A multicenter comparative study on the efficacy, safety, and acceptability of the contraceptive subdermal implants Norplant and Norplant-II.

In order to assess efficacy, safety, and acceptability of the contraceptive subdermal implants Norplant and Norplant-II in Mexican women, a comparative phase III clinical trial was undertaken in eight clinics across the country. The study involved 1052 women who were followed-up trimonthly for three years. Cumulative pregnancy rates were 0.29% and 0.34% for Norplant and Norplant-II implants, respectively. Similar overall cumulative discontinuation rates were observed at three years: 50.38% for Norplant capsules, and 50.44% for Norplant-II rods. The main method-related reason for termination was endometrial bleeding irregularity which led to discontinuation rates of 11.94% and 11.62% for Norplant and Norplant-II contraceptive systems, respectively. In 15,279 woman-months of experience accumulated with Norplant implants and 14,092 with Norplant-II implants, there were few adverse events reported. No difference was found between the two groups in either difficulty for implants placement and removal or women's discomfort, even though the time required for insertion and removal of Norplant capsules was longer than for Norplant-II rods. It is concluded that during the first three years of use, both implants systems are equally effective, safe, and acceptable.

[Abortion in Mexico. Social and public health problem]. / El aborto en Mexico. Problema social y de salud publica.

PIP: Published estimates of the annual incidence of abortion in Mexico have ranged from 50,000 to 6 million. Induced abortion is difficult to measure because it is a sensitive topic and an illegal act. Hospital records indicate that slightly fewer than 110,000 women were admitted in 1985 for abortion complications, but induced and spontaneous abortions were not distinguished, and no information was available on the proportion of induced abortions requiring hospitalization. Data from the 1987 Survey of Fertility and Health indicate that 14.3% of women aged 15-49 had had at least one spontaneous or induced abortion. Only 13% admitted having an induced abortion. The data suggest a rate of 12.2 abortions per 1000 fertile aged women in 1986, or 250,000 in Mexico. Among women ever pregnant, 22.7% had had at least one abortion, with the proportion rising to 34% at 45-49. Men aged 15-59 and women aged 15-49 were interviewed in Mexico City for the Survey of Reproductive Health, a project to develop a methodology for obtaining reliable data on induced abortion. The women reported that 9.3% of first pregnancies terminated in abortions, of which 58.4% were considered spontaneous, 28.8% were declared spontaneous but may have been induced, and 20.8% were reported as induced. The men reported that 10.6% of pregnancies ended in abortion, with 45.5% reported induced and only 4.5% considered probably induced. Despite limited available data, it is clear that induced abortion is a social and public health problem in Mexico.^ieng