Immediate postpartum insertion of the norplant contraceptive device.
Fertil Steril
; 66(1): 43-8, 1996 Jul.
Article
em En
| MEDLINE
| ID: mdl-8752609
ABSTRACT
PIP: During December 1992 to October 1994, in Texas, clinical researchers conducted a prospective case control study (15 cases receiving Norplant immediately postpartum vs. 6 controls undergoing bilateral tubal ligation immediately postpartum) to determine the safety and efficacy of inserting the contraceptive implant Norplant (6 capsules inserted subdermally, each containing 35 mg levonorgestrel) immediately postpartum. They followed the cases and the controls for three months. The study subjects were 18-35 years old, received prenatal care at one of the Department of Obstetrics and Gynecology's (Texas Tech University Health Sciences Center) community clinics, had an uncomplicated term pregnancy and normal spontaneous vaginal delivery, and did not breast feed. They tended to be poor. During the first week after Norplant insertion, serum levonorgestrel levels peaked at about 2000 pg/ml, then fell abruptly until about the eighth week to about 250 pg/ml. This lower levonorgestrel level concerned the researchers because it is just slightly higher than levels associated with pregnancy. They were also concerned about the possibility of Norplant inducing a hypoestrogenic state in postpartum women. The Norplant group was more likely than the tubal ligation group to experience irregular bleeding (p 0.01), headaches (p 0.01), hair loss (p 0.05), and abdominal discomfort (p 0.05). The various serum metabolic biomarkers, serum electrolytes, and blood components fell into the normal range in both groups. The serum estradiol, progesterone, and urinary steroid biomarkers suggested that the Norplant group experienced very suppressed steroid secretion throughout the three month study period, while the controls had normal postpartum ovarian activity. Thus, ovarian activity was absent in the Norplant group. These findings suggest that postpartum insertion of Norplant is safe and effective. Yet further clinical evaluation is needed to address concerns about the long-term hypoestrogenic state and contraceptive efficacy beyond the three month postpartum period.
Palavras-chave
Americas; Case Control Studies; Contraception; Contraceptive Agents, Female--side effects; Contraceptive Agents, Progestin--side effects; Contraceptive Agents--side effects; Contraceptive Effectiveness; Contraceptive Implants; Contraceptive Methods; Developed Countries; Family Planning; Health; Insertion; Levonorgestrel--side effects; North America; Northern America; Postpartum Women; Public Health; Puerperium; Reproduction; Research Methodology; Research Report; Safety; Studies; Texas; Treatment; United States
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Levanogestrel
/
Anticoncepcionais Femininos
/
Período Pós-Parto
Tipo de estudo:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Fertil Steril
Ano de publicação:
1996
Tipo de documento:
Article
País de afiliação:
Estados Unidos