Phemister D A, Laurent S, Harrison F N
Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte 28232.
Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):175-9. doi: 10.1016/0002-9378(95)90109-4.
Our purpose was to determine the safety and tolerance of levonorgestrel contraceptive implants (Norplant, Wyeth-Ayerst, Philadelphia) when inserted immediately post partum, to document the effects on weight and blood pressure, and to determine the side effects.
After vaginal delivery, 250 women were randomized to receive Norplant within 48 hours of delivery (study group) or at the 4- to 6-week postpartum visit (control group). Baseline measurements were recorded and compared with those obtained at the 4- to 6-week follow-up visit. A diary was maintained by patients who recorded bleeding and side effects. Statistical analysis was performed with t test and chi 2 analysis.
There were no episodes of acute postpartum hemorrhage or clinically significant bleeding. Compared with the control group, the immediate group reported significantly more bleeding days (p < 0.01). There was no significant difference between the two groups in the hemoglobin values obtained at 4 to 6 weeks post partum. The immediate insertion group reported significantly more headaches (p < 0.01) and acne (p = 0.01).
Norplant is well tolerated and should be available for interested patients immediately post partum.
我们的目的是确定产后立即植入左炔诺孕酮避孕植入剂（Norplant，惠氏-艾尔斯特公司，费城）的安全性和耐受性，记录其对体重和血压的影响，并确定副作用。
经阴道分娩后，250名妇女被随机分为两组，一组在分娩后48小时内接受Norplant植入（研究组），另一组在产后4至6周就诊时接受植入（对照组）。记录基线测量值，并与4至6周随访时获得的测量值进行比较。患者记录出血和副作用情况并记日记。采用t检验和卡方分析进行统计分析。
未发生急性产后出血或具有临床意义的出血事件。与对照组相比，立即植入组报告的出血天数明显更多（p<0.01）。产后4至6周时两组的血红蛋白值无显著差异。立即植入组报告的头痛（p<0.01）和痤疮（p=0.01）明显更多。
Norplant耐受性良好，有兴趣的患者产后应立即可以使用。
