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INTRODUCTION: 24 % of abortion in Italy are repeated procedure. The cause of repeated abortion can be traced back to the inadequacy of the contraceptive counseling during the previous admission or to the adoption of an ineffective contraception method. This study aims to evaluate the Italian situation on the perceived quality of contraceptive counselling by patients undergoing abortion. The second aim is to verify if the chosen methods were available for immediate start. STUDY DESIGN: Multicentric, prospective, non-interventional, non-randomized, non-pharmacological clinical observational study. We analyzed anonymous questionnaires on contraceptive counseling and LARC (Long Acting Reversable Contraceptives) availability and SARC (Short Acting Reversable Contraceptives) prescription at hospital discharge, distributed to women who requested abortion. RESULTS: 1074 participants on 15 hospitals through Italy. 82 % of the interviewees reported that they had received correct information regarding contraception. 74 % of the patients who chose LARC methods reported to have them inserted at the time of abortion. 73 % of women who had chosen a SARC method stated that they had received the prescription before discharge. After contraceptive counselling, we reported a significative reduction of "none or natural methods use" and a significant increase of SARC and LARC use compared to before the abortion. CONCLUSION: Contraceptive counselling could allow a better contraceptive choice in patient who required abortion and we hope that future strategies will implement LARC choice. We think that a greater availability of LARC at an affordable price at the time of abortion could improve LARC choice. In case of SARC choice, we have to implement the prescription at hospital discharged.
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The percentage of repeat abortion in Italy is about 25%. It is therefore important to implement the strategies that can facilitate the adoption of the most effective contraceptive methods. Long-acting reversible contraceptive methods are currently considered the most effective and with the highest rates of 12-months continuation, with a reported reduction of recurrent abortion. Our study has the aim to evaluate the contraceptive choice of women requesting abortion, when an accurate and dedicate counselling is offered and the availability of a LARC method is given immediately after pregnancy termination, both in case of surgical and medical abortion. LARC methods were chosen both in case of surgical and medical abortion, by an high percentage of patients. We reported no differences between the surgical and pharmacological groups on the choice of LARC and SARC. Our observational study shows the feasibility to perform an accurate, dedicate, and personalised counselling on contraception at time of abortion. This approach has enabled a high number of women to have a LARC method inserted at the time of abortion, as a valid strategy to prevent the risk unplanned pregnancy.
Repeated abortion is an international problem which could be reduced by LARCs methods use. Contraceptive counselling during hospitalisation for abortion could implement the use of LARC.
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Aborto Habitual , Aborto Induzido , Anticoncepcionais Femininos , Gravidez , Humanos , Feminino , Anticoncepção/métodos , Gravidez não Planejada , AconselhamentoRESUMO
Objective: In fertile women, hysterocele is a rare condition. Genital prolapse can be treated conservatively with laparoscopic hysterosacropexy. It is objected to present a successful case series of laparoscopic hysteropexy for patients with hysterocele after vaginal delivery. Case report: We presented a successful case series of three patients with III or IV degrees of hysterocele who were treated conservatively with an uncomplicated laparoscopic hysteropexy within a year of delivery. Given our patients' young ages and the fact that they all have infant children at home, we chose a conservative surgery performed laparoscopically due to the lower surgical impact and quicker return to normal life. All surgical procedures were successfully performed, without complications, with a prompt recovery of all women and with a regular subsequent follow-up, without recurrence nowadays. Conclusion: For young women who have not terminated their desire to bear children, laparoscopic hysterepexy may be a safe and effective surgical option.
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Objective: In case of uterine prolapse, hyseroxacropexy, a conservative surgical approach, which allows the sparing of body image and sexuality, could be the choice in fertile women. Few information are reported on subsequent pregnancy after surgery. Case report: A 33 years-old women with symptomatic prolapse underwent a laparoscopic hysterosacropexy. Subsequently she expressed her pregnancy desire and she got pregnant. A scheduled caesarean section was performed without complication. The subsequent follow-up was regular: the patient was asymptomatic and presented no sign of prolapse recurrence. Conclusion: In motivate and well counselled patient, informed about the risk of prolapse recurrence, pregnancy could be considered after hysterosacropexy.
