摘要
应用历史前瞻性研究方法,调查360例剖宫产(CS)后5年的避孕、人工流产及发病情况,并与同期自然分娩(ND)401人作对照。结果显示:宫内节育器(IUD)使用最为普遍,其中以Tcu Vcu效果最好,阴道药具及甾体避孕药等因使用不当而效果较差。CS组惰性金单环的带器妊娠率(5.4％)明显高于ND组(2.4％),Tcu Vcu带器妊娠率很低,分别为1.6％及1.5％。CS组宫外孕发生率1.7％,对照组为0(P<0.05)。多因素回归分析显示,子宫周围粘连及产褥感染为宫外孕的主要危险因素,RR分别为3.02及7.84。提示CS后以选择活性非O形IUD为宜,子宫活动度受限者不宜用IUD,用综合性节育措施应加强技术指导。
A five-year prospective study was carried out among 306 cesarean section (CS) women and 401 normal deliveries (ND). Information about use of contraceptive methods and their efficacy, after deliveries was analyzed. The results showed that the most popular contraceptive method was intrauterine device(IUD),among which the medicated Tcu had Vcu IUD had the highest continuation rate,while the vaginal and oral contraceptives had the lowest continuation rate. The Pearl index of pregnancy with inert IUD in situ in CS group was 5. 4%,which was much higher than that of ND group (2. 4%,P<0. 01). The Pearl index of pregnancy with Tcu or Vcu in situ were 1.6% and 1. 5% respectively. The ectopic pregnancy rate was 1.7% in CS group, which was significantly higher than that in ND) group(0%). Logistic regression analysis showed that the main risk factors for ectopic pregnancy were puerperal infection and inflammatory adhesion between the uterus and abdominal wall, with relative risk of 3. 02 and 7. 84 respectively. It suggested that medicated non ring-shaped IUD should be choice after CS. If the mobility of the uterus is restricted due to the adhesion, other contraceptive methods rather than IUD should be advised.
出处
《生殖医学杂志》
CAS
1993年第3期131-135,共5页
Journal of Reproductive Medicine
关键词
剖腹产术
避孕
宫内节育器
Cesarean section
Contraception
Intrauterine device
