Post-abortion long-acting reversible contraception in a sample of Italian women: intrauterine device versus subdermal implant

Abstract

Long-acting reversible contraceptives (LARC) represent an especially effective kind of post-abortion contraception. We aimed at assessing satisfaction, discontinuation, efficacy, and tolerability associated with either levonorgestrel intrauterine device (L-IUCD), the copper intrauterine device (C-IUCD) and implant (IMP) after termination of pregnancy (TOP). We recorded baseline data about the patients and performed phone surveys at 3, 6 and 12 months after insertion to assess the bleeding profile. Furthermore, women were inquired about possible adverse events, satisfaction, and discontinuation at 12 months after insertion. LARC continuers (>12 months after TOP) were divided into three groups: L-IUCD (n = 47), C-IUCD (n = 6) and IMP (n = 36). Satisfaction rates among L-IUCD users were higher than among IMP users (100% vs. 72.2%, p < .05). A higher, yet not significant, share of patients decided to withdraw contraception in IMP group (3.6% in IUCD group and 12.2% in IMP group). The bleeding profile was significantly more favorable among L-IUCD users than among IMP users. Finally, the reported rate of treatment-associated adverse events did not differ significantly among the groups. L-IUCD insertion after TOP is associated with higher satisfaction and lower discontinuation rates than IMP. Such pattern could be attributed to a more favorable bleeding profile.

摘要：

长效可逆避孕(LARC)是一种特别有效的人工流产后避孕方法。我们主要的目的是：对终止妊娠后应用左炔诺孕酮宫内节育器(L-IUCD)、含铜宫内节育器(C-IUCD)和皮下埋植剂(IMP)的患者进行满意度、停止使用、疗效和耐受性(上图)情况的评估。我们记录了患者的基线数据, 并在放置后3个月、6个月和12个月进行电话随访, 来评估出血情况。此外, 还询问了患者在采取长效可逆避孕方法后12个月中发生的不良反应、满意度和停止使用等的情况。继续使用LARC的患者(在终止妊娠后使用>12个月)被分成三组:LIUCD (n=47), C-IUCD (n=6)和IMP (n=36)。L-IUCD组患者的满意率高于IMP组患者(100% vs. 72.2%, p<.05)。在IMP组决定停止使用的比例较高, 但无显著差别(IUCD组为3.6%, IMP组为12.2%)。L-IUCD组患者的出血情况明显好于IMP组患者。最后, 治疗相关的不良反应报告率在各组之间没有显著差异。与IMP组相比, L-IUCD组患者术后满意度更高, 停用率更低。得出这种结论的原因是L-IUCD组患者出血情况的改变更能让患者接受。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Long-acting contraceptives
• implant
• intrauterine contraceptive device
• termination of pregnancy

Disclosure statement

No potential conflict of interest was reported by the authors.