瘢痕子宫妇女人工流产术后即时放置宫内节育器的临床观察

Cinical observation on intrauterine device insertion immediately after induced abortion among women with scarred uterus

目的:观察剖宫产术后1年内行人工流产术后即时放置宫内节育器(IUD)的临床效果。方法:根据有无剖宫产史及剖宫产术后时间将410例人工流产妇女分为3组,A组132例为剖宫产术后12个月内,B组97例为剖宫产术后12个月以上,C组181例无剖宫产史。对比3组人工流产术后即时放置IUD 12个月的副作用发生情况及IUD避孕效果。结果:置器后1、3、6、12个月随访,3组各种副作用发生率无统计学差异(P>0.05),无一例发生闭经及宫腔粘连。因症取出率均以术后6个月最高,分别为A组2.31/百妇女年,B组3.16/百妇女年,C组2.27/百妇女年,但3组比较无统计学差异(P>0.05)。3组12个月内带器妊娠率均为0,B组置器后第1个月脱落1例,其余随访期间,3组均未发生IUD脱落及下移。12个月累计续用率A组94.49/百妇女年,B组94.62/百妇女年,C组95.40/百妇女年,3组比较无统计学差异(P>0.05)。结论:剖宫产后1年内人工流产术后即时放置IUD避孕安全、可行。

Objective：To observe the effect of intrauterine device（IUD）insertion immediately after induced abortion among women who experienced cesarean section within one year.Methods：A total of 410 women seeking for induced abortion were divided into three groups according to the history of cesarean section and the operation time,in which 132 women in group A underwent cesarean section less than one year,97 in group B had scarred uterus more than 1years,and 181 women in group C had no history of cesarean section.The incidence of side effects and contraceptive effects were compared among three groups.Results：There was no significant difference in the incidence of side effects 1,3,6,12 months after IUD insertion among three groups（P〈0.05）.No amenorrhea and intrauterine adhesion were found.The removal rates of three groups were highest（2.31 per 100woman-years,3.16 per 100woman-years,and2.27 per 100woman-years,respectively）within 6months after IUD insertion,while there was no significant difference among three groups（P〈0.05）.No pregnancy with IUD in situ was found in three groups.The IUD expulsion was found in one women.The cumulative continuation rate within 12 months were 94.49 per 100woman-years in group A,94.62 per 100woman-years in group B and 95.40 per 100woman-years in group C,showing no significant differences（P〈0.05）.Conclusion：IUD insertion immediately after induced abortion could be safe and feasible among women experiencing cesarean section within one year.