients were satisfied with their lactation. Conclusion We found injectable DMPA used as a contraceptive in the immediate postpartum period to be a safe and effective alternate method with no deleterious effect on lactation and an acceptable side effect profile. However, more awareness programs are necessary to encourage women, especially those in low-resource areas, to continue using DMPA.

摘要

引言 通过其国家计划生育计划,印度一直在不懈努力减少社会未满足的避孕需求。产后时期对于满足这些避孕需求至关重要,因为生育和与分娩相关的性交行为会发生变化。醋酸甲羟孕酮长效避孕针(DMPA)是产后早期可用的安全选择之一。在本研究中,我们旨在评估其在古鲁·戈宾德·辛格医学院和医院分娩的产后妇女中的疗效和可接受性。

方法 我们招募了206名产后早期妇女参与研究。在进行充分咨询并确保建立泌乳后,我们为愿意接受的患者肌肉注射150mg DMPA,并每三个月重复注射一次。然后,我们在她们的随访期间或通过电话使用预先设计的表格评估她们的症状、副作用和泌乳状况。

结果 我们发现DMPA作为产后早期避孕措施的有效率为100%。接受的主要原因是其使用方便、单剂量的长期效果以及不影响泌乳。然而,在我们的研究中,第二剂的续用率仅为18%,这突出表明需要更好地咨询并提高我们患者的认识。我们99%的患者对其泌乳情况感到满意。

结论 我们发现产后立即使用注射用DMPA作为避孕方法是一种安全有效的替代方法,对泌乳没有有害影响,副作用也可以接受。然而,需要开展更多的宣传项目,以鼓励妇女,特别是资源匮乏地区的妇女继续使用DMPA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/6e5f766f11d7/cureus-0016-00000066454-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/764c03ed4d1a/cureus-0016-00000066454-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/d91adff8ea2e/cureus-0016-00000066454-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/6e5f766f11d7/cureus-0016-00000066454-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/764c03ed4d1a/cureus-0016-00000066454-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/d91adff8ea2e/cureus-0016-00000066454-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64db/11380525/6e5f766f11d7/cureus-0016-00000066454-i03.jpg

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