LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

Complications of Pregnancy in Patients with Systemic Lupus Erythematosus (Gabon)

Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women, we describe the characteristics of these pregnancies to clarify their main complications and to make recommendations to their follow-up in low resource countries. Patients and Methods: This is a longitudinal descriptive study conducted over a period of six years, from 1 January 2008 to October 31, 2013, in Libreville (Gabon). We’ve included, systemic lupus erythematosus women carrying a pregnancy during the period of the study. Results: Seventy-two SLE women were followed and were eligible. Only 8 patients (11%) were pregnant during the follow up period. These 8 SLE patients allowed us to monitor 10 pregnancies. The average parity was 0.88. Eight pregnancies in ten (80%) had complications and most frequent was preeclampsia. Nine pregnancies (90%) resulted in the birth of viable children of which 4 (44.4%) were born by caesarean section and the 5 others (55.6%) were born by natural route. Conclusion: We recommend a monthly prenatal care for these high-risk pregnancies and early detection of preeclampsia.