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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >Insertion of an intrauterine contraceptive device after induced or spontaneous abortion: a review of the evidence.
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Insertion of an intrauterine contraceptive device after induced or spontaneous abortion: a review of the evidence.

机译：人工流产或自然流产后插入宫内避孕器：证据复习。

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OBJECTIVE: Assess the safety and efficacy of intrauterine contraceptive device (IUCD) insertion immediately after induced or spontaneous abortion. DESIGN: Systematic search for randomised trials that had at least one treatment arm that involved IUCD insertion immediately after an induced or spontaneous miscarriage using Medline, Popline, EMBASE, and review articles supplemented by correspondence with investigators. POPULATION: Women of any age or gravidity who had an IUCD inserted immediately after evacuation for spontaneous or induced abortion. METHODS: Articles were abstracted and the raw data from tables were analysed with RevMan 3.1 software. We focused on Tietze-Potter gross life table probabilities with denominators of person-time of exposure. MAIN OUTCOME MEASURES: Rates of perforation, expulsion, pelvic inflammatory disease, contraceptive failure, and method continuation. RESULTS: Complication rates for immediate post-abortal IUCD insertion were low. Perforation was rare with a rate of approximately one per 1,000 insertions. One year gross cumulative expulsion rates ranged from 1.8% to 12.6%, pregnancy rates from 0.6% to 2.1%, and continuation rates from 54% to 90%. The net discontinuation rate due to pelvic inflammatory disease was low, ranging from 0.0 to 0.8 per 100 women at one year. Increasing gestational age at insertion was associated with increased expulsion rates. CONCLUSIONS: Post-abortal IUCD insertion is safe and effective. The risks of perforation, expulsion, pelvic inflammatory disease and contraceptive failure were low and similar to those reported for interval insertion. Second trimester gestational age is associated with an increased risk of expulsion. Immediate insertion may have a higher expulsion rate than delayed insertion. However, these risks may be outweighed by the benefit of immediate contraception.
机译：目的：评估人工流产或自然流产后立即插入宫内避孕器（IUCD）的安全性和有效性。设计：使用Medline，Popline，EMBASE，系统性地搜索随机试验，该试验至少有一个涉及诱导或自发流产后立即插入IUCD的治疗组，并复习了研究人员的通讯并补充了相关文章。人口：由于自然流产或人工流产而在撤离后立即插入IUCD的任何年龄或妊娠的妇女。方法：使用RevMan 3.1软件对文章进行摘要，并对表中的原始数据进行分析。我们将重点放在Tietze-Potter总寿命表的概率与暴露时间的分母上。主要观察指标：穿孔率，排出率，盆腔炎，避孕失败和方法继续使用率。结果：立即植入IUCD的并发症发生率很低。穿孔很少见，每千次插入大约发生一次。一年的总累积开除率从1.8％到12.6％不等，怀孕率从0.6％到2.1％不等，持续率从54％到90％不等。盆腔炎导致的净停药率很低，一年中每100名妇女0.0至0.8。插入时胎龄增加与驱逐率增加有关。结论：人工流产IUCD是安全有效的。穿孔，驱逐，盆腔炎和避孕失败的风险较低，与间隔插入报道的风险相似。孕中期胎龄与被驱逐的风险增加有关。立即插入可能比延迟插入的驱逐率更高。但是，立即避孕的好处可能会抵消这些风险。

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