人工流产术后即刻放置依托孕烯植入剂避孕的可行性研究

Feasibility analysis of the etonogestrel implants in women undergoing postabortion immediate placement

目的:探讨人工流产术后是否可即刻放置依托孕烯植入剂进行避孕。方法:要求避孕的66例因非意愿妊娠行人工流产术后妇女即刻放置依托孕烯植入剂为研究组,另同期征集84例健康妇女于月经期放置该植入剂作为对照组,术后1、6、12个月随访,随访阴道出血情况,植入剂取出原因,并在放置12个月时进行满意度调查。结果:在放置12个月期间所有对象均未怀孕。研究组闭经/出血稀发发生率为53.0%,出血频发/出血延长发生率为15.1%,对照组闭经/出血稀发发生率为58.4%,出血频发/出血延长发生率为27.3%;满12个月时,研究组取出20例,续用率为69.7%,满意度为69.6%;对照组取出22例,续用率为73.8%,满意度为72.6%。结论:人工流产术后即刻放置依托孕烯植入剂与月经期放置效果相同,人工流产术后妇女即刻放置依托孕烯植入剂进行避孕也是一个较合适的放置时机。

Objective： To estimate the vaginal bleeding pattern, discontinuation rate and satisfaction of the etonogestrel implants in women with immediate postabortion placement. Methods： Totally 66 women who required of contraception and received the etonogestrel implants immediately after postabortion were treated as research group, 84 women undergoing menstrual placement of the etonogestrel implants during the same period were treated as control group. Follow-up of 1, 6, 12 months after implantation were performed. The 12-month vaginal bleeding pattern, discontinuation rate and satisfaction for the etonogestrel implants were compared between the two group. Results： Over the study period in 12 months, pregnancy rate in two groups was 0%. In the research group, amenorrhea/infrequent bleeding occurred in 53.0%, and frequent/prolonged bleeding occurred in 15.1%. In control group the rate of amenorrhea/infrequent bleeding and frequent/prolonged bleeding was 58.4% and 27.3%. After 12 months of implantation, 20 cases were removed in the research group, the continuation rate was 69.7%, and satisfaction rate was 69.6%; in control group, 22 cases were removed, the continuation rate was 73.8%, and satisfaction rate was 72.6%. Conclusion： Women who undergo immediate postabortion placement of the etonogestrel implants have high rates of continuation that are equivalent to women undergoing menstrual insertion. Maybe, the time immediately after the postabortion with etonogestrel implants is a more appropriate time.